Food Prices Are Associated with Dietary Quality, Fast Food Consumption, and Body Mass Index among U.S. Children and Adolescents

Abstract

Food prices are expected to affect dietary intakes, however, previous findings are mixed and few are based on nationally representative data. We examined the associations of price indices of fast foods (FF-PI) and fruits and vegetables (FV-PI) with dietary intakes and BMI among U.S. children and adolescents using data from the Continuing Survey of Food Intakes by Individuals (CSFII; 1994-1998) for 6759 children (2-9 y) and 1679 adolescents (10-18 y). FF-PI and FV-PI were linked to individuals' CSFII dietary data through city-level geocodes. Main outcomes included intakes of selected nutrients and food groups, a fast food consumption index (FF-CI), diet quality using the 2005 Healthy Eating Index (HEI), and BMI. Among children (2-9 y), a higher FF-PI (by $1) was associated with intakes of lower FF-CI (β ± SE: -0.9 ± 0.3 count/d), higher HEI (6.6 ± 2.5), higher intakes of fiber (2.7 ± 0.7 g/d), calcium (225.7 ± 52.3 mg/d), dairy (172.5 ± 36.2 g/d), and fruits and vegetables (113.3 ± 23.4 cup equivalents/d). FV-PI was inversely related to fiber intake (β ± SE: -3.3 ± 1.5 g/d) and positively associated with BMI (4.3 ± 1.2 kg/m(2)). Less consistent findings were ascribed to FV-PI and among adolescents (10-18 y). Significant associations were almost equally balanced between low and high family income groups, with some significant interactions between food prices and family income observed, particularly among children (2-9 y). Our findings suggest that among U.S. children aged 2-9 y, higher FF-PI is associated with better dietary quality, whereas higher FV-PI is linked to higher BMI and lower fiber intake. Associations varied by family income in children for many dietary intake variables.

Eating patterns and food systems: critical knowledge requirements for policy design and implementation

“…According to Beydoun et al [47], 'food [relative] prices are associated with dietary quality, fast-food consumption and body mass index among US children and adolescents.' f More specifically, this study shows that lower prices of fruit and vegetables are associated with greater fiber consumption and reduced body mass index and higher fast-food prices are associated with lower consumption of fast foods and higher consumption of dietary fibers, dairy products, calcium and fruit and vegetables.…”

Measuring the Food Environment: From Theory to Planning Practice

“…Food affordability, and specifically food and restaurant prices, has been found to exert generally small effects on body weight outcomes, although these findings also seem to vary by socioeconomic status, with the association between prices and body weight stronger among socioeconomically disadvantaged populations (Beydoun, Powell, Chen, & Wang, 2011;Powell & Chaloupka, 2009). Among children, relatively higher food prices of fruits and vegetables have been associated with lower frequency of fruit and vegetable intake (Sturm & Datar, 2011), lower fiber intake, and higher weight (Beydoun et al, 2011). In addition, relative higher prices of fast food have been associated with better diet quality among young children (Beydoun et al, 2011).…”

“…Among children, relatively higher food prices of fruits and vegetables have been associated with lower frequency of fruit and vegetable intake (Sturm & Datar, 2011), lower fiber intake, and higher weight (Beydoun et al, 2011). In addition, relative higher prices of fast food have been associated with better diet quality among young children (Beydoun et al, 2011).…”

“…However, the application of the Nutrition Environment Measures Survey (NEMS), a validated instrument, found considerable variation of food quality within specific outlet types for both stores and restaurants . Despite this, relying solely on food access has limitations, since neighborhood differences in food supply exist even after accounting for store type (Baker, Schootman, Barnidge & Kelly, 2006;Farley, Rice, Bodor, Cohen, Bluthenthal, & Rose, 2009;Horowitz, Colson, Hebert & Lancaster, 2004;Zenk, Schulz, HollisNeely et al, 2005). Moreover, viewing food access as merely a geographical construct ignores the reality that physical limitations, lack of access to a car for food shopping, and individual-level economic disadvantage can all impair food access (Burns et al, 2011;Coveney & O'Dwyer, 2009;Cummins & MacIntyre, 2006).…”

Food Environments and Childhood Weight Status: Effects of Neighborhood Median Income

“…Previous research has shown that access to low-priced fresh fruit and vegetables is associated with lower BMI among 2-to 9-year-old children. 16 Supermarkets tend to have the most diverse, low-priced produce, compared to the four other categories of food establishments we examined. Because parents and families face both budget and time constraints, by living closer to supermarkets, it is likely more convenient for parents and children to purchase and consume produce on a more frequent basis and, as a result, foster a lower BMI z-score.…”