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Associations of built environment and proximity of food outlets with weight status: Analysis from 14 cities in 10 countries

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Abstract
The study aimed to examine associations of neighborhood built environments and proximity of food outlets (BE measures) with body weight status using pooled data from an international study (IPEN Adult). Objective BE measures were calculated using geographic information systems for 10,008 participants (4463 male, 45%) aged 16-66 years in 14 cities. Participants self-reported proximity to three types of food outlets. Outcomes were body mass index (BMI) and overweight/obesity status. Male and female weight status associations with BE measures were estimated by generalized additive mixed models. Proportion (95% CI) of overweight (BMI 25 to <30) ranged from 16.6% (13.1, 19.8) to 41.1% (37.3, 44.7), and obesity (BMI ≥ 30) from 2.9% (1.3, 4.4) to 31.3% (27.7, 34.7), with Hong Kong being the lowest and Cuernavaca, Mexico highest for both proportions. Results differed by sex. Greater street intersection density, public transport density and perceived proximity to restaurants (males) were associated with lower odds of overweight/obesity (BMI ≥ 25). Proximity to public transport stops (females) was associated with higher odds of overweight/obesity. Composite BE measures were more strongly related to BMI and overweight/obesity status than single variables among men but not women. One standard deviation improvement in the composite measures of BE was associated with small reductions of 0.1-0.5% in BMI but meaningful reductions of 2.5-5.3% in the odds of overweight/obesity. Effects were linear and generalizable across cities. Neighborhoods designed to support public transport, with food outlets within walking distance, may contribute to global obesity control.
Keywords
Public Health, Environmental and Occupational Health, Epidemiology, BMI, IPEN Adult study, international, obesity, obesogenic environment, walkability

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MLA
Cochrane, Thomas, et al. “Associations of Built Environment and Proximity of Food Outlets with Weight Status: Analysis from 14 Cities in 10 Countries.” Preventive Medicine, vol. 129, 2019.
APA
Cochrane, T., Yu, Y., Davey, R., Cerin, E., Cain, K., Conway, T., … Sallis, J. (2019). Associations of built environment and proximity of food outlets with weight status: Analysis from 14 cities in 10 countries. Preventive Medicine, 129.
Chicago author-date
Cochrane, Thomas, Yan Yu, Rachel Davey, Ester Cerin, Kelli Cain, Terry Conway, Jacqueline Kerr, et al. 2019. “Associations of Built Environment and Proximity of Food Outlets with Weight Status: Analysis from 14 Cities in 10 Countries.” Preventive Medicine 129.
Chicago author-date (all authors)
Cochrane, Thomas, Yan Yu, Rachel Davey, Ester Cerin, Kelli Cain, Terry Conway, Jacqueline Kerr, Lawrence Frank, James Chapman, Marc Adams, Duncan Macfarlane, Delfien Van Dyck, Poh-Chin Lai, Olga Sarmiento, Jens Troelsen, Deborah Salvo, Rodrigo Reis, Josef Mitáš, Grant Schofield, Neville Owen, and James Sallis. 2019. “Associations of Built Environment and Proximity of Food Outlets with Weight Status: Analysis from 14 Cities in 10 Countries.” Preventive Medicine 129.
Vancouver
1.
Cochrane T, Yu Y, Davey R, Cerin E, Cain K, Conway T, et al. Associations of built environment and proximity of food outlets with weight status: Analysis from 14 cities in 10 countries. Preventive Medicine. 2019;129.
IEEE
[1]
T. Cochrane et al., “Associations of built environment and proximity of food outlets with weight status: Analysis from 14 cities in 10 countries,” Preventive Medicine, vol. 129, 2019.
@article{8638628,
  abstract     = {The study aimed to examine associations of neighborhood built environments and proximity of food outlets (BE measures) with body weight status using pooled data from an international study (IPEN Adult). Objective BE measures were calculated using geographic information systems for 10,008 participants (4463 male, 45%) aged 16-66 years in 14 cities. Participants self-reported proximity to three types of food outlets. Outcomes were body mass index (BMI) and overweight/obesity status. Male and female weight status associations with BE measures were estimated by generalized additive mixed models. Proportion (95% CI) of overweight (BMI 25 to <30) ranged from 16.6% (13.1, 19.8) to 41.1% (37.3, 44.7), and obesity (BMI ≥ 30) from 2.9% (1.3, 4.4) to 31.3% (27.7, 34.7), with Hong Kong being the lowest and Cuernavaca, Mexico highest for both proportions. Results differed by sex. Greater street intersection density, public transport density and perceived proximity to restaurants (males) were associated with lower odds of overweight/obesity (BMI ≥ 25). Proximity to public transport stops (females) was associated with higher odds of overweight/obesity. Composite BE measures were more strongly related to BMI and overweight/obesity status than single variables among men but not women. One standard deviation improvement in the composite measures of BE was associated with small reductions of 0.1-0.5% in BMI but meaningful reductions of 2.5-5.3% in the odds of overweight/obesity. Effects were linear and generalizable across cities. Neighborhoods designed to support public transport, with food outlets within walking distance, may contribute to global obesity control.},
  articleno    = {105874},
  author       = {Cochrane, Thomas and Yu, Yan and Davey, Rachel and Cerin, Ester and Cain, Kelli  and Conway, Terry and Kerr, Jacqueline and Frank, Lawrence  and Chapman, James  and Adams, Marc and Macfarlane, Duncan and Van Dyck, Delfien and Lai, Poh-Chin and Sarmiento, Olga  and Troelsen, Jens and Salvo, Deborah and Reis, Rodrigo and Mitáš, Josef and Schofield, Grant and Owen, Neville and Sallis, James},
  issn         = {0091-7435},
  journal      = {Preventive Medicine},
  keywords     = {Public Health,Environmental and Occupational Health,Epidemiology,BMI,IPEN Adult study,international,obesity,obesogenic environment,walkability},
  language     = {eng},
  pages        = {13},
  title        = {Associations of built environment and proximity of food outlets with weight status: Analysis from 14 cities in 10 countries},
  url          = {http://dx.doi.org/10.1016/j.ypmed.2019.105874},
  volume       = {129},
  year         = {2019},
}

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