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Peng K, Rodríguez DA, Peterson M, Braun LM, Howard AG, Lewis CE, Shikany JM, Gordon-Larsen P. GIS-Based Home Neighborhood Food Outlet Counts, Street Connectivity, and Frequency of Use of Neighborhood Restaurants and Food Stores. J Urban Health 2020; 97:213-225. [PMID: 32086738 PMCID: PMC7101458 DOI: 10.1007/s11524-019-00412-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Researchers have linked neighborhood food availability to the overall frequency of using food outlets without noting if those outlets were within or outside of participants' neighborhoods. We aimed to examine the association of neighborhood restaurant and food store availability with frequency of use of neighborhood food outlets, and whether such an association was modified by neighborhood street connectivity using a large and diverse population-based cohort of middle-aged U.S. adults. We used self-reported frequency of use of fast food restaurants, sit-down restaurants, and grocery stores in respondents' home neighborhoods using data from the Coronary Artery Risk Development in Young Adults study Year 20 exam in 2005-2006 (n = 2860; Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA) and geographically matched GIS-measured neighborhood-level food resource, street, and U.S. Census data. We used mixed-effects logistic regression to examine the associations of the GIS-measured count of neighborhood fast food restaurants, sit-down restaurants, and grocery stores with self-reported frequency of using neighborhood restaurants and food stores and whether such associations differed by GIS-measured neighborhood street connectivity among those who perceived at least one such food outlet. In multivariate analyses, we observed a positive association between the GIS-measured count of neighborhood sit-down restaurants (OR = 1.02, 95% CI 1.00-1.04) and the self-reported frequency of using neighborhood sit-down restaurants. We observed no statistically significant association between GIS-measured count of neighborhood fast food restaurants and self-reported frequency of using neighborhood fast food restaurants, nor did we observe a statistically significant association between GIS-measured count of neighborhood grocery stores and self-reported frequency of using neighborhood grocery stores. We observed inverse associations between GIS-measured neighborhood street connectivity and the self-reported frequencies of using neighborhood fast food restaurants (OR = 0.42, 95% CI 0.26-0.68) and grocery stores (OR = - 2.26, 95% CI - 4.52 to - 0.01). Neighborhood street connectivity did not modify the association between GIS-measured neighborhood restaurant and food store count and the self-reported frequency of using neighborhood restaurants and food stores. Our findings suggest that, for those who perceived at least one sit-down restaurant in their neighborhood, individuals who have more GIS-measured sit-down restaurants in their neighborhoods reported more frequent use of sit-down restaurants than those whose neighborhoods contain fewer such restaurants. Our results also suggest that, for those who perceived at least one fast food restaurant in their neighborhood, individuals who live in neighborhoods with greater GIS-measured street connectivity reported less use of neighborhood fast food restaurants than those who live in neighborhoods with less street connectivity. The count of neighborhood sit-down restaurants and the connectivity of neighborhood street networks appear important in understanding the use of neighborhood food resources.
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Grants
- HHSN268201800004I NHLBI NIH HHS
- HHSN268201800003I NHLBI NIH HHS
- HHSN268201800007I NHLBI NIH HHS
- R01 HL114091 NHLBI NIH HHS
- P30 DK056350 NIDDK NIH HHS
- R24 HD050924 NICHD NIH HHS
- HHSN268201800006I NHLBI NIH HHS
- R01 HL104580 NHLBI NIH HHS
- R01 HL143885 NHLBI NIH HHS
- P30 ES010126 NIEHS NIH HHS
- HHSN268201800005I NHLBI NIH HHS
- P2C HD050924 NICHD NIH HHS
- National Heart, Lung, and Blood Institute
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute for Environmental Health Sciences
- National Heart, Lung, and Blood Institute and University of Alabama at Birmingham
- National Heart, Lung, and Blood Institute and University of Minnesota
- National Heart, Lung, and Blood Institute and Northwestern University
- National Heart, Lung, and Blood Institute and Kaiser Foundation Research Institute
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Affiliation(s)
- Ke Peng
- Department of Urban Planning, School of Architecture, Hunan University, Changsha, China
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514 USA
| | - Daniel A. Rodríguez
- Department of City and Regional Planning,, University of California, Berkeley, Berkeley, CA 94720 USA
| | - Marc Peterson
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514 USA
| | - Lindsay M. Braun
- Department of Urban and Regional Planning, University of Illinois at Urbana Champaign, Champaign, IL 61820 USA
| | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514 USA
| | - Cora E. Lewis
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205 USA
| | - James M. Shikany
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205 USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 123 W. Franklin Street, Chapel Hill, NC USA
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Lamb KE, Thornton LE, King TL, Ball K, White SR, Bentley R, Coffee NT, Daniel M. Methods for accounting for neighbourhood self-selection in physical activity and dietary behaviour research: a systematic review. Int J Behav Nutr Phys Act 2020; 17:45. [PMID: 32238147 PMCID: PMC7115077 DOI: 10.1186/s12966-020-00947-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-selection into residential neighbourhoods is a widely acknowledged, but under-studied problem in research investigating neighbourhood influences on physical activity and diet. Failure to handle neighbourhood self-selection can lead to biased estimates of the association between the neighbourhood environment and behaviour. This means that effects could be over- or under-estimated, both of which have implications for public health policies related to neighbourhood (re)design. Therefore, it is important that methods to deal with neighbourhood self-selection are identified and reviewed. The aim of this review was to assess how neighbourhood self-selection is conceived and accounted for in the literature. METHODS Articles from a systematic search undertaken in 2017 were included if they examined associations between neighbourhood environment exposures and adult physical activity or dietary behaviour. Exposures could include any objective measurement of the built (e.g., supermarkets), natural (e.g., parks) or social (e.g., crime) environment. Articles had to explicitly state that a given method was used to account for neighbourhood self-selection. The systematic review was registered with the PROSPERO International Prospective Register of Systematic Reviews (number CRD42018083593) and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS Of 31 eligible articles, almost all considered physical activity (30/31); few examined diet (2/31). Methods used to address neighbourhood self-selection varied. Most studies (23/31) accounted for items relating to participants' neighbourhood preferences or reasons for moving to the neighbourhood using multi-variable adjustment in regression models (20/23) or propensity scores (3/23). Of 11 longitudinal studies, three controlled for neighbourhood self-selection as an unmeasured confounder using fixed effects regression. CONCLUSIONS Most studies accounted for neighbourhood self-selection by adjusting for measured attributes of neighbourhood preference. However, commonly the impact of adjustment could not be assessed. Future studies using adjustment should provide estimates of associations with and without adjustment for self-selection; consider temporality in the measurement of self-selection variables relative to the timing of the environmental exposure and outcome behaviours; and consider the theoretical plausibility of presumed pathways in cross-sectional research where causal direction is impossible to establish.
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Affiliation(s)
- Karen E Lamb
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia. .,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia. .,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
| | - Lukar E Thornton
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Tania L King
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kylie Ball
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Simon R White
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Rebecca Bentley
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Neil T Coffee
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Mark Daniel
- Health Research Institute, University of Canberra, Canberra, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
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53
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Kris-Etherton PM, Petersen KS, Velarde G, Barnard ND, Miller M, Ros E, O'Keefe JH, Williams K, Horn LV, Na M, Shay C, Douglass P, Katz DL, Freeman AM. Barriers, Opportunities, and Challenges in Addressing Disparities in Diet-Related Cardiovascular Disease in the United States. J Am Heart Assoc 2020; 9:e014433. [PMID: 32200727 PMCID: PMC7428614 DOI: 10.1161/jaha.119.014433] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In the United States, cardiovascular disease (CVD) is the leading cause of death and disability. Suboptimal diet quality is responsible for a greater percentage of CVD-related morbidity and mortality than any other modifiable risk factor. Further troubling are the stark racial/ethnic and socioeconomic disparities in diet quality. This represents a major public health concern that urgently requires a coordinated effort to better characterize the barriers to healthy dietary practices in population groups disproportionally affected by CVD and poor diet quality to inform multifaceted approaches at the government (policy), community environment, sociocultural, and individual levels. This paper reviews the barriers, opportunities, and challenges involved in shifting population behaviors, especially in underserved populations, toward healthy dietary practices. It is imperative that public health policies address the social determinants of nutrition more intensively than previously in order to significantly decrease CVD on a population-wide basis.
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Affiliation(s)
- Penny M Kris-Etherton
- Department of Nutritional Sciences The Pennsylvania State University University Park PA
| | - Kristina S Petersen
- Department of Nutritional Sciences The Pennsylvania State University University Park PA
| | - Gladys Velarde
- Division of Cardiology Department of Medicine University of Florida Jacksonville FL
| | - Neal D Barnard
- Adjunct Faculty George Washington University School of Medicine Physicians Committee for Responsible Medicine Washington DC
| | - Michael Miller
- Department of Medicine University of Maryland School of Medicine Baltimore MD
| | - Emilio Ros
- Lipid Clinic Endocrinology and Nutrition Service Institut d'Investigacions Biomediques August Pi Sunyer Hospital Clinic University of Barcelona, and Centro de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición Instituto de Salud Carlos III Madrid Spain
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute School of Medicine University of Missouri-Kansas City MO
| | | | - Linda Van Horn
- Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Muzi Na
- Department of Nutritional Sciences The Pennsylvania State University University Park PA
| | - Christina Shay
- Center for Health Metrics and Evaluation American Heart Association American Heart Association Dallas TX
| | - Paul Douglass
- Wellstar Medical Group, Metro Atlanta Cardiovascular Medicine Atlanta GA
| | - David L Katz
- Yale-Griffin Prevention Research Center Derby CT
| | - Andrew M Freeman
- Division of Cardiology Department of Medicine National Jewish Health Denver CO
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54
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Schlosser AV, Joshi K, Smith S, Thornton A, Bolen SD, Trapl ES. "The coupons and stuff just made it possible": economic constraints and patient experiences of a produce prescription program. Transl Behav Med 2020; 9:875-883. [PMID: 31570919 DOI: 10.1093/tbm/ibz086] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although produce prescription (PRx) programs have been shown to improve fruit and vegetable (FV) consumption, few studies have examined how economic constraints influence participant experience. We conducted a qualitative study of patient experience of a 3-month PRx program for hypertension (PRxHTN) including 3 safety-net clinics and 20 farmers' markets (FMs). We interviewed 23 PRxHTN participants using semistructured guides to understand their program experiences. Interviews were audio-taped, transcribed, and analyzed to identify a priori and emergent themes. PRxHTN participants completing qualitative interviews were mostly middle-aged (mean: 62 years) African American (100%) women (78%). Economic hardship as a barrier to maximum program participation and sustainability was a main theme identified, with three subthemes: (i) transportation issues shaped shopping and eating patterns and limited participant ability to access FMs to utilize PRxHTN vouchers; (ii) limited and unstable income shaped participant shopping and eating behavior before, during, and after PRxHTN; and (iii) participants emphasized individual-level influences like personal or perceived motivations for program participation, despite significant structural constraints, such as economic hardship, shaping their program engagement. Future PRx programs should bolster economic and institutional supports beyond FM vouchers such as transportation assistance, partnering with local food banks and expansion to local grocery stores offering year-round FV access to support sustained behavior change. Additionally, structural competency tools for providers may be warranted to reorient focus on structural influences on program engagement and away from potentially stigmatizing individual-level explanations for program success. These efforts have potential to enhance the translation of PRx programs to the needs of economically vulnerable patients who struggle to manage chronic illness and access basic nutrition.
