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The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study

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  • Christine L Gray
  • Lynne C Messer
  • Kristen M Rappazzo
  • Jyotsna S Jagai
  • Shannon C Grabich
  • Danelle T Lobdell

Abstract

Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for state, adjusted for percent minority and rural-urban status. We modelled overall and sex-specific estimates, reporting prevalence differences (PD) and 95% confidence intervals (CI). In the overall population, the PD increased from best (PD = 0.341 (95% CI: 0.287, 0.396)) to worst (PD = 0.645 (95% CI: 0.599, 0.690)) EQI tertile. We observed similar trends in males from best (PD = 0.244 (95% CI: 0.194, 0.294)) to worst (PD = 0.601 (95% CI: 0.556, 0.647)) quality environments, and in females from best (PD = 0.446 (95% CI: 0.385, 0.507)) to worst (PD = 0.655 (95% CI: 0.607, 0.703)). We found that poor environmental quality exacerbates the LTPIA-obesity relationship. Efforts to improve obesity through LTPIA may benefit from considering this relationship.

Suggested Citation

  • Christine L Gray & Lynne C Messer & Kristen M Rappazzo & Jyotsna S Jagai & Shannon C Grabich & Danelle T Lobdell, 2018. "The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-14, August.
    • Handle: RePEc:plo:pone00:0203301
    DOI: 10.1371/journal.pone.0203301
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    References listed on IDEAS

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    1. Jennifer D Roberts & Jameson D Voss & Brandon Knight, 2014. "The Association of Ambient Air Pollution and Physical Inactivity in the United States," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-10, March.
    2. Nelson, D.E. & Powell-Griner, E. & Town, M. & Kovar, M.G., 2003. "A Comparison of National Estimates from the National Health Interview Survey and the Behavioral Risk Factor Surveillance System," American Journal of Public Health, American Public Health Association, vol. 93(8), pages 1335-1341.
    3. Borrell, L.N. & Samuel, L., 2014. "Body mass index categories and mortality risk in US adults: The effect of overweight and obesity on advancing death," American Journal of Public Health, American Public Health Association, vol. 104(3), pages 512-519.
    4. Von Hippel, P. & Benson, R., 2014. "Obesity and the natural environment across US counties," American Journal of Public Health, American Public Health Association, vol. 104(7), pages 1287-1293.
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    3. Achraf Ammar & Omar Boukhris & Nicole Halfpaap & Berit Kristin Labott & Corinna Langhans & Fabian Herold & Bernhard Grässler & Patrick Müller & Khaled Trabelsi & Hamdi Chtourou & Piotr Zmijewski & Tar, 2021. "Four Weeks of Detraining Induced by COVID-19 Reverse Cardiac Improvements from Eight Weeks of Fitness-Dance Training in Older Adults with Mild Cognitive Impairment," IJERPH, MDPI, vol. 18(11), pages 1-19, May.
    4. Awaworyi Churchill, Sefa & Koomson, Isaac & Munyanyi, Musharavati Ephraim, 2023. "Transport poverty and obesity: The mediating roles of social capital and physical activity," Transport Policy, Elsevier, vol. 130(C), pages 155-166.

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