Nationwide study redefines how food environment influences cardiometabolic disease

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Cardiometabolic disease (CMD) is an umbrella term that includes conditions such as obesity, diabetes, high cholesterol, and high blood pressure. Unfortunately, many adults in the United States have CMD, and the rate is increasing. Researchers are now working to understand the factors driving this increase by examining geographic aspects of the food environment, such as the type and availability of nearby food retailers.

A collaboration between researchers at the University of Connecticut, Emory University, the State University of New York at Albany, and the University of South Carolina incorporates an important element that seems largely missing from current food environment research: human mobility. I got it.

Their findings are published in Nature Communications.

Historically, cardiometabolic diseases were thought to be inseparable from the food environment, explains first author Ran Xu, a researcher in UConn’s School of Allied Health Sciences.

The underlying assumption is that people only shop in their own neighborhood, but we know that’s probably not true, just intuitively — Ran Xu, Faculty of Health Sciences

“National agencies have used food environment measures, such as the Food Access Survey Atlas and the Modified Retail Food Environment Index, as evidence when designing health initiatives and policy interventions to improve diet-related health outcomes. ” said Xu.

The problem with these environmental measures is that they are all location-based, such as counting the number of retail stores in a neighborhood, which limits the overall picture.

“The underlying assumption is that people shop exclusively within their local area, but we know that’s probably not true, just intuitively,” says Schuh.

Many previous studies have attempted to link place-based food environments to diet-related health outcomes. For example, we look at the relationship between accessibility to fast food restaurants and obesity. The researchers noted that the results of these studies were mixed and inconclusive. One important variable missing from past research is human mobility, or more simply, where people buy their food.

“In this paper, we argue that human mobility is largely missing from previous studies that have only examined food environments in terms of physical store locations,” Xu says. “We incorporate human mobility components into a national study of the food environment at a fine-grained spatial scale; that is the main contribution of our paper.”

Peter Chen, co-author and principal investigator of the project and assistant professor in the Department of Geography, says this step is key and novel.

“This is the first time this mobile data has been used nationally to study eating behavior on a large scale in the United States. There are other studies that utilize mobile data to study behavior, but these studies are regional in scale and may have limited health and policy implications.”

Researchers analyzed extensive GPS tracking data covering more than 94 million total food retailers and approximately 359,000 food retailers nationwide. They used the tracking data to create a new index at the census tract level called the Retail Food Activity Index (RFAI). There, the number of visits to food retail stores and the proportion of visits to stores selling fruits and vegetables were determined. The term is coined “green retailer.”

They found that, on average, only 20% of food retail store visits are within the 800m boundaries of residents’ home census tracts, and that most retail store visits are far beyond residents’ immediate vicinity. discovered. The researchers then looked at the health effects resulting from this migration pattern.

This is the first time this mobile data has been used nationally to study eating behavior on a large scale in the United States. — Peter Chen, Assistant Professor, Department of Geography

“We looked at the prevalence of obesity, high cholesterol, high blood pressure, diabetes, and coronary heart disease and how they were associated with various dietary environmental indicators,” says Xu. “Activity-based indices have much stronger associations, especially with obesity and hypertension, compared to location-based indices. We also conducted a number of sensitivity analyzes to ensure that our results were robust. I did.”

“This speaks to the limitations of traditional location-based measures, because when 80% of a food retailer’s visits are outside of a residential area, it stands to reason that traditional food environmental measures and health Because we don’t see much of a correlation between the above outcomes,” says Xu.

The RFAI is a promising tool, and Chen said one expected lesson from the index is that policymakers need to think beyond grocery store placement when it comes to interventions. .

“Evidence shows that place-based policy initiatives, known as “geographic instruments,” such as opening new stores or extending store hours, have modest effects on improving health outcomes in local neighborhoods. “Yes,” Chen said. “Our data show that most people don’t shop in their neighborhoods, so store-level interventions are unlikely to impact neighborhood health outcomes.”

Chen added, “The important point is that just because you open a new health food retail store doesn’t mean people will shop there. Policymakers should take that into account and encourage people to go green.” We think we need to find ways to improve the neighborhoods where people live, including areas where they don’t shop as much in retail stores.”

Future research will delve deeper into the policy implications of the new index and examine more closely why consumers in some regions do not shop at green retailers in their own communities. It will also utilize data such as consumer purchasing information and large-scale surveys. The research team hopes to collaborate with nutrition scientists and policy makers in future research to develop more reliable and effective policy interventions.

This research was supported by a Hatch grant from the University of Connecticut College of Agriculture, Health, and Natural Resources, funding from the U.S. Department of Agriculture’s National Institute of Food and Agriculture, grant number CONS01031, and The Alan R. Bennett public. Funding for Health Policy Research from the University of Connecticut College of Liberal Arts and Sciences (CLAS) and internal funding for a pilot study to address health disparities in the United States from the University of Connecticut Institute for Health, Intervention, and Policy Collaboration (InCHIP) There is.

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