Abstract
Background. Previous studies have shown that neighborhood factors are associated with obesity, but few studies have evaluated the association with weight control behaviors. This study aims to conduct a multi-level analysis to examine the relationship between neighborhood SES and weight-related health behaviors. Methods. In this ancillary study to Look AHEAD (Action for Health in Diabetes) a trial of long-term weight loss among individuals with type 2 diabetes, individual-level data on 1219 participants from 4 clinic sites at baseline were linked to neighborhood-level data at the tract level from the 2000 US Census and other databases. Neighborhood variables included SES (% living below the federal poverty level) and the availability of food stores, convenience stores, and restaurants. Dependent variables included BMI, eating patterns, weight control behaviors and resource use related to food and physical activity. Multi-level models were used to account for individual-level SES and potential confounders. Results. The availability of restaurants was related to several eating and weight control behaviors. Compared to their counterparts in neighborhoods with fewer restaurants, participants in neighborhoods with more restaurants were more likely to eat breakfast (prevalence Ratio [PR] 1.29 95% CI: 1.01-1.62) and lunch (PR = 1.19, 1.04-1.36) at non-fast food restaurants. They were less likely to be attempting weight loss (OR = 0.93, 0.89-0.97) but more likely to engage in weight control behaviors for food and physical activity, respectively, than those who lived in neighborhoods with fewer restaurants. In contrast, neighborhood SES had little association with weight control behaviors. Conclusion. In this selected group of weight loss trial participants, restaurant availability was associated with some weight control practices, but neighborhood SES was not. Future studies should give attention to other populations and to evaluating various aspects of the physical and social environment with weight control practices.
Original language | English (US) |
---|---|
Article number | 312 |
Journal | BMC public health |
Volume | 10 |
DOIs | |
State | Published - 2010 |
Externally published | Yes |
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
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In: BMC public health, Vol. 10, 312, 2010.
Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Neighborhood and weight-related health behaviors in the Look AHEAD (Action for Health in Diabetes) Study
AU - Gary-Webb, Tiffany L.
AU - Baptiste-Roberts, Kesha
AU - Pham, Luu
AU - Wesche-Thobaben, Jacqueline
AU - Patricio, Jennifer
AU - Pi-Sunyer, F. Xavier
AU - Brown, Arleen F.
AU - Jones, Lashanda
AU - Brancati, Frederick L.
N1 - Funding Information: Nevitt, PhD; Ann Schwartz, PhD; John Shepherd, PhD; Jason Maeda, MPH; Cynthia Hayashi; Michaela Rahorst; Lisa Palermo, MS, MA Central Laboratory, Northwest Lipid Research Laboratories Santica M. Marcovina, PhD, ScD; Greg Strylewicz, MS ECG Reading Center, EPICARE, Wake Forest University School of Medicine Ronald J. Prineas, MD, PhD; Zhu-Ming Zhang, MD; Charles Campbell, AAS, BS; Sharon Hall Diet Assessment Center, University of South Carolina, Arnold School of Public Health, Center for Research in Nutrition and Health Disparities Elizabeth J Mayer-Davis, PhD; Cecilia Farach, DrPH Federal Sponsors National Institute of Diabetes and Digestive and Kidney Diseases: Barbara Harrison, MS; Susan Z.Yanovski, MD; Van S. Hubbard, MD PhD National Heart, Lung, and Blood Institute: Lawton S. Cooper, MD, MPH; Eva Obarzanek, PhD, MPH, RD; Denise Simons-Morton, MD, PhD Centers for Disease Control and Prevention: David F. Williamson, PhD; Edward W. Gregg, PhD Funding and Support This study is supported by the Department of Health and Human Services through the following cooperative agreements from the National Institutes of Health: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, and DK56992. The following federal agencies have contributed support: National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; Office of Research on Women's Health; and the Centers for Disease Control and Prevention. