Frank 2004 - "Obesity Relationships with Community Design, Physical Activity, and Time Spent in Cars"

Lawrence D. Frank, Martin A. Anderson, Thomas L. Schmid
"Obesity Relationships with Community Design, Physical Activity, and Time Spent in Cars"
American Journal of Preventative Medicine
2004; 27(2), pp87-96

Based on a survey of 10,878 Atlanta residents taken in 2000-2002, Frank and colleagues investigated the relationships among body mass index (BMI), time spent in cars, distance walked, and built environment measures (including residential density, street connectivity, and land use mix) within a 1-km walk or drive of respondents' homes.

Adjusting for demographics, each quartile increase in land use mix was associated with a 12.2 percent reduction in the odds of being obese.  More time spent in cars increased the risk of obesity:  an additional 60 minutes per day in the car translated into an additonal 6 percent odds of being obese.  Each kilometer walked translated into a 4.8 percent reduction in the odds of being obese.

However, connectivity and residential density were not significantly related to obesity; though they were closely correlated with land use mix.

  • "[T]he proportion of obese persons...decoined from 20.2% in the lowest to 15.5% in the highest land-use-mix quartile.
  • The findings "affirm that increased time spent driving, a sedentary form of behavior associated with other environmental and economic costs, is associated with increased odds of being obese."  Add fat to the cost of driving.
  • 91.4 % of the respondents reported no walking at all during the 2-day survey period!!!
  • Those who did walked averaged >2 km per day.
  • One somewhat unexpected result -- even after controlling for walking distance, "land use mix was still a significant and meaningful variable."  That is, people who lived in mixed-use neighborhoods were less overweight even if they didn't walk!  Frank suggests that people in mixed-use neighborhoods may have access to more nutritious food.


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