The association between the retail food environment, economic deprivation, fast food intake and obesity; Findings from the Survey of the Health of Wisconsin

摘要

Background: The Retail Food Environment (RFE) has been identified as key factor of the obesogenic environment. The access to certain types of food retailers is assumed to determine individuals' dietary behavior and weight status. Aims: This work aims to investigate the relationships between the RFE, socioeconomic deprivation, dietary habits, and obesity prevalence. Methods: Data was obtained from the population-based Survey of the Health of Wisconsin of 1570 residents aged 21 to 74 years and from an ESRI retailer database. Using ArcGIS network analyst the mean distance from the individuals' homes to the three closest a) supermarkets, b) convenience stores and c) fast food restaurants was calculated. Further, the Wisconsin Retail Food Environment Index (WRFEI), defined by the ratio of the mean distance to the three closest supermarkets to the mean distance of the three closest fast food restaurants/convenience stores was assessed. Regression models were adjusted for sex, age, education, income, race, physical activity and stratified for urbanicity-level. Results: Residents living in more deprived neighborhoods faced a less favorable Retail Food Environment (WRFEI=1.77) than residents from the least deprived neighborhoods (WRFEI=2.53; p＜0.001). Participants with low (OR=0.62; CI: 0.38-0.99) or average access (OR=0.59; CI: 0.32-1.08) to fast food restaurants were less likely to have regular fast food consumption (≥2 times/week) compared to peers with high access. Urban residents with average (OR=2.10; CI: 1.15-3.90) or low access (OR= 3.24; CI: 1.73-6.08) to convenience stores were more likely to be obese than individuals with high access. Further, regular fast food intake was associated with a higher risk for being obese (OR=1.39; CI: 1.02-1.89). Conclusion: The retail food environment is crucially codetermined by socioeconomic deprivation. Proximity to fast food restaurants is associated with dietary habits but not with the weight status. More in-depth research is needed to examine the complex relationship between the food environment and humans' health.