Kimberly B. Morland

Periconceptional vitamin use, dietary folate, and the occurrence of neural tube defects.

With a case-control study, we investigated whether periconceptional intake of supplemental or dietary folate reduced the risk of having a neural tube defect (NTD)-affected pregnancy. Mothers of 549 (88% of eligible) cases and 540 (88%) controls were interviewed in person about vitamin supplements used in either the 3 months before or the 3 months after conception and also about usual diet in the 3 months before conception. Women with any use of a folic acid-containing vitamin in the 3 months before conception had a lower risk of having an NTD-affected pregnancy [odds ratio (OR) = 0.65; 95% confidence interval (CI) = 0.45–0.94]. ORs were similar for 3 levels (< 0.4, 0.4–0.9, and >0.9 mg per day) of average daily intake of folic acid. Any level of use in the first 3 months after conception resulted in a lowered risk as well (OR = 0.60; 95% CI = 0.46–0.79). Reduced risks were less marked for Hispanics and were not observed among women who graduated from college. Modest reduced risks were noted among non-vitamin users whose estimated daily dietary intake of folate was more than 0.227 mg. We observed decreasing risk with increasing folate intake from combined dietary sources and vitamin supplements. A reduction in NTD risk associated with folate intake is consistent with other studies; however, the reduced risk may be particular to subsets of the population, primarily non-Hispanic women and women whose education does not exceed high school.

Obesity prevalence and the local food environment

Disparities in access to healthy foods have been identified particularly in the United States. Fewer studies have measured the effects these disparities have on diet-related health outcomes. This study measured the association between the presence of food establishments and obesity among 1295 adults living in the southern region of the United States. The prevalence of obesity was lower in areas that had supermarkets and higher in area with small grocery stores or fast food restaurants. Our findings are consistent with other studies showing that types of food stores and restaurants influence food choices and, subsequently, diet-related health outcomes.

Disparities in the availability of fruits and vegetables between racially segregated urban neighbourhoods.

OBJECTIVE Public health professionals continue to see the benefits of fruit and vegetable consumption on population health. While studies that evaluate the availability of produce are sparse in the medical literature, disparities in availability may explain the disproportional intake of produce for some people. Therefore, the purpose of this study was to evaluate the availability and variety of produce located in two racially and economically diverse urban neighbourhoods. DESIGN A cross-sectional study was conducted in which 50% of the supermarkets, small grocery stores, delicatessens, and fruit and vegetable markets located in specific neighbourhoods were randomly sampled and surveyed between September 2004 and July 2005. Food stores were evaluated for the availability of 20 types of fresh fruits and 19 types of fresh vegetables, as well as their varieties and whether they were canned, frozen or previously prepared. 2000 US Census information was used to determine characteristics of the geo-coded census tracts where the food stores were located. SETTING Brooklyn, New York. RESULTS A supermarket was located in approximately every third census tract in predominantly white areas (prevalence = 0.33) and every fourth census tract in racially mixed areas (prevalence = 0.27). There were no supermarkets located in the predominantly black areas. With the exception of bananas, potatoes, okra and yucca, a lower proportion of predominantly black area stores carried fresh produce, while supermarkets carried the largest variety of produce types. Canned and frozen fruits and vegetables were found in the majority of stores, whereas prepared and organic produce was limited to predominantly white area stores. CONCLUSIONS These data demonstrate that the availability and variety of fresh produce is associated with neighbourhood racial composition and may be a factor contributing to differences in intake among residents.

