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Means of transportation to work and overweight and obesity: A population-based study in Southern Sweden
Abstract
To investigate the association between means of transportation to work and overweight+obesity and obesity.
The 2004 public health survey in Skåne is a cross-sectional postal questionnaire study of the population aged 18-80 with a 59% response rate including 16,705 employed participants.
Forty-six percent of men and 26.6% of women were overweight (BMI 25.0-29.9); 11.6% of men and 10.3% of women were obese (BMI 30.0-); 18.2% of men and 25.9% of women bicycled and/or walked to work and 10.4% and 16.2% used public transportation, respectively. In contrast, 68.3% of men and 55.8% of women went to work by car. The odds ratios of overweight+obesity among persons who walked or bicycled were significantly lower and remained 0.62 (95% CI 0.51-0.76) among men and 0.79 (95% CI 0.67-0.94) among women in the models including all confounders compared to the car driving reference category. The odds ratios of obesity were initially significantly lower among both men and women who walked or bicycled, but in the final models only among women. The odds ratios of overweight+obesity as well as obesity were also lower among men using public transportation.
Walking and bicycling to work are significantly negatively associated with overweight+obesity and, to some extent, obesity. Public transportation is significantly negatively associated with overweight+obesity and obesity among men.
... Increased transit mobility provides economic benefits, including increased probability of employment, especially for welfare recipients (Kawabata, 2003;Ong & Houston, 2002;Yi, 2006). Transit, walking, and biking have been shown to be associated with a range of health benefits, including lower rates of obesity (Lindström, 2008) and lower BMIs (Frank et al., 2006). Non-auto modes (and the denser urban environments that foster their use) also provide a number of environmental benefits, particularly in terms of greenhouse gas (GHG) emissions reductions (Lee & Lee, 2014;Ercan, Onat, & Tatari, 2016) and fewer deaths from air pollution (Rojas-Rueda et al., 2012). ...
... The focus on "modal mismatch" tends to focus primarily on the disparities in access resulting from differences in car-ownership and policy recommendations tend to circle around helping people gain access to automobiles. Even when modal mismatch literature considers modes of transportation other than driving, it tends only to look at public transit and diminishes the importance of non-auto modes -particularly walking and bikingwhich is disappointing given the range of additional health (Booth et al., 2005;Saelens et al., 2003;Lindström, 2008), economic (Kwan et al., 2017), and environmental benefits (Ercan et al., 2016;Rojas-Rueda et al., 2012) that these modes provide. ...
... In Chicago, communities that have been traditionally marginalized in terms of access to urban investment and infrastructureparticularly Black and Hispanic neighbourhoodsare faced with systematically higher travel costs (and thus lower potential mobility) by the transit, bicycling, and walking modes, while those in creative class occupations tend to be privileged with lower travel costs by all modes. Given the additional social and economic barriers that members of these non-white racial and ethnic groups often faceincluding reduced spatial access to economic opportunities and servicesas well as the important role that active transportation behaviour plays in public health outcomes (Frank et al., 2004(Frank et al., , 2006Lindström, 2008;Wang et al., 2016), the fact that travel by transit, bicycling, and walking tends to be more expensive to and from these neighbourhoods is an important finding that provides a clear target for progressive policy intervention. ...
This paper develops a method to dynamically model urban passenger mode trade-offs at fine-grained spatial and temporal scales using data from OpenTripPlanner (OTP) and the City of Chicago’s Transportation Network Providers (TNP) dataset. This approach can be used to calculate dynamic modal cost-distance trade-offs for specific times, routes, and geographic areas of interest, providing a framework for creating aggregate mode choice profiles for individual cities and neighbourhoods that can be used to assess structural differences in transportation investment and mobility, as well as to test various assumptions about travel behaviour, observe temporal changes in modal trade-offs, and model the system-wide implications of changes to the transportation system to modal trade-offs. Using this dynamic mode choice framework, this paper explores the features underlying observed structural heterogeneity in the ratio of cost to distance (i.e., speed or potential mobility) for observed flows across the city for each mode. It finds that Census tracts with larger proportions of Black and Hispanic population tend to have significantly larger cost-distance ratios (i.e., slower speeds/lower potential mobility) for non-auto modes, while Census tracts with higher proportions of “creative class” employment and features of walkable built environments have significantly lower cost-distance ratios (i.e., faster speeds/higher potential mobility).
... For instance, Siervo et al. (2006) pointed out that urbanization increased the prevalence of overweight in Gambia due to social and behavioral changes. Lindström (2008) also found that people living in more urbanized areas had a higher risk of being overweight because of their travel behaviors. At the heart of this literature is a rapid transition in lifestyle in rapidly urbanizing areas. ...
... Previous studies have shown that lifestyle changes associated with urbanization increase or decrease people's risk of being overweight in the following ways. First, people living in more urbanized areas are more likely to choose motorized travel modes than those living in less urbanized areas, because motorized travel is not only safer and more convenient but also more affordable for urban residents (Lindström, 2008). As driving instead of walking may decrease one's physical exertion, residents of more urbanized areas are more likely to have a sedentary lifestyle due to the frequent use of cars (Frank, Saelens, Powell, & Chapman, 2007;Lindström, 2008). ...
... First, people living in more urbanized areas are more likely to choose motorized travel modes than those living in less urbanized areas, because motorized travel is not only safer and more convenient but also more affordable for urban residents (Lindström, 2008). As driving instead of walking may decrease one's physical exertion, residents of more urbanized areas are more likely to have a sedentary lifestyle due to the frequent use of cars (Frank, Saelens, Powell, & Chapman, 2007;Lindström, 2008). Second, the pace of life increases with urbanization, and people living in more urbanized areas are more apt to eat outside instead of cooking at home for themselves. ...
Rapid urbanization has led to many health-related problems in China, and the increasing prevalence of overweight is one of the greatest threats to public health. Although previous literature has documented a linkage between urbanization and the prevalence of overweight in developing countries such as China, little research has been done to investigate the role of lifestyle related to energy intake and expenditure in mediating the effect of urbanization on individuals' risk of overweight. To bridge this knowledge gap, this study aims to examine the impacts of urbanization on individuals' odds of overweight and explore the mediating effect of lifestyle choices using data from 2016 China Labor-Force Dynamics Survey. Results show that the effect of urbanization on being overweight has two sides. Specifically, while urbanization results in a sedentary lifestyle, which increases the risk of being overweight, urbanization rate weakens the effect of eating out frequently on being overweight and strengthens the influence of physical exercise on being overweight. Urbanization exerts complex effects on re-sidents' risk of being overweight among Chinese people by shaping their lifestyle.
... Regarding mechanisms through which population density affects health, a significant body of research in developed countries has noted the importance of lifestyle as a mediating component of health protection [16][17][18][19][20][21][22][23][24][25]. Indeed, the healthy lifestyle theory states that lifestyle is a bridge between environmental and human factors that affects health outcomes [16]. ...
... Previous studies have concluded that there are two main lifestyle choices through which population density reduces the risk of being overweight in developed countries. First, 'Transportation mode' [14,[17][18][19][20][21][22][23][24][25] and the '3D' theory (population Density, pedestrian-friendly Design, and a diversity of Destinations) claim that population density may increase the walkability of a neighbourhood [20,25] and reduce the distance to amenities [14,17,18]. Therefore, residents living in communities with a higher population density would prefer walking and using public transport to private transport, thereby increasing their engagement in physical exercise, which invariably reduces the risk of being overweight [21,24]. ...
... Previous studies have concluded that there are two main lifestyle choices through which population density reduces the risk of being overweight in developed countries. First, 'Transportation mode' [14,[17][18][19][20][21][22][23][24][25] and the '3D' theory (population Density, pedestrian-friendly Design, and a diversity of Destinations) claim that population density may increase the walkability of a neighbourhood [20,25] and reduce the distance to amenities [14,17,18]. Therefore, residents living in communities with a higher population density would prefer walking and using public transport to private transport, thereby increasing their engagement in physical exercise, which invariably reduces the risk of being overweight [21,24]. ...
Background
The increasing prevalence of obesity across all age groups has become a major health concern in China. Previous studies have found strong links between population density, sedentary lifestyle, and the risk of being overweight among adults and adolescents in Western countries. However, little research has been conducted to disentangle this relationship in China, which is rapidly urbanizing and densely populated. Compared to other age groups, middle-aged and older adults tend to have a higher risk of being overweight, which increases their risk of diabetes, high blood pressure, and other weight-related chronic diseases. In addition, they are especially sensitive to neighbourhood environmental factors such as population density. Therefore, we aimed to unravel the link between population density and the risk of being overweight among Chinese middle-aged and older adults, with a particular focus on the mediating role of lifestyle choices.
Methods
Data from the 2011 China Health and Retirement Longitudinal Study were analysed. Individuals (N = 5285) were sampled from 405 neighbourhoods nested within 150 cities. Body Mass Index (BMI) was calculated based on self-reported body weight and height (being overweight was defined as a BMI ≥ 24 kg/m2). Multilevel regression and mediation analyses were applied to explore associations between population density, a sedentary lifestyle, and the risk of being overweight.
Results
Middle-aged and older adults who lived in densely populated neighbourhoods had higher odds of being overweight. Further, this link was mediated by residents’ mode of travel and physical exercise; specifically, these residents had higher odds of owning a car and spending lesser time on weekly physical exercise, thereby increasing their risk of being overweight. Furthermore, the association between car ownership and the odds of being overweight varied by neighbourhood population density.
Conclusions
There was a positive association between neighbourhood population density and middle-aged and older adults’ risk of being overweight. This relationship may exist because people who live in densely populated neighbourhoods tend to lead a sedentary lifestyle. Our findings also suggest that, in rapidly urbanizing countries, a sedentary lifestyle may be especially harmful to middle-aged and older adults who live in densely populated neighbourhoods.
... (ii) Socio-economic status is proxied for by median household income. (iii) Variables related to "healthy, active built environments" capture various aspects of a neighbourhood's physical environment that influence health outcomes, including population density (per m 2 ) and percent pedestrian and bike commuting, which are both indicators of the kinds of dense, walkable built environments that encourage physical activity and generally lead to lower rates of chronic disease and obesity (Besser & Dannenberg, 2005;Booth et al., 2005;Cerin et al., 2017;Feng et al., 2010;Frank et al., 2004Frank et al., , 2006Lindstrom, 2008;Saelens et al., 2003;Wang et al., 2016), as well as a hospital accessibility score 2 that proxies for underlying spatial accessibility to healthcare resources, and the percentage of tracts identified as "food deserts 3 " by the 2017 USDA report "Low-Income and Low-Supermarket-Access Tracts, 2010-2015" within each ZCTA was included as a general indicator of spatial access to healthy foods (Rhone et al., 2017). Finally, (iv) several COVID-19 2 The Euclidean distance from each ZCTA centroid in the Chicago metropolitan region to the point location of hospitals provided by the Department of Homeland Security (HIFLD, 2020) was calculated using the "access" package in Python 3.7 and then weighted by a distance decay parameter (β) of −.5 within a cutoff threshold of 16,000 m (roughly 10 miles). ...
... To that end, the results suggest that neighbourhoods with higher levels of occupational exposure (from healthcare service workers), crowded housing (where one infected individual is more likely to infect a greater number of people), and lower density and levels of pedestrian commuting tend to have significantly higher rates of COVID-19 infection. Density and walkability in particular are widely known to be important factors in supporting the underlying healthiness of a neighbourhood and reducing rates of chronic disease (Besser & Dannenberg, 2005;Booth et al., 2005;Cerin et al., 2017;Feng et al., 2010;Frank et al., 2004Frank et al., , 2006Lindstrom, 2008;Saelens et al., 2003;Wang et al., 2016), which have been observed to be significant predictors of COVID-19 case severity and death. Interestingly, exercise specifically has been forwarded as one of the primary factors that may tend to decrease COVID-19 case severity (Barney, 2020;Yan, 2020). ...
This paper compares ZIP code‐level data on observed COVID‐19 testing and case rates for the City of Chicago and New York City to better understand both 1) the extent to which racial and ethnic disparities in COVID‐19 testing and case rates exist at the neighborhood level, and 2) the most important neighborhood‐level drivers of these observed disparities. Through exploratory spatial mapping and econometric approaches, the paper finds that, across both cities, Hispanic‐majority neighborhoods have significantly lower testing rates than other racial/ethnic neighborhood types, even when controlling for observed infection rates – which are also significantly higher for Hispanic‐majority neighborhoods. At the same time, white‐majority neighborhoods have significantly higher testing rates and lower observed infection rates. Given this observed disparity, the paper also examines a range of underlying factors that are potentially driving observed neighborhood‐level COVID‐19 case rates. The findings suggest that higher socioeconomic status and the provision of healthy, active built environments are significantly negatively associated with COVID‐19 infection rates, while several aspects of social vulnerability are significant positive predictors of COVID‐19 infection rates. These findings suggest that the health benefits from higher density, walkable built environments may play a larger “protective” role from observed COVID‐19 case rates at the neighborhood‐level than previously assumed, while at the same time indicating that the increased prevalence of COVID‐19 in Hispanic‐ and Black‐majority neighborhoods may be in part due to their greater risk of occupational exposure and multi‐generational household structure (particularly for Hispanic‐majority neighborhoods).
... Muchas de las investigaciones que tratan sobre la salud pública informaron que los niveles de actividad física han disminuido o siguen siendo bajos en las últimas décadas en los países más desarrollados (Andersen et al., 1999;Foster y Giles-Corti, 2008;Frank y Engelke, 2001;Jurj et al., 2007;Lindström, 2008;Marcus y Forsyth, 1999;Mokdad et al., 1999;Parra et al., 2011). ...
... ; F. Ogilvie y Goodman, 2012; Vogel y Mattfeld, 2010; L. Yang et al., 2010).En resumen, la movilidad urbana (como caminar o andar en bicicleta) y los sistemas públicos de bicicletas compartidas han comenzado a surgir a través de programas y servicios que impulsan el cambio de la fuerte cultura de dependencia de los vehículos a motor que se tiene en los países más desarrollados(Börjesson y Eliasson, 2012;Fishman et al., 2012aFishman et al., , 2013Frank y Engelke, 2001;Kahn, 2012;Li et al., 2012;Lin y Yang, 2011;Lindström, 2008;Liu et al., 2012;Martens, 2004Martens, , 2007Noland e Ishaque, 2006;F. Ogilvie y Goodman, 2012;Rojas-Rueda et al., 2011;Sayarshad et al., 2012). ...
The growing pollution in the cities and the increase in obesity and overweight recommend the use of active means of transport. One of these means, which has become extremely popular in recent years is the bicycle sharing system. Currently, hardly any study provides information about the users characteristics and the usage habits of the service in Spain. Therefore, in this study it is intended to categorize the ages of the participants in this system, as well as the frequency of use and the characteristics of the routes. Objective: The objective of the study was to analyse the uses of a public bike system according to user characteristics, as well as the time of use of bicycles, months, seasons and weather. Methods: It has been designed a quantitative and longitudinal study with data collection and analysis in the public bike system of Vilagarcía de Arousa from July 17, 2009 to January 18, 2012. The sample was the uses of public bike (n=84,183). Statistics used to analyse were SPSS 16.1, measures of central tendency, t, ANOVA and Post ANOVA Bonferroni test. Results: The average age of the users was 46 years (men 49; women 38,7), being the significant differences t=83,06; p<0,001. The highest frequency of use is initiated and finished in the city centre (15,995 uses; 19%). Men between 50 and 69 years old and women between 30 and 49 years old are those who use the bicycles more. Coastal routes are the most preferred by women. The average minutes of use in the public bicycle trips was 36,1 (men 38,1; women 31,4), with statistically significant differences t84181=26,30;" p<0,001. Conclusions: Users of the bicycle sharing system are middle-aged. If we take into consideration the gender, the service is more used by men than by women. Women show an earlier usage of the service, compared to men. The routes that are most frequented are parallel to coastal promenades and women use them more than men. The routes that are initiated and finished in the city centre show the highest impact of usage.
