Density Of Food Outlets Research Articles

Food Outlet Accessibility and Fruit and Vegetable Consumption

To examine if spatial access to healthy and unhealthy outlets comprising the local food environment was associated with fruit and vegetable consumption. Cross-sectional. Population-based sample residing in Hawaii. Subjects . Three hundred and eighty-four adults (36% Asian-American, 33% non-Hispanic white, 31% other/mixed race). A spatial model of the local food environment was constructed using radial buffers extending from participants' place of residence. Fruit and vegetable intake was estimated using the National Cancer Institute Fruit and Vegetable All-Day Screener. Mean intakes of fruits and vegetables were compared for spatial access to total, healthy, and unhealthy food outlets at distances of .5 to 3.5 km. Multiple linear regression was used to estimate differences in fruit and vegetable intake for residing further from a food outlet or for residing in an area with a greater number of food outlets. Residing in an area with a greater density of total or healthy food outlets was associated with a higher mean intake of fruits and vegetables (p < .05) at .5 km. No differences in mean intakes were detected for distances beyond .5 km or for regression models. Findings suggest that greater spatial accessibility to food outlets comprising the local food environment in Hawaii may not be meaningfully associated with fruit and vegetable consumption; however, associations were detected for the smallest spatial scale examined, warranting further investigation.

Associations of built food environment with body mass index and waist circumference among youth with diabetes

BackgroundYouth with diabetes are at increased risk for obesity and cardiovascular disease complications. However, less is known about the influence of built food environment on health outcomes in this population. The aim of this study was to explore the associations of accessibility and availability of supermarkets and fast food outlets with Body Mass Index (BMI) z-score and waist circumference among youth with diabetes.MethodsInformation on residential location and adiposity measures (BMI z-score and waist circumference) for 845 youths with diabetes residing in South Carolina was obtained from the South Carolina site of the SEARCH for Diabetes in Youth study. Food outlets 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 on franchised supermarket and fast food outlets was then used to construct three accessibility and availability measures around each youth’s residence.ResultsIncreased number and density of chain supermarkets around residence location were associated with lower BMI z-score and waist circumference among youth with diabetes. For instance, for a female child of 10 years of age with height of 54.2 inches and weight of 70.4 pounds, lower supermarket density around residence location was associated with about 2.8–3.2 pounds higher weight, when compared to female child of same age, height and weight with highest supermarket density around residence location. Similarly, lower supermarket density around residence location was associated with a 3.5–3.7 centimeter higher waist circumference, when compared to residence location with the highest supermarket density. The associations of number and density of chain fast food outlets with adiposity measures, however, were not significant. No significant associations were observed between distance to the nearest supermarket and adiposity measures. However, contrary to our expectation, increased distance to the nearest fast food outlet was associated with higher BMI z-score, but not with waist circumference.ConclusionsFood environments conducive to healthy eating may significantly influence health behaviors and outcomes. Efforts to increase the availability of supermarkets providing options/selections for health-promoting foods may significantly improve the dietary intake and reduce adiposity among youth with diabetes.

Food outlet availability, deprivation and obesity in a multi-ethnic sample of pregnant women in Bradford, UK

The obesogenic environment model would suggest that increased availability or access to energy dense foods which are high in saturated fat may be related to obesity. The association between food outlet location, deprivation, weight status and ethnicity was analysed using individual level data on a sample of 1198 pregnant women in the UK Born in Bradford cohort using geographic information systems (GIS) methodology. In the non South Asian group 24% were obese as were 17% of the South Asian group (BMI > 30). Food outlet identification methods revealed 886 outlets that were allocated into 5 categories of food shops. More than 95% of all participants lived within 500 m of a fast food outlet. Women in higher areas of deprivation had greater access to fast food outlets and to other forms of food shops. Contrary to hypotheses, there was a negative association between BMI and fast food outlet density in close (250 m) proximity in the South Asian group. Overall, these women had greater access to all food stores including fast food outlets compared to the non South Asian group. The stronger association between area level deprivation and fast food density than with area level deprivation and obesity argues for more detailed accounts of the obesogenic environment that include measures of individual behaviour.