Race and food store availability in an inner-city neighbourhood

BACKGROUND A growing body of research has shown that disparities in resources, including food stores, exist at the neighbourhood level and the greatest disparities are seen in minority neighbourhoods, the same neighbourhoods at increased risk of obesity and diabetes. Less is known about whether differences in availability of resources by African American or Latino race/ethnicity exist within a single minority community. OBJECTIVE The present study examined whether census blocks either 75% African American (AA) or 75% Latino (L) are associated with food store availability, as compared with racially mixed (RM) census blocks, in East Harlem, New York. DESIGN/METHODS A cross-sectional study utilising a walking survey of East Harlem was performed. Food stores were classified into: supermarkets, grocery stores, convenience stores, specialty stores, full-service restaurants and fast-food stores. RESULTS One hundred and sixty-five East Harlem census blocks were examined; 17 were AA, 34 were L and 114 were RM. Of AA census blocks, 100% had neither supermarkets nor grocery stores. AA census blocks were less likely to have convenience stores (prevalence ratio (PR) = 0.25, 95% confidence interval (CI) 0.07-0.86) compared with RM census blocks. In contrast, predominantly L census blocks were more likely to have convenience stores (PR = 1.8, 95% CI 1.20-2.70), specialty food stores (PR = 3.74, 95% CI 2.06-7.15), full-service restaurants (PR = 1.87, 95% CI 1.04-3.38) and fast-food restaurants (PR = 2.14, 95% CI 1.33-3.44) compared with RM census blocks. CONCLUSIONS We found that inequities in food store availability exist by race/ethnicity in East Harlem, New York. This has implications for racial/ethnic differences in dietary quality, obesity and obesity-related disorders.

Air Pollution, Lung Function, and Physical Symptoms in Communities Near Concentrated Swine Feeding Operations

Background: Concentrated animal feeding operations emit air pollutants that may affect health. We examined associations of reported hog odor and of monitored air pollutants with physical symptoms and lung function in people living within 1.5 miles of hog operations. Methods: Between September 2003 and September 2005, we measured hydrogen sulfide (H2S), endotoxin, and particulate matter (PM10, PM2.5, and PM2.5–10) for approximately 2-week periods in each of 16 eastern North Carolina communities. During the same time periods, 101 adults sat outside their homes twice a day for 10 minutes, reported hog odor and physical symptoms, and measured their lung function. Conditional fixed-effects logistic and linear regression models were used to derive estimates of associations. Results: The log odds (±1 standard error) of acute eye irritation following 10 minutes outdoors increased by 0.53 (±0.06) for every unit increase in odor, by 0.15 (±0.06) per 1 ppb of H2S, and by 0.36 (±0.11) per 10 &mgr;g/m3 of PM10. Odor and H2S were also associated with irritation and respiratory symptoms in the previous 12 hours. The log odds of difficulty breathing increased by 0.50 (±0.15) per unit of odor. A 10 &mgr;g/m3 increase in mean 12-hour PM2.5 was associated with increased log odds of wheezing (0.84 ± 0.29) and declines in forced expiratory volume in 1 second (−0.04 ± 0.02 L). A 10 EU/mg increase in endotoxin was associated with increased log odds of sore throat (0.10 ± 0.05), chest tightness (0.09 ± 0.04), and nausea (0.10 ± 0.05). Conclusions: Pollutants measured near hog operations are related to acute physical symptoms in a longitudinal study using analyses that preclude confounding by time-invariant characteristics of individuals.

Body burdens of polybrominated diphenyl ethers among urban anglers

Polybrominated diphenyl ethers (PBDEs) have been widely used in the United States and worldwide as flame retardants. Recent PBDE production figures show that worldwide use has increased. To determine whether fish consumption is a source of PBDE exposure for humans, a cross-sectional epidemiologic study of New York and New Jersey urban anglers was conducted during the summers of 2001–2003. Frequency of local fish consumption was assessed by questionnaire, and blood samples for PBDE analysis were collected from 94 anglers fishing from piers on the lower Hudson River and Newark Bay. We analyzed PBDEs by gas chromatography–isotope dilution–high-resolution mass spectrometry. The congeners found in anglers’ serum at the highest concentrations were, by International Union of Pure and Applied Chemistry numbers, BDE-47, BDE-153, and BDE-99. Anglers reporting consumption of local fish had higher, but nonstatistically significantly different, concentrations of PBDEs than did anglers who did not eat local fish. For some congeners (BDE-100 and BDE-153), we observed moderate dose–response relationships between serum PBDE levels and frequency of reported fish intake. These findings suggest that consumption of locally caught fish is not a major route of human exposure for this study population.