... Active commuting on foot or by biking is a good strategy to incorporate physical activity into daily routines among physically inactive populations [44]. In this sense, considering the competing academic and occupational goals in university students [5], ACU might lead to them integrating physical activity engagement in daily routine easier than LTPA in other life domains (e.g., recreational or domestic) and improve healthy levels [45], such as reducing obesity [40,46,47]. ...
... This could be due to students from higher-SES areas being able to afford motor vehicles (i.e., cars or motorbikes), and the possibility of access to parking facilities [31]. Considering previous research, it is clear that the use of a motor vehicle is associated with weight gain and increased risk of obesity [47]. As it seems that high-SES students from the current study are more likely to commute passively by driving to university, more active modes of transport should be promoted to favor the adoption of physical activity guidelines. ...
The role of neighborhood characteristics in promoting physical activity and sedentary behaviors (SB) has not been extensively studied in university students. The study purpose was to analyze the associations of neighborhood built environment and neighborhood socioeconomic status (SES) with active commuting, leisure-time physical activity (LTPA), and SB among university students. This is a cross-sectional study of 308 undergraduate students from two urban universities in Valencia, Spain. Participants’ residential neighborhoods were classified according to walkability and SES levels. Walkability was defined as an index of three built environment attributes (i.e., residential density, land-use mix, and street connectivity) based on geographical information system data. Active commuting to and from university (ACU), active commuting in the neighborhood, LTPA, and SB were evaluated through a questionnaire. Mixed model regression analyses were performed. There were no significant SES–walkability interactions for any of the outcomes analyzed. However, university students living in more walkable areas reported two more ACU trips per week compared to those living in less walkable neighborhoods (p < 0.01). University students living in lower-SES neighborhoods reported more ACU trips per week than those living in higher-SES neighborhoods (p < 0.05). Regarding LTPA, there were no significant SES or walkability main effects. Neighborhood SES was negatively related to active commuting in the neighborhood and to time spent in SB (all p < 0.05). Participants living in lower-SES neighborhoods reported more active commuting per week and had the highest average minutes spent in SB. This study highlights the relevance of assessing university’s residential environment when active transportation and SB are analyzed.
... Also, to some extent, transportation evaluation needs to take population density into account [23]. Many studies have been conducted on this topic [24,25]. In light of this, LandScan population data in 2015 were used in this study to adjust transportation indices [26] (see Figure 1). ...
The Belt and Road Initiative (BRI) is a Chinese strategy, proposed to strengthen the connectivity and cooperation among BRI countries. Under this circumstance, many transportation projects are planned to be carried out, which means the transportation accessibility evaluation is of significance in providing valuable suggestions for transportation construction. This research established a global transportation accessibility index (GTAI) model in the BRI region using raster data. Based on its gridded outputs, we conducted classification evaluation, autocorrelation analysis, and a geographical weighted regression model to explore the spatial characteristics of the GTAI distribution and its correlation with population density. The results show that: (1) most countries in Europe and the Middle East, western Russia, and eastern China enjoy high accessibility, while central regions (e.g., Central Asia and western China) have poor access to destinations; (2) the GTAI values are distributed as a spindle, where about 60% areas belong to the middle transportation accessibility region, mapped as a non-significant type; and (3) there is a positive relationship between transportation accessibility and population distribution, but their connection tends to be weaker as socioeconomic development increases. Finally, several policy implementations are provided: (1) give a priority to road or railway construction between China and Central Asian countries; (2) establish an innovative transportation system and introduce advanced technologies to enhance the exchange and cooperation among the BRI countries; (3) improve public transport management in well-developed regions, and introduce talents and strengthen transportation infrastructure construction in developing regions.
... The percent of non-white residents was significant in the diabetes model where an increase in the percentage of minorities was associated with an increase in diabetes. Average commute time was only significant in the obesity model but with a contrary effect to what has been seen in several notable studies Hoehner et al., 2012;Lindstrom, 2008;Mobley et al., 2006;Pendola and Gen, 2007;Wen et al., 2006). Our results suggest that a longer commute is significantly associated with a lower obesity rate. ...
Children who are too young to drive and adults who are unable to drive can represent a significant transportation burden, one typically shouldered by family members, i.e., “family chauffeur-associated-burdens” (Family CABs). This research examines how one’s experience chauffeuring family members influences support for strategies to address family chauffeuring burdens. The research also examines if one’s own experience chauffeuring family members affects perceptions of the possibility that they may reach a point at which they are no longer able to drive, and potentially become a transportation burden to others. Descriptive statistics and linear and logistic regression models of a household survey ( n = 349) demonstrate the significance of demographics in the type and extent of chauffeuring burdens. Chauffeur youth and money spent chauffeuring are each positively-correlated with the desire to move to a more walkable place to address chauffeuring burdens. Alternately, youth and being male are each positively-correlated with favoring technological solutions (e.g., autonomous vehicles) to address chauffeuring burdens. One’s own experience as a chauffeur does not significantly influence perceptions of eventually becoming a transportation burden for others. Women are more likely to prefer moving to a more walkable location and relying on family or friends if they are no longer able to drive, while men prefer the idea of relying on autonomous vehicles if they lose the ability to drive. Findings from this work can guide appropriate planning, policy, and technological responses to chauffeuring burdens.
... In addition to visited locations, our system also aims at detecting the transportation mode used when individuals move between locations, since evidence exists that the way one commutes is correlated with overweight and obesity [10]. ...
Obesity is currently affecting very large portions of the global population. Effective prevention and treatment starts at the early age and requires objective knowledge of population-level behavior on the region/neighborhood scale. To this end, we present a system for extracting and collecting behavioral information on the individual-level objectively and automatically. The behavioral information is related to physical activity, types of visited places, and transportation mode used between them. The system employs indicator-extraction algorithms from the literature which we evaluate on publicly available datasets. The system has been developed and integrated in the context of the EU-funded BigO project that aims at preventing obesity in young populations.
... Many studies have shown varying levels of transit physical activity moderated by factors such as age, gender, income, and car ownerships. For example, the effects of using public transport on overweight and obesity only occurred in men for both studies in Australia (Wen and Rissel, 2008) and Sweden (Lindström, 2008). This is probably attributable to less walking minutes among females compared to male in transits (Morency et al., 2011;Wasfi et al., 2013). ...
Transport sector’s contribution to total energy-related CO2 emissions globally has increased at a faster rate than other energy end-use sectors. Road vehicles constituted 80% of the transport emissions, especially from the emerging economies. Health cobenefits of climate mitigations can provide added justifications for governments to mainstream climate actions into national policies. Public transport is one of the urban transport strategies to reduce emissions. This chapter discusses how public transport can promote health cobenefits among population sustainably in their daily rhythmic commute. Results and assessment methods in recent empirical studies and scenario modeling on the three health determinants (air pollution, traffic injuries, and physical activity) in relation to public transport are reviewed. The last section briefly discusses about modal shift and access to public transport services.
... Robust public transportation is commonly understood to be a facilitator for healthy living (Booth et al., 2005;Lindstrom, 2008;Moudon et al., 2007;Sallis et al., 2012). As a key factor in designing healthy built environments, having good public transportation enables more incidental exercise throughout the day, access to healthcare, running errands, accessing high quality grocery stores to buy food. ...
Urban environments create unique challenges for the management of type 2 diabetes (T2D). City living is associated with unhealthy occupational, nutritional, and physical activity patterns. However, it has also been linked to behaviours that promote health, such as walking and cycling for transportation. Our research is situated at the intersection of these contradictory findings. We ask: What aspects of urban living impact the ability of those living with diabetes to reach optimal health? What contextual and structural factors influence how barriers are experienced in the everyday lives of those living with T2D?
We conducted semi-structured interviews with 29 individuals living in Toronto and Vancouver. Interviews were recorded, transcribed, and systematically coded for themes and sub-themes.
In addition to affirming readily acknowledged barriers to diabetes management, such as accessing healthy, culturally appropriate food and the cost of management, our findings suggest that the unpredictable nature of urban living creates barriers to routinizing self-management practices. As large, cosmopolitan centres with an abundance of activities on offer, cities pulls people away from home, making adherence to self-management recommendations more difficult. Moreover, our findings challenge commonly held assumptions about the mutually exclusive and static nature of barriers and facilitators. Public transit, a readily acknowledged facilitator of healthy living, can be experienced as a barrier to diabetes management. Participants report intentional non-adherence to their medication regimens for fear of hypoglycemia in subway or traffic delays. While the stimulating nature of cities promotes walkability, it produces barriers as well: participants partake in more restaurant eating than they would if they lived in a rural area and were home to cook their own meals.
Understanding how barriers are experienced by people living with diabetes will help mitigate some of the unintended consequences associated with various contextual factors. We recommend that healthcare professionals acknowledge and support people with T2D in routinizing self-management and developing contingency plans for the unpredictability and complexity that urban living entails. We suggest further research be carried out to develop contextually-tailored municipal policies and interventions that will support self-management and improve outcomes for individuals living with T2D in urban settings.
... 11 Working trips act as a potential opportunity to promote the level of physical activity on the daily basis. 12 Thus, it is crucial to explore the change of transit-related walking to work and how it could provide recommended amount of physical activity. By exploring this trend, this study could inform policymakers in formulating transit-related policies in providing the equal access to all groups. ...
Background:
This study explored the percentage change of walking to/from public transit to work from 2009 to 2017 in general and for specific sociodemographic characteristics. Furthermore, this study also examined the sociodemographic characteristics of those who walked to/from transit to work and those who walked 30 minutes or more per day to/from transit to work and compared the difference between 2009 and 2017.
Methods:
2009 and 2017 National Household Travel Survey were used. This study used weighted logistic regressions to explore the sociodemographic characteristics of those who walked to/from transit to work and those who walked 30 minutes or more per day to/from transit to work in both 2009 and 2017.
Results:
The percentage of trips achieving the recommended level of physical activity (30 min or more per day) by walking to/from transit work solely has a slightly increase from 9 in 2009 to 9.5 in 2017. However, the weighted percentages of walking to/from transit to work decreased for low-education, low-income, and minority populations. High population density areas were related to more transit-related walking trips to work in both 2009 and 2017.
Conclusions:
Policymakers in terms of transit location and service should consider low-education, low-income, and minority populations to address potential equity issues.
... Environment features can influence active forms of transport, such as walking and cycling, and provide opportunities to incorporate physical activity into daily living and reduce obesity. Some previous studies have found associations between active transport and reduced obesity risk (Lindström, 2008;Millett et al., 2013;Flint et al., 2014). Also, higher walkability neighborhoods are associated with a lower prevalence of obesity (Creatore et al., 2016). ...
Introduction: The aim of this study was to analyze the association between neighborhood environment and the objective measures of physical activity (PA) according to nutritional status in the adult population. Methods: A cross-sectional study design was employed. The information was collected from 161 representative subjects of the CESCAS study population from Temuco-Chile. The perception of the neighborhood environment was determined using the IPAQ Environmental-Module. PA was measured objectively by a triaxial accelerometer for 7 consecutive days. Weight and height were measured. The relationship between the residential environment and the PA levels was summarized through linear regression models stratified by nutritional status. Results: The perceived residential environmental attributes that support active transport were positively associated with total moderate-vigorous PA (MVPA) (β 397 min/week, CI 80-714, p = 0.019) in people with normal nutritional status, but not in overweight and obese individuals. In addition, living near to a public transport stop was associated with higher levels of moderate PA only in normal-weight subjects (β 383 min/week, CI 72-694, p = 0.021). Also living in a neighborhood with traffic safety was associated with higher levels of light PA in normal-weight subjects (β 518 min/week, CI 208-829, p = 0.004). Conclusions: There was no significant association between perceived neighborhood environment and PA in people with obesity.
R E S U M E N
Introducción: El objetivo de este estudio fue analizar la asociación entre la percepción del entorno de residencia y medidas objetivas de actividad física (AF) de acuerdo al estado nutricional en población adulta. Métodos: Estudio de corte transversal realizado en 161 participantes representativos del estudio CESCAS de Temuco-Chile. La percepción del entorno de residencia fue determinada usando el Modulo Ambiental del IPAQ. La actividad física fue medida objetivamente por un acelerómetro https://doi. T triaxial por siete días consecutivos. El peso y la talla fueron medidos de forma estandarizada. La relación entre en entorno de residencia y los niveles de AF fue analizada mediante modelos de regresion lineal estratificados por estado nutricional. Resultados: La percepción de los atributos del entorno de residencia que promueven el transporte activo, fue positivamente asociado con el total de AF moderada y vigorosa (β 397 min/week, CI 80-714, p = 0.019) en personas con estado nutricional normal, pero no en personas con so-brepeso u obesidad. Además, vivir cerca de una parada de transporte público fue asociado con altos niveles de AF moderada sólo en personas con estado nutricional normal (β 383 min/week, CI 72-694, p = 0.021). Finalmente, vivir en un barrio con seguridad en el tránsito, fue asociado con altos niveles de AF ligera en sujetos normo-peso (β 518 min/week, CI 208-829, p = 0.004). Conclusión: No hubo asociación significativa entre el entorno de residencia y AF en personas con obesidad.
R E S U M O
Introdução: Este estudo tem como objetivo analisar a associação entre o ambiente residencial e as medidas objetivas de atividade física (AF) de acordo com o estado nutricional na população adulta. Métodos: Estudo transversal realizado em 161 participantes do estudo CESCAS em Temuco, Chile. A percepção do ambiente residencial foi determinada usando o IPAQ Environmental Module. A atividade física foi medida objetivamente por um acelerômetro triaxial por sete dias consecutivos. Peso e altura foram medidos de forma padronizada. A relação entre o ambiente de residência e os níveis de AF foi analisada utilizando modelos de regressão linear estratificados por estado nutricional. Resultados: Os atributos percebidos do ambiente residencial que suportam o transporte ativo foram positivamente associados com AF moderada-vigorosa total (β 397 min/semana, IC 80-714, p = 0,019) em pessoas com estado nutricional normal, mas não em indivíduos com sobrepeso e obesidade. Também, morar próximo a uma parada do transporte público estava associado a níveis mais altos de AF moderada somente em indivíduos com peso normal (β 383 min/semana, IC 72-694, p = 0,021). Adicionalmente, morar em um ambiente residencial com segurança no trânsito foi associado com níveis mais elevados do AF ligeira em indivíduos com peso normal (β 518 min/semana, CI 208-829, p = 0,004). Conclusões: Não houve associação significativa entre ambiente residencial e AF em pessoas com obesidade.
