ABSTRACT
The aim of this study is to explore the relationship between individual-level factors and cycling for transportation in a cohort of participants living in São Paulo city, Brazil. The same participants (n = 1,431 adults) were interviewed in 2014/2015 (Wave 1) and 2020/2021 (Wave 2) as part of the 'São Paulo Health Survey-ISA: Physical Activity and Environment'. For the longitudinal transport cycling binary outcome, participants who reported cycling at both time-points and those who were cycling at Wave 2 only were coded as a positive longitudinal pattern for cycling. Those who were not cycling at either Waves, and those who were cycling at Wave 1 only, were grouped into a negative pattern for cycling. The relationship between the longitudinal patterns for transport cycling and sociodemographics, health characteristics, and behaviors at Wave 1 were tested using bivariate analysis, and the significant individual-level factors were then examined in a multivariable binary logistic regression model. The odds of being classified in the positive cycling pattern were lower for women [OR = 0.09; 95 % CI = 0.04---0.19], and higher for persons aged 30 - 39 [OR = 3.25; 95 % CI = 1.38---7.66], those who owned a bicycle [OR = 2.00; 95 % CI = 1.13---3.54], and those who engaged in ≥ 120 min/week of transport walking [OR = 2.07; 95 % CI = 1.24---3.47] or leisure-time physical activity [OR = 1.77; 95 % CI = 1.02---3.06]. Cycling interventions and promotion should target women, the mid-aged and involve facilitating bicycle access. Advocacy for physical activity interventions is needed to influence transport cycling.
ABSTRACT
We conducted a systematic review to describe and summarize possible associations between the walkability index, overweight, and obesity. Systematic searches using seven electronic databases and reference lists were conducted to identify papers published until December 2017. Observational studies, describing associations using regression-based statistical methods, published in English and Portuguese, reporting markers of overweight and obesity, and involving adults (≥18 years) were included. Of the 2469 references initially retrieved, ten were used for the descriptive synthesis. Seven studies showed significant inverse associations between walkability and overweight and obesity, however, all were cross-sectional studies. High risk of bias scores were observed in "selection bias" and "withdrawals and dropouts". All studies were published in high-income countries with sample sizes ranging among 75 to 649,513 participants. Weight and height as measures for determining BMI tended to be self-reported. Indicators of walkability, such as land-use mix, street connectivity and residential density were used as components of the indices. Based on this review, more studies should be conducted in low, middle, and middle-high income countries, using longitudinal designs that control neighborhood self-selection; other indicators of the neighborhood environment, such as food access, physical activity facilities, sidewalks, and safety and crime prevention should be considered.
