. 2020 Jul 3;22(Suppl 1):e13076. doi: 10.1111/obr.13076

TABLE 2.

Measures of the access to grocery stores and body‐weight status in 18 included studies

First author (year)	Measures of access to full‐service restaurants (FSR)	Other environmental factors adjusted for in the model	Measures of weight‐related outcomes or behaviours	Results of weight‐related outcomes or behaviours
Cohort studies
Chen (2016) ²⁶	Number of FSRs along the most direct street route from home to school within 50‐m buffer on either side of the street	The same measure for fast food restaurants	• Measured BMI z‐score (based on the 2000 U.S. CDC growth charts)	Better access to FSRs on the route from a student's home to school was associated with lower hazard for the onset of obesity over the study period.
Chen (2016) ²⁶		The same measure for fast food restaurants	• Obesity: BMI ≥ 95th percentile
Lee (2012) ²⁹	• Density of FSRs per 1.6 km² in home census tract	Density of convenience stores, grocery stores and fast‐food chain restaurants	Measured BMI percentile (based on the 2000 U.S. CDC growth charts)	Less affluent and minority areas also have significantly greater access to food establishments that are not obviously linked to obesity risk, including large‐scale grocery stores and FSRs.
Lee (2012) ²⁹	• Density of FSRs per 1000 persons in home census tract
Leung (2011) ⁶	Density of FSRs per 1000 persons in 0.4/1.6‐km home road‐network buffer (in tertiles and quintiles)	NA	• Measured BMI z‐score (based on the 2000 U.S. CDC growth charts)	There were no significant associations between the availability of restaurants within a 0.4‐km network buffer and girls' overweight or BMI z‐scores.
Leung (2011) ⁶		NA	• Overweight (BMI ≥85th percentile on the 2000 U.S. CDC growth charts)
Powell (2009) ²¹	Density of FSRs per 10 000 persons in home county	The same measure for fast‐food restaurants, supermarkets, convenience stores and physical activity facilities	• Self‐reported BMI	No association was found between density of FSRs and BMI.
Powell (2009) ²¹	Density of FSRs per 10 000 persons in home county		• Overweight: age‐sex specific BMI percentile ≥95th (based on the 2000 U.S. CDC growth charts)	No association was found between density of FSRs and BMI.
Shier (2016) ²⁴	Number of FSRs in 3.2‐km home straight‐line buffer	Residential region	• Measured BMI z‐score and BMI percentile (based on the 2000 U.S. CDC growth charts)	• Neither the actual nor the perceived availability of particular food outlets in the neighbourhood is associated with children's diet or BMI.
			• Obese or overweight: if the BMI percentile ≥85th	• Availability of FSRs was unrelated to children's dietary behaviours or how often children eat restaurant meals.
			• Children's dietary behaviours were collected via a modified version of the Beverage and Snack Questionnaire
Sturm (2005) ¹⁵	Density of FSRs per 1000 persons in home/school postal zone	NA	Measured BMI	The per capita number of restaurants sometimes became significant, but this result disappeared when we included prices or switched to a different method for adjusting for the clustering.
Zhang (2016) ²³	Straight‐line distance from home to the nearest FSRs (in quartiles)	Distance from home to the nearest grocery store, free market and food stall	Measured BMI	The Chinese restaurants seemed to have protective effects, with boys and girls in the second quartile of the proximity to the nearest Chinese restaurant having lower BMI compared to those in the first quartile.
Cross‐sectional studies
Auld (2009) ²⁰	Density of FSRs per 10 000 persons in school postal zone	NA	Self‐reported BMI (based on the 2000 CDC growth charts)	• Restaurant availability is not associated with weight.
				• Restaurant density has very little effect on any conditional quantile of distribution of BMI.
				• Restaurant access is not statistically or economically associated with BMI.
Davis (2009) ²⁷	• Density of FSRs within 0.8 km from school	The same measure for fast‐food restaurant and other types of establishments such as gas stations, motels and grocery stores	• Measured BMI	There was a smaller relationship between FSRs and a youth's weight status.
Davis (2009) ²⁷	• Number of FSRs within 0.8‐km road‐network buffer around school		• Overweight (BMI ≥85th percentile) and obesity (BMI ≥95th percentile on the U.S. CDC growth charts)
Fiechtner (2013) ²⁸	Road‐network distance from home to the nearest FSRs	Road‐network distance from home address to nearest convenience stores/bakeries/coffee shops/candy stores/supermarkets.	• BMI obtained from the electronic health record	The association between proximity to FSRs and child BMI was not observed.
