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Kim Y, Rangel J, Colabianchi N. Food Environments and Cardiovascular Disease: Evidence From the Health and Retirement Study. Am J Prev Med 2024; 67:201-209. [PMID: 38484903 DOI: 10.1016/j.amepre.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Residential food environments are one of the important determinants of cardiovascular health. However, past literature has been limited by short-term follow-ups, time-invariant environmental measurements at baseline, and/or not investigating both healthy and unhealthy aspects of the food environment. This study examines the effects of time-varying healthy and unhealthy food environments on incident cardiovascular disease (CVD) over 10 years, extracting data from the Health and Retirement Study (2006-2016; N=10,413). METHODS Cox proportional hazards modeling was performed with inverse probability weighting to assess the association between time-varying food environmental measures (i.e., densities of grocery stores, supercenters/club stores, full-service restaurants, and fast-food restaurants) and incident CVD over 10 years. Education level and race/ethnicity were tested as potential moderators. Analyses were conducted in 2022-2023. RESULTS Race/ethnicity had a significant interaction effect with supercenters/club stores and indicated that a 1-standard-deviation increase in the density of supercenters/club stores was associated with a 6%-8% lower risk of incident CVD in non-Hispanic Black (HR=0.78, 95% CI=0.70-0.87) and Hispanic older adults (HR=0.69, 95% CI=0.50-0.96), but not non-Hispanic White older adults. Additionally, education had a significant interaction effect with full-service restaurants, indicating that a 1-standard-deviation increase in the density of full-service restaurants was associated with a 10% lower risk of incident CVD in individuals with 13+ years of schooling, but not those with 0-12 years of schooling. CONCLUSIONS Findings suggest that public policymakers should be aware of the benefits and nuances of varying food environment components as they can contribute to positive or negative cardiovascular health.
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Affiliation(s)
- Yeonwoo Kim
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas; School of Social Work, University of Texas at Arlington, Arlington, Texas.
| | - Joseph Rangel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
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Bodnar LM, Odoms-Young A, Kirkpatrick SI, Naimi AI, Petersen JM, Martin CL. Experiences of Racial Discrimination and Periconceptional Diet Quality. J Nutr 2023; 153:2369-2379. [PMID: 37271415 PMCID: PMC10447608 DOI: 10.1016/j.tjnut.2023.05.028] [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: 02/02/2023] [Revised: 04/18/2023] [Accepted: 05/31/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Racism is a key determinant of perinatal health disparities. Poor diet may contribute to this effect, but research on racism and dietary patterns is limited. OBJECTIVE We aimed to describe the relation between experiences of racial discrimination and adherence to the 2015‒2020 Dietary Guidelines for Americans. METHODS We used data from a prospective pregnancy cohort study conducted at 8 United States medical centers (2010‒2013). At 6‒13 weeks of gestation, 10,038 nulliparous people with singleton pregnancies were enrolled. Participants completed a Block food frequency questionnaire, assessing usual diet in the 3 mo around conception, and the Krieger Experiences of Discrimination Scale, assessing the number of situational domains (e.g., at school and on the street) in which participants ever experienced racial discrimination. Alignment of dietary intake with the 2015-2020 Dietary Guidelines for Americans was assessed using the Healthy Eating Index (HEI)-2015. RESULTS The study showed that 49%, 44%, 35%, and 17% of the Asian, Black, Hispanic, and White participants reported experiences of racial discrimination in any domain. Most participants experienced discrimination in 1 or 2 situational domains. There were no meaningful differences in HEI-2015 total or component scores in any racial or ethnic group according to count of self-reported domains in which individuals experienced discrimination. For example, mean total scores were 57‒59 among Black, 61‒66 among White, 61‒63 among Hispanic, and 66‒69 among Asian participants across the count of racial discrimination domains. CONCLUSIONS This null association stresses the importance of going beyond interpersonal racial discrimination to consider the institutions, systems, and practices affecting racialized people to eliminate persistent inequalities in diet and perinatal health.
