The Neighborhood Food Environment and the Onset of Child-Hood Obesity: A Retrospective Time-Trend Study in a Mid-sized City in China

Nowadays, obesity and its associated chronic diseases have become a steadily growing public health problem, spreading from the older to younger age groups. Studies have contended that the built environment, particularly the food environment and walkability, may contribute to the prevalence of childhood obesity. In Asian countries which are characterized by rapid urbanization, high population density and oriental diets, little is known about how such urban built environment affects the onset of childhood obesity. This study juxtaposes the effect of food environment, walkability, and outdoor activity spaces at the neighborhood level upon childhood body weight in a mid-sized city in China. This observational study utilizes a retrospective time-trend study design to examine the associations between neighborhood built environment and children's body weight in Zhanjiang City, a mid-sized city in Guangdong Province, China. Robust multiple linear and logistic regression models were used to estimate associations between the built environments and child BMI and weight status (i.e., overweight/obesity and obesity only). This study finds that: (1) Western-style fast food and Chinese-style fast food have divergent impacts on childhood body weight. At neighborhood level, while increased exposure to Western-style fast food may increase child BMI and the risk of overweight and obesity, increased exposure to Chinese-style fast food, on the contrary, may reduce child BMI and the risk of overweight and obesity, indicating a positive health impact of Chinese-style fast food. (2) However, the positive health impacts brought about by Chinese-style fast food, walkable environments and accessible traditional fruit/vegetable markets have gradually disappeared in recent years. This study is among the first to simultaneously consider the divergent and changing impact of food environment upon childhood body weight in urban China. The findings provide important implications for healthy city design and the management of food retail industry in addressing the obesity epidemic in younger generations living in Asian cities. As prominent differences exist in food culture between Asian and Western cities, more attention should be paid to healthy food environment in future studies and related urban planning strategies formulation.

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Impact of neighbourhood food environment on diet and obesity in China: a systematic review

Public Health Nutrition ◽

10.1017/s1368980019002167 ◽

2019 ◽

Vol 23 (3) ◽

pp. 457-473 ◽

Cited By ~ 2

Author(s):

Ruopeng An ◽

Li He ◽

MS Jing Shen

Keyword(s):

Body Weight ◽

Food Environment ◽

Fast Food ◽

Weight Status ◽

Dietary Diversity ◽

Portion Size ◽

Cochrane Library ◽

Convenience Stores ◽

Fast Food Restaurants ◽

Local Residents

AbstractObjective:This study systematically reviewed literature on the neighbourhood food environment in relation to diet and obesity among residents in China.Design:A keyword search of peer-reviewed articles was performed in Cochrane Library, PubMed, and Web of Science. Eligibility criteria include study designs: longitudinal/cohort studies or cross-sectional studies; study participants: people of all ages; exposures: neighbourhood food environment (e.g. restaurants, supermarkets, wet markets, fast-food restaurants, or convenience stores); outcomes: diet and/or body weight status; and country: China.Results:Seventeen studies met all criteria and were included. Among the eight studies that assessed the neighbourhood food environment in relation to diet, six reported at least one statistically significant relationship in the expected direction, whereas the remaining two exclusively reported null effects. Among the eleven studies that assessed the neighbourhood food environment in relation to body weight or overweight/obesity, ten reported a significant association whereas the remaining one reported a null relationship. Variety, density, and proximity of food outlets were positively associated with local residents’ dietary diversity, portion size, and daily caloric intake. Density and proximity of fast-food restaurants and convenience stores were positively associated with local residents’ adiposity in some but not all studies. Evidence linking any specific food outlet type to diet/obesity remains lacking due to the small number of studies and heterogeneities in food environment measures, geographical locations, and population subgroups.Conclusions:The neighbourhood food environment may influence diet and obesity among Chinese residents but the evidence remains preliminary. Future studies adopting an experimental study design and objective/validated environment and dietary measures are warranted.

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Is the local food environment associated with excess body weight in adolescents in São Paulo, Brazil?

