Availability Of Unhealthy Foods Research Articles

Factors Influencing Adolescents' Dietary Behaviors in the School and Home Environment in Addis Ababa, Ethiopia.

BackgroundMalnutrition affects many adolescents in Ethiopia. Over one-third of adolescent girls and two-thirds of boys are thin. Overweight and obesity in Ethiopia is mostly a concern in urban populations of higher wealth quintiles. Urbanization and globalization of diets is shifting food environments. The objective of this study was to assess whether food environments in and around schools in urban Ethiopia influence dietary diversity, quality, BMI status or perceptions of adolescents.MethodsTwelve high schools were selected in Addis Ababa (private/government). From each school, 20 pupils aged 15–19 years were randomly selected (n = 217) and interviewed about assets in their households, their diets (categorized into 10 food groups of the Minimum Dietary Diversity, the Global Dietary Recommendations scores and four categories of the NOVA classification based on level of processing) and their use of pocket money. In addition, food environment audits were conducted within the school compound and a 0.5 km radius around each school and types of food outlets.ResultsOn average there were 436 food outlets and 246 food or drink advertisements around each school. The majority of the advertisements (89.9%) were of ultra-processed foods, mostly sugar-sweetened beverages (SSBs). Most were positioned on food outlets (89.1%). SSBs or sweets were visibly on display in 26.3% of the outlets and fresh fruits and vegetables in 17.9% of outlets. Dietary diversity of adolescents was poor with an average of 3.6 food groups out of 10 consumed in the last 24 h. Ultra-processed foods and beverages were consumed by 23.5% of adolescents. The majority of adolescents spent their pocket money on SSBs, sweets or fried foods. Our analysis found that higher assets in adolescents' households were associated with higher dietary diversity and consumption of healthy food groups. We found no association between the food environment and dietary indicators or the BMI-z-score.ConclusionWhile the school food environments investigated were not conducive with promoting healthy dietary behaviors, we cannot conclude that these environmental factors directly influence adolescents' diets. The pervasive advertising and availability of unhealthy foods and beverages requires policy action for healthy school food environments.

Food Availability in Different Food Environments Surrounding Schools in a Vulnerable Urban Area of Santiago, Chile: Exploring Socioeconomic Determinants.

The analysis of the food environment is used to identify areas with gaps in the availability of healthy foods and can be used as a public policy assessment tool. In recent decades, Chile has implemented several strategies and regulations to improve food environments, with encouraging results. Little is known about the scope of these measures in socially vulnerable environments. This study is part of a project that seeks to build an integrated intervention model for healthy school environments in a vulnerable area of Santiago, Chile. The objective of this study was to evaluate the availability of healthy and unhealthy foods around schools and the relationship between it and socioeconomic determinants of the school community in the Chilean context. A cross-sectional study to measure the food environment of informal markets (street food), formal markets (stores), and institutions (schools) was conducted in and around 12 schools (100 m surrounding schools) in a vulnerable urban area of Santiago, Chile. A lack of healthy foods was observed, which was related to some socio-economic determinants and the multidimensional poverty was the most relevant. The diagnosis of food environments around schools can represent an important target for governments to implement policies focused at improving the availability of healthy foods.

Choice, Motives, and Mixed Messages: A Qualitative Photo-Based Inquiry of Parents' Perceptions of Food and Beverage Marketing to Children in Sport and Recreation Facilities.

Unhealthy food and beverage availability and sponsorship undermine healthy food practices in sport and recreation. We conducted a focused ethnography with reflexive photo-interviewing to examine parents’ awareness, reactions, and experiences of food and beverage marketing in and around their children’s physical activity in public sport and recreation facilities. Eleven parents took photos of what they thought their facility was ‘saying about food and eating’. Photos guided semi-structured interviews on the ‘4Ps’ of marketing (product, pricing, placement, promotion). Thematic analysis was conducted by holistic coding followed by in vivo, versus, and value coding. Photo-taking increased parents’ awareness of food marketing in facilities. Reactions to food and beverage marketing were positive or negative depending on parents’ perspectives of healthy food availability (choice), marketers’ motives, and mixed messages within the facility. Parents experienced their children requesting ‘junk’ food at the facility leading to parents actively attempting to reduce the frequency of these requests. Healthy eating promotion in sport and recreation facilities was misaligned with the foods and beverages available which contributed to parents’ distrust of social marketing initiatives. Critically evaluating the alignment of commercial and social marketing in recreation and sport may help inform effective healthy eating interventions that are accepted and supported by parents.

