General and central obesity in two Iranian ethnic groups living in Urmia, West Azerbaijan, Iran: Effect of the neighborhood environment

Emerging evidence suggests that neighborhood characteristics can have direct and indirect effects on the weight
status of the residents.
Objectives: Toassess the relationshipbetweengeneralandcentral obesityandtheneighborhoodenvironment intwoethnic groups
(Azeri Turks and Kurds) living in Urmia city, Northwestern Iran.
Patients and Methods: In this cross-sectional study, 723 participants (427 women and 296 men) aged 20 - 64 years from two ethnic
groups (Azeri Turks, n = 445; Kurds, n = 278) were selected from 38 neighborhoods using a combination of cluster, random, and
systematic sampling methods. Neighborhood characteristics were obtained by a validated 22-item neighborhood and a health observational
checklist. General and central obesity were measured and evaluated using standard methods. Principal component
analysis (PCA) was used to define the dominant neighborhood environment. The association of neighborhood characteristics with
general and central obesity was analyzed by a logistic regression model.
Results: Three common neighborhood environments were identified: 1) modern-affluent, 2) central-high access and 3) marginal.
These three factors explained 73.2% of the total variance. Overall, the participants living in a higher tertile of the central-high access
neighborhoods had an increased chance of central obesity (OR = 1.63, 95% CI: 1.13 - 2.34). Azeri Turks living in the highest tertile of the
modern-affluent neighborhoods had a significantly higher likelihood of having general obesity (OR = 2.49, 95% CI: 1.37 - 4.01). Adjustment
for age, gender, marital status, socioeconomic status (SES), energy intake, and physical activity did not change the results.
However, after adjustment for educational level, the association was not significant.
Conclusions: The findings point to a relationship between neighborhood characteristics and obesity only in the Azeri Turks. However,
educational level was more important than neighborhood quality in predicting the risk of obesity