Research DayAvailability of Healthy Foods and its Associations with Dietary Patterns and Body Mass Index: The MESA Study in Baltimore
Manuel Franco, MD, PhD; Ana Diez-Roux, MD, PhD; Frederick Brancati, MD; Thomas Glass, PhD; Benjamin Caballero, MD, PhD Powerpoint Slides We investigated the association between the availability of healthy foods, diet quality and body mass index (BMI). A cross-sectional study of 759 participants at the Baltimore site of the Multi-Ethnic Study of Atherosclerosis (MESA) was conducted. A Healthy Food Availability Index (HFAI) was measured for each participant based on the availability of healthy foods in all food stores within the participant’s neighborhood of residence. To assess diet quality, two dietary patterns were used, reflecting low- and high-diet quality. BMI was directly measured. We found that residents of neighborhoods with low food availability tend to eat lower quality diets and consequently had a higher body weight. After adjustment for age, sex, income and education, adults living in neighborhoods with low availability of healthy foods scored higher on the low-quality dietary pattern (P = 0.04) compared to adults in neighborhoods with high availability of healthy food. Large race/ethnicity disparities were observed: 24 percent of black participants lived in neighborhoods with low healthy-food-availability, compared to 5 percent % of white participants (P <0.0001). Compared to white participants, black participants scored lower on the high-quality dietary pattern (P <0.0001) and higher on the low-quality dietary pattern (P <0.0001). Adjusted for age, sex, income, education, physical activity and caloric intake, mean differences of BMI comparing low- to high-availability measures (SE) were: 1.75 kg/m2 (0.62) for neighborhood availability, 1.24 kg/m2 (0.50) for closest store availability and 1.08 kg/m2 (0.53) for all stores within 1 mile, (p values < 0.005) Improvements in the distribution of locally produced fruits and vegetables may result in higher availability of healthy foods in Baltimore neighborhoods. Such sustainable food store improvements will encourage individual behavior change in Baltimore residents towards higher quality diets and weight gain prevention. Manuel Franco studied medicine in Spain and Germany. He received a Fulbright Scholar Award to study at Hopkins where he completed his PhD. In 2005 he received the CLF Innovation Award for his thesis project: Food Availability and Cardiovascular Risk in Baltimore. His current project, which received a CLF Directed Research Award, is on food environment in Baltimore and is a collaboration with the Baltimore City Health Department. | 
