Contributions of Built Environment to Childhood Obesity

ArticleinMount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine 78(1):49-57 · January 2011with94 Reads
DOI: 10.1002/msj.20235 · Source: PubMed
Abstract
As childhood obesity has reached epidemic proportions, it is critical to devise interventions that target the root causes of obesity and its risk factors. The two main components of childhood obesity are physical inactivity and improper nutrition, and it is becoming increasingly evident that the built environment can determine the level of exposure to these risk factors. Through a multidisciplinary literature review, we investigated the association between various built environment attributes and childhood obesity. We found that neighborhood features such as walkability/bikeability, mixed land use, accessible destinations, and transit increase resident physical activity; also that access to high-caloric foods and convenience stores increases risk of overweight and obesity, whereas the presence of neighborhood supermarkets and farmers' markets is associated with lower childhood body mass index and overweight status. It is evident that a child's built environment impacts his access to nutritious foods and physical activity. In order for children, as well as adults, to prevent onset of overweight or obesity, they need safe places to be active and local markets that offer affordable, healthy food options. Interventions that are designed to provide safe, walkable neighborhoods with access to necessary destinations will be effective in combating the epidemic of obesity.
    • "Other factors not included in this analysis such as foods from other meals, which contribute to approximately 70 % of total daily energy intake in children ages 2 to 5 years [25] may be influencing body weight in this sample, The Head Start sites included in this study are located in low-income neighborhoods, presenting high unemployment and crime rates, which may also have contributed to the increased prevalence of obesity. Lower socioeconomic status neighborhoods are at a higher risk of obesity [44, 45]. Overall our findings are consistent with previous studies, which also could not establish a relationship in preschool children between portion size, healthfulness, and obesity, although researchers report this behavior presents itself as obesity promoting [6, 46]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Obesity disproportionately affects children from low-income families and those from racial and ethnic minorities. The relationship between snacking and weight status remains unclear, although snacking is known to be an important eating episode for energy and nutrient intake particularly in young children. The purpose of this pilot study was to examine the snack intake of minority preschool children enrolled in the Head Start Program in four centers in Detroit, Michigan, and investigate differences by child weight status. Methods This secondary data analysis used snack time food observation and anthropometric data from a convenience sample of 55 African American children (44 % girls, mean age = 3.8 years). Snack intake data was obtained over a mean of 5 days through direct observation of children by dietetic interns, and later converted into food group servings according to the United States Department of Agriculture (USDA) meal patterns and averaged for each child. Height and weight measurements were systematically collected and BMI-for-age percentiles were used to classify children into weight categories. One sample, paired samples and independent samples t-tests were performed to test for differences within and between means. ResultsBased on BMI-for-age percentiles, 72.7 % of the sample was under/healthy weight and 27.3 % was overweight/obese. Average (mean ± SD) intake of milk (0.76 ± 0.34) and overall fruits/vegetables (0.77 ± 0.34) was significantly lower than one USDA serving, while average intake of grains and breads (2.04 ± 0.89), meat/meat alternates (2.20 ± 1.89) and other foods (1.43 ± 1.08) was significantly higher than one USDA serving (p ≤ 0.05). Children ate more when offered canned versus fresh fruits (0.93 ± 0.57 vs. 0.65 ± 0.37, p = 0.007). Except for a significantly higher milk intake in the overweight/obese group compared to the under/healthy weight group (0.86 ± 0.48 vs. 0.72 ± 0.27, p = 0.021], no relationship was found between snack food intake and weight category. Only in the overweight/obese group was the intake of milk and fresh fruits not significantly different than one USDA serving. Conclusions Findings suggest that regardless of weight status low-income minority preschool children are consuming larger serving sizes when offered less healthy versus healthier snack foods. Continued efforts should be made to provide healthful snack foods at preschool settings to prevent obesity and promote healthier food habits.
