Frank LD, Andresen MA, Schmid TL. Obesity relationships with community design, physical activity, and time spent in cars. Am J Prev Med 27, 87-96

School of Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada.
American Journal of Preventive Medicine (Impact Factor: 4.53). 09/2004; 27(2):87-96. DOI: 10.1016/j.amepre.2004.04.011
Source: PubMed


Obesity is a major health problem in the United States and around the world. To date, relationships between obesity and aspects of the built environment have not been evaluated empirically at the individual level.
To evaluate the relationship between the built environment around each participant's place of residence and self-reported travel patterns (walking and time in a car), body mass index (BMI), and obesity for specific gender and ethnicity classifications.
Body Mass Index, minutes spent in a car, kilometers walked, age, income, educational attainment, and gender were derived through a travel survey of 10,878 participants in the Atlanta, Georgia region. Objective measures of land use mix, net residential density, and street connectivity were developed within a 1-kilometer network distance of each participant's place of residence. A cross-sectional design was used to associate urban form measures with obesity, BMI, and transportation-related activity when adjusting for sociodemographic covariates. Discrete analyses were conducted across gender and ethnicity. The data were collected between 2000 and 2002 and analysis was conducted in 2004.
Land-use mix had the strongest association with obesity (BMI >/= 30 kg/m(2)), with each quartile increase being associated with a 12.2% reduction in the likelihood of obesity across gender and ethnicity. Each additional hour spent in a car per day was associated with a 6% increase in the likelihood of obesity. Conversely, each additional kilometer walked per day was associated with a 4.8% reduction in the likelihood of obesity. As a continuous measure, BMI was significantly associated with urban form for white cohorts. Relationships among urban form, walk distance, and time in a car were stronger among white than black cohorts.
Measures of the built environment and travel patterns are important predictors of obesity across gender and ethnicity, yet relationships among the built environment, travel patterns, and weight may vary across gender and ethnicity. Strategies to increase land-use mix and distance walked while reducing time in a car can be effective as health interventions.

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Available from: Tom L Schmid, Jul 30, 2014
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    • "Journal of Transport & Health (2015), http: // car owning households had lower overall mortality, lower rates of long-term illness, fewer symptoms, and better mental health. This is despite evidence that there is a relationship between the time spent in cars and obesity (Frank et al., 2004). For older people, access to public transport is important to allow them to access places which provide them with physical activity (Marsden et al., 2007). "
    • "Technological forces also took physical activity out of transportation and communication. Suburbanization is the clearest (Frank, Martin, and Schmid 2004) indicator (Brownson et al. 2005; Ewing et al. 2003; Frumkin 2002; Mirowsky 2014). Urban scale increased enormously, while urban density decreased. "
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    ABSTRACT: Education has a large and increasing impact on health in America. This paper examines one reason why. Education gives individuals the ability to override the default American lifestyle. The default lifestyle has three elements: displacing human energy with mechanical energy, displacing household food production with industrial food production, and displacing health maintenance with medical dependency. Too little physical activity and too much food produce imperceptibly accumulating pathologies. The medical industry looks for products and services that promise to soften the consequences but do not eliminate the underlying pathologies. This "secondary prevention" creates pharmacologic accumulation: prolonging the use of medications, layering them, and accruing their side effects and interactions. Staying healthy depends on recognizing the risks of the default lifestyle. Overriding it requires insight, knowledge, critical analysis, long-range strategic thinking, personal agency, and self-direction. Education develops that ability directly and indirectly, by way of creative work and a sense of controlling one's own life. © American Sociological Association 2015.
    Journal of Health and Social Behavior 08/2015; 56(3). DOI:10.1177/0022146515594814 · 2.72 Impact Factor
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    • "The remainder were five studies in Australia (Clark et al., 2010; Ding et al., 2012; Koohsari, Sugiyama, Kaczynski and Owen, 2014; Sugiyama et al., 2007, 2012a), one study in Belgium (Van Dyck et al., 2010), one study in Denmark (Storgaard et al., 2013), one study in Germany (Wallmann-Sperlich et al., 2013), one study in Japan (Kikuchi et al., 2013), and one multi-country study, using pooled data from the United States, Australia and Belgium (Van Dyck et al., 2012). Twelve studies sampled the general adult population (Clark et al., 2010; Ding et al., 2012; Fields et al., 2013; Frank et al., 2004; Koohsari et al., 2014; Kozo et al., 2012; Storgaard et al., 2013; Sugiyama et al., 2012a; Sugiyama et al., 2007; Van Dyck et al., 2010, 2012; Wallmann-Sperlich et al., 2013), with the remainder examining specific populations including African-American women (Coogan et al., 2012), African-American adults (Strong et al., 2013), women (Lee et al., 2012), Japanese older adults (Kikuchi et al., 2013), and households where at least one person commuted to work in a private vehicle (Zolnik, 2011). Sample sizes ranged from 189 to 20,303; three studies had a sample size smaller than 1000 participants (Ding et al., 2012; Fields et al., 2013; Lee et al., 2012), and five studies used a sample size larger than 10,000 participants (Clark et al., 2010; Coogan et al., 2012; Frank et al., 2004; Storgaard et al., 2013; Sugiyama et al., 2012a). "
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    ABSTRACT: Objective: Physical activity recommendations are beginning to address sedentary behaviors – time spent sitting. Environmental and policy initiatives for physical activity might assist in addressing sedentary behaviors, but sedentary-specific innovations may be required. This review synthesizes current evidence on associations of neighborhood environmental attributes with adults’ sedentary behaviors. Methods: A search was conducted using three electronic databases (PubMed, Web of Science, and Transport Research Information Services). Relevant articles were assessed for their eligibility for inclusion (English-language articles with a quantitative examination of associations of neighborhood environmental attributes with adults’ sedentary behaviors). Results: Within 17 studies meeting inclusion criteria, associations of environmental attributes with sedentary behaviors were examined in 89 instances. Significant associations were found in 28% (n=25) of them; however, non-significant associations were found in 56% (n=50) of these instances. The most consistent association was for lower levels of sedentary behavior among residents of urban compared to regional areas. Conclusions: There is a modest but mixed initial evidence in associations of neighborhood environmental attributes with adults’ sedentary behaviors. A research agenda required for this emerging field should include the development of more-relevant conceptual models, measuring domain-specific sedentary behavior objectively, examining environments in close vicinity of and a larger area around home, and the use of prospective designs.
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