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Does transportation mode modify associations between distance to food store, fruit and vegetable consumption, and BMI in low-income neighborhoods?

ABSTRACT: A consistent body of research has shown that the neighborhood food environment is associated with fruit and vegetable (F&V) consumption and obesity in deprived neighborhoods in the United States. However, these studies have often neglected to consider how transportation can moderate associations between food accessibility and diet-related outcomes.This study examined associations between distance to primary food store, fruit and vegetable consumption, and BMI and whether mode of transportation to the primary food store moderates this relation.Cross-sectional data from the baseline wave of the Philadelphia Neighborhood Food Environment Study were used. A telephone survey of adult (?18 y of age) household primary food shoppers residing in 2 Philadelphia neighborhoods was conducted (n = 1440).In a bivariate linear regression analysis, distance to primary food store did not predict F&V consumption (? = 0.04; 95% CI: -0.00, 0.09). Linear regression analysis stratified by transportation mode to the main F&V store showed no difference in F&V consumption between car, public, and multimodal transportation users. Compared with respondents using multimodal transportation, those using public transit had a significantly lower BMI (? = -1.31; 95% CI: -2.50, -0.10), whereas those using an automobile did not (? = -0.41; 95% CI: -1.36, 0.54).The assumption that using an automobile to access food stores results in increased F&V consumption was not confirmed. Significant associations were found for the relation between transportation mode and BMI. Theory-based mechanisms explaining relationships between the primary transportation mode used to access food stores and BMI should be further explored.

SUBMITTER: Fuller D

PROVIDER: S-EPMC3712124 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Does transportation mode modify associations between distance to food store, fruit and vegetable consumption, and BMI in low-income neighborhoods?

Fuller Daniel D Cummins Steven S Matthews Stephen A SA

The American journal of clinical nutrition 20121128 1

<h4>Background</h4>A consistent body of research has shown that the neighborhood food environment is associated with fruit and vegetable (F&V) consumption and obesity in deprived neighborhoods in the United States. However, these studies have often neglected to consider how transportation can moderate associations between food accessibility and diet-related outcomes.<h4>Objective</h4>This study examined associations between distance to primary food store, fruit and vegetable consumption, and BMI ...[more]

PMID: 23193006

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Project description:BACKGROUND:In developed countries, adolescent and young adult diets have been found to be nutritionally poor. The aim of this study was to examine whether a choice architecture intervention, re-arrangement of produce within a grocery store to increase the accessibility of fruit and vegetables, affected purchasing behaviour on a university campus. METHODS:A database of daily sales data from January 2012 to July 2017 was obtained from a campus grocery store. Two changes to the layout were made during this time period. In January 2015, fruit and vegetables were moved from the back of the store, furthest from the entrance, to the aisle closest to the entrance and an entrance-facing display increasing their accessibility. In April 2016, the entrance-facing display of fruit and vegetables was replaced with a chiller cabinet so that fruit and vegetables remained more accessible than during the baseline period, but less accessible than in the period immediately previously. A retrospective interrupted time series analysis using dynamic regression was used to model the data and to examine the effect of the store re-arrangements on purchasing. All analyses were carried out both for sales-by-quantity and for sales-by-money. RESULTS:The first shop re-arrangement which made fruit and vegetables more prominent, increased the percentage of total sales that were fruit and vegetables, when analysed by either items purchased or money spent. The second rearrangement also had a positive effect on the percentage of total sales that were fruit and vegetables compared to baseline, however this was not significant at the 5% level. Over the five year period, the percentage of sales that were fruit and vegetables declined both in terms of items purchased, and money spent. CONCLUSIONS:Increasing accessibility of fruit and vegetables in a grocery store is a feasible way to improve the diet of students in tertiary education. There is evidence of declining fruit and vegetable consumption among the studied population, which should be further investigated.

