Characteristics of walkable built environments and BMI z-scores in children: evidence from a large electronic health record database.
Characteristics of walkable built environments and BMI z-scores in children: evidence from a large electronic health record database.
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DOI：
10.1289/ehp.1307704
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发表时间：
2014-12
影响因子：
10.4
通讯作者：
Taveras EM
中科院分区：
文献类型：
--
作者：
Duncan DT;Sharifi M;Melly SJ;Marshall R;Sequist TD;Rifas-Shiman SL;Taveras EM
背景：儿童肥胖仍然是一个突出的公共卫生问题。可步行的建筑环境可能会防止体重过度增加。目的：我们在大量儿童和青少年样本中研究了可步行的建筑环境特征与身体质量指数（BMI） z得分的关系。方法：我们使用了2011年8月至2012年8月期间在哈佛先锋医疗协会14个儿科诊所就诊的49,770名4至19岁以下儿童和青少年的电子健康记录中的地理编码居住地址数据。我们使用八个地理信息系统（GIS）变量来描述可步行的建筑环境。结果是最近一次访问的BMI z-score和从最早（2008-2011）到最近（2011-2012）访问的BMI z-score变化。多变量模型根据儿童年龄、性别、种族/民族和社区家庭收入中位数进行了调整。结果：在多变量横断面模型中，居住在靠近休闲开放空间的地方与较低的BMI z-score相关。例如，居住在最近的娱乐开放空间附近（四分位数1）的儿童的BMI z-score （β = -0.06; 95% CI: -0.08, -0.03）比居住在最远的地方（四分位数4；参考）的儿童低。居住在休闲开放空间较少、居住密度、交通密度、人行道完整性和十字路口密度较低的社区，其横断面BMI z-score较高，且随时间增加。结论：总体而言，在大量儿童样本中，可能增加步行性的建筑环境特征与较低的BMI z分数相关。修改现有的建筑环境，使其更适合步行，可能会减少儿童肥胖。引用本文：Duncan DT， Sharifi M, melanie SJ, Marshall R, Sequist TD, Rifas-Shiman SL, Taveras EM. 2014。儿童可步行建筑环境的特征和BMI z评分：来自大型电子健康记录数据库的证据环境健康展望122:1359-1365；http://dx.doi.org/10.1289/ehp.1307704
Background: Childhood obesity remains a prominent public health problem. Walkable built environments may prevent excess weight gain. Objectives: We examined the association of walkable built environment characteristics with body mass index (BMI) z-score among a large sample of children and adolescents. Methods: We used geocoded residential address data from electronic health records of 49,770 children and adolescents 4 to < 19 years of age seen at the 14 pediatric practices of Harvard Vanguard Medical Associates from August 2011 through August 2012. We used eight geographic information system (GIS) variables to characterize walkable built environments. Outcomes were BMI z-score at the most recent visit and BMI z-score change from the earliest available (2008–2011) to the most recent (2011–2012) visit. Multivariable models were adjusted for child age, sex, race/ethnicity, and neighborhood median household income. Results: In multivariable cross-sectional models, living in closer proximity to recreational open space was associated with lower BMI z-score. For example, children who lived in closest proximity (quartile 1) to the nearest recreational open space had a lower BMI z-score (β = –0.06; 95% CI: –0.08, –0.03) compared with those living farthest away (quartile 4; reference). Living in neighborhoods with fewer recreational open spaces and less residential density, traffic density, sidewalk completeness, and intersection density were associated with higher cross-sectional BMI z-score and with an increase in BMI z-score over time. Conclusions: Overall, built environment characteristics that may increase walkability were associated with lower BMI z-scores in a large sample of children. Modifying existing built environments to make them more walkable may reduce childhood obesity. Citation: Duncan DT, Sharifi M, Melly SJ, Marshall R, Sequist TD, Rifas-Shiman SL, Taveras EM. 2014. Characteristics of walkable built environments and BMI z-scores in children: evidence from a large electronic health record database. Environ Health Perspect 122:1359–1365; http://dx.doi.org/10.1289/ehp.1307704
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DOI：
10.3390/ijerph10105083
发表时间：
2013-10-15
影响因子：
--
作者：
Gose M;Plachta-Danielzik S;Willié B;Johannsen M;Landsberg B;Müller MJ
通讯作者：
Müller MJ
影响因子：
5.5
作者：
Bell JF;Wilson JS;Liu GC
通讯作者：
Liu GC
DOI：
10.1111/j.1467-789x.2009.00572.x
发表时间：
2009-07
期刊：
Obesity reviews : an official journal of the International Association for the Study of Obesity
影响因子：
--
作者：
Dunton GF;Kaplan J;Wolch J;Jerrett M;Reynolds KD
通讯作者：
Reynolds KD
DOI：
10.3390/ijerph8114160
发表时间：
2011-11
影响因子：
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作者：
Duncan DT;Aldstadt J;Whalen J;Melly SJ;Gortmaker SL
通讯作者：
Gortmaker SL
DOI：
10.1186/1479-5868-7-70
发表时间：
2010-10-04
期刊：
The international journal of behavioral nutrition and physical activity
影响因子：
--
作者：
Boone-Heinonen J;Guilkey DK;Evenson KR;Gordon-Larsen P
通讯作者：
Gordon-Larsen P