Relationship between Perceptions about Neighborhood Environment and Prevalent Obesity: Data from the Dallas Heart Study

Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute
Obesity (Impact Factor: 4.39). 01/2013; 21(1). DOI: 10.1002/oby.20012
Source: PubMed

ABSTRACT Although psychosocial stress can result in adverse health outcomes, little is known about how perceptions of neighborhood conditions, a measure of environment-derived stress, may impact obesity. We examined the association between perceptions of neighborhood environment and obesity [defined as body mass index (BMI) ò 30 kg/m(2) ] among 5907 participants in the Dallas Heart Study, a multi-ethnic, probability-based sample of Dallas County residents. Participants were asked to respond to 18 questions about perceptions of their neighborhood. Using factor analysis, we identified three factors associated with neighborhood perceptions: neighborhood violence, physical environment, and social cohesion. Logistic regression analyses were performed to determine the relationship between each factor (higher quintile = more unfavorable perceptions) and the odds of obesity. Decreasing age, income, and education associated with unfavorable overall neighborhood perceptions and unfavorable perceptions about specific neighborhood factors (p trend <0.05 for all). Increasing BMI was associated with unfavorable perceptions about physical environment (p trend <0.05), but not violence or social cohesion. After adjustment for race, age, sex, income, education, and length of residence, physical environment perception score in the highest quintile remained associated with a 25% greater odds of obesity [OR 1.25,(95% CI 1.03-1.50)]. Predictors of obesity related to environmental perceptions included heavy traffic [OR 1.39,(1.17-1.64)], trash/litter in neighborhood[OR 1.27,(1.01-1.46)], lack of recreational areas[OR 1.21,(1.01-1.46)], and lack of sidewalks[OR 1.25,(95% CI 1.04-1.51)]. Thus, unfavorable perceptions of environmental physical conditions are related to increased obesity. Efforts to improve the physical characteristics of neighborhoods, or the perceptions of those characteristics, may assist in the prevention of obesity in this community.

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    ABSTRACT: BackgroundObesity among patients with schizophrenia is a growing concern because being overweight is widely regarded as a major risk factor for cardiovascular disease and premature death. Dietary patterns have been suggested as one modifiable factor that may play a role in development of obesity. The objective of this study was to examine the association between dietary patterns and obesity among patients with schizophrenia in Japan.MethodsWe recruited patients (n = 338) aged 44.0 ± 13.2 (mean ± SD) years with a DSM-IV diagnosis of schizophrenia who were admitted to four psychiatric hospitals using a cross-sectional design. Diet was assessed with a validated brief-type self-administered diet history questionnaire (BDHQ). Dietary patterns from 52 predefined food groups were extracted by principal component analysis.ResultsA total of 61 subjects (18.0%) were classified as obese. Three dietary patterns were identified: the healthy dietary pattern, the processed food dietary pattern, and the alcohol and accompanying dietary patterns. After adjusting for age and gender, patients within the high tertile of each healthy dietary pattern (OR = 0.29, 95% CI = 0.13 to 0.62) and processed food dietary pattern (OR = 0.44, 95% CI = 0.22 to 0.89) had a significantly lower risk for obesity compared with low tertile of dietary pattern.ConclusionsOur findings suggest that dietary patterns, including higher intake of protein, fat, n-3 polyunsaturated fatty acids, n-6 polyunsaturated fatty acids, and vitamins, may be related to a decreased prevalence of obesity within patients with schizophrenia. Future longitudinal research exploring dietary patterns and obesity among patients with schizophrenia is warranted.
    BMC Psychiatry 06/2014; 14(1):184. DOI:10.1186/1471-244X-14-184 · 2.24 Impact Factor
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    ABSTRACT: Patterns of fat distribution are heavily influenced by psychological stress, sex, and among women, by menopause status. Emerging evidence suggests the lack of perceived neighborhood safety due to crime may contribute to psychological stress and obesity among exposed residents. Our objective is to determine if perceived neighborhood safety is associated with abdominal adiposity among African-American men and women, and among pre- and postmenopausal women in the Jackson Heart Study.
    PLoS ONE 08/2014; 9(8):e105251. DOI:10.1371/journal.pone.0105251 · 3.53 Impact Factor
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    ABSTRACT: Objective The aim of this study is to examine a relationship between neighborhood-level socioeconomic deprivation and weight change in a multi-ethnic cohort from Dallas County, Texas and whether behavioral/psychosocial factors attenuate the relationship. Methods Non-movers (those in the same neighborhood throughout the study period) aged 18–65 (N = 939) in Dallas Heart Study (DHS) underwent weight measurements between 2000 and 2009 (median 7-year follow-up). Geocoded home addresses defined block groups; a neighborhood deprivation index (NDI) was created (higher NDI = greater deprivation). Multi-level modeling determined weight change relative to NDI. Model fit improvement was examined with adding physical activity and neighborhood environment perceptions (higher score = more unfavorable perceptions) as covariates. A significant interaction between residence length and NDI was found (p-interaction = 0.04); results were stratified by median residence length (11 years). Results Adjusting for age, sex, race/ethnicity, smoking, and education/income, those who lived in neighborhood > 11 years gained 1.0 kg per one-unit increment of NDI (p = 0.03), or 6 kg for those in highest NDI tertile compared with those in the lowest tertile. Physical activity improved model fit; NDI remained associated with weight gain after adjustment for physical activity and neighborhood environment perceptions. There was no significant relationship between NDI and weight change for those in their neighborhood ≤ 11 years. Conclusions Living in more socioeconomically deprived neighborhoods over a longer time period was associated with weight gain in DHS.
    Preventive Medicine 09/2014; 66:22–27. DOI:10.1016/j.ypmed.2014.05.011 · 2.93 Impact Factor

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