CC BY 4.0Chandrabose, ManojCao, Yingting (Tina)Hadgraft, NyssaHiggs, CarlShuvo, FaysalDunstan, David W.Owen, NevilleSugiyama, Takemi2025-10-172025-10-1720222022-12-011368-980010.1017/S1368980022001197https://hdl.handle.net/20.500.14802/23016Objective: Higher neighbourhood walkability would be expected to contribute to better health, but the relevant evidence is inconsistent. This may be because residents’ dietary attributes, which vary with socio-economic status (SES) and influence their health, can be related to walkability. We examined associations of walkability with dietary attributes and potential effect modification by area-level SES. Design: The exposure variable of this cross-sectional study was neighbourhood walkability, calculated using residential density, intersection density and destination density within 1-km street-network buffer around each participant’s residence. The outcome variables were dietary patterns (Western, prudent and mixed) and total dietary energy intake, derived from a FFQ. Main and interaction effects with area-level SES were estimated using two-level linear regression models. Setting: Participants were from all states and territories in Australia. Participants: The analytical sample included 3590 participants (54 % women, age range 34 to 86). Results: Walkability was not associated with dietary attributes in the whole sample. However, we found interaction effects of walkability and area-level SES on Western diet scores (P < 0·001) and total energy intake (P = 0·012). In low SES areas, higher walkability was associated with higher Western dietary patterns (P = 0·062) and higher total energy intake (P = 0·066). In high SES areas, higher walkability was associated with lower Western diet scores (P = 0·021) and lower total energy intake (P = 0·058). Conclusions: Higher walkability may not be necessarily conducive to better health in socio-economically disadvantaged areas. Public health initiatives to enhance neighbourhood walkability need to consider food environments and socio-economic contexts.built environmentpopulation healthhealth inequalitiesFFQcardiometabolic diseasesJournal article2-s2.0-85131884467Published as ‘gold’ (paid) open accessOpenPUB020109166923320010075449100003100396011076721078360