Abstract
Objectives
Among studies of the built environment, few examine neighbourhood food environments in relation to children’s diets. We examined the associations of residential and school neighbourhood access to different types of food establishments with children’s diets.
Methods
Data from QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), an ongoing study on the natural history of obesity in 630 Quebec youth aged 8–10 years with a parental history of obesity, were analyzed (n=512). Three 24-hour diet recalls were used to assess dietary intake of vegetables and fruit, and sugar-sweetened beverages. Questionnaires were used to determine the frequency of eating/snacking out and consumption of delivered/take-out foods. We characterized residential and school neighbourhood food environments by means of a Geographic Information System. Variables included distance to the nearest supermarket, fast-food restaurant and convenience store, and densities of each food establishment type computed for 1 km network buffers around each child’s residence and school. Retail Food Environment indices were also computed. Multivariable logistic regressions (residential access) and generalized estimating equations (school access) were used for analysis.
Results
Residential and school neighbourhood access to supermarkets was not associated with children’s diets. Residing in neighbourhoods with lower access to fast-food restaurants and convenience stores was associated with a lower likelihood of eating and snacking out. Children attending schools in neighbourhoods with a higher number of unhealthful relative to healthful food establishments scored most poorly on dietary outcomes.
Conclusions
Further investigations are needed to inform policies aimed at shaping neighbourhood-level food purchasing opportunities, particularly for access to fast-food restaurants and convenience stores.
Key words: Built environment, children, diet, food environment, residential neighbourhood, school neighbourhood, QUALITY cohort
Mots clés: milieu bâti, enfant, régime alimentaire, environnement alimentaire, quartier résidentiel, quartier scolaire, cohorte QUALITY
Résumé
Objectifs
Rares sont les études du milieu bâti qui s’intéressent aux environnements alimentaires des quartiers par rapport aux régimes alimentaires des enfants. Nous avons examiné les associations entre l’accès des quartiers résidentiels et scolaires à différents types d’établissements alimentaires et les régimes des enfants.
Méthode
Nous avons analysé les données de l’étude QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth), une étude en cours sur l’histoire naturelle de l’obésité chez 630 jeunes Québécois de 8 à 1 0 ans ayant une histoire parentale d’obésité (n=512). Trois rappels alimentaires de 24 heures ont servi à évaluer l’apport en fruits et légumes et en boissons édulcorées au sucre. À l’aide de questionnaires, nous avons déterminé la fréquence des repas et des collations pris à l’extérieur et la consommation d’aliments livrés à domicile ou à emporter. Nous avons caractérisé l’environnement alimentaire des quartiers résidentiels et scolaires au moyen d’un système d’information géographique. Les variables étaient la distance jusqu’au supermarché, au restaurant rapide et au dépanneur le plus proche, et les densités de chacun de ces types d’établissements, calculées sur un réseau tampon d’1 km autour du domicile et de l’école de chaque enfant. Des indices d’environnement alimentaire de détail ont aussi été calculés. La régression logistique multivariée (accès à partir du domicile) et des équations d’estimation généralisées (accès à partir de l’école) ont servi à l’analyse.
Résultats
L’accès des quartiers résidentiels et scolaires aux supermarchés n’était pas associé aux régimes des enfants. Le fait d’habiter un quartier où les restaurants rapides et les dépanneurs sont moins accessibles était associé à une plus faible probabilité de prendre des repas et des collations à l’extérieur. Les enfants qui fréquentaient des écoles de quartiers comptant davantage d’établissements alimentaires malsains que d’établissements sains ont obtenu les pires scores pour ce qui est de leur régime.
Conclusions
Des enquêtes plus poussées sont nécessaires pour formuler des politiques qui influencent les occasions d’achat d’aliments à l’échelle des quartiers, particulièrement l’accès aux restaurants rapides et aux dépanneurs.
Footnotes
Acknowledgements: The QUALITY study is funded by the Canadian Institutes of Health Research (CIHR), the Heart and Stroke Foundation of Canada (HSFC) and the Fonds de la recherche en santé du Québec. The QUALITY Residential and School Built Environment complementary studies were funded by the HFSC and the CIHR, respectively. A.Van Hulst received support from a CIHR/HSFC Training Grant in Population Intervention for Chronic Disease Prevention, and a doctoral scholarship from the Fonds de la recherche en santé du Québec; T. Barnett and Y. Kestens are research scholars with Fonds de la recherche en santé du Québec; L. Gauvin holds a CIHR/Centre de Recherche en Prévention de l’Obésité Chair in Applied Public Health on Neighbourhoods, Lifestyle, and Healthy Body Weight; and M. Bird received a Masters’ scholarship from tine Fondation du CHU Sainte-Justine. Dr. Marie Lambert passed away on February 20, 2012. Her leadership and devotion to the QUALITY cohort will always be remembered and appreciated.
Conflict of Interest: None to declare
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