Examining the association between intervention-related changes in diet, physical activity, and weight as moderated by the food and physical activity environments among rural, Southern adults

Details

• Alternative Title:
  J Acad Nutr Diet
• Personal Author:
  Jilcott Pitts, Stephanie B. ; Keyserling, Thomas C. ; Johnston, Larry F. ; Evenson, Kelly R. ; McGuirt, Jared T. ; Gizlice, Ziya ; Whitt, Olivia R. ; Ammerman, Alice S.
• Description:
  Background
  
  Few studies have been conducted in rural areas assessing the influence of community-level environmental factors on residents’ success improving lifestyle behaviors.
  
  Objective
  
  To examine whether 6-month changes in diet, physical activity, and weight were moderated by the food and physical activity environment in a rural adult population receiving an intervention designed to improve diet and physical activity.
  
  Design
  
  We examined associations between self-reported and objectively-measured changes in diet, physical activity, and weight, and perceived and objectively-measured food and physical activity environments. Participants were followed for 6 months.
  
  Participants/Setting
  
  Participants were enrolled in the Heart Healthy Lenoir (HHL) Project, a lifestyle intervention study conducted in Lenoir County, located in rural southeastern NC. Sample sizes ranged from 132 to 249, depending upon the availability of the data.
  
  Intervention
  
  Participants received 4 counseling sessions that focused on healthy eating (adapted Mediterranean diet pattern) and increasing physical activity.
  
  Potential moderating factors
  
  Density of and distance to food and physical activity venues, modified food environment index, Walk Score®, crime, and perceived nutrition and physical activity neighborhood barriers.
  
  Outcome Measures
  
  Diet quality, physical activity, and weight loss.
  
  Statistical Analyses
  
  Correlation and linear regression, controlling for potential confounders (baseline values of the dependent variables, age, race, education, and sex).
  
  Results
  
  In adjusted analysis, there was an inverse association between weight change and the food environment, suggesting that participants who lived in a less healthy food environment lost more weight over the 6-month intervention period (P = 0.01). Also, there was a positive association between self-reported physical activity and distance to private gyms (P = 0.04) and an inverse association between private gym density and pedometer-measured steps (P = 0.03), indicating that those who lived further from gyms and in areas with lower density of gyms had greater increases in physical activity and steps, respectively.
  
  Conclusions
  
  Contrary to our hypotheses, results indicated that those living in less favorable food and physical activity environments had greater improvements in diet, PA and weight, compared to those living in more favorable environments. Additional research should be undertaken to address these paradoxical findings, and if confirmed, to better understand them.
  
  
• Subjects:
  Adult Aged Body Weight Counseling Diet Environment Exercise Female Healthy Lifestyle Humans Male Middle Aged North Carolina Program Evaluation Residence Characteristics Rural Population

  More +
• Keywords:
  Built Environment Diet Food Environment Lifestyle Intervention Physical Activity
• Source:
  J Acad Nutr Diet. 117(10):1618-1627
• Pubmed ID:
  28606554
• Pubmed Central ID:
  PMC5623155
• Document Type:
  Journal Article
• Funding:
  P30 DK056350/DK/NIDDK NIH HHSUnited States/ ; P50 HL105184/HL/NHLBI NIH HHSUnited States/ ; T32 CA128582/CA/NCI NIH HHSUnited States/ ; U48DP001944/ACL/ACL HHSUnited States/
• Volume:
  117
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:414a36f68dffa8e39a84af67a0844207d4b0682905789c02517346656e6d0f38
• Download URL:
  https://stacks.cdc.gov/view/cdc/48495/cdc_48495_DS1.pdf
• File Type:
  [PDF - 359.15 KB ]