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Affiliation(s)
- Lisa M Bodnar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
| | | | - Sharon I Kirkpatrick
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Ashley I Naimi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Julie M Petersen
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Chantel L Martin
- Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC
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Herbozo S, Brown KL, Burke NL, LaRose JG. A Call to Reconceptualize Obesity Treatment in Service of Health Equity: Review of Evidence and Future Directions. Curr Obes Rep 2023; 12:24-35. [PMID: 36729299 PMCID: PMC9894524 DOI: 10.1007/s13679-023-00493-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW Rates of obesity and associated comorbidities are higher among Black and Latino adults compared to white adults. We sought to provide an overview of both structural and individual factors contributing to obesity inequities and synthesize available evidence regarding treatment outcomes in Black and Latino adults, with an eye towards informing future directions. RECENT FINDINGS Obesity disparities are influenced by myriad systemic issues, yet the vast majority of interventions target individual-level factors only, and most behavioral treatments fail to target drivers beyond eating and physical activity. Extant treatments are not equally accessible, affordable, or effective among Black and Latino adults compared with white counterparts. Asset-based, culturally relevant interventions that target the root causes of obesity and address intersectional stress-designed in partnership with intended beneficiaries-are urgently needed. Treatment trials must improve enrollment of Black and Latino adults and report treatment outcomes by race and ethnicity.
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Affiliation(s)
- Sylvia Herbozo
- Department of Surgery, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Illinois at Chicago, Chicago, USA.
- Department of Psychiatry and Behavioral Sciences and Department of Surgery, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL, 60612, USA.
| | - Kristal Lyn Brown
- Division of General Internal Medicine, School of Medicine, The Johns Hopkins University, Baltimore, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, The Bronx, USA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
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Ayala GX, Pickrel JL, Baquero B, Sanchez-Flack J, Lin SF, Belch G, Rock CL, Linnan L, Gittelsohn J, Ji M, Elder JP, Mayer J. The El Valor de Nuestra Salud clustered randomized controlled trial store-based intervention to promote fruit and vegetable purchasing and consumption. Int J Behav Nutr Phys Act 2022; 19:19. [PMID: 35177070 PMCID: PMC8851758 DOI: 10.1186/s12966-021-01220-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/25/2021] [Indexed: 12/14/2022] Open
Abstract
Background Modifying the environment to promote healthy foods is a population-based approach for improving diet. This study evaluated the outcome effectiveness of a food store intervention that used structural and social change strategies to promote fruits and vegetables. It was hypothesized that intervention versus control store customers would improve their consumption of fruits and vegetables at 6 months. Trial design Clustered randomized controlled trial Methods Sixteen pair-matched stores were randomized to an intervention or wait-list control condition. With the research team’s support, intervention stores modified the availability, accessibility, and promotion of fruits and vegetables, including augmenting produce displays within the store and building employees’ capacity to place and promote fruits and vegetables throughout the store (Phase 1), followed by the delivery of a customer-directed marketing campaign for 6 months (Phase 2). From months 7 to 12, stores were encouraged to maintain strategies on their own (Phase 3). Customer-reported daily fruit and vegetable consumption (cups/day) were collected by blinded research assistants at three time-points (baseline, 6 months and 12 months post-baseline) from 369 participating customers (an average of 23/store). Secondary outcomes included customer-reported fruit and vegetable purchasing and other behaviors. Results The study retained the 16 stores and most customers at 6 (91%) and 12 (89%) months. Although significant differences were not observed in the overall sample for vegetable consumption, male customers of intervention versus control stores consumed significantly more fruit daily at 6 months [mean (standard deviation) cups at baseline and six months; intervention: 1.6 (1.5) to 1.6 (1.5) vs. control: 1.4 (1.2) to 1.1 (0.8)]. However, this difference was not observed at 12 months, or among females. There was an overall increase in dollars spent at the targeted store in the intervention versus control condition among male versus female customers at 6 months; however, no change was observed in the percent of dollars spent on fruits and vegetables at the targeted store. Frequency of shopping at the targeted store did not modify intervention effects. Conclusions Structural and social change interventions can modify customers’ behavior in the short-term. Future research should consider methods for achieving longer-term changes, and potential generalizability to other products (e.g., energy-dense sweet and savory products). Trial registration NCT01475526 Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01220-w.
