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Chan JA, Koster A, Eussen SJPM, Pinho MGM, Lakerveld J, Stehouwer CDA, Dagnelie PC, van der Kallen CJ, van Greevenbroek MMJ, Wesselius A, Bosma H. The association between the food environment and adherence to healthy diet quality: the Maastricht Study. Public Health Nutr 2023; 26:1775-1783. [PMID: 37340803 PMCID: PMC10478064 DOI: 10.1017/s1368980023001180] [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] [Received: 04/02/2022] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVE The purpose of this study is to determine if healthier neighbourhood food environments are associated with healthier diet quality. DESIGN This was a cross-sectional study using linear regression models to analyse data from the Maastricht Study. Diet quality was assessed using data collected with a FFQ to calculate the Dutch Healthy Diet (DHD). A buffer zone encompassing a 1000 m radius was created around each participant home address. The Food Environment Healthiness Index (FEHI) was calculated using a Kernel density analysis within the buffers of available food outlets. The association between the FEHI and the DHD score was analysed and adjusted for socio-economic variables. SETTING The region of Maastricht including the surrounding food retailers in the Netherlands. PARTICIPANTS 7367 subjects aged 40-75 years in the south of the Netherlands. RESULTS No relationship was identified between either the FEHI (B = 0·62; 95 % CI = -2·54, 3·78) or individual food outlets, such as fast food (B = -0·07; 95 % CI = -0·20, 0·07) and diet quality. Similar null findings using the FEHI were identified at the 500 m (B = 0·95; 95 % CI = -0·85, 2·75) and 1500 m (B = 1·57; 95 % CI = -3·30, 6·44) buffer. There was also no association between the food environment and individual items of the DHD including fruits, vegetables and sugar-sweetened beverages. CONCLUSION The food environment in the Maastricht area appeared marginally unhealthy, but the differences in the food environment were not related to the quality of food that participants reported as intake.
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Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, CA, USA
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Simone JPM Eussen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Maria Gabriela M Pinho
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Coen DA Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Carla J van der Kallen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Marleen MJ van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Anke Wesselius
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
- School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
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Hobbs M, McLeod GFH, Mackenbach JD, Marek L, Wiki J, Deng B, Eggleton P, Boden JM, Bhubaneswor D, Campbell M, Horwood LJ. Change in the food environment and measured adiposity in adulthood in the Christchurch Health and development birth cohort, Aotearoa, New Zealand: A birth cohort study. Health Place 2023; 83:103078. [PMID: 37517383 DOI: 10.1016/j.healthplace.2023.103078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/11/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023]
Abstract
This study investigated associations between change in the food environment and change in measured body mass index (BMI) and waist circumference (WC) in the Christchurch Health and Development Study (CHDS) birth cohort. Our findings suggest that cohort members who experienced the greatest proportional change towards better access to fast food outlets had the slightly larger increases in BMI and WC. Contrastingly, cohort members who experienced the greatest proportional change towards shorter distance and better access to supermarkets had slightly smaller increases in BMI and WC. Our findings may help explain the changes in BMI and WC at a population level.
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Affiliation(s)
- Matthew Hobbs
- Faculty of Health, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand; Te Taiwhenua o Te Hauora - GeoHealth Laboratory, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand; The Cluster for Community and Urban Resilience (CURe), University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand.
| | - Geraldine F H McLeod
- Christchurch Health and Development Study, University of Otago - Te Whare Wānanga o Ōtākou, Christchurch, Canterbury, New Zealand
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije University, Amsterdam, the Netherlands; Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Amsterdam, the Netherlands
| | - Lukas Marek
- Faculty of Health, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand; Te Taiwhenua o Te Hauora - GeoHealth Laboratory, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand
| | - Jesse Wiki
- Te Taiwhenua o Te Hauora - GeoHealth Laboratory, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand; School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland - Waipapa Taumata Rau, Auckland, New Zealand
| | - Bingyu Deng
- Faculty of Health, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand; Te Taiwhenua o Te Hauora - GeoHealth Laboratory, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand
| | - Phoebe Eggleton
- Faculty of Health, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand; Te Taiwhenua o Te Hauora - GeoHealth Laboratory, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand
| | - Joseph M Boden
- Christchurch Health and Development Study, University of Otago - Te Whare Wānanga o Ōtākou, Christchurch, Canterbury, New Zealand
| | - Dhakal Bhubaneswor
- Christchurch Health and Development Study, University of Otago - Te Whare Wānanga o Ōtākou, Christchurch, Canterbury, New Zealand
| | - Malcolm Campbell
- Te Taiwhenua o Te Hauora - GeoHealth Laboratory, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand; School of Earth and Environment, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, Canterbury, New Zealand
| | - L John Horwood
- Christchurch Health and Development Study, University of Otago - Te Whare Wānanga o Ōtākou, Christchurch, Canterbury, New Zealand
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Fuster M, Dimond E, Handley MA, Rose D, Stoecker C, Knapp M, Elbel B, Conaboy C, Huang TTK. Evaluating the outcomes and implementation determinants of interventions co-developed using human-centered design to promote healthy eating in restaurants: an application of the consolidated framework for implementation research. Front Public Health 2023; 11:1150790. [PMID: 37275479 PMCID: PMC10233011 DOI: 10.3389/fpubh.2023.1150790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Background Restaurants are an emerging yet underutilized setting to facilitate healthier eating, particularly among minoritized communities that disproportionately experience health inequities. The present study aimed to examine outcomes from interventions co-developed using Human-Centered Design (HCD) in two Latin American restaurants, including sales of healthier menu items (HMI) and the consumer nutrition environment. In addition, we aimed to assess implementation outcomes (acceptability, fidelity, and sustainability) and elucidate the determinants for implementation using the Consolidated Framework for Implementation Research. Methods This study used a mixed-methods, longitudinal design. Data were collected pre-, during, and post-intervention testing. Intervention outcomes were examined through daily sales data and the Nutrition Environment Measures Survey for Restaurants (NEMS-R). Changes in HMI sales were analyzed using interrupted time series. Implementation outcomes and determinants were assessed through site visits [observations, interviews with staff (n = 19) and customers (n = 31)], social media monitoring, and post-implementation key informant interviews with owners and staff. Qualitative data were analyzed iteratively by two independent researchers using codes developed a priori based on CFIR. Results The HCD-tailored interventions had different outcomes. In restaurant one (R1), where new HMI were introduced, we found an increase in HMI sales and improvements in NEMS-R scores. In restaurant two, where existing HMI were promoted, we found no significant changes in HMI sales and NEMS-R scores. Acceptance was high among customers and staff, but fidelity and sustainability differed by restaurant (high in R1, low in R2). Barriers and facilitators for implementation were found across all CFIR constructs, varying by restaurant and intervention. Most relevant constructs were found in the inner setting (restaurant structure, implementation climate), individual characteristics, and process (HCD application). The influence of outer setting constructs (policy, peer pressure) was limited due to lack of awareness. Conclusion Our findings provide insights for interventions developed in challenging and constantly changing settings, as in the case of restaurants. This research expands the application of CFIR to complex and dynamic community-based settings and interventions developed using HCD. This is a significant innovation for the field of public health nutrition and informs future interventions in similarly dynamic and understudied settings.
