Store Density Research Articles

Assessing county-level determinants of diabetes in the United States (2003-2012).

Using data from the United States Behavioral Risk Factor Surveillance System (2003-2012; N=3,397,124 adults), we estimated associations between prevalent diabetes and four county-level exposures (fast food restaurant density, convenience store density, unemployment, active commuting). All associations confirmed our a priori hypotheses in conventional multilevel analyses that pooled across years. In contrast, using a random-effects within-between model, we found weak, ambiguous evidence that within-county changes in exposures were associated with within-county change in odds of diabetes. Decomposition revealed that the pooled associations were largely driven by time-invariant, between-county factors that may be more susceptible to confounding versus within-county associations.

도시지역 중학생의 알코올 접근성과 음주 경험

Objectives: As the drinking rate and drinking-related harms of adolescents has been increasing, it is emphasized to make efforts to prevent youth alcohol drinking. Despite the regulatory policy for restricting sales of alcoholic beverages to adolescents, they mostly buy alcohol at the convenience stores easily. However, there is a lack of empirical research on alcohol access and drinking of adolescents. Therefore, this study aimed to investigate the impact of convenience store accessibility in community on alcohol drinking of adolescents, and examine whether alcohol prevention education in schools can reduce the alcohol drinking risk of adolescents. Methods: Multilevel logistic regression analysis was conducted on the middle schools students in urban areas who responded to the Youth Health Behavior Survey in 2016. We analyzed the influence of the convenience stores density in community on alcohol drinking experience of adolescents, and stratified analysis was also conducted according to the respondents’ experience of school-based alcohol prevention education. Results: Of the 29,047 respondents, 7,098 students(24.4%) had a drinking experience. The students who were boys, older, living without families, or those whose father’s education was lower were more likely to have drinking experience(p<.001). Those who perceived more severe stress or depression were also more likely to drink alcohol(p<.001). After adjusting for those individuals factors influencing on their drinking behaviors, the students whose schools were in a community with more convenience stores were more likely to drink alcohol(p=.010). According to the stratified analysis, the significant impact of convenience store density on adolescents’ drinking behaviors were not found with the students who had school-based alcohol prevention education(p=.106). Conclusions: In order to effectively prevent adolescents’ drinking behaviors and drinking-related harms, it is necessary to strengthen both the regulation of alcohol access and school-based education for adolescents’ drinking prevention.

The neighborhood effect of online reviews

PurposeOnline reviews have been indicated to play an important role in consumers’ decision-making process, as supported by numerous studies. However, none of them has considered the neighborhood effect of online reviews. The purpose of this paper is to analyze the impact of neighbor store’s reviews on central store’s, along with the moderating effects of store density and product similarity.Design/methodology/approachUsing data from dianping.com, this study conducts economic analysis accounting for endogeneity.FindingsThe results show that the neighbor store’s reviews exert a negative impact on that of central stores. Nevertheless, the relationship is moderated by store density and product similarity, such that the negative effect is stronger if there are a lot of stores around the central store, or if the neighbor store and central store provide similar products.Originality/valueThis study is the first to investigate the neighborhood effect of online reviews.

Impact of neighbourhood food environment on diet and obesity in China: a systematic review.

This study systematically reviewed literature on the neighbourhood food environment in relation to diet and obesity among residents in China. A keyword search of peer-reviewed articles was performed in Cochrane Library, PubMed, and Web of Science. Eligibility criteria include study designs: longitudinal/cohort studies or cross-sectional studies; study participants: people of all ages; exposures: neighbourhood food environment (e.g. restaurants, supermarkets, wet markets, fast-food restaurants, or convenience stores); outcomes: diet and/or body weight status; and country: China. Seventeen studies met all criteria and were included. Among the eight studies that assessed the neighbourhood food environment in relation to diet, six reported at least one statistically significant relationship in the expected direction, whereas the remaining two exclusively reported null effects. Among the eleven studies that assessed the neighbourhood food environment in relation to body weight or overweight/obesity, ten reported a significant association whereas the remaining one reported a null relationship. Variety, density, and proximity of food outlets were positively associated with local residents' dietary diversity, portion size, and daily caloric intake. Density and proximity of fast-food restaurants and convenience stores were positively associated with local residents' adiposity in some but not all studies. Evidence linking any specific food outlet type to diet/obesity remains lacking due to the small number of studies and heterogeneities in food environment measures, geographical locations, and population subgroups. The neighbourhood food environment may influence diet and obesity among Chinese residents but the evidence remains preliminary. Future studies adopting an experimental study design and objective/validated environment and dietary measures are warranted.