... A utilização da bicicleta oferece vários benefıćios para o indivıduo: melhora o condicionamento fıśico, aumenta a capacidade cardiorrespiratória, reduz o risco de desenvolver doenças cardiovasculares, obesidade e depressão (Hu et al., 2003;Wen e Rissel, 2008;Damant-Sirois e El-Geneidy, 2015;Wang et al., 2014;Braun et al., 2016). O uso diário da bicicleta para deslocamentos a trabalho, por exemplo, apresenta maiores vantagens do que o uso por lazer, somente nos 1ins de semana, pois os benefıćios observados são maiores quando existe regularidade (Wen e Rissel, 2008;Lindström, 2008). A utilização desse modo de transporte ajuda os indivıduos a serem 1isicamente ativos na sua rotina diária e contribui para substituir viagens atualmente realizadas por modos motorizados. ...
O objetivo deste estudo é identificar as questões mais valorizadas pelos potenciais usuários de bicicleta em viagens a trabalho e avaliar o impacto de medidas de estímulo ao uso da bicicleta. Para isto, foi realizado um estudo de caso com os funcionários da Companhia Riograndense de Saneamento (CORSAN), na cidade de Porto Alegre, por meio de um estudo de Preferência Declarada. Modelos logit ordenados foram utilizados para estimar a probabilidade de uso da bicicleta em diferentes cenários. Os resultados mostraram que a implantação de vestiários, bicicletários, empréstimo de bicicletas, treinamento para funcionários e a presença de ciclovias para o acesso à CORSAN, estimulam a utilização de bicicleta. A disponibilidade de vestiário mostrou-se a variável mais importante. A implantação conjunta de vestiário, bicicletário e bicicletas para empréstimo aumentaria a demanda em 65%. Os procedimentos adotados podem ser facilmente aplicados em outros contextos, expandindo pesquisas desta natureza.
... In addition to visited locations, our system also aims at detecting the transportation mode used when individuals move between locations, since evidence exists that the way one commutes is correlated with overweight and obesity [10]. ...
Obesity is currently affecting very large portions of the global population. Effective prevention and treatment starts at the early age and requires objective knowledge of population-level behavior on the region/neighborhood scale. To this end, we present a system for extracting and collecting behavioral information on the individual-level objectively and automatically. The behavioral information is related to physical activity, types of visited places, and transportation mode used between them. The system employs indicator-extraction algorithms from the literature which we evaluate on publicly available datasets. The system has been developed and integrated in the context of the EU-funded BigO project that aims at preventing obesity in young populations.
... Il pendolarismo attivo migliora la percezione dello stato di salute generale e riduce il rischio di essere in sovrappeso, obesi o affetti da sindrome metabolica (60,61). Il pendolarismo attivo oltre a contribuire ad una riduzione dell'obesità e ad una maggiore attività fisica, è percepito come più rilassante ed emozionante del pendolarismo in auto o con mezzi pubblici, che viene segnalato come più stressante e noioso rispettivamente (62,64). Diversi altri studi insistono sui benefici del pendolarismo attivo (64,65). ...
Objectives:
Commuting is generally described as a modern society issue; despite the relevance of this phenomenon, only few studies investigated occupational and health effects of commuting on workers exposed to it. According to the 15th census of the Italian population, in Italy about 29 millions of people (48,6% of total resident population) daily moved to reach their work. During last ten years, this number increased of about 2.1 millions of people, and also time and distances needed to reach work grew, with a potential high impact on health and environment. Thus, the aim of this study is to analyze the possible relationship between commuting and health effects on a group of workers exposed to this risk factor.
Methods:
Our study analyses health effects related to commuting in an exposed occupational population, by means of the self-completed ad-hoc questionnaire provided to workers of different plants in the North of Italy.
Results:
Our results are consistent with scientific literature ones. Commuting exposed workers showed increased risk of headache and sleep disorders.
Conclusions:
Our study is an explorative but structured evaluation of health effects of commuting and a base for further researches.
... According to research on the working population in Scania there is a strong correlation between overweight/obesity and the mode of transport used to commute to work. Commuting by active modes of transport such as walking or cycling has a strong negative correlation with overweight/obesity, while the opposite is true for commuting by car (Lindström, 2008). For the policy makers and urban planners in Scania and elsewhere, it is important to recognise the potential for daily physical activity during a person's commute to work and to include it as a perspective in transport planning. ...
Introduction: The World Health Organization (WHO) has concluded that physical inactivity and overweight/obesity are the world's fourth and fifth leading risk factors for non-communicable diseases, respectively. This article investigates the potential for active commuting by bicycle in Scania county, southern Sweden, and its possible impact on public health. Physical inactivity is a growing problem on both an individual and a societal level.
Method, setting and population: A complete statistical survey and geographic analysis has been carried out based on data concerning the home and work addresses of the entire working population in the county of Scania, Sweden as of the end of 2014. This data set includes a total of 575,959 individuals.
Results: Approximately 27.9% of the population can reach their workplace by a 15-min bicycle commute, while 47.2% can reach their workplace in 30 min. It is possible to achieve a 47.2% modal share for active transport in Scania if all individuals within cycling distance of work choose to commute by bicycle. If that were to happen, 19.2% of the working population would meet the WHO's global health recommendations just through their commutes.
Conclusion: The results demonstrate that the spatial distribution of homes and workplaces in Scania is conducive to increasing the mode share for active transport through well-designed physical environments and transport systems that prioritise physical activity.
... Lindstrom ve ark. (24) , yaptıkları çalışmada, yaşam tarzı değişikliğinin (fiziksel egzersiz yapma, her gün sebze veya esmer ekmek tüketme vb.) diyabet riski yüksek olan ileri yaş grubunda etkili olduğu, yaş grubu küçük olanlarda etkili olmadığını bulmuşlardır. Olgun ve ark. ...
... Some studies showed that active and passive travel modes have different influence on people's SWB [40]. Active commuting types like cycling and walking have positive effects on emotional SWB, because they are reported to be more relaxing and exciting than passive commuting types [34,41]. ...
How and to what extent household car ownership and commuting behavior affect individual subjective well-being (SWB) is of great interest for urban and transportation planning. Increasing attention has been paid to the associations between car ownership, commuting and SWB. However, only a limited number of studies examined the effects of travel-related factors on both cognitive and affective SWB aspects. This research empirically investigated the relationships from the two SWB aspects. Furthermore, we extend the modeling of generic cognitive SWB to several specific measures (e.g., satisfaction with life compared to a specific group of people, degree of free choice, social position, and social equality) to explore how car ownership and commuting behavior contribute to individual SWB. Drawing on the data derived from the 2014 China Labor-Force Dynamics Survey, a set of ordered probit models based on Bayesian inference are estimated. The findings point out that household car ownership has a significant effect on cognitive SWB but a limited influence on affective SWB. It appears that commuting time is significantly and negatively associated with individuals’ cognitive and affective well-being, whereas a positive correlation is found between the commuting by bicycle and affective SWB. The effects of commuting time and transportation modes on different measured satisfactions with life have no big differences. Finally, results of the Wald tests indicate that incorporating household car ownership and commuting behavior into the modeling framework can significantly improve the prediction accuracy of individual SWB.
... The World Health Organization (WHO) promotes active travel, such as cycling and walking (World Health Organization, 2010). Active travel has the potential to increase physical activity levels and is associated with a reduced risk of cardiovascular events (Hamer & Chida, 2008a,b), obesity (Lindstrom, 2008), and cancer (Celis-Morales et al., 2017) and type 2 diabetes (Rasmussen et al., 2016). In 2008, Hamer and Chida (2008a,b) published a review and meta-analysis regarding active commuting and the risk of CVD, including 173,146 participants from eight prospective cohorts. ...
Introduction: Active travel is recommended and promoted to increase physical activity and reduce the risk of several non-communicable diseases. The health effects of active travel in populations of low socioeconomic status (SES) are unclear. This study was performed to investigate the associations of cycling and walking for travel with diabetes and other risk factors for cardiovascular disease (CVD) in a multi-ethnic, low-SES population. Methods: Cross-sectional data from 2445 adults (age, 48.0 ± 9.8 years; 43.6% men) in two multi-ethnic, low-SES districts in Oslo, Norway, were collected. The data included objective measurements (blood pressure, weight, height, blood parameters), questionnaire data (physical activity, diabetes, use of medication, working status, education, smoking), sex, age, and country of origin. Associations were analyzed by multiple logistic regression models. Results: Cycling and walking for travel were performed by 26.5% and 80.1% of adults, respectively. Self-reported diabetes (OR, 0.47; 95% CI 0.23–0.94) high-density lipoprotein cholesterol level of <1.3 mmol/L (OR, 0.77; 95% CI, 0.62–0.95) and obesity (OR, 0.71; 95% CI, 0.55–0.92) were inversely associated with cycling after adjustment for SES, smoking, leisure-time physical activity, walking for travel, age, and sex. Systolic blood pressure of >140 mmHg (OR, 0.74; 95% CI, 0.57–0.97) was inversely associated with walking for travel. Conclusion: In the current multi-ethnic low SES population, those engaged in active travel and cycling for travel in particular had lower odds of diabetes and lower risk factors for cardiovascular disease compared to those not engaged in active travel.
... Active transportation features such as bike lanes, sidewalks, trails, in addition to nearby parks, street lighting, and leisure and recreational facilities on campus have helped people be more physically active [27,28,29,30,31]. Even access to public transportation improves PA levels through active transportation [32,33,34] and decreases obesity levels [35]. Studies have shown accessibility or even perceived accessibility to parks and recreation facilities have led to a greater probability of increased PA among adults [36,37,38,39]. ...
... Obesity has become a significant public health problem globally. Its growing prevalence and its numerous medical, psychological and socio-economic consequences affect all countries, all social classes, and all age groups [3]. ...
Introduction: Obesity is defined as an excess of body fat resulting in a high cardiovascular risk. Its pandemic development spares no country. This study aims to analyze the trend of nutritional status (obesity and overweight) depending on gender and age in Kénitra region, the Northwest of Morocco, from 10 December 2020 to 25 January 2021. Methods: This work focused on a sample of 100 subjects over the age of 18. The obesity assessment was based on Body Mass Index (BMI), the weight and height measurements taken according to criteria recommended by the World Health Organization (WHO). Results: The studied parameter is the body mass index (BMI) that revealed to be higher in men than women with 25.94 kg/m 2 and 23.77 kg/m 2 , respectively. In addition, the age groups of 50-60 years and 40-50 years represent a maximum BMI (body mass index) respectively with 27.93 kg/m 2 and 27.23 kg/m 2. Conclusion: The results of our study show that obesity affects men more than women and specifically the age groups between 40 and 60 years, which requires an adequate strategy to fight obesity in this sample population.
... So far, most studies have focused mainly on how to convince physicians to settle down in rural areas [2,6,[13][14][15][16]. Other studies have examined general health aspects of commuting or the commuting behavior of the whole population without consideration of specific professional subgroups [17][18][19]. Consequently, our results are only partially comparable to the existing literature. ...
Background
Many countries are faced with a decrease in physicians in non-urban areas. Especially for regions with decreasing populations, temporary solutions like commuting models might be a suitable option. So far, little is known about the willingness to commute among future physicians.
Methods
In this multicenter, cross-sectional survey, five years of medical students (8th to 10th semester) from three German universities (Charité Berlin, Halle, Leipzig) were questioned about their willingness to commute to work, the maximum acceptable commute time, and how several job-related factors might enhance the attractiveness of commuting.
Results
Altogether 1108 of 1203 (92.1%) students completed the questionnaire. For 55.9% of the participants it was imaginable to commute to a non-urban area in the future. The most important job-related factors that would increase the attractiveness of such a commuting model were remuneration of the commuting time, higher remuneration in general, working self-employed in a joint practice with 2–3 physicians, existence of a specifically qualified “supply assistant”, provision of a home office, good public transport connection, and a driver service. The maximum acceptable commute time was on average 39.0 min (one-way). If the way to work would be a salaried integral part of the normal working time, the participants stated they would accept traveling 51.2 min (one-way).
Conclusions
Most future physicians are open-minded regarding models of commuting. The attractiveness of such models can be increased mainly through higher remuneration, reduction of the physicians’ burden, and comfortable modes of transport.
... Moreover, Kjellstrom et al. [33], and Lindstrom [34] add that urban areas require less energy-caloric expenditure related to commuting and leisure activities. Thus, more travelling by car and less walking or biking for transportation or leisure contribute to overweight and obesity. ...
The effect of the overweight epidemic on energy consumption and environmental
degradation was investigated for a panel of thirty-one countries from Europe from 1990 to 2016.The quantile via moments approach was used and revealed that the overweight epidemic increases the consumption of energy and carbon dioxide (CO2) emissions. It does this in two ways. First, overweight increases the consumption of processed foods from multinational food corporations, fast-food chains and multinational supermarket chains. This process impacts the multinational food corporations and farm production positively to attend to the demand for processed foods. This increase impacts the consumption of energy from non-renewable energy sources. Second, overweight reduces physical activities as well as outdoor activities, which increases the intensive use of home appliances and motorised transportation and consequently stimulates the consumption of energy and thus CO2 emissions rise.
... sustainable, cost-effective, and environmental-friendly modes of travel with a potential to lower the risk of many health problems including obesity, chronic diseases, mental disorders, and mortality [8][9][10][11][12]. Considering the numerous benefits of walking and bicycling, promoting these nonmotorized modes of travel has become the focus of many transportation and planning professionals and agencies in recent years. ...
Research continues to reveal the benefits of nonmotorized travel modes such as walking and bicycling. Therefore, identification of the factors that nurture these activities is essential in developing sustainable urban planning policies and designs. Among those factors are the built environment characteristics of the place of residence. To date, research on the role of the built environment in nonmotorized travel has focused on neighborhood-level factors. However, people do not stay within their neighborhoods; they live and work at a regional scale and travel to various destinations and distances each day. Nonetheless, little is known about the impact of built environment factors at larger spatial scales on nonmotorized travel behavior. Guided by the principles of the ecological model of behavior, this study investigates the role of the built environment at hierarchical spatial scales in nonmotorized travel behavior. Multilevel Structural Equation Models have been developed to comprehensively examine the complex links between the built environment and individuals’ nonmotorized travel. Findings indicate that built environment factors at multiple spatial scales can influence nonmotorized travel behavior. Thus, to promote walking and bicycling, more effective policies are those that include multilevel built environment and land use interventions and consider the overall physical form of urban areas.
... The research questions relating the two have primarily focused on the effects cycling has on people's health. As expected, previous research has concluded that, on average, cyclists have a lower prevalence of diabetes, hypercholesterolemia, and obesity (Riiser et al. 2018;Lindström 2008). Understanding the interconnection of cycling preferences and health could lead to infrastructure that is better suited to the less healthy segment of the population, motivating this group to increase their cycling frequency and improve their health outcomes. ...
This study aims to understand how self-assessed health status relates to preferences for cycling infrastructure. An integrated latent class and latent variable choice model is fitted using responses to a stated preference experiment from a panel of New York City residents (N = 801). Estimates show that people with stated good physical health tend to have preference parameters similar to those of experienced cyclists. This result means that the provision of cycling infrastructure with the purpose of attracting non-cyclists also has the potential of attracting those with worse health outcomes. This result suggests a double benefit coming from car use reduction and lower health spending.
