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
Evaluating the association between fruit and vegetable consumption and chronic disease prevalence among food pantry users in the northeastern United States
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
- Award ID(s):
- 2115405
- PAR ID:
- 10543540
- Publisher / Repository:
- Luminescience
- Date Published:
- Journal Name:
- Journal of Food, Nutrition and Diet Science
- ISSN:
- 3005-9607
- Page Range / eLocation ID:
- 122 to 129
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
PurposeTo evaluate cardiovascular disease (CVD) risk factors among smokeless tobacco (ST) users. Exclusive ST users were compared to exclusive cigarette smokers and non-tobacco users. DesignCross-sectional study SampleData were used from 16,336 adult males who participated in one of the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018. MeasuresBiochemically verified tobacco use, CVD risk factors (hypertension, cholesterol levels, BMI categories), physical activity, cotinine concentration, and sociodemographic variables. AnalysisWeighted analysis of the aggregate data was performed. ST users were compared with cigarette smokers and nontobacco users for their association with CVD risk factors. Associations were examined using univariate and multiple logistic regression with odds ratios (OR) and 95% confidence intervals (CI) reported. ResultsPrevalence of exclusive ST use was 4.4% whereas, exclusive smoking was 22.2%. Among ST users, 36.2% were hypertensive, 24.5% had high cholesterol levels, and most of them were overweight (31.1%) or obese (52.6%). ST users were more likely to have hypertension compared to smokers (aOR = 1.48, 95%CI: 1.12, 1.95) and nontobacco users (aOR = 1.41, 95%CI: 1.09, 1.83) adjusted for other covariates. ST users were twice more likely to be obese than nontobacco users (aOR = 2.18, 95%CI: 1.52, 3.11). ST users had significantly higher cotinine concentration than smokers. ConclusionStudy findings indicate substantial association of ST use among males with hypertension and obesity which are independent risk factors of CVD.more » « less
-
null (Ed.)Abstract Background Human populations native to high altitude exhibit numerous genetic adaptations to hypobaric hypoxia. Among Tibetan plateau peoples, these include increased vasodilation and uncoupling of erythropoiesis from hypoxia. Objective/Methods We tested the hypothesis that these high-altitude adaptations reduce risk for hypertension and diabetes-associated anemia among the Mosuo, a Tibetan-descended population in the mountains of Southwest China that is experiencing rapid economic change and increased chronic disease risk. Results Hypertension was substantially less common among Mosuo than low-altitude Han populations, and models fit to the Han predicted higher probability of hypertension than models fit to the Mosuo. Diabetes was positively associated with anemia among the Han, but not the Mosuo. Conclusion The Mosuo have lower risk for hypertension and diabetes-associated anemia than the Han, supporting the hypothesis that high-altitude adaptations affecting blood and circulation intersect with chronic disease processes to lower risk for these outcomes. As chronic diseases continue to grow as global health concerns, it is important to investigate how they may be affected by local genetic adaptations.more » « less
-
Objectives:To assess changes in food acquisition behavior, food insecurity, and dietary behavior and identify factors associated with fruit and vegetable (FV) consumption during the transitional period (before and after the initial vaccine rollout for all adults) of the COVID-19 pandemic. Design:Successive independent samples design. Online surveys were conducted from October 2020 to February 2021 (time 1, before the vaccine rollout) and from October 2021 to December 2021 (time 2, after the vaccine rollout). Descriptive analysis examined changes in food sources, food security, and daily FV consumption in cup equivalents (CEs) from time 1 to time 2. A multivariable logistic regression analysis examined factors associated with FV consumption. Setting:The Capital Region of New York State. Participants:1553 adults 18 years of age and older. Main Outcome Measure:Meeting the 2020-2025 MyPlate daily FV consumption recommendations. Results:There were statistically significant (P< .05) increases in the use of supermarkets, eat-in restaurants, farmers’ markets, and convenience stores from time 1 to time 2. Food insecurity (40.1% vs 39.4%) and FV consumption (2.6 CE vs 2.4 CE) slightly declined but not significantly. Home food procurement such as gardening and foraging (OR, 1.61; 95% CI, 1.08-2.37) and shopping at food co-op/health food stores (OR, 1.64; 95% CI, 1.07-2.49) were significantly associated with the FV outcome, and these relationships were not modified by food security status. Conclusions:The present study highlights the importance of food sources in understanding adult dietary behavior during the transitional period of the pandemic. Continuing efforts to monitor access to food sources, food insecurity, and dietary behavior are warranted as various COVID-related emergency food assistance measures have expired.more » « less
-
Abstract BackgroundRoughly a quarter of the US population suffers from moderate to severe chronic pain for at least six months in any given year. The complexity of managing chronic pain has encouraged providers to use innovative methods to address it. Research has shown that problem lists are potential tools that support the care of patients with diabetes and chronic kidney disease. ObjectivesTo examine the extent to which the inclusion of chronic pain in a problem list is associated with follow-up specialty pain care. MethodsThe association between chronic pain documentation on the problem list and specialty pain care was investigated in this retrospective cohort study using 4531 patient records. ResultsChronic pain documentation in the problem list was associated with higher odds of receiving specialty pain care. The most common diagnosis was chronic pain (69.7%). A migraine diagnosis was associated with decreased odds of receiving specialty care, and chronic pain syndrome was associated with increased odds of receiving specialty care compared with the other chronic pain groups. ConclusionDocumenting chronic pain on the problem list was associated with a higher likelihood of patients receiving specialty pain care.more » « less
An official website of the United States government