Food Culture in Youth Athletics: Exploration of the Beliefs in USA Stakeholders

Objectives. The present study examined beliefs surrounding food culture in youth athletics. Design. Qualitative research. Methods. Coaches (n = 62), parents (n = 161), and youth athletes (n = 40) in the USA completed questionnaires that explored aspects of the food environment of youth athletics, including practices related to food and beverage consumption and perspectives on the nutritional value of available foods and beverages. Results. Coaches, parents, and athletes all reported a high number of available foods and beverages, and were mixed both about whether these were healthy or unhealthy, and whether the availability of unhealthy foods and beverages was problematic. Conclusions. This study aimed to add to the literature an examination of multiple perspectives on the current food culture in youth athletics. Participant perspectives suggest that the food environment of youth sport may be an unhealthy mismatch with the physical, social, and psychological benefits of participation. Further research could aim to identify optimal environments for promoting health in youth sport. Limitations and additional directions for future research are discussed.

Community support for policy interventions targeting unhealthy food environments in public institutions.

Understanding community support for obesity prevention policy is important for developing effective preventive health action. This study assessed support for a range of obesity prevention interventions, including food environment policies designed to improve healthy food and drink availability and promotion within public institutions. An online cross-sectional survey was completed by 2006 NSW adults. Questions explored attitudes and beliefs about obesity, the importance of government-led prevention and support for eight obesity prevention interventions. Regression analyses examined associations between intervention support and sociodemographic, attitudinal and behavioural characteristics. Most respondents (80%) believed obesity was a large problem and that poor individual choices (86%) and the widespread availability of unhealthy food and drink (78%) contributed to the issue. There was moderate to high support for most (n=7) initiatives. Support for food environment policies was highest for schools (76%-82%) and hospitals (67%-79%). Supporters and opponents rationalised opinions based on perceived effectiveness, the government's role and cost benefits. Opponents were a minority, but principles of autonomy were predominant. Attributing obesity to environment-related factors, and personal lower SSB consumption strongly predicted support. There is a significant recognition of the obesity issue and strong support for policies designed to improve the availability and promotion of healthy food and drink in public institutions, particularly in schools and hospitals. SO WHAT?: Substantial community support for healthy food environment policies in schools and hospitals warrants continued implementation in NSW. This may foster further acceptance for wider implementation. Our findings could inform the framing of policy advocacy messages.

Availability of foods according to the degree of processing in families with young elderly and oldest-old (POF 2017-2018)

ABSTRACT Objective To compare the availability of healthy and unhealthy foods in families with and without elderly and oldest-old people. Methods This is an observational, cross-sectional study with secondary data from the Household Budget Survey, conducted by the Brazilian Institute of Geography and Statistics between 2017 and 2018. Families were characterized based on the oldest member: Control (without elderly and oldest-old) or with elderly and oldest-old. The sociodemographic characteristics of the families and the foods purchased by the families were obtained, according to the Nova classification (in natura, processed and ultra-processed foods, in addition to culinary ingredients). Results Families with elderly and oldest-old people had greater availability of fresh foods and fewer ultra-processed foods. In contrast, young families showed greater acquisition of all ultra-processed food items. Conclusion The unfavorable nutritional transition process with fewer in natura foods seemed to be less evident in families with higher age groups. It is concluded that the presence of the elderly and oldest-old in the family could be related to a better quality of the family diet, with a greater presence of fresh foods and a lower acquisition of ultra-processed foods.

Determinants of overweight and obesity among adolescents in Zimbabwe: A scoping review

Background: Childhood obesity is a growing public health concern worldwide. Unfortunately, the health interventions remain biased towards addressing undernutrition. Aims: The study aimed to summarize the evidence on the determinants of obesity among adolescents in Zimbabwe. Methods: The Bronfenbrenner socio-ecological model (SEM) was used to classify these determinants: individual, social, environmental, and economic or government policies. The five-stage Arksey and O’Malley review methodology was used to formulate research questions, systematically search, and screen for relevant studies done between 2010 and 2020, data extraction, and summarizing the evidence. Google, PubMed, Google scholar, and United Nations websites were searched to identify relevant studies. The search yielded 22 results. Anthropometric indicators and the determinants assessed in each study were extracted. Results: Only 10 studies explored the determinants of obesity among adolescents in Zimbabwe. The risk of obesity was higher among older adolescents (16-19 years), particularly girls who reside in urban settings. Interestingly, girls had higher nutrition knowledge compared to boys. At the environmental level, fast food consumption, unhealthy snacking, low dietary diversity, carrying a packed lunchbox to school, and using non-active forms of transport to school was associated with obesity. In addition, having formally employed parents, and a small family size increased the odds of obesity. At the societal level, high family income and Christianity increased the rate of obesity. Economic instability appears to drive the availability and consumption of cheap unhealthy foods, particularly within the school environments. Conclusions: Adolescence is a critical stage where obesity starts to increase especially in girls as they graduate into adulthood. Sedentary lifestyles and the adoption of unhealthy dietary decisions appear to be exuberating this obesity problem in urban areas. School-based, family-oriented obesity prevention interventions which address gender discrepancies in eating habits and physical activity are recommended in these and related settings. Keywords: Adolescents, obesity, socio-ecological model, malnutrition, Zimbabwe.

