Abstract
OBJECTIVES: To identify characteristics of the food environment associated with child overweight/obesity that could, if subjected to intervention, mitigate the risk of childhood overweight/obesity. We examined whether the proximity to or density of grocery and convenience stores or fast food restaurants, or the prices of healthy food options were more strongly associated with overweight/obesity risk in children.
METHODS: We collected geocoded data by residential addresses for 1,469 children aged 10-14 years and conducted a census of all food outlets in Saskatoon. The Nutrition Environment Measures Survey (NEMS-Stores and the NEMS-Restaurants were used to measure availability, quality and relative price of healthy food items in stores and restaurants. Children’s weight status was calculated on the basis of measured height and weight. Logistic regression was used to test the associations between overweight/obesity and food environment variables.
RESULTS: Within an 800 m walking distance from home, 76% of children did not have access to a grocery store; 58% and 32% had access to at least one convenience store or one fast-food restaurant respectively. A significantly lower odds of overweight/obesity was associated with lower price of healthy food items/options in grocery stores (odds ratio [OR] = 0.87, 95% confidence interval [CI] 0.77-0.99) and fast-food restaurants (OR = 0.97, 95% CI 0.95-0.99) within walking distance of home. Neither the distance to the closest food outlet nor the density of food outlets around children’s homes was associated with odds of overweight/obesity.
CONCLUSIONS: Improving economic access to healthy food in food outlets or fast-food restaurants is one strategy to counter childhood overweight/obesity.
KEY WORDS: Environment, public health, child health, obesity
Résumé
OBJECTIFS : Cerner les caractéristiques de l’environnement alimentaire associées au surpoids/à l’obésité des enfants qui pourraient, si elles étaient soumises à une intervention, atténuer le risque de surpoids/d’obésité juvénile. Nous avons cherché à déterminer si la proximité ou la densité des épiceries, des dépanneurs ou des restaurants rapides, ou les prix des choix alimentaires sains, étaient plus fortement associés au risque de surpoids/d’obésité chez les enfants.
MÉTHODE : Nous avons recueilli des données géocodées par adresse résidentielle pour 1,469 enfants de 10-14 ans et recensé tous les points de vente alimentaires de Saskatoon. Nous avons utilisé les sondages Nutrition Environment Measures Survey (NEMS-Stores et NEMS-Restaurants pour mesurer la disponibilité, la qualité et le prix relatif des produits alimentaires dans les magasins et les restaurants, respectivement. Le statut pondéral des enfants a été calculé à partir de la taille et du poids mesurés. Nous avons procédé par régression logistique pour tester les associations entre le surpoids/l’obésité et les variables de l’environnement alimentaire.
RÉSULTATS : À distance de marche de 800 m de leur domicile, 75% des enfants n’avaient pas accès à une épicerie; 60% et 33% avaient accès à au moins un dépanneur ou un restaurant rapide, respectivement. Une probabilité significativement plus faible de surpoids/d’obésité était associée aux prix plus bas des produits ou des choix alimentaires sains dans les épiceries (rapport de cotes [RC] = 0.87, intervalle de confiance [IC] de 95%: 0.77-0.99) et les restaurants rapides (RC = 0.97, IC de 95%: 0.95-0.99) situés à distance de marche du domicile. Ni la distance du point de vente alimentaire le plus proche, ni la densité des points de vente alimentaires autour des domiciles des enfants n’était associée à la probabilité de surpoids/d’obésité.
CONCLUSIONS : Améliorer l’accès économique aux aliments sains dans les points de vente alimentaires ou les restaurants rapides est une stratégie pour contrer le surpoids/l’obésité juvénile.
MOTS CLÉS: environnement, santé publique, santé de l’enfant, obésité
Footnotes
Source of Funding: This research was funded by the Canadian Institutes of Health Research (Grant #106643).
Conflict of Interest: None to declare.
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