Department of Public Health, University of Texas at San Antonio, San Antonio, TX 78249, USA.
National Council for Science and Technology (CONACYT), Mexico City 03940, Mexico.
Int J Environ Res Public Health. 2022 Jan 26;19(3):1353. doi: 10.3390/ijerph19031353.
Shifting food environments in Latin America have potentially contributed to an increase in the consumption of ultra-processed foods and sugar-sweetened beverages, along with decreases in healthy foods, such as fruits and vegetables. Yet, little is known about the impact that such changes in the food environment have on blood pressure in low- and middle-income countries, including Mexico. We utilized individual-level systolic and diastolic blood pressure (SBP and DBP) measures from the 2016 Mexican Health and Nutrition Survey (ENSANUT, = 2798 adults). Using an inventory of food stores based on the economic census for 2010 and 2016, we calculated the change in the density of fruit and vegetable stores, convenience stores, and supermarkets. Multilevel regression was used to estimate the association between the 2010-2016 food environment neighborhood-level changes with individual-level blood pressure measured in 2016. Declines in neighborhood-level density of fruit and vegetable stores were associated with higher individual SBP (2.67 mmHg, 95% CI: 0.1, 5.2) in unadjusted models, and marginally associated after controlling for individual-level and area-level covariates. Increases in the density of supermarkets were associated with higher blood pressure outcomes among adults with undiagnosed hypertension. Structural interventions targeting the retail food environment could potentially contribute to better nutrition-related health outcomes in Latin American cities.
拉丁美洲不断变化的食品环境可能导致超加工食品和含糖饮料的消费增加，同时健康食品（如水果和蔬菜）的消费减少。然而，对于这种食品环境变化对包括墨西哥在内的中低收入国家的血压的影响，我们知之甚少。我们利用了 2016 年墨西哥健康和营养调查（ENSANUT，n=2798 名成年人）的个体水平收缩压和舒张压（SBP 和 DBP）测量值。我们使用了基于 2010 年和 2016 年经济普查的食品商店清单，计算了水果和蔬菜商店、便利店和超市密度的变化。我们使用多水平回归来估计 2010-2016 年食品环境邻里层面变化与 2016 年个体水平血压之间的关联。未调整模型中，邻里层面水果和蔬菜商店密度下降与个体 SBP 升高相关（2.67mmHg，95%CI：0.1，5.2），在控制了个体和区域层面协变量后，这种关联具有边际显著性。超市密度增加与未确诊高血压成年人的血压结果升高有关。针对零售食品环境的结构性干预措施可能有助于改善拉丁美洲城市与营养相关的健康结果。
