Residential exposure to green and blue spaces over childhood and cardiometabolic health outcomes: The Generation XXI birth cohort
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Background
Evidence on the effects of exposure to green and blue spaces on childhood cardiometabolic health is inconsistent, limited and mostly cross-sectional.
Objectives
To assess the associations of exposure to green and blue spaces, at birth, 4, 7, and 10 years (to identify vulnerable periods of exposure) and as longitudinal trajectories (to identify the longitudinal effect over time), with cardiometabolic health outcomes at 10 years.
Methods
Participants are from Generation XXI, a population-based birth cohort from Porto Metropolitan Area, Portugal (n=4669). Residential normalized difference vegetation index (NDVI) and Euclidian distance to the nearest urban green and blue space were assessed at birth, 4, 7 and 10 years using geographic information systems and standardized by dividing the observed value by the standard deviation. Longitudinal trajectories of exposures from birth to 10 years were derived using latent class mixed models. At 10 years, we measured body mass index, fat mass index and android-to-gynoid fat ratio, blood pressure, and metabolic outcomes. We defined overweight/obesity by the World Health Organization, high blood pressure by the American Academy of Pediatrics and metabolic syndrome by the IDEFICS study.
Results
No significant associations were observed between natural spaces exposure and body mass index, body fat content and distribution. We found an inverse association between distance to nearest blue space at birth and systolic blood pressure z-scores, and a positive association between distance to nearest green space at 7 and 10 years and metabolic syndrome score (p-values<0.05). Also, compared to children in the high stable trajectory of NDVI500m, those in the descending trajectory of NDVI500m presented a lower diastolic blood pressure z-score and metabolic syndrome score (p-values<0.05). However, after multiple testing correction, all associations lost statistical significance.
Discussion
This study did not find robust associations between the exposure to natural spaces over key developmental periods and cardiometabolic health.
