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Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England

Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England
Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England
BACKGROUND: Geographical inequalities in overweight and obesity prevalence among children are well established in cross-sectional research. We aimed to examine how environmental area characteristics at birth are related to these outcomes in childhood.

METHODS: Anonymised antenatal and birth data recorded by University Hospital Southampton linked to school-measured weight and height data for children within Southampton, UK, were utilised (14,084 children at ages 4-5 and 5637 at ages 10-11). Children's home address at birth was analysed at the Lower and Middle layer Super Output Area (LSOA/MSOA) levels (areas with average populations of 1500 and 7000, respectively). Area-level indices (walkability, relative density of unhealthy food outlets, spaces for social interaction), natural greenspace coverage, supermarket density and measures of air pollution (PM2.5, PM10 and NOx) were constructed using ArcGIS Network Analyst. Overweight/obesity was defined as a body mass index (BMI; kg/m2) greater than the 85th centile for sex and age. Population-average generalised estimating equations estimated the risk of being overweight/obese for children at both time points. Confounders included maternal BMI and smoking in early pregnancy, education, ethnicity and parity. We also examined associations for a subgroup of children who moved residence between birth and outcome measurement.

RESULTS: There were mixed results between area characteristics at birth and overweight/obesity at later ages. MSOA relative density of unhealthy food outlets and PM10 were positively associated with overweight/obesity, but not among children who moved. LSOA greenspace coverage was negatively associated with the risk of being overweight/obese at ages 10-11 in all children (relative risk ratio 0.997, 95% confidence interval 0.995-0.999, p = 0.02) and among children who moved.

CONCLUSIONS: Local access to natural greenspaces at the time of birth was inversely associated with becoming overweight or obese by age 10-11, regardless of migration. Increased access/protection of greenspace may have a role in the early prevention of childhood obesity.
Area indices, Childhood overweight, Greenspace, Obesity
1741-7015
Wilding, Sam
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Ziauddeen, Nida
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Smith, Dianna
e859097c-f9f5-4fd0-8b07-59218648e726
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Chase, Debbie
d4f47e11-d0cd-4de7-afeb-9ebae1222fc9
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382
Wilding, Sam
a026cae1-cc72-49b5-a52b-ec1d931d72e1
Ziauddeen, Nida
8b233a4a-9763-410b-90c7-df5c7d1a26e4
Smith, Dianna
e859097c-f9f5-4fd0-8b07-59218648e726
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Chase, Debbie
d4f47e11-d0cd-4de7-afeb-9ebae1222fc9
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382

Wilding, Sam, Ziauddeen, Nida, Smith, Dianna, Roderick, Paul, Chase, Debbie and Alwan, Nisreen (2020) Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England. BMC Medicine, 18 (1), [43]. (doi:10.1186/s12916-020-01513-0).

Record type: Article

Abstract

BACKGROUND: Geographical inequalities in overweight and obesity prevalence among children are well established in cross-sectional research. We aimed to examine how environmental area characteristics at birth are related to these outcomes in childhood.

METHODS: Anonymised antenatal and birth data recorded by University Hospital Southampton linked to school-measured weight and height data for children within Southampton, UK, were utilised (14,084 children at ages 4-5 and 5637 at ages 10-11). Children's home address at birth was analysed at the Lower and Middle layer Super Output Area (LSOA/MSOA) levels (areas with average populations of 1500 and 7000, respectively). Area-level indices (walkability, relative density of unhealthy food outlets, spaces for social interaction), natural greenspace coverage, supermarket density and measures of air pollution (PM2.5, PM10 and NOx) were constructed using ArcGIS Network Analyst. Overweight/obesity was defined as a body mass index (BMI; kg/m2) greater than the 85th centile for sex and age. Population-average generalised estimating equations estimated the risk of being overweight/obese for children at both time points. Confounders included maternal BMI and smoking in early pregnancy, education, ethnicity and parity. We also examined associations for a subgroup of children who moved residence between birth and outcome measurement.

RESULTS: There were mixed results between area characteristics at birth and overweight/obesity at later ages. MSOA relative density of unhealthy food outlets and PM10 were positively associated with overweight/obesity, but not among children who moved. LSOA greenspace coverage was negatively associated with the risk of being overweight/obese at ages 10-11 in all children (relative risk ratio 0.997, 95% confidence interval 0.995-0.999, p = 0.02) and among children who moved.

CONCLUSIONS: Local access to natural greenspaces at the time of birth was inversely associated with becoming overweight or obese by age 10-11, regardless of migration. Increased access/protection of greenspace may have a role in the early prevention of childhood obesity.

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BMC_Area_Analysis_Clean_After_Peer_Review_29_1_20 - Accepted Manuscript
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More information

Accepted/In Press date: 6 February 2020
e-pub ahead of print date: 19 March 2020
Published date: 19 March 2020
Keywords: Area indices, Childhood overweight, Greenspace, Obesity

Identifiers

Local EPrints ID: 437870
URI: http://eprints.soton.ac.uk/id/eprint/437870
ISSN: 1741-7015
PURE UUID: d0f9d8d0-1ecd-4b6a-a1d3-42fc4ee9ff09
ORCID for Sam Wilding: ORCID iD orcid.org/0000-0003-4184-2821
ORCID for Dianna Smith: ORCID iD orcid.org/0000-0002-0650-6606
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Nisreen Alwan: ORCID iD orcid.org/0000-0002-4134-8463

Catalogue record

Date deposited: 21 Feb 2020 17:30
Last modified: 10 Jan 2022 03:12

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Contributors

Author: Sam Wilding ORCID iD
Author: Nida Ziauddeen
Author: Dianna Smith ORCID iD
Author: Paul Roderick ORCID iD
Author: Debbie Chase
Author: Nisreen Alwan ORCID iD

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