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Lozano PM, Bobb JF, Kapos FP, Cruz M, Mooney SJ, Hurvitz PM, Anau J, Theis MK, Cook A, Moudon AV, Arterburn DE, Drewnowski A. Residential Density Is Associated With BMI Trajectories in Children and Adolescents: Findings From the Moving to Health Study. AJPM FOCUS 2024; 3:100225. [PMID: 38682047 PMCID: PMC11046231 DOI: 10.1016/j.focus.2024.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Introduction This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents. Methods This retrospective cohort study utilized electronic health records of individuals aged 5-18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure). Results At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years. Conclusions Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.
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Affiliation(s)
- Paula Maria Lozano
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Jennifer F. Bobb
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Flavia P. Kapos
- Department of Orthopaedic Surgery and Duke Clinical Research Institute, Duke School of Medicine, Durham, North Carolina
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Maricela Cruz
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Stephen J. Mooney
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington
| | - Philip M. Hurvitz
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, Washington
- Center for Studies in Demography & Ecology, University of Washington, Seattle, Washington
| | - Jane Anau
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Mary Kay Theis
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Andrea Cook
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Anne Vernez Moudon
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, Washington
| | - David E. Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Adam Drewnowski
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
- Center for Public Health Nutrition, University of Washington, Seattle, Washington
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Ganasegeran K, Abdul Manaf MR, Safian N, Waller LA, Abdul Maulud KN, Mustapha FI. GIS-Based Assessments of Neighborhood Food Environments and Chronic Conditions: An Overview of Methodologies. Annu Rev Public Health 2024; 45:109-132. [PMID: 38061019 DOI: 10.1146/annurev-publhealth-101322-031206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The industrial revolution and urbanization fundamentally restructured populations' living circumstances, often with poor impacts on health. As an example, unhealthy food establishments may concentrate in some neighborhoods and, mediated by social and commercial drivers, increase local health risks. To understand the connections between neighborhood food environments and public health, researchers often use geographic information systems (GIS) and spatial statistics to analyze place-based evidence, but such tools require careful application and interpretation. In this article, we summarize the factors shaping neighborhood health in relation to local food environments and outline the use of GIS methodologies to assess associations between the two. We provide an overview of available data sources, analytical approaches, and their strengths and weaknesses. We postulate next steps in GIS integration with forecasting, prediction, and simulation measures to frame implications for local health policies.
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Affiliation(s)
- Kurubaran Ganasegeran
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
- Clinical Research Center, Seberang Jaya Hospital, Ministry of Health Malaysia, Penang, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
| | - Nazarudin Safian
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Khairul Nizam Abdul Maulud
- Earth Observation Centre (EOC), Institute of Climate Change, Universiti Kebangsaan Malaysia, Selangor Darul Ehsan, Malaysia
- Department of Civil Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia, Selangor Darul Ehsan, Malaysia
| | - Feisul Idzwan Mustapha
- Public Health Division, Perak State Health Department, Ministry of Health Malaysia, Perak, Malaysia
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Onufrak SJ, Moore LV, Pierce SL, MacGowan CA, Galuska DA. Changes in Policy Supports for Healthy Food Retailers, Farmers Markets, and Breastfeeding Among US Municipalities, 2014-2021: National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS-HEAL). Prev Chronic Dis 2023; 20:E73. [PMID: 37590900 PMCID: PMC10457115 DOI: 10.5888/pcd20.230018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Policies and practices at the local level can help reduce chronic disease risk by providing environments that facilitate healthy decision-making about diet. METHODS We used data from the 2014 and 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living to examine prevalence among US municipalities of policies to support access to healthier food in supermarkets, convenience stores, and farmers markets, as well as policies to support breastfeeding among government employees. Chi-square tests were conducted to compare prevalence estimates from 2021 to 2014 overall and according to municipal characteristics. RESULTS In 2021, 29% of municipalities had at least 1 policy to encourage full-service grocery stores to open stores, which was not significantly different from 31% in 2014. Prevalence of having at least 1 policy to help corner stores sell healthier foods declined significantly from 13% in 2014 to 9% in 2021. Prevalence of policies providing all local government employees who were breastfeeding breaktime and space to pump breast milk increased significantly from 25% in 2014 to 52% in 2021. The percentage of municipalities that provided 8 or more weeks of paid maternity leave for employees increased significantly from 16% in 2014 to 19% in 2021. CONCLUSION Prevalence of supports for supermarkets, convenience stores, and farmers markets generally did not increase among US municipalities from 2014 to 2021, while some supports for breastfeeding among municipal employees increased during this time. Opportunities exist to improve municipal-level policies that support healthy eating and breastfeeding among community residents and employees.
