The role of the neighbourhood food environment in obesity and dietary intake. Evidence from the South Asia Biobank
File(s)
Author(s)
Atanasova, Petya
Type
Thesis
Abstract
Background: More than 77% of all non-communicable diseases (NCDs) deaths occur in lowand middle-income countries (LMICs). Obesity and unhealthy diet are leading risk factors associated with NCDs. NCDs are caused by exposure to factors in our environment that are amendable to policy interventions, with interventions targeting food environments highlighted as potentially effective for population-wide improvements in diets and weight status. This thesis explores the influence of the availability and advertising mechanisms in the neighbourhood food environment on diet, obesity and their associated inequalities among different population groups (by income, sex, and urbanisation) in the context of LMICs. Methods: I used two datasets (surveillance and environmental mapping) from the South Asia Biobank, a cross-sectional study of adults in Bangladesh, India, Pakistan, and Sri Lanka. I geospatially linked individual-level data with neighbourhood food environment characteristics (number of food retailers and food products advertised) around participants' residential addresses. Global Human Settlement Layer data was utilised to define urbanisation. Using multivariate regression models, I studied associations between the neighbourhood food environment and obesity and diet. Decomposition models were used to evaluate whether differences in the neighbourhood food environment contribute to the urban-rural inequalities in obesity and diet. Findings: The availability of unhealthy food retailers and advertising of unhealthy food in the neighbourhood were significantly associated with unhealthy dietary patterns and higher likelihood of obesity, especially among females and low-income groups. The availability of healthy food retailers was associated with healthier diets and lower likelihood of obesity, especially among females and high-income groups...
Version
Open Access
Date Issued
2025-01-13
Date Awarded
2025-04-01
Copyright Statement
Attribution-NonCommercial 4.0 International Licence (CC BY-NC)
License URL
Advisor
Frost, Gary
Miraldo, Marisa
Sponsor
Economic and Social Research Council (Great Britain)
Grant Number
ES/P000703/1
Publisher Department
Department of Metabolism, Digestion and Reproduction
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)