Impact of the food environment and physical activity environment on behaviors and weight status in rural US communities

Objective. To examine the association between weight status and characteristics of the food and physical activity environments among adults in rural U.S. communities. Method. Cross-sectional telephone survey data from rural residents were used to examine the association between obesity (body mass index [BMI] >30 kg/m(2)) and perceived access to produce and low-fat foods, frequency and location of food shopping and restaurant dining, and environmental factors that support physical activity. Data were collected from July to September 2005 in Missouri, Arkansas, and Tennessee. Logistic regression models (N=826) adjusted for age, education and gender comparing normal weight to obese respondents. Results. Eating out frequently, specifically at buffets, cafeterias, and fast food restaurants was associated with higher rates of obesity. Perceiving the community as unpleasant for physical activity was also associated with obesity. Conclusion. Adults in rural communities were less likely to be obese when perceived food and physical activity environments supported healthier behaviors. Additional environmental and behavioral factors relevant to rural adults should be examined in under-studied rural U.S. populations. (C) 2008 Elsevier Inc. All rights reserved.