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Affiliation(s)
- Allison V Schlosser
- Department of Anthropology, Case Western Reserve University, Cleveland, OH, USA
| | - Kakul Joshi
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | | - Anna Thornton
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Shari D Bolen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.,Better Health Partnership, Cleveland, OH, USA.,Department of Medicine, MetroHealth Medical Center, Cleveland, OH, USA.,Center for Health Care Research and Policy, Case Western Reserve University at the MetroHealth System, Cleveland, OH, USA
| | - Erika S Trapl
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
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55
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Kelman J, Pool LR, Gordon-Larsen P, Carr JJ, Terry JG, Rana JS, Kershaw KN. Associations of Unhealthy Food Environment With the Development of Coronary Artery Calcification: The CARDIA Study. J Am Heart Assoc 2020; 8:e010586. [PMID: 30773088 PMCID: PMC6405647 DOI: 10.1161/jaha.118.010586] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background While prior studies have linked the neighborhood environment and development of subclinical atherosclerosis, it is unknown whether living in neighborhoods with greater availability of “unhealthy” food outlets (fast‐food chain restaurants and convenience stores) is associated with risk of developing coronary artery calcification (CAC). Methods and Results We included 2706 CARDIA study (Coronary Artery Risk Development in Young Adults) participants who underwent CAC measurement during follow‐up years 15 (2000–2001), 20 (2005–2006), and 25 (2010–2011). Neighborhood features examined included percentage of all food outlets that were convenience stores and fast‐food chain restaurants within a 3‐km Euclidean buffer distance from each participant's residence. Econometric fixed effects models, which by design control for all time‐invariant covariates, were used to model the longitudinal association between simultaneous within‐person change in percentage food outlet and change in CAC. At baseline (year 15), 9.7% of participants had prevalent CAC. During 10 years of follow‐up, 21.1% of participants developed CAC. Each 1‐SD increase in percentage of convenience stores was associated with a 1.34 higher odds of developing CAC (95% CI: 1.04, 1.72) after adjusting for individual‐ and neighborhood‐level covariates; however, there was no significant association between increased percentage of fast‐food chain restaurants and developing CAC (odds ratio=1.15; 95% CI: 0.96, 1.38). There were no significant associations between increases in either food outlet percentage and progression of CAC. Conclusions Our findings suggest that increases in the relative availability of convenience stores in participants' neighborhoods is related to the development of CAC over time.
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Affiliation(s)
- Julie Kelman
- 1 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Lindsay R Pool
- 1 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Penny Gordon-Larsen
- 2 Gillings School of Global Public Health University of North Carolina Chapel Hill NC
| | - J Jeffrey Carr
- 3 Department of Radiology Biomedical Informatics and Cardiovascular Medicine Vanderbilt University Nashville TN
| | - James G Terry
- 3 Department of Radiology Biomedical Informatics and Cardiovascular Medicine Vanderbilt University Nashville TN
| | - Jamal S Rana
- 4 Department of Cardiology Kaiser Permanente Northern California Oakland CA
| | - Kiarri N Kershaw
- 1 Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
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56
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Neighborhood Food Outlet Access and Dietary Intake among Adults with Chronic Kidney Disease: Results from the Chronic Renal Insufficiency Cohort Study. J Acad Nutr Diet 2020; 120:1151-1162.e3. [PMID: 32146126 DOI: 10.1016/j.jand.2019.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 12/16/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Healthy diet is essential in the management of chronic kidney disease (CKD) and preventing related comorbidities. Food outlet access has been studied in the general population; however, the influence of the local food environment on dietary intake among people with CKD has not been evaluated. OBJECTIVES This study examined the associations of food outlet density and type of outlets with dietary intake in a multicenter cohort of racially and ethnically diverse patients with CKD. METHODS The Chronic Renal Insufficiency Cohort Study is a multicenter prospective study of patients with CKD that used a validated food frequency questionnaire to capture dietary intake at the baseline visit. This is a cross-sectional analysis of 2,484 participants recruited in 2003-2006 from seven Chronic Renal Insufficiency Cohort Study centers. Food outlet data were used to construct a count of the number of fast-food restaurants, convenience stores, and grocery stores per 10,000 population for each geocoded census block group. Multivariable linear and logistic regression models were used to evaluate the associations between measures of food outlet availability and dietary factors. RESULTS The proportion of participants living in zero-, low-, and high-food outlet density areas differed by gender, race or ethnicity, and income level. Among male subjects, living in areas with zero or the highest number of outlets was associated with having the highest caloric intakes in multivariable models. Male subjects living in areas with zero outlets consumed the highest levels of sodium and phosphorous. Female subjects living in areas with zero outlets had the lowest average intake of calories, sodium, and phosphorous. Among low-income female subjects, close proximity to more outlets was associated with higher calorie consumption. Among all participants, access to fast-food restaurants was not associated with an unhealthy diet score, and access to grocery stores was not associated with a healthy diet score. CONCLUSIONS Average caloric and nutrient intakes differed by outlet availability; however, there were no strong associations with type of food outlet. This should be considered when developing food-focused public health policies.
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57
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Mozaffarian D. Dietary and policy priorities to reduce the global crises of obesity and diabetes. ACTA ACUST UNITED AC 2020. [DOI: 10.1038/s43016-019-0013-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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58
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Saluja T, Davies A, Oldmeadow C, Boyle AJ. Impact of fast-food outlet density on incidence of myocardial infarction in the Hunter region. Intern Med J 2020; 51:243-248. [PMID: 31908114 DOI: 10.1111/imj.14745] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/11/2019] [Accepted: 12/21/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is an established association between fast-food consumption and metabolic diseases. Some studies also suggest that calorie-dense food promotes a proinflammatory response, which is itself linked with myocardial infarction (MI). Whether increased fast-food availability is a risk factor for MI remains unknown. AIM To investigate the role of fast-food outlet density (FFD) as a novel environmental risk factor for MI in the Hunter region, New South Wales (NSW). METHODS We conducted a retrospective cohort study using a database of all MI events between 1996 and 2013, extracted from the Hunter Cardiac and Stroke Outcomes unit. FFD was calculated for each local government area (LGA) of the Hunter region, allowing for a comparative analysis. Stratification by fast-food outlet data and LGA resulted in a total of 3070 cases. Weighted linear regression was used to investigate the role of FFD on incidence of MI in regional and rural Australia. RESULTS FFD was positively correlated with rates of MI, remaining consistent in both single and multivariate predictor models adjusting for age, obesity, hyperlipidaemia, hypertension, smoking status, diabetes and socioeconomic status (P < 0.001). An increase of one fast-food outlet corresponded with four additional cases of MI per 100 000 people per year (4.07, 95% confidence interval, 3.86-4.28). CONCLUSIONS FFD was positively associated with incidence of MI in both rural and metropolitan areas of NSW. This relationship remained consistent after multivariate adjustment for standard cardiovascular risk factors, highlighting the importance of an individual's food environment as a potential contributor towards their health.
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Affiliation(s)
- Tarunpreet Saluja
- Department of Cardiovascular Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Allan Davies
- Department of Cardiovascular Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Chris Oldmeadow
- Department of Cardiovascular Medicine, University of Newcastle, Newcastle, New South Wales, Australia.,Department of Cardiovascular Medicine, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Andrew J Boyle
- Department of Cardiovascular Medicine, University of Newcastle, Newcastle, New South Wales, Australia.,Department of Cardiovascular Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.,Department of Cardiovascular Medicine, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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59
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Hollis-Hansen K, Vermont L, Zafron ML, Seidman J, Leone L. The introduction of new food retail opportunities in lower-income communities and the impact on fruit and vegetable intake: a systematic review. Transl Behav Med 2019; 9:837-846. [PMID: 31570930 PMCID: PMC8679116 DOI: 10.1093/tbm/ibz094] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023] Open
Abstract
A lack of access to fresh fruits and vegetables (F&Vs) is associated with consumption of fewer F&Vs and higher risk of obesity, especially for lower-income individuals. It is widely believed that the addition of new food retail opportunities could improve F&V consumption and subsequently reduce the chronic disease burden. Observational studies provide some support for these hypotheses, but contradictions exist. In this study we sought to examine if the introduction of a food retailer affects F&V consumption in lower-income communities. We used a systematic PRISMA approach to conduct this study. We searched PubMed, EMBASE, and ProQuest Dissertations & Theses for academic journal references and gray literature published before August 2018. Included studies were those looking at the effect of the introduction of a new food retailer on F&V consumption. Studies were also categorized based on which dimensions of food access were targeted by the food retailer. We identified 15 studies meeting inclusion criteria: 11 studies reported a positive increase in F&V consumption attributable to the introduction of a new food retailer, of which 6 were statistically significant. The remaining 4 studies, all of which examined the impact of introducing a new retail supermarket, showed no change or a decrease in F&V intake. Results from studies which change the food environment generally support the idea that increased access to healthy food improves diet, but more studies are needed in order to assess the differences between the various types of retailers, and to identify strategies for improving impact. Understanding which types of new food retail programs are most likely to impact diet has implications for policies which incentivize new food retail.
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Affiliation(s)
- Kelseanna Hollis-Hansen
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Leah Vermont
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | | | - Jennifer Seidman
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Lucia Leone
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
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60
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Lee J, Allen J. Mother’s educational attainment and their young adult daughters’ fast food intake: The role of race/ethnicity. Health Care Women Int 2019; 41:169-187. [DOI: 10.1080/07399332.2019.1669606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jaewon Lee
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Jennifer Allen
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
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61
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Hobbs M, Green MA, Wilkins E, Lamb KE, McKenna J, Griffiths C. Associations between food environment typologies and body mass index: Evidence from Yorkshire, England. Soc Sci Med 2019; 239:112528. [PMID: 31499332 DOI: 10.1016/j.socscimed.2019.112528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/29/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
International research linking food outlets and body mass index (BMI) is largely cross-sectional, yielding inconsistent findings. However, addressing the exposure of food outlets is increasingly considered as an important adult obesity prevention strategy. Our study investigates associations between baseline food environment types and change in BMI over time. Survey data were used from the Yorkshire Health Study (n=8,864; wave one: 2010-2012, wave two: 2013-2015) for adults aged 18-86. BMI was calculated using self-reported height (cm) and weight (kg). Restaurants, cafés, fast-food, speciality, convenience and large supermarkets were identified from the Ordnance Survey Point of Interest database within 1600m radial buffer of home postcodes. K-means cluster analysis developed food environment typologies based on food outlets and population density. Large supermarkets, restaurants, cafés, fast-food, speciality and convenience food outlets all clustered together to some extent. Three neighbourhood typologies were identified. However, multilevel models revealed that relative to cluster one all were unrelated to change in BMI (cluster 2, b= -0.146 [-0.274, 0.566]; cluster 3, b= 0.065 [-0.224, 0.356]). There was also little evidence of gender-based differences in these associations when examined in a three-way interaction. Policymakers may need to begin to consider multiple types of food outlet clusters, while further research is needed to confirm how these relate to changed BMI.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand.
