An official website of the United States government
Abstract Poor diets are a leading cause of morbidity and mortality. Exposure to low-quality food environments saturated with fast food outlets is hypothesized to negatively impact diet. However, food environment research has predominantly focused on static food environments around home neighborhoods and generated mixed findings. In this work, we leverage population-scale mobility data in the U.S. to examine 62M people’s visits to food outlets and evaluate how food choice is influenced by the food environments people are exposed to as they move through their daily routines. We find that a 10% increase in exposure to fast food outlets in mobile environments increases individuals’ odds of visitation by 20%. Using our results, we simulate multiple policy strategies for intervening on food environments to reduce fast-food outlet visits. This analysis suggests that optimal interventions are informed by spatial, temporal, and behavioral features and could have 2x to 4x larger effect than traditional interventions focused on home food environments.
more »
« less
Population mobility data provides meaningful indicators of fast food intake and diet-related diseases in diverse populations
Abstract The characteristics of food environments people are exposed to, such as the density of fast food (FF) outlets, can impact their diet and risk for diet-related chronic disease. Previous studies examining the relationship between food environments and nutritional health have produced mixed findings, potentially due to the predominant focus on static food environments around people’s homes. As smartphone ownership increases, large-scale data on human mobility (i.e., smartphone geolocations) represents a promising resource for studying dynamic food environments that people have access to and visit as they move throughout their day. This study investigates whether mobility data provides meaningful indicators of diet, measured as FF intake, and diet-related disease, evaluating its usefulness for food environment research. Using a mobility dataset consisting of 14.5 million visits to geolocated food outlets in Los Angeles County (LAC) across a representative sample of 243,644 anonymous and opted-in adult smartphone users in LAC, we construct measures of visits to FF outlets aggregated over users living in neighborhood. We find that the aggregated measures strongly and significantly correspond to self-reported FF intake, obesity, and diabetes in a diverse, representative sample of 8,036 LAC adults included in a population health survey carried out by the LAC Department of Public Health. Visits to FF outlets were a better predictor of individuals’ obesity and diabetes than their self-reported FF intake, controlling for other known risks. These findings suggest mobility data represents a valid tool to study people’s use of dynamic food environments and links to diet and health.
more »
« less
- PAR ID:
- 10474184
- Publisher / Repository:
- Nature Publishing Group
- Date Published:
- Journal Name:
- npj Digital Medicine
- Volume:
- 6
- Issue:
- 1
- ISSN:
- 2398-6352
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
Abstract An unhealthy diet is a major risk factor for chronic diseases including cardiovascular disease, type 2 diabetes, and cancer 1–4 . Limited access to healthy food options may contribute to unhealthy diets 5,6 . Studying diets is challenging, typically restricted to small sample sizes, single locations, and non-uniform design across studies, and has led to mixed results on the impact of the food environment 7–23 . Here we leverage smartphones to track diet health, operationalized through the self-reported consumption of fresh fruits and vegetables, fast food and soda, as well as body-mass index status in a country-wide observational study of 1,164,926 U.S. participants (MyFitnessPal app users) and 2.3 billion food entries to study the independent contributions of fast food and grocery store access, income and education to diet health outcomes. This study constitutes the largest nationwide study examining the relationship between the food environment and diet to date. We find that higher access to grocery stores, lower access to fast food, higher income and college education are independently associated with higher consumption of fresh fruits and vegetables, lower consumption of fast food and soda, and lower likelihood of being affected by overweight and obesity. However, these associations vary significantly across zip codes with predominantly Black, Hispanic or white populations. For instance, high grocery store access has a significantly larger association with higher fruit and vegetable consumption in zip codes with predominantly Hispanic populations (7.4% difference) and Black populations (10.2% difference) in contrast to zip codes with predominantly white populations (1.7% difference). Policy targeted at improving food access, income and education may increase healthy eating, but intervention allocation may need to be optimized for specific subpopulations and locations.more » « less
-
Introduction: Fruit and vegetable (FV) consumption can be a protective factor for chronic diseases, but few studies have investigated the association between FV consumption and health risks for chronic disease in the context of the food and nutrition assistance system. The aim of this study was to assess the association between FV consumption and the prevalence of hypertension, type 2 diabetes mellitus, and body mass index (BMI) among food pantry users in small- to mid-sized metropolitan communities in the northeastern United States. Methods: We used data from three health surveys conducted among residents of communities in upstate New York to construct a predictive model of food pantry use. We then applied the model to a regional subset of SMART Behavioral Risk Factor Surveillance System (BRFSS) data collected in the northeastern United States to identify potential food pantry users. We examined the associations between FV intake and diabetes, hypertension, and BMI through univariate and multivariate logistic and linear regressions. Additionally, we investigated food pantry use as a potential modifier of these associations.Results: The analysis dataset included 5,257 respondents, of which 634 individuals (12.06%) were estimated to be food pantry users. Vegetables consumption was associated with decreased odds of hypertension and lower BMI, regardless of food pantry use. Fruits consumption was associated with decreased odds of diabetes regardless of food pantry use. The association between fruit consumption and BMI was modified by the use of food pantry. Among food pantry users, consumption of fruits was associated with a higher BMI, while among food pantry non-users, it was associated with a lower BMI.Conclusion: The overall protective effect of increased FV consumption on chronic disease risks suggest that increasing FV availability in food pantries may not only alleviate hunger but also contribute to better health. Further research is needed to elucidate what is driving the discrepant association between fruit consumption and BMI among food pantry users and non-users.more » « less
-
Obesity is caused by a combination of hereditary and environmental factors. Despite extensive study, contemporary through diet, exercise, education, surgery, and pharmacological treatments, no effective long-term solution has been found to this epidemic. Over the last decade, there has been a tremendous advancement in understanding the science of epigenetics, as well as a rise in public interest in learning more about the influence of diet and lifestyle choices on the health of an individual. Without affecting the underlying DNA sequence, epigenetic alterations impact gene expression. Previous animal studies have shown a link between the type of diet and expression or suppression of obesity genes, but there are very few human studies that demonstrate the relationship between dietary intake and obesity gene expression. This review highlights the effects of carbohydrates, lipids, and protein intake from the diet on obesity-related genes.more » « less
-
The gut microbiome plays an important role in human health and influences the development of chronic diseases ranging from metabolic disease to gastrointestinal disorders and colorectal cancer. Of increasing prevalence in Western societies, these conditions carry a high burden of care. Dietary patterns and environmental factors have a profound effect on shaping gut microbiota in real time. Diverse populations of intestinal bacteria mediate their beneficial effects through the fermentation of dietary fiber to produce short-chain fatty acids, endogenous signals with important roles in lipid homeostasis and reducing inflammation. Recent progress shows that an individual’s starting microbial profile is a key determinant in predicting their response to intervention with live probiotics. The gut microbiota is complex and challenging to characterize. Enterotypes have been proposed using metrics such as alpha species diversity, the ratio of Firmicutes to Bacteroidetes phyla, and the relative abundance of beneficial genera (e.g., Bifidobacterium, Akkermansia) versus facultative anaerobes (E. coli), pro-inflammatory Ruminococcus, or nonbacterial microbes. Microbiota composition and relative populations of bacterial species are linked to physiologic health along different axes. We review the role of diet quality, carbohydrate intake, fermentable FODMAPs, and prebiotic fiber in maintaining healthy gut flora. The implications are discussed for various conditions including obesity, diabetes, irritable bowel syndrome, inflammatory bowel disease, depression, and cardiovascular disease.more » « less
