Cumulative Experience of Neighborhood Walkability and Change in Weight and Waist Circumference in REGARDS.

Neighborhood walkability, features of the built environment that promote pedestrian activity, has been associated with greater physical activity and lower body mass index (BMI) among neighborhood residents. However, much of the literature has been cross-sectional and only a few cohort studies have assessed neighborhood features throughout follow-up. Using data from REGARDS (2003-2016) and a neighborhood walkability index (NWI) measured annually during follow-up, we assessed whether the cumulative experience of neighborhood walkability (NWI-Years) predicted BMI and waist circumference (WC) after ~10 years of follow-up, controlling for these anthropometric measures at enrollment. Analyses adjusted for individual-level socio-demographic covariates and the cumulative experience of neighborhood poverty rate and neighborhood greenspace coverage. Twenty nine percent of participants changed address at least once during follow-up. The first change of residence on average brought the participants to neighborhoods with higher home values and lower NWI scores than their originating neighborhoods. Compared with those having experienced the lowest quartile of cumulative NWI-Years, those that experienced the highest quartile, had 0.83 Kg/M2 lower BMI (95% CI -1.5, -0.16) and 1.07 cm smaller WC (95% CI -1.96, -0.19) at follow-up. These analyses provide additional longitudinal evidence that residential neighborhood features that support pedestrian activity are associated with lower adiposity.