Re: The Effect of Moving to East Village (the Former London 2012 Olympic and Paralympic Games Athletes' Village) on Physical Activity and Adiposity Levels: The Enable London Study

Abstract

Objective: There is considerable interest in whether the built environment influences health behaviours, but longitudinal evidence is limited. We examined the effect of moving into East Village (the former London 2012 Olympic Games Athletes Village, repurposed on active design principles), on levels of physical activity (PA) and adiposity among adults. Design: A natural experiment. Participants: A cohort of 1278 adults seeking to move into social, intermediate, and market-rent East Village accommodation was recruited in 2013-2015, and followed up after two years. Intervention: Moving to East Village. Main outcome: Change in objectively measured daily steps (ActiGraph GT3X+). Methods: Change in environmental exposures associated with physical activity were assessed using Geographic Information System derived measures. Individual objective measures of PA using accelerometry, body mass index (BMI) and bioelectrical impedance (fat mass %) were obtained, as were perceptions of change in the built environment. We examined change in levels of PA and adiposity, using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and household (random effect), comparing those who moved to East Village (intervention group) with those who did not (control group). Effects of housing sector as an effect modifier were also examined. Results: 877 adults (69%) were followed-up, of whom 50% had moved to East Village. Moving to East Village was associated with only a small non-significant increase in mean daily steps (154, 95% CI -231, 539), despite sizeable improvements in walkability and neighbourhood perceptions of crime and quality. There were no appreciable effects on time spent in moderate-to-vigorous PA (MVPA) or sedentary time, BMI or percentage fat mass, overall or by housing sector. Conclusion: Despite strong evidence of large improvements in neighbourhood perceptions and walkability there was no clear evidence that moving to East Village was associated with increased physical activity. Improving the physical activity environment on its own may be insufficient to increase population physical activity. Funding: This research is being supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1) and National Institute for Health Research (12/211/69). Diabetes and obesity prevention research at St George’s, University of London is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London. BR is supported by a St George’s, University of London, PhD Studentship. AE is funded by the UK Medical Research Council as part of the Neighbourhoods and Communities Programme (MC_UU_12017-10). BG-C is supported by an NHMRC Principal Research Fellowship (#1107672). ARC and ASP are supported by NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. Declaration of Interest: We declare that we have no competing interests. Ethical Approval: Full ethical approval was obtained from the relevant Multi-Centre Research Ethics Committee (REC Reference 12/LO/1031). All participants provided written informed consent.