... Second, the importance of moderate physical activity as a determinant of good health is well established (US Department of Health and Human Services, 1996;World Health Organization, 2002) but despite this, walking has been decreasing in many industrialised countries 2 . This fall has been linked to the rise in obesity and obesity related diseases (Bassett et al., 2008;Lindström, 2008), which impose substantial costs on individuals and health care systems. Third, and related to the concern over the effect of crime on neighbourhoods, walking has important externalities. ...
... 22 Although limited to a handful of high-income countries, active transport data (an integral part of overall PA level), indicate that fewer than 5% of individuals in Australia, Switzerland, and the United States (US) use active transportation as opposed to China, France, Germany, Sweden, and the Netherlands. [23][24][25][26][27][28] It also appears that the aggressiveness of the PI pandemic knows no boundaries and as such, the younger generation is not spared. Alarmingly, data from more than 100 countries indicate a significant proportion of adolescents do not meet PA recommendations with prevalence of inactivity extremely high for both sexes (78·4% for boys and 84·4% for girls). ...
Physical inactivity is one of the major contributing factors to the global pandemic of non-communicable diseases. Unfortunately, low levels of habitual movement and physical activity (PA) are seen in an increasing proportion of populations across low- and middle-income countries and high-income countries alike. This new normal – the inactive phenotype – is a significant contributor to multiple health and economic costs. Here we provide a brief historical overview of societal declines in PA, roughly consistent with major transitions in PA and nutrition in recent decades. This is followed by a synthesis of research evidence linking inactivity with poor health outcomes and prevention approaches needed to impact a perpetuation of poor lifestyle behaviors. A major focus of the paper is on the economic/health costs and the reduction of the inactive phenotype. In summary, we demonstrate that the consequences of insufficient PA are manifold, and if sustained, impact short and long-term health and quality of life, along with substantial economic costs.
... Additionally, many students living in such independent off-campus arrangements have a higher degree of active commute as many of them generally commute to campus by walking or bicycling. This can have a considerable impact as active commuting has been shown to be associated with decreased BMI and decreased odds of being obese or overweight [45,46]. ...
Background
The transition to university often involves a change in living arrangement for many first-year students. While weight gain during first year of university has been well documented, Canadian literature on the impact of living arrangement within this context is limited. The objective of this investigation was to explore the effect of living arrangement on anthropometric traits in first-year university students from Ontario, Canada.Methods244 first-year undergraduate students were followed longitudinally with data collected early in the academic year and towards the end of the year. Anthropometric parameters including weight, waist and hip circumference, body mass index (BMI), and waist-to-hip ratio (WHR) were examined. The Wilcoxon signed-rank test was used for pairwise comparison of traits from the beginning to end the year in the absence of adjustments. Additionally, linear regression models with covariate adjustments were used to investigate effect of the type of living arrangement (i.e. on-campus, off-campus, or family home) on the aforementioned traits.ResultsIn the overall sample, a significant weight increase of 1.55kg (95% CI: 1.24-1.86) was observed over the school year (p
... Active transportation promotes energy expenditure [31]. Transportation mode can also influence obesity [32,33]. We found overweight/obesity was associated with transportation mode. ...
The aim of this study was to explore association of physical activity and sitting time with overweight/obesity in Chinese occupational populations for the development of intervention and prevention strategies for obesity.
Methods:
A total of 23,112 participants were selected from the 2010-2012 China National Nutrition and Health Survey (CNNHS). A logistics regression model was used to examine the associations of physical activity and sitting time with overweight/obesity by gender after adjusting for age, educational level, marital status, and family economic level.
Results:
The prevalence of overweight/obesity based on the WHO definition and the WGOC definition was 30.8% and 41.3%, respectively. Male employees with moderate and heavy occupation activity intensity had a lower risk for overweight/obesity than those with light occupation activity intensity (moderate: OR 0.90, 95% CI 0.82-0.98; heavy: OR 0.75, 95% CI 0.65-0.86), and the risk of overweight/obesity of male employees with long work-time spent sitting was higher than those with short work-time spent sitting (2-4.9 h/day: OR 1.26, 95% CI 1.14-1.40; ≥5 h/day: OR 1.29, 95% CI 1.15-1.44). The risk of overweight/obesity of male employees with active transportation mode was lower than those with inactive transportation mode (OR 0.91, 95% CI 0.84-0.99), while the risk of overweight/obesity of female employees with active transportation mode was higher (OR 1.14, 95% CI 1.04-1.25). Female employees with leisure-time physical activity (LTPA) for ≥150 min/week had lower risk of overweight/obesity than those with LTPA for <150 min/week (OR 0.69, 95% CI 0.56-0.84). There was no significant association of leisure-time sitting and housework time with overweight/obesity in Chinese occupational populations.
Conclusion:
Occupation activity intensity, LTPA, transportation mode, and work sitting time were associated with overweight/obesity. Reducing work sitting time, moderate and heavy occupation activity intensity, and an active transportation mode could help male employees decrease the risk of overweight/obesity. Increasing leisure-time physical activity could reduce the risk of overweight/obesity in women. Our findings provided insight into the association of physical activity and sitting time with overweight/obesity. It will be necessary to carry out workplace-based interventions, have an active transportation mode, and increase leisure-time physical activity to decrease the risks of overweight/obesity.
... Men who acquired a vehicle experienced a 1.8 kg greater weight gain and had two times the odds of becoming obese compared to those who did not. Conversely, engaging in active transportation, walking or riding a bicycle to work, reduced the odds of becoming obese [93]. Among the 9856 individuals in Sweden, those who rode a bicycle or walked to work had a 38% lower odds of being overweight and obese compared to the car-driving subjects. ...
The intent of this review is to survey physiological, psychological, and societal obstacles to the control of eating and body weight maintenance and offer some evidence-based solutions. Physiological obstacles are genetic and therefore not amenable to direct abatement. They include an absence of feedback control against gaining weight; a non-homeostatic relationship between motivations to be physically active and weight gain; dependence of hunger and satiation on the volume of food ingested by mouth and processed by the gastrointestinal tract and not on circulating metabolites and putative hunger or satiation hormones. Further, stomach size increases from overeating and binging, and there is difficulty in maintaining weight reductions due to a decline in resting metabolism, increased hunger, and enhanced efficiency of energy storage. Finally, we bear the evolutionary burden of extraordinary human capacity to store body fat. Of the psychological barriers, human craving for palatable food, tendency to overeat in company of others, and gullibility to overeat when offered large portions, can be overcome consciously. The tendency to eat an unnecessary number of meals during the wakeful period can be mitigated by time-restricted feeding to a 6–10 hour period. Social barriers of replacing individual physical work by labor-saving appliances, designing built environments more suitable for car than active transportation; government food macronutrient advice that increases insulin resistance; overabundance of inexpensive food; and profit-driven efforts by the food industry to market energy-dense and nutritionally compromised food are best overcome by informed individual macronutrient choices and appropriate timing of exercise with respect to meals, both of which can decrease insulin resistance. The best defense against overeating, weight gain, and inactivity is the understanding of factors eliciting them and of strategies that can avoid and mitigate them.
... Access to public transport means that it is less than a 10-15-min walk to a transit station (bus stop, train subway station) from a participant's home. In a previous study, the use of public transportation increased the amount of walking activity, which decreased the risk of obesity and reduced sedentary time [38]. Thus, the use of public transportation can promote an active lifestyle for older adults. ...
Sarcopenia is associated with adverse health outcomes among older individuals. However, little is known about its association with neighborhood environmental factors. We explored the relationship between sarcopenia and perceived neighborhood environmental factors among community-dwelling older adults aged 70–84 years. We analyzed 1778 participants (mean age of 75.9 ± 3.8 years; 54.0% women) who lived in urban areas and underwent dual-energy X-ray absorptiometry from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 definition. Perceived neighborhood environmental factors were assessed using the Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). In the multivariate analysis, compared to the fifth quintile of the IPAQ-E score, the odds ratios (ORs) and 95% confidence intervals (CIs) for sarcopenia in the first, second, third, and fourth quintiles were 2.13 (1.40–3.24), 1.72 (1.12–2.64), 1.75 (1.15–2.66), and 1.62 (1.06–2.47), respectively. These neighborhood environmental characteristics were linked with an increased likelihood of sarcopenia: no public transportation access (OR = 2.04; 95% CI = 1.19–3.48), poor recreational facilities access (OR = 1.39; 95% CI = 1.01–1.90), absence of destination (OR = 1.53; 95% CI = 1.06–2.20), many hill hazards (OR = 1.36; 95% CI = 1.03–1.78), and lack of traffic safety (OR = 1.35; 95% CI = 1.02–1.78). Thus, better neighborhood environmental strategies may help prevent sarcopenia among urban-dwelling older adults.
... According to data from the 2010 General Social Survey, 82% of employed adults in Canada relied primarily on cars for travel to work, 12% took public transit and only 6% used active transportation (Turcotte, 2011). The use of active transportation has been associated with higher daily levels of moderate-to-vigorous physical activity (Larouche et al., 2016;Wanner et al., 2012) and lower BMI, adiposity and risk of obesity (Flint et al., 2014;Larouche et al., 2016;Laverty et al., 2013;Lindstrom, 2008;Wanner et al., 2012). Walking or cycling to work has also been associated with reduced CVD risk (Hamer and Chida, 2008), including lower blood lipids (Larouche et al., 2016) and lower likelihood of hypertension (Laverty et al., 2013), and diabetes (Laverty et al., 2013). ...
Introduction
Active transportation (walking/cycling) has been inversely associated with numerous cardiometabolic outcomes, as well as CVD, cancer and overall mortality. Less is known about associations with subjective well-being and quality of life.
Methods
Cross-sectional data from the 2015 General Social Survey (Cycle 29 – Time Use) was used to investigate associations between commuting mode to work/school and multiple indices of subjective well-being and work-life balance, including an analysis of gender differences, among a representative sample of 7646 Canadians aged ≥15. Respondents were asked about travel mode to work/school in the previous week (vehicle as driver/passenger, public transit, walking, biking). Outcomes included self-rated health, self-rated mental health, perceived life stress, life satisfaction, work-life balance, and perception of being a “workaholic”.
Results
Results revealed that 77% of respondents used passive modes of transportation to work/school, 14% used public transit, and 9% actively commuted. Compared to passive commuting, actively commuting to work/school was associated with 35% lower odds of reporting dissatisfaction with work-life balance (p = 0.001), and 25% lower odds of self-identifying as a “workaholic” (p = 0.002). Women who used public transportation (OR 0.65, 95% CI 0.48–0.88) or actively commuted (OR 0.44, 95%CI 0.29–0.67) were significantly less likely to report poor work-life balance. Women who actively commuted were also less likely to report high life stress, while women who used public transportation were more likely to report dissatisfaction with life. Commuting mode was not significantly associated with self-rated health or mental health.
Conclusions
Active commuting to work or school is positively associated with certain indices of subjective well-being and work-life balance among Canadians, especially among women.
... More car travelling and less walking or biking for transportation or leisure contribute to overweight and obesity (KJELLSTROM et al., 2007;LINDSTROM, 2008). Densely populated neighbourhoods, with less recreational space for outdoor activities, and more leisure time spent sitting and in screen-viewing leisure activities, also positively affect overweight (PIRGON and ASLAN, 2015;BRUG et al., 2011). ...
The impact of overweight on the consumption of energy and the impact of energy consumption on overweight was analysed for Latin America and Caribbean Countries for the period from 1975 to 2016. The Quantile via Moments econometric technique was used to assesses the role of energy consumption on the mean body mass index of man and woman controlling for the effects of global, economic and social globalisation, as well as Gross Domestic Product (GDP), urbanisation and carbon dioxide (CO2) emissions. Results point out by one hand, that as we go up in the quantiles the contribution to excess weight decreases for the variables economic globalisation, urbanisation, and energy consumption, and increases for social globalisation and CO2 emissions. On the other hand, the rise of GDP contributes to the downward overweight of women, but as we go up in the quantiles, the contribution fades away. The effect of GDP is statistically insignificant as a driver of man overweight. An additional model estimation to apprise if overweight impacts energy consumption, confirms that as overweight raises the energy consumption rises too.
... Regarding transport mechanism the study found that participants who used their vehicles, cars, Bajaj or motor bike to move from place to place were 1.93 times more likely to be overweight/obese than those who used to walk. Study revealed that those countries with the highest rates of car use for travel have the highest obesity rates (Bassett et al., 2008).This might be walking to work or for other duties from place to place promotes energy expenditure and decreases the risk of overweight/obesity (Lindström, 2008). In this study, 158 (42.7%) of the respondents used own car, Bajaj/motor bike for transportation, which might lead them to overweight/obesity. ...
Overweight and obesity has become a major global health challenge that affects virtually all ages. The aim of this study is to assess the prevalence of overweight/obesity and associated factors among adults of Sodo Town, Southern Ethiopia. Community based cross sectional study was conducted from January to February 2016. A total of 370 households were selected from 14,551 household using a simple random sampling technique., Lottery method was used to select an adult individual with age of ≥25 years. Anthropometric measurements (height and weight) was assessed using the World Health Organization) recommended techniques. Data were analyzed using SPSS windows version 20 Software. Both bivariate and multivariable logistic regression analyses were done. Prevalence of overweight was 32.4% and obesity 16.2%. The combined prevalence of overweight/obesity was 48.6%. Factors associated with overweight/obesity were being female (AOR = 4.0; 95% of CI: 1.7−9.4), Age group between 35–44, 45–54 and age >55 were more likely to be overweight/obesity than age group 25–34 (AOR = 28; 95% CI:1.51–5.15), AOR = 2.44; 95%CI:1.12–5.32), AOR = 5; 95%CI:1.94–12-92) respectively. Similarly, having chronic illness (AOR = 2.9;95%CI:1.1–7.2), using Bajaj/car for transportation (AOR = 1.9; 95% of CI:1.1–3.3), spent 3–5 hours in sitting or reclining (AOR = 3.7;95% CI:1.6–8.5), taking one bottle of soft drink per day (AOR = 2.0;95% CI: 1.1–3.7) and those who consumed vegetable ≥3 times per day (AOR = 5.7; 95% of CI1.6–19.7). Prevalence of overweight/obesity among adult population in Sodo Town is high. Therefore, prioritizing counseling dietary modification about the risk of overweight /obesity in community level, provision of early care and treatment of chronic illness, regular physical exercise by avoiding sedentary life style are recommended.
Objectives: The purpose of this study was to examine the factors affecting regional disparities in the prevalence of adult obesity.Methods: This study is an ecological study in which the unit of analysis were 229 local authorities (si = 78, gun = 82, and gu = 68). The data were obtained from database (ver 1.1) of community health outcomes and health determinants (2015-2017) and Community Health Survey data (2018-2019). Multiple regression analysis was used to identify factors related to the prevalence of obesity in 4 groups (all regions, si, gun, and gu).Results: The prevalence of regional obesity varied 23.5% to 45.15% with a mean of 34.13%. Obesity prevalence was highest in ‘gun’, and lowest in ‘gu’ area. In the overall model, sociodemographic characteristics including sex ratio (β= 0.26), household income over 3 million won (β= -0.23), and the unemployment (β= -0.18)), high-risk drinking (β= 0.18), and satisfaction with public transportation (β= -0.24) were associated with the prevalence of regional obesity. Other than those things, in ‘si’ area, population density, walking practice, in ‘gun’ area, participation in social activity were associated with the prevalence of regional obesity.Conclusions: To reduce obesity prevalence and it’s regional disparities, it is important to make intervention and prevention efforts taking into account the socioeconomic and physical environmental characteristics of the region as well as health behaviors.
