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      Diabetes and Obesity Associated with Poor Food Environments in American Indian Communities: the Tribal Health and Resilience in Vulnerable Environments (THRIVE) Study

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          ABSTRACT

          Background

          American Indians (AIs) have significantly higher rates of diet-related chronic diseases than other racial/ethnic groups, and many live in environments with limited access to healthy food.

          Objective

          As part of the Tribal Resilience in Vulnerable Environments (THRIVE) study, we examined the relations between the perceived food environment, utilization of food retailers, fruit and vegetable intake, and chronic diseases, including obesity, hypertension, and type 2 diabetes among AI adults.

          Methods

          Through a community-based participatory research partnership, we surveyed a cross-sectional sample of 513 AIs living within the Chickasaw Nation and the Choctaw Nation of Oklahoma.

          Results

          Only 57% of participants reported that it was easy to purchase fruits and vegetables in their town, and fewer (35%) reported that available fruits and vegetables were of high quality. Additionally, over half (56%) reported traveling ≥20 miles round trip to shop for food. Few participants met the recommended daily intake for fruit (44%) or vegetables (25%). Obesity (55%), hypertension (49%), and diabetes (25%) were commonly reported. Obesity was significantly higher among participants who reported that the price of fruits and vegetables were cost-prohibitive (prevalence proportion ratio (PPR): 1.24; 95% CI: 1.02, 1.50) and those who shopped frequently for food at nontraditional food retailers, such as Dollar Stores (PPR: 1.35; 95% CI: 1.08, 1.69) and small markets (PPR: 1.38; 95% CI: 1.02, 1.86). Diabetes was significantly higher among participants who frequently shopped at convenience stores/gas stations (PPR: 2.26; 95% CI: 1.22, 4.19).

          Conclusions

          Our study found that the use of nontraditional food retailers, including convenience stores, gas stations, and Dollar Stores, as a regular source of food was associated with obesity and diabetes. These results underscore the importance of interventions to improve rural Tribal food environments. Healthy retail interventions in nontraditional retail settings, such as those implemented through the THRIVE study, may contribute to reducing AI health disparities.

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          Food store types, availability, and cost of foods in a rural environment.

          Andrew Lawson, Brenda K. Weis, Delores Pluto … (2007)
          To characterize the built nutritional environment in terms of types and number of food stores, availability, and cost of selected food items in a rural area. A cross-sectional survey of food stores conducted in 2004. We selected a rural county (population 91,582; 1,106 square miles). Food stores identified from a database were mapped and presence, location, and store type verified by ground-truthing. Stores were surveyed for availability and cost of selected foods. Price and availability of a limited number of staple foods representing the main food groups. Availability comparisons used least square means models and price comparisons used t tests. Of 77 stores identified, 16% were supermarkets, 10% grocery stores, and 74% convenience stores. There were seven stores per 100 square miles and eight stores per 10,000 residents. Availability of more healthful foods was substantially higher at supermarkets and grocery stores. For instance, low-fat/nonfat milk, apples, high-fiber bread, eggs, and smoked turkey were available in 75% to 100% of supermarkets and groceries and at 4% to 29% of convenience stores. Foods that were available at both supermarkets and convenience stores tended to be substantially more expensive at convenience stores. The healthful version of a food was typically more expensive than the less healthful version. In this rural environment, stores offering more healthful and lower-cost food selections were outnumbered by convenience stores offering lower availability of more healthful foods. Our findings underscore the challenges of shopping for healthful and inexpensive foods in rural areas.
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            Validity of diabetes self-reports in the Women's Health Initiative: comparison with medication inventories and fasting glucose measurements.

