The longitudinal association between neighbourhood quality and cardiovascular risk factors among youth receiving obesity treatment

IF 2.7 3区医学 Q1 PEDIATRICS Pediatric Obesity Pub Date : 2023-10-31 DOI:10.1111/ijpo.13080

Cody D. Neshteruk, Shivani Chandrashekaran, Sarah C. Armstrong, Asheley C. Skinner, Jesse Delarosa, Emily M. D'Agostino

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Abstract

Background

Neighbourhood factors are associated with cardiovascular health in adults, but these relationships are under-explored in youth.

Objectives

To characterize the associations between neighbourhood factors and child and adolescent health among youth with obesity.

Methods

Data were drawn from patient health records at a pediatric weight management clinic (n = 2838) and the Child Opportunity Index (COI). Exposures were area-level neighbourhood factors (commute duration, walkability, greenspace and industrial pollutants). Outcomes included BMI relative to the 95th percentile (BMIp95) and blood pressure (continuous variables). Longitudinal models examined associations between COI indicators and outcomes.

Results

Shorter commute duration (β = −4.31, 95% CI: −5.92, −2.71) and greater walkability (β = −4.40, 95% CI: −5.98, −2.82) were negatively associated with BMIp95. Increased greenspace availability was positively associated with BMIp95 (β = 1.93, 95% CI: 0.19, 3.67). None of the COI indicators were associated with cardiovascular outcomes in the full sample. Analyses stratified by sex and race/ethnicity showed similar patterns for BMIp95. For commute duration, there was a negative association with blood pressure for female, non-Hispanic White and other race/ethnicity youth.

Conclusions

Neighbourhood factors should be considered as contextual factors when treating youth with obesity. Additional research is needed to understand the relationship between neighbourhood factors and cardiovascular outcomes.

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在接受肥胖治疗的年轻人中，邻里质量与心血管风险因素之间的纵向关联。

背景：邻居因素与成年人的心血管健康有关，但这些关系在年轻人中尚未得到充分探讨。目的：了解肥胖青年中邻里因素与儿童和青少年健康之间的关系。方法：数据来源于儿科体重管理诊所的患者健康记录（n = 2838）和儿童机会指数（COI）。暴露是区域层面的邻里因素（通勤时间、可步行性、绿地和工业污染物）。结果包括相对于第95百分位的BMI（BMIp95）和血压（连续变量）。纵向模型检验了COI指标和结果之间的相关性。结果：通勤时间更短（β = -4.31，95%置信区间：-5.92，-2.71）和更大的步行能力（β = -4.40，95%CI:5.98，-2.82）与BMIp95呈负相关。绿地可用性的增加与BMIp95呈正相关（β = 1.93,95%可信区间：0.19,3.67）。在整个样本中，没有一项COI指标与心血管结果相关。按性别和种族/民族分层的分析显示BMIp95的模式相似。对于通勤时间，女性、非西班牙裔白人和其他种族/族裔青年的血压呈负相关。结论：在治疗青年肥胖时，应将邻里因素视为背景因素。需要更多的研究来了解邻里因素与心血管结果之间的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.