A study of 6467 children from England--presented at this year's annual meeting of the European Association for the Study of Diabetes (EASD) in Stockholm--shows that no access to a garden at age 3-5 years is linked to an increased risk developing obesity by age 7 years. The research is by Annemarie Schalkwijk, VU University Medical Centre, Amsterdam, the Netherlands, and colleagues.

Overweight and obese children are at increased risk of becoming overweight and obese adults and therefore being overweight or obese in childhood is an important risk factor for developing type 2 diabetes. Being overweight or obese is associated with environmental, parental and socioeconomic status (SES) characteristics. The aims of this study were to assess the association of environmental characteristics during ages 3-5 on being overweight or obese at age 7. Furthermore, the authors assessed if parental behaviours and SES affected this association.

The analysis used the Millennium Cohort Study: a nationally representative study of around 19,000 children born in the UK between 2000-2001 who are followed over time. Data were taken from England, with the surveys carried out at age 9 months, 3 years, 5 years and 7 years. Computer modelling was used to calculate any associations between becoming overweight/obese and determinants: amount of green space in the neighborhood, having access to a garden and the condition of the neighbourhood.

Subsequently, parental and SES determinants including food consumption, physical activity, rules, regularity, education, housing tenure and poverty were evaluated as moderators or mediators of the initial association.

After adjusting for parental influences and SES, the authors found that no garden access for lower educated households (children age 3-5 years) increased the odds of overweight/ obesity at 7 years by 38%. There was also a 38% increased risk of overweight/obesity at 7 years for children of higher educated househoulds living in disadvantaged neighourhoods.

The authors conclude: "Not having access to a garden at age 3 - 5 years for lower educated households increased childhood overweight/obesity at age 7 years. Also the combination of a more disadvantaged neighborhood and higher education increased childhood overweight/obesity. To conclude, we showed that limits on access to outdoor space is associated with future childhood overweight/obesity although moderated by education level. More research is needed to see how we can deploy these findings in the prevention of type 2 diabetes."

The authors are currently planning a further study on the influence of the environment on risk of overweight/obesity.

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