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Relationship between density, proximity, and diversity of food outlets and adult overweight/obesity in Nevada
AuthorRezaei Arya, Sepide
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AbstractAdult overweight and obesity is a rising epidemic that is a major public health concern. Studies suggest that the food environment may be related to the prevalence of overweight and obesity.Objective: This is the first statewide study to examine the density, proximity and diversity of food outlets and adult overweight/obesity prevalence in Nevada. Methods: Population demographics, health status, and health risk behaviors were obtained from 2007- 2008 Nevada Behavior Risk Factor Surveillance Systems (BRFSS), and food outlets information was obtained from Environmental Systems Research Institute, Geographic Information System database. A total number of 2251 subjects were included in the study analysis. Subjects were geocoded and half, 1, and 3 miles buffer zones were created around subjects¡¯ residences. Density of food outlets was measured within each buffer zone and distance to the closest food outlet was determined for each subject. The outcome variable was being overweight/obese (BMI¡Ý25 kg/m2) or neither (BMI<25 kg/m2). Multiple logistic regression was used to estimate the odds ratio of being overweight/obese, and to control for demographics (age, sex, income, employment, marital status, education, race/ethnicity), health status and health risk behavior variables (diabetes, health status, smoking, heavy drinking, disability, life satisfaction, physical activity and fruit and vegetable intake). Results: Adults who had 3 or more vs. 1-2 supermarket/grocery stores within 3 miles of their residences had higher odds of being overweight/obese (AOR= 1.87, 95% CI 1.12- 3.13, p= 0.016). The adjusted odds of overweight/obesity were not significant for the distance to the closest food outlets, density of supermarket/grocery stores within half and 1 mile, and the density of fast-food restaurants and convenience stores within half-mile, 1 mile, and 3 miles buffer zones.Conclusion: The study results differ from the majority of previous studies¡¯ findings in the U.S that suggest higher access to convenience and fast-food stores and lower access to supermarket/grocery is associated with higher prevalence of overweight/obesity. Future studies are needed that incorporate potential confounders such as fast-food consumption habits, shopping habits, accessibility to private and public transportation, and environment features such as urbanization. Longitudinal study designs examining the relationship between food environment and weight status are needed.