title: A food desert in Detroit: associations with food shopping and eating behaviours, dietary intakes and obesity.
abstract: OBJECTIVE
  Currently 67 % of the US population is overweight or obese and obesity is associated with several chronic medical conditions. Geographic areas where individuals lack access to healthy foods have been termed ‘food deserts’. The study aim was to examine if area of residence within Metro Detroit was associated with dietary intake, food and shopping behaviours, and BMI.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Participants were recruited in the waiting area of four primary-care clinics.
  
  
  METHODS
  Individuals (n 1004) completed a questionnaire comprising four sections: demographics; personal health status including self-reported height and weight; a modified diet, transportation and shopping survey; and a subscale from the Diet and Health Knowledge Survey.
  
  
  RESULTS
  Seventy-four per cent of participants were female and the mean age was 46·7 (sd 15·0) years. In univariate analyses, living in Detroit was associated with being African American, unemployment, less education, no regular exercise, worse health self-rating and obesity (P < 0·0005 for all). Participants living in Detroit had a 3·06 (95 % CI 1·91, 4·21) kg/m2 larger BMI compared with people living outside the city (P < 0·0005) in univariate analyses, but the effect was attenuated when adjusted for demographics, disease status, shopping and eating behaviours, dietary intakes and diet knowledge (β = −0·46 kg/m2, 95 % CI −2·23, 1·30 kg/m2, P = 0·60).
  
  
  CONCLUSIONS
  Overweight and obesity are highly prevalent both inside (82·9 %) and outside (72·8 %) the city of Detroit, presenting a major public health problem. However, living in this food desert was not significantly associated with BMI after potential covariates were considered.
authors: 1 Section of General Internal Medicine, Department of Medicine, Primary Care Academic Fellowship, Boston University School of Medicine, Boston, MA, USA.
authors: Katarzyna
authors: K
authors: Budzynska
authors: Patricia
authors: P
authors: West
authors: Ruth T
authors: RT
authors: Savoy-Moore
authors: Darlene
authors: D
authors: Lindsey
authors: Michael
authors: M
authors: Winter
authors: P K
authors: PK
authors: Newby
mesh_terms: D000328:Adult; D001741:Black or African American; D015992:Body Mass Index; D002947:Cities; D004032:Diet / Q000592:standards*; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005523:Food Supply; D015438:Health Behavior; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D057185:Sedentary Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population
references: Ann Intern Med. 2001 Jun 19;134(12):1106-14
references: 11412050
references: Appetite. 2005 Oct;45(2):195-7
references: 15927303
references: Health Bull (Edinb). 1996 Nov;54(6):443-6
references: 8990608
references: JAMA. 2002 Oct 9;288(14):1723-7
references: 12365955
references: Am J Prev Med. 2012 Feb;42(2):129-35
references: 22261208
references: Int J Epidemiol. 2010 Feb;39(1):277-84
references: 19491142
references: Am J Clin Nutr. 2004 Jan;79(1):6-16
references: 14684391
references: Public Health Nutr. 2000 Sep;3(3):263-71
references: 10979146
references: Health Place. 2010 Sep;16(5):876-84
references: 20462784
references: BMJ. 2002 Aug 24;325(7361):436-8
references: 12193363
references: Eur J Clin Nutr. 2000 Sep;54(9):706-14
references: 11002383
references: Eur J Clin Nutr. 1999 Dec;53(12):946-52
references: 10602352
references: J Am Diet Assoc. 2001 Jan;101(1):28-34; quiz 35-6
references: 11209581
references: Am J Public Health. 2002 Aug;92(8):1299-304
references: 12144988
references: Public Health. 2012 Sep;126(9):723-30
references: 22898435
references: JAMA. 2010 Jan 20;303(3):235-41
references: 20071471
references: J Epidemiol Community Health. 2004 Aug;58(8):686-91
references: 15252072
references: J Epidemiol Community Health. 1999 Jan;53(1):55-63
references: 10326055
references: J Am Diet Assoc. 2007 Nov;107(11):1895-902
references: 17964308
references: Obes Rev. 2007 Jul;8(4):307-26
references: 17578381
references: Health Place. 2008 Mar;14(1):32-44
references: 17576089
references: Eur J Public Health. 2001 Mar;11(1):51-9
references: 11276572
references: Am J Public Health. 2002 May;92(5):844-51
references: 11988458
references: Obes Res. 2001 Nov;9 Suppl 4:228S-233S
references: 11707546
references: Eur J Clin Nutr. 2001 May;55(5):366-73
references: 11378810
references: Fam Med. 2010 Apr;42(4):280-4
references: 20373171
references: J Nutr Educ Behav. 2003 Mar-Apr;35(2):83-91
references: 12725714