Availability of healthy foods, BMI, and dietary patterns in urban adolescents

Background: The obesity epidemic among U.S. children and adolescents has produced a generation whose average lifespan may be shorter than that of their parents. Determining how environmental factors relate to individual dietary behavior can elucidate barriers or facilitators that enhance or thwart efforts of medical and public health experts to reduce the prevalence of obesity and chronic diseases in urban African-American adolescents. Objectives: (1) To identify neighborhood and school environmental factors for urban adolescents' food choices, specifically the intake of fresh fruits and vegetables, high-fat foods, high-fiber foods, snack foods, soft drinks, and dairy products. (2) To examine the associations among adolescents' perceived and objective availability of healthy foods, the physical environment, and BMI. Methods: A validated survey will measure individual dietary patterns and frequency of fast-food restaurant visits in a convenience sample of 75 boys and 75 girls of two Baltimore City Magnet High Schools. Sample will be drawn from two schools that were part of the Active Living Research study conducted by Carolyn Voorhees and associates. Survey items will be linked to proximity of fast food establishments and convenience stores within a one-half mile buffer of homes. School nutrition environments in terms of restaurants and food markets, school lunches and vending machines will be audited. Waist-to-hip ratio and BMI were collected. Multivariate analyses will help build comprehensive statistical models with environmental-level data linked to individual-level nutrition practices and BMI values. Results: Environmental-level data will be linked to individual-level nutrition practices and BMI. Conclusions: Determining how environmental factors relate to individual dietary behavior will elucidate factors that impact the prevalence of obesity and chronic diseases in a high-risk population.