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service (I.H.S.) provided personnel, medical oversight, and use of facilities. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the I.H.S. or other funding sources. Additional support was received from The Johns Hopkins Medical Institutions Bayview General Clinical Research Center (M01-RR-02719); the Massachusetts General Hospital Mallinckrodt General Clinical Research Center (M01-RR-01066); the University of Colorado Health Sciences Center General Clinical Research Center (M01 RR00051) and Clinical Nutrition Research Unit (P30 DK48520); the University of Tennessee at Memphis General Clinical Research Center (M01RR00211-40); the University of Pittsburgh General Clinical Research Center (M01 RR000056 44) and NIH grant (DK 046204); and the University of Washington/VA Puget Sound Health Care System Medical Research Service, Department of Veterans Affairs. The following organizations have committed to make major contributions to Look AHEAD: Federal Express; Health Management Resources; Johnson & Johnson, LifeScan Inc.; Optifast-Novartis Nutrition; Roche Pharmaceuticals; Ross Product Division of Abbott Laboratories; Slim-Fast Foods Company; and Unilever. Funding Information: The authors would like to acknowledge the Look AHEAD staff and participants who made this research possible. This project was funded by grants from the National Institutes of Health. Dr. Gary-Webb was funded by grants from the NIDDK (U01-DK57149-05S1) and NHLBI (K01-HL084700) and Dr. Brancati was funded by a grant from the NIDDK (K24-DK6222). The authors would like to acknowledge the Look AHEAD research group, which has been previously described (ref 26). Look AHEAD Research Group at Baseline Clinical Sites The Johns Hopkins Medical Institutions Frederick Brancati, MD, MHS; Debi Celnik, MS, RD, LD; Jeff Honas, MS; Jeanne Clark, MD, MPH; Jeanne Charleston, RN; Lawrence Cheskin, MD; Kerry Stewart, EdD; Richard Rubin, PhD; Kathy Horak, RD Pennington Biomedical Research Center George A. Bray, MD; Kristi Rau; Alli-son Strate, RN; Frank L. Greenway, MD; Donna H. Ryan, MD; Donald Williamson, PhD; Elizabeth Tucker; Brandi Armand, LPN; Mandy Shipp, RD; Kim Landry; Jen-nifer Perault The University of Alabama at Birmingham Cora E. Lewis, MD, MSPH; Sheiki-lya Thomas MPH; Vicki DiLillo, PhD; Monika Safford, MD; Stephen Glasser, MD; Clara Smith, MPH; Cathy Roche, RN; Charlotte Bragg, MS, RD, LD; Nita Webb, MA; Staci Gilbert, MPH; Amy Dobelstein; L. Christie Oden; Trena Johnsey Harvard Center Massachusetts General Hospital: David M. Nathan, MD; Heather Turgeon, RN; Kristina P. Schumann, BA; Enrico Cagliero, MD; Kathryn Hayward, MD; Linda Delahanty, MS, RD; Barbara Steiner, EdM; Valerie Goldman, MS, RD; Ellen Anderson, MS, RD; Laurie Bissett, MS, RD; Alan McNamara, BS; Richard Ginsburg, PhD; Virginia Harlan, MSW; Theresa Michel, MS Joslin Diabetes Center: Edward S. Horton, MD; Sharon D. Jackson, MS, RD, CDE; Osama Hamdy, MD, PhD; A. Enrique Caballero, MD; Sarah Ledbury, MEd, RD; Maureen Malloy, BS; Ann Goebel-Fabbri, PhD; Kerry Ovalle, MS, RCEP, CDE; Sarah Bain, BS; Elizabeth Bovaird, BSN,RN; Lori Lambert, MS, RD Beth Israel Deaconess Medical Center: George Blackburn, MD, PhD; Christos Man-tzoros, MD, DSc; Ann McNamara, RN; Heather McCormick, RD University of Colorado Health Sciences Center James O. Hill, PhD; Marsha Miller, MS, RD; Brent VanDorsten, PhD; Judith Regensteiner, PhD; Robert Schwartz, MD; Richard Hamman, MD, DrPH; Michael McDermott, MD; JoAnn Phillipp, MS; Patrick Reddin, BA; Kristin Wallace, MPH; Paulette Cohrs, RN, BSN; April Hamilton, BS; Salma Benchekroun, BS; Susan Green; Loretta Rome, TRS; Lindsey Munkwitz, BS Baylor College of Medicine John P. Foreyt, PhD; Rebecca S. Reeves, DrPH, RD; Henry Pownall, PhD; Peter Jones, MD; Ashok Balasubramanyam, MD; Molly Gee, MEd, RD University of California at Los Angeles School of Medicine Mohammed F. Saad, MD; Ken C. Chiu, MD; Siran Ghazarian, MD; Kati Szamos, RD; Magpuri Per-petua, RD; Michelle Chan, BS; Medhat Botrous The University of Tennessee Health Science