You Are Where You Shop. Grocery Store Locations, Weight, and Neighborhoods

Veterans Affairs Health Services and Research Development, VA Greater Los Angeles Health Care System, Division of General Internal Medicine, Los Angeles, California 90073, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 08/2006; 31(1):10-7. DOI: 10.1016/j.amepre.2006.03.019
Source: PubMed

ABSTRACT Residents in poor neighborhoods have higher body mass index (BMI) and eat less healthfully. One possible reason might be the quality of available foods in their area. Location of grocery stores where individuals shop and its association with BMI were examined.
The 2000 U.S. Census data were linked with the Los Angeles Family and Neighborhood Study (L.A.FANS) database, which consists of 2620 adults sampled from 65 neighborhoods in Los Angeles County between 2000 and 2002. In 2005, multilevel linear regressions were used to estimate the associations between BMI and socioeconomic characteristics of grocery store locations after adjustment for individual-level factors and socioeconomic characteristics of residential neighborhoods.
Individuals have higher BMI if they reside in disadvantaged areas and in areas where the average person frequents grocery stores located in more disadvantaged neighborhoods. Those who own cars and travel farther to their grocery stores also have higher BMI. When controlling for grocery store census tract socioeconomic status (SES), the association between residential census tract SES and BMI becomes stronger.
Where people shop for groceries and distance traveled to grocery stores are independently associated with BMI. Exposure to grocery store mediates and suppresses the association of residential neighborhoods with BMI and could explain why previous studies may not have found robust associations between residential neighborhood predictors and BMI.

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    • "At present, the overall annual cost of being obese is $2,646 for an obese man and $4,879 for an obese woman [5]. However, the magnitude of health impacts depends on the levels of obesity-related diseases, socioeconomic and behavioral characteristics of individuals and environmental and geographical characteristics of a particular region [16] [17] [18] [19]. High obesity is linked with more disease and less quality of life [8] [9]. "
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    ABSTRACT: Many research outcomes highlight the use of behavioral changes to combat obesity. This study attempts to examine and discuss the potential use of physical activity and less energy intakes in mitigating obesity among the adults in Appalachia, USA. Within the context of utility theory and behavioral aspect of energy balances of an individual, a system of simultaneous equations with three endogenous variables; decision to reduce energy intakes, time engaged in physical activity and Body Mass Index (BMI) were used for the analysis. The results highlight the potentials of weight control by reducing energy intakes and engaging in more physical activity. Importantly, the results emphasize that elderly individuals are less likely to engage in physical activity and reduce energy intakes to control BMI at the same time. The individuals with high BMI values are more likely to reduce energy intakes than engage in physical activity. The male are more likely to engage in physical activity to control obesity than reducing energy intakes while the female are more likely to reduce energy intakes than engaging in physical activity. Higher income generation, job opportunities, service of health professionals, and availability of recreational facilities play a key role in changing behaviors for controlling obesity. Keywords: Appalachia, obesity, energy intakes, physical activity
    01/2014; 2(4):176-181. DOI:10.12691/ajphr-2-4-8
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    • "Moreover, the social environment can also affect healthy eating habits. Communities with higher socioeconomic deprivation have fewer opportunities to access healthy food [15,16] or to practice physical activity, either for leisure or for travel by foot or bicycle [17,18]. Thus, obesity-related policies and programs should encourage individual changes as well as changes to the society and the environment in which people live and work [19]. "
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    ABSTRACT: Obesity is a significant global public health problem and the main cause of many chronic diseases in both developed and developing countries. The increase in obesity in different populations worldwide cannot be explained solely by metabolic and genetic factors; environmental and social factors also have a strong association with obesity. Thus, it is believed that the current obesity epidemic is the result of a complex combination of genetic factors and an obesogenic environment .The purpose of this study was to evaluate individual variables and variables within the built and social environment for their potential association with overweight and obesity in an urban Brazilian population. Cross-sectional study was carried out in a sample of 3404 adults living in the urban area of the city. Information from the surveillance system for chronic diseases of Brazilian Ministry of Health was used and individual data was collected by telephone interviews. The database was geocoded using the Brazilian System of Postal Codes for participant residences. An updated, existing list based on the current addresses of supermarkets and hypermarkets in the city was used as an indicator variable of the availability and access to food. Georeferenced information on parks, public squares, places for practicing physical activity and the population density were also used to create data on the built environment. To characterize the social environment, we used the health vulnerability index (HVI) and georeferenced data for homicide locations. The prevalence was 44% for overweight, poisson regression was used to create the final model. The environment variables that independently associated with overweight were the highest population density, very high health vulnerability index and the homicide rate adjusted for individuals variables. The results of the current study illustrate and confirm some important associations between individual and environmental variables and overweight in a representative sample of adults in the Brazilian urban context. The social environment variables relating to the socioeconomic deprivation of the neighborhood and the built environment variables relating to higher walkability were significantly associated with overweight and obesity in Belo Horizonte.
    BMC Public Health 10/2013; 13(1):988. DOI:10.1186/1471-2458-13-988 · 2.26 Impact Factor
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    • "In some research, proximity of food stores, specifically supermarkets, has been positively linked with healthful dietary intake [4,5], and obesity [6-8], yet in other research, no association or negative associations have been found between the proximity of food stores and dietary intake [9-12] or obesity [11,13-15]. Perhaps helping to explain these inconsistent findings related to food store proximity and diet/ obesity, recent research has found that individuals frequently shop at stores that are not the most proximal [15-17] and little is known about the reasons which do guide selection of a food store. "
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    ABSTRACT: Background Proximity of food stores is associated with dietary intake and obesity; however, individuals frequently shop at stores that are not the most proximal. Little is known about other factors that influence food store choice. The current research describes the development of the Food Store Selection Questionnaire (FSSQ) and describes preliminary results of field testing the questionnaire. Methods Development of the FSSQ involved a multidisciplinary literature review, qualitative analysis of focus group transcripts, and expert and community reviews. Field testing consisted of 100 primary household food shoppers (93% female, 64% African American), in rural and urban Arkansas communities, rating FSSQ items as to their importance in store choice and indicating their top two reasons. After eliminating 14 items due to low mean importance scores and high correlations with other items, the final FSSQ questionnaire consists of 49 items. Results Items rated highest in importance were: meat freshness; store maintenance; store cleanliness; meat varieties; and store safety. Items most commonly rated as top reasons were: low prices; proximity to home; fruit/vegetable freshness; fruit/vegetable variety; and store cleanliness. Conclusions The FSSQ is a comprehensive questionnaire for detailing key reasons in food store choice. Although proximity to home was a consideration for participants, there were clearly other key factors in their choice of a food store. Understanding the relative importance of these different dimensions driving food store choice in specific communities may be beneficial in informing policies and programs designed to support healthy dietary intake and obesity prevention.
    BMC Public Health 06/2013; 13(1):586. DOI:10.1186/1471-2458-13-586 · 2.26 Impact Factor
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