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Affiliation(s)
- Stephen J Onufrak
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 3679 Hermitage Dr, Berkeley Lake, Georgia 30096
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Samantha L Pierce
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carol A MacGowan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deborah A Galuska
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Venkatesh KK, Walker DM, Yee LM, Wu J, Garner J, McNeil B, Haas DM, Mercer B, Reddy UM, Silver R, Wapner R, Saade G, Parry S, Simhan H, Lindsay K, Grobman WA. Association of Living in a Food Desert and Poor Periconceptional Diet Quality in a Cohort of Nulliparous Pregnant Individuals. J Nutr 2023; 153:2432-2441. [PMID: 37364682 PMCID: PMC10447609 DOI: 10.1016/j.tjnut.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND A poor diet can result from adverse social determinants of health and increases the risk of adverse pregnancy outcomes. OBJECTIVE We aimed to assess, using data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be prospective cohort, whether nulliparous pregnant individuals who lived in a food desert were more likely to experience poorer periconceptional diet quality compared with those who did not live in a food desert. METHODS The exposure was living in a food desert based on a spatial overview of food access indicators by income and supermarket access per the Food Access Research Atlas. The outcome was periconceptional diet quality per the Healthy Eating Index (HEI)-2010, analyzed by quartile (Q) from the highest or best (Q4, reference) to the lowest or worst dietary quality (Q1); and secondarily, nonadherence (yes or no) to 12 key aspects of dietary quality. RESULTS Among 7,956 assessed individuals, 24.9% lived in a food desert. The mean HEI-2010 score was 61.1 of 100 (SD: 12.5). Poorer periconceptional dietary quality was more common among those who lived in a food desert compared with those who did not live in a food desert (Q4: 19.8%, Q3: 23.6%, Q2: 26.5%, and Q1: 30.0% vs. Q4: 26.8%, Q3: 25.8%, Q2: 24.5%, and Q1: 22.9%; overall P < 0.001). Individuals living in a food desert were more likely to report a diet in lower quartiles of the HEI-2010 (i.e., poorer dietary quality) (aOR: 1.34 per quartile; 95% CI: 1.21, 1.49). They were more likely to be nonadherent to recommended standards for 5 adequacy components of the HEI-2010, including fruit, total vegetables, greens and beans, seafood and plant proteins, and fatty acids, and less likely to report excess intake of empty calories. CONCLUSIONS Nulliparous pregnant individuals living in a food desert were more likely to experience poorer periconceptional diet quality compared with those who did not live in a food desert.
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Affiliation(s)
- Kartik K Venkatesh
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States.