Center University of Tennessee East. Karen C. Johnson, MD, MPH; Leeann Carmichael, RN; Lynne Lichtermann, RN, BSN University of Tennessee Downtown. Abbas E. Kitabchi, PhD, MD; Jackie Day, RN; Helen Lambeth, RN, BSN; Debra Force, MS, RD, LDN; Debra Clark, LPN; Andrea Crisler, MT, Donna Green, RN; Gracie Cunningham; Maria Sun, MS, RD, LDN; Robert Kores, PhD; Renate Rosenthal, PhD; and Judith Soberman, MD University of Minnesota Robert W. Jeffery, PhD; Carolyn Thorson, CCRP; John P. Bantle, MD; J. Bruce Redmon, MD; Richard S. Crow, MD; Jeanne Carls, MEd; Carolyne Campbell; La Donna James; T. Ockenden, RN; Kerrin Brelje, MPH, RD; M. Patricia Snyder, MA, RD; Amy Keranen, MS; Cara Walcheck, BS, RD; Emily Finch, MA; Birgitta I. Rice, MS, RPh, CHES; Vicki A. Maddy, BS, RD; Tricia Skarphol, BS St. Luke's Roosevelt Hospital Center Xavier Pi-Sunyer, MD; Jennifer Patricio, MS; Jennifer Mayer, MS; Stanley Heshka, PhD; Carmen Pal, MD; Mary Anne Holo-waty, MS, CN; Diane Hirsch, RNC, MS, CDE University of Pennsylvania Thomas A. Wadden, PhD; Barbara J. Maschak-Carey, MSN, CDE; Gary D. Foster, PhD; Robert I. Berkowitz, MD; Stanley Schwartz, MD; Shiriki K. Kumanyika, PhD, RD, MPH; Monica Mullen, MS, RD; Louise Hesson, MSN; Patricia Lipschutz, MSN; Anthony Fabricatore, PhD; Canice Crerand, PhD; Robert Kuehnel, PhD; Ray Carvajal, MS; Renee Davenport; Helen Chomen-towski University of Pittsburgh David E. Kelley, MD; Jacqueline Wesche -Thobaben, RN,BSN,CDE; Lewis Kuller, MD, DrPH.; Andrea Kriska, PhD; Daniel Edmundowicz, MD; Mary L. Klem, PhD, MLIS; Janet Bonk, RN, MPH; Jennifer Rush, MPH; Rebecca Danchenko, BS; Barb Elnyczky, MA; Karen Vujevich, RN-BC, MSN, CRNP; Janet Krulia, RN ,BSN ,CDE; Donna Wolf, MS; Juliet Mancino, MS, RD, CDE, LDN; Pat Harper, MS, RD, LDN; Anne Mathews, MS, RD, LDN Brown University Rena R. Wing, PhD; Vincent Pera, MD; John Jakicic, PhD; Deborah Tate, PhD; Amy Gorin, PhD; Renee Bright, MS; Pamela Coward, MS, RD; Natalie Robinson, MS, RD; Tammy Monk, MS; Kara Gallagher, PhD; Anna Ber-torelli, MBA, RD; Maureen Daly, RN; Tatum Charron, BS; Rob Nicholson, PhD; Erin Patterson, BS; Julie Currin, MD; Linda Foss, MPH; Deborah Robles; Barbara Ban-croft, RN, MS; Jennifer Gauvin, BS; Deborah Maier, MS; Caitlin Egan, MS; Suzanne Phelan, PhD; Hollie Raynor, PhD, RD; Don Kieffer, PhD; Douglas Raynor, PhD; Lauren Lessard, BS; Kimberley Chula-Maguire, MS; Erica Ferguson, BS, RD; Richard Carey, BS; Jane Tavares, BS; Heather Chenot, MS; JP Massaro, BS The University of Texas Health Science Center at San Antonio Steve Haff-ner, MD; Maria Montez, RN, MSHP, CDE; Connie Mobley, PhD, RD; Carlos Lorenzo, MD University of Washington/VA Puget Sound Health Care System Steven E. Kahn, MB, ChB; Brenda Montgomery, MS, RN, CDE; Robert H. Knopp, MD; Edward W. Lipkin, MD, PhD; Matthew L. Maciejewski, PhD; Dace L. Trence, MD; Roque M. Murillo, BS; S. Terry Barrett, BS Southwestern American Indian Center, Phoenix, Arizona and Shiprock, New Mexico William C. Knowler, MD, DrPH; Paula Bolin, RN, MC; Tina Killean, BS; Carol Percy, RN; Rita Donaldson, BSN; Bernadette Todacheenie, EdD; Justin Glass, MD; Sarah Michaels, MD; Jonathan Krakoff, MD; Jeffrey Curtis, MD, MPH; Peter H. Bennett, MB, FRCP; Tina Morgan; Ruby Johnson; Cathy Manus; Janelia Smiley; Sandra Sangster; Shandiin Begay, MPH; Minnie Roanhorse; Didas Fallis, RN; Nancy Scurlock, MSN, ANP; Leigh Shovestull, RD Coordinating Center Wake Forest University School of Medicine Mark A. Espeland, PhD; Judy Bahnson, BA; Lynne Wagenknecht, DrPH; David Reboussin, PhD; W. Jack Rejeski, PhD; Wei Lang, PhD; Alain Bertoni, MD, MPH; Mara Vitolins, DrPH; Gary Miller, PhD; Paul Ribisl, PhD; Kathy Dotson, BA; Amelia Hodges, BS; Patricia Hogan, MS; Kathy Lane, BS; Carrie Combs, BS; Christian Speas, BS; Delia S. West, PhD; William Herman, MD, MPH Central Resources Centers
PY - 2010
Y1 - 2010
