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Longitudinal association of built environment pattern with DXA-derived body fat in elderly Hong Kong Chinese: a latent profile analysis

Abstract

Background

One major limitation of prior studies regarding the associations between built environment (BE) and obesity has been the use of anthropometric indices (e.g., body mass index [BMI]) for assessing obesity status, and there has been limited evidence of associations between BE and body fat. This study aimed to explore the longitudinal association between BE and body fat in a cohort of elderly Hong Kong Chinese and examine whether the BE-body fat associations differed by BMI categories.

Methods

Between 2001 and 2003, 3944 participants aged 65–98 years were recruited and followed for a mean of 6.4 years. BE characteristics were assessed via Geographic Information System. Body fat (%) at whole body and regional areas (trunk, limbs, android, and gynoid) were assessed by dual energy X-ray absorptiometry at baseline and three follow-ups. Latent profile analysis was used to derive BE class, and linear mixed-effects models were used to investigate the associations of BE class with changes in body fat. Stratified analyses by BMI categories were also conducted.

Results

Three BE classes were identified. Participants in Class 2 (characterized by greater open space and proportion of residential land use) had a slower increase in whole body fat (B = −0.403, 95% confidence interval [CI]: −0.780, −0.014) and limbs fat (−0.471, 95% CI: −0.870, −0.071) compared with participants in Class 1 (characterized by high proportion of commercial land use). There were significant interactions of BE class with BMI, and participants in Class 2 had a slower increase in whole body fat and regional fat compared with participants in Class 1 (B ranging from −0.987 [limbs] to −0.523 [gynoid]) among overweight and obese participants only.

Conclusions

We found that those who resided in the areas characterized by greater open space and proportion of residential land use had a slower body fat increase.

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Fig. 1: Flowchart of study participants over study period.
Fig. 2: Standardized mean (Z-score) for each built environment characteristics by latent class.
Fig. 3: Difference in body fat (%) change over 14 years with built environment class stratified by body mass index (BMI; <24 and ≥24 kg/m2).

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Acknowledgements

We thank all the participants and staff who contributed to the present study. We thank the generous donation of Ms. Therese Pei Fong Chow. JSL would like to thank the China Scholarship Council (CSC) for the financial support (No. 202008440343).

Funding

This research was funded by the Vice-Chancellor’s One-off Discretionary Fund of the Chinese University of Hong Kong (No.: 4930785) and the Direct Grant for Research 2017/18 of the Faculty of Social Science, the Chinese University of Hong Kong (No.: 4052187). It is also partially supported by the World Universities Network Research Development Fund 2018. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Contributions

JW and TK led the establishment and follow-ups of the studied cohort in collaboration with JL and BY. KKLL and JSL designed the specific study. JSL conducted the analyses in assistance with FYFC, and JSL prepared the raw draft of this manuscript. KKLL and JSL had primary responsibility for final content. All authors read and approved the final version of the manuscript for publication.

Corresponding authors

Correspondence to Jiesheng Lin or Kevin Ka-Lun Lau.

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The study was approved by the Clinical Research Ethics Committee in the Chinese University of Hong Kong, and all participants provided written informed consent.

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Lin, J., Chan, F.YF., Leung, J. et al. Longitudinal association of built environment pattern with DXA-derived body fat in elderly Hong Kong Chinese: a latent profile analysis. Int J Obes 45, 2629–2637 (2021). https://doi.org/10.1038/s41366-021-00949-5

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