Easier access to healthy foods contributes to greater improvements in dietary quality among adults with metabolic syndrome following dietary interventions
METHODS: Participants were recruited from Worcester County, Massachusetts between May 2009 and January 2012, and randomized (N=240) to a high fiber diet (≥30g/day) or the American Heart Association diet. Dietary intakes were measured by 24-hour dietary recalls at baseline, 3-, 6- and 12-months. Participants with geocodable residential addresses were analyzed (N=221). Healthy food availability in participant communities was assessed annually using the Community Nutrition Environment Evaluation Data System. Accessibility was defined as travel distance from residence to the nearest food store with adequate healthy food availability. Linear regression models were used to evaluate the maximum change in dietary outcomes in relation to accessibility.
RESULTS: The participants had a mean age of 52 years, body mass index of 34.9 kg/m2, and were 72% women and 89% White. The two intervention groups had similar baseline characteristics and healthy food accessibility. In multiple regression models adjusting for baseline characteristics and intervention group, shorter distance to food stores with adequate healthy food availability was associated with greater increases in consumption of dietary fiber (β=-0.94g/day per mile; p<0.01) and total fruit and vegetables (β=-0.19 servings/day per mile; p=0.03) after either intervention.
DISCUSSION: Participants living in communities with better healthy food accessibility reported greater improvements in dietary quality following dietary interventions. This result highlights the importance of community food environment to healthy eating, which should be considered in future interventions.
Learning Areas:Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Public health or related research
Analyze how geographic access to healthy foods modifies the effects of two dietary interventions to improve dietary quality among adults with metabolic syndrome; Discuss importance of community food environment to healthy eating and chronic disease prevention
Keyword(s): Clinical Trials, Built Environment
Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on community environment, nutrition and chronic disease preventions. I have published over 90 research articles, including 5 articles in AJPH I served as either the lead or senior author.
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.