Associations between fast food and physical activity environments and adiposity in mid-life: cross-sectional, observational evidence from UK Biobank

Neil Pearce,Steven Cummins,Kate E Mason

doi:10.1016/s2468-2667(17)30212-8

Neil Pearce, Steven Cummins + Show 1 more

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https://doi.org/10.1016/s2468-2667(17)30212-8

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Abstract

SummaryBackgroundThe built environment might be associated with development of obesity and related disorders. We examined whether neighbourhood exposure to fast-food outlets and physical activity facilities were associated with adiposity in UK adults.MethodsWe used cross-sectional observational data from UK Biobank. Participants were aged 40–70 years and attended 21 assessment centres between 2006 and 2010. Using linked data on environments around each participant's residential address, we examined whether density of physical activity facilities and proximity to fast-food outlets were associated with waist circumference, body-mass index (BMI), and body fat percentage. We used multilevel linear regression models adjusted for potential confounders, and conducted several sensitivity analyses.FindingsComplete case sample sizes were 401 917 (waist circumference models), 401 435 (BMI), and 395 640 (body fat percentage). Greater density of physical activity facilities within 1000 m of home was independently associated with smaller waist circumference and lower BMI and body fat percentage. Compared with people with no nearby facilities, those with at least six facilities close to home had 1·22 cm smaller waist circumference (95% CI −1·64 to −0·80), 0·57 kg/m2 lower BMI (−0·74 to −0·39), and 0·81 percentage points lower body fat (−1·03 to −0·59). Living further from a fast-food outlet was weakly associated with waist circumference and BMI, mostly among women. Compared with people living fewer than 500 m from a fast-food outlet, those living at least 2000 m away had 0·26 cm smaller waist circumference (−0·52 to 0·01).InterpretationThis study shows strong associations between high densities of physical activity facilities and lower adiposity for adults in mid-life. We observed weaker associations for access to fast food, but these are likely to be underestimated owing to limitations of the food environment measure. Policy makers should consider interventions aimed at tackling the obesogenic built environment.FundingCommonwealth Scholarship Commission, Wellcome Trust Institutional Strategic Support Fund.

Highlights

Obesity is strongly linked to a range of chronic diseases, including type 2 diabetes and cardiovascular disease, and contributes substantially to excess morbidity, mortality, and rising health-care costs globally.[1,2] Across the world, increasing urbanisation is recognised as a key driver of obesity and related non-communicable diseases, prompting calls to improve understanding of how urban environmental factors influence health.[3] in urban areas, features of neighbourhood environments, such as access to unhealthy food and few opportunities for physical activity, might be associated with the development of obesity and related disorders
Recent studies indicate that about 21% of UK adults eat takeaway meals at home weekly[6] and about 18% regularly use gyms, with smaller proportions participating in other forms of physical activity likely to involve formal facilities.[7]
Data were potentially available from 502 656 individuals who had visited the 22 UK Biobank assessment centres across the UK between 2006 and 2010

Summary

Introduction

In urban areas, features of neighbourhood environments, such as access to unhealthy food and few opportunities for physical activity, might be associated with the development of obesity and related disorders. Such features are often referred to as the obesogenic environment,[4] and their presence and unequal distribution might partly explain rises in obesity prevalence and persistent social and geographical inequalities in obesity.[5] much research has been done on the influence of various neighbourhood features on obesity, consistent evidence remains elusive.[4]. Recent studies indicate that about 21% of UK adults eat takeaway meals at home weekly[6] and about 18% regularly use gyms, with smaller proportions participating in other forms of physical activity likely to involve formal facilities (eg, swimming and team or racquet sports).[7]

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