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      Neighborhood food environment and mortality among older Japanese adults: results from the JAGES cohort study

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          Abstract

          Background

          Previous research has linked lower availability of food stores selling fruits and vegetables to unhealthy diet. However, the longitudinal association between the availability of healthy food stores and mortality is unknown. This study examined the association between neighborhood availability of food stores and mortality by driving status among older adults.

          Methods

          This study drew upon a three-year follow up of participants in the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese adults aged 65 years or older. Mortality from 2010 to 2013 was analyzed for 49,511 respondents. Neighborhood availability of food stores was defined as the number of food stores selling fruits and vegetables within a 500-m or 1-km radius of a person’s residence. Both subjective (participant-reported) and objective (geographic information system-based) measurements were used to assess this variable. Cox regression models were used to estimate hazard ratios (HR) for mortality.

          Results

          A total of 2049 deaths occurred during the follow up. Lower subjective availability of food stores was significantly associated with increased mortality. Compared with participants reporting the highest availability, the age- and sex-adjusted HR for those reporting the lowest availability was 1.28 (95% CI: 1.04–1.58; p = 0.02). The association remained significant after adjustment for sociodemographic (education, income, cohabitation, marital status, and employment status) and environmental (driving status, use of public transportation, and study site) status (HR = 1.24, 95% CI: 1.01–1.53, p = 0.04). This association was stronger among non-car users, among whom the HR for those reporting the lowest availability of food stores was 1.61 (95% CI: 1.08–2.41, p = 0.02). In contrast, no significant association was seen between objective availability and mortality.

          Conclusions

          Lower availability of healthy food stores measured subjectively, but not objectively, was associated with mortality, especially among non-car users. Considering the decline in mobility with age, living in a neighborhood with many options for procuring fruits and vegetables within walking distance may be important for healthy aging.

          Electronic supplementary material

          The online version of this article (10.1186/s12966-018-0732-y) contains supplementary material, which is available to authorized users.

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          Most cited references18

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          Measuring the food environment using geographical information systems: a methodological review.

          Through a literature review, we investigated the geographic information systems (GIS) methods used to define the food environment and the types of spatial measurements they generate. Review study. Searches were conducted in health science databases, including Medline/Pubmed, PsycINFO, Francis and GeoBase. We included studies using GIS-based measures of the food environment published up to 1 June 2008. Twenty-nine papers were included. Two different spatial approaches were identified. The density approach quantifies the availability of food outlets using the buffer method, kernel density estimation or spatial clustering. The proximity approach assesses the distance to food outlets by measuring distances or travel times. GIS network analysis tools enable the modelling of travel time between referent addresses (home) and food outlets for a given transportation network and mode, and the assumption of travel routing behaviours. Numerous studies combined both approaches to compare food outlet spatial accessibility between different types of neighbourhoods or to investigate relationships between characteristics of the food environment and individual food behaviour. GIS methods provide new approaches for assessing the food environment by modelling spatial accessibility to food outlets. On the basis of the available literature, it appears that only some GIS methods have been used, while other GIS methods combining availability and proximity, such as spatial interaction models, have not yet been applied to this field. Future research would also benefit from a combination of GIS methods with survey approaches to describe both spatial and social food outlet accessibility as important determinants of individual food behaviours.
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            Mobility and aging: new directions for public health action.

            Optimal mobility, defined as relative ease and freedom of movement in all of its forms, is central to healthy aging. Mobility is a significant consideration for research, practice, and policy in aging and public health. We examined the public health burdens of mobility disability, with a particular focus on leading public health interventions to enhance walking and driving, and the challenges and opportunities for public health action. We propose an integrated mobility agenda, which draws on the lived experience of older adults. New strategies for research, practice, and policy are needed to move beyond categorical promotion programs in walking and driving to establish a comprehensive program to enhance safe mobility in all its forms.
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              Neighborhood resources for physical activity and healthy foods and incidence of type 2 diabetes mellitus: the Multi-Ethnic study of Atherosclerosis.

