Journal article
Neighborhood price of healthier food relative to unhealthy food and its association with type 2 diabetes and insulin resistance: The multi-ethnic study of atherosclerosis
Preventive medicine, v 106, pp 122-129
Jan 2018
PMID: 29106915
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
This study examined the association between the price of healthier food relative to unhealthy food and type 2 diabetes prevalence, incidence and insulin resistance (IR). Data came from the Multi-Ethnic Study of Atherosclerosis exam 5 administered 2010–2012 (exam 4, five years prior, was used only for diabetes incidence) and supermarket food/beverage prices derived from Information Resources Inc. For each individual, average price of a selection of healthier foods, unhealthy foods and their ratio was computed for supermarkets within 3miles of the person's residential address. Diabetes status was confirmed at each exam and IR was assessed via the homeostasis model assessment index. Multivariable-adjusted logistic, modified Poisson and linear regression models were used to model diabetes prevalence, incidence and IR, respectively as a function of price and covariates; 2353 to 3408 participants were included in analyses (depending on the outcome). A higher ratio of healthy-to-unhealthy neighborhood food price was associated with greater IR (4.8% higher HOMA-IR score for each standard deviation higher price ratio [95% CI -0.2% to 10.1%]) after adjusting for region, age, gender, race/ethnicity, family history of diabetes, income/wealth index, education, smoking status, physical activity, and neighborhood socioeconomic status. No association with diabetes incidence (relative risk=1.11, 95% CI 0.85 to 1.44) or prevalence (odds ratio=0.95, 95% CI 0.81 to 1.11) was observed. Higher neighborhood prices of healthier food relative to unhealthy food were positively associated with IR, but not with either diabetes outcome. This study provides new insight into the relationship between food prices with IR and diabetes.
•A large multi-ethnic cohort was linked to food prices at nearby stores.•Healthy food cost relative to unhealthy food was associated with insulin resistance.•No food price association was found with diabetes incidence or prevalence.
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Details
- Title
- Neighborhood price of healthier food relative to unhealthy food and its association with type 2 diabetes and insulin resistance: The multi-ethnic study of atherosclerosis
- Creators
- David M Kern - Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, United StatesAmy H Auchincloss - Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, United StatesMark F Stehr - School of Economics, LeBow College of Business, Drexel University, United StatesAna V Diez Roux - Urban Health Collaborative, and Office of Dean, Dornsife School of Public Health, Drexel University, United StatesKari A Moore - Urban Health Collaborative, Dornsife School of Public Health, Drexel University, United StatesGenevieve P Kanter - Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, United StatesLucy F Robinson - Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, United States
- Publication Details
- Preventive medicine, v 106, pp 122-129
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Economics (School of Economics); Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:000425435700017
- Scopus ID
- 2-s2.0-85036663203
- Other Identifier
- 991014878192404721
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- Web of Science research areas
- Public, Environmental & Occupational Health