BACKGROUND: Pathways by which food environments affect residents' diet-related outcomes are still unclear. Understanding pathways may help decision makers identify food environment strategies to promote healthy diets. PURPOSE: To examine the hypothesis that residents' perceptions mediate the relationship between objective food environment and residents' diet quality and weight status. METHODS: In the Waterloo Region, Ontario, objective food environment data were collected from 422 food stores and 912 restaurants using the Nutrition Environment Measure Survey in Stores and Restaurants, a shelf-space measure of fruits and vegetables, and the Retail Food Environment Index. Waterloo Region households (n=2223) completed a subjective food environment perception survey; household members (n=4102) self-reported weight, height, and waist circumference. A subsample (1170 individuals within 690 households) completed diet records. Food environment data were collected in 2010; respondent data were collected from 2009-2010; and data were analyzed in 2012. A series of gender-specific models were conducted to test mediation, adjusting for household income, car ownership, age, and education level. RESULTS: Residents' perceptions did not mediate the relationship between objective measures and diet-related outcomes; instead, results revealed the direct effect of several objectively measured factors of the food environment (notably food access and relative food affordability) on outcomes. Perceptions generally were not associated with diet-related outcomes. CONCLUSIONS: These results reveal that in this setting, strategies aimed at improving residents' perceptions may be less effective than those acting directly on food environments to improve food access and relative food affordability.
BACKGROUND: Pathways by which food environments affect residents' diet-related outcomes are still unclear. Understanding pathways may help decision makers identify food environment strategies to promote healthy diets. PURPOSE: To examine the hypothesis that residents' perceptions mediate the relationship between objective food environment and residents' diet quality and weight status. METHODS: In the Waterloo Region, Ontario, objective food environment data were collected from 422 food stores and 912 restaurants using the Nutrition Environment Measure Survey in Stores and Restaurants, a shelf-space measure of fruits and vegetables, and the Retail Food Environment Index. Waterloo Region households (n=2223) completed a subjective food environment perception survey; household members (n=4102) self-reported weight, height, and waist circumference. A subsample (1170 individuals within 690 households) completed diet records. Food environment data were collected in 2010; respondent data were collected from 2009-2010; and data were analyzed in 2012. A series of gender-specific models were conducted to test mediation, adjusting for household income, car ownership, age, and education level. RESULTS: Residents' perceptions did not mediate the relationship between objective measures and diet-related outcomes; instead, results revealed the direct effect of several objectively measured factors of the food environment (notably food access and relative food affordability) on outcomes. Perceptions generally were not associated with diet-related outcomes. CONCLUSIONS: These results reveal that in this setting, strategies aimed at improving residents' perceptions may be less effective than those acting directly on food environments to improve food access and relative food affordability.
Authors: Erika R Shaver; Richard C Sadler; Alex B Hill; Kendall Bell; Myah Ray; Jennifer Choy-Shin; Joy Lerner; Teresa Soldner; Andrew D Jones Journal: Public Health Nutr Date: 2018-01-24 Impact factor: 4.022
Authors: Shannon N Zenk; Elizabeth Tarlov; Coady Wing; Stephen A Matthews; Kelly Jones; Hao Tong; Lisa M Powell Journal: Health Aff (Millwood) Date: 2017-08-01 Impact factor: 6.301
Authors: Andrew C Stevenson; Anne-Sophie Brazeau; Kaberi Dasgupta; Nancy A Ross Journal: Health Promot Chronic Dis Prev Can Date: 2019-10 Impact factor: 3.240
Authors: Darcy A Freedman; Bethany A Bell; Jill K Clark; Patricia A Sharpe; Erika S Trapl; Elaine A Borawski; Stephanie N Pike; Chaturia Rouse; Ashwini R Sehgal Journal: J Acad Nutr Diet Date: 2019-04-25 Impact factor: 4.910
Authors: Timothy L Barnes; Darcy A Freedman; Bethany A Bell; Natalie Colabianchi; Angela D Liese Journal: Public Health Nutr Date: 2015-10-02 Impact factor: 4.022
Authors: Sandra J Winter; Lisa Goldman Rosas; Priscilla Padilla Romero; Jylana L Sheats; Matthew P Buman; Cathleen Baker; Abby C King Journal: J Immigr Minor Health Date: 2016-10
Authors: Alexandra Feathers; Ana C Aycinena; Gina S Lovasi; Andrew Rundle; Ann Ogden Gaffney; John Richardson; Dawn Hershman; Pam Koch; Isobel Contento; Heather Greenlee Journal: Nutr Res Date: 2015-04-16 Impact factor: 3.315