              Despite increasing interest in the extent to which features of residential environments contribute to incidence of type 2 diabetes mellitus, no multisite prospective studies have investigated this question. We hypothesized that neighborhood resources supporting physical activity and healthy diets are associated with a lower incidence of type 2 diabetes. Person-level data came from 3 sites of the Multi-Ethnic Study of Atherosclerosis, a population-based, prospective study of adults aged 45 to 84 years at baseline. Neighborhood data were derived from a population-based residential survey. Type 2 diabetes was defined as a fasting glucose level of 126 mg/dL or higher (> or =7 mmol/L) or taking insulin or oral hypoglycemic agents. We estimated the hazard ratio of type 2 diabetes incidence associated with neighborhood (US Census tract) resources. Among 2285 participants, 233 new type 2 diabetes cases occurred during a median of 5 follow-up years. Better neighborhood resources, determined by a combined score for physical activity and healthy foods, were associated with a 38% lower incidence of type 2 diabetes (hazard ratio corresponding to a difference between the 90th and 10th percentiles for resource distribution, 0.62; 95% confidence interval, 0.43-0.88 adjusted for age, sex, family history of diabetes, race/ethnicity, income, assets, educational level, alcohol use, and smoking status). The association remained statistically significant after further adjustment for individual dietary factors, physical activity level, and body mass index. Better neighborhood resources were associated with lower incidence of type 2 diabetes, which suggests that improving environmental features may be a viable population-level strategy for addressing this disease.
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                Author and article information

                Contributors
                +81-3-5803-5187 , tani.hlth@tmd.ac.jp
                suzu-nori@chiba-u.jp
                fujihlth@tmd.ac.jp
                hanazato@chiba-u.jp
                naoki-kondo@umin.ac.jp
                y.miyaguni@ncgg.go.jp
                kkondo@chiba-u.jp
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                19 October 2018
                19 October 2018
                2018
                : 15
                : 101
                Affiliations
                [1 ]ISNI 0000 0001 1014 9130, GRID grid.265073.5, Department of Global Health Promotion, , Tokyo Medical and Dental University, ; 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
                [2 ]ISNI 0000 0004 0614 710X, GRID grid.54432.34, Japan Society for the Promotion of Science, ; 5-3-1, Kojimachi, Chiyoda-ku, Tokyo, 102-0083 Japan
                [3 ]ISNI 0000 0004 0370 1101, GRID grid.136304.3, Center for Preventive Medical Sciences, , Chiba University, ; 1-33 Yayoicho, Inage-ku, Chiba-shi, Chiba, 263-8522 Japan
                [4 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Department of Health Education and Health Sociology, School of Public Health, , The University of Tokyo, ; 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
                [5 ]ISNI 0000 0004 1791 9005, GRID grid.419257.c, Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, ; 7-430 Morikoka-cho, Obu-shi, Aichi 474-8511 Japan
                [6 ]ISNI 0000 0004 0370 1101, GRID grid.136304.3, Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, , Chiba University, ; 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8672 Japan
                Author information
                http://orcid.org/0000-0001-5533-2844
                Article
                732
                10.1186/s12966-018-0732-y
                6194719
                30340494
                759f422f-b3d0-4aeb-81cd-7417a94b5591
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 February 2018
                : 9 October 2018
                Funding
                Funded by: Ministry of Education, Culture, Sports, Science and Technology, Japan
                Funded by: FundRef http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: 16K16295 and 16J11423
                Award ID: 22330172, 22390400, 23243070, 23590786, 23790710, 24390469, 24530698, 24683018, 25253052, 25870573, 25870881, 26285138, 26882010, 15H01972
                Award Recipient :
                Funded by: a Lotte Research Promotion Grant
                Funded by: Health Labour Sciences Research Grants
                Award ID: Numbers H22-Choju-Shitei-008, H24-Junkanki[Seishu]-Ippan-007, H24-Chikyukibo-Ippan-009, H24-Choju-Wakate-009, H25-Kenki-Wakate-015, H25-Choju-Ippan-003, H26-Irryo-Shitei-003[Fukkou], H26-Choju-Ippan-006, H27-Ninchisyou-Ippan-001, H28-Choju-Ippan-002
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100009619, Japan Agency for Medical Research and Development;
                Funded by: Research Funding for Longevity Sciences from the National Center for Geriatrics and Gerontology
                Award ID: 24-17 and 24-23
                Funded by: the Japan Foundation for Aging and Health
                Funded by: World Health Organization Centre for Health Development
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Nutrition & Dietetics
                food environment,food store availability,mortality,older adults,japan
                Nutrition & Dietetics
                food environment, food store availability, mortality, older adults, japan

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