title: Associations between the neighbourhood food environment, neighbourhood socioeconomic status, and diet quality: An observational study.
abstract: The neighbourhood environment may play an important role in diet quality. Most previous research has examined the associations between neighbourhood food environment and diet quality, and neighbourhood socioeconomic status and diet quality separately. This study investigated the independent and joint effects of neighbourhood food environment and neighbourhood socioeconomic status in relation to diet quality in Canadian adults.
  
  
  
  We undertook a cross-sectional study with n = 446 adults in Calgary, Alberta (Canada). Individual-level data on diet and socio-demographic and health-related characteristics were captured from two self-report internet-based questionnaires, the Canadian Diet History Questionnaire II (C-DHQ II) and the Past Year Physical Activity Questionnaire (PAQ). Neighbourhood environment data were derived from dissemination area level Canadian Census data, and Geographical Information Systems (GIS) databases. Neighbourhood was defined as a 400 m network-based 'walkshed' around each participant's household. Using GIS we objectively-assessed the density, diversity, and presence of specific food destination types within the participant's walkshed. A seven variable socioeconomic deprivation index was derived from Canadian Census variables and estimated for each walkshed. The Canadian adapted Healthy Eating Index (C-HEI), used to assess diet quality was estimated from food intakes reported on C-DHQ II. Multivariable linear regression was used to test for associations between walkshed food environment variables, walkshed socioeconomic status, and diet quality (C-HEI), adjusting for individual level socio-demographic and health-related covariates. Interaction effects between walkshed socioeconomic status and walkshed food environment variables on diet quality (C-HEI) were also tested.
  
  
  
  After adjustment for covariates, food destination density was positively associated with the C-HEI (β 0.06, 95 % CI 0.01-0.12, p = 0.04) though the magnitude of the association was small. Walkshed socioeconomic status was not significantly associated with the C-HEI. We found no statistically significant interactions between walkshed food environment variables and socioeconomic status in relation to the C-HEI. Self-reported physical and mental health, time spent in neighbourhood, and dog ownership were also significantly (p < .05) associated with diet quality.
  
  
  
  Our findings suggest that larger density of local food destinations may is associated with better diet quality in adults.
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, North West Calgary, Alberta, T2N 4Z6, Canada. mcmciner@ucalgary.ca.
authors.forename: Maria
authors.initials: M
authors.lastname: McInerney
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, North West Calgary, Alberta, T2N 4Z6, Canada.|Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada.
authors.forename: Ilona
authors.initials: I
authors.lastname: Csizmadi
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, North West Calgary, Alberta, T2N 4Z6, Canada.|Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada.|Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Friedenreich
authors.affiliation: The Urban Lab, Faculty of Environmental Design, University of Calgary, PF 3201-2500 University Drive NW, Calgary, Alberta, T2N 1 N4, Canada.
authors.forename: Francisco Alaniz
authors.initials: FA
authors.lastname: Uribe
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, North West Calgary, Alberta, T2N 4Z6, Canada.|Department of Pediatrics, University of Calgary, Calgary, Canada.|Research Institute for Child and Maternal Health, Alberta Children's Hospital, Calgary, Canada.
authors.forename: Alberto
authors.initials: A
authors.lastname: Nettel-Aguirre
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, North West Calgary, Alberta, T2N 4Z6, Canada.
authors.forename: Lindsay
authors.initials: L
authors.lastname: McLaren
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, North West Calgary, Alberta, T2N 4Z6, Canada.|Alberta Cancer Prevention Legacy Fund, Alberta Health Services, Calgary, Canada.
authors.forename: Melissa
authors.initials: M
authors.lastname: Potestio
authors.affiliation: The Urban Lab, Faculty of Environmental Design, University of Calgary, PF 3201-2500 University Drive NW, Calgary, Alberta, T2N 1 N4, Canada.
authors.forename: Beverly
authors.initials: B
authors.lastname: Sandalack
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, North West Calgary, Alberta, T2N 4Z6, Canada.
authors.forename: Gavin R
authors.initials: GR
authors.lastname: McCormack
mesh_terms: D000328:Adult; D000416:Alberta; D000818:Animals; D002170:Canada; D019352:Censuses; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D004285:Dogs; D004777:Environment; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005502:Food / Q000706:statistics & numerical data*; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D008875:Middle Aged; D057805:Pets; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D057566:Self Report; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Built environment; Diet quality; Food environment; Neighbourhood; Socioeconomic status