A food desert in Detroit: associations with food intakes, eating behaviors, and obesity
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Background: The prevalence of overweight and obesity has increasing at an alarming rate and is currently estimated to be 67% ofthe US population. Obesity is associated with several chronic medical conditions, and increasingly has been targeted by numerous programs attempting to halt or reverse this upward trend. Geographic areas where individuals lack access to healthy foods have been termed "food deserts." Other researchers have attributed an unhealthy diet to behavior patterns and sociocultural attitudes. Objective: The aim of this study is to determine if area of residence within the Metro Detroit area impacts dietary intakes, food and shopping behaviors, knowledge and self-reported body mass index (BMI). Design: In this cross-sectional study (n=1004), individuals in primary care settings completed a questionnaire comprising four sections: demographics; personal health status; a modified diet, transportation and shopping survey; and a subscale from the Diet Knowledge Test. Results: Twenty-four percent ofthe sample lived within the city of Detroit. For all respondents, 74.5% reported weight and height that put their calculated body mass index (BMI) into the range of overweight or obese. Seventy-six percent reported being overweight or obese. Seventy four percent were female and the mean age was 46.7 ± 15.0 (SD) years. In univariate analyses, living in Detroit was associated with African American race/ethnicity, unemployment, less education, no regular exercise, worse health status, and obesity (p< 0.0001). Subjects living in Detroit had a 3.06 kg/m (95% CI: 1.91 ; 4.21) larger BMI compared to people living outside the city (p<0.0001) in univariate analyses, but the effect was attenuated by adjusting for demographics, disease status, shopping pattern, food intake and diet knowledge test (β=-0.21 kg/m , 95% CI: -4.06; 3.64, p=0.91). Conclusion: Overweight and obesity are rampant both inside (82.1%) and outside (72.1%) the city of Detroit, presenting a major public health problems throughout the Detroit area. However, living in this food desert was not significantly associated with being overweight or obese once potential confounders were considered.
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