How do changes in the neighborhood food environment influence diet and body mass index over time? An innovative method using 20 years of spatial, diet, and anthropometry data

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  • March 19, 2019
Creator
  • Richardson, Andrea
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
Abstract
  • Cross-sectional studies suggest neighborhood socioeconomic disadvantage is associated with obesogenic food environments. Yet, it is unknown how exposure to neighborhood socioeconomics (SES) patterning through adulthood corresponds to food environments that also change over time. Further, obesity reduction strategies often target neighborhood food resources, without considering separate pathways from multiple types of resources to body mass index (BMI), through diet, or how reverse causality plays a role. We capitalized on a large Geographic Information Systems derived temporally and spatially linked to respondents (residential locations) in the large cardiovascular cohort study called Coronary Artery Risk Development in Young Adults (CARDIA). We estimated longitudinal pathways from neighborhood food resources to BMI and studied pathways from neighborhood fast food, sit-down restaurants, supermarkets and convenience stores to BMI, through diet behaviors. We approximated reverse causality with reverse pathways from period-specific diet behaviors to future neighborhood food resources. Socioeconomically disadvantaged neighborhood residents had fewer sit-down restaurants, more convenience stores, and similar numbers of supermarkets in their neighborhoods than the advantaged residents. Neighborhood fast food and sit-down restaurants were associated with higher BMI through the consumption of foods typically purchased from fast food restaurants (i.e., fast food-type diet). Fast food-type diet was consistently associated with higher BMI while consumption of the sit-down restaurant-type diet was associated with lower BMI. Including reverse pathways from time period specific diet behaviors to future food environment suggests that diet behaviors may act as a proxy for individual preferences/constraints associated with future neighborhood food stores and restaurants. Approximating reverse causality with reverse pathways from time period-specific diet behaviors to future neighborhood food resources, increased both the magnitude and strength of the associations between neighborhood restaurants and diet behaviors, but did not change the associations between neighborhood food stores and diet behaviors. Neighborhood fast food and sit-down restaurants may play comparatively stronger roles than food stores in diet behaviors and BMI. Public health policies that address food environment disparities to improve diet and reduce obesity may need to focus on eating away-from-home behaviors and the types of restaurants (i.e., fast food versus sit-down) more than on food stores.
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  • In Copyright
Advisor
  • Howard, Annie Green
  • Meyer, Katie
  • Popkin, Barry
  • Evenson, Kelly
  • Gordon-Larsen, Penny
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2014
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  • Chapel Hill, NC
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  • This item is restricted from public view for 2 years after publication.
Date uploaded
  • April 23, 2015

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