Kenta Okuyama1,2, Xinjun Li3, Takafumi Abe4, Tsuyoshi Hamano4,5, Paul W Franks6, Toru Nabika4,7, Kristina Sundquist3,4,8. 1. Center for Primary Health Care Research, Lund University, Malmö, Sweden. ko215ok@gmail.com. 2. Center for Community-based Healthcare Research and Education, Shimane University, Shimane, Japan. ko215ok@gmail.com. 3. Center for Primary Health Care Research, Lund University, Malmö, Sweden. 4. Center for Community-based Healthcare Research and Education, Shimane University, Shimane, Japan. 5. Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Kyoto, Japan. 6. Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden. 7. Department of Functional Pathology, Shimane University School of Medicine, Izumo, Japan. 8. Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Abstract
BACKGROUND: While neighborhood deprivation is a well-known predictor of obesity, the mechanisms behind this association are unclear and these are important to clarify before designing interventions focusing on modifiable neighborhood environmental factors in order to reduce obesity risk. OBJECTIVES: This study examined the longitudinal association between availability of fast-food outlets and physical activity facilities and the risk of obesity among adults. METHODS: This study used multiple national register data from Sweden. During the 11-year follow-up period between 2005 and 2015, data from 1,167,449 men and 542,606 women, aged 20-55 years, were accessible for inclusion in this analysis. Incidence of obesity was identified based on a diagnosis of obesity during the follow-up period derived from clinical register data. Neighborhood availability of fast-food outlets and physical activity facilities were assessed in 2005 and Cox regression was used in the statistical analysis. Individual socio-demographic factors and neighborhood deprivation were used as covariates. RESULTS: There were no meaningful associations between neighborhood fast-food outlets or physical activity facilities and obesity in men or women. Neighborhood deprivation was, however, consistently and strongly associated with incidence of obesity in both men and women. CONCLUSIONS: Availability of fast-food outlets and lack of physical activity facilities appear unlikely to cause obesity in Swedish adults. Other potentially modifiable environmental factors within specific social and cultural settings that may influence obesity risk should be examined in future studies.
BACKGROUND: While neighborhood deprivation is a well-known predictor of obesity, the mechanisms behind this association are unclear and these are important to clarify before designing interventions focusing on modifiable neighborhood environmental factors in order to reduce obesity risk. OBJECTIVES: This study examined the longitudinal association between availability of fast-food outlets and physical activity facilities and the risk of obesity among adults. METHODS: This study used multiple national register data from Sweden. During the 11-year follow-up period between 2005 and 2015, data from 1,167,449 men and 542,606 women, aged 20-55 years, were accessible for inclusion in this analysis. Incidence of obesity was identified based on a diagnosis of obesity during the follow-up period derived from clinical register data. Neighborhood availability of fast-food outlets and physical activity facilities were assessed in 2005 and Cox regression was used in the statistical analysis. Individual socio-demographic factors and neighborhood deprivation were used as covariates. RESULTS: There were no meaningful associations between neighborhood fast-food outlets or physical activity facilities and obesity in men or women. Neighborhood deprivation was, however, consistently and strongly associated with incidence of obesity in both men and women. CONCLUSIONS: Availability of fast-food outlets and lack of physical activity facilities appear unlikely to cause obesity in Swedish adults. Other potentially modifiable environmental factors within specific social and cultural settings that may influence obesity risk should be examined in future studies.
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