The Suburbs Made Us Fat

[ukw]

http://www.theatlantic.com/health/ar...e-city/375888/

People in dense cities are thinner and have healthier hearts than people in sprawling subdivisions. New research says the secret is in the patterns of the streets.

...

In prior research, Marshall told me, they found that in the most extreme cases “older, denser, connected cities were killing three times fewer people than sparser, tree-like cities on an annual basis." Of course, people walk and bike more in dense cities, but the research on actual ties to health outcomes is scant. So Garrick and Marshall took on and have just completed a large study of how street networks might influence our health.

They looked at the three fundamental measures of street networks—density, connectivity, and configuration—in 24 California cities, and compared them with various maladies. In the current Journal of Transport and Health, Garrick and Marshall report that cities with more compact street networks—specifically, increased intersection density—have lower levels of obesity, diabetes, high blood pressure, and heart disease. The more intersections, the healthier the humans.

...

They also found that wide streets with many lanes are associated with high rates of obesity and diabetes. That’s most likely indicative of, as Garrick and Marshall put it, “an inferior pedestrian environment.” Similarly, so-called “big box” stores in a neighborhood indicate poor walkability and are associated with 24.9 percent higher rates of diabetes and 13.7 percent higher rates of obesity.

[Shawn]

I have also been hearing rumblings that the sky is blue and water is wet . . .

drive to work + 8 hours sitting at a desk + drive home + American diet = fat people

[James Bond Agent 007]

At the risk of starting a big argument ...

This is actually not true - that is, pedestrian-friendly cities, in and of themselves, cannot be responsible for the relative lack of obesity in those cities. Or, at the very least they can only be a minority of the relative lack of obesity of their residents.

The reason for this is, it has been proven many times over that exercise does not lead to weight loss, and, conversely, lack of exercise does not lead to obesity. The overwhelming reason for obesity is diet. I can provide many links if requested (start here).

The authors of the study simply assumed that walking around leads to, "lower levels of obesity, diabetes, high blood pressure, and heart disease." The problem is, they never first examined that assumption. Here is their explicit error:

Dense cities promote walking and biking, so the push for healthier cities fits with the vogue push for active lifestyles—as opposed to gym routines smattered across an indolent existence.

This is wrong. The problem with this kind of thinking is, you could probably make the same conclusion about, say, the amount of tree cover in a city and rates of obesity: I'd be willing to bet that cities with lower amounts of tree cover have lower obesity rates. But clearly a lack of trees does not cause healthier lifestyles; instead, they happen to be correlated without either being causative.

The reality probably is, people who live in denser cities eat healthier diets than ones who live in curvy-street suburbs. Much of this has to do with income, as it's well-known that wealthier people have lower obesity rates than poorer people. And cities with grid streets (NYC, Boston, SF, Seattle, etc) tend to have large concentrations of wealthier people.

[Dale]

Bigger picture: the fatter we get, the longer we live. This seems to infuriate some people.

[Shawn]

Originally Posted by James Bond Agent 007

The overwhelming reason for obesity is diet.

I can definitely buy this.

To be honest, it's not like Japanese people around me are fitness freaks. Actually, few of my friends do anything to keep in shape - other than eat like a normal Japanese person. You certainly end up walking a lot more anywhere in Japan than you would in equivalent places in the US, but not to a degree that this alone would keep weight off. The key differences are:

1. Types of food (lots of seafood and veggies, few carbs other than rice, buckets of green tea a week); Japanese drinks don't have corn syrup shit and are a lot less sugary. Drinks - both the size and sugar content - are a huge factor in what makes Americans fat.

2. PORTIONS!!! A L-size cola at Japanese McDonald's is almost smaller than the American S-size (50 ml more). When I visit home, I simply cannot finish meals from restaurants. Fast food, mid-level chains, even upscale places: the portions are obscene.

[James Bond Agent 007]

OK I just found the abstract of their study online and it's like, give me a break.

http://www.sciencedirect.com/science...14140514000486

What is the influence of street network design on public health? While the literature linking the built environment to health outcomes is vast, it glosses over the role that specific street network characteristics play. The three fundamental elements of street networks are: street network density, connectivity, and configuration. Without sufficient attention being paid to these individual elements of street network design, building a community for health remains a guessing game. Our previous study found more compact and connected street networks highly correlated with increased walking, biking, and transit usage; while these trends suggest a health benefit, this study seeks to strengthen that connection.