Contribution of home availability, parental child-feeding practices and health beliefs on children's sweets and salty snacks consumption in Europe: Feel4Diabetes-Study.

Adoption of healthy dietary and snacking habits could support optimum physical and mental development in children as they define health in adulthood. This study assessed parameters associated with children's snacking such as food home availability, parenting practices, and parents' health beliefs. In this cross-sectional study 12 039 children, 49·4% boys 5-12 years, participating in the European Feel4Diabetes-Study were included. Children's weekly consumption of sweets and salty snacks, home availability of snacks, food parenting practices, and health beliefs were assessed via questionnaires. Logistic regression was applied to explore associations of a) home availability of snacks, b) food parenting practices (permissiveness and rewarding with snacks) and c) parent's opinions on deterministic health beliefs with children's consumption of sweets and salty snacks. Results showed that home availability (sweets: ORadj: 4·76, 95 % CI: 4·32, 5·23; salty snacks: ORadj: 6·56, 95 % CI: 5·64, 7·61), allowing to consume (sweets: ORadj: 3·29, 95 % CI: 2·95, 3·67; salty snacks: ORadj: 3·41, 95 % CI: 2·98, 3·90) and rewarding with sweets/salty snacks (sweets: ORadj: 2·69, 95 % CI: 2·23, 3·24; salty snacks: ORadj: 4·34, 95 % CI: 3·57, 5·28) 'sometimes/or less frequently' compared to 'always/or often' were associated with lower weekly consumption of sweets and snacks. Parents' disagreement compared to agreement with deterministic health beliefs and inattentive eating were associated with lower consumption of salty snacks and sweets in children. Overall, the findings of this study indicate that attempts to promote healthy snacking habits in children should aim to improve parental dietary habits, food parenting practices, health beliefs, and reducing home availability of unhealthy foods and snacks.

Availability, variety and distribution of healthy and unhealthy foods and beverages sold at street food stands in Mexico City.

To examine differences in the availability, variety and distribution of foods and beverages sold at street food stands (SFS) across neighbourhood income levels in Mexico City. Cross-sectional. Twenty neighbourhoods representing low-, middle- and high-income levels in Mexico City. Direct observations of SFS (n 391). The availability of healthy foods such as fruits/vegetables was high in middle- and high-income neighbourhoods, whereas the availability of unhealthy foods such as processed snacks was higher in low-income neighbourhoods. However, statistically significant differences in food availability across neighbourhoods were only observed for dairy and processed snack items (P < 0·05). Similarly, differences in variety were only observed for cereal and processed snacks (P < 0·05). No statistically significant differences were seen for variety of fruits/vegetable across neighbourhood income levels (P > 0·05). No statistically significant differences across neighbourhood income levels were observed for beverage availability and variety (P > 0·05). Although street foods and beverages were often distributed near homes, public transportation centres and worksites, no differences were observed across neighbourhood income levels (P > 0·05). Findings suggest that SFS can be a source of both unhealthy foods and healthy foods for communities across neighbourhoods in Mexico City. Additional studies are needed to assess the relationship between street food and beverage availability, and consumption.

Support policies that foster a healthy food environment and incentivize healthy food purchases to mitigate cancer inequities.

The COVID-19 pandemic has highlighted the inequitable access to resources, leading to a disproportionate burden of disease in vulnerable communities in the USA. However, these inequities in health outcomes are not limited to COVID-19. Approximately 18% of cancers are related to dietary behaviors and excess body weight. Underserved communities, such as minority racial/ethnic groups living in neighborhoods of low socioeconomic status, experience barriers to healthy eating including lack of access to high-quality healthy foods and higher availability of unhealthy foods and beverages in local retail food outlets. Strikingly, these same populations are more likely to die from cancers related to dietary intake and obesity like colorectal, liver, and pancreatic cancers. To reduce cancer inequities, policy makers can act by supporting programs that incentivize healthy food purchases and improve the local food environment in underserved communities.

