Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
Obesity and the Built Environment: Does the Density of Neighborhood Fast-Food Outlets Matter?
Purpose . Examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast food outlets and residents ' behavioral , psychosocial , and sociodemographic characteristics . Design . Cross-sectional and multilevel design . Setting . Census block groups , used as a proxy for neighborhoods , within the metropolitan region 's Urban Growth Boundary in Portl and , Oregon . Subjects . A total of 1221 residents ( mean age , 65 years ) recruited r and omly from 120 neighborhoods ( 48 % response rate ) . Measures . A geographic information system-based measure of fast food restaurant density across 120 neighborhoods was created . Residents within the sample d neighborhoods were assessed with respect to their body mass indices ( BMI ) , frequency of visits to local fast food restaurants , fried food consumption , levels of physical activity , self-efficacy of eating fruits and vegetables , household income , and race/ethnicity . Analyses . Multilevel logistic regression analyses . Results . Significant associations were found between resident-level individual characteristics and the likelihood of being obese ( BMI ≥ 30 ) for neighborhoods with a high-density of fast food restaurants in comparison with those with a low density : odds ratios for obesity , 95 % confidence intervals ( CI ) , were 1.878 ( CI , 1.006–3.496 ) for weekly visits to local fast food restaurants ; 1.792 ( CI , 1.006–3.190 ) for not meeting physical activity recommendations ; 1.212 ( CI , 1.057–1.391 ) for low confidence in eating healthy food ; and 8.057 ( CI , 1.705–38.086 ) for non-Hispanic black residents . Conclusion . Increased density of neighborhood fast food outlets was associated with unhealthy lifestyles , poorer psychosocial profiles , and increased risk of obesity among older adults
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .