Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 184, Issue 11, Pages 837-846Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kww073
Keywords
absolute exposure; fruit and vegetable intake; geographically weighted regression; local food environment; nonstationarity; relative exposure
Categories
Funding
- National Institute for Health Research Public Health Research Programme [09/3005/09]
- Research Centre, Centre Hospitalier de l'Universite de Montreal
- United Kingdom National Institute of Health Senior Research Fellowship
- National Institute for Health Research [09/3005/09] Funding Source: researchfish
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Studies that explore associations between the local food environment and diet routinely use global regression models, which assume that relationships are invariant across space, yet such stationarity assumptions have been little tested. We used global and geographically weighted regression models to explore associations between the residential food environment and fruit and vegetable intake. Analyses were performed in 4 boroughs of London, United Kingdom, using data collected between April 2012 and July 2012 from 969 adults in the Olympic Regeneration in East London Study. Exposures were assessed both as absolute densities of healthy and unhealthy outlets, taken separately, and as a relative measure (proportion of total outlets classified as healthy). Overall, local models performed better than global models (lower Akaike information criterion). Locally estimated coefficients varied across space, regardless of the type of exposure measure, although changes of sign were observed only when absolute measures were used. Despite findings from global models showing significant associations between the relative measure and fruit and vegetable intake (beta = 0.022; P < 0.01) only, geographically weighted regression models using absolute measures outperformed models using relative measures. This study suggests that greater attention should be given to nonstationary relationships between the food environment and diet. It further challenges the idea that a single measure of exposure, whether relative or absolute, can reflect the many ways the food environment may shape health behaviors.
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