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Affiliation(s)
- Melissa Fuster
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Emily Dimond
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Margaret A. Handley
- Partnership for Research in Implementation Science for Equity (PRIDE) Center and Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, United States
| | - Donald Rose
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Charles Stoecker
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
- Department of Health Policy and Management, New Orleans, LA, United States
| | - Megan Knapp
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, United States
| | - Brian Elbel
- Department of Medicine, New York University Grossman School of Medicine,New York, NY, United States
- Wagner Graduate School of Public Service, New York University,New York, NY, United States
| | - Cara Conaboy
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Terry T. K. Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, City University of New York Graduate School of Public Health and Health Policy, New York, NY, United States
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Fuster M. Furthering nutrition equity through innovative and empathetic collaborations with the restaurant sector: Examples from Latin American restaurants. Front Public Health 2023; 11:1058859. [PMID: 36817908 PMCID: PMC9932526 DOI: 10.3389/fpubh.2023.1058859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
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Fuster M, Kodali H, Ray K, Elbel B, Handley MA, Huang TTK, Johnson G. Area Characteristics and Consumer Nutrition Environments in Restaurants: an Examination of Hispanic Caribbean Restaurants in New York City. J Racial Ethn Health Disparities 2022; 9:1454-1463. [PMID: 34152587 PMCID: PMC8216094 DOI: 10.1007/s40615-021-01083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
Hispanics in the USA, particularly those of Caribbean descent, experience high levels of diet-related diseases and dietary risk factors. Restaurants are an increasingly important yet understudied source of food and may present opportunities to positively influence urban food environments. We sought to explore food environments further, by examining the association between neighborhood characteristics and restaurant consumer nutrition environments within New York City's Hispanic Caribbean (HC) restaurant environments. We applied an adapted version of the Nutrition Environment Measurements Survey for Restaurants (NEMS-R) to evaluate a random sample of HC restaurants (n=89). NEMS-HCR scores (continuous and categorized as low, medium, and high based on data distribution) were examined against area sociodemographic characteristics using bivariate and logistic regression analysis. HC restaurants located in Hispanic geographic enclaves had a higher proportion of fried menu items (p<0.01) but presented fewer environmental barriers to healthy eating, compared with those in areas with lower Hispanic concentrations. No significant differences in NEMS-R scores were found by other neighborhood characteristics. Size was the only significant factor predicting high NEMS-HCR scores, where small restaurants were less likely to have scores in the high category (NEMS-HCR score>6), compared with their medium (aOR: 6.6, 95% CI: 1.8-24.6) and large counterparts (aOR: 5.6, 95% CI: 1.5-21.4). This research is the first to examine the association between restaurant location and consumer nutrition environments, providing information to contribute to future interventions and policies seeking to improve urban food environments in communities disproportionately affected by diet-related conditions, as in the case of HC communities in New York City.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, NY, USA.
| | - Hanish Kodali
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Brian Elbel
- Department of Population Health, Grossman School of Medicine, and Wagner Graduate School of Public Service, New York University, New York, NY, USA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Terry T-K Huang
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, City University of New York, New York, NY, USA
| | - Glen Johnson
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
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Liang LJ, Casillas A, Longstreth WT, PhanVo L, Vassar SD, Brown AF. Fishing for health: Neighborhood variation in fish intake, fish quality and association with stroke risk among older adults in the Cardiovascular Health Study. Nutr Metab Cardiovasc Dis 2022; 32:1410-1417. [PMID: 35346546 PMCID: PMC9472873 DOI: 10.1016/j.numecd.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Fish consumption has been associated with better health outcomes. Dietary patterns may vary substantially by neighborhood of residence. However, it is unclear if the benefits of a healthy diet are equivalent in different communities. This study examines associations of fish consumption with stroke incidence and stroke risk factors, and whether these differ by neighborhood socioeconomic status (NSES). METHODS AND RESULTS We studied 4007 participants in the Cardiovascular Health Study who were 65 years or older and recruited between 1989 and 1990 from 4 US communities. Outcomes included fish consumption type (bakes/broiled vs. fried) and frequency, stroke incidence, and stroke risk factors. Multilevel regressions models were used to estimate fish consumption associations with clinical outcomes. Lower NSES was associated with higher consumption of fried fish (aOR = 1.47, 95% CI: 1.10-1.98) and lower consumption of non-fried fish (0.64, 0.47-0.86). Frequent fried fish (11.9 vs. 9.2 person-years for at least once weekly vs. less than once a month, respectively) and less frequent non-fried fish (17.7 vs. 9.6 person-years for less than once a month vs. at least once weekly, respectively) were independently associated with an increased risk of stroke (p-values < 0.05). However, among those with similar levels of healthy fish consumption, residents with low NSES had less benefit on stroke risk reduction, compared with high NSES. CONCLUSION Fish consumption type and frequency both impact stroke risk. Benefits of healthy fish consumption differ by neighborhood socioeconomic status.
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Affiliation(s)
- Li-Jung Liang
- Division of General Internal Medicine and Health Services Research, University of California, 1100 Glendon Avenue, Suite 850, Los Angeles, CA 90024, USA.
| | - Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, University of California, 1100 Glendon Avenue, Suite 850, Los Angeles, CA 90024, USA
| | - W T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, 908 Jefferson St, Seattle, WA 98104, USA
| | - Lynn PhanVo
- Division of General Internal Medicine and Health Services Research, University of California, 1100 Glendon Avenue, Suite 850, Los Angeles, CA 90024, USA
| | - Stefanie D Vassar
- Division of General Internal Medicine and Health Services Research, University of California, 1100 Glendon Avenue, Suite 850, Los Angeles, CA 90024, USA
| | - Arleen F Brown
- Division of General Internal Medicine and Health Services Research, University of California, 1100 Glendon Avenue, Suite 850, Los Angeles, CA 90024, USA
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Fuster M, Abreu-Runkle R, Handley MA, Rose D, Rodriguez MA, Dimond EG, Elbel B, Huang TTK. Promoting healthy eating in Latin American restaurants: a qualitative survey of views held by owners and staff. BMC Public Health 2022; 22:843. [PMID: 35477376 PMCID: PMC9043880 DOI: 10.1186/s12889-022-13294-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background Restaurants, particularly independently-owned ones that serve immigrant communities, are important community institutions in the promotion of dietary health. Yet, these restaurants remain under-researched, preventing meaningful collaborations with the public health sector for healthier community food environments. This research aimed to examine levels of acceptability of healthy eating promotion strategies (HEPS) in independently-owned Latin American restaurants (LARs) and identify resource needs for implementing HEPS in LARs. Methods We completed semi-structured, online discussions with LAR owners and staff (n = 20), predominantly from New York City (NYC), to examine current engagement, acceptability, potential barriers, and resource needs for the implementation of HEPS. Verbatim transcripts were analyzed independently by two coders using Dedoose, applying sentiment weighting to denote levels of acceptability for identified HEPS (1 = low, 2 = medium/neutral, 3 = high). Content analysis was used to examine factors associated with HEPS levels of acceptability and resource needs, including the influence of the Coronavirus pandemic (COVID-19). Results The most acceptable HEPS was menu highlights of healthier items (mean rating = 2.8), followed by promotion of healthier items (mean rating = 2.7), increasing healthy offerings (mean rating = 2.6), nutrition information on the menu (mean rating = 2.3), and reduced portions (mean rating = 1.7). Acceptability was associated with factors related to perceived demand, revenue, and logistical constraints. COVID-19 had a mixed influence on HEPS engagement and acceptability. Identified resource needs to engage in HEPS included nutrition knowledge, additional expertise (e.g., design, social media, culinary skills), and assistance with food suppliers and other restaurant operational logistics. Respondents also identified potential policy incentives. Conclusions LARs can positively influence eating behaviors but doing so requires balancing public health goals and business profitability. LARs also faced various constraints that require different levels of assistance and resources, underscoring the need for innovative engagement approaches, including incentives, to promote these changes.
