title: Fast food price, diet behavior, and cardiometabolic health: Differential associations by neighborhood SES and neighborhood fast food restaurant availability in the CARDIA study.
abstract: Little research has addressed whether neighborhood context influences associations between fast food price, diet, and cardiometabolic health. We investigated these associations using 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data (n=4,469, observations=21,134). We found a negative association between fast food price and consumption, with stronger inverse associations in more (vs. less) deprived neighborhoods [3rd tertile: β=-0.68 (95% CI: (-0.85, -0.51); 1st tertile: β=-0.22 (95% CI: -0.42, -0.02); p-interaction-0.002], and a similar association for BMI [3rd tertile: β=-1.34 (95% CI: -1.54, -1.14); 1st tertile: β=-0.45 (95% CI: -0.66, -0.25); p-interaction<0.001], but not insulin resistance [3rd tertile: β=-0.07 (95% CI: -0.24, 0.09); 1st tertile: β=0.09 (95% CI: -0.08, 0.26); p-interaction=0.40]. We observed no modification of fast food price by fast food availability. Future research on obesity disparities should consider potential differences in the association between fast food prices and health outcomes across neighborhood socioeconomic levels.
authors: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA. Electronic address: prummo@live.unc.edu.
authors: Pasquale E
authors: PE
authors: Rummo
authors: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA. Electronic address: ktmeyer@email.unc.edu.
authors: Katie A
authors: KA
authors: Meyer
authors: Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA. Electronic address: aghoward@email.unc.edu.
authors: Annie
authors: A
authors: Green Howard
authors: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: jshikany@uabmc.edu.
authors: James M
authors: JM
authors: Shikany
authors: Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA; Department of Economics, University of North Carolina at Chapel Hill Carolina Population Center, Chapel Hill, NC, USA. Electronic address: david_guilkey@unc.edu.
authors: David K
authors: DK
authors: Guilkey
authors: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA.
authors: Penny
authors: P
authors: Gordon-Larsen
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D003132:Commerce; D004032:Diet; D057140:Fast Foods / Q000191:economics / Q000600:supply & distribution; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D012111:Residence Characteristics; D012147:Restaurants / Q000191:economics / Q000600:supply & distribution; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Cardiometabolic health; Diet; Fast food; Food environment; Neighborhood deprivation; food Price