Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities

Introduction: In low-middle income countries (LMICs) the role of food environments on obesity has been understudied. We address this gap by 1) examining the effect of food environments on adults’ body size (BMI, waist circumference) and obesity; 2) measuring the heterogeneity of such effects by inco...

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Main Authors: Atanasova, Petya, Kusuma, Dian, Pineda, Elisa, Anjana, Ranjit Mohan, De Silva, Laksara, Hanif, Abu A. M., Hasan, Mehedi, Hossain, Md Mokbul, Indrawansa, Susantha, Jayamanne, Deepal, Jha, Sujeet, Kasturiratne, Anuradhani, Katulanda, Prasad, Khawaja, Khadija I., Kumarendran, Balachandran, Mrida, Malay K., Rajakaruna, Vindya, Chambers, John Campbell, Frost, Gary, Sassi, Franco, Miraldo, Marisa
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2023
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Online Access:https://hdl.handle.net/10356/164384
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spelling sg-ntu-dr.10356-1643842023-03-05T16:54:03Z Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities Atanasova, Petya Kusuma, Dian Pineda, Elisa Anjana, Ranjit Mohan De Silva, Laksara Hanif, Abu A. M. Hasan, Mehedi Hossain, Md Mokbul Indrawansa, Susantha Jayamanne, Deepal Jha, Sujeet Kasturiratne, Anuradhani Katulanda, Prasad Khawaja, Khadija I. Kumarendran, Balachandran Mrida, Malay K. Rajakaruna, Vindya Chambers, John Campbell Frost, Gary Sassi, Franco Miraldo, Marisa Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Food Environment Obesity Introduction: In low-middle income countries (LMICs) the role of food environments on obesity has been understudied. We address this gap by 1) examining the effect of food environments on adults’ body size (BMI, waist circumference) and obesity; 2) measuring the heterogeneity of such effects by income and sex. Methods: This cross-sectional study analysed South Asia Biobank surveillance and environment mapping data for 12,167 adults collected between 2018 and 2020 from 33 surveillance sites in Bangladesh and Sri Lanka. Individual-level data (demographic, socio-economic, and health characteristics) were combined with exposure to healthy and unhealthy food environments measured with geolocations of food outlets (obtained through ground-truth surveys) within 300 m buffer zones around participants' homes. Multivariate regression models were used to assess association of exposure to healthy and unhealthy food environments on waist circumference, BMI, and probability of obesity for the total sample and stratified by sex and income. Findings: The presence of a higher share of supermarkets in the neighbourhood was associated with a reduction in body size (BMI, β = - 3∙23; p < 0∙0001, and waist circumference, β = −5∙99; p = 0∙0212) and obesity (Average Marginal Effect (AME): −0∙18; p = 0∙0009). High share of fast-food restaurants in the neighbourhood was not significantly associated with body size, but it significantly increased the probability of obesity measured by BMI (AME: 0∙09; p = 0∙0234) and waist circumference (AME: 0∙21; p = 0∙0021). These effects were stronger among females and low-income individuals. Interpretation: The results suggest the availability of fast-food outlets influences obesity, especially among female and lower-income groups. The availability of supermarkets is associated with reduced body size and obesity, but their effects do not outweigh the role of fast-food outlets. Policies should target food environments to promote better diets and reduce obesity. Published version This research was funded by the National Institute for Health Research (NIHR) (16/136/68) using UK aid from the UK Government to support global health research. 2023-01-18T06:46:20Z 2023-01-18T06:46:20Z 2022 Journal Article Atanasova, P., Kusuma, D., Pineda, E., Anjana, R. M., De Silva, L., Hanif, A. A. M., Hasan, M., Hossain, M. M., Indrawansa, S., Jayamanne, D., Jha, S., Kasturiratne, A., Katulanda, P., Khawaja, K. I., Kumarendran, B., Mrida, M. K., Rajakaruna, V., Chambers, J. C., Frost, G., ...Miraldo, M. (2022). Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities. SSM - Population Health, 17, 101055-. https://dx.doi.org/10.1016/j.ssmph.2022.101055 2352-8273 https://hdl.handle.net/10356/164384 10.1016/j.ssmph.2022.101055 35252534 2-s2.0-85125493195 17 101055 en SSM - Population Health © 2022 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Science::Medicine
Food Environment
Obesity
spellingShingle Science::Medicine
Food Environment
Obesity
Atanasova, Petya
Kusuma, Dian
Pineda, Elisa
Anjana, Ranjit Mohan
De Silva, Laksara
Hanif, Abu A. M.
