Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep;25(9):2593-2600.
doi: 10.1017/S1368980022001197. Epub 2022 May 18.

Neighbourhood walkability and dietary attributes: effect modification by area-level socio-economic status

Manoj Chandrabose  1   2 , Yingting Tina Cao  2   3 , Nyssa Hadgraft  1   2 , Carl Higgs  4 , Faysal Shuvo  1 , David W Dunstan  2   5 , Neville Owen  1   2 , Takemi Sugiyama  1   2
Affiliations

Neighbourhood walkability and dietary attributes: effect modification by area-level socio-economic status

Manoj Chandrabose et al. Public Health Nutr. 2022 Sep.

Abstract

Objective: Higher neighbourhood walkability would be expected to contribute to better health, but the relevant evidence is inconsistent. This may be because residents' dietary attributes, which vary with socio-economic status (SES) and influence their health, can be related to walkability. We examined associations of walkability with dietary attributes and potential effect modification by area-level SES.

Design: The exposure variable of this cross-sectional study was neighbourhood walkability, calculated using residential density, intersection density and destination density within 1-km street-network buffer around each participant's residence. The outcome variables were dietary patterns (Western, prudent and mixed) and total dietary energy intake, derived from a FFQ. Main and interaction effects with area-level SES were estimated using two-level linear regression models.

Setting: Participants were from all states and territories in Australia.

Participants: The analytical sample included 3590 participants (54 % women, age range 34 to 86).

Results: Walkability was not associated with dietary attributes in the whole sample. However, we found interaction effects of walkability and area-level SES on Western diet scores (P < 0·001) and total energy intake (P = 0·012). In low SES areas, higher walkability was associated with higher Western dietary patterns (P = 0·062) and higher total energy intake (P = 0·066). In high SES areas, higher walkability was associated with lower Western diet scores (P = 0·021) and lower total energy intake (P = 0·058).

Conclusions: Higher walkability may not be necessarily conducive to better health in socio-economically disadvantaged areas. Public health initiatives to enhance neighbourhood walkability need to consider food environments and socio-economic contexts.

Keywords: Built environment; Cardiometabolic diseases; FFQ; Health inequalities; Population health.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Regression coefficients for the Western diet score (a) and total dietary energy intake (b) corresponding to one sd increment in walkability index, stratified by area-level socio-economic status (SES), AusDiab3 study, 2011–2012 (n 3590). Each model was adjusted for age, gender, education, work status, household income, marital status, household children status and corrected for area-level clustering
See this image and copyright information in PMC

References

    1. Roth GA, Mensah GA, Johnson CO et al. (2020) Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J Am Coll Cardiol 76, 2982–3021. - PMC - PubMed
    1. World Health Organization (2013) Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020. Geneva: WHO.
    1. Giles-Corti B, Vernez-Moudon A, Reis R et al. (2016) City planning and population health: a global challenge. Lancet 388, 2912–2924. - PubMed
    1. Smith M, Hosking J, Woodward A et al. (2017) Systematic literature review of built environment effects on physical activity and active transport – an update and new findings on health equity. Int J Behav Nutr Phys Act 14, 158. - PMC - PubMed
    1. Sallis JF, Cerin E, Kerr J et al. (2020) Built environment, physical activity, and obesity: findings from the International Physical Activity and Environment Network (IPEN) adult study. Ann Rev Public Health 41, 119–139. - PubMed

Publication types