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Affiliation(s)
- Guadalupe X Ayala
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA. .,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA.
| | - Julie L Pickrel
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Barbara Baquero
- Health System and Population Health, School of Public Health, University of Washington, Box 35480, Seattle, WA, 98195, USA
| | - Jennifer Sanchez-Flack
- Department of Pediatrics, University of Illinois Cancer Center, Chicago, USA.,Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, WROB 478, Chicago, IL, 60608, USA
| | - Shih-Fan Lin
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - George Belch
- Marketing Department, Fowler College of Business, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Cheryl L Rock
- Department of Family Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive #0901, La Jolla, CA, 92093, USA
| | - Laura Linnan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 359 Rosenau Hall, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599, USA
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD, 21205-2179, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL, 12901, USA
| | - John P Elder
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
| | - Joni Mayer
- Division of Health Promotion and Behavioral Sciences, School of Public Health, San Diego State University, San Diego, USA.,Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA, 92123, USA
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Shvetsov YB, Shariff-Marco S, Yang J, Conroy SM, Canchola AJ, Albright CL, Park SY, Monroe KR, Le Marchand L, Gomez SL, Wilkens LR, Cheng I. Association of change in the neighborhood obesogenic environment with colorectal cancer risk: The Multiethnic Cohort Study. SSM Popul Health 2020; 10:100532. [PMID: 31909167 PMCID: PMC6940713 DOI: 10.1016/j.ssmph.2019.100532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022] Open
Abstract
Background Neighborhood environment has been associated with health behaviors. Despite the evidence of the influence of neighborhood social and physical factors on cancer risk, no research has evaluated whether changes in the neighborhood obesogenic environment, either by physical moves to different neighborhoods or experiencing neighborhood redevelopment or neglect, affect cancer risk. Methods The association of change in neighborhood environment attributes (socioeconomic status, population density, restaurant and retail food environments, numbers of recreational facilities and businesses, commute patterns, traffic density, and street connectivity) with colorectal cancer (CRC) risk was examined among 95,472 Los Angeles, CA, Multiethnic Cohort participants, including 2295 invasive CRC cases diagnosed between 1993 and 2010 using Cox proportional hazards regression, adjusting for age, race/ethnicity, other risk factors including BMI and physical activity, and baseline levels of neighborhood attributes. Stratified analyses were conducted by racial/ethnic group and moving status. Results 40% of participants moved (changed physical residence) during follow-up. Across all races/ethnicities, upward change in population density was statistically significantly associated with higher CRC risk among male and female non-movers (HR: 1.35 and 1.41, respectively). The same association was also observed separately among female African American and Japanese American non-movers, male Latino non-movers, female African American and male White movers. Downward change in population density was significantly related to higher CRC risk among female non-movers (HR: 1.33). Downward change in traffic density was associated with lower CRC risk among male non-movers but with higher CRC risk among female movers (HR: 0.66 and 1.43, respectively). Downward changes in street connectivity or the number of recreational facilities were associated with higher CRC risk (HR: 1.34 and 1.54, respectively). Upward change in the number of recreational facilities was associated with lower CRC risk among female non-movers (HR: 0.70). Changes in the other neighborhood attributes did not exhibit significant associations with CRC risk within more than one racial/ethnic group. Conclusion Changes over time in neighborhood attributes have an effect on the risk of colorectal cancer, which is separate from the baseline levels of the same attributes and individual-level risk factors, and differs between sexes, movers and non-movers and across racial/ethnic groups. A person's neighborhood environment can change due to physical moves or neighborhood redevelopment. Association of change in neighborhood environment with colorectal cancer risk was examined. The California part of the Multiethnic Cohort was used for the analysis. Upward change in population density was associated with higher colorectal cancer risk among non-movers.
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Affiliation(s)
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Juan Yang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Shannon M Conroy
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Alison J Canchola
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Cheryl L Albright
- University of Hawaii Cancer Center, Honolulu, HI, USA.,University of Hawaii at Manoa, School of Nursing and Dental Hygiene, Honolulu, HI, USA
| | - Song-Yi Park
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | | | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Chen D, Jaenicke EC, Volpe RJ. The Healthfulness of Food-at-Home Expenditures, the Local Food Environment, and Childhood Obesity. Am J Health Promot 2018; 33:412-419. [PMID: 30004249 DOI: 10.1177/0890117118786871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Despite the growth of food-away-from-home expenditures, food-at-home (FAH) expenditures still constitute the majority of American families' food dollars. The FAH expenditures may have important impacts on children's diets and, consequently, their weight statuses. This study examined the association between the composition of FAH expenditures and childhood overweight or obesity. DESIGN We compiled a longitudinal data set from the 2010 to 2012 IRI Consumer Panel and its associated MedProfiler surveys. SETTING This study took place in the United States. PARTICIPANTS One thousand seven hundred thirty-one households across the United States, with 2645 children aged 2 to 17, were surveyed over 3 years (2010-2012). MEASURES The binary outcome variable indicated whether a child was overweight or obese. The key predictor variable-composition of FAH expenditures-was an index reflecting households' adherence to expenditure shares for 24 food categories recommended by the United States Department of Agriculture (USDA) Thrifty Food Plans. The key control variables were FAH expenditure shares from different food stores. ANALYSIS Data were analyzed by multilevel logistic regressions that controlled for a number of individual-level and household-level characteristics. RESULTS Higher compliance with the USDA Thrifty Food Plans was associated with lower risk of childhood overweight or obesity. Channel expenditure shares were not significantly associated with the weight outcomes. CONCLUSION To prevent childhood obesity, the USDA Thrifty Food Plans can provide potential guidelines for households to decide the composition of their FAH expenditures.