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, United Kingdom
| | - E Wilkins
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - K E Lamb
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, 3052, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, 3052, Australia
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QT, United Kingdom
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Maimaiti M, Ma X, Zhao X, Jia M, Li J, Yang M, Ru Y, Yang F, Wang N, Zhu S. Multiplicity and complexity of food environment in China: full-scale field census of food outlets in a typical district. Eur J Clin Nutr 2019; 74:397-408. [DOI: 10.1038/s41430-019-0462-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 11/09/2022]
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63
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Alvarado SE. The indelible weight of place: Childhood neighborhood disadvantage, timing of exposure, and obesity across adulthood. Health Place 2019; 58:102159. [PMID: 31280141 DOI: 10.1016/j.healthplace.2019.102159] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/06/2019] [Accepted: 06/24/2019] [Indexed: 01/21/2023]
Abstract
I use 28 (1986-2014) years of restricted geocoded NLSY tract-level data and find positive associations between exposure to childhood neighborhood disadvantage and adult obesity and BMI among individuals growing up and entering adulthood during the rise of obesity in the United States. Sibling fixed effects and cousin fixed effects models partially address unobserved confounding nested in the nuclear as well as extended family. Furthermore, exposure to neighborhood disadvantage in adolescence is most salient, providing insight into when policy intervention may be most effective. Results are robust to alternative specifications for neighborhood disadvantage, ages of exposure, and to alternative sampling strategies.
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Liveable for whom? Prospects of urban liveability to address health inequities. Soc Sci Med 2019; 232:94-105. [DOI: 10.1016/j.socscimed.2019.05.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 03/13/2019] [Accepted: 05/01/2019] [Indexed: 12/31/2022]
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Abstract
Objective: To explore the perceptions of soldiers participating in a US Army Office of The Surgeon General’s worksite health promotion programme (WHPP) on the local food environment within their campus-style workplace. Design: Focus groups were conducted to evaluate the perceived effectiveness of the WHPP implementation. Further exploration of focus group data through thematic analysis focused on perceived contributions of the military campus-style food environment to soldiers’ nutrition behaviours. Setting: Three US Army installations located in the continental USA. Participants: Active duty soldiers (n 366) participating in one of the fifty-eight focus groups. Results: Soldiers shared a common belief of self-discipline and personal responsibility as the foothold to nutrition behaviour change. Soldiers described aspects of the military campus-style food environment as factors impeding achievement of optimal nutrition. Collectively, soldiers perceived the proximity and density of fast-food restaurants, lack of healthy alternatives on the installation and the cost of healthy food as inhibitors to choosing healthy foods. Overwhelmingly, soldiers also perceived time constraints as a factor contributing to unhealthy food choices. Conclusions: Although nutrition behaviour is individually driven, soldiers perceived the military campus-style food environment inhibits healthy decision making. Nutrition programming in military WHPP must integrate food environment changes to improve soldiers’ nutrition behaviour outcomes. Applicable to the military, food choice behaviour studies suggest environmental changes must be appealing to young adults. Considerations for environmental changes should include an increased portion size for healthy options, broadened use of soldiers’ daily food allowances on local produce and increased availability of grab-and-go options.
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von Philipsborn P, Stratil JM, Burns J, Busert LK, Pfadenhauer LM, Polus S, Holzapfel C, Hauner H, Rehfuess E. Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health. Cochrane Database Syst Rev 2019; 6:CD012292. [PMID: 31194900 PMCID: PMC6564085 DOI: 10.1002/14651858.cd012292.pub2] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Frequent consumption of excess amounts of sugar-sweetened beverages (SSB) is a risk factor for obesity, type 2 diabetes, cardiovascular disease and dental caries. Environmental interventions, i.e. interventions that alter the physical or social environment in which individuals make beverage choices, have been advocated as a means to reduce the consumption of SSB. OBJECTIVES To assess the effects of environmental interventions (excluding taxation) on the consumption of sugar-sweetened beverages and sugar-sweetened milk, diet-related anthropometric measures and health outcomes, and on any reported unintended consequences or adverse outcomes. SEARCH METHODS We searched 11 general, specialist and regional databases from inception to 24 January 2018. We also searched trial registers, reference lists and citations, scanned websites of relevant organisations, and contacted study authors. SELECTION CRITERIA We included studies on interventions implemented at an environmental level, reporting effects on direct or indirect measures of SSB intake, diet-related anthropometric measures and health outcomes, or any reported adverse outcome. We included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) and interrupted-time-series (ITS) studies, implemented in real-world settings with a combined length of intervention and follow-up of at least 12 weeks and at least 20 individuals in each of the intervention and control groups. We excluded studies in which participants were administered SSB as part of clinical trials, and multicomponent interventions which did not report SSB-specific outcome data. We excluded studies on the taxation of SSB, as these are the subject of a separate Cochrane Review. DATA COLLECTION AND ANALYSIS Two review authors independently screened studies for inclusion, extracted data and assessed the risks of bias of included studies. We classified interventions according to the NOURISHING framework, and synthesised results narratively and conducted meta-analyses for two outcomes relating to two intervention types. We assessed our confidence in the certainty of effect estimates with the GRADE framework as very low, low, moderate or high, and presented 'Summary of findings' tables. MAIN RESULTS We identified 14,488 unique records, and assessed 1030 in full text for eligibility. We found 58 studies meeting our inclusion criteria, including 22 RCTs, 3 NRCTs, 14 CBA studies, and 19 ITS studies, with a total of 1,180,096 participants. The median length of follow-up was 10 months. The studies included children, teenagers and adults, and were implemented in a variety of settings, including schools, retailing and food service establishments. We judged most studies to be at high or unclear risk of bias in at least one domain, and most studies used non-randomised designs. The studies examine a broad range of interventions, and we present results for these separately.Labelling interventions (8 studies): We found moderate-certainty evidence that traffic-light labelling is associated with decreasing sales of SSBs, and low-certainty evidence that nutritional rating score labelling is associated with decreasing sales of SSBs. For menu-board calorie labelling reported effects on SSB sales varied.Nutrition standards in public institutions (16 studies): We found low-certainty evidence that reduced availability of SSBs in schools is associated with decreased SSB consumption. We found very low-certainty evidence that improved availability of drinking water in schools and school fruit programmes are associated with decreased SSB consumption. Reported associations between improved availability of drinking water in schools and student body weight varied.Economic tools (7 studies): We found moderate-certainty evidence that price increases on SSBs are associated with decreasing SSB sales. For price discounts on low-calorie beverages reported effects on SSB sales varied.Whole food supply interventions (3 studies): Reported associations between voluntary industry initiatives to improve the whole food supply and SSB sales varied.Retail and food service interventions (7 studies): We found low-certainty evidence that healthier default beverages in children's menus in chain restaurants are associated with decreasing SSB sales, and moderate-certainty evidence that in-store promotion of healthier beverages in supermarkets is associated with decreasing SSB sales. We found very low-certainty evidence that urban planning restrictions on new fast-food restaurants and restrictions on the number of stores selling SSBs in remote communities are associated with decreasing SSB sales. Reported associations between promotion of healthier beverages in vending machines and SSB intake or sales varied.Intersectoral approaches (8 studies): We found moderate-certainty evidence that government food benefit programmes with restrictions on purchasing SSBs are associated with decreased SSB intake. For unrestricted food benefit programmes reported effects varied. We found moderate-certainty evidence that multicomponent community campaigns focused on SSBs are associated with decreasing SSB sales. Reported associations between trade and investment liberalisation and SSB sales varied.Home-based interventions (7 studies): We found moderate-certainty evidence that improved availability of low-calorie beverages in the home environment is associated with decreased SSB intake, and high-certainty evidence that it is associated with decreased body weight among adolescents with overweight or obesity and a high baseline consumption of SSBs.Adverse outcomes reported by studies, which may occur in some circumstances, included negative effects on revenue, compensatory SSB consumption outside school when the availability of SSBs in schools is reduced, reduced milk intake, stakeholder discontent, and increased total energy content of grocery purchases with price discounts on low-calorie beverages, among others. The certainty of evidence on adverse outcomes was low to very low for most outcomes.We analysed interventions targeting sugar-sweetened milk separately, and found low- to moderate-certainty evidence that emoticon labelling and small prizes for the selection of healthier beverages in elementary school cafeterias are associated with decreased consumption of sugar-sweetened milk. We found low-certainty evidence that improved placement of plain milk in school cafeterias is not associated with decreasing sugar-sweetened milk consumption. AUTHORS' CONCLUSIONS The evidence included in this review indicates that effective, scalable interventions addressing SSB consumption at a population level exist. Implementation should be accompanied by high-quality evaluations using appropriate study designs, with a particular focus on the long-term effects of approaches suitable for large-scale implementation.
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Affiliation(s)
- Peter von Philipsborn
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Jan M Stratil
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Jacob Burns
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Laura K Busert
- University College LondonGreat Ormond Street Institute of Child HealthLondonUK
| | - Lisa M Pfadenhauer
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Stephanie Polus
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
| | - Christina Holzapfel
- School of Medicine, Technical University of MunichInstitute of Nutritional Medicine, Else Kroener‐Fresenius Centre for Nutritional MedicineMunichGermany
| | - Hans Hauner
- School of Medicine, Technical University of MunichInstitute of Nutritional Medicine, Else Kroener‐Fresenius Centre for Nutritional MedicineMunichGermany
| | - Eva Rehfuess
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public HealthMarchioninistr. 15MunichBavariaGermany81377
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Grunseit AC, Cook AS, Conti J, Gwizd M, Allman-Farinelli M. "Doing a good thing for myself": a qualitative study of young adults' strategies for reducing takeaway food consumption. BMC Public Health 2019; 19:525. [PMID: 31064366 PMCID: PMC6505251 DOI: 10.1186/s12889-019-6731-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/31/2019] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Increasingly the population is eating meals and snacks prepared outside the home, especially younger adults. Takeaway foods can be energy-dense, high in saturated fat and sodium, and deleterious to health. Extending studies examining the barriers to healthy eating, this paper explores strategies employed by young adults who report reducing consumption of unhealthy takeaway foods. METHODS Young adults aged 18 to 35 years in paid employment were recruited to participate in eight semi-structured focus groups. In response to initial findings, recruitment for the final four groups refocused on participants who either wanted, were in the process of, or had changed their takeaway food habits. Focus group recordings were transcribed verbatim and coded by two researchers for recurrent themes using an inductive method. RESULTS Forty-eight participants with a mean BMI of 23.4 kg/m2 and mean age of 25 years took part, of which 34 were female, and 27 were born outside Australia. Four broad strategies emerged: altering cognitions about consumption/reduction of takeaway food; practical changes to behaviours; finding external support; and, reconfiguring social events. In detail, participants cognitively recast takeaway food consumption as negative (expensive and unhealthy) and reducing consumption of such foods or consuming healthy alternatives as a (positive) self-care action. Setting goals and making personal rules around consumption, and consciously making practical changes, such as planning for food shopping, were other strategies. Externally derived support including supportive food environments and friends and family passively reduced exposure to unhealthy takeaway food. Finally, some participants actively created social environments supportive of healthy choices. CONCLUSIONS Our participants reported strategies they believed led to them successfully reduce their takeaway food consumption by matching the attractions (e.g., convenience) and countering apparent disincentives for reducing consumption (e.g., losing a reward) of takeaway food. They reported eschewing more short-term rewards and costs, to prioritise their health, believing that avoiding these foods would benefit them personally and financially. The identified strategies are consistent with documented techniques for successful behaviour change and corresponded to all levels in the social-ecological model from intrapersonal factors to public policy. The findings could underpin health promotion strategies to support this at-risk group.
