Race, Ethnicity, and Neighborhood Food Environment Are Associated with Adolescent Sugary Drink Consumption During a 5-Year Community Campaign

Abstract Background A multi-level county-wide campaign to reduce sugary drink consumption was associated with significant decreases in retail sales of soda and fruit drinks. The aim of the current study was to examine changes in adolescent beverage consumption during the campaign by race/ethnicity and neighborhood food environment. Methods Beverage consumption among adolescents was evaluated at four time points in a repeated cross-sectional survey of a racially and ethnically diverse sample of sixth graders (N = 13,129) from public middle schools in the county. Each school’s surrounding attendance zone (i.e., neighborhoods where students live) was characterized as providing high or low exposure to unhealthy food retail (e.g., convenience stores, fast-food restaurants). Logistic and multiple linear regression models were used to evaluate changes in beverage consumption over time by student race/ethnicity and high versus low unhealthy food exposure. Results Over the 5 years, there were significant declines in the overall share of students who reported daily sugary drink consumption (49.4 to 36.9%) and their reported daily calories from these products (220 to 158 calories). However, disparities were observed, with higher levels of consumption among Black and Hispanic youth and among youth living in neighborhoods with more unhealthy food retail. Notably, Black students living in healthier neighborhood food environments reported significant decreases in daily consumption and calories after 5 years, while Black students living in neighborhoods with more convenience stores and fast-food outlets did not. Conclusion These findings suggest that both race/ethnicity and neighborhood food environments are important considerations when designing interventions to reduce sugary drink consumption among adolescents.

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Association between Neighborhood Food Environment and Body Mass Index among Older Adults in Beijing, China: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207658 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7658

Author(s):

Man Zhang ◽

Wen Guo ◽

Na Zhang ◽

Hairong He ◽

Yu Zhang ◽

...

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Body Mass ◽

Food Environment ◽

Fast Food ◽

Buffer Zone ◽

Convenience Stores ◽

Neighborhood Food Environment ◽

Fast Food Restaurants ◽

Beijing China

Objective: To investigate the association between the neighborhood food environment and body mass index (BMI) among Chinese older adults. Methods: 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. Results: 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). Conclusion: 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.

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Local Retail Food Environment and Consumption of Fruit and Vegetable among Adults in Hong Kong

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102247 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2247 ◽

Cited By ~ 3

Author(s):

Ting Zhang ◽

Bo Huang

Keyword(s):

Hong Kong ◽

Food Environment ◽

Fast Food ◽

Vegetable Consumption ◽

Grocery Stores ◽

Fruit Consumption ◽

Retail Food Environment ◽

Convenience Stores ◽

Fast Food Restaurants ◽

Retail Food

Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual’s homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04–1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11–2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04–1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people’s home is an important environmental factor in meeting fruit and vegetable consumption guidelines. “Food swamps” (areas with an abundance of unhealthy foods) rather than “food deserts” (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong’s urban areas. We advanced international literature by providing evidence in a non-western setting.

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Impact of neighbourhood food environment on diet and obesity in China: a systematic review

Public Health Nutrition ◽

10.1017/s1368980019002167 ◽

2019 ◽

Vol 23 (3) ◽

pp. 457-473 ◽

Cited By ~ 2

Author(s):

Ruopeng An ◽

Li He ◽

MS Jing Shen

Keyword(s):