| | - Daniel M Walker
- Department of Family and Community Medicine, The Ohio State University, Columbus, OH, United States
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, United States
| | - Jiqiang Wu
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States
| | - Jennifer Garner
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, United States
| | | | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, United States
| | - Brian Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, United States
| | - Uma M Reddy
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States
| | - Robert Silver
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, United States
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States
| | - George Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, United States
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, United States
| | - Hyagriv Simhan
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsbugh, PA, United States
| | - Karen Lindsay
- UCI Susan Samueli Integrative Health Institute, Susan & Henry Samueli College of Health Sciences, University of California, Irvine, CA, United States; Department of Pediatrics, Division of Endocrinology, University of California, Irvine; School of Medicine, Orange, CA, United States
| | - William A Grobman
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States
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Baidal JAW, Duong N, Goldsmith J, Hur C, Lauren BN, Partida I, Rosenthal A, Hulse E, Shea S, Cheung K, Meyer D. Association of a primary care-based mobile food pantry with child body mass index: A propensity score matched cohort study. Pediatr Obes 2023; 18:e13023. [PMID: 36939408 PMCID: PMC10159907 DOI: 10.1111/ijpo.13023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE To test the hypothesis that children in Food FARMacia-a six-month food insecurity intervention from May 2019 to January 2020-would have smaller age-adjusted, sex-specific body mass index (BMIz) gains than matched counterparts. METHODS In this proof-of-concept study, we performed a difference-in-differences (DiD) analysis of a propensity-score matched cohort among paediatric primary care patients aged <6 years with household food insecurity. Children with anthropometric measures prior to and after intervention started were included. The main outcome was child BMIz from standardized clinical anthropometric measurements. We examined differences in child BMIz change between Food FARMacia participants and matched non-participants. RESULTS Among 454 children with household food insecurity, 265 were included, 44 of whom were in Food FARMacia. Mean child age was 1.48 (SD 1.46) years and most reported Hispanic/Latino ethnicity (84.5%). After propensity score matching, children in Food FARMacia had smaller increases in BMIz (unadjusted DiD -0.28 [-0.52, -0.04]) compared to non-participants in the follow-up period. After adjusting for potential confounders, findings remained statistically significant [adjusted DiD, -0.31 units (95% CI: -0.54, -0.08)]. CONCLUSIONS In this proof-of-concept cohort study of children in households with food insecurity, a paediatric primary care-based mobile food pantry program was associated with improvement in child BMIz over 6 months.
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Affiliation(s)
- Jennifer A. Woo Baidal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, USA
| | - Ngoc Duong
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jeff Goldsmith
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Chin Hur
- Department of Medicine, Columbia University, New York, NY, USA
| | | | - Ivette Partida
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Emma Hulse
- Division of Community and Population Health, NewYork-Presbyterian, New York, NY, USA
| | - Steven Shea
- Department of Medicine, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Ken Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Dodi Meyer
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
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Appelhans BM. The Cognitive Burden of Poverty: A Mechanism of Socioeconomic Health Disparities. Am J Prev Med 2023; 64:293-297. [PMID: 36180316 PMCID: PMC10176429 DOI: 10.1016/j.amepre.2022.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/12/2022] [Accepted: 08/19/2022] [Indexed: 01/21/2023]
Affiliation(s)
- Bradley M Appelhans
- From the Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, Illinois; and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois.
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Rick C, Han J, Elbel B, Schwartz AE. The link between gentrification, children's egocentric food environment, and obesity. HOUSING POLICY DEBATE 2022; 33:85-106. [PMID: 37261106 PMCID: PMC10229138 DOI: 10.1080/10511482.2022.2125788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 06/02/2023]
Abstract
While advocates argue that gentrification changes the neighborhood food environment critical to children's diet and health, we have little evidence documenting such changes or the consequences for their health outcomes. Using rich longitudinal, individual-level data on nearly 115,000 New York City children, including egocentric measures of their food environment and BMI, we examine the link between neighborhood demographic change ("gentrification"), children's access to restaurants and supermarkets, and their weight outcomes. We find that children in rapidly gentrifying neighborhoods see increased access to fast food and wait-service restaurants and reduced access to corner stores and supermarkets compared to those in non-gentrifying areas. Boys and girls have higher BMI following gentrification, but only boys are more likely to be obese or overweight. We find public housing moderates the relationship between gentrification and weight, as children living in public housing are less likely to be obese or overweight.
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Affiliation(s)
| | - Jeehee Han
- Bush School of Government and Public Service, Texas A&M University, College Station, TX, USA
| | - Brian Elbel
- Wagner Graduate School of Public Service and Grossman School of Medicine, New York University, New York, NY, USA
| | - Amy Ellen Schwartz
- Biden School of Public Policy and Administration, University of Delaware, Newark, DE, USA
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Affiliation(s)
- Marion Nestle
- Department of Nutrition and Food Studies, New York University, New York
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Deemer SE, Owora AH, Allison DB. Taking a Hard Look at the Empirical Evidence for Popular Community-Based Interventions in Obesity. JAMA Pediatr 2022; 176:639-641. [PMID: 35532910 DOI: 10.1001/jamapediatrics.2022.1150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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