Ethnic disparities in adolescent body mass index in the United States: The role of parental socioeconomic status and economic contextual factors

This paper examined the importance of household and economic contextual factors as determinants of ethnic disparities in adolescent body mass index (BMI). Individual-level data from the National Longitudinal Survey of Youth 1997 for the years 1997 through 2000 were combined with economic contextual data on food prices, outlet density and median household income. The Oaxaca–Blinder decomposition method was used to examine the factors that could help explain ethnic disparities in BMI. Ethnic differences in household demographic, parental socioeconomic status (SES), and economic contextual factors explained the majority of the male black–white (63%), male Hispanic–white (78%) and female Hispanic–white (62%) BMI gaps but less than one-half of the female black–white BMI gap (44%). We found that adding the economic contextual factors increased the explained portion of the ethnic BMI gap for both female and male adolescents: the economic contextual factors explained 28% and 38% of the black–white and Hispanic–white BMI gaps for males and 13% and 8% of the black–white and Hispanic–white BMI gaps for females, respectively. Parental SES was more important in explaining the Hispanic–white BMI gap than the black–white BMI gap for both genders, whereas neighborhood economic contextual factors were more important in explaining the male BMI gap than the female BMI gap for both black–white and Hispanic–white ethnic disparities. A significantly large portion of the ethnic BMI gap, however, remained unexplained between black and white female adolescents.

Food supply and the obesity scourge: Is there a relationship?

This paper reviews literature on the relationship between food supply and obesity. The focus is on the supply, cost, and variety of food through various types of food outlets and the impact of these factors on obesity in developed countries. The article reveals complex relationships between food supply factors and obesity. A numer of factors related to lifestyles including the mobility of populations and the use of motor vehicles greatly reduce the impact of the local environment on family and individual eating patterns. However, obesity is also affected by factors such as the type and density of food outlets, the cost of food, the travel distance and means of transport to the food outlet. While the relationship between food supply and obesity in the literature reveals complex and mixed findings, this paper concludes obesity is complex and food supply is only part of this phenomenon’s predictors. Because the relationship between food supply and obesity is mediated by such multiple and complex factors including population behaviours, beliefs, lifestyles, knowledge and both food and physical environments; multiple strategies including policy development and other strategies aimed at manipulating food environments, physical environments, populations’ beliefs, behaviours and practices must be considered in searching for evidence to effectively combat obesity.

Government regulation to promote healthy food environments – a view from inside state governments

Food policy interventions are an important component of obesity-prevention strategies and can potentially drive positive changes in obesogenic environments. This study sought to identify regulatory interventions targeting the food environment, and barriers/facilitators to their implementation at the Australian state government level. In-depth interviews were conducted with senior representatives from state/territory governments, statutory authorities and non-government organizations (n =45) to examine participants' (i) suggestions for regulatory interventions for healthier food environments and (ii) support for pre-selected regulatory interventions derived from a literature review. Data were analysed using thematic and constant comparative analyses. Interventions commonly suggested by participants were regulating unhealthy food marketing; limiting the density of fast food outlets; pricing reforms to decrease fruit/vegetable prices and increase unhealthy food prices; and improved food labelling. The most commonly supported pre-selected interventions were related to food marketing and service. Primary production and retail sector interventions were least supported. The dominant themes were the need for whole-of-government and collaborative approaches; the influence of the food industry; conflicting policies/agenda; regulatory challenges; the need for evidence of effectiveness; and economic disincentives. While interventions such as public sector healthy food service policies were supported by participants, marketing restrictions and fiscal interventions face substantial barriers including a push for deregulation and private sector opposition.

Activity space environment and dietary and physical activity behaviors: A pilot study

This study examined relationships among individual demographics, environmental features (e.g., fast food outlet density, park land use) of residential neighborhoods and activity spaces, and weight-related behaviors (diet, physical activity). Participants’ movement was tracked for 7 days using global positioning systems (GPS). Two activity space measures (one standard deviation ellipse, daily path area) were derived from the GPS data. Activity spaces were generally larger than residential neighborhoods; environmental features of residential neighborhoods and activity spaces were weakly associated; and some activity space environmental features were related to dietary behaviors. Activity spaces may provide new insights into environmental influences on obesity-related behaviors.

Irish exceptionalism? local food environments and dietary quality

ObjectiveTo explore whether distance to and density of food outlets within the local area have an impact on individual dietary quality, controlling for the socioeconomic characteristics of individuals and their...

