Race, Ethnicity, and Neighborhood Food Environment Are Associated with Adolescent Sugary Drink Consumption During a 5-Year Community Campaign

Background A multi-level county-wide campaign to reduce sugary drink consumption was associated with significant decreases in retail sales of soda and fruit drinks. The aim of the current study was to examine changes in adolescent beverage consumption during the campaign by race/ethnicity and neighborhood food environment. Methods Beverage consumption among adolescents was evaluated at four time points in a repeated cross-sectional survey of a racially and ethnically diverse sample of sixth graders (N = 13,129) from public middle schools in the county. Each school’s surrounding attendance zone (i.e., neighborhoods where students live) was characterized as providing high or low exposure to unhealthy food retail (e.g., convenience stores, fast-food restaurants). Logistic and multiple linear regression models were used to evaluate changes in beverage consumption over time by student race/ethnicity and high versus low unhealthy food exposure. Results Over the 5 years, there were significant declines in the overall share of students who reported daily sugary drink consumption (49.4 to 36.9%) and their reported daily calories from these products (220 to 158 calories). However, disparities were observed, with higher levels of consumption among Black and Hispanic youth and among youth living in neighborhoods with more unhealthy food retail. Notably, Black students living in healthier neighborhood food environments reported significant decreases in daily consumption and calories after 5 years, while Black students living in neighborhoods with more convenience stores and fast-food outlets did not. Conclusion These findings suggest that both race/ethnicity and neighborhood food environments are important considerations when designing interventions to reduce sugary drink consumption among adolescents.

Association between Neighborhood Food Environment and Body Mass Index among Older Adults in Beijing, China: A Cross-Sectional Study

Objective: To investigate the association between the neighborhood food environment and body mass index (BMI) among Chinese older adults. Methods: A multi-stage stratified random sampling method was used to recruit participants from 12 communities in Beijing, China, in 2019. Participants (n = 1764, 1034 women) in this study were older adults aged 65 to 80. We collected the participants’ basic information, measured their height and weight, and calculated their BMI. Neighborhood food environments were measured by the density of and proximity to different food outlets using the Baidu Map Application Programming Interface. Adjusted multiple linear regression was performed to estimate the association between the food environment and BMI. Results: Participants had a mean age of 69.7 ± 4.32 years old and an average BMI of 26.3 ± 3.50 kg/m2. Among the three types of stores, convenience stores had the easiest access, followed by greengrocers and supermarkets. Sit-down restaurants had the best access among different restaurants, followed by Chinese fast-food restaurants, and western fast-food restaurants had the worst access. Easier access to greengrocers (β = 0.281, p < 0.001) and sit-down restaurants (β = 0.304, p < 0.001) was associated with higher BMI in the 250 m buffer zone. More supermarkets were associated with higher BMI in the 500 m buffer zone (β = 0.593, p < 0.001). Access to convenience stores was positively associated with BMI in the 800 m buffer zone (β = 0.057, p < 0.001). Better access to Chinese fast-food restaurants was associated with higher BMI (β = 0.071, p = 0.001), and better access to western fast- food restaurants was associated with lower BMI (β = −0.400, p < 0.001) in the 1000 m buffer zone. There was a negative association between the nearest distance to greengrocers and BMI (β = −0.004, p < 0.001). Conclusion: Although we found some significant associations between the neighborhood food environment and obesity, the current results are not strong enough to draw specific conclusions. Policymakers will need to rely on more evidence to derive concrete policy recommendations.

Effect of Neighborhood Food Environment and Socioeconomic Status on Serum Phosphorus Level for Patients on Chronic Dialysis

BackgroundElevated blood phosphorus levels are common and associated with a greater risk of death for patients receiving chronic dialysis. Phosphorus-rich foods are prevalent in the American diet, and low-phosphorus foods, including fruits and vegetables, are often less available in areas with more poverty. The relative contributions of neighborhood food availability and socioeconomic status to phosphorus control in patients receiving dialysis are unknown.MethodsUsing longitudinal data from a national dialysis provider, we constructed hierarchical, linear mixed-effects models to evaluate the relationships between neighborhood food environment or socioeconomic status and serum phosphorus level among patients receiving incident dialysis.ResultsOur cohort included 258,510 patients receiving chronic hemodialysis in 2005–2013. Median age at dialysis initiation was 64 years, 45% were female, 32% were Black, and 15% were Hispanic. Within their residential zip code, patients had a median of 25 “less-healthy” food outlets (interquartile range, 11–40) available to them compared with a median of four “healthy” food outlets (interquartile range, 2–6). Living in a neighborhood with better availability of healthy food was not associated with a lower phosphorus level. Neighborhood income also was not associated with differences in phosphorus. Patient age, race, cause of ESKD, and mean monthly dialysis duration were most closely associated with phosphorus level.ConclusionsNeither neighborhood availability of healthy food options nor neighborhood income was associated with phosphorus levels in patients receiving chronic dialysis. Modifying factors, such as nutrition literacy, individual-level financial resources, and adherence to diet restrictions and medications, may be more powerful contributors than food environment to elevated phosphorus.

Food Insecurity, Perception of the Neighborhood Food Environment, and Dietary Quality Among Mexican Immigrant Women

Objectives Migration to the US has been associated with food insecurity and detrimental changes in diet quality. How these changes affect women in context of their neighborhood food environment has not been thoroughly explored. This study aimed to assess if food insecurity is associated with diet quality and to explore if perceived food availability moderates this purported association in a sample of Mexican immigrant women. Methods Mexican-born women (n = 57, 41 ± 7 y) residing in a southwestern US metropolitan area for &gt;1 y self-reported food security status, monthly fast-food frequency, and their perception of fruit, vegetables, and low-fat product availability within their neighborhood via survey. Diet was assessed using the Southwest Food Frequency Questionnaire to estimate intake of fruit, vegetables, salty snacks, sugar, and healthy eating index (HEI)-2015 score. Independent samples t-tests compared dietary outcomes between women classified as food secure (n = 41; high or marginal food security) and food insecure (n = 16; low or very low food security). A moderation analysis assessed the effect of the perception of the neighborhood food environment on the relationship between food security and HEI-2015 score. Results Fifty four % of participants worked full time and 42% had a monthly household income &lt;$2000. Relative to women classified as food secure, participants experiencing food insecurity had lower HEI-2015 (61 ± 8 vs. 66 ± 6; P = 0.03). Albeit not significantly different, women experiencing food insecurity reported lower intake of fruit (236 ± 178 vs. 294 ± 239 g), vegetables (303 ± 188 vs. 331 ± 199 g), and salty snacks (6 ± 5 vs. 8 ± 10 g), as well as higher intake of sugar (99 ± 55 vs. 96 ± 56 g) and fast food (2.5 ± 2.5 vs. 1.8 ± 1.7 times per month). Among women experiencing food insecurity, there was a trend for a lower perception of neighborhood fruit, vegetable and low-fat product availability being associated with lower HEI-2015 scores (54 ± 6) relative to those who perceived moderate (63 ± 6) or high (65 ± 8) neighborhood availability of those foods (P = 0.07). Conclusions Findings suggest a need for better understanding of how neighborhood food availability may affect diet quality among Mexican immigrant women experiencing food insecurity. Funding Sources CONACYT, Mexico, and Program for Transborder Communities.