Impact of the urban logistics and pedestrian mobility: Gamarra case, Peru

Goals: This study focuses on assessing disaster risks in a typical inmegacity in Latin America. The baseline focuses on the logistics characteristics of the last mile, the vulnerability of buildings and the mobility of pedestrians.&#x0D; Design / Methodology / Approach: A risk assessment procedure is developed using logistic metrics through a methodology that captures the most relevant urban information within a square kilometer, and two complementary methods that provide support to obtain metrics associated with the occurrence of disasters.&#x0D; Results: The results show that the majority of blocks in the analyzed area have levels of precautionary risk due to their high level of store density, structure’s vulnerability, pedestrian movement and freight flow.&#x0D; Limitations of the research: The main limitations for the data collection were the insecurity, the level of informality and the chaos presented in the studied area.&#x0D; Practical implications: The main findings allow decision makers to know the most vulnerable areas of the place and, thus, propose recommendations for public policies based on urban knowledge. In addition, the proposed method can be taken as a reference to be applied to other zones of similar characteristics.&#x0D; Originality / Value: This research develops a methodology that evaluates the risks and mitigates the impact on a specific unstudied commercial area, combining three existing methodologies to correctly asses risk on certain zones. This work is an extension of the work of Huivin et al. (2020); the added value is that it provides deeper literature reviewing that help decision-makers and researchers to know the actual state of the art.

Factors impacting producer marketing through community supported agriculture.

Nowadays, consumers have become increasingly aware of their local food system as a result of concerning about health and nutrition, food safety and sustainability, and local economic development. This transitional shift from global to direct-to-consumer farm operations has increased the demand for locally produced foods. As an alternative, community supported agriculture (CSA), a direct and sustainable food channel, has gained tremendous popularity in the US. Despite the interest garnered by local agriculture and CSA, relatively few studies have empirically tested the determinants of why this marketing phenomenon has grown so rapidly. The purpose of this study is to explore the factors that drive producers to market their products through CSA by using a county-level data set from the US. Results using a Tobit model indicate that specific operator characteristics, such as young and female operators and those engaged in farming as primary occupation, play a strongly positive role in the likelihood of marketing through CSA; farms with small size, rented land, and engagement in growing vegetables, melons, fruits and tree nut crops are more interested in marketing via CSA; households with higher income and females significantly increase the share of farms marketing through CSA; presence of children and seniors and being married are negatively related to the demand for CSA foods. Moreover, counties with higher density of population, establishments-supermarket and other grocery stores, and legislation or active programs that encourage local food consumption tend to encourage more farms marketing through CSA.

Access to cannabis retail stores across Canada 6 months following legalization: a descriptive study.

On Oct. 17, 2018, Canada legalized recreational cannabis with the dual goals of reducing youth use and eliminating the illicit cannabis market. We examined factors associated with access to physical cannabis stores across Canada 6 months following legalization. We extracted the address and operating hours of all legal cannabis stores in Canada from online government and private listings. We conducted a descriptive study examining the association between private/hybrid (mixture of government and private stores) and government-only retail models with 4 measures of physical access to cannabis: store density, weekly hours of operation, median distance to the nearest school and relative availability of cannabis stores between low- and high-income neighbourhoods. Six months after legalization, there were 260 cannabis retail stores across Canada: 181 privately run stores, 55 government-run stores and 24 stores in the hybrid retail system. Compared to jurisdictions with a government-run model, jurisdictions with a private/hybrid retail model had 49% (95% confidence interval 10%-200%) more stores per capita, retailers were open on average 9.2 more hours per week, and stores were located closer to schools (median 166.7 m). In both retail models, there was over twice the concentration of cannabis stores in neighbourhoods in the lowest income quintile compared to the highest income quintile. Marked differences in physical access to cannabis retail are emerging between jurisdictions with private/hybrid retail models and those with government-only retail models. Ongoing surveillance including monitoring differences in cannabis use and harms across jurisdictions is needed.

