Longitudinal Associations between Objective and Perceived Healthy Food Environment and Diet: The Multi-Ethnic Study of Atherosclerosis
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Longitudinal Associations between Objective and Perceived Healthy Food Environment and Diet: The Multi-Ethnic Study of Atherosclerosis

Public Access Version Available on: January 01, 2023, 12:00 AM
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  • English

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    • Alternative Title:
      Soc Sci Med
    • Description:
      Introduction: Research examining the influence of neighborhood healthy food environment on diet has been mostly cross-sectional and lacked robust characterization of the food environment. We examined longitudinal associations between features of the local food environment and healthy diet, and whether associations were modified by race/ethnicity. Methods: Data on 3,634 adults aged 45–84 at Exam 1 and followed for 10 years were obtained from the Multi-Ethnic Study of Atherosclerosis. Diet quality was assessed using the Alternative Healthy Eating Index at Exam 1 (2000–2002) and Exam 5 (2010–2012). We assessed four measures of local food environment using survey-based measures (e.g. perceptions of healthier food availability) and geographic information system (GIS)-based measures (e.g. distance to and density of healthier food stores) at Exam 1 and Exam 5. Random effects models adjusted for age, sex, education, moving status, per capita adjusted income, and neighborhood socioeconomic status and interactions terms to assess effect modification by race/ethnicity. Results: Net of confounders, one standard z-score higher average composite local food environment was associated with higher average AHEI diet score (1.39, 95% CI: 1.05, 1.73) over the follow-up period from Exam 1 to 5. This pattern of association was consistent across both GIS-based and survey-based measures of local food environment and was more pronounced among minoritized racial/ethnic groups. There was no association between changes in neighborhood environment and change in AHEI score, or effect modification by race/ethnicity. Conclusion: Our findings suggest that neighborhood-level food environment is associated with better diet quality, especially among racially/ethnically minoritized populations.
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