Children who live closer to fast-food establishments and with higher levels of socioeconomic deprivation are more likely to be obese. The conclusion is from a study by the Instituto de Saúde Pública da Universidade do Porto (ISPUP), which sought to understand how the context in which we live influences childhood obesity.
The causes of childhood obesity are complex and multifactorial. Obesity is known to have a genetic component, but it is also influenced by environmental behaviors and exposures that condition personal choices.
According to Ana Isabel Ribeiro, first author of the study, coordinated by Henrique Barros, “this research aimed to show the influence of the ecosystem in which we are inserted in the development of childhood obesity, a condition that is a major public health problem, as it is associated with multiple physical health problems such as diabetes, hypertension and cardiovascular disease, and mental health, including low self-esteem, social exclusion and depression.
The researchers estimated the prevalence of childhood obesity in the Porto Metropolitan Area and saw how obese children were distributed throughout the territory. Then, some characteristics of the children’s areas of residence, such as the level of socioeconomic deprivation of the places, the existence of green spaces and areas for physical activity and the availability of unhealthy fast food options close to home were analyzed. The researchers wanted to understand if those characteristics could or not explain the prevalence of obesity.
To assess obesity, the body mass index (BMI) of 5200 7-year-old children from the Generation XXI cohort was used. BMI information was cross-referenced with the characteristics of the child’s place of residence.
“We found that the prevalence of obesity is 15.4% among children in the Porto Metropolitan Area. However, the distribution of obese children in the territory is quite uneven. There are areas where the prevalence of obesity is significantly higher than this average. They are what we call hotspots, that is, places where the percentage of obese children is higher than expected”, she says.
The researchers found that these hotspots are located in two geographical areas of the Porto Metropolitan Area (in some parishes of Matosinhos and Valongo). “In addition to the contribution of traditional risk factors, the presence of these high prevalence areas was partly explained by their greater proximity to fast food outlets and the high socioeconomic deprivation of these places”, she explains.
“We saw that children who live closer to fast food outlets are about 30 per cent more likely to be obese, and those in poorer areas are also more likely to be obese”, says Ana Isabel Ribeiro.
Regarding the other characteristics of the residential environment, a trend was found. In fact, “children who live in greener areas are less likely to be obese, as are those who live in places with more sports equipment. However, the association was not statistically significant”, the researcher adds.
For the researcher, the article, published in the International Journal of Epidemiology, provides useful information at various levels. “By delimiting areas of the Porto Metropolitan Area with a higher prevalence of obesity, we ended up providing relevant information to those who work in the Public Health Units of these places. Similarly, the research could help municipalities and decision-makers define the geographic areas where they should focus more efforts to combat childhood obesity. Moreover, from an etiological point of view, we have been able to show that obesity is not just a consequence of our individual decisions. There are external aspects that may enhance unhealthy behaviour and possibly lead to childhood obesity”.
The researchers Verónica Vieira and Ana Cristina Santos also participated in the study entitled Hotspots of childhood obesity in a large metropolitan area: does social neighborhood and built environment play a part?.
