Social and Preventive Medicine Department, Université de Montréal, Montreal, Quebec, Canada.
PLoS One. 2012;7(8):e41418. doi: 10.1371/journal.pone.0041418. Epub 2012 Aug 22.
Environmental exposure to food sources may underpin area level differences in individual risk for overweight. Place of residence is generally used to assess neighbourhood exposure. Yet, because people are mobile, multiple exposures should be accounted for to assess the relation between food environments and overweight. Unfortunately, mobility data is often missing from health surveys. We hereby test the feasibility of linking travel survey data with food listings to derive food store exposure predictors of overweight among health survey participants.
Food environment exposure measures accounting for non-residential activity places (activity spaces) were computed and modelled in Montreal and Quebec City, Canada, using travel surveys and food store listings. Models were then used to predict activity space food exposures for 5,578 participants of the Canadian Community Health Survey. These food exposure estimates, accounting for daily mobility, were used to model self-reported overweight in a multilevel framework. Median Odd Ratios were used to assess the proportion of between-neighborhood variance explained by such food exposure predictors.
Estimates of food environment exposure accounting for both residential and non-residential destinations were significantly and more strongly associated with overweight than residential-only measures of exposure for men. For women, residential exposures were more strongly associated with overweight than non-residential exposures. In Montreal, adjusted models showed men in the highest quartile of exposure to food stores were at lesser risk of being overweight considering exposure to restaurants (OR = 0.36 [0.21-0.62]), fast food outlets (0.48 [0.30-0.79]), or corner stores (0.52 [0.35-0.78]). Conversely, men experiencing the highest proportion of restaurants being fast-food outlets were at higher risk of being overweight (2.07 [1.25-3.42]). Women experiencing higher residential exposures were at lower risk of overweight.
Using residential neighbourhood food exposure measures may underestimate true exposure and observed associations. Using mobility data offers potential for deriving activity space exposure estimates in epidemiological models.
环境暴露于食物来源可能构成个体超重风险的区域差异。居住地通常用于评估邻里暴露。然而，由于人们是流动的，应该考虑到多种暴露情况，以评估食物环境与超重之间的关系。不幸的是，健康调查通常缺少流动性数据。本研究旨在检验将旅行调查数据与食物清单相联系，以推导出健康调查参与者超重的食物商店暴露预测因子的可行性。
在加拿大的蒙特利尔和魁北克市，我们使用旅行调查和食物商店清单，计算并建模了考虑非居住活动场所（活动空间）的食物环境暴露措施。然后，我们使用这些模型预测了加拿大社区健康调查 5578 名参与者的活动空间食物暴露情况。这些考虑到日常流动性的食物暴露估计值，被用于多水平框架中对自我报告超重进行建模。中位数比值比（Odd Ratio）用于评估这种食物暴露预测因子对邻里间差异的解释比例。
考虑到住宅和非住宅目的地的食物环境暴露估计值与超重显著相关，并且比仅考虑住宅暴露的指标更具相关性，这一结果在男性中更为明显。对于女性，住宅暴露与超重的相关性强于非住宅暴露。在蒙特利尔，调整后的模型显示，考虑到餐馆（比值比（OR）=0.36 [0.21-0.62]）、快餐店（0.48 [0.30-0.79]）或街角商店（0.52 [0.35-0.78]）的暴露，暴露于最高四分位的食物商店的男性超重风险较低。相反，暴露于最高比例的餐馆为快餐店的男性超重风险更高（2.07 [1.25-3.42]）。暴露于最高住宅暴露的女性超重风险较低。
使用住宅邻里食物暴露措施可能低估了真实暴露情况和观察到的关联。使用流动性数据为在流行病学模型中推导出活动空间暴露估计值提供了可能性。
