Abstract

The aim of this study is to investigate individual and joint associations of the home environment and the neighborhood built environment with adolescent dietary patterns and body mass index (BMI) z-score. Racially/ethnically and socioeconomically diverse adolescents (n=2682; 53.2% girls; mean age14.4 years) participating in the EAT 2010 (Eating and Activity in Teens) study completed height and weight measurements and surveys in Minnesota middle and high schools. Neighborhood variables were measured using Geographic Information Systems data. Multiple regressions of BMI z-score, fruit and vegetable intake, and fast food consumption were fit including home and neighborhood environmental variables as predictors and also including their interactions to test for effect modification. Supportive family environments (i.e., higher family functioning, frequent family meals, and parent modeling of healthful eating) were associated with higher adolescent fruit and vegetable intake, lower fast food consumption, and lower BMI z-score. Associations between the built environment and adolescent outcomes were fewer. Interaction results, although not all consistent, indicated that the relationship between a supportive family environment and adolescent fruit and vegetable intake and BMI was enhanced when the neighborhood was supportive of healthful behavior. Public health interventions that simultaneously improve both the home environment and the neighborhood environment of adolescents may have a greater impact on adolescent obesity prevention than interventions that address one of these environments alone.

Highlights

  • While obesity rates among adolescents have started to plateau for some racial/ethnic groups,[1,2,3,4,5] the prevalence of adolescent obesity remains at an all-time high posing a major public health concern.[4,5] A related concern is the dietary intake of adolescents

  • Previous research has provided a good understanding of individual-level risk and protective factors that are associated with adolescent obesity, the relationship between multiple contexts, such as the home food environment and the neighborhood built environment has been largely overlooked in relation to adolescent dietary intake patterns and obesity

  • Higher family functioning and parent modeling of healthful eating was associated with lower body mass index (BMI) z-score for adolescent girls

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Summary

Introduction

While obesity rates among adolescents have started to plateau for some racial/ethnic groups,[1,2,3,4,5] the prevalence of adolescent obesity remains at an all-time high posing a major public health concern.[4,5] A related concern is the dietary intake of adolescents. Fewer than 1 in 10 American adolescents meet the daily recommendation for fruit or vegetable intake.[6,7] About 33 percent of children and adolescents in the United States consume fast food on a typical day, and intake increases with age.[8,9] it is estimated that on average adolescents visit fast food restaurants approximately twice a week.[10] previous research has provided a good understanding of individual-level risk (e.g., fast food consumption) and protective factors (e.g. fruit and vegetable intake) that are associated with adolescent obesity, the relationship between multiple contexts, such as the home food environment (e.g., family meals, family functioning, modeling of health behaviors) and the neighborhood built environment (e.g., density of fast food, distance to closest supermarket) has been largely overlooked in relation to adolescent dietary intake patterns and obesity. Futhermore, NIH and other entities have called for such multi-contextual analyses to improve our understanding of the complex systems in which people live and by which they are influenced.[11]

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