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Two‐Year Changes in Child Weight Status,Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment
Authors:Brian E Saelens  Karen Glanz  Lawrence D Frank  Sarah C Couch  Chuan Zhou  Trina Colburn  James F Sallis
Institution:1. Seattle Children's Research Institute, Seattle, Washington, USA;2. Department of Pediatrics, University of Washington, Seattle, Washington, USA;3. Rollins School of Public Health, Emory University, Atlanta, Georgia, USA;4. School of Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada;5. Urban Design 4 Health, Inc, Seattle, Washington, USA;6. Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, Ohio, USA;7. Department of Psychology, San Diego State University, San Diego, California, USA
Abstract:

Objective

The aim of this study was to examine 2‐year changes in weight status and behaviors among children living in neighborhoods differing on nutrition and activity environments.

Methods

A prospective observational study, the Neighborhood Impact on Kids study, was conducted in King County, Washington, and San Diego County, California. Children 6 to 12 years old and a parent or caregiver completed Time 1 (n = 681) and Time 2 (n = 618) assessments. Children lived in neighborhoods characterized as “high/favorable” or “low/unfavorable” in nutrition and activity environments, respectively (four neighborhood types). Child BMI z score and overweight or obesity status were primary outcomes, with diet and activity behaviors as behavioral outcomes.

Results

After adjusting for sociodemographics and Time 1 values, children living in two of the three less environmentally supportive neighborhoods had significantly less favorable BMI z score changes (+0.11, 95% CI: 0.01‐0.21; + 0.12, 95% CI: 0.03‐0.21), and all three less supportive neighborhoods had higher overweight or obesity (relative risks, 1.41‐1.49; 95% CI: 1.13‐1.80) compared with children in the most environmentally supportive neighborhoods. Changes in daily energy intake and sedentary behavior by neighborhood type were consistent with observed weight status changes, with unexpected findings for physical activity.

Conclusions

More walkable and recreation‐supportive environments with better nutrition access were associated with better child weight outcomes and related behavior changes.
Keywords:
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