PMID- 30161196
OWN - NLM
STAT- MEDLINE
DCOM- 20190212
LR  - 20230928
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 8
DP  - 2018
TI  - The association between physical inactivity and obesity is modified by five 
      domains of environmental quality in U.S. adults: A cross-sectional study.
PG  - e0203301
LID - 10.1371/journal.pone.0203301 [doi]
LID - e0203301
AB  - Physical inactivity is a primary contributor to the obesity epidemic, but may be 
      promoted or hindered by environmental factors. To examine how cumulative 
      environmental quality may modify the inactivity-obesity relationship, we 
      conducted a cross-sectional study by linking county-level Behavioral Risk Factor 
      Surveillance System data with the Environmental Quality Index (EQI), a composite 
      measure of five environmental domains (air, water, land, built, sociodemographic) 
      across all U.S. counties. We estimated the county-level association (N = 3,137 
      counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 
      2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear 
      regression, with a random intercept for state, adjusted for percent minority and 
      rural-urban status. We modelled overall and sex-specific estimates, reporting 
      prevalence differences (PD) and 95% confidence intervals (CI). In the overall 
      population, the PD increased from best (PD = 0.341 (95% CI: 0.287, 0.396)) to 
      worst (PD = 0.645 (95% CI: 0.599, 0.690)) EQI tertile. We observed similar trends 
      in males from best (PD = 0.244 (95% CI: 0.194, 0.294)) to worst (PD = 0.601 (95% 
      CI: 0.556, 0.647)) quality environments, and in females from best (PD = 0.446 
      (95% CI: 0.385, 0.507)) to worst (PD = 0.655 (95% CI: 0.607, 0.703)). We found 
      that poor environmental quality exacerbates the LTPIA-obesity relationship. 
      Efforts to improve obesity through LTPIA may benefit from considering this 
      relationship.
FAU - Gray, Christine L
AU  - Gray CL
AUID- ORCID: 0000-0002-0751-1626
AD  - Department of Epidemiology, Gillings School of Global Public Health, University 
      of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of 
      America.
AD  - Oak Ridge Institute for Science and Education at the U.S. Environmental 
      Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, 
      United States of America.
FAU - Messer, Lynne C
AU  - Messer LC
AD  - School of Public Health, Oregon Health & Sciences University-Portland State 
      University, Portland, Oregon, United States of America.
FAU - Rappazzo, Kristen M
AU  - Rappazzo KM
AD  - National Health and Environmental Effects Research Laboratory, U.S. Environmental 
      Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, 
      United States of America.
FAU - Jagai, Jyotsna S
AU  - Jagai JS
AD  - Division of Environmental and Occupational Health Sciences, School of Public 
      Health, University of Illinois Chicago, Chicago, Illinois, United States of 
      America.
FAU - Grabich, Shannon C
AU  - Grabich SC
AD  - Oak Ridge Institute for Science and Education at the U.S. Environmental 
      Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, 
      United States of America.
FAU - Lobdell, Danelle T
AU  - Lobdell DT
AD  - National Health and Environmental Effects Research Laboratory, U.S. Environmental 
      Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, 
      United States of America.
LA  - eng
GR  - EP-17-D-000063/EPA/EPA/United States
GR  - EP-17-D-000079/EPA/EPA/United States
GR  - P30 DK092949/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20180830
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Behavioral Risk Factor Surveillance System
MH  - Environment
MH  - *Environmental Pollution
MH  - Female
MH  - Humans
MH  - Leisure Activities
MH  - Male
MH  - Obesity/*epidemiology
MH  - Prevalence
MH  - *Sedentary Behavior
MH  - Socioeconomic Factors
MH  - United States/epidemiology
PMC - PMC6117021
COIS- The authors have declared that no competing interests exist.
EDAT- 2018/08/31 06:00
MHDA- 2019/02/13 06:00
PMCR- 2018/08/30
CRDT- 2018/08/31 06:00
PHST- 2018/02/14 00:00 [received]
PHST- 2018/08/18 00:00 [accepted]
PHST- 2018/08/31 06:00 [entrez]
PHST- 2018/08/31 06:00 [pubmed]
PHST- 2019/02/13 06:00 [medline]
PHST- 2018/08/30 00:00 [pmc-release]
AID - PONE-D-18-05015 [pii]
AID - 10.1371/journal.pone.0203301 [doi]
PST - epublish
SO  - PLoS One. 2018 Aug 30;13(8):e0203301. doi: 10.1371/journal.pone.0203301. 
      eCollection 2018.