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Interrelationships Between Walkability, Air Pollution, Greenness, and Body Mass Index.

ABSTRACT: BACKGROUND:Recent studies have linked urban environmental factors and body mass index (BMI); however, such factors are often examined in isolation, ignoring correlations across exposures. METHODS:Using data on Nurses' Health Study participants living in the Northeastern United States in 2006, we estimated associations between neighborhood walkability (a composite of population density, street connectivity, and business access), greenness (from satellite imagery), and ambient air pollution (from satellite-based spatiotemporally resolved PM2.5 predictions and weighted monthly average concentrations of NO2 from up to five nearest monitors) and self-reported BMI using generalized additive models, allowing for deviations from linearity using penalized splines. RESULTS:Among 23,435 women aged 60-87 years, we observed nonlinear associations between walkability and BMI and between PM2.5 and BMI in single-exposure models adjusted for age, race, and individual- and area-level socioeconomic status. When modeling all exposures simultaneously, only the association between walkability and BMI remained nonlinear and nonmonotonic. Increasing walkability was associated with increasing BMI at lower levels of walkability (walkability index <1.8), while increasing walkability was linked to lower BMI in areas of higher walkability (walkability index >1.8). A 10 percentile increase in walkability, right above 1.8 was associated with a 0.84% decrease in log BMI. The relationship between walkability and BMI existed only among younger participants (<71 years old). CONCLUSIONS:Neighborhood walkability was nonlinearly linked to lower BMI independent of air pollution and greenness. Our findings highlight the importance of accounting for nonlinear confounding by interrelated urban environmental factors when investigating associations between the environment and BMI.

SUBMITTER: James P

PROVIDER: S-EPMC5617802 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Interrelationships Between Walkability, Air Pollution, Greenness, and Body Mass Index.

James Peter P Kioumourtzoglou Marianthi-Anna MA Hart Jaime E JE Banay Rachel F RF Kloog Itai I Laden Francine F

Epidemiology (Cambridge, Mass.) 20171101 6

<h4>Background</h4>Recent studies have linked urban environmental factors and body mass index (BMI); however, such factors are often examined in isolation, ignoring correlations across exposures.<h4>Methods</h4>Using data on Nurses' Health Study participants living in the Northeastern United States in 2006, we estimated associations between neighborhood walkability (a composite of population density, street connectivity, and business access), greenness (from satellite imagery), and ambient air p ...[more]

PMID: 28767514

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Project description:BackgroundDelhi is one of the most polluted cities in the world with annual average ambient PM10 and PM2.5 levels exceeding the World Health Organization standards by over 15 fold. We aimed to study the prevalence of respiratory and allergic symptoms and asthma among adolescent children living in Delhi (D) and compare it with children living in lesser polluted cities of Kottayam (K) and Mysore (M) located in Southern India.Methods4361 boys and girls between the age group of 13-14 and 16-17 years from 12 randomly selected private schools from D, K, and M were invited to participate. Modified and expanded International Study for Asthma and Allergies in Children (ISAAC) questionnaires (Q) were filled by the students who also performed spirometry using the ultrasonic flow-sensor-based nDD Spirometer.Results3157 students (50.4% boys) completed the Q and performed good quality spirometry. The prevalence of asthma and airflow obstruction among children living in Delhi was 21.7% using the ISAAC Q and 29.4% on spirometry, respectively. This was accompanied by significantly higher rates of self-reported cough, shortness of breath, chest tightness, sneezing, itchy and watery eyes, itchy skin, and eczema among Delhi children (vs. K-M, all P < 0.05). Delhi children were more overweight and obese (39.8% vs. 16.4%, P < 0.0001), and this was the only risk factor that was strongly associated with asthma (odds ratio [OR]: 1.79; confidence interval: 1.49-2.14), with a more pronounced effect in Delhi children (P = 0.04). Forced expiratory volume1 and Forced vital capacity values were significantly higher in Delhi children (vs. K-M P < 0.0001). Preserved ratio impaired spirometry was more common in K-M children (P < 0.0001).ConclusionAdolescent children living in the polluted city of Delhi had a high prevalence of asthma, respiratory symptoms, allergic rhinitis, and eczema that was strongly associated with a high body mass index (BMI). Our study suggests an association between air pollution, high BMI, and asthma/allergic diseases, which needs to be explored further.

Project description:Background: Limited evidence suggests an association between prenatal exposure to traffic pollution and greater adiposity in childhood, but the time window during which growth may be most affected is not known. Methods: We studied 1,649 children in Project Viva, a Boston-area pre-birth cohort. We used spatiotemporal models to estimate prenatal residential air pollution exposures and geographic information systems to estimate neighborhood traffic density and roadway proximity. We used weight and stature measurements at clinical and research visits to estimate a BMI trajectory for each child with mixed-effects natural cubic spline models. In primary analyses, we examined associations of residential PM2.5 and black carbon (BC) exposures during the third trimester and neighborhood traffic density and home roadway proximity at birth address with (1) estimated BMI at 6 month intervals through 10 years of age, (2) magnitude and timing of BMI peak and rebound, and (3) overall BMI trajectory. In secondary analyses, we examined associations of residential PM2.5 and BC exposures during the first and second trimesters with BMI outcomes. Results: Median (interquartile range; IQR) concentration of residential air pollution during the third trimester was 11.4 (1.7) ?g/m3 for PM2.5 and 0.7 (0.3) ?g/m3 for BC. Participants had a median (IQR) of 13 (7) clinical or research BMI measures from 0 to 10 years of age. None of the traffic pollution exposures were significantly associated with any of the BMI outcomes in covariate-adjusted models, although effect estimates were in the hypothesized direction for neighborhood traffic density and home roadway proximity. For example, greater neighborhood traffic density [median (IQR) 857 (1,452) vehicles/day x km of road within 100 m of residential address at delivery] was associated with a higher BMI throughout childhood, with the strongest associations in early childhood [e.g., per IQR increment natural log-transformed neighborhood traffic density, BMI at 12 months of age was 0.05 (-0.03, 0.13) kg/m2 higher and infancy peak BMI was 0.05 (-0.03, 0.14) kg/m2 higher]. Conclusions: We found no evidence for a persistent effect of prenatal exposure to traffic pollution on BMI trajectory from birth through mid-childhood in a population exposed to modest levels of air pollution.

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Interrelationships Between Walkability, Air Pollution, Greenness, and Body Mass Index.

Publications

Interrelationships Between Walkability, Air Pollution, Greenness, and Body Mass Index.

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