The Food Environment of Primary School Learners in a Low-to-Middle-Income Area in Cape Town, South Africa.

Rapid changes in food environments, where less nutritious foods have become cheaper and more accessible, have led to the double burden of malnutrition (DBM). The role food environments have played in shaping the DBM has attained global interest. There is a paucity of food environment research in low-to-middle-income countries. We conducted a case study of the food environments of school aged learners. A primary school in Cape Town was recruited. A multi-method design was used: a home food and eating behaviours questionnaire completed by 102 household respondents and four questions completed by 152 learners; learner participatory photography; a semi-structured school principal interview; a tuckshop inventory; observation of three-day tuckshop purchases. Foods that were commonly present in households: refined carbohydrates, fats/oils, chicken, processed meats, vegetables, fruit, legumes, snacks/drinks. Two thirds of households had rules about unhealthy drinks/snacks, ate supper together and in front of the TV, ate a home cooked meal five–seven times/week and ate breakfast together under two times/week. Vegetables were eaten under two times/week in 45% of households. A majority of learners (84%) took a lunchbox to school. Twenty-five learners photographed their food environment and 15 participated in semi-structured interviews. Six themes emerged: where to buy; what is available in the home; meal composition; family dynamics; peer engagement; food preparation. Items bought at informal food outlets included snacks, drinks and grocery staples. The principal interview revealed the establishment of a healthy school food environment, including a vegetable garden, although unhealthy snacks were sold at the tuckshop. Key dimensions of the food environment that require further investigation in disadvantaged urban and informal settlement areas include the home availability of unhealthy foods, eating behaviours in households and healthfulness of foods sold by informal food outlets.

Food Environment in and around Primary School Children's Schools and Neighborhoods in Two Urban Settings in Kenya.

We conducted a cross-sectional study to provide an overview primary school children food environment in two urban settings in Kenya. Six schools, catering to children from low-, medium- and high-income households in the cities of Nairobi and Kisumu in Kenya, participated in the study. Data on types of food places and foods offered were collected and healthy and unhealthy food availability scores calculated for each place. We utilized prevalence ratio analysis to examine associations between food availability, food place characteristics and neighborhood income levels. Altogether, 508 food places, located within 1 km of the schools and the school children’s neighborhoods were observed. Open-air market sellers and kiosks were most common. The proportion of food places with high healthy food availability was 2.2 times greater among food places in Nairobi compared to Kisumu, 1.9 times greater in food places with multiple cashpoints, 1.7 times greater in medium/large sized food places and 1.4 times greater in food places located in high income neighborhoods. These findings highlight differences in availability of healthy foods and unhealthy foods across types of food places and neighborhood income levels and inform public health interventions aimed at promoting healthy food environments in Kenya.

Opportunities and challenges associated with food and nutrition education in Sri Lankan primary schools

ABSTRACT Primary school food and nutrition education helps to establish healthy dietary patterns among young children. Teachers play an important role in the success of this form of education. This study aimed to explore teachers’ perceptions of opportunities and challenges associated with food and nutrition education in Sri Lankan primary schools. Individual face-to-face interviews were conducted in the Sinhala or Tamil languages with 21 primary school teachers from April to June 2019. The recorded interviews were transcribed and later translated into English. The themes were identified using the template analysis technique. Lack of time and resources for teaching, lack of support from parents in practising healthy dietary habits, and availability of unhealthy foods in the school canteen and near-by food outlets were identified as the main challenges associated with teaching food and nutrition concepts to the students. School mid-day meal programmes, simple food and nutrition-related subject contents, and practical activities were identified as opportunities that facilitate food and nutrition teaching. The findings indicate that teachers face some challenges in teaching food and nutrition-related subject matters in the primary school set-ups. Policy planners and education officials have to work with primary school teachers to find ways to overcome these challenges and to further take up new opportunities. This will help to uplift the status of this form of education.

Role of Dental Nutrition Knowledge and Socioecological Factors in Dental Caries in Low-Income Women.

