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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Epidemiology
2015 ; 26
(3
): 344-52
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Does food vendor density mediate the association between neighborhood deprivation
and BMI?: a G-computation mediation analysis
#MMPMID25741628
Zhang YT
; Laraia BA
; Mujahid MS
; Tamayo A
; Blanchard SD
; Warton EM
; Kelly NM
; Moffet HH
; Schillinger D
; Adler N
; Karter AJ
Epidemiology
2015[May]; 26
(3
): 344-52
PMID25741628
show ga
BACKGROUND: In previous research, neighborhood deprivation was positively
associated with body mass index (BMI) among adults with diabetes. We assessed
whether the association between neighborhood deprivation and BMI is attributable,
in part, to geographic variation in the availability of healthful and unhealthful
food vendors. METHODS: Subjects were 16,634 participants of the Diabetes Study of
Northern California, a multiethnic cohort of adults living with diabetes.
Neighborhood deprivation and healthful (supermarket and produce) and unhealthful
(fast food outlets and convenience stores) food vendor kernel density were
calculated at each participant's residential block centroid. We estimated the
total effect, controlled direct effect, natural direct effect, and natural
indirect effect of neighborhood deprivation on BMI. Mediation effects were
estimated using G-computation, a maximum likelihood substitution estimator of the
G-formula that allows for complex data relations such as multiple mediators and
sequential causal pathways. RESULTS: We estimated that if neighborhood
deprivation was reduced from the most deprived to the least deprived quartile,
average BMI would change by -0.73 units (95% confidence interval: -1.05, -0.32);
however, we did not detect evidence of mediation by food vendor density. In
contrast to previous findings, a simulated reduction in neighborhood deprivation
from the most deprived to the least deprived quartile was associated with
dramatic declines in both healthful and unhealthful food vendor density.
CONCLUSIONS: Availability of food vendors, both healthful and unhealthful, did
not appear to explain the association between neighborhood deprivation and BMI in
this population of adults with diabetes.
|*Body Mass Index
[MESH]
|*Poverty Areas
[MESH]
|California/epidemiology
[MESH]
|Diabetes Mellitus, Type 2/etiology
[MESH]
|Fast Foods/adverse effects/statistics & numerical data
[MESH]
|Female
[MESH]
|Food Supply/economics/*statistics & numerical data
[MESH]