The Association Between Obesity Prevalence and the Food Environment

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Background: Obesity affects over 40% of adults in the United States. The food environment is thought to be a potential contributing factor to obesity. This present study aimed to explore the association between the food environment and obesity defined by body mass index (BMI) and body fat. Methods: A prospective cross-sectional study design was employed with participants nested within income strata. Trained interviewers visited participants’ at their place of residence to conduct in-person surveys that included questions about physiological health, neighborhood characteristics, and anthropometrics. The food environment was assessed using the Retail Food Environment Index (RFEI) and the Modified Retail Food Environment Index (mRFEI). Height, weight, and body fat were measured during a visit and used to determine obesity status. Logistic regression was used to examine associations between the food environment indexes and obesity status. Results: Analyses were conducted on data from 436 adult participants living in one of 20 U.S. Census block groups located in Kansas City, KS, and MO. The RFEI and the mRFEI were not associated with BMI-defined obesity (OR = 0.96, 95% CI [0.86 – 1.06]) and (OR = 0.81, 95% CI [0.41 – 1.61]), respectively. The RFEI was negatively (OR = 0.83, 95% CI [0.75 – 0.92]), and the mRFEI was positively (OR = 0.83, 95% CI [0.75 – 0.92]) associated with body fat-defined obesity. Lastly, the RFEI (p=0.419) and mRFEI (p=0.543) did not significantly differ in those with or without BMI-defined obesity. Conclusion: The relationship between obesity and the food environment is complex. The results of this study suggest the relationship depends on the measure of obesity.
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