Urban-rural differences in the association between blood lipids and characteristics of the built environment: a systematic review and meta-analysis

Groot, Rosa de; Hurk, Katja van den; Schoonmade, Linda J.; Kort, Wim de; Brug, Johannes; Lakerveld, Jeroen

doi:10.1136/bmjgh-2018-001017

Cited by 39 publications

(35 citation statements)

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“…This finding is, to some extent, consistent with a previous longitudinal study conducted in the USA that found a greater increase in TG for those who moved to higher walkability neighborhoods from lower walkability neighborhoods [50]. A recent systematic review of mostly cross-sectional studies also found less favorable blood lipid levels among urban residents as compared with rural residents [51]. These inconsistent or unexpected findings may be due to other potentially relevant exposures not measured in this study, such as easier access to unhealthy food outlets [52], which may have some detrimental effects on blood pressure, glucose, and lipids.…”

Section: Discussionsupporting

confidence: 89%

Neighborhood walkability and 12-year changes in cardio-metabolic risk: the mediating role of physical activity

Chandrabose

Cerin

Mavoa

et al. 2019

Int J Behav Nutr Phys Act

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Background Living in walkable neighborhoods may provide long-term cardio-metabolic health benefits to residents. Little empirical research has examined the behavioral mechanisms in this relationship. In this longitudinal study, we examined the potential mediating role of physical activity (baseline and 12-year change) in the relationships of neighborhood walkability with 12-year changes in cardio-metabolic risk markers. Methods The Australian Diabetes, Obesity and Lifestyle study collected data from adults, initially aged 25+ years, in 1999–2000, 2004–05, and 2011–12. We used 12-year follow-up data from 2023 participants who did not change their address during the study period. Outcomes were 12-year changes in waist circumference, weight, systolic and diastolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein cholesterol, and triglycerides. A walkability index was calculated, using dwelling density, intersection density, and destination density, within 1 km street-network buffers around participants’ homes. Spatial data for calculating these measures were sourced around the second follow-up period. Physical activity was assessed by self-reported time spent in moderate-to-vigorous physical activity (including walking). Multilevel models, adjusting for potential confounders, were used to examine the total and indirect relationships. The joint-significance test was used to assess mediation. Results There was evidence for relationships of higher walkability with smaller increases in weight (P = 0.020), systolic blood pressure (P < 0.001), and high-density lipoprotein cholesterol (P = 0.002); and, for relationships of higher walkability with higher baseline physical activity (P = 0.020), which, in turn, related to smaller increases in waist circumference (P = 0.006), weight (P = 0.020), and a greater increase in high-density lipoprotein cholesterol (P = 0.005). There was no evidence for a relationship of a higher walkability with a change in physical activity during the study period (P = 0.590). Conclusions Our mediation analysis has shown that the protective effects of walkable neighborhoods against obesity risk may be in part attributable to higher baseline physical activity levels. However, there was no evidence of mediation by increases in physical activity during the study period. Further research is needed to understand other behavioral pathways between walkability and cardio-metabolic health, and to investigate any effects of changes in walkability.

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Section: Discussionsupporting

confidence: 89%

Neighborhood walkability and 12-year changes in cardio-metabolic risk: the mediating role of physical activity

Chandrabose

Cerin

Mavoa

et al. 2019

Int J Behav Nutr Phys Act

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“…Our findings regarding the association between population density and blood lipid levels differ from the findings of previous studies, largely conducted in LMIC [8]. The absence of an association between population density and blood lipid levels may be explained by several factors, including differences between HIC and LMIC, the absence of information on either the food environment or food intake, the operationalization of urbanization used and the population under study.…”

Section: Discussioncontrasting

confidence: 99%

“…the place where a person lives) is an ‘upstream’ determinant of health behavior and disease outcomes [5–7]. In a recent systematic review, we identified consistent associations between living in an urban area and having higher total cholesterol (TC), low density lipoprotein (LDL) cholesterol and triglyceride levels [8]. The studies included in this review were mainly conducted in low and middle-income countries (LMIC) and the patterns observed may have been attributable to the sedentary and inactive lifestyle associated with life in urban areas in LMIC.…”