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Affiliation(s)
- Danhong Chen
- 1 Department of Agricultural Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Edward C Jaenicke
- 2 Department of Agricultural Economics, Sociology, and Education, Pennsylvania State University, University Park, PA, USA
| | - Richard J Volpe
- 3 Agribusiness Department, California Polytechnic State University, San Luis Obispo, CA, USA
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Barriers to Recruitment and Adherence in a Randomized Controlled Diet and Exercise Weight Loss Intervention Among Minority Breast Cancer Survivors. J Immigr Minor Health 2017; 19:120-129. [PMID: 26801931 DOI: 10.1007/s10903-015-0310-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Minority recruitment to cancer trials is low and there are limited data on minority adherence to lifestyle modification interventions. We examined factors related to recruitment and adherence to a pilot weight loss intervention among Hispanic and black breast cancer survivors. Participants completed a detailed screening interview to assess barriers to enrollment. An index was created to assess adherence at 6 months. 112 potentially eligible women were identified; 66 consented and completed a screening interview. After screening, 9 were ineligible; 15 opted to not enroll; and 42 were randomized. Among eligible women, earlier stage at diagnosis, treatment type, and negative beliefs related to exercise and diet after diagnosis were negatively associated with study enrollment (P < 0.05). Self-reported barriers to adherence included fatigue, family responsibilities, illness, work, transportation, and negative perceptions of exercise and diet. Results from this study emphasize the need to adapt recruitment and adherence strategies to address these factors.
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Ayala GX, Castro IA, Pickrel JL, Lin SF, Williams CB, Madanat H, Jun HJ, Zive M. A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids' Choice Restaurant Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1494. [PMID: 29194392 PMCID: PMC5750912 DOI: 10.3390/ijerph14121494] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 01/01/2023]
Abstract
Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in independently owned restaurants. Eight pair-matched restaurants that met the eligibility criteria were randomized to a menu-only versus a menu-plus intervention condition. Both of the conditions implemented new healthy child menu items and received support for implementation for eight weeks. The menu-plus condition also conducted a marketing campaign involving employee trainings and promotional materials. Process evaluation data captured intervention implementation. Sales of new and existing child menu items were tracked for 16 weeks. Results indicated that the interventions were implemented with moderate to high fidelity depending on the component. Sales of new healthy child menu items occurred immediately, but decreased during the post-intervention period in both conditions. Sales of existing child menu items demonstrated a time by condition effect with restaurants in the menu-plus condition observing significant decreases and menu-only restaurants observing significant increases in sales of existing child menu items. Additional efforts are needed to inform sustainable methods for improving access to healthy foods and beverages in restaurants.
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Affiliation(s)
- Guadalupe X Ayala
- Graduate School of Public Health and the Institute for Behavioral and Community Health (IBACH), San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Iana A Castro
- Marketing Department, Fowler College of Business and IBACH, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Julie L Pickrel
- IBACH, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA.
| | - Shih-Fan Lin
- IBACH, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA.
| | - Christine B Williams
- Department of Pediatrics, University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, #0725, La Jolla, CA 92093, USA.
| | - Hala Madanat
- Graduate School of Public Health and the Institute for Behavioral and Community Health (IBACH), San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Hee-Jin Jun
- IBACH, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA.
| | - Michelle Zive
- Department of Pediatrics, University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, #0725, La Jolla, CA 92093, USA.
