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Neighborhood Food Outlet Access and Dietary Intake among Adults with Chronic Kidney Disease: Results from the Chronic Renal Insufficiency Cohort Study.
Madrigal, JM, Cedillo-Couvert, E, Ricardo, AC, Appel, LJ, Anderson, CAM, Deo, R, Hamm, LL, Cornish-Zirker, D, Tan, TC, Sha, D, et al
Journal of the Academy of Nutrition and Dietetics. 2020;(7):1151-1162.e3
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Abstract
BACKGROUND Healthy diet is essential in the management of chronic kidney disease (CKD) and preventing related comorbidities. Food outlet access has been studied in the general population; however, the influence of the local food environment on dietary intake among people with CKD has not been evaluated. OBJECTIVES This study examined the associations of food outlet density and type of outlets with dietary intake in a multicenter cohort of racially and ethnically diverse patients with CKD. METHODS The Chronic Renal Insufficiency Cohort Study is a multicenter prospective study of patients with CKD that used a validated food frequency questionnaire to capture dietary intake at the baseline visit. This is a cross-sectional analysis of 2,484 participants recruited in 2003-2006 from seven Chronic Renal Insufficiency Cohort Study centers. Food outlet data were used to construct a count of the number of fast-food restaurants, convenience stores, and grocery stores per 10,000 population for each geocoded census block group. Multivariable linear and logistic regression models were used to evaluate the associations between measures of food outlet availability and dietary factors. RESULTS The proportion of participants living in zero-, low-, and high-food outlet density areas differed by gender, race or ethnicity, and income level. Among male subjects, living in areas with zero or the highest number of outlets was associated with having the highest caloric intakes in multivariable models. Male subjects living in areas with zero outlets consumed the highest levels of sodium and phosphorous. Female subjects living in areas with zero outlets had the lowest average intake of calories, sodium, and phosphorous. Among low-income female subjects, close proximity to more outlets was associated with higher calorie consumption. Among all participants, access to fast-food restaurants was not associated with an unhealthy diet score, and access to grocery stores was not associated with a healthy diet score. CONCLUSIONS Average caloric and nutrient intakes differed by outlet availability; however, there were no strong associations with type of food outlet. This should be considered when developing food-focused public health policies.
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Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study.
Ferrari, G, Werneck, AO, da Silva, DR, Kovalskys, I, Gómez, G, Rigotti, A, Sanabria, LYC, García, MY, Pareja, RG, Herrera-Cuenca, M, et al
The international journal of behavioral nutrition and physical activity. 2020;(1):125
Abstract
BACKGROUND Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. METHODS This study examined data from 8185 adults (aged 18-65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix-diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. RESULTS Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. CONCLUSIONS Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA. TRIAL REGISTRATION ClinicalTrials. Gov NCT02226627 . Retrospectively registered on August 27, 2014.
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Longitudinal association between change in the neighbourhood built environment and the wellbeing of local residents in deprived areas: an observational study.
Foley, L, Coombes, E, Hayman, D, Humphreys, D, Jones, A, Mitchell, R, Ogilvie, D
BMC public health. 2018;(1):545
Abstract
BACKGROUND Features of the urban neighbourhood influence the physical, social and mental wellbeing of residents and communities. We explored the longitudinal association between change to the neighbourhood built environment and the wellbeing of local residents in deprived areas of Glasgow, Scotland. METHODS A cohort of residents (n = 365; mean age 50 years; 44% male; 4.1% of the 9000 mailed surveys at baseline) responded to a postal survey in 2005 and 2013. Wellbeing was assessed with the mental (MCS-8) and physical (PCS-8) components of the SF-8 scale. We developed software to aid identification of visible changes in satellite imagery occurring over time. We then used a Geographical Information System to calculate the percentage change in the built environment occurring within an 800 m buffer of each participant's home. RESULTS The median change in the neighbourhood built environment was 3% (interquartile range 6%). In the whole sample, physical wellbeing declined by 1.5 units on average, and mental wellbeing increased by 0.9 units, over time. In multivariable linear regression analyses, participants living in neighbourhoods with a greater amount of change in the built environment (unit change = 1%) experienced significantly reduced physical (PCS-8: -0.13, 95% CI -0.26 to 0.00) and mental (MCS-8: -0.16, 95% CI -0.31 to - 0.02) wellbeing over time compared to those living in neighbourhoods with less change. For mental wellbeing, a significant interaction by baseline perception of financial strain indicated a larger reduction in those experiencing greater financial strain (MCS-8: -0.22, 95% CI -0.39 to - 0.06). However, this relationship was reversed in those experiencing lower financial strain, whereby living in neighbourhoods with a greater amount of change was associated with significantly improved mental wellbeing over time (MCS-8: 0.38, 95% CI 0.04 to 0.72). CONCLUSIONS Overall, we found some evidence that living in neighbourhoods experiencing higher levels of physical change worsened wellbeing in local residents. However, we found a stronger negative relationship in those with lower financial security and a positive relationship in those with higher financial security. This is one of few studies exploring the longitudinal relationship between the environment and health.
