Abstract
Background. Neighborhood infrastructure may provide an important opportunity to prevent overweight among children. In the present study we investigated whether access to shops for modestly priced fresh produce, access to parks and playgrounds, access to recreational facilities and neighborhood safety are related to children's diet, physical and sedentary activities, and body weights. Methods. Data were obtained from the Children's Lifestyle and School-performance Study, a survey including 5471 grade five students and their parents in the province of Nova Scotia, Canada. Students completed the Harvard Food Frequency Questionnaire and had their height and weight measured. Parents completed questions on socio-economic background and how they perceived their neighborhood. We applied multilevel regression methods to relate these neighborhood characteristics with children's fruit and vegetable consumption, dietary fat intake, diet quality, frequency of engaging in sports with and without a coach, screen time, overweight and obesity. Results. Children in neighborhoods with greater perceived access to shops had healthier diets and were less likely to be overweight or obese. Children in neighborhoods with good access to playgrounds, parks and recreational facilities were reportedly more active and were less likely to be overweight or obese, whereas children in safe neighborhoods engaged more in unsupervised sports. Conclusions. The study demonstrated associations between neighborhood characteristics, health behaviors and childhood overweight. This contributes to the knowledge base that is still too narrow to justify informed preventative public health policy. We advocate the evaluation of natural experiments created by new policy that affect neighborhood infrastructures as the optimal opportunity to enlarge this knowledge base.
Acknowledgements
We thank all the Grade five students, parents and schools for their participation in the CLASS project. We are grateful to all the research assistants and public health staff who assisted in the data collection. The research was funded by a Canadian Population Health Initiative operating grant, and through a Canadian Institute of Health Research New Investigator Award, a Canada Research Chair in Population Health and a Alberta Heritage Foundation for Medical Research Scholarship awarded to Dr. Paul Veugelers.