Beyond Access: Characteristics of the Food Environment and Risk of Diabetes

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Beyond Access : Characteristics of the Food Environment and Risk of Diabetes. / Mezuk, Briana; Li, Xinjun; Cederin, Klas; Rice, Kristen; Sundquist, Jan; Sundquist, Kristina.

In: American Journal of Epidemiology, Vol. 183, No. 12, 15.06.2016, p. 1129-37.

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TY - JOUR

T1 - Beyond Access

T2 - American journal of hygiene

AU - Mezuk, Briana

AU - Li, Xinjun

AU - Cederin, Klas

AU - Rice, Kristen

AU - Sundquist, Jan

AU - Sundquist, Kristina

N1 - © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2016/6/15

Y1 - 2016/6/15

N2 - Characteristics of the built environment, including access to unhealthy food outlets, are hypothesized to contribute to type 2 diabetes mellitus (T2D). Swedish nationwide registry data on 4,718,583 adults aged 35-80 years living in 9,353 neighborhoods, each with at least 1 food outlet, were geocoded and linked to commercial registers (e.g., restaurants and grocery stores). Multilevel logistic regression was used to examine the prospective relationship between characteristics of the food environment and T2D from 2005 to 2010. Relative access to health-harming food outlets was associated with greater likelihood of both prevalent and incident T2D in a curvilinear manner, with the highest risk being observed for environments in which one-third of outlets were health-harming. Relative to individuals whose food environment did not change, those who moved into areas with more health-harming food outlets had higher odds of developing T2D (odds ratio = 3.67, 95% confidence interval: 2.14, 6.30). Among those who did not move, living in an area that gained relative access to health-harming food outlets was also associated with higher odds of T2D (odds ratio = 1.72, 95% confidence interval: 1.27, 2.33). These results suggest that local food environment, including changes that result in greater access to unhealthy food outlets, is associated with T2D.

AB - Characteristics of the built environment, including access to unhealthy food outlets, are hypothesized to contribute to type 2 diabetes mellitus (T2D). Swedish nationwide registry data on 4,718,583 adults aged 35-80 years living in 9,353 neighborhoods, each with at least 1 food outlet, were geocoded and linked to commercial registers (e.g., restaurants and grocery stores). Multilevel logistic regression was used to examine the prospective relationship between characteristics of the food environment and T2D from 2005 to 2010. Relative access to health-harming food outlets was associated with greater likelihood of both prevalent and incident T2D in a curvilinear manner, with the highest risk being observed for environments in which one-third of outlets were health-harming. Relative to individuals whose food environment did not change, those who moved into areas with more health-harming food outlets had higher odds of developing T2D (odds ratio = 3.67, 95% confidence interval: 2.14, 6.30). Among those who did not move, living in an area that gained relative access to health-harming food outlets was also associated with higher odds of T2D (odds ratio = 1.72, 95% confidence interval: 1.27, 2.33). These results suggest that local food environment, including changes that result in greater access to unhealthy food outlets, is associated with T2D.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Diabetes Mellitus, Type 2/epidemiology

KW - Environment

KW - Fast Foods/supply & distribution

KW - Female

KW - Food Supply/statistics & numerical data

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Residence Characteristics/statistics & numerical data

KW - Restaurants/supply & distribution

KW - Small-Area Analysis

KW - Socioeconomic Factors

KW - Sweden

U2 - 10.1093/aje/kwv318

DO - 10.1093/aje/kwv318

M3 - Article

VL - 183

SP - 1129

EP - 1137

JO - American journal of hygiene

JF - American journal of hygiene

SN - 0002-9262

IS - 12

ER -