Geographic inequity in healthy food environment and type 2 diabetes: can we please turn off the tap?

Astell-Burt, Thomas; Feng, Xiaoqi

doi:10.5694/mja15.00063

Cited by 18 publications

(14 citation statements)

References 18 publications

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“…Local descriptive norms for overweight/obesity and insufficient fruit intake were defined within road-network buffers constructed by radiating 1600 m (1 mile) along the road-network in all possible directions from each participant’s residential address. The 1600 m distance represents the distance covered by an average adult walking at a comfortable pace (5 km/hour) for approximately 20 min [ 51 ] and has previously been used in studies assessing the impact of the local food environment on health outcomes (e.g., [ 52 – 54 ]).…”

Section: Methodsmentioning

confidence: 99%

Associations between local descriptive norms for overweight/obesity and insufficient fruit intake, individual-level diet, and 10-year change in body mass index and glycosylated haemoglobin in an Australian cohort

Carroll

Niyonsenga

Coffee

et al. 2018

Int J Behav Nutr Phys Act

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BackgroundDescriptive norms (what other people do) relate to individual-level dietary behaviour and health outcome including overweight and obesity. Descriptive norms vary across residential areas but the impact of spatial variation in norms on individual-level diet and health is poorly understood. This study assessed spatial associations between local descriptive norms for overweight/obesity and insufficient fruit intake (spatially-specific local prevalence), and individual-level dietary intakes (fruit, vegetable and sugary drinks) and 10-year change in body mass index (BMI) and glycosylated haemoglobin (HbA1c).MethodsHbA1c and BMI were clinically measured three times over 10 years for a population-based adult cohort (n = 4056) in Adelaide, South Australia. Local descriptive norms for both overweight/obesity and insufficient fruit intake specific to each cohort participant were calculated as the prevalence of these factors, constructed from geocoded population surveillance data aggregated for 1600 m road-network buffers centred on cohort participants’ residential addresses. Latent growth models estimated the effect of local descriptive norms on dietary behaviours and change in HbA1c and BMI, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, employment and education, and area-level median household income).ResultsLocal descriptive overweight/obesity norms were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively), and worsening HbA1c and BMI. Spatially-specific local norms for insufficient fruit intake were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively) and worsening HbA1c but not change in BMI. Individual-level fruit and vegetable intakes were not associated with change in HbA1c or BMI. Sugary drink consumption was also not associated with change in HbA1c but rather with increasing BMI.ConclusionAdverse local descriptive norms for overweight/obesity and insufficient fruit intake are associated with unhealthful dietary intakes and worsening HbA1c and BMI. As such, spatial variation in lifestyle-related norms is an important consideration relevant to the design of population health interventions. Adverse local norms influence health behaviours and outcomes and stand to inhibit the effectiveness of traditional intervention efforts not spatially tailored to local population characteristics. Spatially targeted social de-normalisation strategies for regions with high levels of unhealthful norms may hold promise in concert with individual, environmental and policy intervention approaches.

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Section: Methodsmentioning

confidence: 99%

Associations between local descriptive norms for overweight/obesity and insufficient fruit intake, individual-level diet, and 10-year change in body mass index and glycosylated haemoglobin in an Australian cohort

Carroll

Niyonsenga

Coffee

et al. 2018

Int J Behav Nutr Phys Act

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“…Type 2 diabetes and high body mass index (BMI) were reported to be more prevalent in disadvantaged areas. Related studies report that the type of neighbourhood food outlets [37][38][39], poor physical activity resources [39], individual perception of area level features [40] residential density and service availability [41] were all explanatory variables associated with cardiometabolic risk prevalence among people living in disadvantaged neighbourhoods.…”

Section: Discussionmentioning

confidence: 99%

Geographic and area-level socioeconomic variation in cardiometabolic risk factor distribution: a systematic review of the literature

et al. 2019

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Introduction: A growing number of publications report variation in the distribution of cardiometabolic risk factors (CMRFs) at different geographic scales. A review of these variations may help inform policy and health service organisation. Aim: To review studies reporting variation in the geographic distribution of CMRFs and its association with various proxy measures of area-level socioeconomic disadvantage (ASED) among the adult (≥ 18 years) population across the world. Methods: A systematic search for published articles was conducted in four databases (MEDLINE (Ovid), PubMed, Scopus and Web of Science) considering the interdisciplinary nature of the review question. Population-based crosssectional and cohort studies on geographic variations of one or more biological proxies of CMRFs with/without an analysed contextual association with ASED were included. Two independent reviewers screened the studies and PRISMA guidelines were followed in the study selection and reporting. Result: A total of 265 studies were retrieved and screened, resulting in 24 eligible studies. The review revealed reports of variation in the distribution of CMRFs, at varying geographic scales, in multiple countries. In addition, consistent associations between ASED and higher prevalence of CMRFs were demonstrated. The reports were mainly from industrialised nations and small area geographic units were frequently used. Conclusion: Geographic variation in cardiometabolic risk exists across multiple spatial scales and is positively associated with ASED. This association is independent of individual-level factors and provides an imperative for area-based approaches to informing policy and health service organisation. The study protocol is registered in International prospective register of systematic reviews (Register No: CRD42018115294) PROSPERO 2018.

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“…These might include combining spatial analysis with policy and business interventions to consider how “food deserts” or “food swamps” put poor neighbourhoods at risk in Australia. 13 Greater focus should be on research and accountability of powerful commercial interests.…”

Section: Role Of Implementation Researchmentioning

confidence: 99%

Asking the right question: implementation research to accelerate national non-communicable disease responses

Peters

Wickramasinghe

et al. 2019

BMJ

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Geographic inequity in healthy food environment and type 2 diabetes: can we please turn off the tap?

Cited by 18 publications

References 18 publications

Associations between local descriptive norms for overweight/obesity and insufficient fruit intake, individual-level diet, and 10-year change in body mass index and glycosylated haemoglobin in an Australian cohort

Associations between local descriptive norms for overweight/obesity and insufficient fruit intake, individual-level diet, and 10-year change in body mass index and glycosylated haemoglobin in an Australian cohort

Geographic and area-level socioeconomic variation in cardiometabolic risk factor distribution: a systematic review of the literature

Asking the right question: implementation research to accelerate national non-communicable disease responses

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