Association between parental perceptions of residential neighbourhood environments and childhood obesity in Porto, Portugal

Background: Portugal has one of the highest rates of childhood obesity in Europe. Few studies have explored the relationship between parents' perceptions of their residential neighbourhood (safety concerns and amenities of the built environment) and their children's weight status. This study aims to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children. Methods: Anthropometric measures of height and weight were taken for 2690 children in preschools and elementary schools in Porto. Body mass index (kg/m(2)) was calculated, and the International Obesity Taskforce (IOTF) cut-offs were used. Parents completed the 'Environmental Module' standard questionnaire of the International Physical Activity Prevalence Study. Chi-square tests and the logistic regression model adjusted for age, gender, maternal education and school cluster were used to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children. Results: In this sample, 31.8% of the children were overweight (including obese). Significant associations were found between child obesity and the following residential environmental characteristics: the odds of children being obese were lower if their parents believed that it was safe (low/no crime rate) to walk/cycle at night (OR = 0.65, 95% CI = 0.54-0.79) and during the day (OR = 0.70, 95% CI = 0.55-0.86) and that it was easy and pleasant (pedestrian safety) to walk in their neighbourhoods (OR = 0.73, 95% CI = 0.58-0.90) and when local sidewalks were well maintained and unobstructed (OR = 1.18, 95% CI = 1.01-1.40). Conclusion: Parental perceptions of neighbourhood safety and the quality of local sidewalks are significantly associated with obesity values.