The role of built environments in physical activity, eating, and obesity in childhood.

Over the past forty years various changes in the U.S. "built environment" have promoted sedentary lifestyles and less healthful diets. James Sallis and Karen Glanz investigate whether these changes have had a direct effect on childhood obesity and whether improvements to encourage more physical activity and more healthful diets are likely to lower rates of childhood obesity. Researchers, say Sallis and Glanz, have found many links between the built environment and children's physical activity, but they have yet to find conclusive evidence that aspects of the built environment promote obesity. For example, certain development patterns, such as a lack of sidewalks, long distances to schools, and the need to cross busy streets, discourage walking and biking to school. Eliminating such barriers can increase rates of active commuting. But researchers cannot yet prove that more active commuting would reduce rates of obesity. Sallis and Glanz note that recent changes in the nutrition environment, including greater reliance on convenience foods and fast foods, a lack of access to fruits and vegetables, and expanding portion sizes, are also widely believed to contribute to the epidemic of childhood obesity. But again, conclusive evidence that changes in the nutrition environment will reduce rates of obesity does not yet exist. Research into the link between the built environment and childhood obesity is still in its infancy. Analysts do not know whether changes in the built environment have increased rates of obesity or whether improvements to the built environment will decrease them. Nevertheless, say Sallis and Glanz, the policy implications are clear. People who have access to safe places to be active, neighborhoods that are walkable, and local markets that offer healthful food are likely to be more active and to eat more healthful food-two types of behavior that can lead to good health and may help avoid obesity.