Durch die zunehmende Beliebtheit des Fahrrads als Verkehrsmittel ist in den letzten Jahrzehnten auch die Problematik der mangelnden Sicherheit von Fahrradfahrenden in den Fokus der Verkehrsforschung gerückt. Trotz der zahlreichen Argumente, die für das Fahrradfahren sprechen, verzichten heute noch viele Personen auf das umwelt- und gesundheitsfreundliche Transportmittel aus Angst um die eigene Sicherheit. In Untersuchungen hat sich die Situation zwischen rechtsabbiegenden Autofahrenden und geradeaus fahrenden, die Spur der Autofahrenden querenden Fahrradfahrenden als ein risikobehafteter Konflikt herauskristallisiert. In Zusammenarbeit mit dem Deutschen Zentrum für Luft- und Raumfahrt e.V. (DLR e.V.) wurde im Rahmen des EU-weiten Projekts XCYCLE ein infrastrukturbasiertes Interventionssystem entwickelt, das diesen Konflikt entschärfen soll. Bei dem sogenannten Amber Light handelt es sich um einen adaptiven Schutzblinker, der die rechtsabbiegenden Fahrzeuge mithilfe der intelligenten Vernetzung der Kreuzungs- und Systemelemente vor Konflikten mit geradeaus fahrenden Fahrradfahrenden warnt. Untersucht wurde, ob das Amber Light einen positiven Einfluss auf den Konflikt zwischen rechtsabbiegenden Autofahrenden und querenden Fahrradfahrenden an innerstädtischen Kreuzungen hat. Hierzu wurde es nach einer siebentägigen Erhebung ohne das Amber Light vier Wochen lang an der Anwendungsplattform Intelligente Mobilität (AIM)-Forschungskreuzung in Braunschweig installiert und aktiviert. Mit der Aufstellung des Amber Lights hat die durchschnittliche Geschwindigkeit der Autofahrenden und die relative Häufigkeit kritischer Situationen zugenommen. Trotz des Anstiegs der relativen Häufigkeit aller kritischen Situationen, konnte eine Abnahme der höheren Risikostufen beobachtet werden. Basierend auf den Ergebnissen kann von einer Verhaltensanpassung der Verkehrsteilnehmenden an die durch das Amber Light veränderte Situation ausgegangen werden. Die Verschiebung des Verhältnisses der Risikolevel zu weniger kritischen Risikostufen deutet darauf hin, dass das Amber Light den Konflikt zwischen rechtsabbiegenden Autofahrenden und querenden Radfahrenden entschärft hat.
Introduction
The results of examining the nexus of weight loss and physical activity associated with transit use are mixed. Proponents claim that public transit use is positively associated with weight loss, as it indirectly contributes to active commuting for access and egress. Opponents, however, argue that proof of the effects of transit use on weight loss is expected to be indecisive and practically insignificant.
Methods
This study evaluates the sources of contention between proponents and opponents by systematically reviewing 54 research articles through a rigorous investigation of the source, type, and size of the data alongside baseline Body Mass Index (BMI), transit-use, and access to transit. The review process consists of (1) establishing the criteria of the review, (2) determining the proper keywords, (3) collecting relevant articles from online databases, (4) assessing the eligibility of the articles, (5) eliminating irrelevant results and determining the primary database, (6) conducting a descriptive analysis, (7) synthesizing the data and report the findings, and (8) presenting the conclusions and offering suggestions for further studies.
Results
Three broad patterns can be discerned. First, neither positive nor negative statistically significant association asserted in the existing literature is practically significant. This means, in practice, transit use has no meaningful contribution to weight loss. Second, much of the research employs the cross-sectional design corroborating a correlation rather than causation between transit use and weight loss. Third, neither positive nor negative causation between transit use and weight loss is firmly concluded by research with a longitudinal design. The analysis suggests contradictory outcomes increase as studies employ secondary data, cross-sectional design, access to transit, and self-reported measures.
Conclusions
Findings may be a valuable reference point for researchers and practitioners to reevaluate their interpretation derived from the scientific literature on the association between transit use or access to transit and weight loss. This review assists in distinguishing facts from theories and offers a perspective to diminish the risk of indistinct future outcomes.
Background
While welding has conventionally been known to predispose welders to ocular morbidity (OM), organised sector requires implementation of stringent workplace safety rules. Are welders still predisposed to OM by virtue of their occupation?
Materials and Method
This cross-sectional study involved 552 workers; 276 welders and 276 nonwelders. An interviewer-administered questionnaire was followed by ocular examination and testing by means of a Titmus Vision Tester.
Results
The prevalence of OM among the two study groups comparable in age and duration of employment (DOE), was found to be significantly higher among welders with odds ratio (OR) of 1.75 (95% confidence interval (CI):1.45 - 2.11)) despite regular PPE (personal protective equipment) use. Arc eye was limited to welders. Prevalence of cataract was greater in welders (OR = 3.60, 95% CI: 2.27–5.70) and was associated with a younger age and a shorter DOE compared to nonwelders. There were more cases of diminished colour vision among the welders (OR = 4.09, 95% CI: 1.63 - 10.28) and they did not differ significantly from the nonwelders with the same ocular morbidity in terms of mean age and DOE. Visual field defects, pterygium and myopia were more prevalent among welders; however statistical significance was weak.
Conclusions
Welders have a greater burden of ocular morbidity compared to nonwelders despite regular PPE use.
Top
More than 50 bikeshare programs have been launched in the U.S. since 2010. In this paper, I estimate the effects of bikeshare programs on the prevalence of obesity at the county level. To do so, I merge bikeshare system data with obesity data released by Centers for Disease Control and Prevention, and construct a county-level panel covering the period of 2007–2013. I employ a difference-in-differences empirical framework, in which I compare the obesity rate before and after the introduction of the bikeshare programs in counties that have ever launched bikeshare programs, and use counties that have never introduced bikeshare programs as the control group. Difference-in-differences estimates suggest the significant public health effect of bikeshare programs: the introduction of the bikeshare programs leads to moderate declines in obesity rates; a possible mechanism is its impacts on leisure-time physical activities. I also conduct various additional tests to check the robustness of the above findings. These tests show that the conclusion of this paper is robust to changes to samples and empirical models.
The main objective of this thesis was to analyze the effect of exercise training on the maximal fat oxidation (FATMAX) and the cardiometabolic profile in overweight adolescents, as well as investigating the influence of polymorphisms genes in the ADRB2 and ADRB3 genes. For this, three different studies were conducted, in Study 1, the objective was to compare the influence of two protocols of exercise training on maximal fat oxidation and profile cardiometabolic in overweight adolescents. In Study 2, the same variables as in the first study, plus analysis of possible interactions genetics with the Gln27Glu polymorphism of the ADRB2 gene and in Study 3 with the Trp64Arg of the ADRB3 gene. The total sample consisted of 203 overweight adolescents, of both sexes, aged between 10 and 17 years. The evaluations were carried out in the phase initial and after 12 weeks of intervention programs. the adolescents were submitted to clinical analyses, which measured height, body mass, circumference abdominal (CA), pubertal stage, systolic (SBP) and diastolic (DBP) blood pressure. Body mass index (BMI) and BMI-score Z were calculated. basal insulin concentrations (INS), basal blood glucose (GLI), total cholesterol (TC), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c), lipids total (LT) and triglycerides (TG). Body composition was obtained by bioelectrical impedance (BIA). Physical fitness tests consisted of cardiorespiratory assessment performed by incremental treadmill test and by the maximum strength test (1RM). From the maximum direct oxygen consumption value (VO2max) there was a cardiorespiratory profile classification and FATMAX calculation. in the second and third studies were added to genetic evaluations, in which the genotyping of polymorphisms were performed by the Taqman PCR method. The sample was stratified in two intervention groups with different protocols and a control group without exercise (GControl). The continuous aerobic training group (GTAContinuo) was composed of sessions 90 min of aerobic exercise (45 min of indoor cycling and 45 min of walking) plus 20 min of stretching, totaling 110 minutes. The combined training group (GTCombined) consisted of 10 minutes of warm-up, 6 resistance exercises (3 series; 6-10 rep; 30 minutes), followed by 30 minutes of aerobic exercise (walk/run), totaling 70 min/session. The weekly frequency of groups intervention was three times, for a period of 12 weeks, while the intensity of the aerobic exercises of the protocols was progressive from 35 to 85% of the VO2max or HRR Student's t test or the U - Mann Whitney test was used to compare the adolescents according to sex and analysis of variance (ANOVA) to assess the effects of time and the group x time interaction. For the main variables that had an effect significant in the training group after 12 weeks the paired t test was performed and the Cohen’s d. The significance level adopted was p≤0.05. Results Study 1: by dividing the sample according to sex, boys had greater height (p<0.01), FFM (p<0.01), %MLG (p<0.01), QUICKI (p<0.01), absolute VO2max (p<0.01) and FATMAX (p<0.01), while girls had higher WHtR (p<0.01), %MG (p<0.01) and TG (p=0.04). After 12 weeks, among girls, the interaction factor group x time indicated that GTAContinuous greater reduction in BM (p<0.01), BMI (p<0.01), BMI-z (p<0.01), and, increase in HDL-c (p<0.01), absolute VO2max (p<0.02), VO2max relative to MLG (p<0.01) and FATMAX (p<0.04). In addition, in GTCombinado there was a greater reduction in MG (p<0.01) and %MG (p<0.01), and more significant increase in FFM (p<0.01) and QUICKI (p<0.01). Between the boys, there was a greater reduction in BM (p=0.01), BMI (p=0.01), BMI-z in the GTAContinuos (p=0.01), CA (p=0.01) and RCEst (p=0.01), as well as an increase in FATMAX (p=0.01), while in GTCombinado there was a greater reduction in MG (p=0.01), %MG (p=0.03) and HOMA-IR (p=0.01), and, more than QUICKI increase (p=0.01). Finally, in GControle there was increase in DBP (p=0.01). Conclusion Study 1: both intervention protocols resulted in improvements in health parameters among adolescents, however the TAContinuo was more efficient in increasing the maximal fat oxidation and the TCombined provided a more effective decrease in fat mass and increased insulin sensitivity in overweight adolescents of both sexes. Results Study 2: the frequency of the 27Glu allele was 24.68% (p=0.13). the bearers of the 27Gln allele showed lower means of RCEst (p=0.03) and TC (p=0.03), as well as higher FATMAX rates (p=0.02) when compared to carriers of the 27Glu allele. After 12 weeks, carriers of the 27Gln allele of GTAContinuo OBTAINED greater reduction of MC (p<0.01), BMI (p<0.01), BMI-z (p<0.01), CA (p<0.01) and RCEst (p<0.01), in addition to increase in HDL-c (p<0.01) and absolute VO2max (p=0.01). However, allele carriers 27Gln of GTCombinado showed greater reduction of MG (p<0.01), %MG (p<0.01) and FCMAX (p=0.05), as well as an increase in MLG (p=0.05), QUICKI (p<0.01) and VO2max relative to FFM (p<0.01). Among the carriers of the 27Glu allele of GTCombinado, it was observed greater reduction of HOMA-IR (p<0.01) and FATMAX zone (p=0.02), in addition to increase of FATMAX (p<0.01). Finally, an increase in DBP (p=0.01) was identified among allele carriers 27Glu of the GControl. Conclusion Study 2: carriers of the 27Gln allele in GTAContinuous benefited from the reduction of adiposity parameters, in addition to the increase in HDL-c and absolute VO2max and reduction of fat mass and FCMAX, and in GTCombinado they obtained increase in MLG, QUICKI and VO2max relative to MLG. However, among allele carriers 27Glu of GTCombinado showed greater reduction of HOMA-IR and FATMAX zone, in addition to of increase of FATMAX. Finally, an increase in DBP was identified among patients with 27Glu allele of the GControl. Results Study 3: The allelic frequency of 64Arg was 16.46% (p=0.67). Adolescents carrying the polymorphism (64Arg allele) presented higher means TC (p<0.01), LDL-c (p<0.01) and HRREP (p=0.04) compared to noncarriers of the polymorphism (64Trp allele). After 12 weeks, group x interaction was observed time only of the 64Trp allele and the GTAContinuous in the reduction of the BMI-z (p=0.01). The effect time indicated that there were reductions in BMI-z, AC, MG, %MG, in groups GTAContinuo and GCombined, regardless of the presence or absence of the polymorphism. It was also noticed increase in HDL-c, VO2max and FATMAX (GTAContinuous > GTCombinado), as well as decrease in HOMA-IR and increase in QUICKI (GTCombined > GTAContinuous) in both the genotypes. In addition, in GTAContinuo the 64Arg allele carriers presented significant reduction in FCREP (p=0.00) and in GTCombinado the 64Trp allele carriers showed a significant reduction in insulin (p=0.01). Conclusion Study 3: the intervention protocols provided results on cardiometabolic and FATMAX, regardless of the Trp64Arg polymorphism, however there was an interaction between the allele 64Trp and GTAContinuous only for IMC-z. Final Considerations: physical exercise proved to be an essential factor in promoting important biological adaptations with relevant implications for preventing the risk of development or progression of obesity and its related diseases in both sexes. There was interaction between carriers and non-carriers of the Gln27Glu polymorphism in both protocols training, with emphasis on carriers of the 27Glu allele of GTCombinado that showed greater reductions in insulin resistance and increased FATMAX. Regarding to the Trp64Arg polymorphism, both training protocols promoted reductions in body composition, improvement of cardiometabolic parameters and maximal fat oxidation, regardless of the presence or absence of the polymorphism.
Keywords: lipolysis, genetic polymorphism, physical exercise, cardiometabolic profile, adolescents.
