People don鈥檛 gain or lose weight because they live near a fast-food restaurant or supermarket, according to a new led by the 天美影视传媒. And, living in a more 鈥渨alkable,” dense neighborhood likely only has a small impact on weight.

These 鈥渂uilt-environment鈥� amenities have been seen in as essential contributors to losing weight or tending toward obesity. The idea appears obvious: If you live next to a fast-food restaurant, you鈥檒l eat there more and thus gain weight. Or, if you have a supermarket nearby, you鈥檒l shop there, eat healthier and thus lose weight. Live in a neighborhood that makes walking and biking easier and you鈥檒l get out, exercise more and burn more calories.

The new study based on anonymized medical records from more than 100,000 Kaiser Permanente Washington patients did not find that living near supermarkets or fast-food restaurant had any impact on weight. However, urban density, such as the number of houses in a given neighborhood, which is closely linked to neighborhood 鈥渨alkability鈥� appears to be the strongest element of the built environment linked to change in body weight over time.

鈥淭here’s a lot of prior work that has suggested that living close to a supermarket might lead to lower weight gain or more weight loss, while living close to lots of fast-food restaurants might lead to weight gain,鈥� said , lead author of the study and a research scientist in the UW School of Public Health. 鈥淥ur analyses of the food environment and density together suggests that the more people there are in an area 鈥� higher density 鈥� the more supermarkets and fast-food restaurants are located there. And we found that density matters to weight gain, but not proximity to fast food or supermarkets. So, that seems to suggest that those other studies were likely observing a false signal.鈥�

The UW-led study, published earlier this month in the International Journal of Obesity, found that people living in neighborhoods with higher residential and population density weigh less and have less obesity than people living in less-populated areas. And that didn鈥檛 change over a five-year period of study.

鈥淥n the whole, when thinking about ways to curb the obesity epidemic, our study suggests there鈥檚 likely no simple fix from the built environment, like putting in a playground or supermarket,鈥� said Buszkiewicz, who did his research for the study while a graduate student in the UW Department of Epidemiology.

Rather than 鈥渟omething magical about the built environment itself鈥� influencing the weight of those individuals, Buszkiewicz said, community-level differences in obesity are more likely driven by systematic factors other than the built environment 鈥� such as income inequality, which is often the determining factor of where people can afford to live and whether they can afford to move.

鈥淲hether you can afford to eat a healthy diet or to have the time to exercise, those factors probably outweigh the things we鈥檙e seeing in terms of the built environment effect,鈥� he said.

The researchers used the Kaiser Permanente Washington records to gather body weight measurements several times over a five-year period. They also used geocodable addresses to establish neighborhood details, including property values to help establish socioeconomic status, residential unit density, population density, road intersection density, and counts of supermarkets and fast-food restaurants accessible within a short walk or drive.

鈥淭his study really leverages the power of big data,鈥� said Dr. David Arterburn, co-author and senior investigator at Kaiser Permanente Washington Health Research Institute. 鈥淥ur use of anonymized health care records allows us to answer important questions about environmental contributions to obesity that would have been impossible in the past.鈥�

This study is part of a 12-year, joint聽UW聽and聽Kaiser Permanente Washington聽research project called Moving to Health. The goal of the study, according to the UW鈥檚 , is to provide population-based, comprehensive, rigorous evidence for policymakers, developers and consumers regarding the features of the built environment that are most strongly associated with risk of obesity and diabetes.

鈥淥ur next goal is to better understand what happens when people move their primary residence from one neighborhood to another,鈥� Arterburn said. 鈥淲hen our neighborhood characteristics change rapidly 鈥� such as moving to a much more walkable residential area 鈥� does that have an important effect on our body weight?鈥�

Co-authors include Jennifer Bobb, Andrea Cook, Maricela Cruz, Paula Lozano, Dori Rosenberg, Mary Kay Theis and Jane Anau at Kaiser Permanente Washington Health Research Institute; , UW Urban Form Lab, College of Built Environments; , UW Department of Epidemiology; , UW Urban Form Lab and Center for Studies in Demography and Ecology; and , UW Center for Public Health Nutrition and Department of Epidemiology. This research manuscript was supported by grants from the National Institutes of Health: 1 R01 DK 114196, 5 R01 DK076608, and 4 R00LM012868.

