Combined measure of neighborhood food and physical activity environments and weight-related outcomes: The CARDIA study.

Engagement in healthy lifestyle behaviors likely reflects access to a diverse and synergistic set of food and physical activity resources, yet most research examines discrete characteristics. We characterized neighborhoods with respect to their composition of features, and quantified associations with diet, physical activity (PA), body mass index (BMI), and insulin resistance (IR) in a longitudinal biracial cohort (n=4143; aged 25-37; 1992-2006). We used latent class analysis to derive population-density-specific (<vs.≥1750 people per sq km) clusters of neighborhood indicators: road connectivity, parks and PA facilities, and food stores/restaurants. In lower population density areas, a latent class with higher food and PA resource diversity (relative to other clusters) was significantly associated with higher diet quality. In higher population density areas, a cluster with relatively more natural food/specialty stores; fewer convenience stores; and more PA resources was associated with higher diet quality. Neighborhood clusters were inconsistently associated with BMI and IR, and not associated with fast food consumption, walking, biking, or running.