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Affiliation(s)
- Anne C Grunseit
- Sydney School of Public Health, University of Sydney Prevention Research Collaboration, Sydney, Australia
| | - Amelia S Cook
- School of Science and Health, Western Sydney University, Sydney, Australia.
| | - Janet Conti
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Melissa Gwizd
- Sydney School of Public Health, University of Sydney Prevention Research Collaboration, Sydney, Australia
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, University of Sydney School of Life and Environmental Sciences, Sydney, Australia
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de Groot R, van den Hurk K, Schoonmade LJ, de Kort WLAM, Brug J, Lakerveld J. Urban-rural differences in the association between blood lipids and characteristics of the built environment: a systematic review and meta-analysis. BMJ Glob Health 2019; 4:e001017. [PMID: 30740247 PMCID: PMC6347938 DOI: 10.1136/bmjgh-2018-001017] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/28/2022] Open
Abstract
Introduction The built environment defines opportunities for healthy eating and physical activity and may thus be related to blood lipids. The aim of this study is to systematically analyse the scientific evidence on associations between built-environment characteristics and blood lipid levels in adults. Methods PubMed, EMBASE and Web of Science were searched for peer-reviewed papers on population-based studies up to 9 October 2017. We included studies that reported on built-environment characteristics and blood lipid levels in adult populations (≥18 years). Two reviewers independently screened titles/abstracts and full-texts of papers and appraised the risk of bias of included studies using an adapted version of the Quality Assessment Tool for Quantitative Studies. We performed meta-analyses when five or more studies had sufficient homogeneity in determinant and outcome. Results After screening 6902 titles/abstracts and 141 potentially relevant full-text articles, we included 50 studies. Forty-seven studies explored associations between urban versus rural areas with blood lipid levels. Meta-analyses on urban versus rural areas included 133 966 subjects from 36 studies in total. Total cholesterol levels were significantly and consistently higher in urban areas as compared with rural areas (mean difference 0.37 mmol/L, 95% CI 0.27 to 0.48). Urban/rural differences in high density lipoprotein cholesterol were inconsistent across studies and the pooled estimate showed no difference (0.00 mmol/L 95% CI −0.03 to 0.04). Low density lipoprotein (LDL) cholesterol and triglyceride levels were higher in urban than in rural areas (mean difference 0.28, 95% CI 0.17 to 0.39 and 0.09, 95% CI 0.03 to 0.14, respectively). Conclusions Total and LDL cholesterol levels and triglycerides were consistently higher in residents of urban areas than those of rural areas. These results indicate that residents of urban areas generally have less favourable lipid profiles as compared with residents of rural areas. Prospero registration number CRD42016043226.
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Affiliation(s)
- Rosa de Groot
- Department of Donor Medicine – Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Medicine – Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Linda J Schoonmade
- Department of Medical Library, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Wim L A M de Kort
- Department of Donor Medicine – Donor Studies, Sanquin Research, Amsterdam, The Netherlands
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Johannes Brug
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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Huang TTK, Aitken J, Ferris E, Cohen N. Design Thinking to Improve Implementation of Public Health Interventions: An Exploratory Case Study on Enhancing Park Use. DESIGN FOR HEALTH (ABINGDON, ENGLAND) 2019; 2:236-252. [PMID: 31773070 PMCID: PMC6879094 DOI: 10.1080/24735132.2018.1541047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 09/05/2018] [Accepted: 10/16/2018] [Indexed: 01/21/2023]
Abstract
Design thinking, a human-centred, iterative process to innovate solutions aligned with communities' tacit knowledge, has the potential to augment public health interventions. This paper presents a case study of a design thinking workshop to illustrate the process and methods to train public health researchers. A workshop was conducted to engage participants in a systematic, non-linear process of design thinking to design possible interventions to enhance use of renovated New York City parks. Participants engaged in exercises to rapidly craft proposals for park re-design. The process involved learning about design methods to overcome limitations of linear thinking and how design thinking can be applied to public health problems that require community input. The case study demonstrated the feasibility of training public health researchers in design thinking methods that can be applied to public health problems. With increased capacity, public health researchers could apply design thinking to community collaborations to develop solutions embedded in the unique contexts of the community.
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Affiliation(s)
- Terry T-K Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, United States of America
| | | | - Emily Ferris
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, United States of America
| | - Nevin Cohen
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, United States of America
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Neighborhoods and Breast Cancer Survival: The Case for an Archetype Approach. ENERGY BALANCE AND CANCER 2019. [DOI: 10.1007/978-3-030-18408-7_10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Zhang H, Yin L. A Meta-analysis of the Literature on the Association of the Social and Built Environment With Obesity: Identifying Factors in Need of More In-Depth Research. Am J Health Promot 2018; 33:792-805. [DOI: 10.1177/0890117118817713] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: This study aims to identify groups of the social and built environment factors that have been studied substantially along with factors that need further attention, to guide the research, designing, and planning of the social and built environment for reducing obesity prevalence. Data Source: A systematic search of literature was undertaken from PubMed, Google Scholar, and Web of Knowledge. Study Inclusion and Exclusion Criteria: Keyword combination of “built environment,” “social environment,” and “obesity” were used to expand the search scope. Exclusion criteria included (1) any article with less than 50 citations from 2005 to 2010, and those with less than 25 citations from 2011 to 2015. In this way we included the most prominent peer-reviewed studies published in recent years while excluding less influential publications; (2) any article published in a language other than English; (3) literature review articles; (4) any article studying health outcomes not obesity related. We included research on eating behaviors since the studies contributed profoundly to food environment research. Data Synthesis: A meta-analysis of 153 empirical studies, selected from 2005 to 2015 based on a series of criteria, was conducted using factor analysis. The exploratory factor analysis was undertaken to group the prevalence and use of the social and built environment factors associated with obesity. Results: The findings suggested that the research community has gained a substantial understanding of the D variables of the built environment, including density, diversity, design, distance to transit, and destination access. Factors concerning different age groups, minority populations, groups with low socioeconomic status, food environment, and street-level urban design features have been less examined. Conclusions: The findings are important to guide future research directions, giving more attention to the factors in need of more in-depth research.
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Affiliation(s)
- Hao Zhang
- Department of Urban and Regional Planning, School of Architecture and Planning, University at Buffalo, Buffalo, NY, USA
| | - Li Yin
- Department of Urban and Regional Planning, School of Architecture and Planning, University at Buffalo, Buffalo, NY, USA
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McGuirt JT, Jilcott Pitts SB, Gustafson A. Association between Spatial Access to Food Outlets, Frequency of Grocery Shopping, and Objectively-Assessed and Self-Reported Fruit and Vegetable Consumption. Nutrients 2018; 10:E1974. [PMID: 30551652 PMCID: PMC6316649 DOI: 10.3390/nu10121974] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/04/2018] [Accepted: 12/11/2018] [Indexed: 12/30/2022] Open
Abstract
Because supermarkets are a critical part of the community food environment, the purpose of this paper is to examine the association between accessibility to the supermarket where participants were surveyed, frequency of shopping at the supermarket, and self-reported and objectively-assessed fruit and vegetable consumption. Accessibility was assessed using Geographic Information Systems (GIS) measured distance and multiple versions of the modified Retail Food Environment Index (mRFEI), including a localized road network buffer version. Frequency of shopping was assessed using self-report. The National Cancer Institute Fruit and Vegetable screener was used to calculate daily servings of fruits and vegetables. Skin carotenoids were assessed using the "Veggie Meter™" which utilizes reflection spectroscopy to non-invasively assess skin carotenoids as an objective measure of fruit and vegetable consumption. Bivariate and multivariable statistics were used to examine the associations in RStudio. There was a positive association between skin carotenoids and the Special Supplemental Nutrition Program for Women Infants and Children (WIC) and mRFEI scores, suggesting that WIC participation and a healthier food environment were associated with objectively-assessed fruit and vegetable consumption (skin carotenoids). Future research should examine these associations using longitudinal study designs and larger sample sizes.
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Affiliation(s)
- Jared T McGuirt
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC 27412, USA.
| | - Stephanie B Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, School of Human Environmental Sciences, University of Kentucky, Lexington, KY 40506, USA.
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Exploring absolute and relative measures of exposure to food environments in relation to dietary patterns among European adults. Public Health Nutr 2018; 22:1037-1047. [PMID: 30523774 PMCID: PMC6536821 DOI: 10.1017/s1368980018003063] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objective To explore the associations of absolute and relative measures of exposure to food retailers with dietary patterns, using simpler and more complex measures. Design Cross-sectional survey. Setting Urban regions in Belgium, France, Hungary, the Netherlands and the UK. Participants European adults (n 4942). Supermarkets and local food shops were classified as ‘food retailers providing healthier options’; fast-food/takeaway restaurants, cafés/bars and convenience/liquor stores as ‘food retailers providing less healthy options’. Simpler exposure measures used were density of healthy and density of less healthy food retailers. More complex exposure measures used were: spatial access (combination of density and proximity) to healthy and less healthy food retailers; density of healthier food retailers relative to all food retailers; and a ratio of spatial access scores to healthier and less healthy food retailers. Outcome measures were a healthy or less healthy dietary pattern derived from a principal component analysis (based on consumption of fruits, vegetables, fish, fast foods, sweets and sweetened beverages). Results Only the highest density of less healthy food retailers was significantly associated with the less healthy dietary pattern (β = −129·6; 95 % CI −224·3, −34·8). None of the other absolute density measures nor any of the relative measures of exposures were associated with dietary patterns. Conclusions More complex measures of exposure to food retailers did not produce stronger associations with dietary patterns. We had some indication that absolute and relative measures of exposure assess different aspects of the food environment. However, given the lack of significant findings, this needs to be further explored.
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Al-Zubaidi AM, Alzobydi AH, Alsareii SA, Al-Shahrani A, Alzaman N, Kassim S. Body Mass Index and Helicobacter pylori among Obese and Non-Obese Patients in Najran, Saudi Arabia: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112586. [PMID: 30463266 PMCID: PMC6267233 DOI: 10.3390/ijerph15112586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/13/2018] [Accepted: 11/16/2018] [Indexed: 12/14/2022]
Abstract
Objective: We examine obese and non-obese patients with respect to Helicobacter pylori (H. pylori) positive-infection (HPPI) and associated factors, specifically body mass index (BMI). Methods: This study took place in the Department of Endoscopy of a central hospital in the Najran region of Saudi Arabia (SA). A total of 340 obese Saudi patients (BMI ≥ 30 kg/m2) who had undergone diagnostic upper endoscopy before sleeve gastrectomy, were compared with 340 age and gender-matched control patients (BMI < 30 kg/m2) who had undergone diagnostic upper endoscopy for other reasons. Data collected included diagnosis of HPPI. Descriptive and multivariable binary logistic regression was conducted. Results: Mean patient age was 31.22 ± 8.10 years, and 65% were males. The total prevalence of HPPI was 58% (95% CI = 54–61%) with obese patients presenting significantly more HPPI than non-obese patients (66% vs. 50%, OR = 1.98, 95% CI = 1.45–2.70, p < 0.0005). Age and gender did not associate significantly with HPPI (p = 0.659, 0.200, respectively) and increases in BMI associated significantly with increases in HPPI (p < 0.0005). BMI remained a significant factor in HPPI when modelled with both age and gender (OR = 1.022, 95% CI = 1.01–1.03, p < 0.0005). Conclusions: Within the limitations of this study, the significance of HPPI in obese Saudi patients residing in the Najran region in SA was demonstrated alongside the significance role of BMI in HPPI.
