[1685.8] The Weight of Place: The Role of the Neighborhood in Pre-School Obesity
Julia B. Morinis, Gerald Lebovic, Sarah Carsley, Marina Khovratovich, Jonathon L. Maguire, Patricia C. Parkin, Richard H. Glazier, Matthew W. Gillman, Catherine S. Birken. Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada; Center for Research on Inner City Health, Li Ka Shing Knowledge Institute, Keenan Research Center, St Michael's Hospital, Toronto, ON, Canada; Applied Health Research Center of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada; Institute for Clinical Evaluative Science, Toronto, ON, Canada; Harvard Medical School, Department of Population Medicine, Boston, MA.
BACKGROUND: It is recognized that childhood obesity results from complex interactions between a child's dietary intake, physical activity, sedentary behavior, and the environment within which they live. Previous research in adults has shown a strong association between the built environment and both obesity and diabetes. However, limited research on young children has been conducted.
OBJECTIVE: To determine if the neighbourhood built environment as measured by the Activity Friendly Index (AFI), a validated index combining: car ownership; population; distance to retail locations; crime per 100,000, is associated with body mass index (zBMI) in childhood, after adjustment for individual level risk factors.
DESIGN/METHODS: Data was collected prospectively from children under 6 years recruited from TARGet Kids! affiliated primary care research practices in Toronto. The relationship between the child's neighborhood AFI and child's zBMI was examined, while adjusting for possible individual level confounding factors. Multivariable random effect modeling was performed with AFI as the predictor, and zBMI as the outcome, adjusting for dietary intake, physical activity, sedentary behavior, family history of cardiovascular disease, age, sex, birth weight, ethnicity, family income, and immigration status. Neighbourhood characteristics were derived from the Canadian census.
RESULTS: 3928 children were included in the analysis (mean age 33.5 months: 51.6% males). The proportion of children with zBMI >1 (overweight) was 20.5% and zBMI >2 (obese) was 4.8%. Local indicator of spatial association (LISA) maps showed a correlation between areas of low walkability (AFI) and high zBMI. Univariate analysis revealed a statistically significant association between AFI and zBMI (p = 0.001). The relationship between AFI and zBMI remained (p < 0.05) when adjusted for possible confounding factors.
CONCLUSIONS: These findings show that living in a walkable neighborhood is associated with a lower likelihood of obesity in young children. Further research is needed to better understand the mechanisms involved in the relationship between neighborhood factors and obesity in order to modify a child's risk of obesity through neighborhood intervention and urban planning.
First Author is a Fellow in Training
Session: Platform Session: Obesity I: Social Determinants of Childhood Obesity (2:45 PM - 4:45 PM)
Date/Time: Saturday, May 4, 2013 - 4:30 PM
Room: 150B - Walter E. Washington Convention Center
Course Code: 1685