Residential proximity to urban centres, local-area walkability and change in waist circumference among Australian adults.
Consistent associations have been observed between macro-level urban sprawl and overweight/obesity, but whether residential proximity to urban centres predicts adiposity change over time has not been established. Further, studies of local-area walkability and overweight/obesity have generated mixed results. This study examined 4-year change in adults' waist circumference in relation to proximity to city centre, proximity to closest suburban centre, and local-area walkability. Data were from adult participants (n=2080) of a cohort study on chronic conditions and health risk factors in Adelaide, Australia. Baseline data were collected in 2000-03 with a follow-up in 2005-06. Multilevel regression models examined in 2015 the independent and joint associations of the three environmental measures with change in waist circumference, accounting for socio-demographic covariates. On average, waist circumference rose by 1.8cm over approximately 4years. Greater distance to city centre was associated with a greater increase in waist circumference. Participants living in distal areas (20km or further from city centre) had a greater increase in waist circumference (mean increase: 2.4cm) compared to those in proximal areas (9km or less, mean increase: 1.2cm). Counterintuitively, living in the vicinity of a suburban centre was associated with a greater increase in adiposity. Local-area walkability was not significantly associated with the outcome. Residential proximity to city centre appears to be protective against excessive increases in waist circumference. Controlled development and targeted interventions in the urban fringe may be needed to tackle obesity. Additional research needs to assess behaviours that mediate relationships between sprawl and obesity.
Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia; Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia; Centre for Design Innovation, Faculty of Health Arts & Design, Swinburne University of Technology, Melbourne, VIC, Australia. Electronic address: takemi.sugiyama@acu.edu.au.
Takemi
T
Sugiyama
Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia.
Theo
T
Niyonsenga
Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia.
Natasha J
NJ
Howard
Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia.
Neil T
NT
Coffee
Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia; Research Centre of the Douglas Mental Health University Institute, Verdun, Québec, Canada.
Catherine
C
Paquet
Population Research and Outcome Studies, The University of Adelaide, SA, Australia.
Anne W
AW
Taylor
Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia; Department of Medicine, The University of Melbourne, St Vincent's Hospital, Melbourne, VIC, Australia; South Australian Health & Medical Research Institute, Adelaide, SA, Australia.
Mark
M
Daniel
D001315:Australia; D015992:Body Mass Index; D002958:City Planning; D015331:Cohort Studies; D004777:Environment; D005260:Female; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000209:etiology; D012307:Risk Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055105:Waist Circumference / Q000502:physiology*; D016138:Walking
Central adiposity; Environment; Longitudinal study; Sprawl; Urban planning