Relationship Between Neighborhood Food Environment and Diet Variety in Japanese Rural Community-dwelling Elderly: A Cross-sectional Study.

Tatsunosuke Gomi,Shigeru Inoue,Jun Kitayuguchi,Hiroharu Kamioka,Masamitsu Kamada,Kenta Okuyama,Yoshiteru Mutoh

doi:10.2188/jea.je20200415

Tatsunosuke Gomi, Shigeru Inoue + Show 5 more

Open Access

https://doi.org/10.2188/jea.je20200415

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Abstract

BackgroundFood access is an important aspect of health promotion for the elderly. The aim of this study was to investigate the relationship between distance to the nearest food store and diet variety in rural community-dwelling elderly Japanese.MethodsThis cross-sectional study analyzed data from 1,103 elderly participants surveyed by mail in rural areas of Japan. Diversity of food intake was assessed using the diet variety score (DVS). Street network distance from home to food store was calculated and categorized by quartile using a geographic information system and analyzed in relation to diet using multivariable regression with the primary outcome as low DVS. Sub-analysis of the association with DVS was conducted for each food store category (convenience store, supermarket, and small food store). The association between intake frequency of each food group and distance was also analyzed.ResultsParticipants in the fourth quartile of distance to food store had significantly higher prevalence ratio (1.15; 95% CI, 1.01–1.32) for low DVS than those in the first quartile. There was a significant tendency between greater distance to food store and lower DVS (P for trend = 0.033). Supermarkets and convenience stores, in particular, showed significant associations. Greater distance was significantly associated with lower frequency of meat and fruit intake.ConclusionThere was significant association between distance to nearest food store and diet variety in rural Japanese elderly. These findings suggest the importance of interventions for areas at high risk of low diet variety, such as places far away from food stores.

Highlights

Frailty among the elderly is a major problem worldwide.[1]
Several studies have been conducted on food environment and healthy eating[8]: obesity[9] and type 2 diabetes[10] were associated with food accessibility among adults in the United States, which led to interventions such as increasing the number of grocery stores.[11]
Low diet variability was reportedly related to frailty,[12] lean mass,[13] and physical function[14] in a study of Japan’s elderly and efforts are focused on expanding diet variety to maintain and improve health

Summary

Introduction

Frailty among the elderly is a major problem worldwide.[1]. Japan, the most rapidly aging society in the world, China, Canada, and many European countries will have aging population rates greater than 30% by 2050.2One cause of frailty is lack of nutrients and calories. The previous study reported that distance to the nearest supermarket was not associated with diet variety,[12] whereas Harada et al showed that it was significantly associated with lower diet variety.[15] The contradiction between these two studies may be that only one type of food store, supermarket, was examined and not the whole food environment. No study has examined the relationship between diet variety and neighborhood food environment, including small retail food and convenience stores; this has limited efforts to conduct dietary interventions.

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