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

Overview

Journal Child Obes

Publisher Mary Ann Liebert

Specialties Endocrinology
Pediatrics

Date 2015 Apr 30

PMID 25923838

Citations 22

Authors

Lauren Fiechtner

Mona Sharifi

Thomas Sequist

Jason Block

Dustin T Duncan

Steven J Melly

Sheryl L Rifas-Shiman

Elsie M Taveras

Affiliations

Soon will be listed here.

Abstract

Background: A key aspect of any intervention to improve obesity is to better understand the environment in which decisions are being made related to health behaviors, including the food environment.

Methods: Our aim was to examine the extent to which proximity to six types of food establishments is associated with BMI z-score and explore potential effect modification of this relationship. We used geographical information software to determine proximity from 49,770 pediatric patients' residences to six types of food establishments. BMI z-score obtained from the electronic health record was the primary outcome.

Results: In multivariable analyses, living in closest proximity to large (β, -0.09 units; 95% confidence interval [CI], -0.13, -0.05) and small supermarkets (-0.08 units; 95% CI, -0.11, -0.04) was associated with lower BMI z-score; living in closest proximity to fast food (0.09 units; 95% CI, 0.03, 0.15) and full-service restaurants (0.07 units; 95% CI, 0.01, 0.14) was associated with a higher BMI z-score versus those living farthest away. Neighborhood median income was an effect modifier of the relationships of convenience stores and full-service restaurants with BMI z-score. In both cases, closest proximity to these establishments had more of an adverse effect on BMI z-score in lower-income neighborhoods.

Conclusions: Living closer to supermarkets and farther from fast food and full-service restaurants was associated with lower BMI z-score. Neighborhood median income was an effect modifier; convenience stores and full-service restaurants had a stronger adverse effect on BMI z-score in lower-income neighborhoods.

Citing Articles

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