Direct effects of the home, school, and consumerfood environments on the association between food purchasing patterns and dietary intake among rural adolescents in Kentucky and North Carolina, 2017

Alison Gustafson, Stephanie Jilcott Pitts, Jordan McDonald, Hannah Ford, Paige Connelly, Rachel Gillespie, Emily Liu, Heather Bush, Candace Brancato, Toyin Babatande, Janet Mullins

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Background: Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake among rural adolescents. Methods: A baseline survey was conducted among adolescents in eight rural high schools (four in Eastern Kentucky, and four in Eastern North Carolina). Participants answered questions about food purchasing patterns, dietary intake, home food availability, and demographics. The school and consumer food environments were assessed using validated measures from the School Meals Cost Study (United States Department of Agriculture-Mathematica) and the Nutrition Environment Measurement Survey for Stores, Restaurants, and Corner Stores. Results: Of 432 adolescents, 55% were normal weight, 24% were overweight, and 21% were obese. There was a direct association between unhealthy food purchasing patterns (shopping frequently at gas stations, fast food, and dollar stores) and consuming more added sugars, when compared to those with a healthy shopping pattern (shopping less frequently at gas stations, fast food, and dollar stores) [Odds Ratio = 2.41 (95% CI (confidence interval) 0.99, 3.82)]. Those who reported always having fruits and vegetables in the home consumed more servings of fruits and vegetables [OR = 0.31 cups (95% CI 0.22, 0.44)] compared to those who reported never having fruits and vegetables in the home. Adolescents attending a school with a low healthy food availability score consumed fewer servings of fruits and vegetables [−0.001 (95% CI −0.001, 0.0001)] compared to those attending a school with a high healthy food availability score. Conclusions: There are direct associations between food purchasing patterns, the home and school food environments, and dietary intake among rural adolescents. These cross-sectional results informed the development of the “Go Big and Bring it Home” program, a text messaging intervention to improve adolescents’ fruit, vegetable, and healthy beverage intake.

Original languageEnglish
Article number1255
JournalInternational Journal of Environmental Research and Public Health
Volume14
Issue number10
DOIs
StatePublished - Oct 21 2017

Bibliographical note

Publisher Copyright:
© 2017 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Acknowledgments: The study authors would like to acknowledge the dedication of the high school staff, cooperative extension agents, and principals, teachers, and graduate students who assisted with data collection and recruitment. Funding for this study was provided by the United States Department of Agriculture (USDA) Agriculture and Food Research Initiative, grant 30000045856.

FundersFunder number
U.S. Department of Agriculture30000045856
U.S. Department of Agriculture

    Keywords

    • Adolescent obesity
    • Consumer food environment
    • Home food availability
    • Nutrition
    • School food environment

    ASJC Scopus subject areas

    • Pollution
    • Public Health, Environmental and Occupational Health
    • Health, Toxicology and Mutagenesis

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