Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada.
BMJ Open
; 7(4): e013889, 2017 04 08.
Article
en En
| MEDLINE
| ID: mdl-28391234
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:
78â 023 Toronto residents, aged 18â 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 OUTCOMEMEASURES:
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 (-2.64â kg/m2, 95% CI -2.98 to -2.30; p<0.001), systolic blood pressure (-1.35â mmâ Hg, 95% CI -2.01 to -0.70; p<0.001), diastolic blood pressure (-0.60â mmâ 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 (0.052â 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 (-4.44â kg/m2, 95% CI -5.09 to -3.79; p<0.001), adults aged 40-65 (-2.74â kg/m2, 95% CI -3.24 to -2.23; p<0.001) and adults aged over 65 (-0.87â 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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Características de la Residencia
/
Salud Pública
/
Diabetes Mellitus Tipo 2
/
Dislipidemias
/
Hipertensión
/
Obesidad
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
BMJ Open
Año:
2017
Tipo del documento:
Article
País de afiliación:
Canadá