Neighbourhood Walkability and Daily Steps in Adults with Type 2 Diabetes

<div><p>Introduction</p><p>There is evidence that greater neighbourhood walkability (i.e., neighbourhoods with more amenities and well-connected streets) is associated with higher levels of total walking in Europe and in Asia, but it remains unclear if this association holds in the Canadian context and in chronic disease populations. We examined the relationships of different walkability measures to biosensor-assessed total walking (i.e., steps/day) in adults with type 2 diabetes living in Montreal (QC, Canada).</p><p>Materials and Methods</p><p>Participants (60.5±10.4 years; 48.1% women) were recruited through McGill University-affiliated clinics (June 2006 to May 2008). Steps/day were assessed once per season for one year with pedometers. Neighbourhood walkability was evaluated through participant reports, in-field audits, Geographic Information Systems (GIS)-derived measures, and the Walk Score^®. Relationships between walkability and daily steps were estimated using Bayesian longitudinal hierarchical linear regression models (n = 131).</p><p>Results</p><p>Participants who reported living in the most compared to the least walkable neighbourhoods completed 1345 more steps/day (95% Credible Interval: 718, 1976; Quartiles 4 versus 1). Those living in the most compared to the least walkable neighbourhoods (based on GIS-derived walkability) completed 606 more steps per day (95% CrI: 8, 1203). No statistically significant associations with steps were observed for audit-assessed walkability or the Walk Score^®.</p><p>Conclusions</p><p>Adults with type 2 diabetes who perceived their neighbourhoods as more walkable accumulated more daily steps. This suggests that knowledge of local neighborhood features that enhance walking is a meaningful predictor of higher levels of walking and an important component of neighbourhood walkability.</p></div

The distribution of neighbourhood walkability (based on the Walk Score^®)^a in the study population.

<p>(n = 131).</p

Additional file 1 of Prospective associations between changes in physical activity and sedentary time and subsequent lean muscle mass in older English adults: the EPIC-Norfolk cohort study

Additional file 1: Table S1. Participant characteristics for those included versus excluded

Mean differences in daily steps across quartiles of each of the measures of neighbourhood walkability (n = 131).

<p>Mean differences in daily steps across quartiles of each of the measures of neighbourhood walkability (n = 131).</p

Characteristics of the study population at baseline by quartile of neighbourhood walkability (n = 131).^{^a,^b}

<p>Characteristics of the study population at baseline by quartile of neighbourhood walkability (n = 131).^{^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0151544#t001fn001" target="_blank">a</a>},^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0151544#t001fn002" target="_blank">b</a>}}</p

Do older English adults exhibit day-to-day compensation in sedentary time and in prolonged sedentary bouts? An EPIC-Norfolk cohort analysis - Fig 1

Association between initial day and subsequent day sedentary time stratified by retirement status (Panel A) and smoking status (Panel B). Each interaction term was tested in the model separately with all models adjusted for age, sex and wear-time. Values of total daily sedentary time for initial and subsequent day are constrained to the range demonstrated in the dataset (81–919 minutes/day). Panel A: Variation by retirement status. Panel A is for 65 year old male. Panel B: Variation by smoking status. Panel B is for a 65 year old male.</p

Estimated moderation effects of sociodemographic factors on day-to-day associations of sedentary time^a.

Estimated moderation effects of sociodemographic factors on day-to-day associations of sedentary timea.</p

Descriptive characteristics of study population stratified by low, medium, and high sedentary time.

Sedentary time = ST.</p

Do older English adults exhibit day-to-day compensation in sedentary time and in prolonged sedentary bouts? An EPIC-Norfolk cohort analysis - Fig 2

Association between initial day and subsequent day time in prolonged sedentary bouts by retirement status (Panel A) and by age (Panel B). Each interaction term was tested in the model separately with all models adjusted for age, sex and wear-time. Values of time spent in sedentary bouts ≥30 minutes for the initial day are constrained to the range within the dataset (0–691 minutes/day). Panel A: Variation by retirement status. Panel A is for a 65 year old male. Panel B: Variation by age. Panel B is for a male.</p

Focus Group Interview Questions.

<p>Focus Group Interview Questions.</p