Neighbourhood context and binge drinking from adolescence into early adulthood in a US national cohort.

Underage binge drinking is a serious health concern that is likely influenced by the neighbourhood environment. However, longitudinal evidence has been limited and few studies have examined time-varying neighbourhood factors and demographic subgroup variation. We investigated neighbourhood influences and binge drinking in a national cohort of US 10th grade students at four times (2010-2014; n = 2745). We estimated odds ratios (OR) for past 30-day binge drinking associated with neighbourhood disadvantage, personal and property crime (quartiles), and number of liquor, beer and wine stores within 5 km, and then evaluated whether neighbourhood associations differ by age, sex and race/ethnicity. Neighbourhood disadvantage was associated with binge drinking before 18 [OR = 1.54; 95% confidence interval (1.14, 2.08)], but not after 18 years of age. Property crime in neighbourhoods was associated with a higher odds of binge drinking [OR = 1.54 (0.96, 2.45)], an association that was stronger in early adulthood [4th vs 1st quartile: OR = 1.77 (1.04, 3.03)] and among Whites [4th vs 1st quartile: OR = 2.46 (1.03, 5.90)]. Higher density of liquor stores predicted binge drinking among Blacks [1-10 stores vs none: OR = 4.31 (1.50, 12.36)] whereas higher density of beer/wine stores predicted binge drinking among Whites [one vs none for beer: OR = 2.21 (1.06, 4.60); for wine: OR = 2.04 (1.04, 4.03)]. Neighbourhood conditions, particularly those related to economic circumstances, crime and alcohol outlet density, were related to binge drinking among young adults, but associations varied across age and individual characteristics.

1649-P: Community Predictors of Diabetes Prevalence and Change in Burden Over Time: U.S. Counties, 2003-2012

Introduction: This study applies a novel epidemiologic approach to perform temporal, multilevel analysis of nationally representative, repeated cross-sectional data to assess the relationship between diabetes and various county-level environmental measures, including socioeconomic context, walkability, and the food environment. Methods: We obtained data from the 2003-2012 Behavioral Risk Factor Surveillance System, an ongoing, nationally representative, cross-sectional telephone survey of the U.S. noninstitutionalized population ages ≥ 18 years. County-level variables included economic (unemployment), food (convenience store and fast food density), and built environment (active commuting) measures. Using random-effects within-between (REWB), we fit a logistic mixed-effects model to estimate associations between community exposures and odds of prevalent diabetes, adjusted for individual-level demographic and other characteristics. REWB models incorporate temporality into analyses of repeated cross-sectional surveys by using group-mean-centering. Results: Age-adjusted diabetes prevalence across the study period was 7.9%. County unemployment, fast food density, and convenience store density were positively associated with diabetes prevalence, and active commuting had an inverse association. Odds ratios ranged from 0.95 for an increment in active commuting to 1.05 for convenience store density. Within-county associations were attenuated for convenience stores and fast food restaurants, but within-county change in active commuting was higher (aOR: 0.92; 95% CI: 0.82, 1.02). Discussion: These analyses demonstrate the utility of REWB models in evaluating effects of group-level exposures on diabetes risk using repeated cross-sectional survey data and provide preliminary evidence towards our hypotheses of community-level drivers of diabetes risk. Disclosure P.M. Lopez: None. J. Feldman: None. P.E. Rummo: None. B. Elbel: None. L. Thorpe: None.

Use of GIS to Measure Food Environment and Its Relationship with Obesity in School-aged Children in Mexico (P04-142-19)