This paper describes the redesign, field-testing, and convergent validity of a practical tool—Physical Activity Campus Environmental Supports (PACES) audit. Methods. The audit includes two parts: (1) PACES-Programs, which is comprised of questions regarding populations served, fees, programs (recreation/fitness classes and intramurals), proximity, adequacy of facilities, and marketing, and (2) PACES-Facilities, which is comprised of questions regarding built environment (aesthetics, bike racks, stairs, and universal design), recreation equipment, staff, amenities, and access. Each item criterion is specifically scored using a five-point, semantic-differential scale ranging from limited to extensive environmental support. A few questions utilize select all that apply for a summed score. PACES training, interrater reliability, and data collection are all accessible via an online portal. PACES was tested on 76 college campuses. Convergent validity was examined by comparing the PACES-Programs questions to Healthy Campus Initiatives-Programs questions (HCI-Programs) and comparing the PACES-Facilities questions to questions contained in the Physical Activity Resource Assessment (PARA) Instrument. Statistical analyses included Cronbach’s alpha, ANOVA, latent profile analysis, and Spearman correlations. Results. The PACES-Programs audit includes 10 items for a potential total of 73 points (α = 0.72) and PACES-Facilities audit includes 15 items for a potential total of 77 points (α = 0.837). Most (77.8%) of the 153 facilities assessed scored in the most healthful range (20–42), which was mainly due to the extensiveness of the aerobic equipment/amenities and the competence/accessibility of staff. Significant differences in PACES-Total and PACES-Programs scores were associated with campus size and PACES-Facilities across regions. For the paired validation assessments, correlations were significant between PACES-Programs and HCI-Programs ((n=41) r=0.498, p
The effects of urbanisation on the overweight epidemic in nineteen countries of Latin America and the Caribbean (LAC) region, from 1975 to 2016, was researched applying the Quantile via Moments model. The results support that urbanisation has contributed to intensifying the overweight epidemic that materializes in LAC countries. The deepening of urbanisation allows the presence of fast-food chains, supermarkets, and multinational supermarkets, offering a ready supply of processed foods. Also contributes to the increase in travelling by motorised vehicles and less walking or biking, which reduces the energy caloric expenditure and subsequently contribute to overweight and obesity. This process also influences the creation of more sedentary jobs, such as desk and manufacturing jobs, and consequently reduce the creation of fewer active jobs, such as farming. Active measures should be taken to mitigate the effect of urbanisation on the overweight epidemic. Restrict the sale of unhealthy food through taxation; promote health campaigns backed by the media; overhaul the regulatory system that allows industry-sponsorships and revert their massive influence on markets and mindsets; apply policies that emphasise the need to practice physical activity, and a balanced diet; limit the influence of corporate lobby groups from multinational food corporations to put health first; and stimulate the local governments to encourage the food sector to produce and deliver foods that are enjoyable, affordable, and nutrient-rich.
Our current consumption patterns cause high levels of CO 2 emissions. Encouraging sustainable lifestyle changes is one tool among many to reduce emissions. Looking towards the public health literature, we identify three strategies for dealing with excess consumption: redeem, replace and reduce . We highlight the benefits and challenges that individuals face when employing these strategies. Finally, we present a promising approach to moving beyond individual-level strategies and their challenges.
Introducción: Uno de los grandes retos de la sociedad es combatir el sedentarismo para prevenir la aparición de enfermedades y problemas cardiovasculares asociados a la inactividad física. Los sistemas de bicicletas públicos son una alternativa sostenible y equitativa que se ofrece desde las distintas instituciones para paliar, en cierta forma, los bajos niveles de actividad física, reducir los niveles de contaminación de las ciudades y los problemas de tráfico a motor.
Objetivo: Conocer si los usuarios del sistema público de bicicletas compartidas de Vilagarcía de Arousa (España) cumplen con las recomendaciones de actividad física para la salud establecidas por la OMS.
Material y Métodos: En este estudio de cortelongitudinal se realiza un análisis del uso de las bicicletas compartidas en un municipio del noroeste de España para comprobar si alcanzan las recomendaciones mínimas de actividad física para la salud marcadas por la OMS en el año 2010. Se utilizó el programa informático SPSS para realizar los cálculos estadísticos. La muestra estuvo compuesta por un total de 3268 usuarios del servicio de bicicletas compartidas y se contabilizó un total de 84183 usos desde el 17 de julio de 2009 hasta el 18 de enero de 2012.
Resultados: Los resultados indican que los usuarios del sistema Vaibike de Vilagarcía de Arousa cumplen las recomendaciones mínimas de actividad física dado que la media de minutos de uso de las bicicletas es superior a 30 minutos.
Conclusiones: Los trayectos que han tenido más media de minutos de uso de las bicicletas del sistema han sido los correspondientes con el centro y los que transcurren por la costa de la ciudad, superando los 30 minutos de uso y cumpliendo las recomendaciones marcadas por la OMS en el año 2010.
This study identifies the most valued factors for potential bicycle users on work trips and evaluate the impact of implementing different strategies to improve bicycle use. We applied an online stated-preference survey from 127 Companhia Riograndense de Saneamento (CORSAN) employees in Porto Alegre (Brazil). Then, we formulated hybrid ordered logit models to estimate the probability of bicycle use under different hypothetical scenarios. The results showed that locker rooms, bicycle parking, bike-sharing systems (bike loaner programs run by the company), training for employees in bicycle use and the presence of bike paths for access to CORSAN all encourage bicycle use. The availability of locker rooms proved to be the most important variable. The joint implementation of locker rooms, bicycle parking and bike-sharing systems (loaner programs) would increase demand by 66%. The strategies discussed in this article can easily be adapted to other contexts where there is a desire to increase shared bicycle commuting to workplaces.
Introduction
Overweight and obesity are significant health issues in the modern era and correlate with daily activities, including travelling. This study focuses on understanding the relationship between overweight/obesity and travel patterns and built environment for individuals belonging to different socioeconomic groups for developing countries, where limited research is witnessed from a transportation perspective on such health parameters.
Method
The data was collected using a face-to-face home interview survey in Navi Mumbai city in Maharashtra. The sample size used for the analysis is 4253 respondents. A logistic regression model is developed to assess the impact of travel patterns, socioeconomic factors, and built environment around an individual on the likelihood of getting overweight/obese.
Results
The results indicate that commuting by private modes is associated with increased chances of getting overweight/obese. In contrast, a negative association is observed in the chances of getting overweight/obese if commuting by active mode. The study provides quantitative support on the relationship between commuting vehicle preferences and their chances of getting overweight/obese. The interaction of walk score and population density suggests that the probability of getting overweight/obese reduces at higher values of walk score as the population density increases. The odds ratio helps understand the impact of different travel modes and their risk on the likelihood of being overweight/obese within a specific age category.
Conclusion
The highest risk is observed for car/cab users compared to other modes in all age categories. The study highlights the importance of sustainable transportation modes (walking and public transport) on overweight/obesity—a crucial physical wellbeing parameter. Improving walkability measures such as walk score coupled with appropriate population density and efficient public transport system can be effective public health intervention and overweight/obesity preventative strategies.
Context The prevalence of obesity and overweight increased in the United States
between 1978 and 1991. More recent reports have suggested continued increases
but are based on self-reported data.Objective To examine trends and prevalences of overweight (body mass index [BMI]
≥25) and obesity (BMI ≥30), using measured height and weight data.Design, Setting, and Participants Survey of 4115 adult men and women conducted in 1999 and 2000 as part
of the National Health and Nutrition Examination Survey (NHANES), a nationally
representative sample of the US population.Main Outcome Measure Age-adjusted prevalence of overweight, obesity, and extreme obesity
compared with prior surveys, and sex-, age-, and race/ethnicity–specific
estimates.Results The age-adjusted prevalence of obesity was 30.5% in 1999-2000 compared
with 22.9% in NHANES III (1988-1994; P<.001).
The prevalence of overweight also increased during this period from 55.9%
to 64.5% (P<.001). Extreme obesity (BMI ≥40)
also increased significantly in the population, from 2.9% to 4.7% (P = .002). Although not all changes were statistically significant,
increases occurred for both men and women in all age groups and for non-Hispanic
whites, non-Hispanic blacks, and Mexican Americans. Racial/ethnic groups did
not differ significantly in the prevalence of obesity or overweight for men.
Among women, obesity and overweight prevalences were highest among non-Hispanic
black women. More than half of non-Hispanic black women aged 40 years or older
were obese and more than 80% were overweight.Conclusions The increases in the prevalences of obesity and overweight previously
observed continued in 1999-2000. The potential health benefits from reduction
in overweight and obesity are of considerable public health importance.
The prevalence of obesity increased in the United States between 1976-1980 and 1988-1994 and again between 1988-1994 and 1999-2000.
To examine trends in obesity from 1999 through 2008 and the current prevalence of obesity and overweight for 2007-2008.
Analysis of height and weight measurements from 5555 adult men and women aged 20 years or older obtained in 2007-2008 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Data from the NHANES obtained in 2007-2008 were compared with results obtained from 1999 through 2006.
Estimates of the prevalence of overweight and obesity in adults. Overweight was defined as a body mass index (BMI) of 25.0 to 29.9. Obesity was defined as a BMI of 30.0 or higher.
In 2007-2008, the age-adjusted prevalence of obesity was 33.8% (95% confidence interval [CI], 31.6%-36.0%) overall, 32.2% (95% CI, 29.5%-35.0%) among men, and 35.5% (95% CI, 33.2%-37.7%) among women. The corresponding prevalence estimates for overweight and obesity combined (BMI > or = 25) were 68.0% (95% CI, 66.3%-69.8%), 72.3% (95% CI, 70.4%-74.1%), and 64.1% (95% CI, 61.3%-66.9%). Obesity prevalence varied by age group and by racial and ethnic group for both men and women. Over the 10-year period, obesity showed no significant trend among women (adjusted odds ratio [AOR] for 2007-2008 vs 1999-2000, 1.12 [95% CI, 0.89-1.32]). For men, there was a significant linear trend (AOR for 2007-2008 vs 1999-2000, 1.32 [95% CI, 1.12-1.58]); however, the 3 most recent data points did not differ significantly from each other.
In 2007-2008, the prevalence of obesity was 32.2% among adult men and 35.5% among adult women. The increases in the prevalence of obesity previously observed do not appear to be continuing at the same rate over the past 10 years, particularly for women and possibly for men.
The recent White Paper, 'Scotland's Health: A Challenge To Us All', emphasises the importance of lifestyle factors, such as smoking, diet and exercise, in Scotland's poor health record. Targets are to be set for improvements in diet, and individuals will be encouraged to improve their eating habits. In this paper we suggest that attention should be given to the price and availability of healthy foods, particularly in socio-economically deprived areas. To illustrate the possible importance of this, we present findings from a small exploratory study of two socially contrasting and non-contiguous localities in Glasgow which indicates that price disincentives to eating healthy may be greater in poorer than in more affluent areas.
The purpose of this study was to analyse misclassification of height, weight and body mass index (BMI), derived from mail questionnaires, and its dependency on socioeconomic factors.
A random sample of 4442 adults aged 18-84 years, living in Stockholm county, Sweden, were in 1984-1985 asked about their height and weight. A few months later 3208 of these adults participated in a health examination that included measures of height and weight. In this study we have used occupational class as the socioeconomic indicator. We have used sensitivity as a measure of misclassification of height, weight and BMI.
The difference in mean measured height between socioeconomic groups I and III was 2.7 cm for men and 2.0 cm for women. The mean difference in measured height between socioeconomic groups I and III was higher for men than for women in all age groups. The mean difference between self-reported and measured height was 0.6 cm for men and 0.79 cm for women. For weight, the corresponding difference was -0.74 kg for men and -1.64 kg for women. Women's BMI was more underestimated than men's (-0.85 for women, -0.40 for men). When using self-reported height and weight for calculating BMI, 81% of the men and 78% of the women were classified correctly, but only 61% of the obese men and 55% of the obese women were identified. The BMI was underestimated in all socioeconomic groups. Manual workers had a lower proportion of underweight, compared to professionals and intermediate non-manual workers, while the objective measure showed the inverse relationship. The prevalence of overweight and obesity in men was 42% higher in socioeconomic group III compared with group I with self-reported data compared with 28% when measured. Underestimation of BMI was highest among women, the obese, the elderly, and male non-manual workers and female manual workers.
Our study shows that socioeconomic differences in height, when using self-reported information, involve an underestimation. This means that the height differences between socioeconomic groups in Sweden may actually be higher than that reported by individuals in surveys. The socioeconomic differences in underweight tend to be underestimated for men, as well as obesity for women, when using self-reported information. The socioeconomic differences in overweight and obesity are shown to be overestimated for men.
In light of the well-documented health benefits of physical activity and the fact that the majority of adult men and women are inactive, promoting regular physical activity is a public health priority. This chapter reviews current research findings regarding the determinants of exercise behavior. It also discusses the implications of this knowledge for individual and public health recommendations and intervention strategies for promoting physical activity. The discussion is predicated on the belief that physical activity is a complex, dynamic process. During their lives, individuals typically move through various phases of exercise participation that are determined by diverse factors. This chapter discusses physical activity determinants in two broad categories: individual characteristics, including motivations, self-efficacy, exercise history, skills, and other health behaviors; and environmental characteristics such as access, cost, and time barriers and social and cultural supports.
Because larger food portions could be contributing to the increasing prevalence of overweight and obesity, this study was designed to weigh samples of marketplace foods, identify historical changes in the sizes of those foods, and compare current portions with federal standards.
We obtained information about current portions from manufacturers or from direct weighing; we obtained information about past portions from manufacturers or contemporary publications.
Marketplace food portions have increased in size and now exceed federal standards. Portion sizes began to grow in the 1970s, rose sharply in the 1980s, and have continued in parallel with increasing body weights.
Because energy content increases with portion size, educational and other public health efforts to address obesity should focus on the need for people to consume smaller portions.
Dependence on motorized forms of transportation may contribute to the worldwide obesity epidemic. Shifts in transportation patterns occurring in China provide an ideal opportunity to study the association between vehicle ownership and obesity. Our objective was to determine whether motorized forms of transportation promote obesity.
A multistage random-cluster sampling process was used to select households from eight provinces in China. Data were included on household vehicle ownership and individual anthropometric and sociodemographic status. Cross-sectional data (1997) from 4741 Chinese adults aged 20 to 55 years were used to explore the association between vehicle ownership and obesity. Cohort data (1989 to 1997) from 2485 adults aged 20 to 45 years in 1989 (59% follow-up) were used to measure the impact of vehicle acquisition on the odds of becoming obese.
Our main outcome measure was current obesity status and the odds of becoming obese over an 8-year period. In 1997, 84% of adults did not own motorized transportation. However, the odds of being obese were 80% higher (p < 0.05) for men and women in households who owned a motorized vehicle compared with those who did not own a vehicle. Fourteen percent of households acquired a motorized vehicle between 1989 and 1997. Compared with those whose vehicle ownership did not change, men who acquired a vehicle experienced a 1.8-kg greater weight gain (p < 0.05) and had 2 to 1 odds of becoming obese.
Encouraging active forms of transportation may be one way to protect against obesity.
The prevalence of obesity and overweight increased in the United States between 1978 and 1991. More recent reports have suggested continued increases but are based on self-reported data.
To examine trends and prevalences of overweight (body mass index [BMI] > or = 25) and obesity (BMI > or = 30), using measured height and weight data.
Survey of 4115 adult men and women conducted in 1999 and 2000 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population.
Age-adjusted prevalence of overweight, obesity, and extreme obesity compared with prior surveys, and sex-, age-, and race/ethnicity-specific estimates.
The age-adjusted prevalence of obesity was 30.5% in 1999-2000 compared with 22.9% in NHANES III (1988-1994; P<.001). The prevalence of overweight also increased during this period from 55.9% to 64.5% (P<.001). Extreme obesity (BMI > or = 40) also increased significantly in the population, from 2.9% to 4.7% (P =.002). Although not all changes were statistically significant, increases occurred for both men and women in all age groups and for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Racial/ethnic groups did not differ significantly in the prevalence of obesity or overweight for men. Among women, obesity and overweight prevalences were highest among non-Hispanic black women. More than half of non-Hispanic black women aged 40 years or older were obese and more than 80% were overweight.
The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000. The potential health benefits from reduction in overweight and obesity are of considerable public health importance.