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Who is behind the stocking of energy-dense foods and beverages in small stores? The importance of food and beverage distributors. Public Health Nutr 2017; 20:3333-3342. [PMID: 28969723 DOI: 10.1017/s1368980016003621] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study examined food and beverage distributors' sourcing, placement and promotion of obesogenic (energy-dense, nutrient-poor) product categories from the perspective of small food store owners/managers. The obesogenic product categories of interest were savoury snacks, sugary beverages, sweet snacks, confectionery and frozen treats. Specifically, we examined how frequently distributors sourced these products, and the types of agreements and expectations they had for their placement and promotion. Differences were explored by store size and ethnicity. Fresh produce was used as a comparison when examining differences in frequency of sourcing only, with implications for healthy food access. DESIGN Survey research involving in-person interviews. SETTING Four urban areas in the USA: Baltimore, MD; Durham, NC; Minneapolis/St. Paul, MN; and San Diego, CA. SUBJECTS Seventy-two small food store owners/managers, 65 % consent rate. RESULTS Most distributors sourced obesogenic products weekly. Agreements to place products were predominantly informal (e.g. handshake) with sweet snack, confectionery and frozen treat distributors, and formal (e.g. contract) with savoury snack and sugary beverage distributors. Free-standing displays were the most common incentive provided by distributors and they expected some control over their placement and pricing. Free/discounted products and signage were also common incentives but slotting fees were not. Smaller stores and ethnic stores were less likely to receive various incentives, but among sweet snack distributors, they were more likely to control the price in ethnic v. non-ethnic stores. CONCLUSIONS Obesogenic products are ubiquitous. Influencing what is made available to consumers in the retail food environment needs to consider the distributor.
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Canchola AJ, Shariff-Marco S, Yang J, Albright C, Hertz A, Park SY, Shvetsov YB, Monroe KR, Le Marchand L, Gomez SL, Wilkens LR, Cheng I. Association between the neighborhood obesogenic environment and colorectal cancer risk in the Multiethnic Cohort. Cancer Epidemiol 2017; 50:99-106. [PMID: 28850934 DOI: 10.1016/j.canep.2017.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/07/2017] [Accepted: 08/14/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Information on the role of the neighborhood environment and colorectal cancer risk is limited. We investigated the association between a comprehensive suite of possible obesogenic neighborhood attributes (socioeconomic status, population density, restaurant and retail food environments, numbers of recreational facilities and businesses, commute patterns, traffic density, and street connectivity) and colorectal cancer risk in the Multiethnic Cohort Study. METHODS Among 81,197 eligible participants living in California (35,397 males and 45,800 females), 1973 incident cases (981 males and 992 females) of invasive colorectal cancer were identified between 1993 and 2010. Separately for males and females, multivariable Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for colorectal cancer risk overall and by racial/ethnic group (African American, Japanese American, Latino, white). RESULTS In males, higher traffic density was associated with an increased risk of colorectal cancer (HR=1.29, 95% CI: 1.03-1.61, p=0.03, for quintile 5 vs. quintile 1; p-trend=0.06). While this association may be due to chance, this pattern was seen (albeit non-statistically significant) in all racial/ethnic groups except whites. There were no other significant associations between other neighborhood obesogenic attributes and colorectal cancer risk. CONCLUSION Findings from our large racial/ethnically diverse cohort suggest neighborhood obesogenic characteristics are not strongly associated with the risk of colorectal cancer.
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Affiliation(s)
- Alison J Canchola
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA.
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA; Stanford Cancer Institute, 265 Campus Drive, Suite G2103, Stanford, CA 94305, USA.
| | - Juan Yang
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA.
| | - Cheryl Albright
- University of Hawaii School of Nursing and Dental Hygiene, 2528 McCarthy Mall, Webster 401, Honolulu, HI 96822, USA.
| | - Andrew Hertz
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA.
| | - Song-Yi Park
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Yurii B Shvetsov
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Kristine R Monroe
- University of Southern California, 1450 Biggy Street, Los Angeles, CA 90033, USA.
| | - Loïc Le Marchand
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA; Stanford Cancer Institute, 265 Campus Drive, Suite G2103, Stanford, CA 94305, USA.
| | - Lynne R Wilkens
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Iona Cheng
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA; Stanford Cancer Institute, 265 Campus Drive, Suite G2103, Stanford, CA 94305, USA.