Disparities in Neighborhood Food Environments: Implications of Measurement Strategies

abstractPublic health researchers have begun to map the neighborhood “food environment” and examine its association with the risk of overweight and obesity. Some argue that “food deserts”—areas with little or no provision of fresh produce and other healthy food—may contribute to disparities in obesity, diabetes, and related health problems. While research on neighborhood food environments has taken advantage of more technically sophisticated ways to assess distance and density, in general, it has not considered how individual or neighborhood conditions might modify physical distance and thereby affect patterns of spatial accessibility. This study carried out a series of sensitivity analyses to illustrate the effects on the measurement of disparities in food environments of adjusting for cross-neighborhood variation in vehicle ownership rates, public transit access, and impediments to pedestrian travel, such as crime and poor traffic safety. The analysis used geographic information systems data for New York City supermarkets, fruit and vegetable markets, and farmers’ markets and employed both kernel density and distance measures. We found that adjusting for vehicle ownership and crime tended to increase measured disparities in access to supermarkets by neighborhood race/ethnicity and income, while adjusting for public transit and traffic safety tended to narrow these disparities. Further, considering fruit and vegetable markets and farmers’ markets, as well as supermarkets, increased the density of healthy food outlets, especially in neighborhoods with high concentrations of Hispanics, Asians, and foreign-born residents and in high-poverty neighborhoods.

Spatial accessibility and availability measures and statistical properties in the food environment

Spatial accessibility is of increasing interest in the health sciences. This paper addresses the statistical use of spatial accessibility and availability indices. These measures are evaluated via an extensive simulation based on cluster models for local food outlet density. We derived Monte Carlo critical values for several statistical tests based on the indices. In particular we are interested in the ability to make inferential comparisons between different study areas where indices of accessibility and availability are to be calculated. We derive tests of mean difference as well as tests for differences in Moran’s I for spatial correlation for each of the accessibility and availability indices. We also apply these new statistical tests to a data example based on two counties in South Carolina for various accessibility and availability measures calculated for food outlets, stores, and restaurants.

P40 *Local food environments and dietary quality

IntroductionDietary quality is an important predictor of health outcome and plays a prominent role in premature death from a number of chronic health conditions including cardiovascular disease and some cancers....

Disparities in the Food Environments of New York City Public Schools

Studies of the food environment near schools have focused on fast food. Research is needed that describes patterns of exposure to a broader range of food outlet types and that examines the influence of neighborhood built environments. Using data for New York City, this paper describes the prevalence of five different food outlet types near schools, examines disparities by economic status and race/ethnicity in access to these food outlets, and evaluates the extent to which these disparities are explained by the built environment surrounding the school. National chain and local fast-food restaurants, pizzerias, small grocery stores ("bodegas"), and convenience stores within 400 m of public schools in New York City were identified by matching 2005 Dun & Bradstreet data to 2006-2007 school locations. Associations of student poverty and race/ethnicity with food outlet density, adjusted for school level, population density, commercial zoning, and public transit access, were evaluated in 2009 using negative binomial regression. New York City's public school students have high levels of access to unhealthy food near their schools: 92.9% of students had a bodega within 400 m, and pizzerias (70.6%); convenience stores (48.9%); national chain restaurants (43.2%); and local fast-food restaurants (33.9%) were also prevalent within 400 m. Racial/ethnic minority and low-income students were more likely to attend schools with unhealthy food outlets nearby. Bodegas were the most common source of unhealthy food, with an average of nearly ten bodegas within 400 m, and were more prevalent near schools attended by low-income and racial/ethnic minority students; this was the only association that remained significant after adjustment for school and built-environment characteristics. Nearly all New York City public school students have access to inexpensive, energy-dense foods within a 5-minute walk of school. Low-income and Hispanic students had the highest level of exposure to the food outlets studied here.

The association between the geography of fast food outlets and childhood obesity rates in Leeds, UK

Objective To analyse the association between childhood overweight and obesity and the density and proximity of fast food outlets in relation to the child’s residential postcode. Design This was an observational study using individual level height/weight data and geographic information systems methodology. Setting Leeds in West Yorkshire, UK. This area consists of 476 lower super-output areas. Participants Children aged 3–14 years who lived within the Leeds metropolitan boundaries ( n=33,594). Main outcome measures The number of fast food outlets per area and the distance to the nearest fast food outlet from the child’s home address. The weight status of the child: overweight, obese or neither. Results 27.1% of the children were overweight or obese with 12.6% classified as obese. There is a significant positive correlation ( p<0.001) between density of fast food outlets and higher deprivation. A higher density of fast food outlets was significantly associated ( p=0.02) with the child being obese (or overweight/obese) in the generalised estimating equation model which also included sex, age and deprivation. No significant association between distance to the nearest fast food outlet and overweight or obese status was found. Conclusions There is a positive relationship between the density of fast food outlets per area and the obesity status of children in Leeds. There is also a significant association between fast food outlet density and areas of higher deprivation.

