Dataset Information

Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada.

ABSTRACT:

Objective

To determine whether neighbourhood walkability is associated with clinical measures of obesity, hypertension, diabetes and dyslipidaemia in an urban adult population.

Design

Observational cross-sectional study.

Setting

Urban primary care patients.

Participants

78?023 Toronto residents, aged 18?years and over, who were formally rostered or had at least 2 visits between 2012 and 2014 with a primary care physician participating in the University of Toronto Practice Based Research Network (UTOPIAN), within the Canadian Primary Care Sentinel Surveillance Network (CPCSSN).

Main outcome measures

Differences in average body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, haemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglyceride between residents in the highest versus the lowest quartile of neighbourhood walkability, as estimated using multivariable linear regression models and stratified by age. Outcomes were objectively measured and were retrieved from primary care electronic medical records. Models adjusted for age, sex, smoking, medications, medical comorbidities and indices of neighbourhood safety and marginalisation.

Results

Compared with those in the lowest walkability quartile, individuals in the highest quartile had lower mean BMI (-2.64?kg/m², 95% CI -2.98 to -2.30; p<0.001), systolic blood pressure (-1.35?mm?Hg, 95% CI -2.01 to -0.70; p<0.001), diastolic blood pressure (-0.60?mm?Hg, 95% CI 1.06 to -0.14; p=0.010) and HbA1c (-0.063%, 95% CI -0.11 to -0.021; p=0.003) and higher mean HDL (0.052?mmol/L, 95% CI 0.029 to 0.075; p<0.001). In age-stratified analyses, differences in the mean BMI were consistently observed for adults aged 18 to under 40 (-4.44?kg/m², 95% CI -5.09 to -3.79; p<0.001), adults aged 40-65 (-2.74?kg/m², 95% CI -3.24 to -2.23; p<0.001) and adults aged over 65 (-0.87?kg/m², 95% CI -1.48 to -0.26; p=0.005).

Conclusions

There was a clinically meaningful association between living in the most walkable neighbourhoods and having lower BMI in adults of all ages.

SUBMITTER: Loo CK

PROVIDER: S-EPMC5775455 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada.

Loo C K Jennifer CK Greiver Michelle M Aliarzadeh Babak B Lewis Daniel D

BMJ open 20170408 4

<h4>Objective</h4>To determine whether neighbourhood walkability is associated with clinical measures of obesity, hypertension, diabetes and dyslipidaemia in an urban adult population.<h4>Design</h4>Observational cross-sectional study.<h4>Setting</h4>Urban primary care patients.<h4>Participants</h4>78 023 Toronto residents, aged 18 years and over, who were formally rostered or had at least 2 visits between 2012 and 2014 with a primary care physician participating in the University of Toronto Pra ...[more]

PMID: 28391234

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Project description:ObjectivesStudies have investigated the influence of neighbourhood walkability on residents' walking behaviour, aiming to increase physical activity and reduce dependence on automobiles. Previous research, however, has not considered how the amount of time spent in the residential neighbourhood may modify this relationship. Our objective was to determine how time spent in the residential neighbourhood affects the relationship between neighbourhood walkability and walking for transport.DesignUsing a cross-sectional sample of 2411 adults, we analysed the association between walkability (an index combining land-use mix, dwelling density and street connectivity) and transport-related walking (controlling for the effects of gender, age, income, self-rated health and regular access to private transport) testing for interactions by time spent in the neighbourhood.Primary outcome measureMinutes spent walking for transport per week.SettingToronto, Canada.ParticipantsParticipants were aged 25 to 65. The survey had a 72% response rate.ResultsAfter adjusting for potential confounders, the walkability index was weakly associated with walking (1 SD of walkability score is associated with 0.25 more minutes walking/week, p<0.01). Land-use mix was more strongly associated with walking than the walkability index. Time spent at the residential neighbourhood modified the relationship between land-use mix and transport-related walking in a dose-effect manner (p<0.01), those spending 5?hours on average at their residential neighbourhood have 0.2?min/day more walking for each additional land-use mix score and those spending 12?hours have 0.5?min/day more walking for each additional land-use mix score.ConclusionsOur findings suggest that walkability is associated with increased walking time, but it is modified by time spent in the neighbourhood. Our study underscores the importance of testing 'time spent in the neighbourhood' as a modifier of environmental exposures in studies of environmental correlates of walking.

Project description:Walking, and in particular, outdoor walking, is the most common form of physical activity for older adults. To date, no study investigated the association between the neighborhood built environment and physical activity habits of older adults of low SES. Thus, our overarching aim was to examine the association between the neighborhood built environment and the spectrum of physical activity and walking for transportation in older adults of low socioeconomic status.Cross-sectional data were from the Walk the Talk Study, collected in 2012. Participants (n?=?161, mean age?=?74 years) were in receipt of a rental subsidy for low income individuals and resided in neighbourhoods across Metro Vancouver, Canada. We used the Street Smart Walk Score to objectively characterize the built environment main effect (walkability), accelerometry for objective physical activity, and the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure walking for transportation. We used regression analyses to examine associations of objectively measured physical activity [total volume, light intensity and moderate intensity physical activity (MVPA)] and self-reported walking for transportation (any, frequency, duration) with walkability. We adjusted analyses for person- and environment-level factors associated with older adult physical activity.Neighbourhood walkability was not associated with physical activity volume or intensity and self-reported walking for transportation, with one exception. Each 10-point increase in Street Smart Walk Score was associated with a 45% greater odds of any walking for transportation (compared with none; OR?=?1.45, 95% confidence interval?=?1.18, 1.78). Sociodemographic, physical function and attitudinal factors were significant predictors of physical activity across our models.The lack of associations between most of the explored outcomes may be due to the complexity of the relation between the person and environment. Given that this is the first study to explore these associations specifically in older adults living on low income, this study should be replicated in other settings.

Dataset Information

Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada.

Similar Datasets

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