Obesity and Supermarket Access: Proximity or Price?

Drewnowski, Adam; Aggarwal, Anju; Hurvitz, Philip M.; Monsivais, Pablo; Moudon, Anne Vernez

doi:10.2105/ajph.2012.300660

Cited by 239 publications

(286 citation statements)

References 42 publications

Supporting

Mentioning

266

Contrasting

Order By: Relevance

“…Another challenging point is to be able to separate endogenous from context factors, which in many cases are strongly interrelated (e.g. disentangling the characteristics of a neighbourhood from the shopping practices of the residents) (31) . Indeed, good measures of the food environment should be able to 'put the individual back into the equation' (5) , i.e.…”

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

Modifying the food environment for childhood obesity prevention: challenges and opportunities

et al. 2014

View full text Add to dashboard Cite

The prevention of childhood obesity is a global priority. However, a range of complex social and environmental influences is implicated in the development of obesity and chronic disease that goes beyond the notion of individual choice. A population-level approach recognises the importance of access to and availability of healthy foods outside the home. These external food environments, in restaurants, supermarkets, and in school, or recreation and sports settings, are often characterised by energy dense, nutrient-poor food items that do not reflect the current nutritional guidelines for health. In addition, our understanding of these broader influences on nutritional intake is still limited. Particularly, lacking is a clear understanding of what constitutes the food environment, as well as robust measures of components of the food environment across different contexts. Therefore, this review summarises the literature on food environments of relevance to childhood obesity prevention, with a focus on places where children live, learn and play. Specifically, the paper highlights the approaches and challenges related to defining and measuring the food environment, discusses the aspects of the food environment unique to children and reports on environmental characteristics that are being modified within community, school and recreational settings. Results of the review show the need for a continued focus on understanding the intersection between individual behaviour and external factors; improved instrument development, especially regarding validity and reliability; clearer reported methodology including protocols for instrument use and data management; and considering novel study design approaches that are targeted at measuring the relationship between the individual and their food environment.

show abstract

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

Modifying the food environment for childhood obesity prevention: challenges and opportunities

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Sixty percent of food-insecure US households have participated in at least one federal food and nutrition assistance program, the largest being the Supplemental Nutrition Assistance Program (SNAP, called Cal-Fresh in California) [21]. SNAP benefits may be insufficient for people with chronic illness to access healthy foods, which tend to cost more than less healthy foods [22][23][24]. In addition, many food-insecure individuals are excluded from participation in the federal food safety-net: in 2012, almost 30% of food-insecure households in the US had incomes above the eligibility thresholds for federal nutrition assistance [25]; SNAP also excludes undocumented immigrants.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health

et al. 2017

View full text Add to dashboard Cite

Food insecurity is associated with negative chronic health outcomes, yet few studies have examined how providing medically appropriate food assistance to food-insecure individuals may improve health outcomes in resource-rich settings. We evaluated a communitybased food support intervention in the San Francisco Bay Area for people living with HIV and/or type 2 diabetes mellitus (T2DM) to determine the feasibility, acceptability, and potential impact of the intervention on nutritional, mental health, disease management, healthcare utilization, and physical health outcomes. The 6-month intervention provided meals and snacks designed to comprise 100% of daily energy requirements and meet nutritional guidelines for a healthy diet. We assessed paired outcomes at baseline and 6 months using validated measures. Paired t tests and McNemar exact tests were used with continuous and dichotomous outcomes, respectively, to compare pre-post changes. Fifty-two participants (out of 72 initiators) had both baseline and follow-up assessments, including 23 with HIV, 24 with T2DM, and 7 with both HIV and T2DM. Median food pick-up adherence was 93%. Comparing baseline to follow-up, very low food security decreased from 59.6% to 11.5% (p < 0.0001). Frequency of consumption of fats (p = 0.003) decreased, while frequency increased for fruits and vegetables (p = 0.011). Among people with diabetes, frequency of sugar consumption decreased (p = 0.006). We also observed decreased depressive symptoms (p = 0.028) and binge drinking (p = 0.008). At follow-up, fewer participants sacrificed food for healthcare (p = 0.007) or prescriptions (p = 0.046), or sacrificed healthcare for food (p = 0.029). Among people with HIV, 95% adherence to antiretroviral therapy increased from 47 to 70% (p = 0.046). Among people with T2DM, diabetes distress (p < 0.001), and perceived diabetes self-management (p = 0.007) improved. Comprehensive, medically appropriate food support is feasible and may improve multiple health outcomes for food-insecure individuals living with chronic health conditions. Future studies should formally test the impact of medically appropriate food support interventions for food-insecure populations through rigorous, randomized controlled designs.

show abstract

“…Research on the impact of supermarkets on consumer nutritional status in developing countries is rare. Studies in the USA show that access to supermarkets is nowadays often associated with lower obesity rates (18)(19)(20)(21) , but the situation in developing countries is different. We are aware of only one study that has looked at the impact of supermarkets on nutritional status in a developing country, namely Guatemala (15) .…”

mentioning

confidence: 99%

Do supermarkets contribute to the obesity pandemic in developing countries?

Kimenju¹,

Rischke²,

Klasen³

et al. 2015

Public Health Nutr.

View full text Add to dashboard Cite

Objective: Many developing countries are undergoing a nutrition transition with rising rates of overweight and obesity. This nutrition transition coincides with a rapid expansion of supermarkets. The objective of the present research is to study whether supermarkets directly contribute to overweight and other changes in nutritional status. Design: This research builds on cross-sectional observational data. Householdand individual-level data were collected in Kenya using a quasi-experimental survey design. Instrumental variable regressions were employed to analyse the impact of supermarket purchase on nutritional status. Causal chain models were estimated to examine pathways through which supermarkets affect nutrition. Setting: Small towns in Central Province of Kenya with and without supermarkets. Subjects: A total of 615 adults and 216 children and adolescents. Results: Controlling for other factors, buying in a supermarket is associated with a significantly higher BMI (P = 0·018) and a higher probability of overweight (P = 0·057) among adults. This effect is not observed for children and adolescents. Instead, buying in a supermarket seems to reduce child undernutrition measured by height-for-age Z-score (P = 0·017). Impacts of supermarkets depend on many factors including people's initial nutritional status. For both adults and children, the nutrition effects occur through higher food energy consumption and changes in dietary composition. Conclusions: Supermarkets and their food sales strategies contribute to changing food consumption habits and nutritional outcomes. Yet the types of outcomes differ by age cohort and initial nutritional status. Simple conclusions on whether supermarkets are good or bad for nutrition and public health are not justified.

show abstract

Obesity and Supermarket Access: Proximity or Price?

Abstract: Improving physical access to supermarkets may be one strategy to deal with the obesity epidemic; improving economic access to healthy foods is another.

Cited by 239 publications

References 42 publications

Modifying the food environment for childhood obesity prevention: challenges and opportunities

Modifying the food environment for childhood obesity prevention: challenges and opportunities

Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health

Do supermarkets contribute to the obesity pandemic in developing countries?

Contact Info

Product

Resources

About