Association between perceived neighbourhood environmental attributes and body mass index: A 12 country study

Abstract

Purpose: The overall purpose of this study was to examine the strength, direction and shape of the associations between perceived neighbourhood built environmental attributes and BMI. Variation of the associations by study site as well as the interactions with neighbourhood-level socioeconomic status (SES) were also explored. Methods: Pooled data from the 12 participating countries (5 continents) of the International Physical Activity Environment Network (IPEN) study were used. Similar measures and protocols were executed in all study sites. Perceived neighbourhood built environmental attributes were measured with the NEWS questionnaire, BMI was assessed by self-reporting height and weight in eight countries and by objective data using standardised techniques in four countries. Results: In general, only few environmental attributes were predictive of weight status or BMI over and above the socio-demographic characteristics. Safety from traffic was the only environmental attribute that was predictive of both a better weight status (less overweight/obese), and a lower BMI. For the continuous BMI variable, higher land use mix diversity and perceived safety from crime (curvilinear) were additionally related with lower BMI. Conclusions: The closer the perceived walking proximity to nine categories of common destinations, and the safer it is to reach these destinations (no heavy traffic along nearby streets, slow traffic speed, speeding drivers), the lower the body mass of the inhabitants of the urban and suburban regions across the world. Moreover, in neighbourhoods with very low perceived crime safety, a small increase in crime safety could possibly lead to a strong decrease in BMI.