The spatial distribution of campylobacteriosis in New Zealand, 1997–2005

In New Zealand Campylobacter infection rates have increased steadily since 1980, reaching a peak in 2003 (396/100,000 population). Compared to other nations, disease rates are unfavourably high (e.g. Australia 117/100,000 population, UK 85/100,000 population, USA 13/100,000 population). This ecological study investigated spatial variations in Campylobacter infection rates across New Zealand's Territorial Local Authorities (TLAs, n=73) for the period 1997-2005. Applying multiple linear regression, we examined whether geographical factors such as socio-demographic characteristics, climate, land use, water and the food environment were associated with local differences in the occurrence of Campylobacter infection rates. The results suggested significant variations in campylobacteriosis across TLAs (average annual rates ranging from 97 to 526/100,000 population), with higher rates in the South Island. Disease rates were associated with lower socio-economic deprivation (P<0.01), the proportion of the population aged 25-44 years (P<0.01) and fresh food outlet density (P<0.76). The results underline the role of area-level characteristics in explaining the spatial distribution of campylobacteriosis in New Zealand. In particular, the findings draw attention to the relatively unexplored role of fresh food outlets as a potential risk factor for increased Campylobacter notifications.

An audit of local government planning tools for their potential use in addressing community food and nutrition issues

This project aimed to identify how local government planning tools could be used to influence physical and policy environments to support healthy eating behaviours in communities. An audit of Queensland's legislative and non-legislative local government planning tools was conducted by a public health nutritionist to assess their potential use in addressing strategies to achieve positive nutrition outcomes. Ten strategies were identified and covered the following themes: improving access to healthy foods and drinks; increasing access to breastfeeding facilities; decreasing fast food outlet density; and unhealthy food advertising. The audit found that all of the 10 strategies to achieve positive nutrition outcomes could be considered through three or more of the planning tools. Based on the findings of this audit, local government planning tools provide opportunities to address food and nutrition issues and contribute toward creating physical and policy environments that support healthy eating behaviours.

Impact of neighbourhood food environment on food consumption in children aged 9–10 years in the UK SPEEDY (Sport, Physical Activity and Eating behaviour: Environmental Determinants in Young people) study

Poor diet in childhood increases risk of obesity but the relationship between access to food and children's food choice is underexplored. We determined relationships between distance to and density of food outlets on children's food choice. Children (n 1721) aged 9-10 years who participated in a cross-sectional study from a sample of state and private schools across urban and rural areas. Food consumption was reported using a short validated FFQ. A Geographic Information System was used to determine proximity to local food outlets. Multivariable regression analyses were performed to determine associations between food consumption and distance to and density of local food outlets. Norfolk, England. Boys (n 754) and girls (n 967) aged 9-10 years. The impact of distance to or density of food outlets on food choice was small after adjustment. Living further away from a supermarket increased portions of fruit (0.11 portions/week per 1 km increase in distance to nearest supermarket, P < 0.05) and vegetables (0.11 portions/week, P < 0.05) consumed. Living closer to convenience stores was also associated with an increased consumption of crisps, chocolate and white bread. Density of supermarkets was associated with both an increase in vegetable intake (0.31 portions/week, P < 0.05) and unhealthy foods. Distance to and density of food outlets are both associated with children's food choice, although the impact appears to be small and the relationship is complex. However, the effects of individual foods combined could be important, particularly as even small differences in intake can impact on body weight over time.

Obesity and the Built Environment: Does the Density of Neighborhood Fast-Food Outlets Matter?

Examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast food outlets and residents' behavioral, psychosocial, and sociodemographic characteristics. Cross-sectional and multilevel design. Census block groups, used as a proxy for neighborhoods, within the metropolitan region's Urban Growth Boundary in Portland, Oregon. A total of 1221 residents (mean age, 65 years) recruited randomly from 120 neighborhoods (48% response rate). A geographic information system-based measure of fast food restaurant density across 120 neighborhoods was created. Residents within the sampled neighborhoods were assessed with respect to their body mass indices (BMI), frequency of visits to local fast food restaurants, fried food consumption, levels of physical activity, self-efficacy of eating fruits and vegetables, household income, and race/ethnicity. Multilevel logistic regression analyses. Significant associations were found between resident-level individual characteristics and the likelihood of being obese (BMI > or = 30) for neighborhoods with a high-density of fast food restaurants in comparison with those with a low density: odds ratios for obesity, 95% confidence intervals (CI), were 1.878 (CI, 1.006-3.496) for weekly visits to local fast food restaurants; 1.792 (CI, 1.006-3.190) for not meeting physical activity recommendations; 1.212 (CI, 1.057-1.391) for low confidence in eating healthy food; and 8.057 (CI, 1.705-38.086) for non-Hispanic black residents. Increased density of neighborhood fast food outlets was associated with unhealthy lifestyles, poorer psychosocial profiles, and increased risk of obesity among older adults.

