Local Food Outlets, Weight Status, and Dietary Intake: Associations in Children Aged 9–10 Years

BackgroundThe rising prevalence of childhood obesity is a key public health issue worldwide. Limited evidence suggests that there may be interactions between environmental factors at a neighborhood level and the development of obesity, with the availability and accessibility of food outlets being potentially important.PurposeTo examine how the weight status and dietary intake of 1669 children aged 9–10 years was associated with neighborhood food outlets in a cross-sectional study.MethodsAvailability of food outlets was computed from GIS data for each child's unique neighborhood. Outlets were grouped into BMI-healthy, BMI-unhealthy, or BMI-intermediate categories according to food type sold. Weight status measurements were objectively collected, and food intake was recorded using 4-day food diaries. Data were collected in 2007 and analyzed in 2009.ResultsAvailability of BMI-healthy outlets in neighborhoods was associated with lower body weight (1.3 kg, p=0.03); BMI (0.5 kg/m2, p=0.02); BMI z-score (0.20, p=0.02); waist circumference (1.3 cm, p=0.02); and percentage body fat (1.1%, p=0.03) compared to no availability. In contrast, neighborhood availability of BMI-unhealthy outlets was inversely associated with body weight (1.3 kg, p=0.02); BMI (0.4 kg/m2, p=0.05); BMI z-score (0.15, p=0.05); waist circumference (1.1 cm, p=0.04); and percentage body fat (1.0%, p=0.03). Unhealthy food intake (fizzy drinks 15.3%, p=0.04, and noncarbonated “fruit” drinks 11.8%, p=0.03) was also associated with availability of BMI-unhealthy food outlets.ConclusionsFeatures of the built environment relating to food purchasing opportunities are correlated with weight status in children.