Morland K, Wing S, Diez Roux A. The contextual effect of the local food environment on residents' diets: the atherosclerosis risk in communities study. American Journal of Public Health. 2002; 92:1761-1767.
The authors measured the association between the physical availability of food stores and food service places-the presence of supermarkets, grocery stores, restaurants, and fast-food outlets-and people's adherence to health authorities' recommendations for a healthy diet. Healthy diet was measured in terms of 1) servings of fruits and vegetables per day; 2) percentage of calories from fat; 3) saturated fat; and 4) dietary cholesterol.
Among blacks, the presence of supermarkets was found to be associated with meeting dietary recommendations. In fruit and vegetable consumption, there was a dose-response association among blacks corresponding to the number of supermarkets in their census tract. Only 8 percent of blacks-vs. 31 percent of whites-lived in a census tract with at least one supermarket. The presence of a small grocery store in an area showed little association with the reported diets of blacks. Seventy-nine percent of blacks lived in areas with full-service restaurants, which were associated with lower intake of saturated fats. Nearly 60 percent of black respondents lived in neighborhoods with at least one fast-food restaurant. However, the results indicated that there was little association between the presence of fast-food restaurants and reported dietary intake of recommended foods and nutrients. For whites, the presence of supermarkets, grocery stores, restaurants, and fast-food outlets was not found to be associated with diet. The authors noted that whites were more likely than blacks to have access to private transportation; hence, the diets of whites might not be as influenced by the proximity of food services.
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