Research in transportation, urban design, and planning has examined associations between physical environment variables and individuals' walking and cycling for transport. Constructs, methods, and findings from these fields can be applied by physical activity and health researchers to improve understanding of environmental influences on physical activity. In this review, neighborhood environment characteristics proposed to be relevant to walking/cycling for transport are defined, including population density, connectivity, and land use mix. Neighborhood comparison and correlational studies with nonmotorized transport outcomes are considered, with evidence suggesting that residents from communities with higher density, greater connectivity, and more land use mix report higher rates of walking/cycling for utilitarian purposes than low-density, poorly connected, and single land use neighborhoods. Environmental variables appear to add to variance accounted for beyond sociodemographic predictors of walking/cycling for transport. Implications of the transportation literature for physical activity and related research are outlined. Future research directions are detailed for physical activity research to further examine the impact of neighborhood and other physical environment factors on physical activity and the potential interactive effects of psychosocial and environmental variables. The transportation, urban design, and planning literatures provide a valuable starting point for multidisciplinary research on environmental contributions to physical activity levels in the population.
I sought to examine whether pedestrian-oriented, mixed-use neighborhoods encourage enhanced levels of social and community engagement (i.e., social capital).
The study investigated the relationship between neighborhood design and individual levels of social capital. Data were obtained from a household survey that measured the social capital of citizens living in neighborhoods that ranged from traditional, mixed-use, pedestrian-oriented designs to modern, car-dependent suburban subdivisions in Galway, Ireland.
The analyses indicate that persons living in walkable, mixed-use neighborhoods have higher levels of social capital compared with those living in car-oriented suburbs. Respondents living in walkable neighborhoods were more likely to know their neighbors, participate politically, trust others, and be socially engaged.
Walkable, mixed-use neighborhood designs can encourage the development of social capital.
The aim of this study was to investigate the 1986-1994 trend in obesity, overweight and sedentary leisure-time physical activity status, and the educational gradient in overweight and obesity in the city of Malmö, Sweden.
The public health surveys in Malmö 1986 and 1994 are cross-sectional studies. A total of 4,800 and 5,600 individuals aged 20-80 years were randomly chosen to be interviewed by a postal questionnaire. The participation rates were 74% and 71%. Obesity was defined as BMI 30.0 or more and overweight as BMI 25.0-29.9. The prevalences of leisure-time physical inactivity, obesity and overweight were computed, and the differences between 1986 and 1994 as well as educational gradients in overweight and obesity were assessed.
The prevalence of obesity increased from 4.6% to 11.4% (p<0.001) among men and from 6.1% to 9.8% (p<0.001) among women. The prevalence of overweight (BMI 25.0-29.9) increased from 33.9% to 45.2% (p<0.001) among men, and from 19.6% to 29.1% (p<0.001) among women. The prevalence of leisure time physical inactivity increased among men from 14.7% to 18.1% (p<0.001) among men and from 19.4% to 26.7% (p<0.001) among women. The increasing prevalences of obesity, overweight and physical inactivity were observed in all age, country of origin and educational status groups. The educational differences in BMI 25.0+ observed among both men and women in 1986 disappeared among men in 1994. In contrast, educational differences in obesity (BMI 30.0+), not seen in 1986, appeared in 1994 among men.
The proportions of the population with obesity and overweight increased significantly between 1986 and 1994 for both men and women. The increasing prevalence of physical inactivity seems to be an important explanation.
Prevalence of obesity in the United States has increased dramatically in recent decades, but the magnitude of change in cardiovascular disease (CVD) risk factors among the growing proportion of overweight and obese Americans remains unknown.
To examine 40-year trends in CVD risk factors by body mass index (BMI) groups among US adults aged 20 to 74 years.
Analysis of 5 cross-sectional, nationally representative surveys: National Health Examination Survey (1960-1962); National Health and Nutrition Examination Survey (NHANES) I (1971-1975), II (1976-1980), and III (1988-1994); and NHANES 1999-2000.
Prevalence of high cholesterol level (> or =240 mg/dL [> or =6.2 mmol/L] regardless of treatment), high blood pressure (> or =140/90 mm Hg regardless of treatment), current smoking, and total diabetes (diagnosed and undiagnosed combined) according to BMI group (lean, <25; overweight, 25-29; and obese, > or =30).
The prevalence of all risk factors except diabetes decreased over time across all BMI groups, with the greatest reductions observed among overweight and obese groups. Compared with obese persons in 1960-1962, obese persons in 1999-2000 had a 21-percentage-point lower prevalence of high cholesterol level (39% in 1960-1962 vs 18% in 1999-2000), an 18-percentage-point lower prevalence of high blood pressure (from 42% to 24%), and a 12-percentage-point lower smoking prevalence (from 32% to 20%). Survey x BMI group interaction terms indicated that compared with the first survey, the prevalence of high cholesterol in the fifth survey had fallen more in obese and overweight persons than in lean persons (P<.05). Survey x BMI changes in blood pressure and smoking were not statistically significant. Changes in risk factors were accompanied by increases in lipid-lowering and antihypertensive medication use, particularly among obese persons. Total diabetes prevalence was stable within BMI groups over time, as nonsignificant 1- to 2-percentage-point increases occurred between 1976-1980 and 1999-2000.
Except for diabetes, CVD risk factors have declined considerably over the past 40 years in all BMI groups. Although obese persons still have higher risk factor levels than lean persons, the levels of these risk factors are much lower than in previous decades.
To examine possible associations between driving to work, physical activity and overweight and obesity.
Secondary analysis of cross-sectional data from a representative sample of the 2003 New South Wales Adult Health Survey, Australia.
A total of 6810 respondents aged 16 years or over.
Self-reported height and weight, modes of transport to work, level of physical activity, fruit and vegetable intake and social-economic status.
Almost half of the respondents (49%) were overweight. The main mode of transport to work was driving a car (69%), 15% used public transport, 7% walked, 2% cycled and 6% worked at home. People who drove to work were less likely to achieve recommended levels of physical activity compared to non-car users (56.3 vs 44.3%, chi2 = 82.5, P<0.0001). Driving to work was associated with being overweight or obese (adjusted odds ratio = 1.13 (95% CI 1.01-1.27), P = 0.047). Inadequate level of physical activity was independently associated with overweight or obesity. Socially and economically disadvantaged people were also more likely to be overweight and obese. In addition, being female or never married or having higher level of education was associated with a significantly reduced odds ratio of being overweight or obese, as was speaking a language other than English at home. No association was found between weight status and recommended vegetable or fruit intake.
Driving to work is the dominant mode of commuting in a modern society and its impact on health requires scrutiny. The association found in this study between driving to work and overweight and obesity warrants further investigation to establish whether this relationship is causal. If proved as such, then promoting active transport modes such as walking, cycling and public transport should form a key component of global obesity prevention efforts.
Research in transportation, urban design, and planning has examined associations between physical environment variables and individuals' walking and cycling for transport. Constructs, methods, and findings from these fields can be applied by physical activity and health researchers to improve understanding of environmental influences on physical activity. In this review, neighborhood environment characteristics proposed to be relevant to walking/cycling for transport are defined, including population density, connectivity, and land use mix. Neighborhood comparison and correlational studies with nonmotorized transport outcomes are considered, with evidence suggesting that residents from communities with higher density, greater connectivity, and more land use mix report higher rates of walking/cycling for utilitarian purposes than low-density, poorly connected, and single land use neighborhoods. Environmental variables appear to add to variance accounted for beyond sociodemographic predictors of walking/cycling for transport. Implications of the transportation literature for physical activity and related research are outlined. Future research directions are detailed for physical activity research to further examine the impact of neighborhood and other physical environment factors on physical activity and the potential interactive effects of psychosocial and environmental variables. The transportation, urban design, and planning literatures provide a valuable starting point for multidisciplinary research on environmental contributions to physical activity levels in the population.
Increases in per capita vehicle usage and associated emissions have spawned an increased examination of the ways in which our communities and regions are developing. Associated with increased vehicle usage are decreased levels of walking and biking, two valid forms of physical activity. The Surgeon General's 1996 report, Physical Activity and Health, highlights the increasing level of physical inactivity as a growing cause of mortality. The costs and benefits of contrasting land development and transportation investment practices have been the subject of considerable debate in the literature. Findings have been refuted based on methodological grounds and inaccurate interpretation of data. Several of these studies, their methodological approaches, and their critiques are analyzed. While most agree that the built environment influences travel, considerable disagreement exists over the likely impacts of increased density, mix, and street connectivity on air quality, and on transportation system performance and household activity patterns.
Increases in per capita vehicle usage and associated emissions have spawned an increased the examination of the ways in which our communities and regions are developing. Associated with increased vehicle usage are decreased levels of walking and biking, two valid forms of physical activity. The Surgeon General's 1996 report, Physical Activity and Health, highlights the increasing level of physical inactivity as a growing cause of mortality. The costs and benefits of contrasting land development and transportation investment practices have been the subject of considerable debate in the literature. Findings have been refuted based on methodological grounds and inaccurate interpretation of data. Several of these studies, their methodological approaches, and their critiques are analyzed. While most agree that the built environment influences travel, considerable disagreement exists over the likely impacts of increased density, mix, and street connectivity on air quality, transportation system performance, and household activity patterns.
The association between leisure time physical activity and the risk of all-cause and cardiovascular disease mortality was analyzed in a Finnish cohort of 1,072 men age 35-63 years who were followed up for 10 years and 10 months. During the period, 168 deaths were recorded, 93 of which were the result of cardiovascular diseases. Leisure time physical activity was assessed by several measures: 1) a single question combining an estimate of the frequency and intensity of the total amount of leisure time physical activity, 2) a compiled measure of leisure time physical activity derived from three separate questions concerning the intensity and frequency of activity, 3) a physical energy expenditure index computed as an estimate of weekly energy expenditure for leisure time activity and commuting to work, 4) 16 separate specified activities of daily living and domestic chores included in the leisure time physical activity index. The association between baseline leisure time physical activity and the risk of death was assessed using the Cox proportional hazards model. After adjustment for potential confounders, the leisure time physical activity energy expenditure index and participation in several specific activities of daily living and domestic chores showed that the mortality risk for all causes and cardiovascular diseases was highest in the most sedentary men. With respect to the leisure time physical activity energy expenditure index, sedentary men ( those with an estimated weekly energy expenditure in leisure time physical activity of < 800 kcal) had an increased risk of 2.74 (95% confidence interval 1.46-5.14) for all-cause mortality and a risk of 3.58 (95% confidence interval 1.45-8.85) for cardiovascular disease mortality compared with the most active persons (those with an estimated weekly energy expenditure in leisure time physical activity of at least 2,100 kcal) when age, initial health status, marital status, employment status, and smoking were controlled.
Several studies have shown socioeconomic differences in leisure-time physical activity. One explanation may be socioeconomic differences in relevant psychosocial conditions. The Malmö Diet and Cancer Study is a prospective cohort study including inhabitants in Malmö, Sweden. The baseline questionnaire used in this cross-sectional study was completed by the 11,837 participants born 1926-1945 in 1992-1994. Leisure-time physical activity was measured by an item presenting a variety of activities. These activities were aggregated into a summary measure of leisure-time physical activity that takes both the intensity and duration of each specific activity into consideration. The effects of the psychosocial variables on the socioeconomic differences in leisure-time physical activity were calculated in a multivariate logistic regression analysis. The quartile with the lowest degree of leisure-time physical activity was not evenly distributed between the socioeconomic groups. Socioeconomic differences were seen as odds ratios 1.5 for skilled and 1.5 for unskilled male manual workers, compared to the high level non-manual employees. An OR 1.6 was observed for female unskilled manual workers. Self-employed men and female pensioners also had a significantly increased risk of low leisure-time physical activity. Adjustment for age, country of origin and previous/current diseases had no effect on these SES differences. Finally, adjusting for social participation almost completely erased the SES differences. Among the psychosocial variables, social participation was the strongest predictor of low physical activity, and a strong predictor for socioeconomic differences in low leisure-time physical activity. Social participation measures the individual's social activities in, for example political parties and organisations. It therefore seems possible that some of the socioeconomic differences in leisure-time physical activity are due to differing social capital between socioeconomic groups.
Promoting physical activity is a public health priority, and changes in the environmental contexts of adults' activity choices are believed to be crucial. However, of the factors associated with physical activity, environmental influences are among the least understood.
Using journal scans and computerized literature database searches, we identified 19 quantitative studies that assessed the relationships with physical activity behavior of perceived and objectively determined physical environment attributes. Findings were categorized into those examining five categories: accessibility of facilities, opportunities for activity, weather, safety, and aesthetic attributes.
Accessibility, opportunities, and aesthetic attributes had significant associations with physical activity. Weather and safety showed less-strong relationships. Where studies pooled different categories to create composite variables, the associations were less likely to be statistically significant.
Physical environment factors have consistent associations with physical activity behavior. Further development of ecologic and environmental models, together with behavior-specific and context-specific measurement strategies, should help in further understanding of these associations. Prospective studies are required to identify possible causal relationships.
Physical inactivity is associated with multiple adverse health outcomes. Results from the transportation literature suggest that aspects of the urban environment may influence walking for transportation. In this paper we examine the association between a proxy measure of the urban environment and walking behavior.
We analyzed the association between home age and walking behavior in U.S. adults using data from the Third National Health and Nutrition Examination Survey. Logistic regression was used to estimate odds ratios and 95% confidence intervals and to control for the effects of gender, race/ethnicity, age, education level, household income, and activity limitations.
Adults who lived in homes built before 1946 and from 1946 to 1973 were significantly more likely to walk 1+ miles > or =20 times per month than those who lived in homes built after 1973. This association was present among people living in urban and suburban counties, but absent among those living in rural counties. The association was also found in models that controlled for gender, race/ethnicity, age, education, income, and any health-related activity limitation. Other forms of leisure-time physical activity were not independently associated with home age.
These results support the hypothesis that environmental variables influence walking frequency and suggest that home age may be a useful proxy for features of the urban environment that influence physical activity in the form of walking. Such proxy measures could facilitate testing ecologic models of health behavior using survey data.
Research on physical activity and the physical environment is at the correlates stage, so it is premature to attribute causal effects. This paper provides a conceptual approach to understanding how the physical design of neighborhoods may influence behavior by disentangling the potential effects of income, university education, poverty, and degree of urbanization on the relationship between walking to work and neighborhood design characteristics.
The study merges Canadian data from 27 neighborhood observations with information on walking to work from the 1996 census. Hierarchical linear modeling was used to create a latent environment score based on 18 neighborhood characteristics (e.g., variety of destinations, visual aesthetics, and traffic). The relationship between the environment score and walking to work was modeled at the second level, controlling for income, university education, poverty, and degree of urbanization.
With the exceptions of visual interest and aesthetics, each neighborhood characteristic contributed significantly to the environment score. The environment score was positively associated with walking to work, both with and without adjustment for degree of urbanization. Controlling for university education, income, and poverty did not influence these relationships.
The positive association between the environment score and walking to work, controlling for degree of urbanization supports the current movement toward the development of integrated communities for housing, shops, workplaces, schools, and public spaces. Given the need for research to guide environmental interventions, collaboration among public health practitioners, urban planners, and transportation researchers is essential to integrate knowledge across sectors.
We studied the association between the local food environment and residents' report of recommended dietary intake.