Hasan, Mehedi
Hossain, Md Mokbul
Indrawansa, Susantha
Jayamanne, Deepal
Jha, Sujeet
Kasturiratne, Anuradhani
Katulanda, Prasad
Khawaja, Khadija I.
Kumarendran, Balachandran
Mrida, Malay K.
Rajakaruna, Vindya
Chambers, John Campbell
Frost, Gary
Sassi, Franco
Miraldo, Marisa
Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities
description Introduction: In low-middle income countries (LMICs) the role of food environments on obesity has been understudied. We address this gap by 1) examining the effect of food environments on adults’ body size (BMI, waist circumference) and obesity; 2) measuring the heterogeneity of such effects by income and sex. Methods: This cross-sectional study analysed South Asia Biobank surveillance and environment mapping data for 12,167 adults collected between 2018 and 2020 from 33 surveillance sites in Bangladesh and Sri Lanka. Individual-level data (demographic, socio-economic, and health characteristics) were combined with exposure to healthy and unhealthy food environments measured with geolocations of food outlets (obtained through ground-truth surveys) within 300 m buffer zones around participants' homes. Multivariate regression models were used to assess association of exposure to healthy and unhealthy food environments on waist circumference, BMI, and probability of obesity for the total sample and stratified by sex and income. Findings: The presence of a higher share of supermarkets in the neighbourhood was associated with a reduction in body size (BMI, β = - 3∙23; p < 0∙0001, and waist circumference, β = −5∙99; p = 0∙0212) and obesity (Average Marginal Effect (AME): −0∙18; p = 0∙0009). High share of fast-food restaurants in the neighbourhood was not significantly associated with body size, but it significantly increased the probability of obesity measured by BMI (AME: 0∙09; p = 0∙0234) and waist circumference (AME: 0∙21; p = 0∙0021). These effects were stronger among females and low-income individuals. Interpretation: The results suggest the availability of fast-food outlets influences obesity, especially among female and lower-income groups. The availability of supermarkets is associated with reduced body size and obesity, but their effects do not outweigh the role of fast-food outlets. Policies should target food environments to promote better diets and reduce obesity.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Atanasova, Petya
Kusuma, Dian
Pineda, Elisa
Anjana, Ranjit Mohan
De Silva, Laksara
Hanif, Abu A. M.
Hasan, Mehedi
Hossain, Md Mokbul
Indrawansa, Susantha
Jayamanne, Deepal
Jha, Sujeet
Kasturiratne, Anuradhani
Katulanda, Prasad
Khawaja, Khadija I.
Kumarendran, Balachandran
Mrida, Malay K.
Rajakaruna, Vindya
Chambers, John Campbell
Frost, Gary
Sassi, Franco
Miraldo, Marisa
format Article
author Atanasova, Petya
Kusuma, Dian
Pineda, Elisa
Anjana, Ranjit Mohan
De Silva, Laksara
Hanif, Abu A. M.
Hasan, Mehedi
Hossain, Md Mokbul
Indrawansa, Susantha
Jayamanne, Deepal
Jha, Sujeet
Kasturiratne, Anuradhani
Katulanda, Prasad
Khawaja, Khadija I.
Kumarendran, Balachandran
Mrida, Malay K.
Rajakaruna, Vindya
Chambers, John Campbell
Frost, Gary
Sassi, Franco
Miraldo, Marisa
author_sort Atanasova, Petya
title Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities
title_short Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities
title_full Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities
title_fullStr Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities
title_full_unstemmed Food environments and obesity: a geospatial analysis of the South Asia Biobank, income and sex inequalities
title_sort food environments and obesity: a geospatial analysis of the south asia biobank, income and sex inequalities
publishDate 2023
url https://hdl.handle.net/10356/164384
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