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Exploring the links between population density, lifestyle, and being overweight: secondary data analyses of middle-aged and older Chinese adults

Exploring the links between population density, lifestyle, and being overweight: secondary data analyses of middle-aged and older Chinese adults
Exploring the links between population density, lifestyle, and being overweight: secondary data analyses of middle-aged and older Chinese adults
Background
The increasing prevalence of obesity across all age groups has become a major health concern in China. Previous studies have found strong links between population density, sedentary lifestyle, and the risk of being overweight among adults and adolescents in Western countries. However, little research has been conducted to disentangle this relationship in China, which is rapidly urbanizing and densely populated. Compared to other age groups, middle-aged and older adults tend to have a higher risk of being overweight, which increases their risk of diabetes, high blood pressure, and other weight-related chronic diseases. In addition, they are especially sensitive to neighbourhood environmental factors such as population density. Therefore, we aimed to unravel the link between population density and the risk of being overweight among Chinese middle-aged and older adults, with a particular focus on the mediating role of lifestyle choices.

Methods
Data from the 2011 China Health and Retirement Longitudinal Study were analysed. Individuals (N = 5285) were sampled from 405 neighbourhoods nested within 150 cities. Body Mass Index (BMI) was calculated based on self-reported body weight and height (being overweight was defined as a BMI ≥ 24 kg/m2). Multilevel regression and mediation analyses were applied to explore associations between population density, a sedentary lifestyle, and the risk of being overweight.

Results
Middle-aged and older adults who lived in densely populated neighbourhoods had higher odds of being overweight. Further, this link was mediated by residents’ mode of travel and physical exercise; specifically, these residents had higher odds of owning a car and spending lesser time on weekly physical exercise, thereby increasing their risk of being overweight. Furthermore, the association between car ownership and the odds of being overweight varied by neighbourhood population density.

Conclusions
There was a positive association between neighbourhood population density and middle-aged and older adults’ risk of being overweight. This relationship may exist because people who live in densely populated neighbourhoods tend to lead a sedentary lifestyle. Our findings also suggest that, in rapidly urbanizing countries, a sedentary lifestyle may be especially harmful to middle-aged and older adults who live in densely populated neighbourhoods.
1477-7525
Wang, Ruoyu
87337ca7-1c03-4c1c-a6b5-3dbf54d390ad
Feng, Zhixin
33c0073f-a67c-4d8a-9fea-5a502420e589
Xue, Desheng
47ad0de9-9efe-4a3a-b0cf-4f72f876f012
Liu, Ye
b8f0aad7-cbbf-4b87-b69e-c271a582c172
Wu, Rong
35499551-cef1-465d-a0a8-e1bd9481663d
Wang, Ruoyu
87337ca7-1c03-4c1c-a6b5-3dbf54d390ad
Feng, Zhixin
33c0073f-a67c-4d8a-9fea-5a502420e589
Xue, Desheng
47ad0de9-9efe-4a3a-b0cf-4f72f876f012
Liu, Ye
b8f0aad7-cbbf-4b87-b69e-c271a582c172
Wu, Rong
35499551-cef1-465d-a0a8-e1bd9481663d

Wang, Ruoyu, Feng, Zhixin, Xue, Desheng, Liu, Ye and Wu, Rong (2019) Exploring the links between population density, lifestyle, and being overweight: secondary data analyses of middle-aged and older Chinese adults. Health and Quality of Life Outcomes, 17 (100). (doi:10.1186/s12955-019-1172-3).

Record type: Article

Abstract

Background
The increasing prevalence of obesity across all age groups has become a major health concern in China. Previous studies have found strong links between population density, sedentary lifestyle, and the risk of being overweight among adults and adolescents in Western countries. However, little research has been conducted to disentangle this relationship in China, which is rapidly urbanizing and densely populated. Compared to other age groups, middle-aged and older adults tend to have a higher risk of being overweight, which increases their risk of diabetes, high blood pressure, and other weight-related chronic diseases. In addition, they are especially sensitive to neighbourhood environmental factors such as population density. Therefore, we aimed to unravel the link between population density and the risk of being overweight among Chinese middle-aged and older adults, with a particular focus on the mediating role of lifestyle choices.

Methods
Data from the 2011 China Health and Retirement Longitudinal Study were analysed. Individuals (N = 5285) were sampled from 405 neighbourhoods nested within 150 cities. Body Mass Index (BMI) was calculated based on self-reported body weight and height (being overweight was defined as a BMI ≥ 24 kg/m2). Multilevel regression and mediation analyses were applied to explore associations between population density, a sedentary lifestyle, and the risk of being overweight.

Results
Middle-aged and older adults who lived in densely populated neighbourhoods had higher odds of being overweight. Further, this link was mediated by residents’ mode of travel and physical exercise; specifically, these residents had higher odds of owning a car and spending lesser time on weekly physical exercise, thereby increasing their risk of being overweight. Furthermore, the association between car ownership and the odds of being overweight varied by neighbourhood population density.

Conclusions
There was a positive association between neighbourhood population density and middle-aged and older adults’ risk of being overweight. This relationship may exist because people who live in densely populated neighbourhoods tend to lead a sedentary lifestyle. Our findings also suggest that, in rapidly urbanizing countries, a sedentary lifestyle may be especially harmful to middle-aged and older adults who live in densely populated neighbourhoods.

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Accepted/In Press date: 3 June 2019
Published date: 11 June 2019

Identifiers

Local EPrints ID: 431972
URI: http://eprints.soton.ac.uk/id/eprint/431972
ISSN: 1477-7525
PURE UUID: af1ea46c-6994-48d3-a886-80649516ba7a

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Date deposited: 25 Jun 2019 16:30
Last modified: 16 Dec 2019 17:35

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