ObjectivesTo determine the association between food environment and obesity in school-aged children using Geographic Information Database (GIS). MethodsA total of 218 school-age children (8.4 ± 1.5 y) from a low-income setting in Mexico participated in this cross-sectional study. Weight and height were measured in all children to calculate BMI- for-age z-score (BMIz). Body composition (total body fat and abdominal fat) was measured using DXA. Geolocation of both convenience stores (CS) and participants’ households was collected and introduced into a GIS database. The shelf-space of processed foods and unprocessed foods available at each CS was measured. The distance to the closest CS, the number of CS, and the shelf-space of processed foods of CS within a 250 m radius from each participant’s household was calculated using GIS. Multivariable model assessing the association between obesity and food environment were performed controlling for confounders, using SPSS v23.0. ResultsMore than half of the children (55%) were girls, and 52% of the children had elevated body fat % (>30% for girls and >25% for boys). A total of 58 food venues were found in this community; from these venues, 40 were CS. 91% of the children had access to a CS within a 250 m radius. In average, 48% of the shelf-meters of the CS were of processed food. A positive association between BMIz (β = 0.028; IC 95%: 0.005,0.047; P < 0.05), total body fat % (β = 0.145, IC 95%: 0.048, 0.241; P < 0.05) and abdominal fat % (β = 0.206, IC 95%: 0.069,0.343; P < 0.05) was found with the distance to the nearest CS within the 250 radius. However, a negative association was found between BMIz (β = −0.002; IC 95%: −0.004, −0.001; P < 0.05), total body fat % (β = −0.009, IC 95%: −0.017, −0.001; P < 0.05) and abdominal fat % (β = −0.012, IC 95%: −0.023, −0.001; P < 0.05) with the proximity of CS. Finally, BMIz was positively associated with the meters of processed foods in the CS within 250 m radius (β = 0.002; IC 95%: 0.001,0.003; P < 0.05). ConclusionsA high density and proximity of convenience stores with a high availability of processed food were associated with obesity in children of this community. GIS methods may provide a new approach to assess food environment and its association with obesity risk factors in different settings and populations. Funding SourcesCONACYT.

Research on the correlation between pedestrian density and street spatial characteristics of commercial blocks in downtown area: a case study on Shanghai Tianzifang

ABSTRACTTaking Shanghai Tianzifang as an example, this study attempted to utilize theories, such as the Space Syntax Theory, to build a multivariate model with street spatial characteristics as variables, and investigate the correlation between street spatial characteristics and pedestrian density in commercial blocks using multivariate regression analyses of the variables in this model. This study inspected two aspects of spatial characteristics of street space. First, in terms of commercial use characteristics, this study examined how pedestrian density is affected by three variables: store density, overflow ratio of store-front space. Density of building exits and entrances. Next, in terms of structural characteristics, this study probed the relationship between commercial pedestrian density and three other variables: street integration, height of buildings on both sides of the streets, and the stores’ distance from block entrances. Last, a multivariate regression analysis was conducted on the research data of the six variables. The results validated that four of the variables are correlated with commercial pedestrian density, in the order of their degree of influence: street integration, store density, density of building exits and entrances, and height of buildings on both sides of the streets.

Grace expands colloidal silica manufacturing in Germany to support customer growth and innovation

Food environments are potential targets for interventions to reduce obesity prevalence, particularly in island settings that are typically dependent on food imports. This observational study aimed to characterise the availability, quality and price of foods and beverages in a nationally representative sample of grocery stores in Malta using the Nutrition Environment Measures Survey for Stores (NEMS-S) instrument, and to examine the association between area-level density of different types of food stores and the likelihood of children living in these areas being overweight or obese. Fieldwork was carried out between March and May 2014. There was a strong positive correlation between store size and NEMS-S score (p = <0.001), suggesting that smaller grocery stores generally offered a smaller range of products and fewer healthy food/beverage options than larger supermarkets. Across all stores, median prices of certain ‘healthier’ versions of foods were more expensive than their less healthy alternatives. A significant association between risk of childhood overweight, and density of confectionery stores in children’s locality of residence, was found (OR 1.19; 95% CI: 1.04, 1.37). These baseline findings highlight opportunities to improve the food environment in Malta to support more healthful eating, and may be of particular interest to public health practitioners in island settings.

Increased adolescent coffee, tea, or other sugar-sweetened beverage consumption is associated with less satisfactory dietary quality, body fatness and serum uric over 18 years in Taiwan