Maternal occupational and hobby chemical exposures as risk factors for neural tube defects

In a case-control study, we investigated whether occupational and nonoccupational (hobbies) chemical exposures to women in the periconceptional period increased their risk for having neural tube defect-affected pregnancies. Women were asked about occupational tasks and hobbies performed during the 3

The utilization of local food environments by urban seniors

OBJECTIVE The objective of this study was to describe food shopping patterns for urban seniors and measure the influence of neighborhood and individual level factors on intake of fresh fruits and vegetables. METHOD Between September 2005 and August 2006, 314 Black, White and Latino participants from ten Brooklyn Senior Centers were interviewed about types of produce recently purchased, satisfaction with selection, cost and quality of produce, intake of produce, and location of food store used to purchase produce. RESULTS Individual level factors (race/ethnicity and age) were significantly associated with produce intake. Although environmental and distance factors did not reach statistical significance in multivariate models, living or shopping in a Black or racially mixed neighborhood was positively associated with the reported number of servings per day of fruits and vegetables. Also, a greater proportion of Blacks traveled more than a mile to do primary food shopping and most seniors do not shop within their residential census tract. Blacks and Latinos consumed less produce than Whites. CONCLUSION This study illuminates a number of important factors about the delivery of foods to urban seniors and how those seniors navigate their local environment to obtain healthy diets, measured here as intake of fruits and vegetables. The albeit small increase in servings per day associated with distance traveled to primary food stores does suggest that fruits and vegetables are not locally available and therefore presents an opportunity for policy makers and city planners to develop areas where healthy food options are convenient for consumers.

Disparities in Food Access: Inner-City Residents Describe their Local Food Environment

ABSTRACT Existing research emphasizes individual characteristics, such as psychosocial barriers and preferences, as the main barrier that low-income groups face when attempting to maintain a healthy diet. This study is one component of a partnership between a community and academics who are addressing limited food access in East New York, Brooklyn, by establishing a community-owned food store that provides affordable, nutritious groceries. Prior to the stores opening, focus groups were held with residents in order to understand their experiences related to obtaining food in East New York. These residents identified factors within the built environment that limit their ability to obtain healthy food options, including (1) poor quality of food, (2) higher cost of food, (3) few store options, (4) limited transportation, and (5) concerns about food marketing practices.

Brooklyn, New York foodscape 2007-2011: a five-year analysis of stability in food retail environments.

BackgroundFood retail studies have focused on the availability of food stores, and on disparities in food access by neighborhood race and income level. Previous research does not address possible changes in local food environments over time, because little is known about the extent to which food environments fluctuate.MethodsRecords of stores licensed to sell food with the New York State Department of Agriculture and Markets from 2007–2011 were compared to detect differences in the total number of food stores and supermarkets annually, as well as the total change for the five-year period. Food stores and supermarkets per 10,000 persons were also calculated. Food retail stability – how many individual food stores opened and closed – was also calculated for total stores and supermarkets. All results were stratified by income level and racial characteristics of 2000 Census Bureau census tracts.ResultsThere was an overall increase in all food stores, as well as in supermarkets specifically. However, stability – the proportion of stores that remained open for five years – was greater in higher-wealth and predominantly white areas. Supermarkets remained open in greater proportion than total stores in all racial/ethnic and income areas, but areas with the highest wealth had the greatest supermarket stability. Those areas also had slightly more supermarkets per 10,000 persons, and had no permanent closures of supermarkets. The proportion of new store locations was similar between areas, but lowest-income areas had the greatest proportion of new supermarket locations.ConclusionsThese data suggest that food retail environments change over short periods of time. Stability of food retail environments varies between neighborhoods by race and income. Fluctuations may need to be studied further to understand their impact on food behaviors and health of residents. Finally, the dynamic nature of food retail environments suggests opportunities for policymakers and community organizations to create programs that promote the availability of healthier foods at the neighborhood level.