Using data (n=60,775 women) from the Women’s Health Initiative Clinical Trial (WHI CT)— a national study of postmenopausal women aged 50 to 79 years — we analyzed cross-sectional associations between the availability of different types of food outlets in the 1.5 miles surrounding a woman’s residence, census tract neighborhood socioeconomic status (NSES), body mass index (BMI) and blood pressure (BP). We simultaneously modeled NSES and food outlets using linear and logistic regression models, adjusting for multiple socio-demographic factors, population density and random effects at the tract and metropolitan statistical area (MSA) level. We found significant associations between NSES, availability of food outlets and individual-level measurements of BMI and BP. As grocery store/supermarket availability increased from the 10th to the 90th percentile of its distribution, controlling for confounders, BMI was lower by 0.30 kg/m2. Conversely, as fast-food outlet availability increased from the 10th to the 90th percentile, BMI was higher by 0.28 kg/m2. When NSES increased from the 10th to the 90th percentile of its distribution, BMI was lower by 1.26 kg/m2. As NSES increased from the 10th to the 90th percentile, systolic and diastolic BP were lower by 1.11 mm and 0.40 mm Hg, respectively. As grocery store/supermarket outlet availability increased from the 10th and 90th percentiles diastolic BP was lower by 0.31 mm Hg. In this national sample of post-menopausal women, we found important independent associations between the food and socioeconomic environments and BMI and BP. These findings suggest that changes in the neighborhood environment may contribute to efforts to control obesity and hypertension.

Parental reporting of height and weight was evaluated for US children aged 2-13 years. The prevalence of obesity (defined as a body mass index value (calculated as weight (kg)/height (m)(2)) in the 95th percentile or higher) and its height and weight components were compared in child supplements of 2 nationally representative surveys: the 1996-2008 Children of the National Longitudinal Survey of Youth 1979 Cohort (NLSY79-Child) and the 1997 Child Development Supplement of the Panel Study of Income Dynamics (PSID-CDS). Sociodemographic differences in parent reporting error were analyzed. Error was largest for children aged 2-5 years. Underreporting of height, not overreporting of weight, generated a strong upward bias in obesity prevalence at those ages. Frequencies of parent-reported heights below the Centers for Disease Control and Prevention's (Atlanta, Georgia) first percentile were implausibly high at 16.5% (95% confidence interval (CI): 14.3, 19.0) in the NLSY79-Child and 20.6% (95% CI: 16.0, 26.3) in the PSID-CDS. They were highest among low-income children at 33.2% (95% CI: 22.4, 46.1) in the PSID-CDS and 26.2% (95% CI: 20.2, 33.2) in the NLSY79-Child. Bias in the reporting of obesity decreased with children's age and reversed direction at ages 12-13 years. Underreporting of weight increased with age, and underreporting of height decreased with age. We recommend caution to researchers who use parent-reported heights, especially for very young children, and offer practical solutions for survey data collection and research on child obesity.

Objectives-The objectives were to: (1) document correlations among facility provision (availability and adequacy) in elementary schools, child sociodemographic factors, and school characteristics nationwide; and (2) investigate whether facility provision is associated with physical education (PE) time, recess time, and obesity trajectory.Methods-The analytic sample included 8935 fifth graders from the Early Childhood Longitudinal Survey Kindergarten Cohort. School teachers and administrators were surveyed about facility provision, PE, and recess time in April 2004. Multivariate linear and logistic regressions that accounted for the nesting of children within schools were used.Results-Children from disadvantaged backgrounds were more likely to attend a school with worse gymnasium and playground provision. Gymnasium availability was associated with an additional 8.3 min overall and at least an additional 25 min of PE per week for schools in humid climate zones. These figures represent 10.8 and 32.5%, respectively, of the average time spent in PE. No significant findings were obtained for gymnasium and playground adequacy in relation to PE and recess time, and facility provision in relation to obesity trajectory.Conclusions-Poor facility provision is a potential barrier for school physical activity programs and facility provision is lower in schools that most need them: urban, high minority, and high enrollment schools.

Background-Physical activity at school can support obesity prevention among youth. This paper assesses the role of existing school physical activity programs for a national cohort from 1st grade to 5th grade.

The School Meals Planner Package supported the design of nutritious, locally sourced menus for the school feeding program in Ghana. The tool can be similarly adapted for other countries to meet context-specific needs.