(P24-070-23) Neighborhood Quality Is Associated With Dietary Pattern and Body Mass Index Among Children

Objectives: Extensive evidence indicates that healthy diets substantially reduce the risk of childhood obesity. For example, components of the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND), such as high fiber and low saturated fat, are linked to better cardiometabolic health and lower adiposity in children. Limited research has considered neighborhood quality in relation to diet and obesity risk. In this study, we examined whether the association between MIND dietary pattern adherence and children’s body mass index (BMI) varied based on neighborhood quality.

Methods: We conducted a cross-sectional analysis using data from the Adolescent Brain Cognitive Development study, a representative sample of 9- and 10-year-olds in the U.S. Neighborhood quality, linked to home address, was operationalized using the Child Opportunity Index (COI) 2.0, a composite measure of 29 different indicators spanning three domains: 1) education, 2) health/environment, 3) social/economic. COI was modeled as a 5-category variable from very low to very high. Diet scores were computed by summing parent responses to a modified 14-item FFQ capturing child adherence to a dietary pattern that resembled the MIND. The dependent variable was BMI z-score, modeled using objectively measured height and weight. Unadjusted and adjusted (race/ethnicity, nativity, gender, age, parent education, income) multivariate regression quantified associations between BMI and diet score. Next, we added an interaction term between diet score and COI to test whether the association between diet and weight varied across neighborhoods.

Results: In adjusted models, a 1-unit increase in diet score was associated with a 0.03-point lower mean BMI z-score (CI=-0.03, -0.01). The interaction term revealed that diet was not associated with BMI in lower-quality neighborhoods. However, in very high-quality areas, each 1-unit increase in diet score was associated with a 0.06-point lower BMI z-score (CI=0-.09, -0.02).

Conclusions: Our findings suggest that the benefits of a healthy diet on children’s obesity risk may vary by neighborhood context. Future research should identify the structural determinants of obesity that limit the effectiveness of behaviors on healthy weight maintenance, particularly in marginalized neighborhoods.

Funding Sources: None