An ecological analysis of food outlet density and prevalence of type II diabetes in South Carolina counties

Alhasan, Dana M.; Eberth, Jan M.

doi:10.1186/s12889-015-2681-6

Cited by 22 publications

(35 citation statements)

References 37 publications

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“…However, the Swedish study was an aggregate-level analysis, since the participants' dwelling could only be geocoded at the level of small geographical units (that averaged 1000 participants per unit) and failed to adjust for key confounders, such as physical activity. Another countylevel ecological study 29 that used self-reported data in South Carolina, USA, reported no association between density of food outlets and county-level type 2 diabetes, subsequent to all adjustments.…”

Section: Discussionmentioning

confidence: 99%

“…A few studies have reported null or counterintuitive findings. 28,29 Most studies have been small in population size and geo graphical scale with relatively homogen eous populations and exposure characteristics, which has limited their statistical power and generalisability, and many were based on self-reported, survey-based measures. Further, most of the studies evaluating the association of food outlet accessi bility with chronic disease risks have been done in the USA, and there have been no studies that have examined the associations between accessibility to ready-to-eat food environments selling food that can be instantly consumed and type 2 diabetes at a national scale in the UK.…”

Section: Implications Of All the Available Evidencementioning

confidence: 99%

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Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants

Sarkar

Webster

Gallacher

2018

The Lancet Planetary Health

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Background Rapid urbanisation and associated socioeconomic transformations have modified current lifestyles, shifting dietary preferences towards ready-to-eat, calorie-dense food of poor nutritional quality. The effect of ready-toeat food environments that sell food for instant consumption on the risk of type 2 diabetes has received scant attention. We therefore aimed to examine the association between exposure to ready-to-eat food environments and type 2 diabetes in a large and diverse population sample. Methods We conducted a cross-sectional study of adult male and female participants from the baseline phase of the UK Biobank cohort. Participants in this cohort were aged 37-73 years and resided in one of 21 cities in the UK. Readyto-eat food environments, which we determined from a modelled and linked built environment database, were objectively measured within 1-km catchment areas of the residential streets of participants and were expressed as metrics of density and proximity to the participants' homes. We used logistic regression models to examine the associations between exposure to ready-to-eat food environments and the odds of type 2 diabetes, adjusting for individual covariates such as physical activity. As sensitivity analyses, we investigated the associations between the street distance to the nearest ready-to-eat food outlet and type 2 diabetes. We also tested post hoc for effect modification by sex, income, body-mass index, and location of the UK Biobank collection centre. Findings Of 502 635 UK Biobank participants enrolled between March 13, 2006, and Oct 1, 2010, the sample analysed included 347 551 (69•1%) participants. The density of ready-to-eat food environments within a 1-km catchment area was associated with higher odds of type 2 diabetes for participants in the groups with highest exposure to restaurants and cafeterias (odss ratio 1•129, 95% CI 1•05-1•21; p=0•0007) and a composite measure of ready-to-eat outlet density (1•112, 1•02-1•21; p=0•0134) compared with those with no exposure. Exposure to hot and cold takeaways was only significantly associated with higher odds of type 2 diabetes at the second highest exposure category that we examined (1•076, 1•01-1•14; p=0•0171), representing a density of 0•75-2•15 units per km². A protective effect with distance decay was observed: participants in the highest quintile of street distance to nearest ready-to-eat food outlet reported lower odds of type 2 diabetes than those in the lowest quintile (0•842, 0•78-0•91; p<0•0001 for restaurants and cafeterias; and 0•913, 0•85-0•98; p=0•0173 for hot and cold takeaways). These effects were most pronounced in overweight participants (p=0•0329), but there was no evidence of interaction by sex, income, or UK Biobank collection centre. Interpretation Access to ready-to-eat food environments was positively associated with type 2 diabetes. Top-down policies aimed at minimising unhealthy food access could potentially reduce unhealthy consumption and risks of chronic diseases. Further long-term studies are needed t...

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Section: Discussionmentioning

confidence: 99%

Section: Implications Of All the Available Evidencementioning

confidence: 99%

Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants

Sarkar

Webster

Gallacher

2018

The Lancet Planetary Health

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“…Data for these measures were obtained from the U.S. Census Bureau's 2005–2009 American Community Survey (ACS) 5‐year Estimates. Measures of the health and healthcare context of counties included: the age‐adjusted percentage of adults (≥20 years) with obesity, the age‐adjusted percentage of adults (≥20 years) who were physically inactive, the number of outpatient visits per 1,000 people, the percentage of the population without health insurance, and the number of physicians per 1,000 people. Obesity and physical inactivity prevalence data for adults were obtained from the CDC's Diabetes Interactive Atlas.…”