Background and Objectives: Taiwan has a high density of convenience stores and beverage shops, which makes sugar-sweetened beverages (SSBs) very accessible to teenagers. This study examined the changes and the association between SSBs and biomarkers and nutrient intake, for teenagers over the course of 18 years using a national representative sample. Methods and Study Design: This cross-sectional study used data from the Nutrition and Health Survey in Taiwan (NAHSIT). Complete data for teenagers aged 13 to 19 years including a 24-hour dietary recall, anthropometric and clinical measurements, and SSBs from two periods were analyzed (1993-1996: N=1820; 2010-2011: N=2513). SAS callable SUDAAN was used for statistical analysis, adjusting for the sampling scheme. Log transformation was used for non-normal variables before linear models were used. Coffee or tea and SSB (excluding tea or coffee) consumers were categorized as non-drinkers, low (below), or high (above) consumers based on median intake during 1993-1996. Results: Intake of coffee or tea increased significantly in the 18 years of this study (p＜0.01), whereas intake of SSBs (excluding coffee or tea) decreased significantly (p＜0.05). Intake was significantly higher among ever-smokers and those with high total energy intakes (p＜0.01). For both coffee/tea and SSB, the high-intake groups had higher serum uric acid and intake of carbohydrates (p＜0.05), lower intake of protein and phosphorus (p ＜ 0.05) and lower dietary diversity score. Conclusions: Consumption of coffee or tea increased in adolescents during the 18 years. High intakes of SSB, coffee or tea was associated with high serum uric acid values and worse dietary quality.

Association between the food and physical activity environment, obesity, and cardiovascular health across Maine counties

BackgroundAccounting for nearly one-third of all deaths, cardiovascular disease is the leading cause of mortality and morbidity in the United States. Adverse health behaviors are major determinants of this high incidence of disease. Examining local food and physical activity environments and population characteristics in a poor, rural state may highlight underlying drivers of these behaviors. We aimed to identify demographic and environmental factors associated with both obesity and overall poor cardiovascular health (CVH) behaviors in Maine counties.MethodsOur cross-sectional study analyzed 40,398 Behavioral Risk Factor Surveillance System (BRFSS) 2011–2014 respondents alongside county-level United States Department of Agriculture (USDA) Food Environment Atlas 2010–2012 measures of the built environment (i.e., density of restaurants, convenience stores, grocery stores, and fitness facilities; food store access; and county income). Poor CVH score was defined as exhibiting greater than 5 out of the 7 risk factors defined by the American Heart Association (current smoking, physical inactivity, obesity, poor diet, hypertension, diabetes, and high cholesterol). Multivariable logistic regression models described the contributions of built environment variables to obesity and overall poor CVH score after adjustment for demographic controls.ResultsBoth demographic and environmental factors were associated with obesity and overall poor CVH. After adjustment for demographics (age, sex, personal income, and education), environmental characteristics most strongly associated with obesity included low full-service restaurant density (OR 1.34; 95% CI 1.24–1.45), low county median household income (OR 1.31; 95% CI 1.21–1.42) and high convenience store density (OR 1.21; 95% CI 1.12–1.32). The strongest predictors of overall poor CVH behaviors were low county median household income (OR 1.30; 95% CI 1.13–1.51), low full-service restaurant density (OR 1.38; 95% CI 1.19–1.59), and low fitness facility density (OR 1.27; 95% CI 1.11–1.46).ConclusionsIn a rural state, both demographic and environmental factors predict overall poor CVH. These findings may help inform communities and policymakers of the impact of both social determinants of health and local environments on health outcomes.

Inter-brand competition in the convenience store industry, store density and healthcare utilization

We investigate the impact of access to convenience stores and competition between convenience store chains on the use of medical care in Taiwan. Using insurance claims from 0.85 million individuals and administrative data on store sales, we find that greater store density and more inter-brand competition reduced expenditures on outpatient medical services and prescription drugs. In support of these findings, we demonstrate that convenience store competition was associated with greater consumption of healthy foods and lower obesity rates. Our estimates suggest that the rise in convenience store competition from 2002 to 2012 reduced outpatient expenditures in Taiwan by 0.44 percent and prescription drug expenditures by 0.85 percent.

