Residing in more walkable neighborhoods could protect against the risk of overall obesity-related cancers in female patients, according to a recent study published by India-Aldana et al in Environmental Health Perspectives.
Background
Obesity has previously been linked to an increased risk of developing 13 types of cancer in female patients. However, physical activity—independent of body size—may lower the risk for some of these cancer types.
Neighborhood walkability is a set of urban design features that promotes pedestrian activity, supports overall physical activity, and may be associated with a lower body mass index. Individual-level interventions to increase physical activity and reduce obesity can be costly and may have only short-term effects.
“Urban design can create a context that promotes walking, increases overall physical activity, and reduces car dependency—which could lead to subsequent improvements in preventing diseases attributed to unhealthy weight,” explained co–study author Andrew Rundle, DrPH, Professor of Epidemiology at the Columbia University Mailman School of Public Health.
Until recently, long-term studies of neighborhood walkability and obesity-related cancer risk were limited.
Study Methods and Results
In this study, researchers recruited 14,272 female patients (aged 34–65) from 1985 to 1991. They then measured neighborhood walkability in the participant’s residential census-tract throughout the follow-up period—measured by the average destination accessibility and population density—and assessed the association between neighborhood walkability and the risk of overall and site-specific obesity-related cancers, including postmenopausal breast cancer, ovarian cancer, endometrial cancer, and multiple myeloma.
Among the patients involved in the study, 18% had a first obesity-related cancer by the end of 2016—53% of whom had postmenopausal breast cancer, 14% of whom had colorectal cancer, and 12% of whom had endometrial cancer.
After 24 years of follow-up, the researchers found that the patients who resided in neighborhoods with higher walkability levels had a lower risk of developing obesity-related cancers, particularly postmenopausal breast cancer. However, moderate protective associations were also found for endometrial cancer, ovarian cancer, and multiple myeloma. Additionally, female patients who resided in areas with the highest levels of neighborhood walkability (the top 25% of walkability) had a 26% lower risk of developing obesity-related cancers compared with those who lived in neighborhoods in the lowest 25% of walkability.
“We further observed that the association between high neighborhood walkability and lower risk of overall obesity-related cancers was stronger for [female patients] living in neighborhoods with higher levels of poverty,” emphasized lead study author Sandra India-Aldana, PhD, of the Icahn School of Medicine at Mount Sinai. “These findings suggest that neighborhood social and economic environments are also relevant to risk of developing obesity-related cancers,” she added.
Conclusions
“Our study is unique in that the long-term follow-up allowed us to study effects of walkability with potential long latency periods of cancer, and we were able to measure neighborhood walkability as the participants moved residences around the country during follow-up,” highlighted senior study author Yu Chen, PhD, of the New York University Grossman School of Medicine.
“These results contribute to the growing evidence of how urban design affects the health and well-being in aging populations,” Dr. Rundle concluded.
Disclosure: The research in this study was supported by grants from the National Institutes of Health. For full disclosures of the study authors, visit ehp.niehs.nih.gov.