Body Weight ◽

Food Environment ◽

Fast Food ◽

Weight Status ◽

Dietary Diversity ◽

Portion Size ◽

Cochrane Library ◽

Convenience Stores ◽

Fast Food Restaurants ◽

Local Residents

AbstractObjective:This study systematically reviewed literature on the neighbourhood food environment in relation to diet and obesity among residents in China.Design:A keyword search of peer-reviewed articles was performed in Cochrane Library, PubMed, and Web of Science. Eligibility criteria include study designs: longitudinal/cohort studies or cross-sectional studies; study participants: people of all ages; exposures: neighbourhood food environment (e.g. restaurants, supermarkets, wet markets, fast-food restaurants, or convenience stores); outcomes: diet and/or body weight status; and country: China.Results:Seventeen studies met all criteria and were included. Among the eight studies that assessed the neighbourhood food environment in relation to diet, six reported at least one statistically significant relationship in the expected direction, whereas the remaining two exclusively reported null effects. Among the eleven studies that assessed the neighbourhood food environment in relation to body weight or overweight/obesity, ten reported a significant association whereas the remaining one reported a null relationship. Variety, density, and proximity of food outlets were positively associated with local residents’ dietary diversity, portion size, and daily caloric intake. Density and proximity of fast-food restaurants and convenience stores were positively associated with local residents’ adiposity in some but not all studies. Evidence linking any specific food outlet type to diet/obesity remains lacking due to the small number of studies and heterogeneities in food environment measures, geographical locations, and population subgroups.Conclusions:The neighbourhood food environment may influence diet and obesity among Chinese residents but the evidence remains preliminary. Future studies adopting an experimental study design and objective/validated environment and dietary measures are warranted.

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Kids in a Candy Store: An objective analysis of children's interactions with food in convenience stores

10.21203/rs.2.19808/v1 ◽

2019 ◽

Author(s):

Christina McKerchar ◽

Moira Smith ◽

Ryan Gage ◽

Jonathan Williman ◽

Gillian Abel ◽

...

Keyword(s):

Food Environment ◽

Cross Sectional Study ◽

Dietary Behaviour ◽

Convenience Store ◽

Unhealthy Food ◽

Cross Sectional ◽

Product Packaging ◽

Sugary Drinks ◽

Convenience Stores ◽

Food And Drink

Abstract Background: Increasing rates of childhood obesity worldwide has focused attention on the obesogenic food environment and how it influences dietary behaviour and bodyweight in children. The neighbourhood convenience store is a key setting in children’s food environments. The Kids’Cam study enabled the objective measurement of the world in which children live. This paper reports on an analysis of children’s interaction with food in convenience stores.Methods: Kids’Cam NZ was a cross-sectional study conducted from July 2014 to June 2015 in the Wellington region of New Zealand, in which 168 randomly selected children aged 11-14 years old wore a wearable camera for a 4-day period. The camera captured a 136° image of the children’s surroundings every seven seconds. In this ancillary study, ‘Kids’Cam Convenience Stores’, images from children who visited a convenience store were manually coded for food and drink availability, marketing, purchase and consumption. Results: Twenty-two percent of children (n=37) visited convenience stores on 62 occasions during the 4-day data collection period. Non-core items dominated the food and drinks available to children in convenience stores at a rate of 8.3 to 1 (means, 300 non-core and 36 core, respectively). The food and drinks marketed in-store were overwhelmingly non-core, and promoted using accessible placement, price offers, product packaging, and signage. Most of the 70 items purchased by children were non-core foods or drinks (94.6%) and all of the purchased food or drink subsequently consumed by children was non-core. Confectionary and sugary drinks were the items most frequently purchased and consumed. Conclusions: This research highlights convenience stores as a key source of unhealthy food and drink for children, where unhealthy food and drinks are marketed, available, and subsequently purchased and consumed. Policies are urgently needed to reduce the role of convenience stores in the obesogenic food environment in which children live.

