Timothy Leslie1, Lisa Pawloski2, Jillian Kallman-Price3, Carey Escheik4, Noreen Hossain3, Yun Fang3, Lynn H Gerber5, Zobair M Younossi3. 1. Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Department of Geography & Geoinformation Science, George Mason University, Fairfax, VA, United States. 2. Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, United States. 3. Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States. 4. Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States. 5. Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, United States; Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, United States.
Abstract
BACKGROUND: Obesity, a complex disease determined both by genetic and environmental factors, is strongly associated with NAFLD, and has been demonstrated to have a negative impact on HCV and other chronic liver diseases (CLD). RATIONALE: This study assessed the association between type and location of food sources and chronic liver disease (CLD) using Geographic Information Systems (GIS). RESULTS: CLD patients completed surveys [267 subjects, 56.5% female, age 55.8 ± 12.0, type of CLD: 36.5% hepatitis C (HCV), 19.9% hepatitis B (HBV), 19.9% non-alcoholic fatty liver disease (NAFLD); primary food source (PFS): 80.8% grocery store, secondary: 26.2% bulk food store, tertiary: 20.5% restaurants; fresh food (FF): 83%, pre-packaged (PP) 8.7%, already prepared (AP) 8.3%]. FF consumers had significantly fewer UEH servings/month (p = 0.030) and lived further away from convenience stores (1.69 vs. 0.95 km, p = 0.0001). Stepwise regression reveals the lowest FF consumers were NAFLD patients, subjects with UEH or restaurants and ethnic food stores as their PFS (R = 0.557, p = 0.0001). Eating already-packaged foods and utilizing restaurants or ethnic food stores as the PFS positively correlated with NAFLD (R = 0.546, p = 0.0001). CONCLUSIONS: Environmental food source measures, including type and density, should be included when examining areas hyper-saturated with a variety of food options. In hyper-saturated food environments, NAFLD patients consume more prepared food and less FF. CLD patients with UEH also eat significantly more prepared food and frequent restaurants and ethnic food stores as their PFS.
BACKGROUND: Obesity, a complex disease determined both by genetic and environmental factors, is strongly associated with NAFLD, and has been demonstrated to have a negative impact on HCV and other chronic liver diseases (CLD). RATIONALE: This study assessed the association between type and location of food sources and chronic liver disease (CLD) using Geographic Information Systems (GIS). RESULTS: CLD patients completed surveys [267 subjects, 56.5% female, age 55.8 ± 12.0, type of CLD: 36.5% hepatitis C (HCV), 19.9% hepatitis B (HBV), 19.9% non-alcoholic fatty liver disease (NAFLD); primary food source (PFS): 80.8% grocery store, secondary: 26.2% bulk food store, tertiary: 20.5% restaurants; fresh food (FF): 83%, pre-packaged (PP) 8.7%, already prepared (AP) 8.3%]. FF consumers had significantly fewer UEH servings/month (p = 0.030) and lived further away from convenience stores (1.69 vs. 0.95 km, p = 0.0001). Stepwise regression reveals the lowest FF consumers were NAFLD patients, subjects with UEH or restaurants and ethnic food stores as their PFS (R = 0.557, p = 0.0001). Eating already-packaged foods and utilizing restaurants or ethnic food stores as the PFS positively correlated with NAFLD (R = 0.546, p = 0.0001). CONCLUSIONS: Environmental food source measures, including type and density, should be included when examining areas hyper-saturated with a variety of food options. In hyper-saturated food environments, NAFLD patients consume more prepared food and less FF. CLD patients with UEH also eat significantly more prepared food and frequent restaurants and ethnic food stores as their PFS.
Authors: Oriol Juanola; Sebastián Martínez-López; Rubén Francés; Isabel Gómez-Hurtado Journal: Int J Environ Res Public Health Date: 2021-05-14 Impact factor: 3.390