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Affiliation(s)
- Melissa Fuster
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
| | - Rosa Abreu-Runkle
- Department of Hospitality Management, School of Professional Studies, New York City College of Technology, City University of New York, New York, NY, USA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
| | - Donald Rose
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Michelle A Rodriguez
- City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Emily G Dimond
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Brian Elbel
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.,Wagner Graduate School of Public Service, New York University, New York, NY, USA
| | - Terry T K Huang
- Department of Community Health and Social Sciences and Center for Systems and Community Design, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
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Lalusu EY, Ramli R, Sattu M, Sutady F, Otoluwa AS. Unhealthy Food Consumption Pattern and Nutritional Status among Adolescents: A Cross-sectional Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Nutritional balance is needed during adolescence for health and optimal growth. The aim of the study is to analyse the nutritional status and food consumption patterns of adolescents in Luwuk.
Methods: This study was conducted with a cross-sectional design involving 385 adolescents at four high schools (grade 10-12). The sample was divided into four schools and selected by the accidental sampling method. Food consumption patterns were assessed using a World Health Organization-designed Global School-based Student Health Survey questionnaire (modified for Indonesia). Nutritional status is based on the results of anthropometric. Data were analysed using frequency distribution and inferential analysis.
Results: Of the total 385 adolescents studied, there were 4.7% adolescents overweight and 2.3% were obese. On the other hand, there are also 10.6% thin adolescents and 4.4% with very thinness. 49.9% of adolescents do not consume fruit, 22.3% do not eat vegetables, 23.5% drink soft drinks with carbonated >=1 time per day, 54.8% eat fast food >=1 day a week, 66 .5% rarely or never breakfast, 58.2% never bring lunch and 18.7% usually eat street snacks.
Conclusion: Some adolescents in Luwuk City had nutritional problems and unhealthy food consumption patterns. A nutritional surveillance program is needed for adolescents which includes monitoring nutritional status, consumption patterns, and risk factors related to nutrition.
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Residents' Insights on Their Local Food Environment and Dietary Behaviors: A Cross-City Comparison Using Photovoice in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910134. [PMID: 34639435 PMCID: PMC8507815 DOI: 10.3390/ijerph181910134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/26/2022]
Abstract
Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants’ narratives about their local food environment in two cities in Spain. We used the participatory methodology of Photovoice to engage participants in Madrid (n = 24) and Bilbao (n = 17) who took and discussed photographs about their local food environment (Madrid; n = 163 and Bilbao; n = 70). Common themes emerged across both cities (food insecurity, poverty, use of public spaces for eating and social gathering, cultural diversity and overconsumption of unhealthy foods); however, in Bilbao citizens perceived that there was sufficient availability of healthy foods despite that living in impoverished communities. Photovoice was a useful tool to engage participating citizens to improve their local food environments in both cities. This new approach allowed for a photovoice cross-city comparison that could be useful to fully understand the complexity and diversity of residents’ perceptions regardless of their place of residence.
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Benita F, Gasca-Sanchez F. The main factors influencing COVID-19 spread and deaths in Mexico: A comparison between phases I and II. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2021; 134:102523. [PMID: 34334843 PMCID: PMC8313543 DOI: 10.1016/j.apgeog.2021.102523] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/11/2021] [Accepted: 07/23/2021] [Indexed: 05/05/2023]
Abstract
This article investigates the geographical spread of confirmed COVID-19 cases and deaths across municipalities in Mexico. It focuses on the spread dynamics and containment of the virus between Phase I (from March 23 to May 31, 2020) and Phase II (from June 1 to August 22, 2020) of the social distancing measures. It also examines municipal-level factors associated with cumulative COVID-19 cases and deaths to understand the spatial determinants of the pandemic. The analysis of the geographic pattern of the pandemic via spatial scan statistics revealed a fast spread among municipalities. During Phase I, clusters of infections and deaths were mainly located at the country's center, whereas in Phase II, these clusters dispersed to the rest of the country. The regression results from the zero-inflated negative binomial regression analysis suggested that income inequality, the prevalence of obesity and diabetes, and concentration of fine particulate matter (PM 2.5) are strongly positively associated with confirmed cases and deaths regardless of lockdown.
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Affiliation(s)
- Francisco Benita
- Engineering Systems and Design, Singapore University of Technology and Design, Singapore
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Translation and Validation of the Arabic Version of the Capability Assessment for Diet and Activity (CADA) Questionnaire in Saudi University Employed Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126246. [PMID: 34207752 PMCID: PMC8296046 DOI: 10.3390/ijerph18126246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Capability Assessment for Diet and Activity (CADA) is a questionnaire that was developed in English and designed to measure the practical barriers and opportunities for diet and physical activity. OBJECTIVE This study aimed to translate, culturally adapt, and validate the CADA questionnaire for the Arabic context in a sample of Saudi women employed at a university. METHODS The CADA was translated into Arabic using the forward and backward translation process. The Arabic version was then validated with a sample of 125 female Saudi participants. In order to evaluate the psychometric properties of the Arabic version, Spearman's rank correlation coefficient was assessed, and a principal component analysis was performed. RESULTS The translated CADA had good psychometric quality. The content validity analysis revealed a representativeness score of 99.3% and a degree of clarity of 98.6%, indicating excellent compatibility. The principal component analysis showed a single-factor structure. CONCLUSIONS The Arabic version of the CADA questionnaire is now available to assess opportunities to achieve a healthy diet and physical activity level as part of health behavior management, which can lead to more effective interventions for improving people's health in Arabic-speaking countries.
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Kelly C, Callaghan M, Gabhainn SN. 'It's Hard to Make Good Choices and It Costs More': Adolescents' Perception of the External School Food Environment. Nutrients 2021; 13:nu13041043. [PMID: 33804848 PMCID: PMC8063803 DOI: 10.3390/nu13041043] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/04/2022] Open
Abstract
Research on the impact of school and community food environments on adolescent food choice is heavily reliant on objective rather than subjective measures of food outlets around schools and homes. Gaining the perspective of adolescents and how they perceive and use food environments is needed. The aim of this study was to explore adolescent’s perception and use of the food environment surrounding their schools. Purposive sampling was used to recruit schools. Mapping exercises and discussion groups were facilitated with 95 adolescents from six schools. Thematic analysis showed that adolescents are not loyal to particular shops but are attracted to outlets with price discounts, those with ‘deli’ counters and sweets. Cost, convenience and choice are key factors influencing preference for food outlets and foods. Quality, variety and health were important factors for adolescents but these features, especially affordable healthy food, were hard to find. Social factors such as spending time with friends is also an important feature of food environments that deserves further attention. Adolescents’ perceptions of their food environment provide insights into features that can be manipulated to enable healthy choices.
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13
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PEREIRA FA, QADIR JA, KAMRAN S. Frequency of Elevated Blood Pressure Associated With Physical Activity and Dietary Patterns among School Going Adolescents in Karachi: A Cross Sectional Survey. BALNEO RESEARCH JOURNAL 2020. [DOI: 10.12680/balneo.2020.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Studies have suggested that atherosclerotic changes take place in the body since childhood due to altered dietary patterns and sedentary lifestyle. It is critical to identify gap areas and update current literature to produce effective changes in our lifestyle.
Study design: A cross-sectional survey conducted among school going adolescents in Karachi.
Methods: A cross sectional study was performed in three different schools of Karachi. A sample size of 288 was drawn through non-probability, purposive sampling technique. Students were given a questionnaire comprising of questions regarding their physical activity levels, dietary patterns and knowledge regarding blood pressure. Blood pressure and Body Mass Index data was also recorded.
