Geographical inequalities in overweight and obesity prevalence among children are well established in cross-sectional research. We aimed to examine how environmental area characteristics at birth are related to these outcomes in childhood. Anonymised antenatal and birth data recorded by University Hospital Southampton linked to school-measured weight and height data for children within Southampton, UK, were utilised (14,084 children at ages 4–5 and 5637 at ages 10–11). Children’s home address at birth was analysed at the Lower and Middle layer Super Output Area (LSOA/MSOA) levels (areas with average populations of 1500 and 7000, respectively). Area-level indices (walkability, relative density of unhealthy food outlets, spaces for social interaction), natural greenspace coverage, supermarket density and measures of air pollution (PM2.5, PM10 and NOx) were constructed using ArcGIS Network Analyst. Overweight/obesity was defined as a body mass index (BMI; kg/m2) greater than the 85th centile for sex and age. Population-average generalised estimating equations estimated the risk of being overweight/obese for children at both time points. Confounders included maternal BMI and smoking in early pregnancy, education, ethnicity and parity. We also examined associations for a subgroup of children who moved residence between birth and outcome measurement. There were mixed results between area characteristics at birth and overweight/obesity at later ages. MSOA relative density of unhealthy food outlets and PM10 were positively associated with overweight/obesity, but not among children who moved. LSOA greenspace coverage was negatively associated with the risk of being overweight/obese at ages 10–11 in all children (relative risk ratio 0.997, 95% confidence interval 0.995–0.999, p = 0.02) and among children who moved. Local access to natural greenspaces at the time of birth was inversely associated with becoming overweight or obese by age 10–11, regardless of migration. Increased access/protection of greenspace may have a role in the early prevention of childhood obesity.

中文翻译：

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学龄儿童出生时的环境区域特征是否与超重和肥胖有关？英格兰南部基于SLOPE（研究终生肥胖症研究者）人群的研究结果。

在横断面研究中，儿童超重和肥胖患病率的地理不平等现象已得到充分证实。我们旨在研究出生时的环境区域特征与儿童期的这些结果之间的关系。利用南安普敦大学医院记录的匿名产前和出生数据，与英国南安普敦市内儿童通过学校测得的体重和身高数据进行了关联（4,5岁的儿童有1,8044名，10-11岁的儿童是5637名）。在下层和中层超级输出区域（LSOA / MSOA）级别（平均人口分别为1500和7000的区域）分析了孩子出生时的家庭住址。区域级指数（步行性，不健康食品出口的相对密度，社交互动空间），自然绿地覆盖率，超级市场密度和空气污染度量（PM2.5，PM10和NOx）是使用ArcGIS Network Analyst构建的。超重/肥胖定义为体重指数（BMI; kg / m2），大于性别和年龄的第85个百分位数。人口平均广义估计方程式估计了两个时间点儿童超重/肥胖的风险。混杂因素包括孕妇的BMI和早孕，教育，种族和均等方面的吸烟。我们还检查了在出生和结局测量之间迁移居所的儿童亚组的关联。出生时的区域特征与晚年的超重/肥胖之间的结果好坏参半。不健康食品商店和PM10的MSOA相对密度与超重/肥胖呈正相关，但在迁徙儿童中则不然。所有儿童的LSOA绿地覆盖率与10-11岁时超重/肥胖的风险呈负相关（相对风险比0.997，95％置信区间0.995-0.999，p = 0.02）。无论出生与否，到出生时在当地进入自然绿地与到10-11岁变得超重或肥胖成反比。增加对绿色空间的访问/保护可能在早期预防儿童肥胖中起作用。