Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods: This study uses data from the Sao Paulo Health Survey (n=3,145). Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and mix of destinations score in 500m buffers was the exposure variable. Associations between mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results: After adjustment for covariates, mix of destinations was inversely associated with minutes of sitting time on a weekday (β=-8.8, p=0.001) and weekend day (β=-6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion: Greater mix of destinations within 500m of peoples’ residences were inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.

Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods: This study uses data from the Sao Paulo Health Survey. Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and mix of destinations score in 500m buffers was the exposure variable. Associations between mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results: After adjustment for covariates, mix of destinations was inversely associated with minutes of sitting time on a weekday (β=-8.8, p=0.001) and weekend day (β=-6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion: Greater mix of destinations within 500m of peoples’ residences were inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.

Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods: This study uses data from the Sao Paulo Health Survey. Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and mix of destinations score in 500m buffers was the exposure variable. Associations between mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results: After adjustment for covariates, mix of destinations was inversely associated with minutes of sitting time on a weekday (β=-8.8, p=0.001) and weekend day (β=-6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion: Greater mix of destinations within 500m of peoples’ residences were inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.

Background: Sedentary behavior is influenced by contextual, social and individual factors, including the built environment. However, the associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil.Methods: This study uses data from the Sao Paulo Health Survey (n=3,145). Sedentary behavior was assessed by questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. Mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500m of each participant's residence. Linear and categorical (<4, ≥4 hours/day) measures of sitting time were derived and analyzed using linear and logistic multilevel regression. Models accounted for clustering within census-tracts and households, were stratified by gender, and adjusted for environmental, sociodemographic, and health-related factors.Results: Average minutes of sitting, and the likelihood of sitting for more than four hours, were significantly higher among males, younger people, the more educated, single persons, smokers, those who engaged in low levels of physical activity, the obese and those with chronic disease, and those who owned a private motor vehicle. Among females, mix of destinations was inversely related with minutes of sitting time on a weekday (β= -11 minutes; p=0.001) and weekend day (β= -8 minutes;p=0.012). Females who had a higher mix of destinations within their residential catchment had a significantly lower likelihood of sitting for four hours or more on weekdays (OR=0.66 IC95%0.47-0.94). No significant associations were found for males.Conclusion: This is the first-known study to examine the relationship between mix of destinations and sedentary behavior among adults in Sao Paulo City, Brazil. Our results suggest that health promotion and policy should focus on reducing sedentary behavior in the whole population, and especially those groups who engage in higher-levels of sitting time. 4