Results: Mean age of participants was 14.10 ± 1.097. Of the 288 students that participated in this study (122 boys and 166 girls), 227 were normal for hypertension status (93 boys and 134 girls), 27 were pre-hypertensive (7 boys and 20 girls), and 34 were hypertensive (22 boys and 12 girls). Mean systolic blood pressure was 112.73 ± 13.49, and mean diastolic blood pressure was 71.25 ± 13.03. Awareness among participants was high regarding hypertension being linked to the foods they consumed (62.8%).
Conclusion: Our study did not show strong correlation between physical activity and dietary patterns, with status of hypertension. Screening programs should be conducted in schools to monitor blood pressure and body mass index. High risk groups should be approached and advised for lifestyle modification..
Keywords: hypertension, adolescents, life style,
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Affiliation(s)
| | | | - Sajida KAMRAN
- 2. Institute of Physical Therapy & Rehabilitation, Jinnah Sindh Medical University, Karachi, Pakistan
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14
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Fuster M, Pouget ER, Handley MA, Ray K, Elbel B, Sakowitz EN, Halvey K, Huang T. Ethnic Restaurant Nutrition Environments and Cardiovascular Health: Examining Hispanic Caribbean Restaurants in New York City. Ethn Dis 2020; 30:583-592. [PMID: 32989358 DOI: 10.18865/ed.30.4.583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To adapt and apply the Nutrition Environment Measures Survey for Restaurants (NEMS-R) to Hispanic Caribbean (HC) restaurants and examine associations between restaurant characteristics and nutrition environment measures. Methods We adapted the NEMS-R for HC cuisines (Cuban, Puerto Rican, Dominican) and cardiovascular health-promoting factors, and applied the instrument (NEMS-HCR) to a random sample of HC restaurants in New York City (NYC) (N=89). Multivariable linear regression was used to assess independent associations between NEMS-HCR score and restaurant characteristics (cuisine, size, type [counter-style vs sit-down] and price). Results None of the menus in the restaurants studied listed any main dishes as "healthy" or "light." More than half (52%) offered mostly (>75%) nonfried main dishes, and 76% offered at least one vegetarian option. The most common facilitator to healthy eating was offering reduced portion sizes (21%) and the most common barrier was having salt shakers on tables (40%). NEMS-HCR scores (100-point scale) ranged from 24.1-55.2 (mean=39.7). In multivariable analyses, scores were significantly related to cuisine (with Puerto Rican cuisine scoring lower than Cuban and Dominican cuisines), and size (with small [<22 seats] restaurants scoring lower than larger restaurants). We found a significant quadratic association with midpoint price, suggesting that scores increased with increasing price in the lowest price range, did not vary in the middle range, and decreased with increasing price in the highest range. Conclusions Our application of the NEMS-R to HC restaurants in NYC revealed areas for potential future interventions to improve food offerings and environmental cues to encourage healthful choices.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, NY
| | - Enrique R Pouget
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY
| | - Brian Elbel
- Department of Population Health, Grossman School of Medicine, and Wagner Graduate School of Public Service, New York University, New York, NY
| | - Eddie N Sakowitz
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, NY
| | - Kayla Halvey
- Department of Health and Nutrition Science, Brooklyn College, City University of New York, Brooklyn, NY
| | - Terry Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
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15
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Elliston KG, Schüz B, Albion T, Ferguson SG. Comparison of Geographic Information System and Subjective Assessments of Momentary Food Environments as Predictors of Food Intake: An Ecological Momentary Assessment Study. JMIR Mhealth Uhealth 2020; 8:e15948. [PMID: 32706728 PMCID: PMC7407250 DOI: 10.2196/15948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/18/2020] [Accepted: 04/26/2020] [Indexed: 11/30/2022] Open
Abstract
Background It has been observed that eating is influenced by the presence and availability of food. Being aware of the presence of food in the environment may enable mobile health (mHealth) apps to use geofencing techniques to determine the most appropriate time to proactively deliver interventions. To date, however, studies on eating typically rely on self-reports of environmental contexts, which may not be accurate or feasible for issuing mHealth interventions. Objective This study aimed to compare the subjective and geographic information system (GIS) assessments of the momentary food environment to explore the feasibility of using GIS data to predict eating behavior and inform geofenced interventions. Methods In total, 72 participants recorded their food intake in real-time for 14 days using an ecological momentary assessment approach. Participants logged their food intake and responded to approximately 5 randomly timed assessments each day. During each assessment, the participants reported the number and type of food outlets nearby. Their electronic diaries simultaneously recorded their GPS coordinates. The GPS data were later overlaid with a GIS map of food outlets to produce an objective count of the number of food outlets within 50 m of the participant. Results Correlations between self-reported and GIS counts of food outlets within 50 m were only of a small size (r=0.17; P<.001). Logistic regression analyses revealed that the GIS count significantly predicted eating similar to the self-reported counts (area under the curve for the receiver operating characteristic curve [AUC-ROC] self-report=0.53, SE 0.00 versus AUC-ROC 50 m GIS=0.53, SE 0.00; P=.41). However, there was a significant difference between the GIS-derived and self-reported counts of food outlets and the self-reported type of food outlets (AUC-ROC self-reported outlet type=0.56, SE 0.01; P<.001). Conclusions The subjective food environment appears to predict eating better than objectively measured food environments via GIS. mHealth apps may need to consider the type of food outlets rather than the raw number of outlets in an individual’s environment.
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Affiliation(s)
| | - Benjamin Schüz
- Institute of Public Health and Nursing Science, University of Bremen, Bremen, Germany.,Leibniz Science Campus, Digital Public Health, Bremen, Germany
| | - Tim Albion
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Stuart G Ferguson
- College of Health and Medicine, University of Tasmania, Hobart, Australia
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Finlay J, Esposito M, Tang S, Gomez-Lopez I, Sylvers D, Judd S, Clarke P. Fast-food for thought: Retail food environments as resources for cognitive health and wellbeing among aging Americans? Health Place 2020; 64:102379. [PMID: 32838895 PMCID: PMC7480653 DOI: 10.1016/j.healthplace.2020.102379] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 01/24/2023]
Abstract
In this exploratory sequential mixed-methods study, interviews with 125 adults aged 55-92 (mean age 71) living in the Minneapolis (Minnesota) metropolitan area suggested that eateries, including coffee shops and fast-food restaurants, represent popular neighborhood destinations for older adults and sources of wellbeing. Thematic analysis of how older adults perceived and utilized local eateries included sites of familiarity and comfort; physical and economic accessibility; sociability with friends, family, staff, and customers; and entertainment (e.g., destinations for outings and walks, free newspapers to read). To test the hypothesis that these sites, and the benefits they confer, are associated with cognitive welfare, we analyzed data from urban and suburban community-dwelling participants in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national racially diverse sample of older Americans followed since 2003 (n = 16,404, average age at assessment 72 years). Results from multilevel linear regression models of these data demonstrated a positive association between kernel density of local eateries and cognitive functioning, which corroborated qualitative findings. Taken together, these results complicate our understanding of casual eatery settings as possible sites of wellbeing through social interaction and leisure activities. Results prompt further research investigating whether and how retail food environments can serve as community spaces for older adults that may help buffer against cognitive decline.
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Affiliation(s)
- Jessica Finlay
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States.
| | - Michael Esposito
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States.
| | - Sandra Tang
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States.
| | - Iris Gomez-Lopez
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States.
| | - Dominique Sylvers
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, United States.
