Neighborhood availability of convenience stores and diet quality: findings from 20 years of follow-up in the coronary artery risk development in young adults study

Abstract

Objectives: We examined the association between neighborhood convenience stores and diet outcomes for 20 years of the Coronary Artery Risk Development in Young Adults study.

Methods: We used dietary data from the Coronary Artery Risk Development in Young Adults study years 1985-1986, 1992-1993, and 2005-2006 (n = 3299; Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA) and geographically and temporally matched neighborhood-level food resource and US Census data. We used random effects repeated measures regression to estimate associations between availability of neighborhood convenience stores with diet outcomes and whether these associations differed by individual-level income.

Results: In multivariable-adjusted analyses, greater availability of neighborhood convenience stores was associated with lower diet quality (mean score = 66.3; SD = 13.0) for participants with lower individual-level income (b = -2.40; 95% CI = -3.30, -1.51); associations at higher individual-level income were weaker. We observed similar associations with whole grain consumption across time but no statistically significant associations with consumption of sugar-sweetened beverages, artificially sweetened beverages, snacks, processed meats, fruits, or vegetables.

Conclusions: The presence of neighborhood convenience stores may be associated with lower quality diets. Low-income individuals may be most sensitive to convenience store availability.

FIGURE 1—

Multivariable-adjusted model of differences in association between a priori diet quality score and percentage of convenience stores relative to total neighborhood food stores and restaurants by individual-level income, years 0–20: Coronary Artery Risk Development in Young Adults (CARDIA) study; Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA; 1985–2006. Note. Asterisk indicates that the a priori diet quality score is statistically significantly different from referent score (≤ 10% convenience stores relative to total food outlets). Adjusted for individual-level age, gender, race (Black, White), maximum educational attainment (completed elementary school, ≤ 3 years high school, 4 years high school, ≤ 3 years college, or ≥ 4 years college); community-level population density (population/km²), cost of living (relative to a standard of 1 from years 1982–1984), total food stores and restaurants (≤ 10, 11–99, ≥ 100 counts), neighborhood deprivation score (derived using principle components analysis of 4 tract-level variables: (1) percentage of tract education < high school at aged 25 years; (2) education ≥ college at aged 25 years; (3) median household income; and (4) percentage of people with household incomes < 150% of federal poverty level according to the Department of Health and Human Services), and time. All values are derived from repeated measures random effects linear regression model of percentage of convenience stores relative to total food resources (in a 3-km network buffer) on a priori diet quality score and the interaction with maximum income (continuous) reported during the study ($/y). There were 3922 participants with no implausible or missing dietary, income, or education data at CARDIA examination years 0, 7, and 20. Mean (SD) of a priori diet quality score = 66.3 (13.0).