Influence of the Built Environment on Physical Activity, Diet, and Obesity in Children Ian Janssen, Ph.D. CRC Chair in Physical Activity and Obesity Queen s University Kingston, ON
Prevalence (%) Changing Prevalence of Obesity in Canadian Youth, 1980 2008 1980 2008 14 12 10 300% 9% 8 6 4 2 0 BMI Waist Circumference Janssen et al., Obes Rev 2011;12:397-405
Prevalence (%) Changing Prevalence of Obesity in Canadian Youth, 1980 2008 1980 2008 14 12 10 300% 9% 8 6 4 2 0 BMI Waist Circumference Janssen et al., Obes Rev 2011;12:397-405
Prevalence (%) Changing Prevalence of Obesity in Canadian Youth, 1980 2008 1980 2008 14 12 10 8 6 4 2 300% 0 BMI Waist Circumference Janssen et al., Obes Rev 2011;12:397-405
Overweight and Obesity in 5-17 Year Old Canadians BMI Category Prevalence (%) Number Thinness 2 107,000 Healthy weight 66 3,334,000 Overweight 20 994,000 Obese 12 584,000
Initial Efforts on Obesity Prevention Focused on Behaviour Change Theories
Difficult to Change Behaviours in Obesogenic Environments
Difficult to Change Behaviours in Obesogenic Environments
Difficult to Change Behaviours in Obesogenic Environments
Difficult to Change Behaviours in Obesogenic Environments
Built Environments for Children
Built Environments for Children
Built Environments for Children
Built Environments for Children
Health Behaviour in School-Aged Children Survey (HBSC) National survey of 6-10 th grade youth (11-15 year olds) Repeated cross-sectional design (2002, 2006, 2010) Student participants are clustered in schools Three components: - student survey - principal survey - GIS measures of school and home neighbourhoods
Built Environments in Home Neighbourhoods 1 km buffer around home or 5 km buffer around school
Built Environments in Home Neighbourhoods 1. Recreation facilities 2. Outdoor play spaces 3. Aesthetics 4. Roads and sidewalks
Odds Ratio (95% CI) Neighbourhood Recreation Facilities and Physical Activity Outside of School Density of Facilities Nichol et al., J Physical Activity Health 2010;7:442-50
Odds Ratio (95% CI) * Neighbourhood Outdoor Play Spaces and Physical Activity Laxer and Janssen, unpublished thesis
Neighbourhood Disorder and Excessive Screen Time Carson and Janssen, Int J Behav Nutr Phys Act 2012;9:66
Odds Ratio (95% CI) Neighbourhood Disorder and Excessive Screen Time * Low Physical/ Low Social High Physical/ Low Social Low Physical/ High Social High Physical/ High Social Carson and Janssen, Int J Behav Nutr Phys Act 2012;9:66
Walkability
Odds Ratio (95% CI) Street Connectivity and Physical Activity in Youth * * * Street Connectivity Mecredy et al., Int J Environ Res Public Health 2011;8:3333-50
Odds Ratio (95% CI) Walkability and Youth Physical Activity Walkability = connectivity + road speeds + sidewalk coverage + land use * * * Walkability R. Laxer and Janssen, MSc thesis
Odds Ratio (95% CI) Street Connectivity and Active Transportation to School Street Connectivity Gropp et al., Int J Behav Nutr Phys Act 2012;16:124
Neighbourhood Fast Food Environment
Odds Ratio (95% CI) Neighbourhood Fast Food Environment and Excessive Fast Food Consumption * * Density of Fast Food Restaurants Laxer and Janssen, unpublished thesis
School and its Neighbourhood
% Yes Presence of Physical Activity Facilities at Canadian Schools
School Recreation Facilities and Student Physical Activity Levels at School Boys Girls Class-Time Activity Free-Time Activity Number of Facilities Number of Facilities Nichol et al., J Physical Activity Health 2009;79:247-54
Physical Activity at School (hours/week) School Recreation Facilities and Student Physical Activity Levels at School low PA policies medium PA policies high PA policies Number of Facilities B. Button, MSc thesis
Food Retail Environment at KCVI school cafeteria, tuck shop, and vending machines >10 fast food restaurants within 1 km 8 variety stores within 1 km 7 coffee shops within 1 km
% Yes within 1 km School Neighbourhood Food Environments 50% 40% 33%
Odds Ratio (95% CI) Fast Food Restaurants in School Neighbourhood and Lunchtime Eating # of fast food restaurants within 1 km of School Héroux et al., Health & Place 2012;18:1240-74
Community/Municipal Built Environment
Urban-Rural Location
Odds Ratio (95% CI) Urban/Rural Location is Associated with Obesity junk food and pop screen time Bruner et al., Int J Ped Obes 2008;4:205-211
Urban Sprawl New York City 8.2 million people 300 square miles Los Angeles 9.8 million people 4000 square miles
Odds Ratio (95% CI) Urban Sprawl is Positively Associated with Active Transportation in Youth Kingston Toronto Guelph London Brantford Urban Sprawl Score Seliske et al., Health Reports 2012;23:17-25
Concluding Remarks The associations between the built environment and obesity-related behaviours is complicated
Concluding Remarks Associations are weak to modest in strength, but exposure level is high. Therefore, PAR% can be high.
Concluding Remarks Level of evidence is weak. Experimental studies are needed.