Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts

Research output: Contribution to journalArticlepeer-review


  • Nadja Kartschmit
  • Robynne Sutcliffe
  • Mark Patrick Sheldon
  • Susanne Moebus
  • Karin Halina Greiser
  • And 13 others
  • Saskia Hartwig
  • Detlef Thürkow
  • Ulrike Stentzel
  • Neeltje van den Berg
  • Kathrin Wolf
  • Werner Maier
  • Annette Peters
  • Salman Ahmed
  • Corinna Köhnke
  • Rafael Mikolajczyk
  • Andreas Wienke
  • Alexander Kluttig
  • Gavin Rudge

Colleges, School and Institutes

External organisations

  • German Center for Diabetes Research (DZD)
  • University Clinics Essen
  • DKFZ (German Cancer Research Centre)
  • Martin-Luther University Halle-Wittenberg
  • Unit of Periodontology; University Medicine, Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
  • Institute of Cancer Epidemiology - Denmark
  • King's College London
  • Department of Cardiology II-Electrophysiology, University Hospital Münster, Münster, Germany.


OBJECTIVES: To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models.

SETTING: Five different regions and cities of Germany using data from five cohort studies.

PARTICIPANTS: For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male.

OUTCOMES: (1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height.

RESULTS: Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (ß: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (ß: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (ß: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance.

CONCLUSION: We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.


Original languageEnglish
Article numbere033941
Number of pages11
JournalBMJ open
Issue number4
Publication statusPublished - 28 Apr 2020


  • Epidemiology, Public health, Social medicine

ASJC Scopus subject areas