Abstract

Introduction. Urbanization has reduced exposure to natural environments, while childhood and adolescent obesity continues to rise globally. Green spaces may protect against adiposity by encouraging physical activity, reducing stress, and improving environmental quality. This study examined the association between urban green space exposure and adiposity in adolescents from a Brazilian birth cohort.

Methods. A cross-sectional analysis was conducted with 2,446 adolescents (mean age 11.6 years) from the Ribeirão Preto BRISA cohort. Green exposure was quantified using the Normalized Difference Vegetation Index (NDVI) and Percentage of Vegetation Cover (PVC) derived from CBERS-4A satellite imagery within 300 m and 500 m buffers around residences. Body fat percentage was measured by dual-energy X-ray absorptiometry (DXA). Generalized linear models estimated associations between vegetation metrics and adiposity, adjusting for socioeconomic class (Critério Brasil – CCEB) and physical activity (PAQ-C questionnaire). Analyses were performed with StataSE 14.0, at a 5% significance level.

Results. Higher green exposure was consistently associated with lower body fat percentage. After adjustment, NDVI at 300 m was inversely associated with adiposity (β = –11.10; 95% confidence interval [CI] –17.20 to –5.10; p < 0.001). Similar associations were observed for NDVI at 500 m and for PVC across both radii. Unexpectedly, adolescents from lower socioeconomic classes (D/E) showed lower adiposity compared to higher-income peers, possibly reflecting contextual influences such as greater non-recreational physical activity or food insecurity.

Conclusion. Residential green exposure was inversely associated with adolescent adiposity. Findings support urban planning strategies that enhance equitable access to green spaces as a means to prevent obesity and promote planetary health.