Understanding environmental influences on nutrition and physical activity behaviors: where should we look and what should we count?

Research interest in the influence of environmental factors on nutrition and physical activity behaviors has surged internationally in recent years. This is evident from a rapidly expanding literature and facilitated by advances in methodological and analytical approaches to assessing multiple levels of influence on health behaviors. However, a number of conceptual challenges complicate research endeavours in this field. The purpose of this paper is to provide a 'state of the science' overview of evidence regarding environmental influences on nutrition and physical activity behaviors. We focus particularly on a number of key conceptual and methodological issues, including: a consideration of how the environment is defined; the selection and operationalization of environmental exposures; and the importance of integrating existing understanding of individual influences on behavior with the emerging data on the role of the environment. We draw on examples from the published literature including our own research studies to illustrate these issues. We conclude by proposing a research agenda to progress understanding of the influences of the environment on population nutrition and physical activity behaviors

How does perceived risk mediate associations between perceived safety and parental restriction of adolescents\u27 physical activity in their neighborhood?

BackgroundThere is evidence that adolescence is a critical period of decline in physical activity. However, adolescents may have limited opportunities to be physically active outdoors if their parents are concerned about neighborhood safety and restrict their adolescent&rsquo;s physical activity within their neighborhood. Pathways that lead to parental restriction of adolescents&rsquo; physical activity (constrained behavior) are under-researched. This study aimed to examine perceived risk as a potential mediator of associations between perceived safety/victimization and constrained behavior.MethodsCross-sectional study of adolescents (43% boys) aged 15&ndash;17&thinsp;years (n&thinsp;=&thinsp;270) in Melbourne, Australia. Parents reported perceived safety (road safety, incivilities and personal safety) and prior victimization in their neighborhood, perceived risk of their children being harmed and whether they constrained their adolescent&rsquo;s physical activity. Constrained behavior was categorized as &lsquo;avoidance&rsquo; or &lsquo;defensive&rsquo; behavior depending on a whether physical activity was avoided or modified, respectively, due to perceived risk. MacKinnon&rsquo;s product-of-coefficients test of mediation was used to assess potential mediating pathways between perceived safety/victimization and constrained behavior.ResultsFor girls only, perceived risk was a significant mediator of associations between perceived road safety and avoidance/defensive behavior, and between perceived incivilities, perceived personal safety, victimization and defensive behavior.ConclusionsAssociations between perceived safety/victimization and constrained behavior are complex. Findings may guide the design of interventions that aim to improve actual and perceived levels of safety and reduce perceptions of risk. This is of particular importance for adolescent girls among whom low and declining levels of physical activity have been observed worldwide.<br /

Children\u27s takeaway and fast-food intakes: associations with the neighbourhood food intakes : associations with the neighbourhood food environment

Objective: The present study aimed to examine associations between availability of outlets where takeaway or fast food could be purchased and consumption of takeaway or fast food among children.Design Cross-sectional: Parents completed a questionnaire regarding the frequency per week their child usually ate takeaway or fast foods. The availability of outlets where these foods could be purchased close to home and en route to school was determined with a Geographic Information System (presence of any outlets and density of outlets within 800 m from home and along the route to school, and distance from home to closest outlet).Setting: Greater Melbourne and Geelong, Australia.Subjects: Three hundred and fifty-three children aged 5&ndash;6 years and 463 children aged 10&ndash;12 years.Results: Overall, 69&middot;4 % of children consumed takeaway or fast foods once weekly or more often. Only one measure of availability of outlets close to home was associated with consumption; each additional outlet within 800 m was associated with 3 % lower odds of consuming takeaway or fast foods at least once weekly (OR = 0&middot;97, 95 % CI 0&middot;95, 1&middot;00). There were no associations between availability en route to school and the likelihood of consuming takeaway or fast food at least once weekly.Conclusions:&nbsp; Access to outlets where takeaway or fast food could be purchased did not predict frequency of consumption of takeaway or fast food in the expected direction. Such relationships appear to be complex and may not be adequately captured by the measures of access included in the current study.<br /

Socioeconomic position and children\u27s physical activity and sedentary behaviors : longitudinal findings from the CLAN study

