Enrique Jacoby

Influences of Built Environments on Walking and Cycling: Lessons from Bogota

ABSTRACT Bogotá, Colombia, is well known for its sustainable urban transport systems, including an extensive network of bike lanes and set-aside street space for recreational cyclists and pedestrians on Sundays and holidays, called Ciclovía (“cycleway”). This paper examines how such facilities along with other attributes of the built environment—urban densities, land-use mixes, accessibility, and proximity to transit—are associated with walking and cycling behavior as well as Ciclovía participation. We find that whereas road facility designs, like street density, connectivity, and proximity to Ciclovía lanes, are associated with physical activity, other attributes of the built environment, like density and land-use mixtures, are not. This is likely because most neighborhoods in built-up sections of Bogotá evolved during a time when non-automobile travel reigned supreme, meaning they are uniformly compact, mixed in their land-use composition, and have comparable levels of transport accessibility. Thus facility designs are what sway nonmotorized travel, not generic land-use attributes of neighborhoods.

Social class, family, and life-style factors associated with overweight and obesity among adults in Peruvian cities.

BACKGROUND Overweight and obesity have reached epidemic proportions in Latin America. OBJECTIVE The purpose of this study was to explore social and behavioral factors associated with obesity in Peruvian cities. DESIGN Between 1998 and 2000 health examination surveys were conducted among adults in 1176 families identified in six cities. Stratified by social class, multistaged random sampling was used. Using body mass index (weight (kg)/height (m)(2)), men and women were classified into normal weight (BMI <25), overweight (BMI 25-29), or obese (BMI > or =30); abdominal circumference (> or =94 cm in men and > or =84 cm in women) further identified morbidity risk. Several demographic, social, and behavioral variables were collected following standardized procedures. RESULTS Adjusting for age, 37% of women were categorized as normal weight, 40% overweight, and 23% obese; corresponding figures for men were 40, 44, and 16%. More developed cities, e.g., Lima, Arequipa, and Ica, had the largest prevalence of overweight and obesity for both men and women. Adjusted logistic models showed that BMI > or =25 was positively correlated with age; whereas, education was negatively associated, only among women. Other significant associated factors of overweight included city of residence, television viewing > or =4 h daily in women, and underestimation of body weight status. CONCLUSIONS The study showed elevated rates of overweight across the income level spectrum. Factors such as urban development stage, income, education, and gender posed differential relationships with the risk of overweight and must be considered in designing future public health interventions. Underestimation of body weight status and sedentary behavior may also constitute specific areas of intervention.

Do Health Benefits Outweigh the Costs of Mass Recreational Programs? An Economic Analysis of Four Ciclovía Programs

One promising public health intervention for promoting physical activity is the Ciclovía program. The Ciclovía is a regular multisectorial community-based program in which streets are temporarily closed for motorized transport, allowing exclusive access to individuals for recreational activities and physical activity. The objective of this study was to conduct an analysis of the cost–benefit ratios of physical activity of the Ciclovía programs of Bogotá and Medellín in Colombia, Guadalajara in México, and San Francisco in the USA. The data of the four programs were obtained from program directors and local surveys. The annual cost per capita of the programs was: US

Television viewing and its association with overweight in Colombian children: results from the 2005 National Nutrition Survey: A cross sectional study

6.0 for Bogotá, US

Promoting Physical Activity in the Americas

23.4 for Medellín, US

Breakfast prevents delays of attention and memory functions among nutritionally at-risk boys

6.5 for Guadalajara, and US

Rapid changes in lifestyle make increased physical activity a priority for the Americas

70.5 for San Francisco. The cost–benefit ratio for health benefit from physical activity was 3.23–4.26 for Bogotá, 1.83 for Medellín, 1.02–1.23 for Guadalajara, and 2.32 for San Francisco. For the program of Bogotá, the cost–benefit ratio was more sensitive to the prevalence of physically active bicyclists; for Guadalajara, the cost–benefit ratio was more sensitive to user costs; and for the programs of Medellín and San Francisco, the cost–benefit ratios were more sensitive to operational costs. From a public health perspective for promoting physical activity, these Ciclovía programs are cost beneficial.

[Is there a link between continuous quality improvement programs and health service users' satisfaction with prenatal care? An experience in Peruvian hospitals].

BackgroundThere has been an ongoing discussion about the relationship between time spent watching television and childhood obesity. This debate has special relevance in the Latin American region were the globalization process has increased the availability of screen-based entertainment at home. The aim of this study is to examine the association between television viewing and weight status in Colombian children.MethodsThis cross sectional investigation included children aged 5 to12 yrs from the National Nutrition Survey in Colombia (ENSIN 2005). Weight and height were measured in 11,137 children in order to calculate body mass index. Overweight was defined by international standards. Time spent viewing television was determined for these children through parental reports. Multiple logistic regression analyses were conducted for different subgroups and adjusted for potential confounders in order to study the association between television viewing and weight status in this population.ResultsAmong the surveyed children, 41.5% viewed television less than two hours/day; 36.8% between two and 3.9 hours/day and 21.7% four or more hours/day. The prevalence of overweight (obesity inclusive) in this population was 11.1%. Children who were classified as excessive television viewers (between two and 3.9 hours/day or 4 or more hours/day) were more likely to be overweight (OR: 1.44 95% CI: 1.41–1.47 and OR: 1.32 95% CI: 1.30–1.34, respectively) than children who reported to watch television less than 2 hours/day. Stratified analyses by age, gender and urbanization levels showed similar results.ConclusionTelevision viewing was positively associated with the presence of overweight in Colombian children. A positive association between urbanization level and television viewing was detected. Considering that the majority of Colombian children lives in densely populated cities and appear to engage in excessive television viewing these findings are of public health relevance for the prevention of childhood obesity.

Patrocinio de programas de actividad física por parte de la industria de bebidas azucaradas: ¿salud pública o relaciones públicas?

Physical inactivity, obesity, and noncommunicable disease rates are rapidly climbing to epidemic proportions and are becoming the leading causes of death and disability in the Americas and globally. The causes are complex and will require a multifaceted, multisectoral approach. Recognizing this, the World Health Organization adopted a broad-ranging process to develop a Global Strategy for the Promotion of Diet, Physical Activity, and Health, as mandated by the World Health Assembly in May 2002. The results of the yearlong effort are to be presented at the World Health Assembly in May 2004.

Sponsorship of physical activity programs by the sweetened beverages industry: public health or public relations?

Abstract This paper presents the results of an experiment with 54 elementary school boys in the highlands of Peru that assessed the main effects of breakfast consumption and nutritional status (either at-risk or not-at-risk) on six tests of cognition. The subjects spent two nights at a research center, one week apart, where they were randomly assigned to either a breakfast or a no-breakfast condition on the first morning and to the opposite treatment the second morning. The same test battery was administered at 11:00 am on both occasions. It consisted of three paper-and-pencil tests (Number Discrimination, Peabody Picture Vocabulary and Raven Progressive Matrices) and three computer tests (Stimulus Discrimination, Reaction Time and Sternberg Memory Search). Whereas fasting apparently had no negative effects on the no-risk group, it delayed stimulus discrimination and memory retrieval time among the nutritionally at-risk children. Glucose levels were not associated with test performance for either group under either treatment condition.