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Nutrition Environment Scores of Local Food Retailers and Proximity to Study Participants' Residence in Rural South (P04-157-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.p04-157-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Melissa Goodman ◽

Jessica Thomson ◽

Alicia Landry

Keyword(s):

African American Women ◽

Food Environment ◽

Fast Food ◽

Grocery Store ◽

Grocery Stores ◽

Fast Food Restaurant ◽

Convenience Stores ◽

Food Retailers ◽

Fast Food Restaurants ◽

Study Participants

Abstract Objectives An 18-month, two-arm, randomized, controlled trial designed to evaluate the comparative impact of two home visiting programs on gestational weight gain, postpartum weight loss, and diet was conducted with rural, Southern, African American women. Although nutrition education was an experimental treatment component, the intervention was not effective at improving participants’ poor diets. To better understand the dietary choices made by these women, an examination of the food environment was conducted in the towns in which they resided. Methods Food retailers were measured with the Nutritional Environment Measures Surveys (NEMS). ArcGIS was used to geocode study participants’ residence and food retailers and to compute driving distances between participants’ residence and food retailers. Participants’ diet quality was measured with Healthy Eating Index (HEI). Associations among food retailers’ type and NEMS score, driving distances between residences and food retailers, and HEI total and component scores were examined. Results Significant differences between types of food retailers were found for % of maximum NEMS scores: grocery stores (60%), full service restaurants (42%), fast food restaurants (36%), and convenience stores (26%). Participants were closer to convenience stores (mean = .4 miles) and fast food restaurants (mean = .5 miles) than to full service restaurants (mean = 1.1 miles) and grocery stores (mean = 1.6 miles). Three-fourths of participants lived within ½ mile of a convenience store and two-thirds lived within ½ mile of a fast food restaurant, while 6% lived within ½ mile of a grocery store. Only 19% shopped at their closest grocery store while two-thirds traveled a greater distance to shop at a larger national chain grocery store. The mean distance to the closest grocery store was 1.6 miles as compared to 4.2 miles for the store where most of the food was purchased. The refined grains HEI score was negatively correlated with distances to the closest convenience store, fast food restaurant, and full service restaurant. Conclusions The food environment of these rural, Southern, African American women provided numerous, convenient opportunities for unhealthy eating. Funding Sources US Department of Agriculture, Agricultural Research Service.

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Abstract 98: Discount Food Stores in High Disadvantage Los Angeles County Neighborhoods Explain Most Individual Difference in Body Mass Index

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.5.suppl_1.a98 ◽

2012 ◽

Vol 5 (suppl_1) ◽

Author(s):

Peter Capone-Newton ◽

Arleen F Brown ◽

Paul M Ong

Keyword(s):

Los Angeles ◽

Food Environment ◽

Fast Food ◽

English Language ◽

Causal Link ◽

Grocery Stores ◽

Food Environments ◽

Poor Diet ◽

Discount Stores ◽

Racial Ethnic

Introduction: Poor diet and physical inactivity is the second leading cause of mortality in the US after smoking. Cross-sectional, ecologic studies have associated specific obesogenic food environments (OFE examples: smaller distance to fast food restaurants, higher counts of fast food per population, larger distance to grocery stores, lower counts of grocery stores per population) to higher rates of poor diet or higher body mass index (BMI). OFEs are more prevalent in some low-income and racial/ethnic minority neighborhoods potentially contributing to widening health disparities. Recent analyses of two longitudinal cohorts (CARDIA; Framingham Offspring Cohort), found no associations between ecologic measures of OFEs and poor diet or BMI, possibly because they do not capture the characteristics of the OFEs associated with poor diet or BMI. Hypothesis: We assessed the hypothesis that current ecologic OFE measures do not capture the link between food environments and BMI because they ignore variability in food store types and actual distance traveled to purchase food. Populations defined by store type or distance may better describe the potential causal link. Methods: The Los Angeles Family and Neighborhood Survey (LAFANS) is a longitudinal cohort of 2619 households in Los Angeles County. In 2001-2, households were asked where they shopped for groceries (store name/location) and self-reported BMI. A six-category food environment measure based on store name and frequency was developed: high-frequency (HF) English-language named stores (“major chain”), discount stores (“less”, “value”, etc. in the name), HF Spanish-language stores, English-language specialty stores, multi-purpose or bulk purchase stores, other HF stores, and other low frequency stores of any language. We analyzed associations of this food environment measure with self-reported BMI, controlling for individual, household, and neighborhood characteristics. Results: In LAFANS households, 2297 (88%) reported both BMI and a valid store name. Of these, 37% of households shop at the nearest grocery store and only 13% shop in their home census tract. In adjusted models, discount store shoppers have substantially higher BMI than the referent group, major chain store shoppers in low disadvantage neighborhoods (BMI difference 1.40 points, (95% CI 0.62 - 2.18, p = 0.004), equivalent to a weight difference of 8.4 lbs. for an individual of median height and weight (5’5”,160 lbs.). Conclusions: In conclusion, distinguishing between store types may better describe the causal link between individuals, stores and BMI than ecologic measures. In L.A. County, discount stores, found almost exclusively in high disadvantage and racial/ethnic minority neighborhoods are associated with individual differences in BMI. Further research should assess whether the association between discount stores and BMI is related to unmeasured elements of store content or individual characteristics. Current policy efforts focused on modifying small markets or building major chain stores in high disadvantage neighborhoods may inadequately address food environment based racial/ethnic and income based health disparities in BMI.

