Neighbourhood food environments and body mass index among New York City adults

Abstract

Background Studies evaluating the impact of the neighborhood food environment on obesity have summarized the density or proximity of individual food outlets. Though informative, there is a need to consider the role of the entire food environment; however, few measures of whole system attributes have been developed. New variables measuring the food environment were derived and used to study the association with body mass index (BMI). Methods Individual data on BMI and socio-demographic characteristics was collected from 48,482 respondents of the 2002–2006 community health survey in New York City and linked to residential zip code level characteristics. The food environment of each zip code was described in terms of the diversity of outlets (number of types of outlets present in a zip code), the density of outlets (outlets per Km2) and the proportion of outlets classified as BMI-unhealthy (e.g. fast food, bodegas). Results Results of the cross-sectional, multi-level analyses revealed an inverse association between BMI and food outlet density (−0.32 BMI units across the inter-quartile range (IQR), 95% CI −0.45, −0.20), a positive association between BMI and the proportion of BMI-unhealthy food outlets (0.26 BMI units per IQR, 95% CI 0.09, 0.43) and no association with outlet diversity. The association between BMI and the proportion of BMI-unhealthy food outlets was stronger in lower (< median for % poverty) poverty zip codes than in high poverty zip codes. Conclusions These results support a more nuanced assessment of the impact of the food environment and its association with obesity.

The food environment is a complex social network

“…In fact, Sturm and Hattori show that the increase in combined prevalence of overweight and obesity since the ban has been significantly larger in Los Angeles than elsewhere (Sturm and Hattori, 2015, p. 5e7). These findings not only contradict expectations based on studies that link obesity with fast food consumption (Anderson et al, 2011;Stark et al, 2013;BooneHeinonen et al, 2011) and the reduction of obesity with increased penetration of grocery stores (Morland et al, 2006;Larson et al, 2009), but demand new conversations about policy, healthy food access, and health disparities.…”

“…Sturm and Hattori's study adds to the body of literature that suggests that the "food environment" is a much more complex phenomenon than was imagined when policymakers enacted the South LA fast food ban (Stark et al, 2013;Caspi et al, 2012). Studies that count the number and types of food outlets are unlikely to capture the complexity of the food landscape (Farley et al, 2009).…”

Neighborhood socioeconomic status and food environment: A 20-year longitudinal latent class analysis among CARDIA participants

“…Greater total food outlet density has been inversely associated with BMI, perhaps because greater density typically offers a wider array of food options or lower prices so that residents can make healthier food purchases (Stark, Neckerman et al 2013) despite rising fast food availability (Economic Research Service - USDA 2004). Conversely, lower BMI in areas with high food outlet density may reflect overall dietary preferences of the residents (Poti, Duffey et al 2013).…”

How Incarceration Influences Native-Born Black Men’s Risk of Obesity

“…4 In addition, the food environment of a neighborhood, cultural variation in food preference, and exposure to poverty predict obesity. 5,6 James 7 argues barriers to healthy eating such as networks that promote unhealthy lifestyles predict obesity-related morbidity for Black men. Behavioral factors including physical activity, cigarette smoking, and binge drinking correlate with obesity risk among Black men.…”