Associations between residential food environment and dietary patterns in urban-dwelling older adults: results from the VoisiNuAge study

Abstract

Objective: To examine associations between the availability of residential-area food sources and dietary patterns among seniors. Design: Cross-sectional analyses. Individual-level data from the NuAge study on nutrition and healthy ageing were merged with geographic information system data on food store availability and area-level social composition. Two dietary patterns reflecting lower-and higher-quality diets (respectively designated 'western' and 'prudent') were identified from FFQ data. Two food source relative availability measures were calculated for a 500 m road-network buffer around participants' homes: (i) proportion of fast-food outlets (%FFO) relative to all restaurants and (ii) proportion of stores potentially selling healthful foods (%HFS, healthful food stores) relative to all food stores. Associations between dietary patterns and food source exposure were tested in linear regression models accounting for individual (health and sociodemographic) and area-level (socio-economic and ethnicity) covariates. Setting: Montréal metropolitan area, Canada. Subjects: Urban-dwelling older adults (n 751), aged 68 to 84 years. Results: %FFO was inversely associated with prudent diet (b 5 20?105; P , 0?05) and this association remained statistically significant in models accounting for %HFS. %HFS was inversely associated with lower western diet scores (b 5 20?124; P , 0?01). This latter association no longer reached significance once models were adjusted for area-level covariates. Conclusions: In Montréal, the food environment is related to the diet of older adults but these links are more complex than straightforward. The absence of significant relationships between healthful food stores and prudent diets, and between fast-food outlets and western diets, deserves further investigation.

Foodscapes of southern Ontario: Neighbourhood deprivation and access to healthy and unhealthy food retail

“…19 We then classified supermarkets, grocery stores and fruit and vegetable shops as "healthy" and fast-food outlets and convenience stores as "unhealthy" FR. This classification scheme is similar to previous research 5,6,20,21 and is summarized in Table 1, along with definitions of each FR type.…”

“…However, our finding of plentiful access to unhealthy food sources in absolute terms (alongside better absolute access to healthy FR) in Hamilton and Brampton/Mississauga is a concern, given recent research linking a greater share of unhealthy FR to poorer dietary patterns and higher levels of obesity and diabetes. 5,6,21 There are also growing concerns that "food swamps" may influence food choices more strongly than poor access to sources of healthy food. 7 Additionally, residents of lower-income areas may be more vulnerable to their surrounding FR environment because of limited transportation options, time and financial constraints, and value for money of fast food.…”

Food retail assessment and family food purchase behavior in Ashongman estates, Ghana

“…Further, it has been identified as a key driver of the nutrition transition [1][2][3]. Studies in urban areas in many developed countries have shown that the food environment has been influenced by the modern built environment, making it increasingly easier to access unhealthy food options [4,5]. This characteristic of the urban food environment has also been described as 'food desert', a term used to describe neighborhoods with limited physical and economic access to healthier food options such as fruits, vegetables and other healthy whole foods [6][7][8].…”

The food environment and diet quality of urban-dwelling older women and men: Assessing the moderating role of diet knowledge

“…6 Although nutrition knowledge does not necessarily translate into healthier diets, it is a prerequisite for the selection of healthy foods in a competitive food environment where healthy and unhealthy food options co-exist. 7 Few studies have investigated the influence of food environment among older adults, 8,9 despite the importance of residential neighbourhood influence posited by ecological models of aging. 10 Among younger adults, evidence suggests that better access to supermarkets and the availability of healthy foods as measured in grocery stores are associated with more healthy food choices in the US, but this relationship is not observed consistently elsewhere.…”

“…12 A small but growing number of studies have used such metrics to estimate associations with dietrelated outcomes. 8,12,13 Inconsistent findings might also be linked to variations in the dose-response relationship. Ecological models have long recognized dynamic and complex interactions between individuals and their environments.…”