Changes in the Neighborhood Food Store Environment and Children's Body Mass Index at Peripuberty in the United States

Abstract

Background Little is known about the relationship between changes in food store environment and children’s obesity risk in the US. This study examines children’s weight status associated with the changes in the quantity of food stores in their neighborhoods. Methods A nationally representative cohort of schoolchildren in the US was followed from 5th grade in 2004 to 8th grade in 2007 (n=7090). In 2004 and 2007, children’s body mass index (BMI) was directly measured in schools. ZIP-Code Business Patterns data from the Census Bureau in 2004 and 2007 characterized the numbers of food stores in every ZIP-code area by type of store: supermarkets, limited-service restaurants, small-size grocery and convenience stores. Baseline and change in the numbers of stores were the major exposures of interest. Results Girls living in neighborhoods with ≥ 3 supermarkets had a lower BMI three years later (by −0.62 kg/m2; 95% C.I.: −1.05, −0.18) than did those living in neighborhoods without any supermarkets. Girls living in neighborhoods with many limited-service restaurants had a greater BMI three years later (by 1.02 kg/m2; 95% C.I.: 0.36, 1.68) than did those living in neighborhoods with ≤1 limited-service restaurant. Exposure to a decreased quantity of small-size grocery stores in neighborhoods was associated with girls’ lower BMI by eighth grade. Conclusions The longitudinal association between neighborhood food environment and children’s BMI differed by gender. For girls, supermarkets in neighborhoods seemed protective against obesity, while small-size grocery stores and limited-service restaurants in neighborhoods increased obesity risk. There was no significant longitudinal finding for boys.

Two‐Year Changes in Child Weight Status, Diet, and Activity by Neighborhood Nutrition and Physical Activity Environment

“…Present analyses also did not examine how neighborhood environment may be impacting children’s within-home environments or how much exposure children or their parent(s)/caregiver(s) had to their neighborhood environment, although prior analyses from this study did find relationships between parenting practices/rules around eating and children’s diet quality [37]. Unlike Chen and colleagues [12], this study did not examine changes to environments over time. More natural experiments are needed to evaluate changes in policies, systems, and environments designed to, or that may inadvertently, affect children’s weight outcomes [38].…”

Barriers to and Facilitators of Stocking Healthy Food Options: Viewpoints of Baltimore City Small Storeowners

“…There are stark differences in local food environments in the US according to the community’s racial and economic composition (Franco et al 2008; Kumanyika et al 2014; Raja, Ma, and Yadav 2008), and these differences are thought to be related to obesity (Walker, Keane, and Burke 2010; Odoms-Young, Zenk, and Mason 2009; Gordon-Larsen 2014). In two recent studies, the retail food environment was found to be associated with childhood obesity; with supermarkets being protective, and small stores enhancing risk (Chen and Wang, 2016; Tang et al 2014). …”

Retail Environments as a Venue for Obesity Prevention

“…Additionally, Morland and colleagues reported that the presence of convenience stores was associated with higher obesity prevalence [62]. Despite the studies yielding statistically significant results in the desired direction [51, 54, 56, 62, 65–68], a fair percentage of studies observed null findings [52, 55, 57, 58, 69–71]. Contrary to most findings, studies reporting unexpected or negative results also exist in the literature [49, 50, 55, 57].…”

“…The vast majority of the studies conducted have employed a cross-sectional study design [12••, 49, 51, 54, 56, 62, 65–69]. Longitudinal studies in this area have been limited [50, 52, 58, 63, 71]. Thus, the lack of experimental studies and longitudinal analyses make it difficult to assess underlying relationships between the food environment and obesity.…”