The role of behaviors and the built environment in the prevalence of overweight in Portugal

Abstract

The aim of this study was to evaluate the role of the built environment, among other factors, on overweight in Portugal, through the Portuguese Network of Healthy Municipalities (RPMS) data sample. A cross-sectional population-based survey was applied, carried out between May/2020-April/2021, with a sample of 10,047 adult individuals (≥18 years old). Data on anthropometric measures, food consumption, self-assessed health status and health conditions were self-reported. The prevalence of Diabetes Mellitus-DM and Systemic Arterial Hypertension-SAH were also included, based the report of previous medical diagnosis. Overweight was assessed using the Body Mass Index ≥25kg/m2, and was associated with: (i) individual conditions (demographic/socioeconomic/health/behavioral) and (ii) residence area contextual characteristics (availability of sports equipment /leisure/recreation; access to green spaces and food stores). Logistic regressions models, adjusted for age and sex, were developed. Overweight ranged between 37.5 and 48%, being more prevalent in the population living in rural municipalities. Overweight was significantly associated with: poor self-assessed health status, SAH and DM, low physical activity practice, worse socioeconomic status, low consumption of fruits and vegetables and frequent consumption of sausages and soft drinks. Conditions of the built environment were also associated with overweight in medium-sized municipalities (with a population between 30 and 80 thousand inhabitants and between 80 and 150 thousand inhabitants). The results highlight the importance of place characteristics to tackle combating overweight and obesity.