Does transportation mode modify associations between distance to food store, fruit and vegetable consumption, and BMI in low-income neighborhoods?

Abstract

A consistent body of research has shown that the neighborhood food environment is associated with fruit and vegetable (F&V) consumption and obesity in deprived neighborhoods in the United States. However, these studies have often neglected to consider how transportation can moderate associations between food accessibility and diet-related outcomes. This study examined associations between distance to primary food store, fruit and vegetable consumption, and BMI and whether mode of transportation to the primary food store moderates this relation. Cross-sectional data from the baseline wave of the Philadelphia Neighborhood Food Environment Study were used. A telephone survey of adult (≥18 y of age) household primary food shoppers residing in 2 Philadelphia neighborhoods was conducted (n = 1440). In a bivariate linear regression analysis, distance to primary food store did not predict F&V consumption (β = 0.04; 95% CI: -0.00, 0.09). Linear regression analysis stratified by transportation mode to the main F&V store showed no difference in F&V consumption between car, public, and multimodal transportation users. Compared with respondents using multimodal transportation, those using public transit had a significantly lower BMI (β = -1.31; 95% CI: -2.50, -0.10), whereas those using an automobile did not (β = -0.41; 95% CI: -1.36, 0.54). The assumption that using an automobile to access food stores results in increased F&V consumption was not confirmed. Significant associations were found for the relation between transportation mode and BMI. Theory-based mechanisms explaining relationships between the primary transportation mode used to access food stores and BMI should be further explored.