The food retail environment in school neighborhoods and its relation to lunchtime eating behaviors in youth from three countries

Abstract

This study examined the relation between the chain food retail environment surrounding schools, youths’ lunchtime eating behavior, and youths’ obesity levels across three countries. Participants consisted of 26,778 students 13–15 years old from 687 schools across Canada, Scotland and the US. The density of convenience stores, chain fast food restaurants, and chain cafés within 1 km of each school was measured. Lunchtime eating behaviors, weight, and height were self-reported. Although the density of chain food retailers was highest in the US, fewer American students (2.6%) routinely ate their lunch at a food retailer during the school week than did Canadian (7.7%) and Scottish (43.7%) students. The density of chain food retailers was associated with eating lunch at a food retailer in Canada only whereby students attending schools with 1–2, 3–4, and 5+ chain food retailers within 1 km from their schools were 1.39 (95% CI: 0.84–2.29), 1.87 (95% CI: 1.10–3.20), and 2.50 (95% CI: 1.56–4.01) times more likely to eat at a chain food retailer compared to students attending schools with no nearby chain food retailers. No associations were found between chain food retailer density and obesity.

Associations between Food Environment around Schools and Professionally Measured Weight Status for Middle and High School Students

“…28 Previous studies do not make a distinction between convenience stores and small grocery stores, which are neighborhood stores with a small selection of healthy food options. [8][9][10]17,29,30 As a result, these studies offer little insight into the potential of upgrading these neighborhood stores to improve their healthy food offerings. Unlike previous research, [8][9][10]17,29,30 we did not find a significant association between proximity to convenience stores and students' weight status.…”

“…Extensive research and associated interventions have focused on improving the school food environments. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] In addition to the nutritional quality of food served in schools, the food environment around schools can also be influential in impacting the diets of children and adolescents. Schools are often surrounded by food outlets that sell energy-dense, low-cost foods, and students are more likely to purchase foods from these outlets if they are located within close proximity to their schools.…”

“…7,8,19 A recent systematic review on the influence of the retail food environment around schools on obesity-related outcomes found that the evidence was inconsistent, and the studies often used different methodologies and different age groups, making comparisons difficult. 21 Most studies have relied on self-reported measures of heights and weights.…”

“…21 Most studies have relied on self-reported measures of heights and weights. 8,[11][12][13]18 These measures have been shown to be biased and less reliable than professional measurements, but are often used because of easy availability of self-reported data. Further, small stores that offer some healthy offerings have not been investigated.…”

School lunches in the Republic of Ireland: a comparison of the nutritional quality of adolescents’ lunches sourced from home or purchased at school or ‘out’ at local food outlets

“…Favouring low-nutrient, energy-dense foods is associated with the displacement of nutrients as demonstrated by a study in which adolescents who purchased low-nutrient energydense foods in addition to obtaining a school lunch wasted more of the latter foods, had higher intakes of total energy and fat, and lower intakes of Ca, thiamin and vitamins C and A at lunchtime than students who did not purchase these foods with their lunch (19) . The literature indicates that food retailers in close proximity to secondary schools are an important influence on the dietary behaviours of young people because they are potentially easily accessible by students before, during lunchtime (if permitted) and after school (11)(12)(13) . Studies show that students who attend schools within a 1 km radius of fast-food restaurants are more likely to purchase fast food, and report higher soft drink consumption and lower fruit and vegetable consumption, compared with students who do not have easy access to such environments (12,20) .…”