Associations between residential greenness and obesity phenotypes among adults in Southwest China

Bin Yu; Wenge Tang; Yunzhe Fan; Chunlan Ma; Tingting Ye; Changwei Cai; Yiming Xie; Yuanyuan Shi; Kangzhuo Baima; Tingting Yang; Yanjiao Wang; Peng Jia; Shujuan Yang

doi:10.1016/j.healthplace.2024.103236

Associations between residential greenness and obesity phenotypes among adults in Southwest China

Health Place. 2024 Apr 8:87:103236. doi: 10.1016/j.healthplace.2024.103236. Online ahead of print.

Authors

Bin Yu¹, Wenge Tang², Yunzhe Fan³, Chunlan Ma³, Tingting Ye³, Changwei Cai³, Yiming Xie⁴, Yuanyuan Shi⁵, Kangzhuo Baima⁶, Tingting Yang⁷, Yanjiao Wang⁸, Peng Jia⁹, Shujuan Yang¹⁰

Affiliations

¹ Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
² Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China.
³ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
⁴ Jianyang Center for Disease Control and Prevention, Jianyang, China.
⁵ School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
⁶ High Altitude Health Science Research Center of Tibet University, Lhasa, Tibet, China.
⁷ School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China.
⁸ School of Public Health, Kunming Medical University, Kunming, China.
⁹ School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; Hubei Luojia Laboratory, Wuhan, China; School of Public Health, Wuhan University, Wuhan, China. Electronic address: jiapengff@hotmail.com.
¹⁰ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China. Electronic address: rekiny@126.com.

PMID: 38593578
DOI: 10.1016/j.healthplace.2024.103236

Abstract

Background: Although exposure to greenness has generally benefited human metabolic health, the association between greenness exposure and metabolic obesity remains poorly studied. We aimed to investigate the associations between residential greenness and obesity phenotypes and the mediation effects of air pollutants and physical activity (PA) level on the associations.

Methods: We used the baseline of the China Multi-Ethnic Cohort (CMEC) study, which enrolled 87,613 adults. Obesity phenotypes were defined based on obesity and metabolic status, including metabolically unhealthy obesity (MUO), non-obesity (MUNO), metabolically healthy obesity (MHO), and non-obesity (MHNO). Greenness exposure was measured as the 3-year mean values of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) within the 500-m buffer zones around the participants' residence. Multivariable logistic regression was used to estimate the associations between greenness and obesity phenotypes. Stratified analyses by age, sex, educational level, and urbanicity were performed to identify how the effect varies across different subgroups. Causal mediation analysis was used to examine the mediation effects of air pollutants and PA level.

Results: Compared with MHNO, each interquartile range (IQR) increase in greenness exposure was associated with reduced risks of MHO (OR_NDVI [95% CI] = 0.87 [0.81, 0.93]; OR_EVI = 0.91 [0.86, 0.97]), MUO (OR_NDVI = 0.83 [0.78, 0.88]; OR_EVI = 0.86 [0.81, 0.91]), and MUNO (OR_NDVI = 0.88 [0.84, 0.91]; OR_EVI = 0.89 [0.86, 0.92]). For each IQR increase in both NDVI and EVI, the risks of MHO, MUO, and MUNO were reduced more in men, participants over 60 years, those with a higher level of education, and those living in urban areas, compared to their counterparts. Concentrations of particulate matter (PM) and PA level partially mediated the associations between greenness exposure and obesity phenotypes.

Conclusions: Exposure to residential greenness was associated with decreased risks of MHO, MUO, and MUNO, which was mediated by concentrations of PM and PA level, and modified by sex, age, educational level, and urbanicity.

Keywords: Greenness; Metabolic health; Metabolic obesity phenotype; Obesity.