Background: This study aimed to examine cross-sectional and longitudinal associations between socioeconomic position (SEP) and physical activity and sedentary behaviors amongst children and adolescents. Methods: Maternal education was reported by parents of 184 5-6 year-old and 358 10-12 year-old children in 2001. In 2001 and 2004, physical activity was assessed by accelerometry. Older children self-reported and parents of younger children proxy-reported physical activity and television (TV) viewing behaviors. Linear regression was used to predict physical activity and sedentary behaviors, and changes in these behaviors, from maternal education. Results: Among all children, accelerometer-determined and self/parent-reported moderate and vigorous physical activity declined over three years. Girls of higher SEP demonstrated greater decreases in TV viewing behaviours than those of low SEP. In general, no prospective associations were evident between SEP and objectively-assessed physical activity. A small number of prospective associations were noted between SEP and self-reported physical activity, but these were generally weak and inconsistent in direction. Conclusions: This study did not find strong evidence that maternal education was cross-sectionally or longitudinally predictive of children&rsquo;s physical activity or sedentary behaviors. Given the well-documented inverse relationship of SEP with physical activity levels in adult samples, findings suggest that such disparities may emerge after adolescence.<br /

Do food and physical activity environments vary between disadvantaged urban and rural areas? Findings from the READI study

Issues addressed: The presence or absence of amenities in local neighbourhood environments can either promote or restrict access to opportunities to engage in healthy and/or less healthy behaviours. Rurality is thought to constrain access to facilities and services. This study investigated whether the presence and density of environmental amenities related to physical activity and eating behaviours differs between socioeconomically disadvantaged urban and rural areas in Victoria, Australia.Methods: We undertook cross-sectional analysis of environmental data collected in 2007-08 as part of the Resilience for Eating and Activity Despise Inequality (READI) study. These data were sourced and analysed for 40 urban and 40 rural socioeconomically disadvantaged areas. The variables examined were the presence, raw count, count/km2, and count/\u27000 population of a range of environmental amenities (fast-food restaurants, all supermarkets (also separated by major chain and other supermarkets), greengrocers, playgrounds, gyms/leisure centres, public swimming pools and public open spaces).Results: A greater proportion of urban areas had a fast-food restaurant and gym/leisure centre present while more rural areas contained a supermarket and public swimming pool. All amenities examined (with the exception of swimming pools) were more numerous per km2 in urban areas, however rural areas had a greater number of all supermarkets, other supermarkets, playgrounds, swimming pools and public open area per \u27000 population.Conclusion: Although opportunities to engage in healthy eating and physical activity exist in many rural areas, a lower density per km2 suggests a greater travel distance may be required to reach these

How is active transport associated with children's and adolescents' physical activity over time?

Background : As few longitudinal studies have examined how active transport is associated with physical activity among children and adolescents over time, and how active transport tracks through childhood and adolescence, it is important to understand whether physically active children retain their activity patterns through adolescence. This study aimed to examine (a) tracking of active transport and of moderate-to-vigorous physical activity (MVPA) across childhood and adolescence in two age cohorts; and (b) associations between active transport and MVPA at three distinct time-points, over five years.Methods : This longitudinal study of two cohorts aged 5-6 years (n = 134) and 10-12 years (n = 201) at baseline (T1), in Melbourne, Australia, gathered follow-up data at three (T2) and five years (T3). Walking/cycling to local destinations was survey-reported; while MVPA was recorded using accelerometers and mean time spent daily in MVPA on week days and on weekends was computed. Tracking of these behaviours was examined over five years using General Estimating Equations. Linear regression analyses were performed to examine associations between active transport and MVPA at each time-point.Results : Active transport tracked moderately among children (boys, bs = 0.36; girls, bs = 0.51) but not among adolescents. Physical activity tracked moderately (bs value range: 0.33-0.55) for both cohorts. Active transport was not associated with children&rsquo;s MVPA at any time-point, but was associated with adolescent boys&rsquo; MVPA on week days at T1 (B = 1.37 (95% CI: 0.15, 2.59)), at T2 (B = 1.27 (95% CI: 0.03, 2.51)) and at T3 (B = 0.74 (95% CI: 0.01, 1.47)), and with adolescent girls&rsquo; MVPA on week days (B = 0.40 (95% CI: 0.04, 0.76)) and on weekends (B = 0.54 (95% CI:0.16, 0.93)) at T3 only.Conclusion : Active transport was associated only with boys&rsquo; MVPA during early adolescence and with boys&rsquo; and girls&rsquo; MVPA during late adolescence. While active transport should be encouraged among all school-aged children, it may provide an important source of habitual physical activity for adolescent girls, in particular, among whom low and declining physical activity levels have been reported world-wide.<br /