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35233, United States.
| | - Philippa Clarke
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, United States; School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, United States.
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17
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Jacobson M, Crossa A, Liu SY, Locke S, Poirot E, Stein C, Lim S. Residential mobility and chronic disease among World Trade Center Health Registry enrollees, 2004-2016. Health Place 2020; 61:102270. [PMID: 32329735 DOI: 10.1016/j.healthplace.2019.102270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/04/2019] [Accepted: 12/09/2019] [Indexed: 11/30/2022]
Abstract
Residential mobility is hypothesized to impact health through changes to the built environment and disruptions in social networks, and may vary by neighborhood deprivation exposure. However, there are few longitudinal investigations of residential mobility in relation to health outcomes. This study examined enrollees from the World Trade Center Health Registry, a longitudinal cohort of first responders and community members in lower Manhattan on September 11, 2001. Enrollees who completed ≥2 health surveys between 2004 and 2016 and did not have diabetes (N = 44,089) or hypertension (N = 35,065) at baseline (i.e., 2004) were included. Using geocoded annual home addresses, residential mobility was examined using two indicators: moving frequency and displacement. Moving frequency was defined as the number of times someone was recorded as living in a different neighborhood; displacement as any moving to a more disadvantaged neighborhood. We fit adjusted Cox proportional hazards models with time-dependent exposures (moving frequency and displacement) and covariates to evaluate associations with incident diabetes and hypertension. From 2004 to 2016, the majority of enrollees never moved (54.5%); 6.5% moved ≥3 times. Those who moved ≥3 times had a similar hazard of diabetes (hazard ratio (HR) = 0.78; 95% Confidence Interval (CI): 0.40, 1.53) and hypertension (HR = 0.99; 95% CI: 0.68, 1.43) compared with those who never moved. Similarly, displacement was not associated with diabetes or hypertension. Residential mobility was not associated with diabetes or hypertension among a cohort of primarily urban-dwelling adults.
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Affiliation(s)
- Melanie Jacobson
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, World Trade Center Health Registry, NY, NY, USA; New York University School of Medicine, Department of Pediatrics, Division of Environmental Pediatrics, New York, NY 10016, USA.
| | - Aldo Crossa
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
| | - Sze Yan Liu
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
| | - Sean Locke
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, World Trade Center Health Registry, NY, NY, USA
| | - Eugenie Poirot
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
| | - Cheryl Stein
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, World Trade Center Health Registry, NY, NY, USA
| | - Sungwoo Lim
- New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services, Long Island City, NY, USA
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18
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Drewnowski A, Buszkiewicz J, Aggarwal A, Rose C, Gupta S, Bradshaw A. Obesity and the Built Environment: A Reappraisal. Obesity (Silver Spring) 2020; 28:22-30. [PMID: 31782242 PMCID: PMC6986313 DOI: 10.1002/oby.22672] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022]
Abstract
The built environment (BE) has been viewed as an important determinant of health. Numerous studies have linked BE exposure, captured using a variety of methods, to diet quality and to area prevalence of obesity, diabetes, and cardiovascular disease. First-generation studies defined the neighborhood BE as the area around the home. Second-generation studies turned from home-centric to person-centric BE measures, capturing an individual's movements in space and time. Those studies made effective uses of global positioning system tracking devices and mobile phones, sometimes coupled with accelerometers and remote sensors. Activity space metrics explored travel paths, modes, and destinations to assess BE exposure that was both person and context specific. However, as measures of the contextual exposome have become ever more fine-grained and increasingly complex, connections to long-term chronic diseases with complex etiologies, such as obesity, are in danger of being lost. Furthermore, few studies on obesity and the BE have included intermediate energy balance behaviors, such as diet and physical activity, or explored the potential roles of social interactions or psychosocial pathways. Emerging survey-based applications that identify habitual destinations and associated travel patterns may become the third generation of tools to capture health-relevant BE exposures in the long term.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, School of Public Health, University of Washington
- Department of Epidemiology, School of Public Health, University of Washington
| | - James Buszkiewicz
- Department of Epidemiology, School of Public Health, University of Washington
| | - Anju Aggarwal
- Center for Public Health Nutrition, School of Public Health, University of Washington
- Department of Epidemiology, School of Public Health, University of Washington
| | - Chelsea Rose
- Center for Public Health Nutrition, School of Public Health, University of Washington
| | - Shilpi Gupta
- Center for Public Health Nutrition, School of Public Health, University of Washington
| | - Annie Bradshaw
- Department of Epidemiology, School of Public Health, University of Washington
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19
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Lear SA, Gasevic D. Ethnicity and Metabolic Syndrome: Implications for Assessment, Management and Prevention. Nutrients 2019; 12:nu12010015. [PMID: 31861719 PMCID: PMC7019432 DOI: 10.3390/nu12010015] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome (MetS) is a constellation of cardiometabolic risk factors that identifies people at increased risk for type 2 diabetes and cardiovascular disease. While the global prevalence is 20%–25% of the adult population, the prevalence varies across different racial/ethnic populations. In this narrative review, evidence is reviewed regarding the assessment, management and prevention of MetS among people of different racial/ethnic groups. The most popular definition of MetS considers race/ethnicity for assessing waist circumference given differences in visceral adipose tissue and cardiometabolic risk. However, defining race/ethnicity may pose challenges in the clinical setting. Despite 80% of the world’s population being of non-European descent, the majority of research on management and prevention has focused on European-derived populations. In these studies, lifestyle management has proven an effective therapy for reversal of MetS, and randomised studies are underway in specific racial/ethnic groups. Given the large number of people at risk for MetS, prevention efforts need to focus at community and population levels. Community-based interventions have begun to show promise, and efforts to improve lifestyle behaviours through alterations in the built environment may be another avenue. However, careful consideration needs to be given to take into account the unique cultural context of the target race/ethnic group.
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Affiliation(s)
- Scott A. Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Division of Cardiology, Providence Health Care, Vancouver, BC V6Z 1Y6, Canada
- Correspondence: ; Tel.: +1-604-682-2344 (ext. 62778)
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
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20
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Abstract
A growing body of work identifies distinct health lifestyles among children, adolescents, and young adults and documents important social correlates. This study contributes to that line of research by identifying the health lifestyles of U.S. adults entering late middle age, assessing structural predictors of membership in different health lifestyles in this understudied age-group, and examining net associations between health lifestyles, chronic conditions, and physical health. The data come from the National Longitudinal Survey of Youth 1979 50+ Health Module. The analysis is based on respondents who answered the 50+ Health Module in 2008, 2010, 2012, or 2014 (N = 7,234). The results confirm similar relationships between health lifestyles and structural factors like class, gender, and race that prior studies observe and also reveal a unique pattern of associations between health lifestyle and health status because of diagnosed conditions that impact health behaviors in adulthood.
