Multiple pathways from the neighborhood food environment to increased body mass index through dietary behaviors: A structural equation-based analysis in the CARDIA study

Academic Article


  • Objectives: To examine longitudinal pathways from multiple types of neighborhood restaurants and food stores to BMI, through dietary behaviors. Methods: We used data from participants (n=5114) in the United States-based Coronary Artery Risk Development in Young Adults study and a structural equation model to estimate longitudinal (1985-86 to 2005-06) pathways simultaneously from neighborhood fast food restaurants, sit-down restaurants, supermarkets, and convenience stores to BMI through dietary behaviors, controlling for socioeconomic status (SES) and physical activity. Results: Higher numbers of neighborhood fast food restaurants and lower numbers of sit-down restaurants were associated with higher consumption of an obesogenic fast food-type diet. The pathways from food stores to BMI through diet were inconsistent in magnitude and statistical significance. Conclusions: Efforts to decrease the numbers of neighborhood fast food restaurants and to increase the numbers of sit-down restaurant options could influence diet behaviors. Availability of neighborhood fast food and sit-down restaurants may play comparatively stronger roles than food stores in shaping dietary behaviors and BMI.
  • Published In

  • Health and Place  Journal
  • Digital Object Identifier (doi)

    Author List

  • Richardson AS; Meyer KA; Howard AG; Boone-Heinonen J; Popkin BM; Evenson KR; Shikany JM; Lewis CE; Gordon-Larsen P
  • Start Page

  • 74
  • End Page

  • 87
  • Volume

  • 36