Neighborhood food environment and mortality among older Japanese adults: results from the JAGES cohort study

Abstract

BackgroundPrevious research has linked lower availability of food stores selling fruits and vegetables to unhealthy diet. However, the longitudinal association between the availability of healthy food stores and mortality is unknown. This study examined the association between neighborhood availability of food stores and mortality by driving status among older adults.MethodsThis study drew upon a three-year follow up of participants in the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese adults aged 65 years or older. Mortality from 2010 to 2013 was analyzed for 49,511 respondents. Neighborhood availability of food stores was defined as the number of food stores selling fruits and vegetables within a 500-m or 1-km radius of a person’s residence. Both subjective (participant-reported) and objective (geographic information system-based) measurements were used to assess this variable. Cox regression models were used to estimate hazard ratios (HR) for mortality.ResultsA total of 2049 deaths occurred during the follow up. Lower subjective availability of food stores was significantly associated with increased mortality. Compared with participants reporting the highest availability, the age- and sex-adjusted HR for those reporting the lowest availability was 1.28 (95% CI: 1.04–1.58; p = 0.02). The association remained significant after adjustment for sociodemographic (education, income, cohabitation, marital status, and employment status) and environmental (driving status, use of public transportation, and study site) status (HR = 1.24, 95% CI: 1.01–1.53, p = 0.04). This association was stronger among non-car users, among whom the HR for those reporting the lowest availability of food stores was 1.61 (95% CI: 1.08–2.41, p = 0.02). In contrast, no significant association was seen between objective availability and mortality.ConclusionsLower availability of healthy food stores measured subjectively, but not objectively, was associated with mortality, especially among non-car users. Considering the decline in mobility with age, living in a neighborhood with many options for procuring fruits and vegetables within walking distance may be important for healthy aging.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0732-y) contains supplementary material, which is available to authorized users.

Associations of perceived daily walking duration with residential food outlets in small Chinese cities: a cross-sectional study

“…Secondly, to further understand the impact of food outlets on DailyWalk among different age groups, participants were categorised into younger adults (aged [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] and older adults (aged 36-59). This threshold was the same as that used in previous studies in Chinese contexts [15,50].…”

“…a Analyses adjusted for city (Yuncheng, Suihua), gender (male, female), age groups (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), education attainment (junior college or below, bachelor or higher), household income (3,000 or below, 3,001-5,000, 5,001+), occupation (employed, self-employed, others).…”

“…Furthermore, apart from café/tea house, the occurrence of the other six food outlets within walking distance from home was high, suggesting that residents subjectively perceived a high availability of food outlets in their current neighbourhood. Thus, providing local food outlets is not a critical issue in small Chinese cities, compared with developed countries [12,20].…”

“…Many studies have indicated a functional amenity, which have examined associations of neighbourhood food outlets with a series of outcomes, such as mortality [20], body mass index/obesity [21][22][23], unhealthy eating habits [24,25], age-related differences [23,26], socioeconomic status [21,27], neighbourhood characteristics (e.g. school, work site or home) [27] and food intakes/purchase motivations [28][29][30].…”

Does public transportation reduce inequalities in access to dental care among older adults? Japan Gerontological Evaluation Study

“…The independent variables were daily public transportation use and household equivalent income. Daily public transportation use was assessed by the following question: ‘What transportation do you use when you go out daily?’ and the choices were as follows: (a) I walk, (b) bicycle, (c) motorbike, (d) car (driving themselves), (e) car (travelling in a family member's car), (f) train, (g) public bus, (h) hospital bus or other facility bus, (i) wheelchair, (j) electronic wheelchair, (k) walker or silver car, (l) taxi and (m) other. In this study, a daily public transportation user was defined as someone who chose ‘train’ or ‘public bus’.…”