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For more information, contact Buszkiewicz at buszkiew@uw.edu聽 and Caroline Liou Caroline.X.Liou@kp.org

天美影视传媒 professors and are co-authors of the first of this series that explores these connections and suggests several planning alternatives for better health.

The Lancet published the series on Sept. 23 and launched it that day during an event at the United Nations General Assembly in New York. Titled, “,” the series involved researchers in several nations and fields.

Moudon is a professor emerita of urban design and planning and architecture in the UW . Dannenberg is an affiliate professor of environmental and occupational health in the and in urban design and planning.

“Most of the negative consequences of city planning policies on health are related to the high priority given to motor vehicles in land-use and transportation planning,” said Moudon. “City planning policies supporting urban individual car travel directly and indirectly influence such risk exposures as traffic, air pollution, noise, physical inactivity, unhealthy diet, personal safety and social isolation.”

Moudon is second author and Dannenberg a co-author on the first of the three papers, titled “.” and of the University of Melbourne are lead authors of the series, and Corti is lead on this paper, together with several international experts in public health and transportation planning as co-authors. Over two years, the team reviewed 20 years of literature as well as their own research on the health impacts of city planning through transportation mode choice in cities.

The verdict of their lead article: Automobiles are central to the problem of urban planning and human health.

Individualized motor travel in cities is the “root cause,” Moudon and fellow authors write, “of increases in exposures to sedentarism, environmental pollution, social isolation and unhealthy diets, which lead to various types of injury and disease outcomes.”

The lead paper suggests eight major interventions that city and transportation planning can employ to make cities more “compact” and promote health.

At the local urban design level, these ideas include walkable and bikable environments, shorter distances to common daily destinations, mixing housing with commercial developments and services and making common destinations more readily available to citizens. Parking demand would be managed by reducing its availability and increasing its cost.

“Together, these interventions will create healthier and more sustainable, compact cities,” the authors write, “that reduce the environmental, social and behavioral risk factors that affect lifestyle choices, levels of environmental pollution, noise and crime.”

Stevenson is the lead author on the , which focuses on the links between land use, transport and health benefits in compact cities. The , whose lead author is James Sallis of the University of California, San Diego, looks at using science to guide city planning policy and practice for healthy and sustainable cities.

Overall, the series quantifies the health gains that could be achieved if cities incentivize a shift from private car use to cycling and walking, and promote a city model in which employment and amenities 鈥� including public transportation 鈥� are within walking distance.

Series author Giles-Corti placed the multinational research into historic and global perspective, noting that with world population heading to 50 billion by 2050 鈥� and three-quarters of people to be living in cities 鈥� city planning must be part of a comprehensive solution to adverse health outcomes.

“City planning was key to cutting infectious disease outbreaks in the 19th century through improved sanitation, housing and separating residential and industrial areas,” Giles-Corti said. “Today, there is a real opportunity for city planning to reduce non-communicable diseases and road trauma and to promote health and wellbeing more broadly.”

Other co-authors on the first paper in the series are from the University of California, San Diego; Washington University in St. Louis; Pontifical Catholic University of Parana and Federal University of Parana, in Brazil; Queensland University of Technology in Brisbane, Australia; the University of Western Australia in Perth, Australia; and the Australian Catholic University, Baker IDI Heart and Diabetes Institute and Swinburne University of Technology, all of Melbourne, Australia.

Funders for the paper authors included Australia’s National Health and Medical Research Council and Centre for Excellence in Healthy Liveable Communities, the Australian Prevention Partnership Centre, the Hospitals Contribution Fund of Australia, VicHealth, as well as the U.S. National Institute of Health and the Robert Wood Johnson Foundation.

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For more information, contact Moudon at 206-276-3133 or moudon@uw.edu or Dannenberg at 404-272-3978 or adannen@uw.edu.

• The series is available at .