Exploring the links between population density, lifestyle, and being overweight: secondary data analyses of middle-aged and older Chinese adults.

Publisher: BioMed Central Country of Publication: England NLM ID: 101153626 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7525 (Electronic) Linking ISSN: 14777525 NLM ISO Abbreviation: Health Qual Life Outcomes

Original Publication: [London] : BioMed Central, c2003-

Population Density* ; Sedentary Behavior*; Obesity/*epidemiology; Aged ; Body Mass Index ; China/epidemiology ; Cross-Sectional Studies ; Exercise/physiology ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Quality of Life ; Self Report

Background: The increasing prevalence of obesity across all age groups has become a major health concern in China. Previous studies have found strong links between population density, sedentary lifestyle, and the risk of being overweight among adults and adolescents in Western countries. However, little research has been conducted to disentangle this relationship in China, which is rapidly urbanizing and densely populated. Compared to other age groups, middle-aged and older adults tend to have a higher risk of being overweight, which increases their risk of diabetes, high blood pressure, and other weight-related chronic diseases. In addition, they are especially sensitive to neighbourhood environmental factors such as population density. Therefore, we aimed to unravel the link between population density and the risk of being overweight among Chinese middle-aged and older adults, with a particular focus on the mediating role of lifestyle choices.
Methods: Data from the 2011 China Health and Retirement Longitudinal Study were analysed. Individuals (N = 5285) were sampled from 405 neighbourhoods nested within 150 cities. Body Mass Index (BMI) was calculated based on self-reported body weight and height (being overweight was defined as a BMI ≥ 24 kg/m ² ). Multilevel regression and mediation analyses were applied to explore associations between population density, a sedentary lifestyle, and the risk of being overweight.
Results: Middle-aged and older adults who lived in densely populated neighbourhoods had higher odds of being overweight. Further, this link was mediated by residents' mode of travel and physical exercise; specifically, these residents had higher odds of owning a car and spending lesser time on weekly physical exercise, thereby increasing their risk of being overweight. Furthermore, the association between car ownership and the odds of being overweight varied by neighbourhood population density.
Conclusions: There was a positive association between neighbourhood population density and middle-aged and older adults' risk of being overweight. This relationship may exist because people who live in densely populated neighbourhoods tend to lead a sedentary lifestyle. Our findings also suggest that, in rapidly urbanizing countries, a sedentary lifestyle may be especially harmful to middle-aged and older adults who live in densely populated neighbourhoods.

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41320104001 National Natural Science Foundation of China; 41871140 National Natural Science Foundation of China; 2017ZT07X355 Guangdong Province Introduction of Innovative R&D Team

Keywords: China; Neighbourhood; Overweight; Population density; Sedentary lifestyle

Date Created: 20190613 Date Completed: 20190812 Latest Revision: 20200225

20240104

PMC6558806

10.1186/s12955-019-1172-3

31186044