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Recommendations for fruit and vegetable consumption are largely unmet. Lower socio-economic status (SES), neighbourhood poverty and poor access to retail outlets selling healthy foods are thought to predict lower consumption. The objective of the present study was to assess the interrelationships between these risk factors as predictors of fruit and vegetable consumption.
Cross-sectional multilevel analyses of data on fruit and vegetable consumption, socio-demographic characteristics, neighbourhood poverty and access to healthy retail food outlets.
Survey data from the 2002 and 2004 New York City Community Health Survey, linked by residential zip code to neighbourhood data.
Adult survey respondents (n 15 634).
Overall 9·9 % of respondents reported eating ≥5 servings of fruits or vegetables in the day prior to the survey. The odds of eating ≥5 servings increased with higher income among women and with higher educational attainment among men and women. Compared with women having less than a high-school education, the OR was 1·12 (95 % CI 0·82, 1·55) for high-school graduates, 1·95 (95 % CI 1·43, 2·66) for those with some college education and 2·13 (95 % CI 1·56, 2·91) for college graduates. The association between education and fruit and vegetable consumption was significantly stronger for women living in lower- v. higher-poverty zip codes (P for interaction < 0·05). The density of healthy food outlets did not predict consumption of fruits or vegetables.
Higher SES is associated with higher consumption of produce, an association that, in women, is stronger for those residing in lower-poverty neighbourhoods.
To examine food concern (FC) and its associations with obesity and diabetes in a racially diverse, urban population.
Cross-sectional population-based survey.
Five boroughs of New York City.
Lower-income adults (n 5981) in the 2004 New York City Community Health Survey.
The overall prevalence of obesity was 24 % and was higher among FC than non-FC white men and women, black women, US- and foreign-born whites and foreign-born blacks. In multivariable analysis, FC was marginally associated with obesity (OR = 1·18, 95 % CI 0·98, 1·42) among all lower-income New Yorkers, after controlling for socio-economic factors. The association of FC and obesity varied by race/ethnicity, with FC being positively associated with obesity only among white New Yorkers. FC whites had 80 % higher odds of obesity than whites without FC (OR = 1·80; 95 % CI 1·21, 2·68), with a model-adjusted obesity prevalence of 20 % among non-FC whites v. 31 % among FC whites. FC was not associated with diabetes after controlling for obesity and socio-economic factors.
The prevalence of obesity was significantly higher among FC whites and certain subgroups of blacks. FC was positively associated with obesity risk among lower-income white New Yorkers. Programmes designed to alleviate FC and poverty should promote the purchase and consumption of nutritious, lower-energy foods to help address the burden of obesity in lower-income urban populations.
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