title: Walking mediates associations between neighborhood activity supportiveness and BMI in the Women's Health Initiative San Diego cohort.
abstract: OBJECTIVE
  To investigate whether walking mediates neighborhood built environment associations with weight status in middle- and older-aged women.
  
  
  METHODS
  Participants (N=5085; mean age=64 ± 7.7; 75.4% White non-Hispanic) were from the Women's Health Initiative San Diego cohort baseline visits. Body mass index (BMI) and waist circumference were measured objectively. Walking was assessed via survey. The geographic information system (GIS)-based home neighborhood activity supportiveness index included residential density, street connectivity, land use mix, and number of parks.
  
  
  RESULTS
  BMI was 0.22 units higher and the odds ratio for being obese (vs. normal or overweight) was 8% higher for every standard deviation decrease in neighborhood activity supportiveness. Walking partially mediated these associations (22-23% attenuation). Findings were less robust for waist circumference.
  
  
  CONCLUSIONS
  Findings suggest women who lived in activity-supportive neighborhoods had a lower BMI than their counterparts, in part because they walked more. Improving neighborhood activity supportiveness has population-level implications for improving weight status and health.
authors.affiliation: Children's Mercy Hospital, 610 E. 22nd St., Kansas City, MO 64108, USA. Electronic address: jacarlson@cmh.edu.
authors.forename: Jordan A
authors.initials: JA
authors.lastname: Carlson
authors.affiliation: University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: raremigiobaker@ucsd.edu.
authors.forename: Rosemay A
authors.initials: RA
authors.lastname: Remigio-Baker
authors.affiliation: University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: c1anderson@ucsd.edu.
authors.forename: Cheryl A M
authors.initials: CA
authors.lastname: Anderson
authors.affiliation: Arizona State University, 500 N. Third St., Phoenix, AZ 85006, USA. Electronic address: marc.adams@asu.edu.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Adams
authors.affiliation: University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: gnorman@ucsd.edu.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Norman
authors.affiliation: University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: jkerr@ucsd.edu.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Kerr
authors.affiliation: University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: mcriqui@ucsd.edu.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.affiliation: University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: mallison@ucsd.edu.
authors.forename: Matthew
authors.initials: M
authors.lastname: Allison
mesh_terms: D000368:Aged; D000375:Aging; D015992:Body Mass Index; D002140:California; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D012111:Residence Characteristics; D055105:Waist Circumference; D016138:Walking; D016387:Women's Health
keywords: Aging; Obesity; Physical activity; Waist circumference; Walkability