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The food environment and adult obesity in US metropolitan areas

Geospatial health ◽

10.4081/gh.2015.368 ◽

2015 ◽

Vol 10 (2) ◽

Cited By ~ 7

Author(s):

Akihiko Michimi ◽

Michael C. Wimberly

Keyword(s):

Metropolitan Area ◽

Food Environment ◽

Fast Food ◽

Metropolitan Areas ◽

Food Environments ◽

Fast Food Restaurant ◽

Obesity Prevalence ◽

Large Share ◽

Individual Level ◽

The Us

This research examines the larger-scale associations between obesity and food environments in metropolitan areas in the United States (US). The US Census County Business Patterns dataset for 2011 was used to construct various indices of food environments for selected metropolitan areas. The numbers of employees engaged in supermarkets, convenience stores, full service restaurants, fast food restaurants, and snack/coffee shops were standardised using the location quotients, and factor analysis was used to produce two uncorrelated factors measuring food environments. Data on obesity were obtained from the 2011 Behavioral Risk Factor Surveillance System. Individual level obesity measures were linked to the metropolitan area level food environment factors. Models were fitted using generalised estimating equations to control for metropolitan area level intra-correlation and individual level sociodemographic characteristics. It was found that adults residing in cities with a large share of supermarket and full-service restaurant workers were less likely to be obese, while adults residing in cities with a large share of convenience store and fast food restaurant workers were more likely to be obese. Supermarkets and full-service restaurant workers are concentrated in the Northeast and West of the US, where obesity prevalence is relatively lower, while convenience stores and fast-food restaurant workers are concentrated in the South and Midwest, where obesity prevalence is relatively higher. The food environment landscapes measured at the metropolitan area level explain the continental-scale patterns of obesity prevalence. The types of food that are readily available and widely served may translate into obesity disparities across metropolitan areas.

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Obesogenic Environments and Public Health Mitigation Strategies

10.1093/oso/9780190626686.003.0008 ◽

2018 ◽

Author(s):

Allison Karpyn

Keyword(s):

Food Environment ◽

Fast Food ◽

Food Industry ◽

Health Impact ◽

Mitigation Strategies ◽

Farmers Markets ◽

Food Environments ◽

Fast Food Industry ◽

History Of ◽

Obesogenic Environments

The chapter begins with a description of the Health Impact Pyramid, which in many ways has set the stage for addressing challenges in the food environment. A definition and history of the term obesogenic environment is offered alongside the challenges less healthy food environments create. A brief description of the growth in the fast food industry is also provided in this context. Efforts to address challenges are later discussed in terms of strategies to reduce food deserts, improve the product mix in corner stores, and increase access to farmers markets.