33. Tobacco Retail Environment And Alternative Tobacco Product Use Among Teens

The rise of non-cigarette, alternative tobacco product (ATP) use among adolescents may be due to an increase in retail availability of ATPs. This is the first study to examine the relationship of tobacco retailer density and proximity to any ATP use, assess many ATPs simultaneously, and assess this relationship longitudinally. We examine whether the proximity and density of stores near students’ home is associated with a higher likelihood of initiating ATP use over time including e-cigarettes, small and large cigars, chewing or dipping tobacco or moist snuff, tobacco pipes, and hookah. This geospatial analysis of a multilevel, longitudinal data set linked survey data from 728 adolescents (ages 13-19) nested in 191 neighborhoods nested in 10 California high schools with location data for tobacco retailers from a state licensing list. At the individual level, proximity was measured as roadway distance from home to the nearest tobacco retailer. At the census tract level, tobacco retailer density measured tobacco retailers per square mile. Other tract-level and school-level covariates were obtained from the American Community Survey and the California Department of Education. To account for the fact that students who lived in the same census tracts attended different high schools, cross-classified multilevel logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for proximity to a tobacco retailer and tract density (at baseline) with ATP initiation at follow-up. The sample was predominantly female (63.5%) and was racially and ethnically diverse. Approximately one-third of participants (32.5%) reported ever ATP use at Wave 1 and 106 (14.5%) initiated ATP use within one year (Wave 2). The mean number of tobacco retailers per square mile within a tract was 5.66 (SD=6.3) and the average distance from each participant’s residence to the nearest tobacco retailer was 0.61 miles (SD=0.4). In fully adjusted two-level multilevel models (MLM) adjusting for demographic, socioeconomic, and behavioral factors, higher odds of initiating ATP use were associated with living in tracts with higher retail density (OR=1.32, 95% CI= 1.21, 3.81) in the neighborhood-only model and 1.06 (1.03, 1.92) in the school-only model. After adjusting for covariates, greater tobacco retailer density was still associated with higher odds of ATP initiation (AOR=1.22, 95% CI=1.07, 2.12). Neighborhood-level and school-level variations were 4% and 3%, respectively. Only retail density, not proximity, was related to ATP initiation. Our findings show that tobacco retailers clustered around students’ home neighborhood may be an influence on adolescents’ ATP use. These findings suggest the importance of regulating the tobacco retail environment, in order to reduce the marketing and accessibility of ATPs, which can thereby reduce the uptake of ATPs among youth. Moreover, these findings suggest the importance regulations focused on adolescents’ school environment are expanded to also include regulations of the tobacco retail environment in adolescents’ residential neighborhoods. Policy efforts to reduce adolescent ATP use should limit and reduce the density of tobacco retailers.

Increased coffee, tea, or other sugar-sweetened beverage consumption in adolescents is associated with less satisfactory dietary quality, body fatness and serum uric acid profiles over the past 18 years in Taiwan.

Taiwan has a high density of convenience stores and beverage shops, which makes sugar-sweetened beverages (SSBs) very accessible to teenagers. This study examined the changes and the association between SSBs and biomarkers and nutrient intake, for teenagers over the course of 18 years using a national representative sample. This cross-sectional study used data from the Nutrition and Health Survey in Taiwan (NAHSIT). Complete data for teenagers aged 13 to 19 years including a 24-hour dietary recall, anthropometric and clinical measurements, and SSBs from two periods were analyzed (1993-1996: N=1820; 2010-2011: N=2513). SAS callable SUDAAN was used for statistical analysis, adjusting for the sampling scheme. Log transformation was used for non-normal variables before linear models were used. Coffee or tea and SSB (excluding tea or coffee) consumers were categorized as non-drinkers, low (below), or high (above) consumers based on median intake during 1993-1996. Intake of coffee or tea increased significantly in the 18 years of this study (p<0.01), whereas intake of SSBs (excluding coffee or tea) decreased significantly (p<0.05). Intake was significantly higher among second survey and those with high total energy intakes (p<0.01). For both coffee/tea and SSB, the high-intake groups had higher serum uric acid and intake of carbohydrates (p<0.05), lower intake of protein and phosphorus and lower dietary diversity score (p<0.05). Consumption of coffee or tea increased in adolescents during the 18 years. High intakes of SSB, coffee or tea was associated with high serum uric acid values and worse dietary quality.

Assessments of residential and global positioning system activity space for food environments, body mass index and blood pressure among low-income housing residents in New York City.