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Affiliation(s)
- William C Cockerham
- University of Alabama at Birmingham, AL and College of William & Mary, Williamsburg, VA, USA
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21
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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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22
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A Time-Based Objective Measure of Exposure to the Food Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071180. [PMID: 30986919 PMCID: PMC6480343 DOI: 10.3390/ijerph16071180] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/13/2019] [Accepted: 03/29/2019] [Indexed: 12/03/2022]
Abstract
Exposure to food environments has mainly been limited to counting food outlets near participants’ homes. This study considers food environment exposures in time and space using global positioning systems (GPS) records and fast food restaurants (FFRs) as the environment of interest. Data came from 412 participants (median participant age of 45) in the Seattle Obesity Study II who completed a survey, wore GPS receivers, and filled out travel logs for seven days. FFR locations were obtained from Public Health Seattle King County and geocoded. Exposure was conceptualized as contact between stressors (FFRs) and receptors (participants’ mobility records from GPS data) using four proximities: 21 m, 100 m, 500 m, and ½ mile. Measures included count of proximal FFRs, time duration in proximity to ≥1 FFR, and time duration in proximity to FFRs weighted by FFR counts. Self-reported exposures (FFR visits) were excluded from these measures. Logistic regressions tested associations between one or more reported FFR visits and the three exposure measures at the four proximities. Time spent in proximity to an FFR was associated with significantly higher odds of FFR visits at all proximities. Weighted duration also showed positive associations with FFR visits at 21-m and 100-m proximities. FFR counts were not associated with FFR visits. Duration of exposure helps measure the relationship between the food environment, mobility patterns, and health behaviors. The stronger associations between exposure and outcome found at closer proximities (<100 m) need further research.
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23
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Drewnowski A, Arterburn D, Zane J, Aggarwal A, Gupta S, Hurvitz P, Moudon A, Bobb J, Cook A, Lozano P, Rosenberg D. The Moving to Health (M2H) approach to natural experiment research: A paradigm shift for studies on built environment and health. SSM Popul Health 2019; 7:100345. [PMID: 30656207 PMCID: PMC6329830 DOI: 10.1016/j.ssmph.2018.100345] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/22/2018] [Accepted: 12/26/2018] [Indexed: 12/02/2022] Open
Abstract
Improving the built environment (BE) is viewed as one strategy to improve community diets and health. The present goal is to review the literature on the effects of BE on health, highlight its limitations, and explore the growing use of natural experiments in BE research, such as the advent of new supermarkets, revitalized parks, or new transportation systems. Based on recent studies on movers, a paradigm shift in built-environment health research may be imminent. Following the classic Moving to Opportunity study in the US, the present Moving to Health (M2H) strategy takes advantage of the fact that changing residential location can entail overnight changes in multiple BE variables. The necessary conditions for applying the M2H strategy to Geographic Information Systems (GIS) databases and to large longitudinal cohorts are outlined below. Also outlined are significant limitations of this approach, including the use of electronic medical records in lieu of survey data. The key research question is whether documented changes in BE exposure can be linked to changes in health outcomes in a causal manner. The use of geo-localized clinical information from regional health care systems should permit new insights into the social and environmental determinants of health.
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Affiliation(s)
- A. Drewnowski
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - D. Arterburn
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - J. Zane
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - A. Aggarwal
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - S. Gupta
- Center for Public Health Nutrition, 305 Raitt Hall, #353410, University of Washington, Seattle, WA 98195-03410, USA
| | - P.M. Hurvitz
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, 1107 NE 45th Street, Suite 535, Seattle, WA 98195-4802, USA
| | - A.V. Moudon
- Urban Form Lab, Department of Urban Design and Planning, College of Built Environments, University of Washington, 1107 NE 45th Street, Suite 535, Seattle, WA 98195-4802, USA
| | - J. Bobb
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - A. Cook
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - P. Lozano
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
| | - D. Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave. Suite 1600, Seattle, WA 98101, USA
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24
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Kankanhalli A, Shin J, Oh H. Mobile-Based Interventions for Dietary Behavior Change and Health Outcomes: Scoping Review. JMIR Mhealth Uhealth 2019; 7:e11312. [PMID: 30664461 PMCID: PMC6360385 DOI: 10.2196/11312] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/16/2018] [Accepted: 11/22/2018] [Indexed: 01/08/2023] Open
Abstract
Background Mobile apps are being widely used for delivering health interventions, with their ubiquitous access and sensing capabilities. One such use is the delivery of interventions for healthy eating behavior. Objective The aim of this study was to provide a comprehensive view of the literature on the use of mobile interventions for eating behavior change. We synthesized the studies with such interventions and mapped out their input methods, interventions, and outcomes. Methods We conducted a scoping literature search in PubMed/MEDLINE, Association for Computing Machinery Digital Library, and PsycINFO databases to identify relevant papers published between January 2013 and April 2018. We also hand-searched relevant themes of journals in the Journal of Medical Internet Research and registered protocols. Studies were included if they provided and assessed mobile-based interventions for dietary behavior changes and/or health outcomes. Results The search resulted in 30 studies that we classified by 3 main aspects: input methods, mobile-based interventions, and dietary behavior changes and health outcomes. First, regarding input methods, 5 studies allowed photo/voice/video inputs of diet information, whereas text input methods were used in the remaining studies. Other than diet information, the content of the input data in the mobile apps included user’s demographics, medication, health behaviors, and goals. Second, we identified 6 categories of intervention contents, that is, self-monitoring, feedback, gamification, goal reviews, social support, and educational information. Although all 30 studies included self-monitoring as a key component of their intervention, personalized feedback was a component in 18 studies, gamification was used in 10 studies, goal reviews in 5 studies, social support in 3 studies, and educational information in 2 studies. Finally, we found that 13 studies directly examined the effects of interventions on health outcomes and 12 studies examined the effects on dietary behavior changes, whereas only 5 studies observed the effects both on dietary behavior changes and health outcomes. Regarding the type of studies, although two-thirds of the included studies conducted diverse forms of randomized control trials, the other 10 studies used field studies, surveys, protocols, qualitative interviews, propensity score matching method, and test and reference method. Conclusions This scoping review identified and classified studies on mobile-based interventions for dietary behavior change as per the input methods, nature of intervention, and outcomes examined. Our findings indicated that dietary behavior changes, although playing a mediating role in improving health outcomes, have not been adequately examined in the literature. Dietary behavior change as a mechanism for the relationship between mobile-based intervention and health outcomes needs to be further investigated. Our review provides guidance for future research in this promising mobile health area.
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Affiliation(s)
- Atreyi Kankanhalli
- Department of Information Systems and Analytics, National University of Singapore, Singapore, Singapore
| | - Jieun Shin
- Department of Information Systems and Analytics, National University of Singapore, Singapore, Singapore
| | - Hyelim Oh
- Department of Information Systems and Analytics, National University of Singapore, Singapore, Singapore
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Robinson E, Jones A, Whitelock V, Mead BR, Haynes A. (Over)eating out at major UK restaurant chains: observational study of energy content of main meals. BMJ 2018; 363:k4982. [PMID: 30541906 PMCID: PMC6290483 DOI: 10.1136/bmj.k4982] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the energy content of main meals served in major UK restaurant chains and compare the energy content of meals in fast food and "full service" restaurant chains. DESIGN Observational study. SETTING Menu and nutritional information provided by major UK restaurant chains. MAIN OUTCOME MEASURES Mean energy content of meals, proportion of meals meeting public health recommendations for energy consumption (≤600 kcal), and proportion of meals with excessive energy content (≥1000 kcal). RESULTS Main meals from 27 restaurant chains (21 full service; 6 fast food) were sampled. The mean energy content of all eligible restaurant meals (13 396 in total) was 977 (95% confidence interval 973 to 983) kcal. The percentage of all meals that met public health recommendations for energy content was low (9%; n=1226) and smaller than the percentage of meals with an excessive energy content (47%; 6251). Compared with fast food restaurants, full service restaurants offered significantly more excessively calorific main meals, fewer main meals meeting public health recommendations, and on average 268 (103 to 433) kcal more in main meals. CONCLUSIONS The energy content of a large number of main meals in major UK restaurant chains is excessive, and only a minority meet public health recommendations. Although the poor nutritional quality of fast food meals has been well documented, the energy content of full service restaurant meals in the UK tends to be higher and is a cause for concern. REGISTRATION Study protocol and analysis strategy pre-registered on Open Science Framework (https://osf.io/w5h8q/).