Using a multilevel, hierarchical statistical model, this research seeks to fill this gap in the literature through a more robust accounting of street network design. Specifically, we ask the following: what is the influence of the three fundamental measures of street networks on obesity, diabetes, high blood pressure, heart disease, and asthma? We answer this question by examining 24 California cities exhibiting a range a street network typologies using health data from the California Health Interview Survey.

We control for the food environment, land uses, commuting time, socioeconomic status, and street design. The results suggest that more compact and connected street networks with fewer lanes on the major roads are correlated with reduced rates of obesity, diabetes, high blood pressure, and heart disease among residents. Given the cross-sectional nature of our study, proving causation is not feasible but should be examined in future research. Nevertheless, the outcome is a novel assessment of streets networks and public health that has not yet been seen but will be of benefit to planners and policy-makers.

So they ONLY looked at California! I mean - c'mon! How many cities in CA are predominantly grids? San Francisco? So they probably ended up comparing SF to the rest of California.

And this part here is simply crap:

Specifically, we ask the following: what is the influence of the three fundamental measures of street networks on obesity, diabetes, high blood pressure, heart disease, and asthma?

Before they do that, they should FIRST ask, "Can, or do, the configuration of street networks have an effect on obesity, diabetes, high blood pressure, heart disease and asthma?" They simply assumed it did, and then found a correlation without even asking whether or not it was causative.

I give the study an F.

[brickell]

Agree that this probably has more to do with the attractiveness and therefore the wealth of these high intersection densities. Or at least the self selection that might happen due to the differences in the type of city/neighborhood.

The truth is that there's probably many many different variables that have made us (US, Mexico, England, et al) fat. Sprawl is just one. The replacement of real food with high calorie, low nutrient food is probably the biggest factor. The increase in desk jobs. The preponderance of media that allow us to sit and consume for hours on end. The fact that we don't let our children go outside to play anymore. The automobile. Soda. Starbucks. Air Conditioning. 7-11, and more.

[James Bond Agent 007]

Here's a list of the fattest and thinnest cities in the US:

http://www.advisory.com/daily-briefi...t-obese-cities

Thinnest:

1. Boulder, Colo. (where only 12.5% of residents are obese);
2. Charlottesville, Va. (14.3%);
3. Bellingham, Wash. (15.9%);
4. Fort Collins-Loveland, Colo. (16.5%);
5. Naples-Marco Island, Fla. (16.6%);
6. Denver-Aurora, Colo. (17.8%);
7. San Francisco-Oakland-Fremont, Calif. (18.0%);
8. San Luis Obispo-Paso Robles, Calif. (18.1%);
9. Madison, Wis. (18.2%); and
10. Colorado Springs, Colo. (18.3%).

They're pretty much higher-income cities, college towns, state capitols or some combination of the above. I don't see any pattern of grids vs sprawl there.

Now the fattest:

1. McAllen-Edinburg-Mission, Texas (where 38.5% of residents are obese);
2. Huntington-Ashland, W.V., Ky., and Ohio (37.7%);
3. Little Rock-North Little Rock-Conway, Ark. (34.7%);
4. Mobile, Ala. (33.7%);
5. Hagerstown-Martinsburg, Md. and W.V. (33.4%);
6. Myrtle Beach-North Myrtle Beach-Conway, S.C. (33.1%);
7. Toledo, Ohio (33.0%);
8. Charleston, W.V. (32.9%);
9. Reading, Pa. (32.8%); and
9. Erie, Pa. (32.5%); and
9. Beaumont-Port Arthur, Texas (32.5%).

They're pretty much working class/poorer cities. And I don't see any more or fewer sprawl-y cities than I do cities dominated by grids.

[Doady]

Based on my studies back in the day, the fattest communities in the US were the poor, urban, black communities. Poverty and segregation means less food choices. Less fresh food, fewer grocery stores, more fast food and junk food.

But that's just US. I'm not sure about Canada or Europe.

[mhays]

Obviously it's a complex issue. Someone would have to be pretty stupid to attribute the problem to one factor. But activity level is certainly a part, with benefits far beyond the simple calories used.

Let's say you walk a very short way to transit from my office. That means going up a steep hill. If you're fat maybe your difficulty on that hill will be encouragement to turn your life around. Seems like pretty strong encouragement to me.

Let's say you walk five minutes to get coffee and it's entirely flat, and you're now doing that instead of zero exercise at all. And you're walking slowly. Well, it's still an increased heart and breathing rate, and you're exercising muscles a little also. The walk will probably get easier as you do it more. Maybe that'll lead to longer walks, or more. And your metabolism might be improved right off the bat.

