Abstract
OBJECTIVES: This study examines the influence of adolescents’ exposure to unhealthy food outlets on junk food purchasing during trips between home and school, with particular attention to how exposure and purchasing differ according to child’s biological sex, mode of transportation, and direction to or from school.
METHODS: Between 2010 and 2013, students (n = 654) aged 9-13 years from 25 schools in London and Middlesex County, ON, completed a socio-demographic survey and an activity diary (to identify food purchases), and were observed via a global positioning system for 2 weeks (to track routes for trips to/from school). Spatial data on routes and purchase data were integrated with a validated food outlet database in a geographic information system, and exposure was measured as the minutes a child spent within 50 m of an unhealthy food outlet (i.e., fast food restaurants, variety stores). For trips involving junk food exposure (n = 4588), multilevel logistic regression was used to assess the relationship between exposure and purchasing.
RESULTS: Multilevel analyses indicated that adolescents’ duration of exposure to unhealthy food outlets between home and school had a significant effect on the likelihood of junk food purchasing. This relationship remained significant when the data were stratified by sex (female/male), trip direction (to/from school) and travel mode (active/car), with the exception of adolescents who travelled by bus.
CONCLUSION: Policies and programs that mitigate the concentration of unhealthy food outlets close to schools are critical for encouraging healthy eating behaviours among children and reducing diet-related health issues such as obesity.
KEY WORDS: Built environment, food environment, GPS, food purchase, diet, child, adolescent
Résumé
OBJECTIFS : Examiner l’influence de l’exposition des adolescents aux points de vente d’aliments malsains sur leurs achats d’aliments vides durant le trajet entre l’école et la maison, et en particulier à la façon dont l’exposition et les achats diffèrent selon le sexe biologique de l’enfant, le moyen de transport et le sens du trajet.
MÉTHODE : Entre 2010 et 2013, des élèves (n= 654) de 9–13 ans fréquentant 25 écoles du comté de London-Middlesex, ON, ont rempli un questionnaire sociodémographique et un journal de leurs activités (pour repérer leurs achats d’aliments), et ont été observés pendant deux semaines par un système mondial de localisation (pour suivre leurs trajets entre l’école et la maison). Les données spatiales sur les itinéraires et les données d’achat ont été intégrées à une base de données validée de points de vente d’aliments dans un système d’information géographique; l’exposition a été mesurée selon le nombre de minutes qu’un enfant passait à moins de 50 m d’un point de vente d’aliments malsains (p. ex., restaurants rapides, magasins à prix uniques). Pour les trajets où les enfants étaient exposés à des aliments vides (n = 4588), nous avons procédé par régression logistique multiniveau pour évaluer la relation entre l’exposition et l’achat.
RÉSULTATS : Les analyses multiniveaux ont montré que la durée d’exposition des adolescents aux points de vente d’aliments malsains sur le chemin de l’école avait un effet significatif sur leur probabilité d’achat d’aliments vides. Cette relation est demeurée significative lorsque les données ont été stratifiées selon le sexe (fille/garçon), le sens du trajet (vers l’école/vers la maison) et le moyen de transport (transport actif/automobile), sauf pour les adolescents se déplaçant en autobus.
CONCLUSION : Les politiques et les programmes qui atténuent la concentration des points de vente d’aliments malsains près des écoles sont essentiels pour encourager les comportements alimentaires sains chez les enfants et pour réduire les problèmes de santé liés à l’alimentation, comme l’obésité.
MOTS CLÉS: milieu bâti, environnement alimentaire, systèmes d’information géographique, achat d’aliments, régime alimentaire, enfant, adolescent
Footnotes
Acknowledgements: The STEAM (Spatial Temporal Environment and Activity Monitoring) study was jointly funded by the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Canada, with seed funding from the Social Sciences and Humanities Research Council of Canada. Additional support was provided by the Children’s Health Research Institute and the Children’s Health Foundation. We thank the students, parents, teachers, principals and research boards from the Thames Valley District School Board, the London District Catholic School Board, Conseil scolaire catholique Providence and the Conseil scolaire Viamonde. We would also like to acknowledge the dozens of research assistants from the Human Environments Analysis Laboratory who helped with the STEAM project.
Conflict of Interest: None to declare.
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