title: Built environment change and change in BMI and waist circumference: Multi-ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  To examine longitudinal associations of the neighborhood built environment with objectively measured body mass index (BMI) and waist circumference (WC) in a geographically and racial/ethnically diverse group of adults.
  
  
  METHODS
  This study used data from 5,506 adult participants in the Multi-Ethnic Study of Atherosclerosis, aged 45-84 years in 2000 (baseline). BMI and WC were assessed at baseline and four follow-up visits (median follow-up 9.1 years). Time-varying built environment measures (population density, land-use, destinations, bus access, and street characteristics) were created using Geographic Information Systems. Principal components analysis was used to derive composite scores for three built environment factors. Fixed-effects models, tightly controlling for all time-invariant characteristics, estimated associations between change in the built environment, and change in BMI and WC.
  
  
  RESULTS
  Increases in the intensity of development (higher density of walking destinations and population density, and lower percent residential) were associated with less pronounced increases or decreases over time in BMI and WC. Changes in connected retail centers (higher percent retail, higher street connectivity) and public transportation (distance to bus) were not associated with changes in BMI or WC.
  
  
  CONCLUSIONS
  Longitudinal changes in the built environment, particularly increased density, are associated with decreases in BMI and WC.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Jana A
authors.initials: JA
authors.lastname: Hirsch
authors.forename: Kari A
authors.initials: KA
authors.lastname: Moore
authors.forename: Tonatiuh
authors.initials: T
authors.lastname: Barrientos-Gutierrez
authors.forename: Shannon J
authors.initials: SJ
authors.lastname: Brines
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Zagorski
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Rodriguez
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology / Q000209:etiology / Q000378:metabolism; D015992:Body Mass Index; D004777:Environment; D004779:Environment Design; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D008875:Middle Aged; D011156:Population Density; D012111:Residence Characteristics; D055105:Waist Circumference / Q000208:ethnology; D016138:Walking