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      Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review

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          Abstract

          Introduction

          Built environment attributes have been linked to cardiovascular disease (CVD) risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions.

          Objective

          To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks.

          Data Source

          Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted.

          Inclusion Criteria

          Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults.

          Data Extraction

          Author(s), country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies.

          Results

          Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS) to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes.

          Conclusion

          This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live.

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          Most cited references33

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          Role of built environments in physical activity, obesity, and cardiovascular disease.

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            The built environment and obesity: a systematic review of the epidemiologic evidence.

            We completed a systematic search of the epidemiologic literature on built environment and obesity and identified 63 relevant papers, which were then evaluated for the quality of between-study evidence. We were able to classify studies into one of two primary approaches for defining place and corresponding geographic areas of influence: those based on contextual effects derived from shared pre-determined administrative units and those based on individually unique geographic buffers. The 22 contextual papers evaluated 80 relations, 38 of which did not achieve statistical significance. The 15 buffer papers evaluated 40 relations, 24 of which did not achieve statistical significance. There was very little between-study similarity in methods in both types of approaches, which prevented estimation of pooled effects. The great heterogeneity across studies limits what can be learned from this body of evidence. Copyright 2009 Elsevier Ltd. All rights reserved.
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              The built environment and obesity.

              Obesity results from a complex interaction between diet, physical activity, and the environment. The built environment encompasses a range of physical and social elements that make up the structure of a community and may influence obesity. This review summarizes existing empirical research relating the built environment to obesity. The Medline, PsychInfo, and Web of Science databases were searched using the keywords "obesity" or "overweight" and "neighborhood" or "built environment" or "environment." The search was restricted to English-language articles conducted in human populations between 1966 and 2007. To meet inclusion criteria, articles had to 1) have a direct measure of body weight and 2) have an objective measure of the built environment. A total of 1,506 abstracts were obtained, and 20 articles met the inclusion criteria. Most articles (84%) reported a statistically significant positive association between some aspect of the built environment and obesity. Several methodological issues were of concern, including the inconsistency of measurements of the built environment across studies, the cross-sectional design of most investigations, and the focus on aspects of either diet or physical activity but not both. Given the importance of the physical and social contexts of individual behavior and the limited success of individual-based interventions in long-term obesity prevention, more research on the impact of the built environment on obesity is needed.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                23 November 2016
                2016
                : 11
                : 11
                : e0166846
                Affiliations
                [1 ]University of Western Cape, School of Public Health, Robert Sobukwe Rd, Bellville, Cape Town, 7535, South Africa
                [2 ]Non-communicable disease Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, P.O. Box 19070, 7505 Tygerberg, Cape Town, South Africa
                [3 ]Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Boundary Road, Newlands, 7700, Cape Town, South Africa
                University of Bologna, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: PM APK.

                • Data curation: PM APK.

                • Formal analysis: PM.

                • Funding acquisition: TP EVL.

                • Investigation: PM.

                • Methodology: PM APK.

                • Project administration: PM.

                • Supervision: APK ADV EVL TP.

                • Visualization: PM APK.

                • Writing – original draft: PM APK.

                • Writing – review & editing: PM APK.

                Article
                PONE-D-16-21862
                10.1371/journal.pone.0166846
                5120821
                27880835
                f0a85472-0f87-46e0-a124-1099d8e465e4
                © 2016 Malambo et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 9 June 2016
                : 5 November 2016
                Page count
                Figures: 1, Tables: 2, Pages: 13
                Funding
                Funded by: This study was partly supported by Social Innovation in Public Health Impulse fellowship program
                Award Recipient :
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Cardiovascular Medicine
                Cardiovascular Diseases
                Biology and Life Sciences
                Biomechanics
                Biological Locomotion
                Walking
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Walking
                Medicine and Health Sciences
                Physiology
                Biological Locomotion
                Walking
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Research and Analysis Methods
                Database and Informatics Methods
                Database Searching
                Medicine and Health Sciences
                Metabolic Disorders
                Ecology and Environmental Sciences
                Terrestrial Environments
                Built Environment
                Computer and Information Sciences
                Geoinformatics
                Geographic Information Systems
                Earth Sciences
                Geography
                Geoinformatics
                Geographic Information Systems
                Medicine and Health Sciences
                Vascular Medicine
                Blood Pressure
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

                Uncategorized
                Uncategorized

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