The association between greenness around schools and overweight/obesity in Suzhou\'s school-age children and adolescents

• 1、School of Public Health, Soochow Medical College, Soochow University, Suzhou 215000, China

Abstract：Aim: The rates of overweight and obesity among students have still been continuously increasing in recent years. This study aimed to explore the association between greenness around schools and overweight/obesity in students. Methods: 1005935 students from 793 schools in Suzhou during 2020-2021 were obtained. Normalized difference vegetation index (NDVI) and soil adjusted vegetation index (SAVI) were used to evaluate the greenness exposure. We used the China High Air Pollutants dataset to obtain air pollution data. Generalized linear mixed models were used to explore the relationship between school greenness and overweight/obesity. Results: The results indicate that an increase in NDVI by IQR in the 500m, 1000m, and 1500m buffer zones is associated with a reduced risk of overweight. The corresponding OR (95%CI) is 0.965 (0.948-0.982), 0.972 (0.956-0.988), and 0.977 (0.960-0.994) respectively. Air pollutants played a certain mediating role in the relationship between NDVI and overweight/obesity. The results were similar in analysis using SAVI, and the results remained robust when subgroup analyses were performed or first-year students were excluded. Conclusions: The greenness surrounding schools has a beneficial impact on students\' overweight and obesity, and air pollutants played a certain mediating role in this relationship. We ought to create more greenness exposure around schools for students\' health.

keywords： Epidemiology Adolescent Overweight Obesity Greenness Air pollution

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