Longitudinal study of the food environment and adiposity in a multiethnic urban sample

Background. Inequities in the neighborhood food environment are well-documented. Cross-sectional research has found associations between the food environment and individual body mass index (BMI). However, there are few studies that include repeated measures of both the food environment and BMI. The purpose of this study was to examine relationships between the food environment and multiple indicators of adiposity [BMI and waist circumference (WC)] over time in a multiethnic sample. Methods. This analysis drew on in-person food environment audit and probability-sample survey data collected by the Detroit Healthy Environments Partnership in 2002 and 2008. A total of 219 adults completed the survey at both timepoints (49% African-American, 27% Latino, 21% White, 3% Other). The food environment was measured based on availability of five store types (large-grocery, small-grocery, convenience, liquor, specialty), as well as fresh fruit and vegetable counts at stores, within 0.5-mile buffers of respondents' homes. Population marginal models were used to estimate relationships, adjusting for individual- and neighborhood-level covariates. Results. Average weight gain over six years was 0.92 pounds, with 25% of the respondents gaining at least 13 pounds. In 2008, the average BMI was 32.3 +/- 8.6. Overall, the number of convenience stores increased, whereas grocery store availability was similar, although patterns varied across neighborhoods. Relationships between change in neighborhood food store and fruit and vegetable availability and change in BMI and WC over time will be presented. Conclusions. We will discuss implications for environmental and policy interventions to address food environment inequities and reduce weight-related health disparities.