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The relationship between dietary quality and the local food environment differs according to level of educational attainment: a cross-sectional study

The relationship between dietary quality and the local food environment differs according to level of educational attainment: a cross-sectional study
The relationship between dietary quality and the local food environment differs according to level of educational attainment: a cross-sectional study
There is evidence that food outlet access differs according to level of neighbourhood deprivation but little is known about how individual circumstances affect associations between food outlet access and diet. This study explored the relationship between dietary quality and a measure of overall food environment, representing the balance between healthy and unhealthy food outlet access in individualised activity spaces. Furthermore, this study is the first to assess effect modification of level of educational attainment on this relationship. A total of 839 mothers with young children from Hampshire, United Kingdom (UK) completed a cross-sectional survey including a 20-item food frequency questionnaire to measure diet and questions about demographic characteristics and frequently visited locations including home, children’s centre, general practitioner, work, main food shop and physical activity location. Dietary information was used to calculate a standardised dietary quality score for each mother. Individualised activity spaces were produced by creating a 1000m buffer around frequently visited locations using ArcGIS. Cross-sectional observational food outlet data were overlaid onto activity spaces to derive an overall food environment score for each mother. These scores represented the balance between healthy and unhealthy food outlets using weightings to characterise the proportion of healthy or unhealthy foods sold in each outlet type. Food outlet access was dominated by the presence of unhealthy food outlets; only 1% of mothers were exposed to a healthy overall food environment in their daily activities. Level of educational attainment moderated the relationship between overall food environment and diet (mid vs low, p = 0.06; high vs low, p = 0.04). Adjusted stratified linear regression analyses showed poorer food environments were associated with better dietary quality among mothers with degrees (β = -0.02; 95%CI: -0.03, -0.001) and a tendency toward poorer dietary quality among mothers with low educational attainment, however this relationship was not statistically significant (β = 0.01; 95%CI: -0.01, 0.02). This study showed that unhealthy food outlets, like takeaways and convenience stores, dominated mothers’ food outlet access, and provides some empirical evidence to support the concept that individual characteristics, particularly educational attainment, are protective against exposure to unhealthy food environments. Improvements to the imbalance of healthy and unhealthy food outlets through planning restrictions could be important to reduce dietary inequalities.
1932-6203
1-16
Vogel, Christina
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Lewis, Daniel
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Ntani, Georgia
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Cummins, Steven
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Cooper, Cyrus
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Moon, Graham
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Baird, Janis
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Vogel, Christina
768f1dcd-2697-4aae-95cc-ee2f6d63dff5
Lewis, Daniel
e4012b77-3224-472f-a05d-98a0fbd9a4d1
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Cummins, Steven
af945c4e-6089-4698-bf10-3d0db8d63307
Cooper, Cyrus
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Moon, Graham
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Baird, Janis
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Vogel, Christina, Lewis, Daniel, Ntani, Georgia, Cummins, Steven, Cooper, Cyrus, Moon, Graham and Baird, Janis (2017) The relationship between dietary quality and the local food environment differs according to level of educational attainment: a cross-sectional study. PLoS ONE, 12 (8), 1-16, [e0183700]. (doi:10.1371/journal.pone.0183700).

Record type: Article

Abstract

There is evidence that food outlet access differs according to level of neighbourhood deprivation but little is known about how individual circumstances affect associations between food outlet access and diet. This study explored the relationship between dietary quality and a measure of overall food environment, representing the balance between healthy and unhealthy food outlet access in individualised activity spaces. Furthermore, this study is the first to assess effect modification of level of educational attainment on this relationship. A total of 839 mothers with young children from Hampshire, United Kingdom (UK) completed a cross-sectional survey including a 20-item food frequency questionnaire to measure diet and questions about demographic characteristics and frequently visited locations including home, children’s centre, general practitioner, work, main food shop and physical activity location. Dietary information was used to calculate a standardised dietary quality score for each mother. Individualised activity spaces were produced by creating a 1000m buffer around frequently visited locations using ArcGIS. Cross-sectional observational food outlet data were overlaid onto activity spaces to derive an overall food environment score for each mother. These scores represented the balance between healthy and unhealthy food outlets using weightings to characterise the proportion of healthy or unhealthy foods sold in each outlet type. Food outlet access was dominated by the presence of unhealthy food outlets; only 1% of mothers were exposed to a healthy overall food environment in their daily activities. Level of educational attainment moderated the relationship between overall food environment and diet (mid vs low, p = 0.06; high vs low, p = 0.04). Adjusted stratified linear regression analyses showed poorer food environments were associated with better dietary quality among mothers with degrees (β = -0.02; 95%CI: -0.03, -0.001) and a tendency toward poorer dietary quality among mothers with low educational attainment, however this relationship was not statistically significant (β = 0.01; 95%CI: -0.01, 0.02). This study showed that unhealthy food outlets, like takeaways and convenience stores, dominated mothers’ food outlet access, and provides some empirical evidence to support the concept that individual characteristics, particularly educational attainment, are protective against exposure to unhealthy food environments. Improvements to the imbalance of healthy and unhealthy food outlets through planning restrictions could be important to reduce dietary inequalities.

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Accepted/In Press date: 18 August 2017
e-pub ahead of print date: 25 August 2017
Published date: 25 August 2017

Identifiers

Local EPrints ID: 413515
URI: http://eprints.soton.ac.uk/id/eprint/413515
ISSN: 1932-6203
PURE UUID: 81856446-8702-4349-8a0c-fd9d7c834972
ORCID for Christina Vogel: ORCID iD orcid.org/0000-0002-3897-3786
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Graham Moon: ORCID iD orcid.org/0000-0002-7256-8397
ORCID for Janis Baird: ORCID iD orcid.org/0000-0002-4039-4361

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Date deposited: 25 Aug 2017 16:31
Last modified: 18 Mar 2024 03:15

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Contributors

Author: Christina Vogel ORCID iD
Author: Daniel Lewis
Author: Georgia Ntani
Author: Steven Cummins
Author: Cyrus Cooper ORCID iD
Author: Graham Moon ORCID iD
Author: Janis Baird ORCID iD

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