Supermarkets, other food stores, and obesity - The atherosclerosis risk in communities study

Background: Obesity is a leading public health concern, and although environmental factors have been hypothesized to play a role in the prevention of obesity, little empirical data exist to document their effects. The purpose of this Study was to examine whether characteristics of the local food environment are associated with the prevalence of cardiovascular disease risk factors. Methods: A cross-sectional study of men and women participating in the third visit (1993-1995) of the Atherosclerosis Risk in Communities (ARIC) Study was conducted in 2004. The analyses included 10,763 ARIC participants residing in one of the 207 eligible census tracts located in the four ARIC-defined geographic areas. Names and addresses of food stores located in Mississippi, North Carolina, Maryland, and Minnesota were obtained from departments of agriculture. Multilevel modeling was used to calculate prevalence ratios of the associations between the presence of specific types of food stores and cardiovascular disease risk factors. Results: The presence of supermarkets was associated with a lower prevalence of obesity and overweight (obesity prevalence ratio [PR] =0.83, 95% confidence interval [CI] =0.75-0.92; overweight PR=0.94, 95% CI=0.90-0.98), and the presence of convenience stores was associated with a higher prevalence of obesity and overweight (obesity PR=1.16, 95% CI=1.05-1.27; overweight PR=1.06, 95% CI=1.02-1.10). Associations for diabetes, high serum cholesterol, and hypertension were not consistently observed. Conclusions: Results from this study suggest that characteristics of local food environments may play a role in the prevention of overweight and obesity.