213825 Negative perceptions of the food environment and unhealthy dietary patterns: Findings from the Philadelphia area

Tuesday, November 9, 2010 : 3:10 PM - 3:30 PM

Sean C. Lucan, MD, MPH, MS , Department of Family and Social Medicine, Montefiore Medical Center / Albert EInstein College of Medicine, Bronx, NY
Nandita Mitra, PhD , Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
BACKGROUND - The leading causes of death in this country are diet-related chronic diseases. Dietary patterns high in fast foods tend to promote disease; dietary patterns high in fruits and vegetables tend to promote health. While determinants of dietary patterns are multi-factorial, research increasingly focuses on the food environment.

METHODS - To evaluate if perceptions of the food environment are associated with dietary patterns, we conducted cross-sectional analyses of the Public Health Management Corporation's 2004 Household Health Survey. We analyzed individual-level data aggregated to the level of the census tract to allow for mapping. We then corroborated aggregate analyses with multi-level modeling.

RESULTS - After adjusting for age, race, ethnicity, gender, education, poverty status, and household size, negative food-environment perceptions (difficulty finding fruits and vegetables, poor grocery quality, and having to travel outside of one's neighborhood to get to a supermarket) were all strongly correlated with each other, and each directly associated with fast-food consumption (number of times eating fast food in the past week). Negative food-environment perceptions were also inversely associated with fruit-and-vegetable consumption (number of servings of fruits and vegetables eaten in a typical day), but only in aggregate analyses. Census-tract level maps corroborated statistical correlations.

DISCUSSION - Findings imply that negative perceptions of the food environment are associated with less healthy dietary patterns. Aggregate analyses for fruit-and-vegetable consumption may suffer from individualistic fallacy. Future work should correlate people's food-environment perceptions with objective measures.

Learning Areas:
Biostatistics, economics
Chronic disease management and prevention
Public health or related research

Learning Objectives:
To describe how negative perceptions of the food environment (i.e. perceived poor produce availability, supermarket availability, and grocery quality) relate to each other To describe how fruit-and-vegetable and fast-food consumption are associated To discuss how negative perceptions of the food environment relate to both fruit-and-vegetable and fast-food consumption To compare individual and aggregate-level associations, and discuss advantages of multi-level modeling To define individualistic fallacy To identify negative confounding

Keywords: Environment, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a public-health researcher, focusing on how the environment influences people's dietary behaviors. I am also a family physician, treating patients afflicted by obesity and diet-realted diseases.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.