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Community characteristics modify the relationship between obesity prevention efforts and dietary intake in children: the Healthy Communities Study.
Woodward-Lopez, G, Gosliner, W, Au, LE, Kao, J, Webb, KL, Sagatov, RD, Strauss, WJ, Landgraf, AJ, Nagaraja, J, Wilson, DK, et al
Pediatric obesity. 2018;(Suppl 1):46-55
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BACKGROUND The influence of community characteristics on the effectiveness of childhood obesity prevention efforts is not well understood. OBJECTIVE Examine the interaction of community characteristics with the relationship between community programmes and policies (CPPs) and dietary intake. METHODS An observational study of 5138 children in grades K-8 in 130 US communities was conducted in 2013-2015. Key informant interviews identified and characterized CPPs. CPP scores were generated for the number of target behaviours (CPP-Behav) and the number of behaviour change strategies (CPP-Strat) addressed by all CPPs and CPPs with nutrition goals over the prior 6 years in each community. Dietary intake was assessed by dietary screener and included intake of sugar from sugar-sweetened beverages; energy-dense foods; fruits and vegetables; whole grains; and fibre. Multivariate statistical models assessed the interactions between US region, urbanicity, community-level income, and community-level race/ethnicity and CPP scores in relation to dietary intake. RESULTS CPP-Strat was positively associated with healthier dietary intakes in the Northeast and West, and in high Hispanic communities; the reverse was true in the South, and in high African-American and low-income communities. The CPP-Behav was positively associated with healthier dietary intakes in the South and rural areas, and the reverse was true in the West. CONCLUSION The relationships between CPP index scores and dietary intake were most strongly influenced by region and urbanicity and to a lesser extent by community-level race/ethnicity and income. Findings suggest that different considerations may be needed for childhood obesity prevention efforts in communities with different characteristics.
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Two-Year Changes in Child Weight Status, Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment.
Saelens, BE, Glanz, K, Frank, LD, Couch, SC, Zhou, C, Colburn, T, Sallis, JF
Obesity (Silver Spring, Md.). 2018;(8):1338-1346
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OBJECTIVE The aim of this study was to examine 2-year changes in weight status and behaviors among children living in neighborhoods differing on nutrition and activity environments. METHODS A prospective observational study, the Neighborhood Impact on Kids study, was conducted in King County, Washington, and San Diego County, California. Children 6 to 12 years old and a parent or caregiver completed Time 1 (n = 681) and Time 2 (n = 618) assessments. Children lived in neighborhoods characterized as "high/favorable" or "low/unfavorable" in nutrition and activity environments, respectively (four neighborhood types). Child BMI z score and overweight or obesity status were primary outcomes, with diet and activity behaviors as behavioral outcomes. RESULTS After adjusting for sociodemographics and Time 1 values, children living in two of the three less environmentally supportive neighborhoods had significantly less favorable BMI z score changes (+0.11, 95% CI: 0.01-0.21; + 0.12, 95% CI: 0.03-0.21), and all three less supportive neighborhoods had higher overweight or obesity (relative risks, 1.41-1.49; 95% CI: 1.13-1.80) compared with children in the most environmentally supportive neighborhoods. Changes in daily energy intake and sedentary behavior by neighborhood type were consistent with observed weight status changes, with unexpected findings for physical activity. CONCLUSIONS More walkable and recreation-supportive environments with better nutrition access were associated with better child weight outcomes and related behavior changes.
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Neighborhood educational disparities in active commuting among women: the effect of distance between the place of residence and the place of work/study (an ACTI-Cités study).
Perchoux, C, Nazare, JA, Benmarhnia, T, Salze, P, Feuillet, T, Hercberg, S, Hess, F, Menai, M, Weber, C, Charreire, H, et al
BMC public health. 2017;(1):569
Abstract
BACKGROUND Active transportation has been associated with favorable health outcomes. Previous research highlighted the influence of neighborhood educational level on active transportation. However, little is known regarding the effect of commuting distance on social disparities in active commuting. In this regard, women have been poorly studied. The objective of this paper was to evaluate the relationship between neighborhood educational level and active commuting, and to assess whether the commuting distance modifies this relationship in adult women. METHODS This cross-sectional study is based on a subsample of women from the Nutrinet-Santé web-cohort (N = 1169). Binomial, log-binomial and negative binomial regressions were used to assess the associations between neighborhood education level and (i) the likelihood of reporting any active commuting time, and (ii) the share of commuting time made by active transportation modes. Potential effect measure modification of distance to work on the previous associations was assessed both on the additive and the multiplicative scales. RESULTS Neighborhood education level was positively associated with the probability of reporting any active commuting time (relative risk = 1.774; p < 0.05) and the share of commuting time spent active (relative risk = 1.423; p < 0.05). The impact of neighborhood education was greater at long distances to work for both outcomes. CONCLUSIONS Our results suggest that neighborhood educational disparities in active commuting tend to increase with commuting distance among women. Further research is needed to provide geographically driven guidance for health promotion intervention aiming at reducing disparities in active transportation among socioeconomic groups.