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Affiliation(s)
- Ali M Al-Zubaidi
- Department of Medicine, Endoscopy Unit, King Khalid Hospital, Najran 1120, Saudi Arabia.
| | - Abdo H Alzobydi
- Department of Surgery, Bariatric Surgery, King Khalid Hospital-Najran 1120, Saudi Arabia.
| | - Saeed A Alsareii
- Department of Surgery, Najran University Medical College and Hospital, Najran 1988, Saudi Arabia.
| | - AbdulazizTurky Al-Shahrani
- Department of Internal Medicine; Najran University Medical College and Hospital, Nagran 1988, Saudi Arabia.
| | - Naweed Alzaman
- Department of Internal Medicine, Taibah University Medical College, Al-Madinah Al-Munawwarah 42353, Saudi Arabia.
| | - Saba Kassim
- Department of Preventive Dental Sciences, Taibah University Dental College and Hospital, Al-Madinah Al-Munawwarah 42353, Saudi Arabia.
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Woo Baidal JA, Morel K, Nichols K, Elbel E, Charles N, Goldsmith J, Chen L, Taveras E. Sugar-Sweetened Beverage Attitudes and Consumption During the First 1000 Days of Life. Am J Public Health 2018; 108:1659-1665. [PMID: 30359102 DOI: 10.2105/ajph.2018.304691] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To examine the relationship of parental sugar-sweetened beverage (SSB) attitudes with SSB consumption during the first 1000 days of life-gestation to age 2 years. METHODS We studied 394 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-enrolled families during the first 1000 days of life in northern Manhattan, New York, in 2017. In regression models, we assessed cross-sectional relationships of parental SSB attitude scores with habitual daily parent SSB calories and infant SSB consumption, adjusting for demographic and socioeconomic characteristics. RESULTS Each point higher parental SSB attitude score was associated with lower parental SSB consumption (-14.5 median kcals; 95% confidence interval [CI] = -22.6, -6.4). For infants, higher parental SSB attitude score was linked with lower odds of infant SSB consumption (adjusted odds ratio [AOR] = 0.84; 95% CI = 0.71, 0.99), and adjustment for socioeconomic factors slightly attenuated results (AOR = 0.85; 95% CI = 0.71, 1.02). CONCLUSIONS During the first 1000 days of life, greater negativity in parental attitudes toward SSB consumption was associated with fewer parental calories consumed from SSBs and lower likelihood of infant SSB consumption. Public Health Implications. Parental attitudes toward SSBs should be targeted in future childhood obesity interventions during pregnancy and infancy.
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Affiliation(s)
- Jennifer A Woo Baidal
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Kayla Morel
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Kelsey Nichols
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Erin Elbel
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Nalini Charles
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Jeff Goldsmith
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Ling Chen
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Elsie Taveras
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
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Abstract
AbstractObjectiveTo assess access to healthy food retailers among formerly incarcerated individuals.DesignUsing linked data from the National Longitudinal Study of Adolescent to Adult Health and the Modified Retail Food Environment Index, the present study applies multivariate logistic regression to assess the association between incarceration and (i) living in a food desert and (ii) having low access to healthy food retailers. To account for unobserved heterogeneity, additional analyses are performed comparing formerly incarcerated individuals with persons arrested or convicted for a crime but not previously incarcerated.SettingSample of respondents living in urban census tracts in the USA.SubjectsAdults (n10390) aged 24–34 years.ResultsIn adjusted logistic regression models, prior incarceration was not significantly associated with living in a food desert (OR=1·097; 95% CI 0·896, 1·343). Prior incarceration significantly increased the likelihood of living in a census tract with low access to healthy food retailers (OR=1·265; 95% CI 1·069, 1·498). This significant association remained when comparing formerly incarcerated individuals with those who had been arrested or convicted of a crime, but not previously incarcerated (OR=1·246; 95% CI 1·032, 1·503).ConclusionsFormerly incarcerated individuals are more likely to live in areas with low access to healthy food retailers compared with their non-incarcerated counterparts. Because lower access healthy food retailers may be associated with worse health and dietary behaviour, disparities in local food retail environments may exacerbate health inequalities among formerly incarcerated individuals.
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Multilevel Structural Equation Modeling of Students' Dietary Intentions/Behaviors, BMI, and the Healthfulness of Convenience Stores. Nutrients 2018; 10:nu10111569. [PMID: 30360538 PMCID: PMC6266756 DOI: 10.3390/nu10111569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/17/2018] [Accepted: 10/20/2018] [Indexed: 11/16/2022] Open
Abstract
Background: When dietary behaviors are habitual, intentions are low, and environmental cues, such as the consumer food environment, might guide behavior. How might intentions to eat healthily and ultimately actual dietary behaviors, be influenced by the consumer food environment (including the availability and affordability of healthy foods) in convenience stores? This study will determine pathways between the healthfulness of convenience stores and college students’ dietary intentions/behaviors, and body mass index (BMI). Methods: Through multilevel structural equation modeling, a comparison was made of students’ healthful meal intentions (HMI); intake (fruits/vegetables, %kcal/fat, sugar-sweetened beverages (SSBs) and whole-grains); and measured BMI; as well as the healthfulness of convenience stores (fruits/vegetables availability/quality, healthy food availability/affordability). Data was collected on 1401 students and 41 convenience stores across 13 US college campuses. Results: Controlling for gender, HMI was negatively associated with SSBs (β = −0.859) and %kcal/fat (β = −1.057) and positively with whole-grains (β = 0.186) and fruits/vegetables intake (β = 0.267); %Kcal/fat was positively (β = 0.098) and fruits/vegetables intake (β = −0.055) negatively associated with BMI. Campus level, fruits/vegetables availability were positively associated to HMI (β = 0.214, β = 0.129) and directly/negatively to BMI (β = −2.657, β = −1.124). Conclusions: HMI modifies dietary behaviors, with energy from fat and fruit/vegetable intake the most predictive of weight. Availability of fruit/vegetables in convenience stores make it easier for young adults to eat well.
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Local Retail Food Environment and Consumption of Fruit and Vegetable among Adults in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102247. [PMID: 30322198 PMCID: PMC6210243 DOI: 10.3390/ijerph15102247] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 12/28/2022]
Abstract
Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual's homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04⁻1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11⁻2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04⁻1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people's home is an important environmental factor in meeting fruit and vegetable consumption guidelines. "Food swamps" (areas with an abundance of unhealthy foods) rather than "food deserts" (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong's urban areas. We advanced international literature by providing evidence in a non-western setting.
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Sarkar C, Webster C, Gallacher J. Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants. Lancet Planet Health 2018; 2:e438-e450. [PMID: 30318101 DOI: 10.1016/s2542-5196(18)30208-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/23/2018] [Accepted: 09/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Rapid urbanisation and associated socioeconomic transformations have modified current lifestyles, shifting dietary preferences towards ready-to-eat, calorie-dense food of poor nutritional quality. The effect of ready-to-eat food environments that sell food for instant consumption on the risk of type 2 diabetes has received scant attention. We therefore aimed to examine the association between exposure to ready-to-eat food environments and type 2 diabetes in a large and diverse population sample. METHODS We conducted a cross-sectional study of adult male and female participants from the baseline phase of the UK Biobank cohort. Participants in this cohort were aged 37-73 years and resided in one of 21 cities in the UK. Ready-to-eat food environments, which we determined from a modelled and linked built environment database, were objectively measured within 1-km catchment areas of the residential streets of participants and were expressed as metrics of density and proximity to the participants' homes. We used logistic regression models to examine the associations between exposure to ready-to-eat food environments and the odds of type 2 diabetes, adjusting for individual covariates such as physical activity. As sensitivity analyses, we investigated the associations between the street distance to the nearest ready-to-eat food outlet and type 2 diabetes. We also tested post hoc for effect modification by sex, income, body-mass index, and location of the UK Biobank collection centre. FINDINGS Of 502 635 UK Biobank participants enrolled between March 13, 2006, and Oct 1, 2010, the sample analysed included 347 551 (69·1%) participants. The density of ready-to-eat food environments within a 1-km catchment area was associated with higher odds of type 2 diabetes for participants in the groups with highest exposure to restaurants and cafeterias (odss ratio 1·129, 95% CI 1·05-1·21; p=0·0007) and a composite measure of ready-to-eat outlet density (1·112, 1·02-1·21; p=0·0134) compared with those with no exposure. Exposure to hot and cold takeaways was only significantly associated with higher odds of type 2 diabetes at the second highest exposure category that we examined (1·076, 1·01-1·14; p=0·0171), representing a density of 0·75-2·15 units per km2. A protective effect with distance decay was observed: participants in the highest quintile of street distance to nearest ready-to-eat food outlet reported lower odds of type 2 diabetes than those in the lowest quintile (0·842, 0·78-0·91; p<0·0001 for restaurants and cafeterias; and 0·913, 0·85-0·98; p=0·0173 for hot and cold takeaways). These effects were most pronounced in overweight participants (p=0·0329), but there was no evidence of interaction by sex, income, or UK Biobank collection centre. INTERPRETATION Access to ready-to-eat food environments was positively associated with type 2 diabetes. Top-down policies aimed at minimising unhealthy food access could potentially reduce unhealthy consumption and risks of chronic diseases. Further long-term studies are needed to effectively guide such interventions. FUNDING University of Hong Kong, UK Biobank, and UK Economic & Social Research Council.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, UK
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80
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Chacko C, Rajamohan T. Repeatedly heated cooking oils induced alterations in erythrocyte membrane integrity and antioxidant status in cholesterol fed Sprague Dawley rats. J Food Biochem 2018. [DOI: 10.1111/jfbc.12555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Chinu Chacko
- Department of Biochemistry; University of Kerala; Thiruvananthapuram Kerala India
| | - T. Rajamohan
- Department of Biochemistry; University of Kerala; Thiruvananthapuram Kerala India
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81
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Leone LA, Tripicchio GL, Haynes-Maslow L, McGuirt J, Grady Smith JS, Armstrong-Brown J, Kowitt SD, Gizlice Z, Ammerman AS. A Cluster-Randomized Trial of a Mobile Produce Market Program in 12 Communities in North Carolina: Program Development, Methods, and Baseline Characteristics. J Acad Nutr Diet 2018; 119:57-68. [PMID: 29945851 DOI: 10.1016/j.jand.2018.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 04/15/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mobile markets are an increasingly popular method for providing access to fresh fruits and vegetables (F/V) in underserved communities; however, evaluation of these programs is limited, as are descriptions of their development, study designs, and needs of the populations they serve. OBJECTIVE Our aim was to describe the development and theoretical basis for Veggie Van (VV), a mobile produce market intervention, the study design for the VV evaluation, and baseline characteristics of the study population. DESIGN The protocol and sample for a cluster-randomized controlled trial with 12 sites are described. PARTICIPANTS/SETTING Community partner organizations in the Triangle region of North Carolina that primarily served lower-income families or were located in areas that had limited access to fresh produce were recruited. Eligible individuals at each site (older than 18 years of age, self-identified as the main shoppers for their household, and expressed interest in using a mobile market) were targeted for enrollment. A total of 201 participants at 12 sites participated in the VV program and evaluation, which was implemented from November 2013 to March 2016. MAIN OUTCOME MEASURES Change in F/V intake (cups/day), derived from self-reported responses to the National Cancer Institute F/V screener, was the main outcome measure. STATISTICAL ANALYSES PERFORMED We performed a descriptive analysis of baseline sample characteristics. RESULTS Mean reported F/V intake was 3.4 cups/day. Participants reported generally having some access to fresh F/V, and 57.7% agreed they could afford enough F/V to feed their family. The most frequently cited barriers were cost (55.7%) and time to prepare F/V (20.4%). Self-efficacy was lowest for buying more F/V than usual and trying new vegetables. CONCLUSIONS By addressing cost and convenience and building skills for purchasing and preparing F/V, the VV has the potential to improve F/V consumption in underserved communities.