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Affiliation(s)
- Eric Robinson
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool L69 7ZA, UK
| | - Andrew Jones
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool L69 7ZA, UK
| | - Victoria Whitelock
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool L69 7ZA, UK
| | - Bethan R Mead
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool L69 7ZA, UK
| | - Ashleigh Haynes
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool L69 7ZA, UK
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, Christensen A, McKenna J. Fast-food outlet availability and obesity: Considering variation by age and methodological diversity in 22,889 Yorkshire Health Study participants. Spat Spatiotemporal Epidemiol 2018; 28:43-53. [PMID: 30739654 DOI: 10.1016/j.sste.2018.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/17/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
This study investigated if the relationship between residential fast-food outlet availability and obesity varied due to methodological diversity or by age. Cross-sectional data (n = 22,889) from the Yorkshire Health Study, England were used. Obesity was defined using self-reported height and weight (BMI ≥ 30). Food outlets ("fast-food", "large supermarkets", and "convenience or other food retail outlets") were mapped using Ordnance Survey Points of Interest (PoI) database. Logistic regression was used for all analyses. Methodological diversity included adjustment for other food outlets as covariates and continuous count vs. quartile. The association between residential fast-food outlets and obesity was inconsistent and effects remained substantively the same when considering methodological diversity. This study contributes to evidence by proposing the use of a more comprehensive conceptual model adjusting for wider markers of the food environment. This study offers tentative evidence that the association between fast-food outlets and obesity varies by age.
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Affiliation(s)
- M Hobbs
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Ernest Rutherford Building, Christchurch, New Zealand.
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Leeds Beckett University formerly Public Health Team, Rotherham Borough Council, UK
| | - A Christensen
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QT, UK
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Burgoine T, Sarkar C, Webster CJ, Monsivais P. Examining the interaction of fast-food outlet exposure and income on diet and obesity: evidence from 51,361 UK Biobank participants. Int J Behav Nutr Phys Act 2018; 15:71. [PMID: 30041671 PMCID: PMC6497220 DOI: 10.1186/s12966-018-0699-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 06/28/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Household income (as a marker of socioeconomic position) and neighbourhood fast-food outlet exposure may be related to diet and body weight, which are key risk factors for non-communicable diseases. However, the research evidence is equivocal. Moreover, understanding the double burden of these factors is a matter of public health importance. The purpose of this study was to test associations of neighbourhood fast-food outlet exposure and household income, in relation to frequency of consumption of processed meat and multiple measures of adiposity, and to examine possible interactions. METHODS We employed an observational, cross-sectional study design. In a cohort of 51,361 adults aged 38-72 years in Greater London, UK, we jointly classified participants based on household income (£/year, four groups) and GIS-derived neighbourhood fast-food outlet proportion (counts of fast-food outlets as a percentage of all food outlets, quartiles). Multivariable regression models estimated main effects and interactions (additive and multiplicative) of household income and fast-food outlet proportion on odds of self-reported frequent processed meat consumption (> 1/week), measured BMI (kg/m2), body fat (%), and odds of obesity (BMI ≥ 30). RESULTS Income and fast-food proportion were independently, systematically associated with BMI, body fat, obesity and frequent processed meat consumption. Odds of obesity were greater for lowest income participants compared to highest (OR = 1.54, 95% CI: 1.41, 1.69) and for those most-exposed to fast-food outlets compared to least-exposed (OR = 1.51, 95% CI: 1.40, 1.64). In jointly classified models, lowest income and highest fast-food outlet proportion in combination were associated with greater odds of obesity (OR = 2.43, 95% CI: 2.09, 2.84), with relative excess risk due to interaction (RERI = 0.03). Results were similar for frequent processed meat consumption models. There was no evidence of interaction on a multiplicative scale between fast-food outlet proportion and household income on each of BMI (P = 0.230), obesity (P = 0.054) and frequent processed meat consumption (P = 0.725). CONCLUSIONS Our study demonstrated independent associations of neighbourhood fast-food outlet exposure and household income, in relation to diet and multiple objective measures of adiposity, in a large sample of UK adults. Moreover, we provide evidence of the double burden of low income and an unhealthy neighbourhood food environment, furthering our understanding of how these factors contribute jointly to social inequalities in health.
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Affiliation(s)
- Thomas Burgoine
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Special Administrative Region China
| | - Chris J. Webster
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Special Administrative Region China
| | - Pablo Monsivais
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
- Present Address: Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington USA
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Thompson C, Ponsford R, Lewis D, Cummins S. Fast-food, everyday life and health: A qualitative study of 'chicken shops' in East London. Appetite 2018; 128:7-13. [PMID: 29807123 DOI: 10.1016/j.appet.2018.05.136] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/04/2018] [Accepted: 05/22/2018] [Indexed: 11/26/2022]
Abstract
The higher prevalence of fast food outlets in deprived areas has been associated with the production and maintenance of geographical inequalities in diet. In the UK one type of fast food outlet - the 'chicken shop' - has been the focus of intense public health and media interest. Despite ongoing concerns and initiatives around regulating these establishments, the 'chicken shop' is both a commercially successful and ubiquitous feature of disadvantaged urban neighbourhoods. However, little is known about how they are perceived by local residents. We report data from a qualitative study of neighbourhood perceptions in a low SES urban setting. Narrative family interviews, go-along interviews and school video focus group workshops with 66 residents of East London were conducted over two waves. The topic of chicken shops was a prolific theme and a narrative analysis of these accounts revealed that local perceptions of chicken shops are complex and contradictory. Chicken shops were depicted as both potentially damaging for the health of local residents and, at the same time, as valued community spaces. This contradiction was discursively addressed in narrative via a series of rhetorical rebuttals that negated their potential to damage health on the grounds of concepts such as trust, choice, balance, food hygiene and compensatory physical activity. In some instances, chicken shops were described as 'healthy' and patronising them constructed as part of a healthy lifestyle. Chicken shops are embedded in the social fabric of neighbourhoods. Successful strategies to improve diet therefore requires context-sensitive environmental interventions.
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Affiliation(s)
- Claire Thompson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK.
| | - Ruth Ponsford
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK.
| | - Daniel Lewis
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK.
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK.
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Mazidi M, Speakman JR. Association of Fast-Food and Full-Service Restaurant Densities With Mortality From Cardiovascular Disease and Stroke, and the Prevalence of Diabetes Mellitus. J Am Heart Assoc 2018; 7:JAHA.117.007651. [PMID: 29802148 PMCID: PMC6015353 DOI: 10.1161/jaha.117.007651] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND We explored whether higher densities of fast-food restaurants (FFRs) and full-service restaurants are associated with mortality from cardiovascular disease (CVD) and stroke and the prevalence of type 2 diabetes mellitus (T2D) across the mainland United States. METHODS AND RESULTS In this cross-sectional study county-level data for CVD and stroke mortality, and prevalence of T2D, were combined with per capita densities of FFRs and full-service restaurants and analyzed using regression. Mortality and diabetes mellitus prevalence were corrected for poverty, ethnicity, education, physical inactivity, and smoking. After adjustment, FFR density was positively associated with CVD (β=1.104, R2=2.3%), stroke (β=0.841, R2=1.4%), and T2D (β=0.578, R2=0.6%) and full-service restaurant density was positively associated with CVD mortality (β=0.19, R2=0.1%) and negatively related to T2D prevalence (β=-0.25, R2=0.3%). In a multiple regression analysis (FFRs and full-service restaurants together in same model), only the densities of FFRs were significant (and positive). If we assume these relationships are causal, an impact analysis suggested that opening 10 new FFRs in a county would lead to 1 extra death from CVD every 42 years and 1 extra death from stroke every 55 years. Repeated nationally across all counties, that would be an extra 748 CVD deaths and 567 stroke deaths (and 390 new cases of T2D) over the next 10 years. CONCLUSIONS These results suggest that an increased density of FFRs is associated with increased risk of death from CVD and stroke and increased T2D prevalence, but the maximal impact (assuming the correlations reflect causality) of each individual FFR is small. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT03243253.
