Purpose Rural residents are more likely to be obese than urban residents. Research on how people navigate their local food environments through food acquisition behaviors, such as food shopping and restaurant use, in different types of communities may help to create a deeper understanding of the multilevel determinants of obesity. Methods Data are from a national sample of US adults ages 18‐75. Respondents were recruited from an online survey panel in 2015 and asked about food shopping, restaurant use, diet and weight (N = 3,883). Comparisons were made by level of rurality as assessed by Rural‐Urban Continuum Codes (RUCC) and self‐reported rurality of the area around their home. Findings Food acquisition behaviors varied minimally by RUCC‐defined level of rurality, with the exceptions of type and distance to primary food store. Rural residents drove further and were more likely to shop at small grocery stores and supercenters than were residents of semiurban or urban counties. In contrast, all of the food acquisition behaviors varied by self‐reported rurality of residential areas. Respondents living in rural areas shopped for groceries less frequently, drove further, more commonly shopped at small grocery stores and supercenters, and used restaurants less frequently. In multivariable analyses, rural, small town, and suburban areas were each significantly associated with BMI and fruit and vegetable intake, but not percent energy from fat. Conclusion Findings show that self‐reported rurality of residential area is associated with food acquisition behaviors and may partly explain rural‐urban differences in obesity and diet quality.
Background Non‐alcoholic fatty liver disease (NAFLD) is commonly diagnosed in patients presenting with metabolic syndrome (MetS) and has been associated with single nucleotide polymorphisms of rs738409 in the patatin‐like phospholipase domain containing 3 (PNPLA3) gene. This association remains to be investigated in the South Indian population. We aimed to determine the association of the PNPLA3 rs738409 gene polymorphism with MetS and NAFLD among a Chennai‐based population. Methods The study comprised 105 NAFLD cases and 102 controls. All subjects were genotyped for the PNPLA3 rs738409 variant and MetS was defined according to the National Cholesterol Education Program – Adult Treatment Panel III criteria. Our case–control study showed the association of the variant with NAFLD and MetS. Results The PNPLA3 rs738409 variant was associated with NAFLD and the genotype frequencies (CC/CG/GG) were 19 (18.1%), 50 (47.6%) and 36 (34.3%) in the NAFLD group and 59 (57.8%), 29 (28.4%) and 14 (13.7%) in the control group respectively. We also confirmed the interaction between the PNPLA3 rs738409 polymorphism and MetS with respect tto elevated triglyceride levels. However, an association with elevated waist circumference, fasting glucose, blood pressure and decreased high‐density lipoprotein cholesterol was not observed in the present study. Conclusions The PNPLA3 rs738409 gene polymorphism increases the risk of NAFLD by up to four‐fold in subjects with an elevated level of triglyceride independent of other features of MetS.
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