Laboratory-Assessed Markers of Cardiometabolic Health and Associations with GIS-Based Measures of Active-Living Environments
MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
Department of Geography, McGill University, 805 Sherbrooke St. West, Montréal, QC H3A 0B9, Canada
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Ave. West, Montréal, QC H3A 1A2, Canada
Department of Medicine, Divisions of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(10), 2079; https://doi.org/10.3390/ijerph15102079
Received: 20 July 2018 / Revised: 12 September 2018 / Accepted: 14 September 2018 / Published: 21 September 2018
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Active-living-friendly environments have been linked to physical activity, but their relationships with specific markers of cardiometabolic health remain unclear. We estimated the associations between active-living environments and markers of cardiometabolic health, and explored the potential mediating role of physical activity in these associations. We used data collected on 2809 middle-aged adults who participated in the Canadian Health Measures Survey (2007–2009; 41.5 years, SD = 15.1). Environments were assessed using an index that combined GIS-derived measures of street connectivity, land use mix, and population density. Body mass index (BMI), systolic blood pressure (SBP), hemoglobin A1c, and cholesterol were assessed in a laboratory setting. Daily step counts and moderate-to-vigorous intensity physical activity (MVPA) were assessed for seven days using accelerometers. Associations were estimated using robust multivariable linear regressions adjusted for sociodemographic factors that were assessed via questionnaire. BMI was 0.79 kg/m2 lower (95% confidence interval (CI) −1.31, −0.27) and SBP was 1.65 mmHg lower (95% CI −3.10, −0.20) in participants living in the most active-living-friendly environments compared to the least, independent of daily step counts or MVPA. A 35.4 min/week difference in MPVA (95% CI 24.2, 46.6) was observed between residents of neighborhoods in the highest compared to the lowest active-living-environment quartiles. Cycling to work rates were also the highest in participants living in the highest living-environment quartiles (e.g., Q4 vs. Q1: 10.4% vs. 4.9%). Although active-living environments are associated with lower BMI and SBP, and higher MVPA and cycling rates, neither daily step counts nor MVPA appear to account for environment–BMI/SBP relationships. This suggests that other factors not assessed in this study (e.g., food environment or unmeasured features of the social environment) may explain this relationship.