Dental caries is a chronic oral condition that disproportionately affects low-income women. The aim of this research was to investigate relationships between dental nutrition knowledge, socioecological factors, and prevalence of dental caries in low-income women. This quantitative cross-sectional study involved 220 women who were recruited from Central Texas. Participants completed demographics, the Dental Nutrition Knowledge Competency Scale, United States Adult Food Security Survey Module, and the Multidimensional Home Environment Scale. Two dentists measured dental caries via the Decayed, Missing, Filled Teeth Index. Regression models were conducted to test the effects of dental nutrition knowledge and Multidimensional Home Environment Scale factors on dental caries. Finally, mediation analysis explored relationships between dental nutrition knowledge and dental caries, adjusting for Multidimensional Home Environment Scale scores. Results showed that dental nutrition knowledge and Multidimensional Home Environment Scale score were significantly associated with dental caries. Subscales of self-efficacy for eating healthy, oral hygiene practices, emotional eating, availability of unhealthy foods at home, and social support were related to dental caries. The relationship between dental nutrition knowledge and caries was mediated by Multidimensional Home Environment Scale scores. This research emphasizes the role of dental nutrition knowledge and socio-ecological factors on prevalence of dental caries. Public health interventions to reduce dental caries should involve strategies that increase dental nutrition knowledge and encourage behavior change in low-income populations.

An examination between census tract unhealthy food availability and colorectal cancer incidence

BackgroundUnhealthy food environments may be associated with higher risks of developing diet-related cancers, such as, colorectal cancer. We conducted an ecological analysis to evaluate the relationship between the local food environment and colorectal cancer incidence overall and separately for males and females. MethodsData from the Texas Cancer Registry was utilized to geocode individuals aged 40 years and older diagnosed with colorectal cancer from 2005 to 2015 to their residential 2010 census tract. Total number of establishments classified as Limited Service Restaurants for each census tract was retrieved from the 2005 Business Patterns Survey by using a crosswalk to map zip codes to census tract. Census tract unhealthy food availability was calculated by dividing the estimated number of Limited Service Restaurant establishments in each census tract by the census tract population and divided into quartiles. Generalized estimating equations were used to assess the association between unhealthy food availability quartiles and colorectal cancer incidence. ResultsAdjusting for the census tract level sociodemographic characteristics, the incidence of colorectal cancer was slightly higher in unhealthy food availability quartile 2 (Incidence Rate Ratio (IRR) = 1.03, 95 % CI: 1.00–1.05), but not quartile 3 (IRR = 1.02, 95 % CI: 1.00–1.05), and quartile 4 (highest availability, IRR = 1.02, 95 % CI: 0.99–1.05) compared to census tracts with lowest unhealthy food availability. ConclusionColorectal cancer incidence was not strongly associated with census tracts with higher unhealthy food availability. Future observational studies should be conducted to examine the influence of the built environment on colorectal cancer risk.

The Relationships Between Parental Stress, Home Food Environment, and Child Diet Patterns in Families of Preschool Children.

Home food environment, including home food availability and parental food preparation practices, plays a significant role in child diet patterns. Recent evidence suggests that parental psychological stress is related to parental food preparation practices; however, there is limited information about the relationship between parental psychological stress and home food availability. The purpose of the study is to examine the relationships between parental stress, home food availability, child diet patterns, and body mass index (BMI) in families with young children. A secondary data analysis from a mixed-methods design study. The parent study was conducted in both local and online communities using a web-based survey. Participants were 256 parents of children aged 2 to 5 years (53.4% white; 41.5% of overweight or obese children). Parents completed well-validated self-report questionnaires. We used latent structural equation modeling using Bayesian analysis. There was a negative relationship between parents' general stress and healthy food availability at home (β* = -.20, P < .001 for fruits; β* = -.23, P < .001 for vegetables; and β* = -.24, P < .001 for healthy beverage) and a positive relationship between parenting stress and healthy snack and healthy beverage availability (β = .13, P = .03; β = .14, P = .02, respectively). There was no relationship between parental stress and unhealthy food availability at home while unhealthy food availability was significantly associated with child's unhealthy eating pattern (β* = .86, P < .01 for unhealthy snack; β* = .51, P < .01 for unhealthy beverage). There was no moderating effect of children's health insurance on the relationships between parental stress and home food availability. Furthermore, child diet patterns were not associated with child BMI. Parental psychological stress is a potentially important intervention target point for improving home food environment and child diet patterns.

Investigating foods and beverages sold and advertised in deprived urban neighbourhoods in Ghana and Kenya: a cross-sectional study

ObjectivesThe aim of this study was to characterise the local foods and beverages sold and advertised in three deprived urban African neighbourhoods.DesignCross-sectional observational study. We undertook an audit of all...

