Background: While the obesity epidemic is impacting children, survivors of childhood brain tumors (SCBT) are particularly vulnerable to obesity-driven cardiometabolic comorbidities. SCBT have excess body fat (adiposity) with similar body mass measures when compared to matched non-cancer controls. The effect of the built environment on the risk of obesity has received relatively limited attention in survivors. Aim & Methods: The aim of this project was to determine the impact of the built environment on body mass index (BMI) percentile, body fat percentage (BF%), waist-to-hip ratio (WHR), and waist-to-height-ratio (WHtR) in SCBT and non-cancer controls. The data for this secondary analysis were derived from participants in the Canadian Study of Determinants of Endometabolic Health in Children (CanDECIDE), a prospective cohort study based at McMaster Children’s Hospital, a tertiary pediatric academic center in Hamilton, Ontario, Canada. The Neighborhood Environment Walkability Scale (NEWS) was used to assess the built environment. Multivariable regression analyses were used to define the predictors of the association. Results: The built environment was not associated with BMI percentile in SCBT and non-cancer controls including residential density (B 0.276, p value 0.436), land use mix diversity (B -0.286, p value 0.301), land use mix access (B 0.004, p value 0.993), street connectivity (B 0.297, p value 0.431), walking/cycling facilities (B 0.185, p value 0.540), neighborhood aesthetics (B 0.270, p value 0.513), safety from traffic (B -0.368, p value 0.418), and safety from crime (B -0.074, p value 0.907). The built environment was also not associated with adiposity measures (BF%: residential density B 0.031, p value 0.851, land use mix diversity B -0.082, p value 0.513, land use mix access B -0.036, p value 0.861, street connectivity B 0.309, p value 0.055, walking/cycling facilities B 0.109, p 0.439, neighborhood aesthetics B 0.127, p value 0.503, safety from traffic B -0.047, p value 0.825, and safety from crime B -0.154, p value 0.601; WHR: residential density B -0.042, p value 0.362, land use mix diversity B 0.043, p value 0.131, land use mix access B -0.028, p value 0.558, street connectivity B -0.044, p value 0.252, walking/cycling facilities B 0.026, p value 0.476, neighborhood aesthetics B 0.062, p value 0.137, safety from traffic B -0.048, p value 0.336, and safety from crime B -0.083, p value 0.239; WHtR: residential density B 0.011, p value 0.865, land use mix diversity B 0.033, p value 0.462, land use mix access B -0.032, p value 0.662, street connectivity B 0.021, p value 0.720, walking/cycling facilities B 0.042, p value 0.493, neighborhood aesthetics B 0.018, p value 0.790, safety from traffic B -0.020, p value 0.789, and safety from crime B -0.086, p value 0.392). Conclusion: The results of this study suggest that the built environment has less of an impact than brain tumors and their treatments on driving body mass and fat mass changes in SCBT. The use of lifestyle interventions may need to be combined with pharmacotherapies in the treatment of obesity in SCBT. / Thesis / Master of Science (MSc) / Childhood obesity is a global epidemic. Survivors of childhood brain tumors (SCBT) are a subpopulation of childhood cancer survivors who exhibit numerous comorbidities including obesity. SCBT have increased amounts of adipose tissue compared to non-cancer controls at similar body mass. While tumor and treatment related drivers of obesity exist in this population, the impact of environmental factors on obesity and the fat mass are not well understood. In this cross-sectional study, we aimed to determine the association between the built environment and body mass in SCBT and non-cancer controls. There was no association between the built environment and body mass measures in survivors. This study suggests the disproportionate importance of the biological mechanisms including the original tumors and their treatments on body mass in SCBT. Interventions to mitigate obesity and cardiometabolic risk in survivors need to focus on addressing tumor and treatment impacts.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/29878 |
| Date | January 2024 |
| Creators | Ragganandan, Stephanie |
| Contributors | Samaan, M. Constantine, Health Research Methodology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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