[Doady]

I remember someone posted a photo thread thread here of some suburb, in Texas I think it was. I couldn't believe how fat the people were! It was crazy. US is strange, obesity is major problem in both cities and suburbs, but for different reasons.

[ukw]

Keep in mind there are also some "intangibles." When I walk in a leafy suburb, I still somehow feel fat and unhealthy; on the other hand, when I drive in a dense urban neighborhood, I somehow feel healthy. It's a weird phenomenon.

[10023]

Originally Posted by Dale

Bigger picture: the fatter we get, the longer we live. This seems to infuriate some people.

I would love to see an actual causal relationship for this.

Is this correcting for other factors, like income, education, race, etc? Across what type of population sample? In the US, poorer people are generally fatter, but if you take the world as a whole (including developing countries), wealthier people are generally heavier. Wealthier people also live longer.

Anyway, to really understand the impact of built environment on obesity, you would have to be a bit more selective and compare, say, upper middle class, majority white suburbs with upper middle class, majority white urban neighborhoods. In other words, you don't compare New York City to Nassau County, you compare Park Slope to Garden City (and do lots and lots of these comparisons).

[chris08876]

Originally Posted by Doady

I remember someone posted a photo thread thread here of some suburb, in Texas I think it was. I couldn't believe how fat the people were! It was crazy. US is strange, obesity is major problem in both cities and suburbs, but for different reasons.

Yea IDK whats up with that, but I live in the suburbs and I really don't see many fat people. Maybe its a Jersey thing.


Credit: http://3.bp.blogspot.com/-gPGXNJ2iof...unty_large.png

The heck are people eating in Alabama and Louisiana?


Credit: http://cdn.static-economist.com/site...001_1190_0.png

[novawolverine]

Originally Posted by Doady

I remember someone posted a photo thread thread here of some suburb, in Texas I think it was. I couldn't believe how fat the people were! It was crazy. US is strange, obesity is major problem in both cities and suburbs, but for different reasons.

This reminds me of Charles Barkley's jokes about the women in San Antonio

[novawolverine]

Originally Posted by 10023

I would love to see an actual causal relationship for this.

Is this correcting for other factors, like income, education, race, etc? Across what type of population sample? In the US, poorer people are generally fatter, but if you take the world as a whole (including developing countries), wealthier people are generally heavier. Wealthier people also live longer.

Anyway, to really understand the impact of built environment on obesity, you would have to be a bit more selective and compare, say, upper middle class, majority white suburbs with upper middle class, majority white urban neighborhoods. In other words, you don't compare New York City to Nassau County, you compare Park Slope to Garden City (and do lots and lots of these comparisons).

There's definitely a socioeconomic and cultural component to this. Not that it proves a ton, but you can look at PG County, MD vs neighboring Montgomery and Fairfax counties and start to draw some conclusions. Look at Oakland vs. Wayne in SE Michigan for a seemingly counterintuitive example.

[Leo the Dog]

Disagree.

Diet. The food we eat today did not exist a generation ago.

[HomeInMyShoes]

Originally Posted by James Bond Agent 007

At the risk of starting a big argument ...

...

This is wrong. The problem with this kind of thinking is, you could probably make the same conclusion about, say, the amount of tree cover in a city and rates of obesity: I'd be willing to bet that cities with lower amounts of tree cover have lower obesity rates. But clearly a lack of trees does not cause healthier lifestyles; instead, they happen to be correlated without either being causative.

Thank-you for pointing out the fallacy of correlation versus causality.

[10023]

Originally Posted by Leo the Dog

Disagree.

Diet. The food we eat today did not exist a generation ago.

It's both.

[skunkachunks]

It's shocking that there are entire state borders (Oklahoma/Texas, Louisiana/Texas, Illinois/Missouri, Kansas/Colorado, Virginia/West Virgina) in which bordering counties that reside in different states have a huge obesity disparity. I would understand these differences across a border for something that is state legislated (like gun ownership rates or educational attainment) but obesity? Are there some regulations in the states that this phenomenon is occurring in that create these state-specific patterns?

[QUOTE=chris08876;6692136]Yea IDK whats up with that, but I live in the suburbs and I really don't see many fat people. Maybe its a Jersey thing.


Credit: http://3.bp.blogspot.com/-gPGXNJ2iof...unty_large.png