Background: Behavioral interventions targeting weight loss may be affected by socio-environmental factors that influence physical activity (PA) and cardiometabolic outcomes.

Purpose: To evaluate the relation of neighborhood walkability on PA levels and glucose control in a sample of adults participating in a weight loss study.

Methods: Secondary analysis of a prospective observational study providing a 12-month behavioral weight loss intervention to examine lapses after intentional weight loss. Neighborhood walkability was assessed via Walk Score (0-100), PA via waist-worn ActiGraph GT3X, and blood glucose via phlebotomy. Study variables included car-dependent and walkable neighborhoods (Walk Score < vs. ≥50), prediabetes (fasting blood glucose from 100-126mg/dL) and recommended PA (moderate-to-vigorous PA [MVPA] >22 minutes/day; steps ≥7500/day). Standard descriptive and group comparative statistics were employed. Regression results are reported as adjusted odds ratios (OR) with 95% confidence intervals (CI).

Results: The sample (N=112) was mostly female (90.2%), white (90.2%), well educated (75.9% with ≥4 years of college) and on average 51.5±9.8 years of age. At baseline, no differences existed between persons from car-dependent vs. walkable neighborhoods across all metrics. At 12 months, PA and glucose control were improved for the entire sample, with no differences across walkability categories. Neighborhood walkability did not predict attainment of recommended MVPA (OR=1.16, 95% CI: 0.97-1.39) or steps (OR=1.08, 95% CI: 0.90-1.30) at 12 months. However, those from walkable neighborhoods had 17% lower odds of having prediabetes compared to those from car-dependent neighborhoods (OR=0.83, 95% CI: 0.72-0.97).

Conclusion: Our findings corroborate previous studies showing an inverse relation between neighborhood walkability and prediabetes. The key drivers of this association warrant further investigation in a study with a larger, more diverse sample.


J. K. Kariuki: None. J. Cheng: None. L. E. Burke: None. Z. Bizhanova: None. B. Rockette-wagner: None. B. B. Gibbs: None. S. M. Sereika: None. C. Kline: None. K. Erickson: None. D. Mendez: None. I. Pulantara: None.


National Heart, Lung, and Blood Institute (HL107370S to J.K.K.)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at