Neighborhood Walkability and Sedentary Time in Belgian Adults Delfien Van Dyck, MA, Greet Cardon, PhD, Benedicte Deforche, PhD, Neville Owen, PhD, James F. Sallis, PhD, Ilse De Bourdeaudhuij, PhD Background: Sedentary behavior (too much sitting) has deleterious health consequences that are distinct from lack of physical activity (too little exercise). Purpose: This study aimed to examine the associations of neighborhood walkability and sociode- mographic factors with adults’ self-reported and objectively assessed sedentary time. Methods: This Belgian cross-sectional study was conducted between May 2007 and September 2008. Twenty-four neighborhoods were stratifıed on GIS-based walkability and neighborhood SES. In all, 1200 adults (aged 20 – 65 years; 50 per neighborhood; 42.7 [SD=12.6] years; 47.9% men) completed a sociodemographic survey and the International Physical Activity Questionnaire. They also wore an accelerometer for 7 days: Sedentary time was identifıed as accelerometer counts of less than 100 per minute. Statistical analyses were performed in 2009, using multilevel regression models, adjusted for physical activity levels and individual SES. Results: Residents of high-walkable neighborhoods reported more sitting time than those of low-walkable neighborhoods (439.8 vs 403.4 minutes/day of daily sitting time, p0.05). Living in high-walkable versus low-walkable neighborhoods was also associated with 2.9% more accelerometer- measured overall sedentary time (p0.001). Being male, younger, unemployed, more highly edu- cated, having a white-collar job (analysis for employed adults only), and living without children were all signifıcantly associated with more sitting time. Conclusions: Contrary to expectations, living in a high-walkable neighborhood was associated with higher levels of sedentary time. If future studies in other contexts confırm these associations, environmental and policy innovations aiming to promote physical activity may need to address the potential negative health impact of sedentary behavior. (Am J Prev Med 2010;39(1):25–32) © 2010 American Journal of Preventive Medicine Introduction P hysical activity is generally known to be related to a lower risk of obesity, diabetes, coronary heart dis- ease, and some cancers. 1–3 However, results from different studies 3–9 showed that achieving high levels of physical activity alone is not enough to experience health benefıts; moreover, other behaviors, like eating behaviors and sedentary behaviors, are important to consider. Evi- dence from studies in youth 10,11 and adults 12 showed that physical activity and sedentary behavior are poorly cor- related; individuals who are sedentary for large amounts of time were found to be almost as likely to meet physical activity recommendations as those who are less seden- tary. 12 In that context, an Australian study 9 found that a combination of more sedentary behavior and suffıcient physical activity was similarly related to the risk of obesity as a combination of less-sedentary behavior and insuffı- cient physical activity. For both combinations, the odds of being obese were 1.6 times higher compared to low levels of sedentary behavior and suffıcient physical activ- ity. Further, other studies showed that both self-reported and objectively assessed sedentary time are consistently associated with elevated risk of obesity, diabetes, cardio- vascular disease, cancer, the metabolic syndrome and total mortality, and that all these associations exist inde- pendent of physical activity levels. 3–8 From the Fund for Scientifıc Research Flanders (FWO) (Van Dyck, De- forche); Department of Movement and Sports Sciences (Van Dyck, Car- don, Deforche, De Bourdeaudhuij), Ghent University, Ghent; Department of Human Biometrics and Biomechanics (Deforche), Vrije Universiteit Brussels, Brussels, Belgium; School of Population Health (Owen), The University of Queensland, Brisbane, Australia; and Department of Psychol- ogy (Sallis), San Diego State University, San Diego, California Address correspondence to: Delfıen Van Dyck, MA, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium. E-mail: Delfıen. VanDyck@UGent.be. 0749-3797/$17.00 doi: 10.1016/j.amepre.2010.03.004 © 2010 American Journal of Preventive Medicine • Published by Elsevier Inc. Am J Prev Med 2010;39(1)25–32 25