N2 - Background. Previous studies have shown that neighborhood factors are associated with obesity, but few studies have evaluated the association with weight control behaviors. This study aims to conduct a multi-level analysis to examine the relationship between neighborhood SES and weight-related health behaviors. Methods. In this ancillary study to Look AHEAD (Action for Health in Diabetes) a trial of long-term weight loss among individuals with type 2 diabetes, individual-level data on 1219 participants from 4 clinic sites at baseline were linked to neighborhood-level data at the tract level from the 2000 US Census and other databases. Neighborhood variables included SES (% living below the federal poverty level) and the availability of food stores, convenience stores, and restaurants. Dependent variables included BMI, eating patterns, weight control behaviors and resource use related to food and physical activity. Multi-level models were used to account for individual-level SES and potential confounders. Results. The availability of restaurants was related to several eating and weight control behaviors. Compared to their counterparts in neighborhoods with fewer restaurants, participants in neighborhoods with more restaurants were more likely to eat breakfast (prevalence Ratio [PR] 1.29 95% CI: 1.01-1.62) and lunch (PR = 1.19, 1.04-1.36) at non-fast food restaurants. They were less likely to be attempting weight loss (OR = 0.93, 0.89-0.97) but more likely to engage in weight control behaviors for food and physical activity, respectively, than those who lived in neighborhoods with fewer restaurants. In contrast, neighborhood SES had little association with weight control behaviors. Conclusion. In this selected group of weight loss trial participants, restaurant availability was associated with some weight control practices, but neighborhood SES was not. Future studies should give attention to other populations and to evaluating various aspects of the physical and social environment with weight control practices.
AB - Background. Previous studies have shown that neighborhood factors are associated with obesity, but few studies have evaluated the association with weight control behaviors. This study aims to conduct a multi-level analysis to examine the relationship between neighborhood SES and weight-related health behaviors. Methods. In this ancillary study to Look AHEAD (Action for Health in Diabetes) a trial of long-term weight loss among individuals with type 2 diabetes, individual-level data on 1219 participants from 4 clinic sites at baseline were linked to neighborhood-level data at the tract level from the 2000 US Census and other databases. Neighborhood variables included SES (% living below the federal poverty level) and the availability of food stores, convenience stores, and restaurants. Dependent variables included BMI, eating patterns, weight control behaviors and resource use related to food and physical activity. Multi-level models were used to account for individual-level SES and potential confounders. Results. The availability of restaurants was related to several eating and weight control behaviors. Compared to their counterparts in neighborhoods with fewer restaurants, participants in neighborhoods with more restaurants were more likely to eat breakfast (prevalence Ratio [PR] 1.29 95% CI: 1.01-1.62) and lunch (PR = 1.19, 1.04-1.36) at non-fast food restaurants. They were less likely to be attempting weight loss (OR = 0.93, 0.89-0.97) but more likely to engage in weight control behaviors for food and physical activity, respectively, than those who lived in neighborhoods with fewer restaurants. In contrast, neighborhood SES had little association with weight control behaviors. Conclusion. In this selected group of weight loss trial participants, restaurant availability was associated with some weight control practices, but neighborhood SES was not. Future studies should give attention to other populations and to evaluating various aspects of the physical and social environment with weight control practices.
UR - http://www.scopus.com/inward/record.url?scp=77954488995&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954488995&partnerID=8YFLogxK
U2 - 10.1186/1471-2458-10-312
DO - 10.1186/1471-2458-10-312
M3 - Article
C2 - 20525373
AN - SCOPUS:77954488995
SN - 1471-2458
VL - 10
JO - BMC public health
JF - BMC public health
M1 - 312
ER -