Neighbourhood differences in diet: the Atherosclerosis Risk in Communities (ARIC) Study

Objective: The present study examined the association between area socioeconomic status (SES) and food purchasing behaviour. Design: Data were collected by mail survey (64?2 % response rate). Area SES was indicated by the proportion of households in each area earning less than $AUS 400 per week, and individual-level socio-economic position was measured using education, occupation and household income. Food purchasing was measured on the basis of compliance with dietary guideline recommendations (for grocery foods) and variety of fruit and vegetable purchase. Multilevel regression analysis examined the association between area SES and food purchase after adjustment for individual-level demographic (age, sex, household composition) and socioeconomic factors. Setting: Melbourne city, Australia, 2003. Subjects: Residents of 2564 households located in fifty small areas. Results: Residents of low-SES areas were significantly less likely than their counterparts in advantaged areas to purchase grocery foods that were high in fibre and low in fat, salt and sugar; and they purchased a smaller variety of fruits. There was no evidence of an association between area SES and vegetable variety. Conclusions: In Melbourne, area SES was associated with some food purchasing behaviours independent of individual-level factors, suggesting that areas in this city may be differentiated on the basis of food availability, accessibility and affordability, making the purchase of some types of foods more difficult in disadvantaged areas.

Section: Discussionsupporting

confidence: 86%

A multilevel study of area socio-economic status and food purchasing behaviour

Turrell

Bentley

Thomas

et al. 2009

“…All studies were cross-sectional. Only one study used multilevel analyses 24 ; census block districts were the area level used in these analyses. All remaining studies were individual-level analyses.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of associations between environmental factors, energy and fat intakes among adults: is there evidence for environments that encourage obesogenic dietary intakes?

Giskes

Kamphuis

Lenthe

et al. 2007

Objective: To review the literature examining associations between environmental factors, energy and fat intakes among adults, and to identify issues for future research. Methods: Literature searches of studies published between 1980 and 2004 were conducted in major databases (i.e. PubMed, Human Nutrition, Web of Science, PsychInfo, Sociofile). Additional articles were located by citation tracking. Results: Twenty-one articles met the inclusion criteria. No study provided a clear conceptualisation of how environmental factors may influence these dietary intakes. Availability, social, cultural and material aspects of the environment were relatively understudied compared with other factors such as seasonal/day of the week variation and work-related factors. Few studies examined the specific environmental factors implicated in the obesity epidemic, and there was little study replication. All studies were observational and cross-sectional. Conclusions: It is too premature to conclude whether or not environmental factors play a role in obesogenic and unhealthy dietary intakes. More studies need to examine associations with those environmental factors thought to contribute to obesogenic environments. There needs to be more development in theories that conceptualise the relationship between environmental factors and dietary intakes.

“…These studies (8,30,31) applied hierarchical linear modelling or logistic regression. In the current study, we take a latent class (LC) approach and simultaneously identify consumer segments at both the individual level and the food retail environmental level.…”

Section: Discussionmentioning

confidence: 99%

Impacts of fast food and the food retail environment on overweight and obesity in China: a multilevel latent class cluster approach

Zhang

Lans

Dagevos

2011

Objective: To simultaneously identify consumer segments based on individual-level consumption and community-level food retail environment data and to investigate whether the segments are associated with BMI and dietary knowledge in China. Design: A multilevel latent class cluster model was applied to identify consumer segments based not only on their individual preferences for fast food, salty snack foods, and soft drinks and sugared fruit drinks, but also on the food retail environment at the community level. Setting: The data came from the China Health and Nutrition Survey (CHNS) conducted in 2006 and two questionnaires for adults and communities were used. Subjects: A total sample of 9788 adults living in 218 communities participated in the CHNS. Results: We successfully identified four consumer segments. These four segments were embedded in two types of food retail environment: the saturated food retail environment and the deprived food retail environment. A three-factor solution was found for consumers' dietary knowledge. The four consumer segments were highly associated with consumers' dietary knowledge and a number of sociodemographic variables. Conclusions:The widespread discussion about the relationships between fastfood consumption and overweight/obesity is irrelevant for Chinese segments that do not have access to fast food. Factors that are most associated with segments with a higher BMI are consumers' (incorrect) dietary knowledge, the food retail environment and sociodemographics. The results provide valuable insight for policy interventions on reducing overweight/obesity in China. This study also indicates that despite the breathtaking changes in modern China, the impact of 'obesogenic' environments should not be assessed too strictly from a 'Western' perspective. KeywordsChina Obesity Food retail environment Multilevel latent class clusterIn recent years, growing scholarly attention (1)(2)(3) has been paid to the relationships between food retail environments (e.g. access, availability and price) and obesity. Fast food is high in energy and low in micronutrient density, and fast-food consumption may contribute to the obesity epidemic (4)(5)(6) . Although research on the possible interactions between obesity and characteristics of the food environment is at an early stage and the evidence is currently too weak to draw firm conclusions (7) , US studies suggest that the food environment influences a healthy diet and obesity levels in North America (8)(9)(10) .The clearly observable presence of processed foods, fast-food restaurants, supermarkets and other food outlets as factors determining the rising prevalence of overweight and obesity is a topic of research that is particularly relevant in the context of developed countries. Similar to the changing food retailing landscape in the postWorld War II era in Western countries (11,12) , the food retailing sector in China is experiencing dramatic changes half a century later. Over the past decade, supermarkets have been spreading faster in China...