title: Youth dietary intake and weight status: healthful neighborhood food environments enhance the protective role of supportive family home environments.
abstract: The aim of this study is to investigate individual and joint associations of the home environment and the neighborhood built environment with adolescent dietary patterns and body mass index (BMI) z-score. Racially/ethnically and socioeconomically diverse adolescents (n=2682; 53.2% girls; mean age14.4 years) participating in the EAT 2010 (Eating and Activity in Teens) study completed height and weight measurements and surveys in Minnesota middle and high schools. Neighborhood variables were measured using Geographic Information Systems data. Multiple regressions of BMI z-score, fruit and vegetable intake, and fast food consumption were fit including home and neighborhood environmental variables as predictors and also including their interactions to test for effect modification. Supportive family environments (i.e., higher family functioning, frequent family meals, and parent modeling of healthful eating) were associated with higher adolescent fruit and vegetable intake, lower fast food consumption, and lower BMI z-score. Associations between the built environment and adolescent outcomes were fewer. Interaction results, although not all consistent, indicated that the relationship between a supportive family environment and adolescent fruit and vegetable intake and BMI was enhanced when the neighborhood was supportive of healthful behavior. Public health interventions that simultaneously improve both the home environment and the neighborhood environment of adolescents may have a greater impact on adolescent obesity prevention than interventions that address one of these environments alone.
authors.affiliation: University of Minnesota Medical School, Department of Family Medicine and Community Health, Minneapolis, MN, USA. Electronic address: mohl0009@umn.edu.
authors.forename: Jerica M
authors.initials: JM
authors.lastname: Berge
authors.affiliation: Division of Biostatistics in the Department of Psychiatry and Department of Biostatistics in the Mailman School of Public Health, Columbia University, NY, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Wall
authors.affiliation: University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, MN, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Larson
authors.affiliation: Urban Planning and Design, Harvard University, Cambridge, MA, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Forsyth
authors.affiliation: Temple University, Department of Public Health and Center for Obesity Research and Education, Philadelphia, PA, USA.
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Bauer
authors.affiliation: University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, MN, USA.
authors.forename: Dianne
authors.initials: D
authors.lastname: Neumark-Sztainer
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D004032:Diet; D057140:Fast Foods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota; D016487:Parenting; D012111:Residence Characteristics; D011795:Surveys and Questionnaires
keywords: Adolescents; Built environment; Dietary intake; Family functioning; Obesity