Research has examined how the food environment affects the risk of cardiovascular disease (CVD). Many studies have focused on residential neighbourhoods, neglecting the activity spaces of individuals. The objective of this study was to investigate whether food environments in both residential and global positioning system (GPS)-defined activity space buffers are associated with body mass index (BMI) and blood pressure (BP) among low-income adults. Data came from the New York City Low Income Housing, Neighborhoods and Health Study, including BMI and BP data (n=102, age=39.3±14.1 years), and one week of GPS data. Five food environment variables around residential and GPS buffers included: fast-food restaurants, wait-service restaurants, corner stores, grocery stores, and supermarkets. We examined associations between food environments and BMI, systolic and diastolic BP, controlling for individual- and neighbourhood-level sociodemographics and population density. Within residential buffers, a higher grocery store density was associated with lower BMI (β=- 0.20 kg/m2, P<0.05), and systolic and diastolic BP (β =-1.16 mm Hg; and β=-1.02 mm Hg, P<0.01, respectively). In contrast, a higher supermarket density was associated with higher systolic and diastolic BP (β=1.74 mm Hg, P<0.05; and β=1.68, P<0.01, respectively) within residential buffers. In GPS neighbourhoods, no associations were documented. Examining how food environments are associated with CVD risk and how differences in relationships vary by buffer types have the potential to shed light on determinants of CVD risk. Further research is needed to investigate these relationships, including refined measures of spatial accessibility/exposure, considering individual's mobility.

Strategies for the Leftover Food Treatment Process: A Case Study of Convenience Store Deli-Style Food Products in Taiwan

The density of convenience stores in Taiwan is the highest in the world. Among the numerous commodities, the market competition for fresh food products is the fiercest and has become a focus of convenience store operations. Due to the change in Taiwanese lifestyles and consumer acceptance of the dining-out model, the demand and supply of fresh food products in convenience stores continues to increase. To benefit marketing performance, not only do convenience stores carry out promotional activities by reducing the price of products but they constantly innovate the taste and variety of fresh food products. For example, the tide of Taiwanese bento, during which promotions were implemented in the President Chain Store, has changed consumer diet habits; despite the raised price, consumers are still willing to purchase the product. However, convenient, real-time fresh food brought by this convenience store usually causes a massive waste of food. In its manufacturing and production processes, the food production chain ranks among the top three for national greenhouse gases. Whenever a piece of food is wasted, greenhouse gases are produced. Moreover, more resources are consumed to dispose of the wasted foods and garbage, further increasing greenhouse gas emissions and multiplying the carbon footprint. The phenomenon of excessive food waste has become an urgent issue in recent years in Taiwan, which is famous for its convenient food culture and service. In addition, because of Taiwan’s special economic development status, as well as rapid urbanization and family structure change, the ways to jointly affect this special consumption and food culture have become a topic worthy of discussion. Therefore, this research selected cooked food products in convenience stores as the main subject to explore the effect of social status and diet consumption from the perspective of daily social patterns and family structure data. It also examined the dilemma of excessive waste of food, to provide improvement advice as a reference to future relevant social policies and research.

Geographical Distribution of Fast Food and CRC Incidence in Young Adults

Background: There is an increasing trend of colorectal cancer (CRC) in young adults who also used to take fast food. However, little is known about the association between fast food and the occurrence of CRC in young adults. Aim: To investigate the impact of fast food diet on the incidence rate of CRC in terms of geographic distribution. Methods: Geographic distribution of fast food diet was measured by the density of fast food stores (numbers of fast food stores/population per 105) according to each county. We summed up total numbers of the fast food stores ranking the top 3 in Taiwan from the corresponding official Web sites. The incidence of CRC from 2004 to 2013 for young adults aged 15 to 49 years old was computed from Interactive Information System of the National Cancer Registry, provided by Health Promotion Administration, Ministry of Health and Welfare. Multilevel random-effect regression model was applied to estimating the effects of geographical location of fast food stores at city/county level on incidence of CRC with adjustment for age and gender at individual level. Results: The incidence rate of CRC in young adults aged 50 years or below was in parallel with the distribution of fast food stores in geographical pattern. After adjusting for age and sex, the results show that an increase in the growth of 1 unit of density in fast food store led to an increase in incidence of CRC by 2%. Approximately 87% accuracy was noted in predicting the highest one-third percentage of incident CRC cases in young adults. Conclusion: The density of fast food stores was highly associated with the increased risk of colorectal cancer incidence in young adults. This may account for the increasing trend of CRC in young adults in Taiwan.