B3930 - Green space and child cardiometabolic health A structured life course approach - 29/11/2021

B number: 
Principal applicant name: 
Daniel Smith | Population Health Sciences, University of Bristol
Prof Deborah Lawlor, Prof Kate Tilling, Dr Andrew Smith
Title of project: 
Green space and child cardiometabolic health: A structured life course approach
Proposal summary: 

This project aims to understand how access to green space in pregnancy, infancy and early childhood impacts subsequent child cardiometabolic health (BMI/obesity and blood pressure). Although research is mixed, there is some evidence that access to green space may be associated with lower childhood BMI/obesity and blood pressure (Luo et al., 2020; Markevych et al., 2014). As childhood BMI and blood pressure predict these traits in adulthood, and that these are key risk factors for cardiovascular disease, child cardiometabolic health is a serious public health concern; if access to green space can lower BMI and blood pressure, this may constitute a potentially modifiable public health intervention.

We will use a structured life course approach to answer this question, which is able to distinguish between different life course trajectories, such as critical periods, sensitive periods, accumulation of risk, and others (Smith et al., 2016; Ben-Shlomo & Kuh, 2002). We will use repeated data on access to green space to explore if and how this is related to child cardiometabolic health in ALSPAC children. In addition, this project will explore whether there is an interaction between socioeconomic position and access to green space in shaping these outcomes. These analyses will also be replicated in an independent UK cohort (Born in Bradford; BiB)

Ben-Shlomo, Y. & Kuh, D. (2002). What is a Life Course Approach to Chronic Disease Epidemiology? Conceptual Models in Life Course Epidemiology. Int. J. Epidemiol., 31, 285–293.
Luo, Y.N., Huang, W.Z., Liu, X.X., Markevych, I., Bloom, M.S., Zhao, T., et al. (2020). Greenspace with overweight and obesity: A systematic review and meta-analysis of epidemiological studies up to 2020. Obes. Rev., 21, 1–28.
Markevych, I., Thiering, E., Fuertes, E., Sugiri, D., Berdel, D., Koletzko, S., et al. (2014). A cross-sectional analysis of the effects of residential greenness on blood pressure in 10-year old children: Results from the GINIplus and LISAplus studies. BMC Public Health, 14, 1–11.
Smith, A.D.A.C., Hardy, R., Heron, J., Joinson, C.J., Lawlor, D.A., Macdonald-Wallis, C., et al. (2016). A structured approach to hypotheses involving continuous exposures over the life course. Int. J. Epidemiol., 45, 1271–1279.

Impact of research: 
To understand if and how access to green space in pregnancy, infancy and early childhood impacts later childhood cardiometabolic health, and the shape of this trajectory. May help inform future interventions regarding access to green space (and at what age may be the most effective) to promote child cardiometabolic health.
Date proposal received: 
Tuesday, 16 November, 2021
Date proposal approved: 
Monday, 29 November, 2021
Epidemiology, Hypertension, Obesity, Statistical methods, Blood pressure, BMI, Cardiovascular, Development