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Valdez Z, Ramírez AS, Estrada E, Grassi K, Nathan S. Community Perspectives on Access to and Availability of Healthy Food in Rural, Low-Resource, Latino Communities. Prev Chronic Dis 2016; 13:E170. [PMID: 27978407 PMCID: PMC5201142 DOI: 10.5888/pcd13.160250] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Attention has focused on the food environment as a result of the growing concern with obesity rates among Latinos in rural areas. Researchers have observed associations between a lack of physical access to affordable produce in areas where supermarkets and grocery stores are limited and poor dietary intake and obesity; these associations are high in rural, low-resource neighborhoods with a high population of Latino residents. We aimed to engage residents of low-resource, Latino-majority neighborhoods in discussions of food access in a rural yet agricultural community setting, which is typically described as a "food desert." METHODS We used a mixed-methods approach and conducted 3 focus groups (n = 20) and in-depth interviews (n = 59) and surveys (n = 79) with residents of a rural yet agricultural community. We used thematic analysis to explore residents' perceptions of access to healthy foods. RESULTS Residents (n = 79; mean age, 41.6 y; 72% female; 79% Latino; 53% Spanish-speaking) reported that dollar and discount stores in this agricultural area provided access to produce; however, produce at retail stores was less affordable than produce at nonretail outlets such as fruit and vegetable stands. Gifts and trades of fruits and vegetables from neighbors and community organizations supplied no-cost or low-cost healthy foods. Residents' suggestions to improve food access centered on lowering the cost of produce in existing retail outlets and seeking out nonretail outlets. CONCLUSION Our findings contribute to understanding of the food environment in low-resource, rural yet agricultural areas. Although such areas are characterized as "food deserts," residents identified nonretail outlets as a viable source of affordable produce, while indicating that the cost of retail produce was a concern. Innovative policy solutions to increase healthy food consumption must focus on affordability as well as accessibility, and consider alternate, nonretail food outlets in agricultural areas.
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Affiliation(s)
- Zulema Valdez
- University of California, Merced, 5200 North Lake Rd, Merced, CA 95343.
| | | | | | - Kathleen Grassi
- Merced County Department of Public Health, Merced, California
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Li Y, Berenson J, Gutiérrez A, Pagán JA. Leveraging the Food Environment in Obesity Prevention: the Promise of Systems Science and Agent-Based Modeling. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0179-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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13
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Rogus S. Do the Poor Pay More for Food? A Review of Food Price Disparities in Urban Environments. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2015. [DOI: 10.1080/19320248.2014.962775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Renzaho AM, Dau A, Cyril S, Ayala GX. The influence of family functioning on the consumption of unhealthy foods and beverages among 1- to 12-y-old children in Victoria, Australia. Nutrition 2014; 30:1028-33. [DOI: 10.1016/j.nut.2014.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/09/2014] [Accepted: 02/06/2014] [Indexed: 11/27/2022]
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Sheats JL, Middlestadt SE. Salient beliefs about eating and buying dark green vegetables as told by Mid-western African-American women. Appetite 2013; 65:205-9. [PMID: 23415980 DOI: 10.1016/j.appet.2013.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 02/01/2013] [Accepted: 02/05/2013] [Indexed: 11/24/2022]
Abstract
Vegetables in the dark green group are the most nutritious, yet intake is low. Studies suggest that an increase in fruit and vegetables may improve diet-related health outcomes of African Americans. The aim of this exploratory study was to use the Reasoned Action Approach (RAA) to qualitatively assess salient, top-of-the-mind, beliefs (consequences, circumstances and referents) about eating and buying more dark green leafy vegetables each week over the next 3months. Adult (n=30), Midwestern African-American women, who buy and prepare food for their household participated in a face-to-face salient belief elicitation. A content analysis of verbatim text and a descriptive analysis were conducted. Findings suggest that the RAA can be used to identify salient consequences, circumstances and referents about eating and buying more dark green leafy vegetables. The use of the RAA allowed for the extraction of specific beliefs that may aid in the development of nutrition education programs that consider the varying priorities, motivators and barriers that subgroups within the population have in regard to buying and consuming dark green leafy vegetables.
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Affiliation(s)
- Jylana L Sheats
- Indiana University-Bloomington School of Public Health, 1025 E. 7th Street, Office 115, Bloomington, IN 47405, USA.
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