Can a child’s neighborhood affect his or her weight status, diet, and activity level? According to new research published today in Obesity, the answer is yes.

Dr. Brian Saelens, a principal investigator at Seattle Children’s Research Institute who led the study, said children living in neighborhoods with favorable nutrition and activity environments, meaning the neighborhoods had at least one high-quality park and were more walkable and there was access to healthy foods or less access to less healthy foods, continue to have lower rates of obesity when compared to children living in less favorable neighborhoods. Less favorable neighborhoods were defined as having no or lower-quality parks and either no supermarket or a higher concentration of fast food restaurants.

The impact of nutrition and physical environments

The research was in follow-up to the Neighborhood Impact on Kids study led by Saelens, which was among the first neighborhood environment studies to look at the impact of both nutrition and physical environments on children’s weight and activity levels. The purpose of the latest research was to examine weight and activity changes in children 2 years after the initial baseline.

“We were curious to see whether what is in a child’s neighborhood affects their change in weight status, diet, and physical activity over time,” said Saelens.

The researchers hypothesized that children living in more favorable areas would have healthier weights and related behavioral changes. They evaluated more than 600 children ages 8 to 13 from neighborhoods in Seattle/King County and San Diego County.

“We found that kids living in the most favorable environments were still doing well, in fact, they were doing much better,” said Saelens. “We found that 2 years later the kids in the most favorable neighborhood environments were about 40%–50% less likely to be overweight or obese than kids living in less favorable environments, even after we accounted for them being at healthier weight at baseline. We also found that about 30% of the children in those most favorable environments who were overweight or obese during our initial study became healthier.”

Saelens said in the least favorable environments, the number of children who were overweight or obese increased. They also found that children in the least favorable environments had a larger increase in daily average caloric intake compared to the most favorable environment neighborhoods.

Addressing an epidemic

Childhood obesity continues to be a serious health concern in the US, putting children at greater risk for developing conditions like heart disease and type 2 diabetes. Today, the prevalence of obesity for children and adolescents 2 to 19 years old is 18.5% and affects about 13.7 million children and adolescents in the US, according to the Centers for Disease Control and Prevention.

Saelens hopes his research will encourage more purposeful design when creating and helping to change neighborhoods, which could potentially provide solutions to the obesity epidemic.

“Activity and healthy eating aren’t always at the forefront of our minds when we think about how things are built—from land use, to park quality, to transportation,” said Saelens. “But what we’ve found is that where a child lives is likely having an impact on what they are eating, how much they’re eating, and their sedentary status. It’s important to focus on trying to improve the activity and nutrition environment.”

Saelens said an ideal neighborhood would have high-quality parks in close proximity to where children live, at least one supermarket providing access to healthy foods, and less fast food restaurants. Neighborhoods like these, according to Saelens, have been associated with reductions in childhood obesity and provide a protective environment where children are more likely to engage in healthy behaviors.

Although the results are promising, Saelens says more longitudinal studies are still needed, particularly to look at how race/ethnicity, income, and other demographic factors, which play a role in childhood obesity, may interact with environment. The present study adjusted for these factors in the analyses, but was not designed to look at the effects of such demographic factors, which we know are critical to consider and to address where disparities exist.

“We’re really hopeful,” said Saelens. “Until we’re able to provide sustainable solutions to improve policies and environments, our work is not done.”