Section: Methodsmentioning

confidence: 99%

“…While this is hopeful news, diabetes prevalence remains an important public health issue and requires continued research to further identify factors relevant to maintaining this progress . Ecological studies exploring diabetes prevalence in the U.S. have shown geographic clusters of high and low diabetes prevalence within single communities and among communities within a single state , as well as across the entirety of the U.S. . Among these studies, racial/ethnic populations and poverty , food environment measures , and local business or entrepreneurial culture have all been shown to be associated with diabetes prevalence.…”

Section: Introductionmentioning

confidence: 99%

“…Ecological studies exploring diabetes prevalence in the U.S. have shown geographic clusters of high and low diabetes prevalence within single communities and among communities within a single state , as well as across the entirety of the U.S. . Among these studies, racial/ethnic populations and poverty , food environment measures , and local business or entrepreneurial culture have all been shown to be associated with diabetes prevalence. Most importantly, ecological diabetes research has established a geographically distinct area known as the “Diabetes Belt,” which is a region of counties ( n = 644) in the Southern U.S. characterized by diabetes prevalence of 11% or greater among the adult population .…”

Section: Introductionmentioning

confidence: 99%

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Diabetes prevalence is associated with different community factors in the diabetes belt versus the rest of the United States

Myers

Slack

Broyles

et al. 2016

Obesity

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Objective This study investigated differences in community characteristics associated with diabetes prevalence between the Diabetes Belt and the rest of the contiguous U.S. Methods We used county-level adult diabetes prevalence estimates (i.e., percent of people [≥20 years] with diagnosed diabetes, 2009) from the Centers for Disease Control and Prevention, in addition to data from the U.S. Census Bureau, U.S. Department of Agriculture, and U.S. Department of Health and Human Services, to carry out a spatial regime analysis to identify county-level factors correlated with diabetes prevalence in the Diabetes Belt versus the remainder of the U.S. Results Counties outside of the Diabetes Belt demonstrated stronger positive associations between diabetes prevalence and persistent poverty and greater percentages of unemployed labor forces. For counties in the Diabetes Belt, diabetes prevalence showed a stronger positive association with natural amenities (e.g., temperate climate and topographic features) and a stronger negative association with fitness/recreation facility density. Conclusions Community-level correlates of diabetes prevalence differed between the Diabetes Belt and elsewhere in the U.S. Economic hardship was shown to be more relevant outside the Diabetes Belt, while recreational context effects were more pronounced among counties within the region. Prevention and treatment targets are geographically unique and public health efforts should acknowledge these differences in crafting policy.

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Neighborhood physical food environment and cardiovascular risk factors in India: Cross-sectional evidence from APCAPS

Mallinson

Bhan

et al. 2019

Environment International

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There has been increasing interest in associations between neighborhood food environments and cardiovascular risk factors. However, results from high-income countries remain inconsistent, and there has been limited research from low- and middle-income countries. We conducted a cross-sectional analysis of the third wave follow-up of the Andhra Pradesh children and parents study (APCAPS) (n = 5764, median age 28.8 years) in south India. We examined associations between the neighborhood availability (vendor density per km2 within 400 m and 1600 m buffers of households) and accessibility (distance from the household to the nearest vendor) of fruit/vegetable and highly processed/take-away food vendors with 11 cardiovascular risk factors, including adiposity measures, glucose-insulin, blood pressure, and lipid profile. In fully adjusted models, higher density of fruit/vegetable vendors within 400 m of participant households was associated with lower systolic blood pressure [−0.09 mmHg, 95% confidence interval (CI): −0.17, −0.02] and diastolic blood pressure (−0.10 mmHg, 95% CI: −0.17, −0.04). Higher density of highly processed/take-away food vendors within 400 m of participant households was associated with higher Body Mass Index (0.01 Kg/m2, 95% CI: 0.00, 0.01), waist circumference (0.22 mm, 95% CI: 0.05, 0.39), systolic blood pressure (0.03 mmHg, 95% CI: 0.01, 0.06), and diastolic blood pressure (0.03 mmHg, 95% CI: 0.01, 0.05). However, within 1600 m buffer, only association with blood pressure remained robust. No associations were found for between neighborhood accessibility and cardiovascular risk factors. Lower density of fruit/vegetable vendors, and higher density of highly processed/take-away food vendors were associated with adverse cardiovascular risk profiles. Public health policies regarding neighborhood food environments should be encouraged in south India and other rural communities in south Asia.

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An ecological analysis of food outlet density and prevalence of type II diabetes in South Carolina counties

Cited by 22 publications

References 37 publications

Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants

Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants

Diabetes prevalence is associated with different community factors in the diabetes belt versus the rest of the United States

Neighborhood physical food environment and cardiovascular risk factors in India: Cross-sectional evidence from APCAPS

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