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Snapshots of Urban and Rural Food Environments: EPOCH-Based Mapping in a High-, Middle-, and Low-Income Country from a Non-Communicable Disease Perspective

Nutrients ◽

10.3390/nu12020484 ◽

2020 ◽

Vol 12 (2) ◽

pp. 484

Author(s):

Mark Spires ◽

Aravinda Berggreen-Clausen ◽

Francis Xavier Kasujja ◽

Peter Delobelle ◽

Thandi Puoane ◽

...

Keyword(s):

South Africa ◽

Low Income ◽

Food Environment ◽

Communicable Disease ◽

Matched Pair ◽

Food Environments ◽

Unhealthy Food ◽

Food Retail ◽

Food Items ◽

Retail Outlets

A changing food environment is implicated as a primary contributor to the increasing levels of non-communicable diseases (NCDs). This study aimed to generate snapshots of selected external food environments to inform intervention strategies for NCD prevention in three countries: Uganda (low income), South Africa (middle income) and Sweden (high income), with one matched pair of urban–rural sites per country. Fifty formal and informal food retail outlets were assessed, and descriptive and comparative statistical analyses were performed. We found that formal food retail outlets in these countries had both positive and negative traits, as they were the main source of basic food items but also made unhealthy food items readily available. The Ugandan setting had predominantly informal outlets, while the Swedish setting had primarily formal outlets and South Africa had both, which fits broadly into the traditional (Uganda), mixed (South Africa) and modern (Sweden) conceptualized food systems. The promotion of unhealthy food products was high in all settings. Uganda had the highest in-community advertising, followed by South Africa and Sweden with the lowest, perhaps related to differences in regulation and implementation. The findings speak to the need to address contextual differences in NCD-related health interventions by incorporating strategies that address the food environment, and for a critical look at regulations that tackle key environment-related factors of food on a larger scale.

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Food shopping behaviours and exposure to discrimination

Public Health Nutrition ◽

10.1017/s136898001300075x ◽

2013 ◽

Vol 17 (5) ◽

pp. 1167-1176 ◽

Cited By ~ 28

Author(s):

Shannon N Zenk ◽

Amy J Schulz ◽

Barbara A Israel ◽

Graciela Mentz ◽

Patricia Y Miranda ◽

...

Keyword(s):

African American ◽

Food Environment ◽

Economic Status ◽

Grocery Store ◽

Food Environments ◽

Cross Sectional ◽

Socio Economic Status ◽

Food Shopping ◽

Unfair Treatment ◽

Race Ethnicity

AbstractObjectiveThe present study examined food shopping behaviours, particularly distance to grocery shop, and exposure to discrimination.DesignCross-sectional observational study utilizing data from a community survey, neighbourhood food environment observations and the decennial census.SettingThree communities in Detroit, Michigan, USA.SubjectsProbability sample of 919 African-American, Latino and white adults in 146 census blocks and sixty-nine census block groups.ResultsOn average, respondents shopped for groceries 3·1 miles (4·99 km) from home, with 30·9 % shopping within 1 mile (1·61 km) and 22·3 % shopping more than 5 miles (8·05 km) from home. Longer distance to shop was associated with being younger, African-American (compared with Latino), a woman, higher socio-economic status, lower satisfaction with the neighbourhood food environment, and living in a neighbourhood with higher poverty, without a large grocery store and further from the nearest supermarket. African-Americans and those with the lowest incomes were particularly likely to report unfair treatment at food outlets. Each mile (1·61 km) increase in distance to shop was associated with a 7 % increase in the odds of unfair treatment; this relationship did not differ by race/ethnicity.ConclusionsThe study suggests that unfair treatment in retail interactions warrants investigation as a pathway by which restricted neighbourhood food environments and food shopping behaviours may adversely affect health and contribute to health disparities. Efforts to promote ‘healthy’ and equitable food environments should emphasize local availability and affordability of a range of healthy food products, as well as fair treatment while shopping regardless of race/ethnicity or socio-economic status.

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