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Does environment influence childhood BMI? A longitudinal analysis of children aged 3–11
  1. Babette C van der Zwaard1,2,
  2. Annemarie A H Schalkwijk2,
  3. Petra J M Elders2,
  4. Lucinda Platt3,
  5. Giel Nijpels2
  1. 1 Department of Orthopaedics, Jeroen Bosch Ziekenhuis, ’s-Hertogenbosch, The Netherlands
  2. 2 Department of General Practice and Elderly Care Medicine and the Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Amsterdam, The Netherlands
  3. 3 Department of Social Policy, London School of Economics and Political Science, London, UK
  1. Correspondence to Dr Babette C van der Zwaard, Department of Orthopaedics, Jeroen Bosch Ziekenhuis, Den Bosch 5200 ME, The Netherlands; b.v.d.zwaard{at}


Background Childhood overweight/obesity has been associated with environmental context, such as green space, gardens, crime and deprivation. This paper assesses the longitudinal association between environment and body mass index (BMI) for children across the ages of 3–11 years. It also investigates the relationship between environment and child overweight/obesity

Methods 6001 children from the UK Millennium Cohort Study living in England were analysed. We estimated fixed effects linear and logistic regression models of the association between environment (levels of green space, gardens, crime and deprivation) and BMI/overweight of children at four time points between the ages of 3 and 11. Models were adjusted for age-related changes in weight, child sex and education level of the main carer.

Results Statistically significant associations were found between environmental measures of both more gardens and lower levels of crime and lower BMI (effect size (95% CI) respectively: −0.02 (−0.04 to 0.00), −0.04 (−0.07 to −0.02)). Areas with less crime were associated with a slightly lower odds of overweight among children with a higher educated parent (OR 0.93 (0.87–0.99))

Conclusions By exploiting longitudinal measures of environment and BMI this study is able to establish a more causal association between environment and BMI. Environments with more gardens and lower crime tend to result in slightly lower BMI. However, the effect sizes are small and non-significant odds of changing weight status do not support environmental factors as a key determinant of cohort changes in childhood overweight/obesity.

  • child health
  • housing
  • life course / childhood circumstances
  • longitudinal studies
  • obesity

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  • Contributors BCvdZ and AAHS contributed to study design, data analysis, data interpretation, literature search, generation of tables and writing of the manuscript. BCvdZ led the writing of the manuscript. GN and PJME contributed to study design, data interpretation and writing of the manuscript. LP contributed to study design, data collection, data analysis, data interpretation and writing of the manuscript. All authors read and approved the final manuscript.

  • Funding AAHS was supported by an EMGO+ Travel Grant.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The South West and London Multi-Centre Research Ethics Committees approved the data collection for MCS sweeps 1–4 and the Northern and Yorkshire REC approved MCS sweep 5 data collection.23

  • Provenance and peer review Not commissioned; externally peer reviewed.