Proximity to Supermarkets Associated with Higher Body Mass Index among Overweight and Obese Preschool-Age Children.
ABSTRACT OBJECTIVE: To examine associations of proximity to food establishments with body mass index (BMI) among preschool-age children. METHODS: We used baseline data from 438 children ages 2-6.9years with a BMI≥85th percentile participating in a RCT in Massachusetts from 2006 to 2009. We used a geographic information system to determine proximity to six types of food establishments: 1) convenience stores, 2) bakeries, coffee shops, candy stores, 3) full service restaurants, 4) large supermarkets, 5) small supermarkets, and 6) fast-food restaurants. The main outcome was child's BMI. RESULTS: Children's mean (SD) BMI was 19.2 (2.4) kg/m(2); 35% lived≤1 mile from a large supermarket, 42% lived >1 to 2 miles, and 22% lived >2 miles. Compared to children living >2 miles from a large supermarket, those who lived within 1 mile had a BMI 1.06kg/m(2) higher. Adjustment for socioeconomic characteristics and distance to fast-food restaurants attenuated this estimate to 0.77kg/m(2). Living in any other distance category from a large supermarket and proximity to other food establishments were not associated with child BMI. CONCLUSIONS: Living closer to a large supermarket was associated with higher BMI among preschool-age children who were overweight or obese.
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ABSTRACT: Background: Studies have tried to link obesity rates and physical activity with multiple aspects of the built environment. Purpose: To determine the relation between residential property values and multiple perceived (self-reported) measures of the obesogenic environment. Methods: The Seattle Obesity Study (SOS) used a telephone survey of a representative, geographically distributed sample Of 2,001 King County adults, collected in 2008-2009 and analyzed in 2012-2013. Home addresses were geocoded. Residential property values at the tax parcel level were obtained from the King County tax assessor. Mean residential property values within a 10-minute walk (833-m buffer) were calculated for each respondent. Data on multiple perceived measures of the obesogenic environment were collected by self-report. Correlations and multi-variable linear regression analyses, stratified by residential density, were used to examine the associations among perceived environmental measures, property values, and BMI. Results: Perceived measures of the environment such as crime, heavy traffic, and proximity to bars, liquor stores, and fast food were all associated with lower property values. By contrast, living in neighborhoods that were perceived as safe, quiet, clean, and attractive was associated with higher property values. Higher property values were associated, in turn, with lower BMIs among women. The observed associations between perceived environment measures and BMI were largely attenuated after accounting for residential property values. Conclusions: Environments perceived as obesogenic are associated with lower property values. Studies in additional locations need to explore to what extent other perceived environment measures can be reflected in residential property values. (C) 2014 American Journal of Preventive MedicineAmerican Journal of Preventive Medicine 07/2014; 47(3). DOI:10.1016/j.amepre.2014.05.006 · 4.28 Impact Factor
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ABSTRACT: Background Few studies have examined the association between the food environment and adiposity in early childhood, a critical time for obesity prevention. The objective of this study was to examine the longitudinal association between neighbourhood food environment and adiposity among low-income preschool-aged children in a major metropolitan region in the USA. Methods The study sample was 32 172 low-income preschool-aged children in Los Angeles County who had repeated weight and height measurements collected between ages 2 and 5 years through a federal nutrition assistance programme. We conducted multilevel longitudinal analyses to examine how spatial densities of healthy and unhealthy retail food outlets in the children's neighbourhoods were related to adiposity, as measured by weight-for-height z-score (WHZ), while controlling for neighbourhood-level income and education, family income, maternal education, and child's gender and race/ethnicity. Results Density of healthy food outlets was associated with mean WHZ at age 3 in a non-linear fashion, with mean WHZ being lowest for those exposed to approximately 0.7 healthy food outlets per square mile and higher for lesser and greater densities. Density of unhealthy food outlets was not associated with child WHZ. Conclusions We found a non-linear relationship between WHZ and density of healthy food outlets. Research aiming to understand the sociobehavioural mechanisms by which the retail food environment influences early childhood obesity development is complex and must consider contextual settings.Journal of Epidemiology & Community Health 07/2014; 68(11). DOI:10.1136/jech-2014-204034 · 3.29 Impact Factor