Associations of residential greenness with peripheral and central obesity in China

Lina Zhang; Chen Chen; Cong Liu; Yi Zhang; Jianlong Fang; Jingxiu Han; Feng Zhao; Peng Du; Qiong Wang; Jiaonan Wang; Wanying Shi; Weidong Wang; Su Shi; Renjie Chen; Haidong Kan; Xia Meng; Tiantian Li; Xiaoming Shi

doi:10.1016/j.scitotenv.2021.148084

Associations of residential greenness with peripheral and central obesity in China

Sci Total Environ. 2021 Oct 15:791:148084. doi: 10.1016/j.scitotenv.2021.148084. Epub 2021 May 28.

Authors

Lina Zhang¹, Chen Chen², Cong Liu¹, Yi Zhang², Jianlong Fang², Jingxiu Han², Feng Zhao², Peng Du², Qiong Wang², Jiaonan Wang³, Wanying Shi², Weidong Wang¹, Su Shi¹, Renjie Chen¹, Haidong Kan¹, Xia Meng⁴, Tiantian Li⁵, Xiaoming Shi²

Affiliations

¹ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China.
² China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
³ Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
⁴ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China. Electronic address: mengxia@fudan.edu.cn.
⁵ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China. Electronic address: litiantian@nieh.chinacdc.cn.

PMID: 34139501
DOI: 10.1016/j.scitotenv.2021.148084

Abstract

Background: Obesity is a well-known risk factor for public health. Recent studies found that greenness exposure may protect against obesity. However, the accumulated evidence on associations of greenness-obesity is inconsistent and most of them are from developed countries.

Objectives: This study aimed to evaluate the associations of greenness exposure with indicators of peripheral and central obesity.

Methods: This cross-sectional study was based on a Chinese national Sub-Clinical Outcomes of Polluted Air (SCOPA) prospective cohort across 15 provinces, and 5849 participants with average age of 64.7 were included. Surrounding greenness was estimated with the Enhanced Vegetation Index (EVI), which was calculated at each participant's residential addresses within a 250 m buffer. Weight, height and waist circumference (WC) were measured, and body mass index (BMI) and the waist-to-height ratio% (WHtR%) were calculated based on those measurements. The relationships between EVI and obese outcomes were explored using multiple linear regression and logistic regression models.

Results: Non-linear associations were observed between EVI and obese indicators. Participants living in Quartile 3 benefited more than in Quartile 4 compared to the lowest quartile (Quartile 1) of greenness. For peripheral obesity, participants living in Quartile 3 of EVI_250m had 0.86 kg/m² (β -0.86, 95% CI: -1.10, -0.61) lower BMI, and 46% (OR 0.54, 95% CI: 0.44-0.66) lower odds of peripheral obesity than in Quartile 1. For central obesity, participants living in Quartile 3 of EVI_250m had 1.85 cm (β -1.85, 95% CI: -2.54, -1.15) lower waist circumference, 1.12% (β -1.12, 95% CI: -1.56, -0.67) lower waist-to-height ratio% (WHtR%), and 33% (OR 0.67, 95% CI: 0.57-0.78) lower odds of central obesity than in Quartile 1 of EVI_250m.

Conclusions: Higher levels of greenness were statistically significant associated with lower obesity risk.

Keywords: Body mass index; Central obesity; Greenness; Peripheral obesity; Waist circumference; Waist-to-height ratio.

MeSH terms

Body Mass Index
China / epidemiology
Cross-Sectional Studies
Humans
Middle Aged
Obesity / epidemiology
Obesity, Abdominal* / epidemiology
Prospective Studies
Risk Factors