Fast Food and Deprivation in Nova Scotia

To examine the relationship between density of fast food restaurants and measures of social and material deprivation at the community level in Nova Scotia, Canada. Census information on population and key variables required for the calculation of deprivation indices were obtained for 266 communities in Nova Scotia. The density of fast food restaurants per 1000 individuals for each community was calculated and communities were divided into quintiles of material and psychosocial deprivation. One-way analysis of variance was used to investigate associations between fast food outlet densities and deprivation scores at the community level. A statistically significant inverse association was found between community-level material deprivation and the mean number of fast food restaurants per 1000 people for Nova Scotia (p < 0.000). Significant positive relationships were found between density of fast food restaurants and psychosocial deprivation (p < 0.000). Both associations were principally linear with greater fast food outlet density occurring as material deprivation decreased and as psychosocial deprivation increased. Community-level deprivation in Nova Scotia is associated with fast food outlet density and lends support for environmental explanations for variations in the prevalence of obesity. Such findings are valuable to population health intervention initiatives targeting the modification of environmental determinants of obesity.

Neighborhood Food Environment and Walkability Predict Obesity in New York City

BackgroundDifferences in the neighborhood food environment may contribute to disparities in obesity.ObjectivesThe purpose of this study was to examine the association of neighborhood food environments with body mass index (BMI) and obesity after control for neighborhood walkability.MethodsThis study employed a cross-sectional, multilevel analysis of BMI and obesity among 13,102 adult residents of New York City. We constructed measures of the food environment and walkability for the neighborhood, defined as a half-mile buffer around the study subject’s home address.ResultsDensity of BMI-healthy food outlets (supermarkets, fruit and vegetable markets, and natural food stores) was inversely associated with BMI. Mean adjusted BMI was similar in the first two quintiles of healthy food density (0 and 1.13 stores/km2, respectively), but declined across the three higher quintiles and was 0.80 units lower [95% confidence interval (CI), 0.27–1.32] in the fifth quintile (10.98 stores/km2) than in the first. The prevalence ratio for obesity comparing the fifth quintile of healthy food density with the lowest two quintiles combined was 0.87 (95% CI, 0.78–0.97). These associations remained after control for two neighborhood walkability measures, population density and land-use mix. The prevalence ratio for obesity for the fourth versus first quartile of population density was 0.84 (95% CI, 0.73–0.96) and for land-use mix was 0.91 (95% CI, 0.86–0.97). Increasing density of food outlets categorized as BMI-unhealthy was not significantly associated with BMI or obesity.ConclusionsAccess to BMI-healthy food stores is associated with lower BMI and lower prevalence of obesity.

Obesity and the community food environment: a systematic review

To examine the relationship between obesity and the community and/or consumer food environment. A comprehensive literature search of multiple databases was conducted and seven studies were identified for review. Studies were selected if they measured BMI and environmental variables related to food outlets. Environmental variables included the geographic arrangement of food stores or restaurants in communities and consumer conditions such as food price and availability within each outlet. The study designs, methods, limitations and results related to obesity and the food environment were reviewed, and implications for future research were synthesized. The reviewed studies used cross-sectional designs to examine the community food environment defined as the number per capita, proximity or density of food outlets. Most studies indirectly identified food outlets through large databases. The studies varied substantially in sample populations, outcome variables, units of measurement and data analysis. Two studies did not find any significant association between obesity rates and community food environment variables. Five studies found significant results. Many of the studies were subject to limitations that may have mitigated the validity of the results. Research examining obesity and the community or consumer food environment is at an early stage. The most pertinent gaps include primary data at the individual level, direct measures of the environment, studies examining the consumer environment and study designs involving a time sequence. Future research should directly measure multiple levels of the food environment and key confounders at the individual level.