Are Perceived and Objective Distances to Fresh Food and Physical Activity Resources Associated with Cardiometabolic Risk?

Abstract

Perceived and objective measures of neighbourhood features have shown limited correspondence. Few studies have examined whether discordance between objective measures and individual perceptions of neighbourhood environments relates to individual health. Individuals with mismatched perceptions may benefit from initiatives to improve understandings of resource availability. This study utilised data from n = 1491 adult participants in a biomedical cohort to evaluate cross-sectional associations between measures of access (perceived, objective, and perceived-objective mismatch) to fruit and vegetable retailers (FVR) and public open space (POS), and clinically-measured metabolic syndrome and its component risk factors: central obesity, dyslipidaemia, hypertension and pre-diabetes/diabetes. Access measures included perceived distances from home to the nearest FVR and POS, corresponding objectively-assessed road network distances, and the discordance between perceived and objective distances (overestimated (i.e., mismatched) distances versus matched perceived-objective distances). Individual and neighbourhood measures were spatially joined using a geographic information system. Associations were evaluated using multilevel logistic regression, accounting for individual and area-level covariates. Hypertension was positively associated with perceived distances to FVR (odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.02, 1.28) and POS (OR = 1.19, 95% CI = 1.05, 1.34), after accounting for covariates and objective distances. Hypertension was positively associated with overestimating distances to FVR (OR = 1.36, 95% CI = 1.02, 1.80). Overestimating distances to POS was positively associated with both hypertension (OR = 1.42, 95% CI = 1.11, 1.83) and dyslipidaemia (OR = 1.25, 95% CI = 1.00, 1.57). Results provide new evidence for specific associations between perceived and overestimated distances from home to nearby resources and cardiometabolic risk factors.

A systematic review of the Australian food retail environment: Characteristics, variation by geographic area, socioeconomic position and associations with diet and obesity

“…Methods used in this group of studies were heterogeneous, with no two studies measuring the same food retail environment characteristic. Five studies found no significant association(s) . Two studies found significant associations in the hypothesized direction, whereby healthier food retail environments were associated with lower measures of people with obesity) .…”

“…The same study reported a significant positive correlation between healthiness of the food retail environment, measured using the Relative Food Environment Index, and four diet scores (total diet, fruit and vegetable, sugary drink and discretionary food—higher being healthier for all scores) . Five studies reported non‐significant associations between fruit and vegetable intake and proximity to and/or density of supermarkets and/or greengrocers/fruit and vegetable retailers, chain supermarkets and fast food outlets or the introduction of a new fast food outlet on fast food consumption …”

“…Approaches to measure the food retail environment were heterogeneous across studies (Table ). Outcome measures were relatively consistent, with self‐reported (parent reported where a child participated) dietary consumption of fruit and vegetables, fast food, or both healthy and unhealthy foods measured using/adapting validated tools in most studies.…”

“…Thirteen studies examined associations between food retail environments and prevalence of people with obesity (Table ). Outcome measures for prevalence of people with obesity were most often collected through self‐report (or parent‐reported) height and weight to generate BMI , four studies objectively measured central obesity/waist circumference two of which used BMI as a measure also . One study used adult/parent self‐reported BMI with children's BMI objectively measured, and one study used the World Health Statistics from 2009 to estimate national prevalence of people with obesity.…”

Revisiting the Role of Place in Geographic Information Science

“…These shortcomings of the place-based perspective of accessibility paved the way for the emergence of person-based accessibility measures, which assess accessibility on an individual level. An increasing number of studies investigate the perceived distances vs. real or Euclidean distances [58,[62][63][64], usually, at an aggregated level to reflect locational privacy. These studies may use concepts of both place-based and people-based approaches-if it is possible to distinguish such approaches.…”