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82
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Mohamed R. Resident Perceptions of Neighborhood Conditions, Food Access, Transportation Usage, and Obesity in a Rapidly Changing Central City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061201. [PMID: 29880764 PMCID: PMC6025634 DOI: 10.3390/ijerph15061201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/29/2018] [Accepted: 06/04/2018] [Indexed: 11/16/2022]
Abstract
There is a lack of research on obesity that uses primary data and fine-grained information on neighborhoods. I use primary data for 367 participants in Detroit to examine neighborhood predictors of obesity. These data were supplemented with public data. I considered multilevel and spatial modeling, but the data lent itself best to ordinary least squares (OLS) regressions. I find that socioeconomic factors, the built environment, transportation usage, and perceptions of neighborhoods are important predictors of obesity. Importantly, litter is associated with higher levels of obesity. Planners can take measures to reduce litter and collaborate with other policy-makers to encourage less driving, though drawing direct lines of causality is complicated.
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Affiliation(s)
- Rayman Mohamed
- Urban Studies and Planning, Wayne State University, Detroit, MI 48202, USA.
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Besser LM, Rodriguez DA, McDonald N, Kukull WA, Fitzpatrick AL, Rapp SR, Seeman T. Neighborhood built environment and cognition in non-demented older adults: The Multi-Ethnic Study of Atherosclerosis. Soc Sci Med 2018; 200:27-35. [PMID: 29355828 PMCID: PMC5893410 DOI: 10.1016/j.socscimed.2018.01.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/05/2018] [Accepted: 01/08/2018] [Indexed: 12/16/2022]
Abstract
Preliminary studies suggest that neighborhood social and built environment (BE) characteristics may affect cognition in older adults. Older adults are particularly vulnerable to the neighborhood environment due to a decreasing range of routine travel with increasing age. We examined if multiple neighborhood BE characteristics are cross-sectionally associated with cognition in a diverse sample of older adults, and if the BE-cognition associations vary by individual-level demographics. The sample included 4539 participants from the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine the associations between five BE measures and four cognitive measures, and effect modification by individual-level education and race/ethnicity. In the overall sample, increasing social destination density, walking destination density, and intersection density were associated with worse overall cognition, whereas increasing proportion of land dedicated to retail was associated with better processing speed. Effect modification results suggest that the association between urban density and worse cognition may be limited to or strongest in those of non-white race/ethnicity. Although an increase in neighborhood retail destinations was associated with better cognition in the overall sample, these results suggest that certain BE characteristics in dense urban environments may have a disproportionately negative association with cognition in vulnerable populations. However, our findings must be replicated in longitudinal studies and other regional samples.
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Affiliation(s)
- Lilah M Besser
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, 4311 11th Ave NE, Suite 300, Seattle, WA 98105, USA.
| | - Daniel A Rodriguez
- Department of City and Regional Planning, Institute for Transportation Studies, University of California, Berkeley, Office 313B, Wurster Hall #1820, Berkeley, CA, 94720, USA.
| | - Noreen McDonald
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, 317 New East Building, CB 3140, Chapel Hill, NC 27599, USA.
| | - Walter A Kukull
- National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, 4311 11th Ave NE, Suite 300, Seattle, WA 98105, USA.
| | - Annette L Fitzpatrick
- Departments of Family Medicine, Epidemiology and Global Health, University of Washington, 1959 NE Pacific Street, Health Sciences Building, F-350, Box 357230, Seattle, WA 98195, USA.
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
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Hayba N, Partridge SR, Nour MM, Grech A, Allman Farinelli M. Effectiveness of lifestyle interventions for preventing harmful weight gain among young adults from lower socioeconomic status and ethnically diverse backgrounds: a systematic review. Obes Rev 2018; 19:333-346. [PMID: 29178423 DOI: 10.1111/obr.12641] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 09/26/2017] [Accepted: 09/30/2017] [Indexed: 12/18/2022]
Abstract
The incidence of overweight and obesity are increasing with each successive generation of young adults. Associated co-morbidities will emerge at an earlier age unless weight gain is prevented. Evidence has demonstrated young adults (aged 18-35 years) from low socioeconomic and ethnically diverse backgrounds are at greater risk of overweight or obesity, yet it is unclear how to effectively intervene in this population. This systematic review aimed to assess the effectiveness of lifestyle interventions conducted in this population. Thirty studies reporting on lifestyle interventions for prevention of weight gain were identified from eight electronic databases searched. Six interventions included subgroup analyses to determine if ethnicity moderated weight change, and two included subgroup analyses to determine if socioeconomic status had an effect on change in weight. Five of these six studies were effective in preventing weight gain, and subgroup analyses showed no differences in effect by ethnicity. Of these five studies, two included a subgroup analysis that showed socioeconomic status to have no effect on weight outcome. Despite the promising results from these five lifestyle interventions utilizing online and mobile components to effectively reach and prevent weight gain in this priority population, the evidence base of high quality trials is limited.
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Affiliation(s)
- N Hayba
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - S R Partridge
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - M M Nour
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - A Grech
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - M Allman Farinelli
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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85
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Spatial access to food: Retiring the food desert metaphor. Physiol Behav 2018; 193:257-260. [PMID: 29454842 DOI: 10.1016/j.physbeh.2018.02.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 02/06/2018] [Accepted: 02/15/2018] [Indexed: 01/08/2023]
Abstract
The food desert metaphor has been widely used over the past few decades as a way to identify regions as being at risk for having little or no access to healthy food. While the simplicity of the metaphor is attractive, this article argues that its usefulness to researchers interested in understanding the relationship between the geography of healthy food opportunities and dietary behaviours is limited. More nuanced approaches to incorporating geography into food access studies, like including transportation, economic factors, and time use, in addition to considering other dimensions of accessibility, are warranted.
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86
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Pinho MGM, Mackenbach JD, Charreire H, Oppert JM, Bárdos H, Rutter H, Compernolle S, Beulens JWJ, Brug J, Lakerveld J. Spatial access to restaurants and grocery stores in relation to frequency of home cooking. Int J Behav Nutr Phys Act 2018; 15:6. [PMID: 29338756 PMCID: PMC5771126 DOI: 10.1186/s12966-017-0640-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 12/21/2017] [Indexed: 01/10/2023] Open
Abstract
Background Little is known about the relation between the neighbourhood food environment and home cooking. We explored the independent and combined associations between residential neighbourhood spatial access to restaurants and grocery stores with home cooking in European adults. Methods Data of 5076 participants of the SPOTLIGHT study were collected across five European countries in 2014. Food retailers were classified into grocery stores (supermarkets and local food shops) and restaurants (full-service restaurants, fast food and take-away restaurants, café/bars). We used multinomial logistic regression models to test the associations between tertiles of spatial access to restaurants and spatial to access grocery stores and the outcome ‘frequency of home cooking’ categorized into 0-3; 4-5; and 6-7 days/week. Additive interaction analysis was used to test the combined association between access to grocery stores and to restaurants with home cooking. Results Mean age was 52.3 years; most participants were women (55.5%) and completed higher education (53.8%). Residents with highest access to restaurants had a reduced likelihood of home cooking 6-7 days/week (vs. 0-3 days/week) (relative risk ratio (RRR) 0.42; 95%CI = 0.23-0.76) when compared with lowest access to restaurants. No association was found for spatial access to grocery stores. Additive interaction analysis showed that individuals with medium access to grocery stores and highest access to restaurants had the lowest likelihood (RRR = 0.29, 95%CI = 0.10-0.84) of cooking 6-7 days/week when compared to individuals with lowest access to restaurants and highest access to grocery stores. Conclusion Greater neighbourhood spatial access to restaurants was associated with lower frequency of home cooking, largely independent of access to grocery stores. Electronic supplementary material The online version of this article (10.1186/s12966-017-0640-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Gabriela M Pinho
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
| | - Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Hélène Charreire
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Université Paris Est, Créteil, UPEC, Lab-Urba, Créteil, France
| | - Jean-Michel Oppert
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Sorbonne Universités, Université Pierre et Marie Curie, Université Paris 06; Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Helga Bárdos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Harry Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Joline W J Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.,Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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Bhutani S, Schoeller DA, Walsh MC, McWilliams C. Frequency of Eating Out at Both Fast-Food and Sit-Down Restaurants Was Associated With High Body Mass Index in Non-Large Metropolitan Communities in Midwest. Am J Health Promot 2018; 32:75-83. [PMID: 27574335 PMCID: PMC5453830 DOI: 10.1177/0890117116660772] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE We investigated the associations between frequency of eating at fast-food, fast-casual, all-you-can-eat, and sit-down restaurants and the body mass index (BMI) in non-large metro Wisconsin communities. To inform prevention efforts, we also analyzed the socioeconomic/environmental and nutrition attitudes/behavior variables that may drive the frequent eating away from home. DESIGN Cross-sectional analysis of an ancillary data set from the Survey of Health of Wisconsin collected between October 2012 and February 2013. SETTING Six Wisconsin counties: 1 classified as rural, 1 as large fringe metro, and 4 as small metro. SUBJECTS Adults ≥18 years (N = 1418). MEASURES Field staff measured height and weight and administered a survey on the frequency of eating away from home, and socioeconomic and nutritional behavior variables. ANALYSIS Multivariable regression. RESULTS The BMI of respondents averaged 29.4 kg/m2 (39% obese). Every 1-meal/week increase in fast-food and sit-down restaurant consumption was associated with an increase in BMI by 0.8 and 0.6 kg/m2, respectively. Unavailability of healthy foods at shopping and eating venues and lack of cooking skills were both positively associated with consumption of fast-food and sit-down meals. Individuals who described their diet as healthy, who avoided high-fat foods, and who believed their diet was keeping their weight controlled did not visit these restaurants frequently. CONCLUSION Obesity prevention efforts in non-large metro Wisconsin communities should consider socioeconomic/environmental and nutritional attitudes/behavior of residents when designing restaurant-based or community education interventions.
