The Association of the Built Environment with Body Mass Measures in Survivors of Childhood Brain Tumors and Non-Cancer Controls
Bibliographic record
Abstract
Background: While the obesity epidemic is impacting children, survivors of childhood brain tumors (SCBT) are particularly vulnerable to obesity-driven cardiometabolic comorbidities. SCBT have excess body fat (adiposity) with similar body mass measures when compared to matched non-cancer controls. The effect of the built environment on the risk of obesity has received relatively limited attention in survivors. Aim & Methods: The aim of this project was to determine the impact of the built environment on body mass index (BMI) percentile, body fat percentage (BF%), waist-to-hip ratio (WHR), and waist-to-height-ratio (WHtR) in SCBT and non-cancer controls. The data for this secondary analysis were derived from participants in the Canadian Study of Determinants of Endometabolic Health in Children (CanDECIDE), a prospective cohort study based at McMaster Children’s Hospital, a tertiary pediatric academic center in Hamilton, Ontario, Canada. The Neighborhood Environment Walkability Scale (NEWS) was used to assess the built environment. Multivariable regression analyses were used to define the predictors of the association. Results: The built environment was not associated with BMI percentile in SCBT and non-cancer controls including residential density (B 0.276, p value 0.436), land use mix diversity (B -0.286, p value 0.301), land use mix access (B 0.004, p value 0.993), street connectivity (B 0.297, p value 0.431), walking/cycling facilities (B 0.185, p value 0.540), neighborhood aesthetics (B 0.270, p value 0.513), safety from traffic (B -0.368, p value 0.418), and safety from crime (B -0.074, p value 0.907). The built environment was also not associated with adiposity measures (BF%: residential density B 0.031, p value 0.851, land use mix diversity B -0.082, p value 0.513, land use mix access B -0.036, p value 0.861, street connectivity B 0.309, p value 0.055, walking/cycling facilities B 0.109, p 0.439, neighborhood aesthetics B 0.127, p value 0.503, safety from traffic B -0.047, p value 0.825, and safety from crime B -0.154, p value 0.601; WHR: residential density B -0.042, p value 0.362, land use mix diversity B 0.043, p value 0.131, land use mix access B -0.028, p value 0.558, street connectivity B -0.044, p value 0.252, walking/cycling facilities B 0.026, p value 0.476, neighborhood aesthetics B 0.062, p value 0.137, safety from traffic B -0.048, p value 0.336, and safety from crime B -0.083, p value 0.239; WHtR: residential density B 0.011, p value 0.865, land use mix diversity B 0.033, p value 0.462, land use mix access B -0.032, p value 0.662, street connectivity B 0.021, p value 0.720, walking/cycling facilities B 0.042, p value 0.493, neighborhood aesthetics B 0.018, p value 0.790, safety from traffic B -0.020, p value 0.789, and safety from crime B -0.086, p value 0.392). Conclusion: The results of this study suggest that the built environment has less of an impact than brain tumors and their treatments on driving body mass and fat mass changes in SCBT. The use of lifestyle interventions may need to be combined with pharmacotherapies in the treatment of obesity in SCBT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".