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Investigating the importance of the local food environment for fruit and vegetable intake in older men and women in 20 UK towns: a cross-sectional analysis of two national cohorts using novel methods.

Hawkesworth, S; Silverwood, RJ; Armstrong, B; Pliakas, T; Nanchahal, K; Sartini, C; Amuzu, A; Wannamethee, G; Atkins, J; Ramsay, SE; et al. Hawkesworth, S; Silverwood, RJ; Armstrong, B; Pliakas, T; Nanchahal, K; Sartini, C; Amuzu, A; Wannamethee, G; Atkins, J; Ramsay, SE; Casas, JP; Morris, RW; Whincup, PH; Lock, K (2017) Investigating the importance of the local food environment for fruit and vegetable intake in older men and women in 20 UK towns: a cross-sectional analysis of two national cohorts using novel methods. Int J Behav Nutr Phys Act, 14 (1). p. 128. ISSN 1479-5868 https://doi.org/10.1186/s12966-017-0581-0
SGUL Authors: Whincup, Peter Hynes

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Abstract

BACKGROUND: Local neighbourhood environments can influence dietary behavior. There is limited evidence focused on older people who are likely to have greater dependence on local areas and may suffer functional limitations that amplify any neighbourhood impact. METHODS: Using multi-level ordinal regression analysis we investigated the association between multiple dimensions of neighbourhood food environments (captured by fine-detail, foot-based environmental audits and secondary data) and self-reported frequency of fruit and vegetable intake. The study was a cross-sectional analysis nested within two nationally representative cohorts in the UK: the British Regional Heart Study and the British Women's Heart and Health Study. Main exposures of interest were density of food retail outlets selling fruits and vegetables, the density of fast food outlets and a novel measure of diversity of the food retail environment. RESULTS: A total of 1124 men and 883 women, aged 69 - 92 years, living in 20 British towns were included in the analysis. There was strong evidence of an association between area income deprivation and fruit and vegetable consumption, with study members in the most deprived areas estimated to have 27% (95% CI: 7, 42) lower odds of being in a higher fruit and vegetable consumption category relative to those in the least deprived areas. We found no consistent evidence for an association between fruit and vegetable consumption and a range of other food environment domains, including density of shops selling fruits and vegetables, density of premises selling fast food, the area food retail diversity, area walkability, transport accessibility, or the local food marketing environment. For example, individuals living in areas with greatest fruit and vegetable outlet density had 2% (95% CI: -22, 21) lower odds of being in a higher fruit and vegetable consumption category relative to those in areas with no shops. CONCLUSIONS: Although small effect sizes in environment-diet relationships cannot be discounted, this study suggests that older people are less influenced by physical characteristics of neighbourhood food environments than is suggested in the literature. The association between area income deprivation and diet may be capturing an important social aspect of neighbourhoods that influence food intake in older adults and warrants further research.

Item Type: Article
Additional Information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Diet, Food environment, Fruit and vegetables, Older people, Public Health, 11 Medical And Health Sciences, 13 Education
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Int J Behav Nutr Phys Act
ISSN: 1479-5868
Language: eng
Dates:
DateEvent
18 September 2017Published
3 September 2017Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
MR/J007145/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
RG/13/16/30528British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PG/09/024British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PG/13/66/30442British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PubMed ID: 28923064
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/109176
Publisher's version: https://doi.org/10.1186/s12966-017-0581-0

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