On your bike! a cross-sectional study of the individual, social and environmental correlates of cycling to school

Background : Active school transport (AST) has declined rapidly in recent decades. While many studies have examined walking, cycling to school has received very little attention. Correlates of cycling are likely to differ to those from walking and cycling enables AST from further distances. This study examined individual, social and environmental factors associated with cycling to school among elementary school-aged children, stratified by gender. Methods : Children (n = 1197) attending 25 Australian primary schools located in high or low walkable neighborhoods, completed a one-week travel diary and a parent/child questionnaire on travel habits and attitudes. Results : Overall, 31.2% of boys and 14.6% of girls cycled &ge; 1 trip/week, however 59.4% of boys and 36.7% of girls reported cycling as their preferred school transport mode. In boys (but not girls), school neighborhood design was significantly associated with cycling: i.e., boys attending schools in neighborhoods with high connectivity and low traffic were 5.58 times more likely to cycle (95% CI 1.11-27.96) and for each kilometer boys lived from school the odds of cycling reduced by 0.70 (95% CI 0.63-0.99). Irrespective of gender, cycling to school was associated with parental confidence in their child\u27s cycling ability (boys: OR 10.39; 95% CI 3.79-28.48; girls: OR 4.03; 95% CI 2.02-8.05), parental perceived convenience of driving (boys: OR 0.42; 95% CI 0.23-0.74; girls: OR 0.40; 95% CI 0.20-0.82); and child\u27s preference to cycle (boys: OR 5.68; 95% CI 3.23-9.98; girls: OR 3.73; 95% CI 2.26-6.17). Conclusion : School proximity, street network connectivity and traffic exposure in school neighborhoods was associated with boys (but not girls) cycling to school. Irrespective of gender, parents need to be confident in their child\u27s cycling ability and must prioritize cycling over driving. <br /

Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods

A detailed understanding of the underlying drivers of obesity-risk behaviours is needed to inform prevention initiatives, particularly for individuals of low socioeconomic position who are at increased risk of unhealthy weight gain. However, few studies have concurrently considered factors in the home and local neighbourhood environments, and little research has examined determinants among children from low socioeconomic backgrounds. The present study examined home, social and neighbourhood correlates of BMI (kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional data were collected from 491 women with children aged 5&ndash;12 years living in forty urban and forty rural socioeconomically disadvantaged areas (suburbs) of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires about the home environment (maternal efficacy, perceived importance/beliefs, rewards, rules and access to equipment), social norms and perceived neighbourhood environment in relation to physical activity, healthy eating and sedentary behaviour. Children\u27s height and weight were measured at school or home. Linear regression analyses controlled for child sex and age. In multivariable analyses, children whose mothers had higher efficacy for them doing physical activity tended to have lower BMI z scores (B = &minus; 0&middot;04, 95 % CI &minus; 0&middot;06, &minus; 0&middot;02), and children who had a television (TV) in their bedroom (B = 0&middot;24, 95 % CI 0&middot;04, 0&middot;44) and whose mothers made greater use of food as a reward for good behaviour (B = 0&middot;05, 95 % CI 0&middot;01, 0&middot;09) tended to have higher BMI z scores. Increasing efficacy among mothers to promote physical activity, limiting use of food as a reward and not placing TV in children\u27s bedrooms may be important targets for future obesity prevention initiatives in disadvantaged communities

Direct and indirect associations between the family physical activity environment and sports participation among 10-12 year-old European children: testing the EnRG framework in the ENERGY project

BACKGROUND: Sport participation makes an important contribution to children’s overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children’s sport participation. The purpose of this study was to examine whether attitude, perceived behavioural control, health belief and enjoyment mediate associations between the family environment and 10–12 year-old children’s sports participation. METHODS: Children aged 10–12 years ( = 7234) and one of their parents (n = 6002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses. RESULTS: Availability of equipment (OR = 1.16), financial (OR = 1.53), logistic (OR = 1.47) and emotional (OR = 1.51) support, and parental modelling (OR = 1.07) were positively associated with participation in ≥ 30mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment. CONCLUSIONS: Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children’s sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children’s sport participation are warranted

Individual, social, and environmental correlates of healthy and unhealthy eating

Few studies use comprehensive ecological approaches considering multilevel factors to understand correlates of healthy (and unhealthy) dietary intake. The aim of this study was to examine the association between individual, social, and environmental factors on composite measures of healthy and unhealthy dietary intake in adults