Recommended intakes of foods and nutrients for 10 623 Atherosclerosis Risk in Communities participants were estimated from food frequency questionnaires. Supermarkets, grocery stores, and full-service and fast-food restaurants were geocoded to census tracts.
Black Americans' fruit and vegetable intake increased by 32% for each additional supermarket in the census tract (relative risk [RR] = 1.32; 95% confidence interval [CI] = 1.08, 1.60). White Americans' fruit and vegetable intake increased by 11% with the presence of 1 or more supermarket (RR = 1.11; 95% CI = 0.93, 1.32).
These findings suggest the local food environment is associated with residents' recommended diets.
The purpose of this paper was to describe the epidemiology of walking for physical activity among respondents to the U.S. Physical Activity Study. Correlates of walking among people who never walk for physical activity, those who walk regularly, and people who walk occasionally were compared.
Data on walking, personal and environmental correlates, and sociodemographics were collected via telephone using a modified random-digit-dialing technique on a national sample. Three categories were analyzed: Regular walkers were those who met public health recommendations by walking (5x wk-1 and 30 min at a time), occasional walkers were those who walked for physical activity but did not meet this recommendation, and never walkers were those who never walked for physical activity. Multiple logistic regression resulting in odds ratios (OR) and 95% confidence intervals were calculated.
Thirty-four percent of this population were regular walkers, 45.6% occasional walkers, and 20.7% never walkers. Walkers reported using neighborhood streets, shopping malls, and parks for walking. Regular walkers had more self-confidence and more social support than occasional or never walkers. Occasional and never walkers reported time as a barrier more than regular walkers (OR 1.91 and 2.36). Never walkers were more likely (OR 3.25) to report feeling unhealthy and more likely (OR 4.43) to report lacking energy to exercise.
Our results identify important information that can be used to help guide future interventions that promote walking as a form of physical activity. An ecological approach that combines individual (e.g., self-confidence), interpersonal (e.g., social support), and community aspects (e.g., improve streets for walking) may be the most beneficial.
Social capital is often operationalised as social participation in the activities of the formal and informal networks of civil society and/or as generalised trust. Social participation and trust are two aspects of social capital that mutually affect each other, according to the literature. In recent years there has been an increased attention to the fact that generalised trust decreases for every new birth cohort that reaches adulthood in the USA, while social participation may take new forms such as ideologically much narrower single-issue movements that do not enhance trust. The phenomenon has been called "the miniaturisation of community". The effects of similar patterns in Sweden on self-reported health and self-reported psychological health are analysed. The odds ratios of bad self-reported global health are highest in the low-social capital category (low-social participation/low trust), but the miniaturisation of community and low-social participation/high-trust categories also have significantly higher odds ratios than the high-social capital category (high-social participation/high trust). The odds ratios of bad self-reported psychological health are significantly higher in both the low-social capital category and the miniaturisation of community category compared to the high-social capital category, while the low-social participation/high-trust category does not differ from the high-social capital reference group.
There is a need for greater understanding of setting-specific influences on physical activity to complement the predominant research paradigm of individual-centered influences on physical activity. In this study, the authors used a cross-sectional multilevel analysis to examine a range of neighborhood-level characteristics and the extent to which they were associated with variation in self-reported physical activity among older adults. The sample consisted of 582 community-dwelling residents age 65 years and older (M = 73.99 years, SD = 6.25) recruited from 56 neighborhoods in Portland, OR. Information collected from participants and neighborhood data from objective sources formed a two-level data structure. These hierarchical data (i.e., individuals nested within neighborhoods) were subjected to multilevel structural-equation-modeling analyses. Results showed that neighborhood social cohesion, in conjunction with other neighborhood-level factors, was significantly associated with increased levels of neighborhood physical activity. Overall, neighborhood-level variables jointly accounted for a substantial variation in neighborhood physical activity when controlling for individual-level variables.
Environmental factors may play an important role on influencing physical activity (PA) behaviors.
Perceptions of access and safety for PA were compared among residents who were stratified as low or high in socioeconomic status (SES).
Residents of a U.S. southeastern county (N = 1,194, 18-96 years of age) were contacted using a random-digit-dial method and asked about neighborhood and community environmental supports for PA. A Geographic Information System (GIS) was used to identify trails, sidewalks, public recreation facilities, and violent crime incidents.
A cluster analysis identified 10 census tracts as low SES and 11 census tracts as high SES (median household income, owner-occupied houses). More African Americans (66.5%) than Whites (33.5%) were classified as living in low-SES areas. Respondents from low-SES areas also reported engaging in less PA based on Centers for Disease Control and Prevention and American College of Sports Medicine recommendations than respondents from high-SES areas (p <.05). Respondents from low-SES (vs. high-SES) areas reported higher perceptions of neighborhood crime, unattended dogs, unpleasantness of neighborhoods, untrustworthy neighbors, and less access to public recreation facilities (ps <.05). GIS data for presence of sidewalks, recreation facilities, and crime did not support these differences in perceptions; however, respondents from low-SES (vs. high-SES) areas had substantially fewer trails. Having and using trails in one's community predicted sufficient PA and walking for 150 min/week for low-SES respondents but not for high SES respondents (ps =.05, adjusted for covariates).
Having access to trails is an important environmental feature among low-SES communities and should be the focus of future community-based PA interventions.
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.
Previous studies have linked social participation and community levels of trust with improved health status. We examined the associations between levels of community participation, self-reported community ratings (trust), and health within a public health surveillance survey conducted in Kansas (N=4601). Independent variables were individual ratings of their communities (excellent, very good, good/ fair, poor), and their involvement in community groups or organizations in the last 5 years (yes/no). Dependent variables were self-rated health status, depressive symptoms, physical activity, smoking, obesity, and binge drinking. After controlling for age, gender, race/ethnicity, education, and having a medical doctor, self-rated health status (p<0.001) and physical activity (PA) (p<0.001) were positively, and smoking (p<0.001) and depressive symptoms (p<0.001) were negatively associated with community ratings. Only PA (p<0.001) remained associated with community involvement in a multivariate analyses. Multilevel analysis using county-level data showed no significant interactions between population density and dependent variables. Individuals from rural areas had the highest community involvement but relatively low levels of community ratings. Our findings suggest that individuals in rural areas, especially in densely settled rural areas, may face increased risks of poor health.
We investigated the association between the neighbourhood socioeconomic environment and physical inactivity, and explored the contribution of neighbourhood characteristics to this association. Data were analysed of 20-69 years old participants of the Dutch GLOBE study who lived in 78 neighbourhoods of Eindhoven (n=8.767). The neighbourhood socioeconomic environment was assessed from aggregated self-reported information of participants’ education and occupation level, and employment status. Aspects of physical inactivity investigated were based on the time spent on (a) walking and cycling to shops or work, (b) walking, cycling and gardening in leisure time, and (c) participation in sports activities. Characteristics of neighbourhoods included the proximity to food shops, general physical design of neighbourhoods, quality of green facilities, noise pollution from traffic and required police attention as evaluated by municipal services (professionals) responsible for these characteristics.
The prevalence of obesity has reached epidemic proportions in many countries and is largely due to behavioral factors that disrupt the energy balance. The purpose of the study was to test how well our conceptual model, combining features from the Theory of Planned Behavior and the Theory of Triadic Influence, explained two behaviors related to the energy balance, namely bicycle use for transportation and snacking behavior in a Dutch adolescent sample.
Data was gathered in an 1997 cross-sectional sample of adolescents (n = 3,859; mean age 14.8 years SD = 1.6) on snacking behavior, bicycle use, demographics, and potential environmental, cognitive and psychological determinants. Data was analyzed using bivariate correlations, multiple linear and binary logistic regression analyses.
Less snacking behavior was associated with female gender and a more positive intention, a more positive attitude, and stronger perceived behavioral control towards restricting snacking. Students who used their bicycle for transportation were more likely to attend secondary education, to be native Dutch, to go to school in a less-urbanized city, to be younger, had a more positive intention and perceived stronger behavioral control and subjective norm towards bicycle use.
The inclusion of environmental factors increased our understanding of bicycle use for transportation and snacking behavior in adolescents. The environmental factors are suggested to be taken into account in interventions aimed at changing these behaviors in more healthy directions.
A study was undertaken to investigate the relationship between country of birth, time in Sweden, and overweight and obesity.
Approximately 4,000 people aged 20-80 participated in a cross-sectional survey in 1994. The ethnic differences in overweight and obesity were analysed in a multivariate logistic regression analysis adjusting for age and education. The effect of number of years spent in Sweden on overweight and obesity was assessed for some of the ethnic groups compared with the Swedish-born group.
Men from Yugoslavia and Arabic-speaking countries were overweight/obese (BMI 25.0-) and obese (BMI 30.0-) to a significantly higher extent than men born in Sweden. Women born in Poland, Arabic-speaking countries, and all other countries were overweight/obese and obese to a significantly higher extent than women born in Sweden. Both Arabic men and women who had immigrated to Sweden in 1989 or earlier had an increased risk of overweight/obesity and obesity compared with the participants born in Sweden, while no increased risk was observed for the Arabic group that immigrated after 1989.
There were significant differences in overweight and obesity between the country of birth groups. The findings follow the patterns of low leisure time physical activity among certain ethnic groups reported in a previous study, which has implications for public health measures directed to decrease differences in overweight and obesity by country of birth.
Nearly half of Americans do not meet the Surgeon General's recommendation of > or =30 minutes of physical activity daily. Some transit users may achieve 30 minutes of physical activity daily solely by walking to and from transit. This study estimates the total daily time spent walking to and from transit and the predictors of achieving 30 minutes of physical activity daily by doing so.
Transit-associated walking times for 3312 transit users were examined among the 105,942 adult respondents to the 2001 National Household Travel Survey, a telephone-based survey sponsored by the U.S. Department of Transportation to assess American travel behavior.
Americans who use transit spend a median of 19 minutes daily walking to and from transit; 29% achieve > or =30 minutes of physical activity a day solely by walking to and from transit. In multivariate analysis, rail users, minorities, people in households earning <$15,000 a year, and people in high-density urban areas were more likely to spend > or =30 minutes walking to and from transit daily.
Walking to and from public transportation can help physically inactive populations, especially low-income and minority groups, attain the recommended level of daily physical activity. Increased access to public transit may help promote and maintain active lifestyles. Results from this study may contribute to health impact assessment studies (HIA) that evaluate the impact of proposed public transit systems on physical activity levels, and thereby may influence choices made by transportation planners.
Obesity and physical inactivity are known to be risk factors for many chronic diseases including hypertension, coronary artery disease, diabetes, and cancer. We sought to explore the association between an indicator of transportation data (Vehicle Miles of Travel, VMT) at the county level as it relates to obesity and physical inactivity in California.
Data from the California Health Interview Survey 2001 (CHIS 2001), the US 2000 Census, and the California Department of Transportation were merged to examine ecological correlations between vehicle miles of travel, population density, commute time, and county indicators of obesity and physical inactivity. Obesity was measured by body mass index (BMI). Physical inactivity was based on self-reported behaviors including walking, bicycling, and moderate to vigorous activity. The unit of analysis was the county. Thirty-three counties in California with population size greater than 100,000 persons per county were retained in the analyses.
CHIS 2001 statewide obesity prevalence ranged from 11.2% to 28.5% by county. Physical inactivity ranged from 13.4% to 35.7%. Daily vehicle miles of travel ranged from 3.3 million to 183.8 million per county. By rank bivariate correlation, obesity and physical inactivity were significantly associated (p<0.01). Furthermore, by rank analysis of variance, the highest mean rank obesity was associated with the highest rank of VMT (p<0.01). Similar rank patterns were observed between obesity and physical inactivity and commute time. Associations between VMT and physical inactivity were examined but failed to reach statistical significance.
This analysis adds to the growing evidence supporting the association between VMT (a measure of automobile transportation) and obesity. An urban design characterized by over dependence on motorized transportation may be related to adverse health effects.
Non-participation in health surveys is a common phenomenon. When differences between participants and non-participants are considerable, the external validity of the sample survey may decrease and false conclusions might be drawn about the health status of the population. For this reason, the authors aimed to investigate the representativity of a postal questionnaire survey performed in the county of Scania, Sweden, in 1999-2000. The survey, which was based on an 18- to 80-year-old population sample, had a 58% response rate (n = 13 604).
For some variables, the information obtained using the questionnaire was compared with information obtained from a population register that covers all the population in the county (for the 18- to 80-year-old group, n = 850 476). The population register includes, among other data, information on age, gender, educational level, country of birth, and healthcare expenditure.
Men, individuals with a low level of education, and immigrants were under-represented in the survey. However, except for immigrants, the under-representation was not large. Among immigrants, particularly those born in former Yugoslavia, the Arabic-speaking countries, and Poland were very significantly under-represented in the study. By contrast, immigrants born in other Nordic countries had responded to almost the same extent as respondents born in Sweden. The survey sample had about the same healthcare utilization costs as did the general population.
In summary, the "Health Survey for Scania, 2000" seems largely representative of the total Scanian population. A major concern, however, is the under-representation of the immigrant population.
Representativity of a postal questionnaire survey in Sweden, with special reference to ethnic differences in participation Exploring the effect of the environment on physical activity: a study examining walking to work Determinants of adolescent bicycle use for transportation and snacking behaviour
- F Carlsson
- J Merlo
- M Lindström
- P O Östergren
- T Lithman
- C L Rcraig
- R C Brownson
- S E Cragg
- A L Dunn
Carlsson, F., Merlo, J., Lindström, M., Östergren, P.O., Lithman, T., 2006. Representativity of a postal questionnaire survey in Sweden, with special reference to ethnic differences in participation. Scand. J. Public Health 34 (2), 132–139. 27M. Lindström / Preventive Medicine 46 (2008) 22–28 rCraig, C.L., Brownson, R.C., Cragg, S.E., Dunn, A.L., 2002. Exploring the effect of the environment on physical activity: a study examining walking to work. Am. J. Prev. Med. 23, 36–43. de Bruijn, G.J., Kremers, S.P.J., Schaalma, H., van Mechelen, W., Brug, J., 2005. Determinants of adolescent bicycle use for transportation and snacking behaviour. Prev. Med. 40, 658–667
Increasing prevalence of overweight, obesity and physical inactivity during leisure time between 1986 and 1994 in Malmö, Sweden
- M Lindström
- S O Isacsson
- J Merlo
Lindström, M., Isacsson, S.O., Merlo, J., 2003. Increasing prevalence of
overweight, obesity and physical inactivity during leisure time between
1986 and 1994 in Malmö, Sweden. Eur. J. Public Health 13, 306-312.
Healthy People 2000: National Health Promotion and Disease Prevention Objectives. US Government Printing Office Neighbourhood inequalities in physical activity: the role of neighbourhood attractiveness, proximity to local facilities and safety in the Netherlands
- Dc
- F J Van Lenthe
- J Brug
- J P Mackenbach
US Department of Health and Human Services, 1990. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. US Government Printing Office, Washington, DC. van Lenthe, F.J., Brug, J., Mackenbach, J.P., 2005. Neighbourhood inequalities in physical activity: the role of neighbourhood attractiveness, proximity to local facilities and safety in the Netherlands. Soc. Sci. Med. 60 (4), 763–775.
Increasing prevalence of overweight, obesity and physical inactivity during leisure time between 1986 and 1994 in Malmö, Sweden
- Lindström