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Affiliation(s)
- Surabhi Bhutani
- Department of Nutritional Sciences, University of Wisconsin,
Madison, Wisconsin, 53706,USA
| | - Dale A Schoeller
- Department of Nutritional Sciences, University of Wisconsin,
Madison, Wisconsin, 53706,USA
| | - Matthew C Walsh
- Department of Population Health Sciences, University of Wisconsin,
School of Medicine and Public Health, Madison, Wisconsin, 53726, USA
| | - Christine McWilliams
- Department of Population Health Sciences, University of Wisconsin,
School of Medicine and Public Health, Madison, Wisconsin, 53726, USA
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88
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Gray MS, Lakkur S, Howard VJ, Pearson K, Shikany JM, Safford M, Gutiérrez OM, Colabianchi N, Judd SE. The Association between Residence in a Food Desert Census Tract and Adherence to Dietary Patterns in the REGARDS Cohort. FOOD AND PUBLIC HEALTH 2018; 8:79-85. [PMID: 31467800 PMCID: PMC6714990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Increased interest in determining areas in need of improved food access led the U.S Department of Agriculture (USDA) to define food desert census tracts; however, no nationwide studies have compared dietary patterns in food desert tracts to other tracts. Our objective was to examine dietary patterns in residents of food desert and non-food desert census tracts. We performed a cross-sectional analysis of 19,179 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled January 2003-October 2007. We used participants' geocoded address with USDA Food Desert Locator to identify food deserts and multivariable-adjusted odds ratios (ORs) to calculate adherence to Southern, Plant-based, and Mediterranean dietary patterns. Odds of adherence to the Southern dietary pattern were higher among white high school graduates (OR=1.41; 95% CI: 1.20-1.67), white college graduates (OR=1.91; 95% CI: 1.55-2.35) and black college graduates (OR=1.38; 95% CI: 1.14-1.68) who reside in a food desert versus non-food desert. Odds of adherence to the Plant-based dietary pattern were 15% lower among non-southeastern residents (OR=0.85; 95% CI: 0.72-0.99), who reside in food desert versus non-food desert. No statistically significant differences were observed for the Mediterranean dietary pattern. Residents living in food deserts had lower adherence to healthy dietary pattern than residents not living in food deserts; the association may vary by race, education, and region.
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Affiliation(s)
- Marquita S. Gray
- Department of Biostatistics, University of Alabama at Birmingham (UAB), Birmingham, AL, USA,Corresponding author: (Marquita S. Gray)
| | - Sindhu Lakkur
- Department of Biostatistics, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | | | - Keith Pearson
- Nutrition and Dietetics, Samford University, Birmingham, AL, USA
| | | | - Monika Safford
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Orlando M. Gutiérrez
- Department of Epidemiology, UAB, Birmingham, AL, USA,Department of Medicine, UAB, Birmingham, AL, USA
| | | | - Suzanne E. Judd
- Department of Biostatistics, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
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89
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Feng X, Astell-Burt T, Badland H, Mavoa S, Giles-Corti B. Modest ratios of fast food outlets to supermarkets and green grocers are associated with higher body mass index: Longitudinal analysis of a sample of 15,229 Australians aged 45 years and older in the Australian National Liveability Study. Health Place 2017; 49:101-110. [PMID: 29253808 DOI: 10.1016/j.healthplace.2017.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 09/24/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Abstract
Food purchasing decisions are made within the context of the range of options available, yet most epidemiological studies focus upon single outlet types. Ratios of fast food outlets to supermarkets and green grocers were linked to addresses of 15,229 adults in the 45 and Up Study at baseline (2006-2008) and follow-up (2009-2010). Compared to having no fast food outlet but having healthy food outlets within 3.2km from home, multilevel growth curves revealed that relative exposure>25% fast food outlets were associated with 0.36-1.19kg/m2 higher BMI (p<0.05). These associations were consistent as people aged. No associations were observed for food outlets<0.8km.
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Affiliation(s)
- Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Australia.
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Australia.
| | - Hannah Badland
- Centre for Urban Research, School of Global, Urban and Social Studies, RMIT University, Australia
| | - Suzanne Mavoa
- Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Billie Giles-Corti
- Centre for Urban Research, School of Global, Urban and Social Studies, RMIT University, Australia
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90
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Rummo PE, Guilkey DK, Ng SW, Meyer KA, Popkin BM, Reis JP, Shikany JM, Gordon-Larsen P. Understanding bias in relationships between the food environment and diet quality: the Coronary Artery Risk Development in Young Adults (CARDIA) study. J Epidemiol Community Health 2017; 71:1185-1190. [PMID: 28983065 PMCID: PMC5713903 DOI: 10.1136/jech-2017-209158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/28/2017] [Accepted: 09/04/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND The relationship between food environment exposures and diet behaviours is unclear, possibly because the majority of studies ignore potential residual confounding. METHODS We used 20 years (1985-1986, 1992-1993 2005-2006) of data from the Coronary Artery Risk Development in Young Adults (CARDIA) study across four US cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; Oakland, California) and instrumental variables (IV) regression to obtain causal estimates of longitudinal associations between the percentage of neighbourhood food outlets (per total food outlets within 1 km network distance of respondent residence) and an a priori diet quality score, with higher scores indicating higher diet quality. To assess the presence and magnitude of bias related to residual confounding, we compared results from causal models (IV regression) to non-causal models, including ordinary least squares regression, which does not account for residual confounding at all and fixed-effects regression, which only controls for time-invariant unmeasured characteristics. RESULTS The mean diet quality score across follow-up was 63.4 (SD=12.7). A 10% increase in fast food restaurants (relative to full-service restaurants) was associated with a lower diet quality score over time using IV regression (β=-1.01, 95% CI -1.99 to -0.04); estimates were attenuated using non-causal models. The percentage of neighbourhood convenience and grocery stores (relative to supermarkets) was not associated with diet quality in any model, but estimates from non-causal models were similarly attenuated compared with causal models. CONCLUSION Ignoring residual confounding may generate biased estimated effects of neighbourhood food outlets on diet outcomes and may have contributed to weak findings in the food environment literature.
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Affiliation(s)
- Pasquale E Rummo
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - David K Guilkey
- Department of Economics, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, Chapel Hill, North Carolina, USA
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, Chapel Hill, North Carolina, USA
| | - Katie A Meyer
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, Chapel Hill, North Carolina, USA
| | - Barry M Popkin
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, Chapel Hill, North Carolina, USA
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, Chapel Hill, North Carolina, USA
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91
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Barrientos-Gutierrez T, Moore KAB, Auchincloss AH, Mujahid MS, August C, Sanchez BN, Diez Roux AV. Neighborhood Physical Environment and Changes in Body Mass Index: Results From the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2017; 186:1237-1245. [PMID: 29206987 PMCID: PMC5860514 DOI: 10.1093/aje/kwx186] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 11/13/2022] Open
Abstract
Longitudinal associations between neighborhood characteristics and body mass index (BMI; weight (kg)/height (m)2) were assessed from 2000 to 2011 among 5,919 participants in the Multi-Ethnic Study of Atherosclerosis. The perceived availability of healthy food and walking environment were assessed via surveys, and 1-mile (1.6-km) densities of supermarkets, fruit-and-vegetable stores, and recreational facilities were obtained through a commercial database. Econometric fixed-effects models were used to estimate the association between within-person changes in neighborhood characteristics and within-person change in BMI. In fully adjusted models, a 1-standard-deviation increase in the healthy food environment index was associated with a 0.16-kg/m2 decrease in BMI (95% confidence interval (CI): -0.27, -0.06) among participants with obesity at baseline. A 1-standard-deviation increase in the physical activity environment index was associated with 0.13-kg/m2 (95% CI: -0.24, -0.02) and 0.14-kg/m2 (95% CI: -0.27, -0.01) decreases in BMI for participants who were overweight and obese at baseline, respectively. Paradoxically, increases in the physical activity index were associated with BMI increases in persons who were normal-weight at baseline. This study provides preliminary longitudinal evidence that favorable changes in neighborhood physical environments are related to BMI reductions in obese persons, who comprise a substantial proportion of the US population.
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Affiliation(s)
| | - Kari A B Moore
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Carmella August
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Brisa N Sanchez
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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92
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Patterns of food and physical activity environments related to children's food and activity behaviors: A latent class analysis. Health Place 2017; 49:19-29. [PMID: 29156415 DOI: 10.1016/j.healthplace.2017.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 10/09/2017] [Accepted: 11/02/2017] [Indexed: 11/20/2022]
Abstract
Relationships between food and physical activity (PA) environments and children's related behaviors are complex. Latent class analyses derived patterns from proximity to healthy and unhealthy food outlets, PA facilities and parks, and counts of residential dwellings and intersections. Regression analyses examined whether derived classes were related to food consumption, PA, and overweight among 404 low-income children. Compared to children living in Low PA-Low Food environments, children in High Intersection&Parks-Moderate Density&Food, and High Density-Low Parks-High Food environments, had significantly greater sugar-sweetened beverage consumption (ps<0.01) and overweight/obesity (ps<0.001). Children in the High Density-Low Parks-High Food environments were more likely to walk to destinations (p = 0.01) Recognizing and leveraging beneficial aspects of neighborhood patterns may be more effective at positively influencing children's eating and PA behaviors compared to isolating individual aspects of the built environment.
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93
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Cooksey-Stowers K, Schwartz MB, Brownell KD. Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1366. [PMID: 29135909 PMCID: PMC5708005 DOI: 10.3390/ijerph14111366] [Citation(s) in RCA: 279] [Impact Index Per Article: 39.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/10/2017] [Accepted: 10/21/2017] [Indexed: 01/14/2023]
Abstract
This paper investigates the effect of food environments, characterized as food swamps, on adult obesity rates. Food swamps have been described as areas with a high-density of establishments selling high-calorie fast food and junk food, relative to healthier food options. This study examines multiple ways of categorizing food environments as food swamps and food deserts, including alternate versions of the Retail Food Environment Index. We merged food outlet, sociodemographic and obesity data from the United States Department of Agriculture (USDA) Food Environment Atlas, the American Community Survey, and a commercial street reference dataset. We employed an instrumental variables (IV) strategy to correct for the endogeneity of food environments (i.e., that individuals self-select into neighborhoods and may consider food availability in their decision). Our results suggest that the presence of a food swamp is a stronger predictor of obesity rates than the absence of full-service grocery stores. We found, even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates. All three food swamp measures indicated the same positive association, but reflected different magnitudes of the food swamp effect on rates of adult obesity (p values ranged from 0.00 to 0.16). Our adjustment for reverse causality, using an IV approach, revealed a stronger effect of food swamps than would have been obtained by naïve ordinary least squares (OLS) estimates. The food swamp effect was stronger in counties with greater income inequality (p < 0.05) and where residents are less mobile (p < 0.01). Based on these findings, local government policies such as zoning laws simultaneously restricting access to unhealthy food outlets and incentivizing healthy food retailers to locate in underserved neighborhoods warrant consideration as strategies to increase health equity.
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Affiliation(s)
- Kristen Cooksey-Stowers
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT 06103, USA.
| | - Marlene B Schwartz
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT 06103, USA.
| | - Kelly D Brownell
- Sanford School of Public Policy, Duke University, Durham, NC 27708, USA.