			• Overweight (BMI 25 to 30 kg/m²)
			• Obese (BMI ≥30 kg/m²)
Fiechtner (2015) ²²	Road‐network distance from home to the nearest FSRs	Road‐network distance from home address to nearest convenience stores/bakeries/coffee shops/candy stores/supermarkets	BMI z‐score obtained from the electronic health record	Living in closest proximity to FSRs was associated with a higher BMI z‐score versus those living farthest away (β = 0.07, 95% CI: 0.01, 0.14).
Galvez (2009) ¹⁸	Number of FSRs in home census tract	NA	• Measured BMI according to a standardized protocol	Statistically significant associations between BMI percentile and number of restaurants on a child's census block were not observed likely due to the small sample size.
Galvez (2009) ¹⁸	Number of FSRs in home census tract	NA	• Age‐ and sex‐specific BMI percentiles based on the 2000 CDC growth charts
Gorski Findling (2018) ¹⁹	Number of FSRs within 1.6‐km straight‐line buffer around home	Rural versus urban household location, vehicle access and closest SNAP retailer	• Self‐reported BMI	There were no other statistically significant relationships between any store types and overweight/obesity when access was set at 0.4 km or 3.2 km.
Gorski Findling (2018) ¹⁹			• Overweight/obesity: BMI ≥ 85th percentile (based on the 2000 CDC growth chart)
Li (2015) ¹⁷	Composite score of probabilities that a child patronizes FSRs equation: $P_{ij} = \frac{(S_{j} / D_{ij}^{β})}{(\sum_{j = 1}^{n} (S_{j} / D_{ij}^{β}))}$ where S_j is the attraction (FSR size) of FSR_j, D_ij is the street distance from home of child i to FSR_j, β is a parameter that reflects the effect of distance on shopping and n is the number of FSRs	NA	• BMI and self‐report BMI (based on the CDC growth charts)	Children with higher probabilities of patronizing FSRs tend to be overweight or obese. The indices of FSRs are negatively associated with children's percentile of BMI.
			• Overweight: BMI 85th–94th
			• Obese: BMI > 95th (based on the 2012 CDC growth charts)
Mellor (2011) ¹⁶	• Density of FSRs within 0.8‐km road‐network buffer around home	NA	• Measured BMI	• The proximity of FSRs to residences did not have a significant positive association with either BMI or overweight.
Mellor (2011) ¹⁶	• Number of FSRs within 0.16‐/0.4‐/0.8‐/1.6‐km road‐network buffer around home	NA	• Obesity: BMI ≥95th percentile (based on the 2000 U.S. CDC growth charts)	• The presence of a FSR within one tenth of 1.6 m from the home has a significant negative association with BMI and obesity.
Powell (2007) ¹³	Density of FSRs per 10 000 persons in school postal zone	Density of chain supermarkets, non‐chain supermarkets, convenience stores, grocery stores and fast‐food restaurants	• Self‐reported BMI	BMI is higher when there are fewer full‐service restaurants.
Powell (2007) ¹³	Density of FSRs per 10 000 persons in school postal zone		• Obesity: BMI ≥95th percentile (based on the 2000 U.S. CDC growth charts)
Seliske (2009) ¹⁴	Density of FSRs per 10 000 persons in 5‐km school straight‐line buffer (in categories of none, low, medium and high exposures)	Density of grocery stores, fast‐food restaurants, sub/sandwich retailers, doughnut/coffee shops and convenience stores	• Self‐reported BMI	Compared with attending schools in neighbourhoods with no FSRs, participants attending schools in neighbourhoods with medium and high numbers of FSRs were less likely to be overweight.
Seliske (2009) ¹⁴			• Overweight and obesity: on the basis of IOTF cut‐offs, equivalent to BMI ≥25 kg/m² in adults)
Wall (2012) ²⁵	• Density of FSRs in 1.6‐km home straight‐line buffer.	NA	Measured BMI z‐score (based on the 2000 U.S. CDC growth charts)	Nearby access to restaurants was associated with higher BMI z‐score in girls suggesting girls may be more influenced by exposure to potentially unhealthy neighbourhood food sources.
Wall (2012) ²⁵	• Straight‐line distance from home to the nearest FSRs.	NA

Abbreviations: BMI, body mass index; CDC, Center for Disease Control and Prevention; D&B, Dun and Bradstreet; ECLS‐K, The Early Childhood Longitudinal Study–Kindergarten; FSRs, full‐service restaurants; GIS, geographic information systems; IOTF, International Obesity Task Force; NAICS, North American Industry Classification System; NEMS‐S, Nutrition Environment Measures Survey for Stores; NA, not available; SNAP, Supplemental Nutrition Assistance Program; WHO, World Health Organization.