Section: Introductionmentioning

confidence: 99%

The association between population density and blood lipid levels in Dutch blood donors

et al. 2019

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BackgroundIn low and middle-income countries (LMIC), the total and LDL cholesterol and triglyceride levels of residents of urban areas are reported to be higher than those of rural areas. This may be due to differences in lifestyle behaviors between residents of urban areas and rural areas in LMIC. In this study, our aims were to (1) examine whether or not LDL cholesterol, total/HDL ratios and triglyceride levels of individuals in densely populated areas are higher than those of individuals living in less-densely populated areas in a high-income country (HIC) and (2) investigate the potential mediating roles of physical activity and sedentary behavior.MethodsWe used cross-sectional data from 2547 Dutch blood donors that participated in Donor InSight-III. Linear regression was used to analyze the association between population density and LDL cholesterol, total/HDL cholesterol ratio and HDL cholesterol. The mediating roles of moderate-to-vigorous physical activity (MVPA) and sedentary behavior were investigated in a subsample (n = 740) for which objectively measured MVPA/sedentary behavior data was available. Multiple mediation with linear regression analyses were performed and the product-of-coefficients method was used to calculate direct and indirect effects.ResultsMean LDL cholesterol and median total cholesterol/HDL cholesterol ratio and triglyceride levels were 2.89, 3.43 and 1.29 mmol/L, respectively. Population density was not associated with LDL cholesterol [β 0.00 (− 0.01; 0.01)], log transformed total/HDL cholesterol ratio [β 1.00 (1.00; 1.00)] and triglyceride levels [β 1.00 (0.99; 1.00)]. No statistically significant direct or indirect effects were found.ConclusionContrary to previous findings in LMIC, no evidence was found that population density is associated with blood lipid levels in blood donors in the Netherlands or that MVPA and sedentary behavior mediate this association. This may be the result of socioeconomic differences and, in part, may be due to the good health of the study population and the relatively high population density in the Netherlands. Also, compared to LMIC, differences in physical activity levels in more versus less populated areas may be less pronounced in HIC.Electronic supplementary materialThe online version of this article (10.1186/s12942-019-0167-y) contains supplementary material, which is available to authorized users.

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“…Rosa de Groot (2018) revealed that LDL and TC and triglyceride levels are consistently less favorable in urban areas as compared with rural areas. 15 No overall differences in HDL-cholesterol were found between urban and rural areas. Anyway, differences in urban and rural areas are likely to become even more relevant as it is projected that 70% of the world's population will reside in urban areas by 2050.…”

Section: Resultsmentioning

confidence: 93%

Role of serum copper and lipid profile in cardiovascular diseases patients of Southern Rajasthan

Dhanak

Sharma

2019

Int J Res Med Sci

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Background: It is clear that deficiencies of some trace elements cause marked alterations in lipid and lipoprotein metabolism. The mechanisms of their effects are not completely obvious and inspite of intense research, the role of these microelements need further elucidation. Thus, the objective of this study is to evaluate the correlations of serum concentrations of trace elements including copper with lipid profile parameters of adult men in Southern Rajasthan.Methods: Present study was conducted in Cardiology and Biochemistry Department in GMCH, Udaipur during the year 2019. A total of 150 MI cases/controls were selected. Blood sample was collected by vein puncture using an aseptic technique. The blood was allowed to settle at 37ºC and then centrifuged at 3000 rpm for 15 min. Serum was then separated and stored at -20ºC until analysis.Results: The study cases had significantly higher lipid values than those of controls (p<0.001). In cases the copper levels are higher than the controls. Copper levels were more in males 95.40±18.93 than in females 86.93±14.54 (p<0.05). Lipid levels were higher in urban population related to rural, TC (238.47 V/s 266.59), TG (219.83 V/s 202.40), HDL (64.39 V/s 54.19) and LDL (131.28 V/s 139.48) (p<0.05). Significant negative correlation was seen in study group between serum copper levels and TC (r=-0.288, p<0.05), TG (r =-0.236, p<0.05), HDL (r=-0.946, p<0.05) and VLDL levels (r=0.102, p<0.05). This indicates that as copper level reduces lipids increases.Conclusions:Our findings indicate the possible effect of Cu level in serum lipid profile and this effect may be due to the role of Cu as an antioxidant. The correlations between the serum concentrations of trace elements with lipid profile in physiological concentrations may not be the same as the changes observed during deficiencies of the trace elements as in hyperlipidemic patients

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Urban-rural differences in the association between blood lipids and characteristics of the built environment: a systematic review and meta-analysis

Cited by 39 publications

References 76 publications

Neighborhood walkability and 12-year changes in cardio-metabolic risk: the mediating role of physical activity

Neighborhood walkability and 12-year changes in cardio-metabolic risk: the mediating role of physical activity

The association between population density and blood lipid levels in Dutch blood donors

Role of serum copper and lipid profile in cardiovascular diseases patients of Southern Rajasthan

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