Built Environment Change and Change in BMI and Waist Circumference: Multi-Ethnic Study of Atherosclerosis

OBJECTIVE: To examine longitudinal associations of the neighborhood built environment with objectively measured body mass index (BMI) and waist circumference (WC) in a geographically and racial/ethnically diverse group of adults. METHODS: This study used data from 5,506 adult participants in the Multi-Ethnic Study of Atherosclerosis, aged 45-84 years in 2000 (baseline). BMI and WC were assessed at baseline and four follow-up visits (median follow-up 9.1 years). Time-varying built environment measures (population density, land-use, destinations, bus access, and street characteristics) were created using Geographic Information Systems. Principal components analysis was used to derive composite scores for three built environment factors. Fixed-effects models, tightly controlling for all time-invariant characteristics, estimated associations between change in the built environment, and change in BMI and WC. RESULTS: Increases in the intensity of development (higher density of walking destinations and population density, and lower percent residential) were associated with less pronounced increases or decreases over time in BMI and WC. Changes in connected retail centers (higher percent retail, higher street connectivity) and public transportation (distance to bus) were not associated with changes in BMI or WC. CONCLUSIONS: Longitudinal changes in the built environment, particularly increased density, are associated with decreases in BMI and WC