title: Neighbourhood food environment and gestational diabetes in New York City.
abstract: The association between neighbourhood characteristics and gestational diabetes has not been examined previously. We investigated the relationship between the number of healthy food outlets (supermarkets; fruit/vegetable and natural food stores), and unhealthy food outlets (fast food; pizza; bodegas; bakeries; convenience, candy/nut and meat stores) in census tract of residence, and gestational diabetes in New York City. Gestational diabetes, census tract and individual-level covariates were ascertained from linked birth-hospital data for 210 926 singleton births from 2001 to 2002 and linked to commercial data on retail food outlets. Adjusted odds ratios (aOR) were estimated using a multilevel logistic model. No association between food environment measures and gestational diabetes was found, with aORs ranging from 0.95 to 1.04. However, an increased odds of pre-pregnancy weight >200 lbs for women living in a given neighbourhood with no healthy food outlets [aOR = 1.14, 95% CI 1.07, 1.21] or only one healthy food place [aOR = 1.10, 95% CI 1.04, 1.18] relative to two or more healthy food outlets was found. Due to probable misclassification of neighbourhood food environment and pre-pregnancy obesity results are likely to be biased towards the null. Future research, including validity studies, on the neighbourhood food environment, obesity during pregnancy and gestational diabetes is warranted.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. teresa.janevic@yale.edu
authors.forename: Teresa
authors.initials: T
authors.lastname: Janevic
authors.forename: Luisa N
authors.initials: LN
authors.lastname: Borrell
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.forename: Amy H
authors.initials: AH
authors.lastname: Herring
authors.forename: Andrew
authors.initials: A
authors.lastname: Rundle
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003132:Commerce / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005523:Food Supply; D006801:Humans; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D012111:Residence Characteristics