    Full-text · Article · Dec 2016
    • "The multitude of studies so far have been conducted in North America with only a few studies in European settings such as Germany, the Netherlands, Belgium or the UK [9, 10, 16, 22, 47, 48]. While studies conducted in North America highlight the relevance of the environmental influences such as walkability/bikeability, mixed land use, accessible destinations, transit or access to high-caloric foods our study did not confirm such an association in Berlin [4, 9, 10, 14] . Spatial urban (and suburban ) structures in Europe and in Germany might differ strongly from the environments investigated in North America. "
    [Show abstract] [Hide abstract] ABSTRACT: In recent years, childhood overweight and obesity have become an increasing and challenging phenomenon in Western cities. A lot of studies have focused on the analysis of factors such as individual dispositions and nutrition balances, among others. However, little is known about the intra-urban spatial patterns of childhood overweight and its associations with influencing factors that stretch from an individual to a neighbourhood level. The aim of this paper is to analyse the spatial patterns of childhood obesity in Berlin, and also to explore and test for associations with a complex set of risk factors at the individual, household and neighbourhood levels. We use data from a survey of 5–6 year-olds that includes health status, height, and weight, as well as several socioeconomic and other risk variables. In addition, we use a set of neighbourhood variables, such as distance, and density measures of parks or fast food restaurants. Our outcome variable is the percentage of children of 5–6 years who were reported overweight or obese in 2012. The aggregated data is available for 60 areas in Berlin. We first analyse the outcome and risk factor data descriptively, and subsequently apply a set of regression analyses to test for associations between reported overweight and obesity, and also individual, household and neighbourhood characteristics. Our analysis returned a distinct spatial distribution of childhood overweight in Berlin with highest shares in the city centre. Moreover, we were able to identify significant effects regarding the social index, and the percentage of non-German children being obese or overweight; additionally, we identified fast food restaurant density as a possible influencing factor. For the other variables, including the neighbourhood variables, we could not identify a significant association on this aggregated level of analysis. Our findings confirm the results of earlier studies, in which the social status and percentage of non-German children is very important in terms of the association with childhood overweight and obesity. Unlike many studies conducted in North America, this study did not reveal an influence of neighbourhood variables. We argue that European urban structures differ from North American structures and highlight the need for a more detailed analysis of the association between the neighbourhood environment and the physical activity of children in urban setting.
    Full-text · Article · Dec 2016
    • "The point that the report focuses on is limited to travels to and from school. The built environment around the living place of children matters: Rahman et al. (2011) find that children residing in walkable/bikable, mixed-use, accessible, transit-oriented neighborhoods have a lower risk of becoming overweight or obese. Such researches only focus on the residential neighborhood as the center of living. "
    [Show abstract] [Hide abstract] ABSTRACT: Problem: Childhood obesity has been an epidemic particularly in high-income countries. There is a considerable volume of data and studies depicting the rising number of obese children and adolescents in different countries. Literature: Children’s physical activity can have a positive role in decreasing body mass index. Active transport to school has been studied during the recent years, as a solution for stopping decreasing physical activity. A limited number of scholars have investigated the association of active transport to school with children’s body weight. Objective: This study seeks to identify the gaps in our knowledge about children’s commuting patterns to school and the linkages to their body mass index. Method: Scientific literature on the topic of children’s physical activity, active transport to school, and children’s body weight and BMI were collected and descriptively analyzed. The large majority of the publications are peer-reviewed journal papers published in English language. The larger part of references has been published after 2005. The rest is mostly related to after 2000. Results: The results illustrate five themes or approaches to the subject of active transport to school and children’s body mass index: differences between active transport to school and body weight correlations between ethnic groups in multi-ethnic countries; associations between the perceptions and mobility behaviors of parents and children concerning barriers of active transport to school; additional research on the associations of active transport to school and obesity to provide consistent results; contextual studies on the topic of active transport to school and body mass index; and finally studies based on separate observation samples of children and adolescents, or solely one of them. Conclusion: Further research based on the identified knowledge gaps as well as interventions based on policymaking are necessary to remove barriers of active transport to school and consequently reduce pediatric obesity.
    Full-text · Technical Report · Aug 2016 · International Journal of Health Geographics
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