Moderation by neighborhood food outlets on relationships between meal sources and diet

Authors: Thomson, Jessica; LANDRY, ALICIA - University Of Central Arkansas; Walls, Tameka; GOODMAN, MELISSA - Retired ARS Employee

Submitted to: American Journal of Health Behavior
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/11/2020
Publication Date: 3/1/2021
Citation: Thomson, J.L., Landry, A.S., Walls, T.I., Goodman, M.H. 2021. Moderation by neighborhood food outlets on relationships between meal sources and diet. American Journal of Health Behavior. 45(2):290-308.
DOI: https://doi.org/10.5993/AJHB.45.2.9

Interpretive Summary: The quality of US adult and adolescent diets remains poor despite recent evidence showing small quality increases in both populations. Evidence suggests that nutrition environments play a role in an individual’s dietary intake, although associations with neighborhood food outlets is equivocal. The objective of this study was to explore relationships among presence of neighborhood food outlets, food outlet shopping, meal sources, and diet in parent-adolescent dyads. Publicly available data from the National Cancer Institute’s Family Life, Activity, Sun, Health and Eating (FLASHE) were analyzed. FLASHE was a cross-sectional, Internet-based survey that was conducted in 2014 with eligible parents and their adolescent children aged 12-17 years. Survey questions included presence of food outlets in home (parent) and school (adolescent) neighborhoods, shopping at (parent) and visiting (adolescent) food outlets, and sources of meals and snacks consumed away from and at home. A dietary screener captured consumption of specific foods and beverages. Frequencies were converted to daily consumption amounts for fruits and vegetables, whole grains, and added sugars. Differential associations between consumption and food outlet shopping and meal sources by presence/absence of neighborhood food outlets were examined in both parents and adolescents. Presence and/or shopping at fruit and vegetable markets was associated with higher consumption of fruits and vegetables and whole grains in parents while shopping at/visiting convenience stores was associated with higher consumption of added sugars in both parents and adolescents. Eating meals away from home at specific food outlets was associated with higher consumption of fruits and vegetables, whole grains, and added sugars while eating scratch cooked meals at home was associated with higher consumption of fruits and vegetables and whole grains for both parents and adolescents. Presence/absence of neighborhood food outlets did not appear to affect these associations. Teaching skills for healthful shopping at numerous food outlet types, avoiding or reducing frequency of eating away from home, and cooking from scratch may be effective strategies for improving dietary behaviors in families irrespective of neighborhood food environments.

Technical Abstract: Objectives: To test for moderation by neighborhood food outlet presence on relationships between food outlet shopping or meal sources and dietary intake. Methods: Parent-adolescent (12-17 years) dyad data from the 2014 Family Life, Activity, Sun, Health and Eating were analyzed using generalized linear models. Questions included food outlet presence in home (parent) and school (adolescent) neighborhoods (yes or no), shopping at food outlets (parent) (never, rarely, sometimes, often or always), and sources of food consumed away from and at home (weekly frequency). Food and beverage intakes were captured via dietary screener. Results: Relationships between adolescent added sugars intake and scratch cooked evening meals and meals away from home were found only when grocery stores and fast food restaurants, respectively, were present in adolescents’ school neighborhoods. Shopping at fruit and vegetable (FV) markets and scratch cooked evening meals were associated with largest increases in parent and adolescent FV intakes, respectively. Meals away from home at convenience stores was associated with largest increases in parent and adolescent intakes of added sugars. Conclusions: Neighborhood grocery store and fast food restaurant presence moderated relationships between meal sources and dietary intake in adolescents only.