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94
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Fruit and vegetable intake among participants in a District of Columbia farmers’ market incentive programme. Public Health Nutr 2017; 21:601-606. [DOI: 10.1017/s1368980017003020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective
Limited research is available on whether participation in healthy food incentive programmes is associated with higher fruit and vegetable intake. The objective of the present study was to determine fruit and vegetable intake among participants in the Produce Plus Program, a farmers’ market-based healthy food incentive programme in Washington, DC, and identify demographic and behavioural factors associated with higher fruit and vegetable intake.
Design
Using a cross-sectional survey, programme participants were interviewed at markets across DC between June and September 2015. Questions included the Behavioral Risk Factor Surveillance System (BRFSS) fruit and vegetable module. Fruit and vegetable intake among 2013 DC BRFSS participants reporting annual household incomes of ≤$US 35 000 was calculated for context.
Setting
Washington, DC, USA.
Subjects
Participants (n 288) in the Produce Plus Program.
Results
On average, participants reported consuming both fruits (interquartile range: 1·0–3·0) and vegetables (interquartile range: 1·3–3·5) two times/d. Participants who reported eating home-cooked meals ≥3 times/week also reported higher median fruit (2·0 v. 0·8) and vegetable (2·3 v. 1·3) intake compared with those eating home-cooked meals less frequently. No statistically significant differences in reported median fruit or vegetable intake were observed over the course of the farmers’ market (June v. August/September) season.
Conclusions
Produce Plus Program participants reported higher median fruit and vegetable intake compared with DC BRFSS respondents with similar incomes, but still below recommended levels. More frequent home-cooked meals were associated with higher fruit and vegetable intake. Thus, efforts to increase home cooking may represent an opportunity to increase fruit and vegetable intake among healthy food incentive participants.
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95
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Zagorsky JL, Smith PK. The association between socioeconomic status and adult fast-food consumption in the U.S. ECONOMICS AND HUMAN BIOLOGY 2017; 27:12-25. [PMID: 28472714 DOI: 10.1016/j.ehb.2017.04.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 03/13/2017] [Indexed: 06/07/2023]
Abstract
Health follows a socioeconomic status (SES) gradient in developed countries, with disease prevalence falling as SES rises. This pattern is partially attributed to differences in nutritional intake, with the poor eating the least healthy diets. This paper examines whether there is an SES gradient in one specific aspect of nutrition: fast-food consumption. Fast food is generally high in calories and low in nutrients. We use data from the 2008, 2010, and 2012 waves of the National Longitudinal Survey of Youth (NLSY79) to test whether adult fast-food consumption in the United States falls as monetary resources rise (n=8136). This research uses more recent data than previous fast-food studies and includes a comprehensive measure of wealth in addition to income to measure SES. We find little evidence of a gradient in adult fast-food consumption with respect to wealth. While adults in the highest quintile are 54.5% less likely to report fast-food consumption than those in the lowest quintile, adults in the second and third quintiles are no less likely to report fast food-food intake than the poorest. Contrary to popular belief, fast-food consumption rises as income rises from the lowest to middle quintiles. The variation in adult fast-food consumption across income and wealth groups is, however, small. Those in the wealthiest quintile ate about one less fast-food meal on average than those in the lowest quintile. Other factors play a bigger role in explaining fast-food consumption: reading ingredient labels is negatively associated while soda consumption and hours of work are positively associated with fast-food consumption.
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Affiliation(s)
- Jay L Zagorsky
- Center for Human Resource Research, The Ohio State University, 921 Chatham Lane, Suite 100, Columbus, OH 43221, USA.
| | - Patricia K Smith
- Department of Social Sciences, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI 48128, USA.
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96
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Wilde P, Steiner A, Ver Ploeg M. For Low-Income Americans, Living ≤1 Mile (≤1.6 km) from the Nearest Supermarket Is Not Associated with Self-Reported Household Food Security. Curr Dev Nutr 2017; 1:e001446. [PMID: 29955686 PMCID: PMC5998793 DOI: 10.3945/cdn.117.001446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/11/2017] [Accepted: 10/15/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Motivated by concern over lack of access to nutritious food in low-income neighborhoods, healthy food financing initiatives have encouraged the introduction of new supermarkets. Extensive research on the association between the food retail environment and nutrition outcomes has shown mixed results. There has been less research specifically on food security outcomes. Objective: We assessed the association between multiple food environment measures and food security for low-income US households. Methods: By using the USDA's nationally representative 2012-2013 Food Acquisition and Purchase Survey (FoodAPS; n = 4826 households), which provides unique information about neighborhood- and household-level food retailer access, we quantified cross-sectional associations between food environment characteristics and household-level outcomes, with and without regression controls. Logistic regression analysis was used for binary household food security outcomes. Results: Most households bypassed the nearest retailer to select a primary retailer farther from home. For low-income households, distance to the nearest supermarket and to the primary retailer was not associated with food security. In comparison to shopping with households' own automobile, the odds of being food secure were lower for households that used another automobile (OR: 0.59; 95% CI: 0.38, 0.90) or other transportation (OR: 0.32; 95% CI: 0.17, 0.61) to reach the primary retailer. Conclusions: Having a closest supermarket ≤1 mile from home was not associated with household food security. In contrast, the mode of transportation used to access the primary retailer was associated with household food security. In future research, it may be valuable to not only focus on the distance to the nearest supermarket but to investigate the qualities of the food retail environment at distances >1 mile that are most strongly associated with food security outcomes.
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Affiliation(s)
- Parke Wilde
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Abigail Steiner
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Michele Ver Ploeg
- Food Economics Division, Economic Research Service, USDA, Washington, DC
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97
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Trapl ES, Pike SN, Borawski E, Flocke SA, Freedman DA, Walsh CC, Schneider C, Yoder L. Food Melt in Consumer Food Environments in Low-income Urban Neighborhoods. Am J Health Behav 2017; 41:710-718. [PMID: 29025499 PMCID: PMC10941207 DOI: 10.5993/ajhb.41.6.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We systematically evaluated changes in availability, price, and quality of perishable food items from the beginning to the end of the month in lowincome, urban neighborhoods. METHODS The sample included grocery stores or supermarkets in Cleveland, Ohio, within neighborhoods with >30% of population receiving food assistance. We collected data for 2 sequential months during the first and fourth weeks of each month. Two coders evaluated stores, collecting measures of availability, price, and quality for 50 items. We examined difference in number and proportion of items available at the beginning of the month (BOM) to items remaining available at the end of the month (EOM), as well as quality and price of those items. RESULTS Across 48 stores, availability at EOM was lower than BOM; as store size increased, reduction in availability (ie, food melt) was significantly (p < .01) less pronounced. Overall, items became less expensive at the EOM whereas quality remained consistent; we noted no statistically significant differences by store type for price or quality. CONCLUSIONS Food melt differentially affects individuals in neighborhoods without grocery stores. Findings reveal composition of food environments is dynamic rather than static, influencing food-purchasing choices among lowincome consumers.
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Affiliation(s)
- Erika S Trapl
- Assistant Professor, Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio;,
| | - Stephanie N Pike
- Research Associate, Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Elaine Borawski
- Professor, Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Susan A Flocke
- Associate Professor, Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Darcy A Freedman
- Associate Professor, Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland, Ohio
| | - Colleen C Walsh
- Assistant Professor, Cleveland State University, Cleveland, Ohio
| | | | - Laura Yoder
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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98
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Bernsdorf KA, Lau CJ, Andreasen AH, Toft U, Lykke M, Glümer C. Accessibility of fast food outlets is associated with fast food intake. A study in the Capital Region of Denmark. Health Place 2017; 48:102-110. [PMID: 29031108 DOI: 10.1016/j.healthplace.2017.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 09/22/2017] [Accepted: 10/03/2017] [Indexed: 11/30/2022]
Abstract
Literature suggests that people living in areas with a wealth of unhealthy fast food options may show higher levels of fast food intake. Multilevel logistic regression analyses were applied to examine the association between GIS-located fast food outlets (FFOs) and self-reported fast food intake among adults (+ 16 years) in the Capital Region of Denmark (N = 48,305). Accessibility of FFOs was measured both as proximity (distance to nearest FFO) and density (number of FFOs within a 1km network buffer around home). Odds of fast food intake ≥ 1/week increased significantly with increasing FFO density and decreased significantly with increasing distance to the nearest FFO for distances ≤ 4km. For long distances (>4km), odds increased with increasing distance, although this applied only for car owners. Results suggest that Danish health promotion strategies need to consider the contribution of the built environment to unhealthy eating.
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Affiliation(s)
- Kamille Almer Bernsdorf
- Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet - Glostrup, Nordre Ringvej 57, Section 84/85, 2600 Glostrup, Denmark.
| | - Cathrine Juel Lau
- Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet - Glostrup, Nordre Ringvej 57, Section 84/85, 2600 Glostrup, Denmark.
| | - Anne Helms Andreasen
- Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet - Glostrup, Nordre Ringvej 57, Section 84/85, 2600 Glostrup, Denmark.
| | - Ulla Toft
- Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet - Glostrup, Nordre Ringvej 57, Section 84/85, 2600 Glostrup, Denmark.
| | - Maja Lykke
- Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet - Glostrup, Nordre Ringvej 57, Section 84/85, 2600 Glostrup, Denmark.
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Capital Region of Denmark, Rigshospitalet - Glostrup, Nordre Ringvej 57, Section 84/85, 2600 Glostrup, Denmark; Department of Health Sciences and Technology, Aalborg University, Fredrik Bayers vej 7D2, DK-9220 Aalborg, Denmark.
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99
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Machado PP, Claro RM, Canella DS, Sarti FM, Levy RB. Price and convenience: The influence of supermarkets on consumption of ultra-processed foods and beverages in Brazil. Appetite 2017; 116:381-388. [DOI: 10.1016/j.appet.2017.05.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/25/2017] [Accepted: 05/15/2017] [Indexed: 12/26/2022]
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McCloud RF, Kohler RE, Viswanath K. Cancer Risk-Promoting Information: The Communication Environment of Young Adults. Am J Prev Med 2017; 53:S63-S72. [PMID: 28818248 DOI: 10.1016/j.amepre.2017.03.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/07/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
Young adulthood represents a time of myriad transitions, which leave young adults (YAs) more susceptible to the influences of cancer risk-promoting information. The tobacco, alcohol, indoor tanning, and food and beverage industries engage in aggressive marketing strategies through both traditional and social media to target this age group to consume their products, which have known links to cancer. Despite this barrage of messaging, detailed data are lacking on the communication behaviors of subgroups of this diverse age group, particularly those from low SES. This paper explores the available data on media usage among YAs and describes the cancer risk-promoting information environment, with a focus on communication inequalities and their implications for cancer research and control. Nationally representative data on media consumption patterns indicate that the majority of YAs access a diverse range of traditional and social media platforms, but these data do not fully describe differences at the intersection of age and important factors such as SES, gender, race/ethnicity, or urban/rural residence. Meanwhile, risk-promoting information is heavily marketed to YAs across media, with an increasing focus on using social media sites to normalize products and evade marketing restrictions. Gaps in the available data on YAs' media consumption behaviors, coupled with aggressive risk-promoting marketing strategies toward YAs, may impede cancer control efforts. Relationships between exposure to various cancer risk-promoting information, concurrent risk behaviors, SES disparities, and communication inequalities should be investigated to develop innovative and effective control programs and policies to promote cancer control in this important group.
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Affiliation(s)
- Rachel F McCloud
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts.
| | - Racquel E Kohler
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - K Viswanath
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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