Project description:BackgroundMother-to-newborn transmission of obesity-associated microbiota may be modified by birth mode (vaginal vs. Cesarean delivery). Prospective data to test this hypothesis are still sparse.ObjectiveTo examine prospective associations of maternal pre-pregnancy BMI and gestational weight gain with the infant gut microbiome by birth-mode strata.Subjects/methodsIn 335 mother-infant pairs in the New Hampshire Birth Cohort, we ascertained data from questionnaires and medical records, and generated microbiome data from 6-week-old infants' stool using Illumina 16s rRNA gene sequencing (V4-V5 region). Analyses were stratified by birth mode and conducted before and after adjusting for potential confounders, which included maternal age, education, parity, and Mediterranean diet score.ResultsAmong 335 mothers, 56% had normal pre-pregnancy BMI ( < 25, referent), 27% were overweight (BMI 25-30), and 18% obese (BMI > 30). Among the 312 mothers with weight gain data, 10% had inadequate weight gain, 30% adequate (referent), and 60% excess. Birth mode modified associations of pre-pregnancy BMI with several genera, including the most abundant genus, Bacteroides (P for interaction = 0.05). In the vaginal-delivery group, maternal overweight or obesity was associated with higher infant gut microbiome diversity and higher relative abundance of 15 operational taxonomic units (OTUs), including overrepresentation of Bacteroides fragilis, Escherichia coli, Veillonella dispar, and OTUs in the genera Staphylococcus and Enterococcus. In the Cesarean-delivered group, there were no significant associations of pre-pregnancy BMI with infant microbiome (alpha) diversity or OTUs. Gestational weight gain was not associated with differential relative abundance of infant gut microbial OTUs or with measures of microbial diversity in infants delivered vaginally or by Cesarean section.ConclusionsAmong vaginally-delivered infants, maternal overweight and obesity was associated with altered infant gut microbiome composition and higher diversity. These associations were not observed in Cesarean-delivered infants, whose microbiome development differs from vaginally-delivered infants. Our study provides additional evidence of birth-mode dependent associations of maternal body weight status with the infant gut microbiota. The role of these associations in mediating the intergenerational cycle of obesity warrants further examination.

Project description:BackgroundModifying the environment to promote healthy foods is a population-based approach for improving diet. This study evaluated the outcome effectiveness of a food store intervention that used structural and social change strategies to promote fruits and vegetables. It was hypothesized that intervention versus control store customers would improve their consumption of fruits and vegetables at 6 months.Trial designClustered randomized controlled trial METHODS: Sixteen pair-matched stores were randomized to an intervention or wait-list control condition. With the research team's support, intervention stores modified the availability, accessibility, and promotion of fruits and vegetables, including augmenting produce displays within the store and building employees' capacity to place and promote fruits and vegetables throughout the store (Phase 1), followed by the delivery of a customer-directed marketing campaign for 6 months (Phase 2). From months 7 to 12, stores were encouraged to maintain strategies on their own (Phase 3). Customer-reported daily fruit and vegetable consumption (cups/day) were collected by blinded research assistants at three time-points (baseline, 6 months and 12 months post-baseline) from 369 participating customers (an average of 23/store). Secondary outcomes included customer-reported fruit and vegetable purchasing and other behaviors.ResultsThe study retained the 16 stores and most customers at 6 (91%) and 12 (89%) months. Although significant differences were not observed in the overall sample for vegetable consumption, male customers of intervention versus control stores consumed significantly more fruit daily at 6 months [mean (standard deviation) cups at baseline and six months; intervention: 1.6 (1.5) to 1.6 (1.5) vs. control: 1.4 (1.2) to 1.1 (0.8)]. However, this difference was not observed at 12 months, or among females. There was an overall increase in dollars spent at the targeted store in the intervention versus control condition among male versus female customers at 6 months; however, no change was observed in the percent of dollars spent on fruits and vegetables at the targeted store. Frequency of shopping at the targeted store did not modify intervention effects.ConclusionsStructural and social change interventions can modify customers' behavior in the short-term. Future research should consider methods for achieving longer-term changes, and potential generalizability to other products (e.g., energy-dense sweet and savory products).Trial registrationNCT01475526.

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Does transportation mode modify associations between distance to food store, fruit and vegetable consumption, and BMI in low-income neighborhoods?

Publications

Does transportation mode modify associations between distance to food store, fruit and vegetable consumption, and BMI in low-income neighborhoods?

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