Associations of Built Food Environment with Dietary Intake among Youth with Diabetes

Abstract

ObjectiveTo evaluate the associations of supermarket and fast-food outlet accessibility and availability with dietary intake among youth with diabetes. DesignSubjects’ residential location and dietary intake was obtained from the SEARCH for Diabetes in Youth study. Food outlet data obtained from the South Carolina Department of Health and Environmental Control and InfoUSA were merged based on names and addresses of the outlets. The comprehensive data were then used to construct accessibility and availability measures for each participant. SettingState of South Carolina. ParticipantsThree hundred fifty-nine youths with diabetes (10 years old and older) from the SEARCH for Diabetes in Youth study. Phenomena of InterestSupermarket and fast-food outlet accessibility and availability; dietary intake represented by Dietary Approaches to Stop Hypertension (DASH) score. AnalysisGeneralized estimating equations analyses. ResultsIncreased availability and accessibility of supermarkets were significantly associated with higher DASH score, even after adjusting for individual-level correlates, urbanicity, and fast-food outlet accessibility or availability. Fast-food accessibility, however, was associated only with specific food groups (meat, sweets, and low-fat dairy intake), not with the DASH score. Conclusions and ImplicationsEfforts to promote environments conducive to healthful eating may significantly improve the overall dietary intake and reduce diet-related health complications among youth with diabetes.