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Multiple pathways from the neighborhood food environment to increased body mass index through dietary behaviors: A structural equation-based analysis in the CARDIA study.

ABSTRACT: OBJECTIVES:To examine longitudinal pathways from multiple types of neighborhood restaurants and food stores to BMI, through dietary behaviors. METHODS:We used data from participants (n=5114) in the United States-based Coronary Artery Risk Development in Young Adults study and a structural equation model to estimate longitudinal (1985-86 to 2005-06) pathways simultaneously from neighborhood fast food restaurants, sit-down restaurants, supermarkets, and convenience stores to BMI through dietary behaviors, controlling for socioeconomic status (SES) and physical activity. RESULTS:Higher numbers of neighborhood fast food restaurants and lower numbers of sit-down restaurants were associated with higher consumption of an obesogenic fast food-type diet. The pathways from food stores to BMI through diet were inconsistent in magnitude and statistical significance. CONCLUSIONS:Efforts to decrease the numbers of neighborhood fast food restaurants and to increase the numbers of sit-down restaurant options could influence diet behaviors. Availability of neighborhood fast food and sit-down restaurants may play comparatively stronger roles than food stores in shaping dietary behaviors and BMI.

SUBMITTER: Richardson AS

PROVIDER: S-EPMC4791952 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Multiple pathways from the neighborhood food environment to increased body mass index through dietary behaviors: A structural equation-based analysis in the CARDIA study.

Richardson Andrea S AS Meyer Katie A KA Howard Annie Green AG Boone-Heinonen Janne J Popkin Barry M BM Evenson Kelly R KR Shikany James M JM Lewis Cora E CE Gordon-Larsen Penny P

Health & place 20151027

<h4>Objectives</h4>To examine longitudinal pathways from multiple types of neighborhood restaurants and food stores to BMI, through dietary behaviors.<h4>Methods</h4>We used data from participants (n=5114) in the United States-based Coronary Artery Risk Development in Young Adults study and a structural equation model to estimate longitudinal (1985-86 to 2005-06) pathways simultaneously from neighborhood fast food restaurants, sit-down restaurants, supermarkets, and convenience stores to BMI thr ...[more]

PMID: 26454248

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Project description:BackgroundRecent obesity prevention initiatives focus on healthy neighborhood design, but most research examines neighborhood food retail and physical activity (PA) environments in isolation. We estimated joint, interactive, and cumulative impacts of neighborhood food retail and PA environment characteristics on body mass index (BMI) throughout early adulthood.Methods and findingsWe used cohort data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study [n=4,092; Year 7 (24-42 years, 1992-1993) followed over 5 exams through Year 25 (2010-2011); 12,921 person-exam observations], with linked time-varying geographic information system-derived neighborhood environment measures. Using regression with fixed effects for individuals, we modeled time-lagged BMI as a function of food and PA resource density (counts per population) and neighborhood development intensity (a composite density score). We controlled for neighborhood poverty, individual-level sociodemographics, and BMI in the prior exam; and included significant interactions between neighborhood measures and by sex. Using model coefficients, we simulated BMI reductions in response to single and combined neighborhood improvements. Simulated increase in supermarket density (from 25(th) to 75(th) percentile) predicted inter-exam reduction in BMI of 0.09 kg/m(2) [estimate (95% CI): -0.09 (-0.16, -0.02)]. Increasing commercial PA facility density predicted BMI reductions up to 0.22 kg/m(2) in men, with variation across other neighborhood features [estimate (95% CI) range: -0.14 (-0.29, 0.01) to -0.22 (-0.37, -0.08)]. Simultaneous increases in supermarket and commercial PA facility density predicted inter-exam BMI reductions up to 0.31 kg/m(2) in men [estimate (95% CI) range: -0.23 (-0.39, -0.06) to -0.31 (-0.47, -0.15)] but not women. Reduced fast food restaurant and convenience store density and increased public PA facility density and neighborhood development intensity did not predict reductions in BMI.ConclusionsFindings suggest that improvements in neighborhood food retail or PA environments may accumulate to reduce BMI, but some neighborhood changes may be less beneficial to women.

Project description:To investigate the association between the neighborhood food environment and body mass index (BMI) among Chinese older adults. A multi-stage stratified random sampling method was used to recruit participants from 12 communities in Beijing, China, in 2019. Participants (n = 1764, 1034 women) in this study were older adults aged 65 to 80. We collected the participants' basic information, measured their height and weight, and calculated their BMI. Neighborhood food environments were measured by the density of and proximity to different food outlets using the Baidu Map Application Programming Interface. Adjusted multiple linear regression was performed to estimate the association between the food environment and BMI. Participants had a mean age of 69.7 ± 4.32 years old and an average BMI of 26.3 ± 3.50 kg/m2. Among the three types of stores, convenience stores had the easiest access, followed by greengrocers and supermarkets. Sit-down restaurants had the best access among different restaurants, followed by Chinese fast-food restaurants, and western fast-food restaurants had the worst access. Easier access to greengrocers (β = 0.281, p < 0.001) and sit-down restaurants (β = 0.304, p < 0.001) was associated with higher BMI in the 250 m buffer zone. More supermarkets were associated with higher BMI in the 500 m buffer zone (β = 0.593, p < 0.001). Access to convenience stores was positively associated with BMI in the 800 m buffer zone (β = 0.057, p < 0.001). Better access to Chinese fast-food restaurants was associated with higher BMI (β = 0.071, p = 0.001), and better access to western fast- food restaurants was associated with lower BMI (β = -0.400, p < 0.001) in the 1000 m buffer zone. There was a negative association between the nearest distance to greengrocers and BMI (β = -0.004, p < 0.001). Although we found some significant associations between the neighborhood food environment and obesity, the current results are not strong enough to draw specific conclusions. Policymakers will need to rely on more evidence to derive concrete policy recommendations.

Project description:In public health research, it has been well established that geographic location plays an important role in influencing health outcomes. In recent years, there has been an increased emphasis on the impact of neighborhood or contextual factors as potential risk factors for childhood obesity. Some neighborhood factors relevant to childhood obesity include access to food sources, access to recreational facilities, neighborhood safety, and socioeconomic status (SES) variables. It is common for neighborhood or area-level variables to be available at multiple spatial scales (SS) or geographic units, such as the census block group and census tract, and selection of the spatial scale for area-level variables can be considered as a model selection problem. In this paper, we model the variation in body mass index (BMI) in a study of pediatric patients of the Virginia Commonwealth University (VCU) Medical Center, while considering the selection of spatial scale for a set of neighborhood-level variables available at multiple spatial scales using four recently proposed spatial scale selection algorithms: SS forward stepwise regression, SS incremental forward stagewise regression, SS least angle regression (LARS), and SS lasso. For pediatric BMI, we found evidence of significant positive associations with visit age and black race at the individual level, percent Hispanic white at the census block group level, percent Hispanic black at the census tract level, and percent vacant housing at the census tract level. We also found significant negative associations with population density at the census tract level, median household income at the census tract level, percent renter at the census tract level, and exercise equipment expenditures at the census block group level. The SS algorithms selected covariates at different spatial scales, producing better goodness-of-fit in comparison to traditional models, where all area-level covariates were modeled at the same scale. These findings underscore the importance of considering spatial scale when performing model selection.

Dataset Information

Multiple pathways from the neighborhood food environment to increased body mass index through dietary behaviors: A structural equation-based analysis in the CARDIA study.

Publications

Multiple pathways from the neighborhood food environment to increased body mass index through dietary behaviors: A structural equation-based analysis in the CARDIA study.

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