title: Association between neighborhood deprivation and fruits and vegetables consumption and leisure-time physical activity: a cross-sectional multilevel analysis.
abstract: BACKGROUND
  Most studies of the association between neighborhood socioeconomic deprivation and individual lifestyles leading to cardiovascular disease focused on a single cardiovascular risk factor. The concomitant assessment of more than one risk factor may provide clues to specific mechanisms linking neighborhood disadvantage to individual lifestyles. We investigated the association of neighborhood deprivation with fruits and vegetables consumption and leisure-time physical activity in adults living in an urban center in Portugal.
  
  
  METHODS
  In 1999-2003, we assembled a random sample of 2081 adult residents in the city of Porto. Data on sociodemographic characteristics were collected by trained interviewers using structured questionnaires. Fruits and vegetables consumption was estimated using a validated 82-item semiquantitative food frequency questionnaire covering the previous year and expressed in portions per day. Physical activity was evaluated using a questionnaire exploring leisure-time activities over the previous year and expressed in metabolic equivalents (MET).minute/day. Self-reported address was used to place individuals in neighborhoods. Neighborhoods' socioeconomic characterization was based on aggregated data at the census block level provided by the 2001 National Census. Latent class analysis models were used to identify three discrete socioeconomic classes of neighborhoods. Random effects models with random intercepts at the neighborhood level were used to explore clustering and contextual effects of neighborhood deprivation on each of the outcomes.
  
  
  RESULTS
  We found evidence of neighborhood clustering of fruits and vegetables consumption and leisure-time physical activity that persisted after adjustment for neighborhood deprivation only among women. Women living in the most deprived neighborhoods presented a consumption increase of 0.43 (95% CI: -0.033 to 0.89) portions of fruits and vegetables per day and a decrease in leisure-time physical activity of 47.8 (95% CI: -91.8 to 1.41) MET.minute/day, when compared to those living in the most affluent neighborhoods. Among men, no contextual neighborhood deprivation effects were observed.
  
  
  CONCLUSIONS
  Overall, neighborhood deprivation had a small effect on the consumption of fruits and vegetables and leisure-time physical activity. Neighborhood factors other than socioeconomic deprivation may still impact on the studied outcomes among women. This study provides relevant information for the design of interventions directed to neighborhood characteristics in the prevention of cardiovascular diseases.
authors.affiliation: Institute of Public Health, University of Porto, Rua das Taipas, 135-139, 4050-600 Porto, Portugal. lalves@med.up.pt.
authors.forename: Luís
authors.initials: L
authors.lastname: Alves
authors.forename: Susana
authors.initials: S
authors.lastname: Silva
authors.forename: Milton
authors.initials: M
authors.lastname: Severo
authors.forename: Diogo
authors.initials: D
authors.lastname: Costa
authors.forename: Maria Fátima
authors.initials: MF
authors.lastname: Pina
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D004034:Diet Surveys; D005260:Female; D005638:Fruit; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011174:Portugal / Q000453:epidemiology; D011204:Poverty Areas; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014675:Vegetables; D055815:Young Adult