Longitudinal Associations Between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample

Abstract

Introduction Blacks, Hispanics, and women of lower socioeconomic status tend to have a higher risk of obesity. Numerous studies over the past decade examined the role of the neighborhood food environment in body weight. However, few were longitudinal. Purpose This study examined whether multiple measures of neighborhood food availability were associated with body mass index (BMI) over time in a predominately black and Hispanic adult sample living in low to moderate income urban neighborhoods. Methods This longitudinal study utilized two waves of data (2002 (2008), including interviewer-measured height and weight, from a community survey of adults (n=219). In both 2002 and 2008, multiple measures characterized neighborhood food availability: GIS-derived availability of retail food outlets (large grocery store, small grocery store, convenience store, liquor stores), observed fruit and vegetable availability (count of stores selling 10 or more fresh fruit or vegetable varieties), and perceived fruit and vegetable access. Random intercept models estimated multivariable associations, controlling for individual-level demographics and neighborhood median household income. Results Small grocery store availability was associated with 1.22-unit increase in BMI (p=0.047), while each unit increase in perceived fruit and vegetable access was associated with a 0.69-unit decrease in BMI (p=0.055). BMI over time was not associated with large grocery store, convenience store, or liquor store availability, or with observed fruit and vegetable availability. Conclusions Findings suggest that improving the neighborhood food environment, particularly at small grocery stores, may help urban residents living in low to moderate income neighborhoods achieve healthier body weights over time.

Geographic Accessibility Of Food Outlets Not Associated With Body Mass Index Change Among Veterans, 2009–14

“…Our study adds to a still small, but accumulating number of longitudinal studies that have generally found that food outlets have either no effect on BMI or effects that are small in magnitude and not clinically meaningful(42–48). Our findings suggest that cross-sectional results should be interpreted with caution and it is unlikely that additional cross-sectional research will provide needed insights into whether geographic accessibility of supermarkets, fast food restaurants, and/or mass merchandisers are promising targets for policy interventions to promote healthier BMI.…”

Adults with diabetes residing in “food swamps” have higher hospitalization rates

“…Thus, although the ratio of fast food outlets to grocers may be similar in urban and rural areas, this lack of acceptable and affordable healthy options may be spurring rural residents, including those with diabetes, to purchase more unhealthy items. In fact, several studies, including some longitudinal studies, have found a positive association between small grocery stores and increased BMI in contrast to either a negative association or no association between supermarket availability and BMI . In addition, the concentration of supermarkets in regional hubs means that rural residents must travel farther distances than their urban counterparts to access healthy foods, which is also made more difficult by the fact that rural areas often lack any public transportation .…”

“…Zip codes and block groups may capture the food environment near the home, but most residents travel outside of their immediate areas for work and other daily activities and are therefore likely to be impacted by the food environment of neighboring areas. Counties, however, are more likely to capture the majority of their daily routes and, thus, their exposure . Additionally, land use and zoning regulations often occur at the county level, so estimates for smaller units may be harder to apply to any potential policy change discussions .…”

Implementation of a School Nurse-led Intervention for Children With Severe Obesity in New York City Schools

“…Factors outside the school setting such as advertising of unhealthy foods (Andreyeva, Kelly, & Harris, 2011), poor neighborhood walkability (Vandegrift & Yoked, 2004), fast food restaurant access (Newman, Howlett, & Burton, 2014), perceived or actual healthy food access (Rundle et al, 2009; Zenk, Mentz, Schulz, Johnson-Lawrence, & Gaines, 2016), and large portion sizes (Pourshahidi, Kerr, McCaffrey, & Livingstone, 2014) impact health, nutrition, physical activity and body weight. Such factors only intensify physiological, hormonal, and metabolic resistance to weight loss (Farias, Cuevas, & Rodriguez, 2011; Müller, Bosy-Westphal, & Heymsfield, 2010).…”