Association of Home Food Availability with Prediabetes and Diabetes Among Adults in the United States

Abstract Objectives This study examined associations of the availability of healthy and unhealthy foods in the home with prediabetes and diabetes status using National Health and Nutrition Examination Surveys (NHANES) Methods Analyses included 8929 participants (20–70 years) from 2007–2010 NHANES. Diabetes and prediabetes status were determined through self-report diagnosis and laboratory Hemoglobin A1C values. Food availability was measured using questionnaire regarding the frequency of foods/drinks available at home. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression adjusting for confounders. Results Prediabetes status was inversely associated with green vegetable (OR = 0.82; 95% CI = 0.73–0.91; P = 0.0006) and fat-free/low-fat milk (OR = 0.80, 95% CI = 0.65–0.89; P = 0.001) availability, and positively associated with sugary drink availability (OR = 1.24, 95% CI = 1.04–1.48; P = 0.02) adjusting for age, sex, and ethnicity (Model 1). The association remained statistically significant for vegetables (OR = 0.86; 95% CI = 0.78–0.95; P = 0.005) and fat-free/low-fat milk (OR = 0.82; 95% CI = 0.69–0.97; P = 0.02) after adjusting for additional confounders. Overall, participants with high healthy food availability scores had a 45% reduction (P = 0.003) in odds of having prediabetes compared to those with low scores in Model 1 although the association was attenuated in the full model (P = 0.06). The results were consistent across race/ethnicity with no interactions between home food availability and ethnicity. No association between home food availability and diabetes status was observed. Conclusions The results show prediabetes participants had lower availability of healthy foods and higher availability of unhealthy foods compared to individuals without prediabetes or diabetes suggesting the need to improve the home food environment and food choices in this population. Funding Sources N/A.

The association of parenting practices with toddlers' dietary intake and BMI, and the moderating role of general parenting and child temperament.

The objective was to examine the association between parenting practices, toddler's dietary intake and BMI. In addition, potential moderation of these associations by general parenting and child temperament was examined. The current cross-sectional study assessed parenting practices using the Comprehensive Feeding Practices Questionnaire, general parenting using the Comprehensive General Parenting Questionnaire, child temperament using the Child Behavior Check List, and children's dietary intake through parental questionnaires. Children's weight and length were objectively measured to determine BMI z-scores. Associations were examined using multiple linear regression analyses. Moderation was examined using interaction terms. Home setting. 393 Dutch toddlers (age 1-3 years) and their parents recruited through fifty childcare centres and preschools in the Netherlands. Various practices were related to children's diet and BMI. For instance, the availability of healthy foods is the most important predictor of healthy dietary intake (e.g. β = -0·35 for sweets; β = 0·18 for fruit). The association of availability with a healthier diet was strongest when parents scored low on the positive parenting style dimensions, including nurturance, structure and/or behavioural control. In addition, it seemed that a high availability of healthy foods and low availability of unhealthy foods is especially beneficial for children showing withdrawal/depressive, anxious or overactive behaviour, while encouraging balance and variety is not beneficial for these children. All other practices were related to children's diet and/or BMI as well. The findings underline the importance of viewing the impact of parenting practices in the context of general parenting and child temperament.

Association of Home Food Availability with Prediabetes and Diabetes among Adults in the United States.

This study examined associations of home food availabilities with prediabetes and diabetes among 8929 adults (20–70 years) participating in 2007–2010 National Health and Nutrition Examination Surveys. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Relative to non-diabetic participants (individuals without diabetes or prediabetes), prediabetes participants were associated with lower availabilities of green vegetables (OR = 0.82; 95% CI = 0.73–0.91; p = 0.0006) and fat-free/low-fat milk (OR = 0.80, 95% CI = 0.65–0.89; p = 0.001) and higher sugary drink availability (OR = 1.24, 95% CI = 1.04–1.48; p = 0.02), adjusting for age, sex, and ethnicity (Model 1). The associations remained significant for vegetables (p = 0.005) and fat-free/low-fat milk (p = 0.02) adjusting for additional confounders (body mass index, education, Model 2). Adjusting for dietary components did not change the above results (in model 2) significantly. Participants with high healthy food availability scores had approximately 31% reduction (p = 0.003) in odds of prediabetes compared to those with low scores in Model 1. No associations were detected for diabetes except for fat-free/low-fat milk availability, for which an inverse association was observed in Model 1 (OR = 0.80, 95% CI = 0.65–0.99; p = 0.04). The results show prediabetes participants had lower availability of healthy foods and higher availability of unhealthy foods, suggesting the need to improve healthy food availability at home for this population.