Association between the number of physical activity outlets, physical activity intensity opportunities, and obesity prevalence in Aotearoa/New Zealand

We examined the association between availability (count), proxy physical activity intensity opportunities from physical activity outlets and obesity prevalence in New Zealand. This cross-sectional study collected data from two urban and 51 rural geographical locations in Waikato and Lakes District (May 2004-March 2006). Physical activity outlets were recorded by referring to online business directory and Waikato and Lakes District Councils database and confirming it with expert Māori community health workers. METs (Metabolic equivalent of task) was used as a proxy indicator to signify the physical activity intensity opportunity offered by physical activity outlets, which was averaged to obtain a unified score for each geographic location. Information regarding median income and type of location was derived from 2006 New Zealand census of Population and Dwelling. Bivariate analysis reported a significant difference in obesity prevalence using Māori BMI cut-offs between clusters with proxy METs < 5.12 (n = 15) and proxy METs ≥5.12 (n = 10), 56.20 ± 0.22 vs 43.30 ± 0.07% obesity prevalence, t(17.77) = 1.45, p = 0.03. This inverse relationship between low physical activity intensity opportunity (proxy METs) and percent obesity prevalence remained significant after controlling for income and type of locality (β = -0.421, p = 0.03). Furthermore, results highlighted that low income (below the median, ≤ NZ $24,400), moderated the inverse relationship between mean METs proxy indicator and obesity prevalence using Māori BMI cut-offs, b = -0.4661, 95% CI (-0.6054, -0.3268, p < 0.001). These findings support the development of physical activity related public health programs in low-income Māori communities in New Zealand to manage obesity prevalence.