            Lesley Tinker, Camenzind G Robinson, Lihong Qi … (2007)
            Although diabetes is conveniently assessed by self-report, few validation studies have been performed. Therefore, we studied whether self-report of prevalent and incident diabetes in Women's Health Initiative (WHI) participants was concordant with other diagnostic evidence of diabetes. A total of 161 808 postmenopausal women aged 50-79 were enrolled at 40 clinical centers in the U.S. in 1993-1998 and followed prospectively. At baseline, prevalent medication treated diabetes was defined as a self-report of physician diagnosis and treatment with insulin or oral antidiabetic drugs. During followup, incident treated diabetes was defined as a self-report of a new physician diagnosis of diabetes treated with insulin or oral drugs. Diabetes self-reports were compared with medication inventories and fasting glucose levels at baseline and during follow-up. At baseline, self-reported treated diabetes was concordant with the medication inventory in 79% of clinical trial, and 77% of observational study participants. Self-reported incident treated diabetes was concordant with the medication inventory in 78% between baseline and Year 1 in the clinical trials, in 62% between Year 1 and Year 3 in the clinical trials, and in 72% between baseline and Year 3 in the observational study. Over similar periods, 99.9% of those who did not report treated diabetes had no oral antidiabetic drugs or insulin in the medication inventory. At baseline, about 3% not reporting diabetes had fasting glucose >126 mg/dl, and 88% of these subjects subsequently reported treated diabetes during 6.9 years of follow-up. Incident self-reported diabetes treated by lifestyle alone was not determined in WHI. Medication inventories may have been incomplete and fasting glucose may have been lowered by treatment; therefore, concordance with self-reported treatment or fasting glucose > or = 126 may have been underestimated. In the WHI, self-reported prevalent and incident diabetes was consistent with medication inventories, and a high proportion of those with undiagnosed diabetes subsequently reported diabetes treatment. Self-reports of ;treated diabetes' are sufficiently accurate to allow use in epidemiologic studies.
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              Supersizing supercenters? The impact of Walmart Supercenters on body mass index and obesity

              Charles Courtemanche, Art Carden (2011)
              Article 0 comments Cited 44 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Charlotte V Love
                Journal
                Journal ID (nlm-ta): Curr Dev Nutr
                Journal ID (iso-abbrev): Curr Dev Nutr
                Journal ID (publisher-id): cdn
                Title: Current Developments in Nutrition
                Publisher: Oxford University Press
                ISSN (Electronic): 2475-2991
                Publication date Collection: August 2019
                Publication date (Electronic): 05 December 2018
                Publication date PMC-release: 05 December 2018
                Volume: 3
                Issue: Suppl 2
                Pages: 63-68
                Affiliations
                [1 ]Center for Indigenous Health Research and Action, University of Oklahoma-Tulsa, Tulsa, OK
                [2 ]Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, OK
                [3 ]Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA
                [4 ]Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, OK
                [5 ]Choctaw Nation of Oklahoma Health Services Authority, McAlester, OK
                [6 ]Chickasaw Nation Nutrition Services Department, Ada, OK
                Author notes
                Address correspondence to CVL (e-mail: charlie.love@ 123456okstate.edu ).
                Author information
                http://orcid.org/0000-0002-5937-4686
                http://orcid.org/0000-0003-4559-2444
                http://orcid.org/0000-0002-3965-8518
                Article
                Publisher ID: nzy099
                DOI: 10.1093/cdn/nzy099
                PMC ID: 6700455
                PubMed ID: 31453429
                SO-VID: c77bf4ae-1345-4b64-b96d-38f67cb3d848
                Copyright © Copyright © American Society for Nutrition 2018.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com .

                History
                Date received : 03 July 2018
                Date revision received : 19 September 2018
                Date accepted : 03 December 2018
                Page count
                Pages: 6
                Funding
                Funded by: National Heart, Lung, and Blood Institute 10.13039/100000050
                Award ID: HL117729
                Categories
                Subject: Supplements & Symposia
                Subject: Proceedings of the First and Second Annual Conferences on Native American Nutrition

                Keywords: american indians,native americans,food access,perceived food environment,community-based participatory research,obesity,diabetes
                Data availability:
                Keywords: american indians, native americans, food access, perceived food environment, community-based participatory research, obesity, diabetes

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