Perceptions of neighborhood environments and their association with overweight in children, adolescents, and caretakers in a medium-sized city in Brazil

ABSTRACT

Background: Previous studies conducted in developed countries have suggested associations between perceptions of neighborhood characteristics and weight gain. However, there are few studies regarding the adult perception of the residential environment and overweight in children and adolescents in countries with low and medium income. The aim of the study was to assess the associations between caretakers'perceptions of environmental characteristics and overweight in themselves and in their children, in a medium-sized city in Brazil. Methods: Cross-sectional study was performed with 708 children and adolescents and their caretakers. Anthropometric measurements and a structured questionnaire filled out by caretakers concerning child and family characteristics were completed. For environmental assessment, 408 caretakers answered the Portugues eversion of the"Neighborhood Environment Walkability Scale"by telephone call. A 95% confidence interval (95%CI)was used in the analysis. Unadjusted prevalence ratios (PR) were calculated, as were PR adjusted for age, gender, family income, and total time of exercise the children or adolescents practiced (from Poisson regression models predicting children's and adolescents'overweight), and for age and family income (from Poisson regression models predicting caretakers'overweight). Statistical significance was defined as ap value <0.05.Results:Adult perceptions about the absence of sidewalks on most streets (PR = 0.49, 95%CI = 0.42­0.98) and the absence of interesting things to look at (esthetics) in the neighborhood (PR = 0.65, 95%CI = 0.44­0.90) were inversely associated with the prevalence of overweight in the children and adolescents after adjustment. The absence of hillsin the neighborhood (PR = 1.24, 95%CI = 1.05­1.45) and the perception of heavy exhaust fumes (PR = 1.26, 95%CI =1.02­1.56) were directly associated with the prevalence of overweight in the caretakers. Finally, the high speed of traffic on the street (PR = 0.76, 95%CI = 0.63­0.92) was inversely associated with the prevalence of adult overweight. Conclusions: The results showed, in Brazil, the importance of understanding aspects related to obesogenic environment in the context of medium-sized Brazilian cities.