Multiple Pathways from the Neighborhood Food Environment to Increased Body Mass Index Through Dietary Behaviors
A Structural Equation-Based Analysis in the CARDIA Study
Published in: Health & Place, v. 36, Nov. 2015, p. 74-87
Posted on RAND.org on March 16, 2016
OBJECTIVES: To examine longitudinal pathways from multiple types of neighborhood restaurants and food stores to BMI, through dietary behaviors. METHODS: We used data from participants (n=5114) in the United States-based Coronary Artery Risk Development in Young Adults study and a structural equation model to estimate longitudinal (1985–86 to 2005–06) pathways simultaneously from neighborhood fast food restaurants, sit-down restaurants, supermarkets, and convenience stores to BMI through dietary behaviors, controlling for socioeconomic status (SES) and physical activity. RESULTS: Higher numbers of neighborhood fast food restaurants and lower numbers of sit-down restaurants were associated with higher consumption of an obesogenic fast food-type diet. The pathways from food stores to BMI through diet were inconsistent in magnitude and statistical significance. CONCLUSIONS: Efforts to decrease the numbers of neighborhood fast food restaurants and to increase the numbers of sit-down restaurant options could influence diet behaviors. Availability of neighborhood fast food and sit-down restaurants may play comparatively stronger roles than food stores in shaping dietary behaviors and BMI.