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Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study

Sallis, James F and Cerin, Ester and Conway, Terry L and Adams, Marc A and Frank, Lawrence D and Pratt, Michael and Salvo, Deborah and Schipperijn, Jasper and SMITH, Graham and Cain, Kelli L and Davey, Rachel and Kerr, Jacqueline and Lai, Poh-Chin and Mitáš, Josef and Reis, Rodrigo and Sarmiento, Olga L and Schofield, Grant and Troelsen, Jens and Van Dyck, Delfien and De Bourdeaudhuij, Ilse and Owen, Neville (2016) Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study. The Lancet, 387 (10034). pp. 2207-2217. ISSN 01406736

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Abstract or description

Background
Physical inactivity is a global pandemic responsible for over 5 million deaths annually through its effects on multiple non-communicable diseases. We aimed to document how objectively measured attributes of the urban environment are related to objectively measured physical activity, in an international sample of adults.

Methods
We based our analyses on the International Physical activity and Environment Network (IPEN) adult study, which was a coordinated, international, cross-sectional study. Participants were sampled from neighbourhoods with varied levels of walkability and socioeconomic status. The present analyses of data from the IPEN adult study included 6822 adults aged 18–66 years from 14 cities in ten countries on five continents. Indicators of walkability, public transport access, and park access were assessed in 1·0 km and 0·5 km street network buffers around each participant's residential address with geographic information systems. Mean daily minutes of moderate-to-vigorous-intensity physical activity were measured with 4–7 days of accelerometer monitoring. Associations between environmental attributes and physical activity were estimated using generalised additive mixed models with gamma variance and logarithmic link functions.

Results
Four of six environmental attributes were significantly, positively, and linearly related to physical activity in the single variable models: net residential density (exp[b] 1·006 [95% CI 1·003–1·009]; p=0·001), intersection density (1·069 [1·011–1·130]; p=0·019), public transport density (1·037 [1·018–1·056]; p=0·0007), and number of parks (1·146 [1·033–1·272]; p=0·010). Mixed land use and distance to nearest public transport point were not related to physical activity. The difference in physical activity between participants living in the most and least activity-friendly neighbourhoods ranged from 68 min/week to 89 min/week, which represents 45–59% of the 150 min/week recommended by guidelines.

Interpretation
Design of urban environments has the potential to contribute substantially to physical activity. Similarity of findings across cities suggests the promise of engaging urban planning, transportation, and parks sectors in efforts to reduce the health burden of the global physical inactivity pandemic.

Funding
Funding for coordination of the IPEN adult study, including the present analysis, was provided by the National Cancer Institute of National Institutes of Health (CA127296) with studies in each country funded by different sources.

Item Type: Article
Uncontrolled Keywords: JAN2017
Faculty: Previous Faculty of Computing, Engineering and Sciences > Computing
Depositing User: Library STORE team
Date Deposited: 19 Jan 2017 16:55
Last Modified: 23 Jan 2017 13:30
URI: http://eprints.staffs.ac.uk/id/eprint/2962

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