Preliminary Dutch research has shown that feeling safe in the neighborhood is related to greater weight loss when participating in lifestyle interventions.
The term “neighborhood safety” encompassed four dimensions: not being afraid of crime or harassment when walking in the neighborhood, feeling safe walking or biking due to heavy traffic, adequate street lighting during the evening and at night, and no of young people hanging around the neighborhood. area.
In contrast, no significant association was found between access to supermarkets or sports facilities and weight loss.
Lower socioeconomic status , often measured using neighborhood characteristics or ZIP codes, is a known risk factor for obesity. Lifestyle interventions, such as diet and exercise programs, can play an important role in the treatment of obesity. However, little is known about the effect of neighborhood characteristics on the success of such interventions.
To learn more, Boëlle Brouwer of the University Medical Center Rotterdam, the Netherlands, studied the relationship between neighborhood characteristics and changes in waist circumference and weight in people who participated in a combined lifestyle intervention multidisciplinary 1.5 years.
The study involved 122 people living with obesity (74.6 percent women, average BMI = 39 kg/m 2) who participated in the intervention, which included dietary counseling combined with exercise and cognitive behavioral therapy, between October 2011 and April 2022.
Before the start of the program, participants were asked to complete a questionnaire assessing neighborhood characteristics focusing on five factors: neighborhood safety (four items, see above), neighborhood attractiveness (four items: the presence of trees along along the road, the existence of a nearby park, a clean and orderly appearance of the neighborhood, and the general attractiveness of the area as a desirable place to live), social cohesion (three elements: feeling lonely when in the neighborhood, people in the neighborhood have positive social interactions with each other). others and people in the neighborhood are willing to help each other), access to grocery stores (one item: the ability to do daily shopping in the neighborhood) and access to sports facilities (one item: having sports facilities nearby ).
Height, weight and waist circumference were measured before the start of the program, after 10 weeks and after 1.5 years.
The study found that people who scored higher on a neighborhood safety scale (with a possible total score ranging between 1 and 5, with 5 indicating the greatest sense of safety), experienced greater decreases in both weight as in waist circumference.
Higher neighborhood safety scores were associated with greater weight loss after 10 weeks. Specifically, a one-point increase in neighborhood safety score was associated with 1.3% greater initial weight loss.
Similarly, a greater sense of neighborhood safety was linked to greater weight loss and greater decline in waist circumference at the end of the program (after 1.5 years). A one-point increase in the long-term neighborhood safety score was associated with a 3.2% average decrease in weight and a 2.6% average decrease in waist circumference (the latter indicating a change favorable in body composition towards less accumulation of abdominal fat).
Ms Brouwer says: “Surprisingly, these findings were independent of sex, age and educational level. There are several possible reasons why neighborhood safety is important. People may be less willing to go out if they feel unsafe, causing them to be less physically active . Another explanation could be that feelings of insecurity increase stress levels , which can contribute to unhealthy eating behavior and weight gain. "We also cannot rule out that neighborhood safety is associated with other factors, for example, poverty , which may be important for the association we found."
The study also indicated that a one-point increase in the social cohesion score (ranging from 1 to 5, with 5 indicating the greatest feeling of social cohesion ), tended to give an average 1.3 percent decrease in the circumference of waist during the first 10 weeks. Again, this was independent of sex, age, and educational level.
Ms Brouwer says: “It is generally known that social cohesion can provide social support and motivation to participants. Feeling connected and supported by the people around you can increase adherence to healthy behaviors and improve the overall outcomes of lifestyle interventions.”
No other significant associations were found between social cohesion and weight and waist circumference.
No significant associations were found between access to grocery stores or sports facilities and changes in weight or waist circumference.
However, there was evidence of a potential link between neighborhood attractiveness and long-term weight loss and changes in waist circumference, when adjusting for sex, age, and education level.
Ms Brouwer says: “Our results indicate that if you feel unsafe where you live, you may reduce your chances of successfully losing weight in response to combined lifestyle interventions. "We need more research to determine how neighborhood safety may affect weight and waist circumference and whether feelings of safety are related to other factors such as housing, stress or poverty."
Study co-author Professor Elisabeth van Rossum, also from the University Medical Center Rotterdam, adds: “We often focus on individuals in the context of a lifestyle intervention for people with obesity. In this study we found evidence that the social and physical environment in which they live may play a role in the success of the intervention, although we need more research to see if this has a causal relationship.
"If it turns out that these environmental and social factors are indeed the drivers of the success of a guided lifestyle intervention, then we need to study to what extent this also applies to people trying to lose weight on their own."