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Places where preschoolers are (in)active: an observational study on Latino preschoolers and their parents using objective measures.
Cerin, E, Baranowski, T, Barnett, A, Butte, N, Hughes, S, Lee, RE, Mendoza, JA, Thompson, D, O'Connor, TM
The international journal of behavioral nutrition and physical activity. 2016;:29
Abstract
BACKGROUND To combat the disproportionately higher risk of childhood obesity in Latino preschool-aged children, multilevel interventions targeting physical (in) activity are needed. These require the identification of environmental and psychosocial determinants of physical (in) activity for this ethnic group. The objectives were to examine differences in objectively-measured physical activity and sedentary behavior across objectively-determined types of locations in Latino preschool-aged children; and determine whether the differences in physical activity by location were greater in children of parents with higher neighborhood-safety perceptions and physical activity-supportive parenting practices. METHODS An observational field study was conducted in Houston (Texas, USA) from August 2011 to April 2012. A purposive sample of Latino children aged 3-5 years and one of their parents (n = 84) were recruited from Census block groups in Houston (Texas) stratified by objectively-assessed high vs. low traffic and crime safety. Seventy-three children provided valid data. Time spent outdoors/indoors tagged with geographic locations was coded into location types based on objective data collected using Global Positioning Systems units that children wore >8 hr/day for a week. Physical activity parenting practices, perceived neighborhood-safety, and demographics were reported by parents. Time spent in sedentary behavior and moderate-to-vigorous physical activity was measured based on objective data collected using accelerometers (motion sensors) that children wore >8 hr/day for a week. RESULTS The odds of children engaging in moderate-to-vigorous physical activity were 43% higher when outdoors than indoors (95% confidence interval: 1.30, 1.58), and the odds of being sedentary were 14% lower when outdoors compared to indoors (95% confidence intervals: 0.81, 0.91). This difference depended on parental neighborhood-safety perceptions and parenting practices. Children were most active in parks/playgrounds (30% of the time spent in moderate-to-vigorous physical activity) and least active in childcare/school settings (8% of the time spent in moderate-to-vigorous physical activity). CONCLUSIONS Objectively-assessed time spent in specific locations is correlated with physical activity and sedentary behavior in Latino preschoolers. Interventions and policies should identify ways to engage Latino preschool-aged children in more physical activity and less sedentary behavior while in childcare, and encourage parents to spend more time with their young children in parks/playgrounds and other safe outdoor places.
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Ageing in an ultra-dense metropolis: perceived neighbourhood characteristics and utilitarian walking in Hong Kong elders.
Cerin, E, Sit, CH, Barnett, A, Johnston, JM, Cheung, MC, Chan, WM
Public health nutrition. 2014;(1):225-32
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OBJECTIVE The neighbourhood built environment may affect walking behaviour of elders. However, such effects remain underexplored, especially in an Asian context. We examined associations of perceived environmental attributes with overall and neighbourhood-specific walking for transport in a sample of Chinese elders residing in Hong Kong, an ultra-dense Chinese metropolis. DESIGN Cross-sectional observational study using a two-stage stratified sampling strategy. SETTING Hong Kong, China. SUBJECTS Chinese-speaking elders (n 484), with no cognitive impairment and able to walk without assistance, residing in thirty-two selected communities stratified by socio-economic status and walkability, were interviewer-administered validated measures of perceived neighbourhood environment and walking for transport. RESULTS Much higher levels of transport-related walking (mean 569 (sd 452) min/week) than found in Western samples were reported. The degree of perceived access to shops, crowdedness, presence of sitting facilities and easy access of residential entrance were independently positively related to both frequency of overall and within-neighbourhood walking for transportation. Infrastructure for walking and access to public transport were predictive of higher frequency of transport-related walking irrespective of location, while the perceived degree of land-use mix was predictive of higher levels of within-neighbourhood walking. CONCLUSIONS The provision of easy access to shops, residential entrances and sitting facilities in the neighbourhood may promote overall transport-related walking, while a good public transport network and pedestrian infrastructure linking destination-poor with destination-rich locations may compensate for the detrimental effects of living in less walkable neighbourhoods. Governmental investment in these micro- and macro-environmental features would help the promotion of an active lifestyle in elders.