PMID- 33027626
OWN - NLM
STAT- MEDLINE
DCOM- 20210419
LR  - 20210419
IS  - 1096-0953 (Electronic)
IS  - 0013-9351 (Linking)
VI  - 192
DP  - 2021 Jan
TI  - Greenness surrounding schools and adiposity in children and adolescents: Findings 
      from a national population-based study in China.
PG  - 110289
LID - S0013-9351(20)31186-5 [pii]
LID - 10.1016/j.envres.2020.110289 [doi]
AB  - BACKGROUND: Previous studies have indicated that exposure to green space may 
      benefit human health. However, the available evidence concerning the effects of 
      greenness, especially school-based greenness, on pediatric obesity is scarce. 
      OBJECTIVE: To explore the association between school-based greenness and 
      adiposity in children and adolescents in China. METHOD: We conducted a nationwide 
      cross-sectional study of 56,620 children and adolescents (aged 6-18 years) in 
      seven provinces/municipalities across China. School-based greenness was assessed 
      using satellite-derived Normalized Difference Vegetation Index (NDVI) and Soil 
      Adjusted Vegetation Index (SAVI) within 100-, 500-, and 1000-m circular buffers 
      around each school's address. Generalized linear mixed regression models were 
      used to estimate associations of greenness with BMI z-scores (zBMI), waist 
      circumference, and prevalent overweight/obesity. We also explored the potential 
      mediating role of ambient air pollution and physical activity in the 
      greenness-adiposity associations. RESULT: In the adjusted model, an IQR increase 
      in NDVI(-1000m) was associated with lower zBMI (beta: -0.11, 95% confidence 
      interval[CI]: -0.13,-0.09) and waist circumference (beta: -0.64, 95%CI: 
      -0.78,-0.50). Consistently, an IQR increase in NDVI(-100m), NDVI(-500m), 
      NDVI(-1000m) was associated with 7-20% lower odds of overweight/obesity in the 
      adjusted models. Air pollutants mediated 6.5-29.1% of the association between 
      greenness and zBMI. No significant mediation effect was observed for physical 
      activity. CONCLUSION: Higher school-based greenness levels were associated with 
      lower zBMI, waist circumference, and lower odds of overweight and obesity in 
      children and adolescents. Ambient air pollutants may partially mediate the 
      greenness-adiposity associations.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Bao, Wen-Wen
AU  - Bao WW
AD  - Department of Maternal and Child Health, School of Public Health, Sun Yat-sen 
      University, Guangzhou, 510080, China.
FAU - Yang, Bo-Yi
AU  - Yang BY
AD  - Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, 
      Guangdong Provincial Engineering Technology Research Center of Environmental and 
      Health Risk Assessment, Department of Preventive Medicine, School of Public 
      Health, Sun Yat-sen University, Guangzhou, 510080, China.
FAU - Zou, Zhi-Yong
AU  - Zou ZY
AD  - Institute of Child and Adolescent Health, School of Public Health, Peking 
      University, Beijing, 100191, China.
FAU - Ma, Jun
AU  - Ma J
AD  - Institute of Child and Adolescent Health, School of Public Health, Peking 
      University, Beijing, 100191, China.
FAU - Jing, Jin
AU  - Jing J
AD  - Department of Maternal and Child Health, School of Public Health, Sun Yat-sen 
      University, Guangzhou, 510080, China.
FAU - Wang, Hai-Jun
AU  - Wang HJ
AD  - Department of Maternal and Child Health, School of Public Health, Peking 
      University, Beijing, 100191, China.
FAU - Luo, Jia-You
AU  - Luo JY
AD  - Department of Maternal and Child Health, School of Public Health, Central South 
      University, Changsha, 410078, China.
FAU - Zhang, Xin
AU  - Zhang X
AD  - School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
FAU - Luo, Chun-Yan
AU  - Luo CY
AD  - Shanghai Municipal Center for Disease Control and Prevention, Shanghai Institute 
      of Preventive Medicine, Shanghai, 200336, China.
FAU - Wang, Hong
AU  - Wang H
AD  - Department of Maternal and Child Health, School of Public Health and Management, 
      Chongqing Medical University, Chongqing, 400016, China.
FAU - Zhao, Hai-Ping
AU  - Zhao HP
AD  - School of Public Health and Management, Ningxia Medical University, Ningxia, 
      750004, China.
FAU - Pan, De-Hong
AU  - Pan DH
AD  - Liaoning Health Supervision Bureau, Shenyang, 110005, China.
FAU - Gui, Zhao-Huan
AU  - Gui ZH
AD  - Department of Maternal and Child Health, School of Public Health, Sun Yat-sen 
      University, Guangzhou, 510080, China.
FAU - Zhang, Jing-Shu
AU  - Zhang JS
AD  - Department of Maternal and Child Health, School of Public Health, Sun Yat-sen 
      University, Guangzhou, 510080, China.
FAU - Guo, Yu-Ming
AU  - Guo YM
AD  - Department of Epidemiology and Preventive Medicine, School of Public Health and 
      Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
FAU - Ma, Ying-Hua
AU  - Ma YH
AD  - Institute of Child and Adolescent Health, School of Public Health, Peking 
      University, Beijing, 100191, China. Electronic address: yinghuama@bjmu.edu.cn.
FAU - Dong, Guang-Hui
AU  - Dong GH
AD  - Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, 
      Guangdong Provincial Engineering Technology Research Center of Environmental and 
      Health Risk Assessment, Department of Preventive Medicine, School of Public 
      Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address: 
      donggh5@mail.sysu.edu.cn.
FAU - Chen, Ya-Jun
AU  - Chen YJ
AD  - Department of Maternal and Child Health, School of Public Health, Sun Yat-sen 
      University, Guangzhou, 510080, China. Electronic address: 
      chenyj68@mail.sysu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201004
PL  - Netherlands
TA  - Environ Res
JT  - Environmental research
JID - 0147621
SB  - IM
MH  - *Adiposity
MH  - Adolescent
MH  - Child
MH  - China/epidemiology
MH  - Cities
MH  - Cross-Sectional Studies
MH  - Humans
MH  - *Pediatric Obesity/epidemiology
MH  - Schools
OTO - NOTNLM
OT  - Cross-sectional study
OT  - Green space
OT  - Mediating effect
OT  - Obesity
OT  - Overweight
EDAT- 2020/10/08 06:00
MHDA- 2021/04/20 06:00
CRDT- 2020/10/07 20:05
PHST- 2020/07/07 00:00 [received]
PHST- 2020/09/23 00:00 [revised]
PHST- 2020/09/28 00:00 [accepted]
PHST- 2020/10/08 06:00 [pubmed]
PHST- 2021/04/20 06:00 [medline]
PHST- 2020/10/07 20:05 [entrez]
AID - S0013-9351(20)31186-5 [pii]
AID - 10.1016/j.envres.2020.110289 [doi]
PST - ppublish
SO  - Environ Res. 2021 Jan;192:110289. doi: 10.1016/j.envres.2020.110289. Epub 2020 
      Oct 4.