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Affiliation(s)
- Mohsen Mazidi
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.,University of the Chinese Academy of Sciences, Beijing, China
| | - John R Speakman
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China .,Institute of Biological and Environmental Science, University of Aberdeen, Scotland, United Kingdom
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Koohsari MJ, Kaczynski AT, Hanibuchi T, Shibata A, Ishii K, Yasunaga A, Nakaya T, Oka K. Physical Activity Environment and Japanese Adults' Body Mass Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040596. [PMID: 29587441 PMCID: PMC5923638 DOI: 10.3390/ijerph15040596] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/15/2018] [Accepted: 03/20/2018] [Indexed: 01/19/2023]
Abstract
Evidence about the impacts of the physical activity environment on adults’ weight in the context of Asian countries is scarce. Likewise, no study exists in Asia examining whether Walk Score®—a free online walkability tool—is related to obesity. This study aimed to examine associations between multiple physical activity environment measures and Walk Score® ratings with Japanese adults’ body mass index (BMI). Data from 1073 adults in the Healthy Built Environment in Japan study were used. In 2011, participants reported their height and weight. Environmental attributes, including population density, intersection density, density of physical activity facilities, access to public transportation, and availability of sidewalks, were calculated using Geographic Information Systems. Walk Scores® ratings were obtained from the website. Multiple linear regression analysis was conducted to examine the association between each environmental attribute and BMI. Adjusting for covariates, all physical activity environmental attributes were negatively associated with BMI. Similarly, an increase of one standard deviation of Walk Score® was associated with a 0.29 (95% confidence interval (CI) of −0.49–−0.09) decrease in BMI. An activity-friendly built environment was associated with lower adults’ BMI in Japan. Investing in healthy community design may positively impact weight status in non-Western contexts.
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Affiliation(s)
- Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan.
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne 3004, Australia.
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia.
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29229, USA.
- Prevention Research Center, University of South Carolina, Columbia, SC 29229, USA.
| | - Tomoya Hanibuchi
- School of International Liberal Studies, Chukyo University, Nagoya 466-8666, Japan.
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Japan.
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan.
| | - Akitomo Yasunaga
- Faculty of Liberal Arts and Sciences, Bunka Gakuen University, Tokyo 151-8523, Japan.
| | - Tomoki Nakaya
- Department of Geography and Institute of Disaster Mitigation for Urban Cultural Heritage, Ritsumeikan University, Kyoto 603-8577, Japan.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan.
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den Braver NR, Lakerveld J, Rutters F, Schoonmade LJ, Brug J, Beulens JWJ. Built environmental characteristics and diabetes: a systematic review and meta-analysis. BMC Med 2018; 16:12. [PMID: 29382337 PMCID: PMC5791730 DOI: 10.1186/s12916-017-0997-z] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/15/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The built environment influences behaviour, like physical activity, diet and sleep, which affects the risk of type 2 diabetes mellitus (T2DM). This study systematically reviewed and meta-analysed evidence on the association between built environmental characteristics related to lifestyle behaviour and T2DM risk/prevalence, worldwide. METHODS We systematically searched PubMed, EMBASE.com and Web of Science from their inception to 6 June 2017. Studies were included with adult populations (>18 years), T2DM or glycaemic markers as outcomes, and physical activity and/or food environment and/or residential noise as independent variables. We excluded studies of specific subsamples of the population, that focused on built environmental characteristics that directly affect the cardiovascular system, that performed prediction analyses and that do not report original research. Data appraisal and extraction were based on published reports (PROSPERO-ID: CRD42016035663). RESULTS From 11,279 studies, 109 were eligible and 40 were meta-analysed. Living in an urban residence was associated with higher T2DM risk/prevalence (n = 19, odds ratio (OR) = 1.40; 95% CI, 1.2-1.6; I2 = 83%) compared to living in a rural residence. Higher neighbourhood walkability was associated with lower T2DM risk/prevalence (n = 8, OR = 0.79; 95% CI, 0.7-0.9; I2 = 92%) and more green space tended to be associated with lower T2DM risk/prevalence (n = 6, OR = 0.90; 95% CI, 0.8-1.0; I2 = 95%). No convincing evidence was found of an association between food environment with T2DM risk/prevalence. CONCLUSIONS An important strength of the study was the comprehensive overview of the literature, but our study was limited by the conclusion of mainly cross-sectional studies. In addition to other positive consequences of walkability and access to green space, these environmental characteristics may also contribute to T2DM prevention. These results may be relevant for infrastructure planning.
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Affiliation(s)
- N R den Braver
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.
| | - J Lakerveld
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands
| | - F Rutters
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands
| | | | - J Brug
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.,Amsterdam School for Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - J W J Beulens
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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GPS or travel diary: Comparing spatial and temporal characteristics of visits to fast food restaurants and supermarkets. PLoS One 2017; 12:e0174859. [PMID: 28388619 PMCID: PMC5384745 DOI: 10.1371/journal.pone.0174859] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/16/2017] [Indexed: 01/19/2023] Open
Abstract
To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/- 10 minutes, and +/- 30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.
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Davies IG, Blackham T, Jaworowska A, Taylor C, Ashton M, Stevenson L. Saturated and trans-fatty acids in UK takeaway food. Int J Food Sci Nutr 2016; 67:217-24. [PMID: 26911372 DOI: 10.3109/09637486.2016.1144723] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to analyze the saturated fatty acid (SFA) and trans-fatty acid (TFA) contents of popular takeaway foods in the UK (including English, pizza, Chinese, Indian and kebab cuisine). Samples of meals were analyzed by an accredited public analyst laboratory for SFA and TFA. The meals were highly variable for SFA and TFA. English and Pizza meals had the highest median amount of SFA with 35.7 g/meal; Kebab meals were high in TFA with up to 5.2 g/meal. When compared to UK dietary reference values, some meals exceeded SFA and TFA recommendations from just one meal. Takeaway food would be an obvious target to reduce SFA and TFA contents and increase the potential of meeting UK recommendations. Strategies such as reformulation and smaller takeaway portion sizes warrant investigation.
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Affiliation(s)
- Ian Glynn Davies
- a School of Sports Studies, Leisure and Nutrition, Faculty of Education , Health and Community, Liverpool John Moores University , Liverpool , UK
| | - Toni Blackham
- a School of Sports Studies, Leisure and Nutrition, Faculty of Education , Health and Community, Liverpool John Moores University , Liverpool , UK
| | - Agnieszka Jaworowska
- b Department of Life and Sports Science; School of Engineering and Science , University of Greenwich , London , UK
| | | | - Matthew Ashton
- c Trading Standards, Knowsley Council/NHS , Liverpool , UK
| | - Leonard Stevenson
- a School of Sports Studies, Leisure and Nutrition, Faculty of Education , Health and Community, Liverpool John Moores University , Liverpool , UK
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