Urban environment, air pollution and childhood growth and obesity

Understanding the determinants of childhood obesity has never been more urgent given the high levels across the world. It is increasingly recognized that the urban environment may affect childhood growth and obesity, and may provide important potential for community-level intervention. This thesis a...

Descripción completa

Detalles Bibliográficos
Autor: De Bont, Jeroen
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:CBUC, CESCA
Repositorio:TDR. Tesis Doctorales en Red
OAI Identifier:oai:www.tdx.cat:10803/670315
Acceso en línea:http://hdl.handle.net/10803/670315
Access Level:acceso abierto
Palabra clave:Urban environment
Air pollution
Green spaces
Built environment
Catalonia
Entorn urbà
Contaminació atmosfèrica
Espais verds
Entorns construits
Catalunya
614
Descripción
Sumario:Understanding the determinants of childhood obesity has never been more urgent given the high levels across the world. It is increasingly recognized that the urban environment may affect childhood growth and obesity, and may provide important potential for community-level intervention. This thesis aimed to investigate how time trends in prevalence and incidence of overweight and obesity among children differ by sociodemographic characteristics, and to evaluate the association between the urban environment, especially on ambient air pollution, and childhood growth and obesity. This thesis used longitudinal data from primary care health records and from two cross-sectional studies in Catalonia, Spain. We observed an overall reduction over time in the prevalence of childhood obesity across Catalonia, but the prevalence increased over time among children from more deprived areas or with non-Spanish nationality, indicating increasing deprivation disparities. We observed that early-life exposure to air pollution was associated with a small increase of body mass index (BMI) growth during early postnatal growth and an increased risk of developing childhood obesity during childhood. These associations were stronger among children living in more deprived areas. Other urban factors such as population density were associated with increased BMI growth, whereas green spaces and land use mix were associated with decreased BMI growth. Finally, we observed that urban areas with higher levels of air pollution, noise and traffic, and lower levels of green spaces were associated with a higher odd of overweight and obesity in school-aged children (9-12 years). In conclusion, the findings of this thesis suggest that the urban environment, especially ambient air pollution, may have a small influence on childhood weight status from birth until mid-childhood. Socioeconomic status plays an important role in increasing inequalities of childhood obesity and in the association between the urban environment and childhood obesity.