Cadernos de Saúde Pública ◽

10.1590/0102-311x00048619 ◽

2020 ◽

Vol 36 (2) ◽

Cited By ~ 1

Author(s):

Luana Romão Nogueira ◽

Mariane de Mello Fontanelli ◽

Breno Souza de Aguiar ◽

Marcelo Antunes Failla ◽

Alex Antonio Florindo ◽

...

Keyword(s):

Food Environment ◽

Fast Food ◽

Weight Status ◽

Local Food ◽

Sao Paulo ◽

Overweight And Obesity ◽

Excess Body Weight ◽

Sample Population ◽

São Paulo ◽

Cross Sectional

The obesogenic environment stimulates an inadequate diet by hampering healthy choices. This cross-sectional study evaluated the association between the local food environment and the prevalence of overweight and obesity in a representative sample population of adolescents living in the city of São Paulo, Brazil, using multilevel logistic regression models. Among the adolescents, 29.6% were overweight/obese. There were no significant differences between food environment and adolescents’ weight status. However, the presence of fast food restaurants near their home increased the chances of being overweight or obese (OR = 2.53; 95%CI: 1.02-6.27). Results suggest the need to intensify food and nutrition policies, development of culinary skills, and the reduction in prices of healthy foods to facilitate access to these foods, so that adolescents have options in locations to socialize with friends and family.

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Retail food environment around schools and overweight: a systematic review

Nutrition Reviews ◽

10.1093/nutrit/nuz110 ◽

2020 ◽

Vol 78 (10) ◽

pp. 841-856 ◽

Cited By ~ 3

Author(s):

Carla Marien da Costa Peres ◽

Danielle Soares Gardone ◽

Bruna Vieira de Lima Costa ◽

Camila Kümmel Duarte ◽

Milene Cristine Pessoa ◽

...

Keyword(s):

Children And Adolescents ◽

Food Environment ◽

Fast Food ◽

Observational Studies ◽

Protective Factor ◽

Overweight And Obesity ◽

Grocery Stores ◽

Inverse Association ◽

The Impact ◽

Retail Food

Abstract Context The presence of retail food establishments around schools can be a potentiating or protective factor for overweight in students, depending on access to these places as well as types of foods available therein. The hypothesis for this study was that a greater density and proximity of retail food establishments around schools influence the weight of students. Objective To systematically review the available observational literature on the association between retail food establishments around schools and the occurrence of overweight and obesity in schoolchildren and adolescents. Data Sources Observational studies were searched in the MEDLINE, EMBASE, and SCOPUS databases published until May 2019. Data Extraction Two independent reviewers extracted relevant data. Data Analysis Data on the 31 included studies were summarized with narrative synthesis according to meta-analyses of observational studies in epidemiology, exploring the type of food establishments around schools and analyzing qualitatively the impact of proximity or density on overweight and obesity rates. Conclusion Of the 31 articles, a direct association between proximity or density of establishments (mainly fast food restaurants, convenience stores, grocery stores) around schools and overweight and obesity in children and adolescents were found in 14 studies. However, authors of 13 papers found no association and inverse association was presented in 4 papers. The studies presented different methods of classification, location, and analysis of retail food establishments, making it difficult to conclude the real influence that the presence of these establishments near schools have on the nutritional status of children and adolescents. Therefore, future studies should consider the use of longitudinal designs and standardized analysis of the food environment around schools to better understand this food environment and its influence on health-related behaviors.

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Childhood Obesity: Is the Built Environment More Important Than the Food Environment?

Clinical Medicine Insights Pediatrics ◽

10.1177/1179556520932123 ◽

2020 ◽

Vol 14 ◽

pp. 117955652093212

Author(s):

Wenes Pereira Reis ◽

Mark Ghamsary ◽

Caroline Galustian ◽

Henrik Galust ◽

Patti Herring ◽

...

Keyword(s):

Childhood Obesity ◽

Built Environment ◽

Food Environment ◽

Fast Food ◽

Family Income ◽

Grocery Stores ◽

Cross Sectional ◽

Perceived Safety ◽

Fast Food Restaurants ◽

Parents Education

Obesity continues to be a health burden to society and new efforts may be needed to combat this epidemic. This study aims to investigate the contribution of parents education and level of income, food environment (grocery stores and fast food restaurants), and built environment (perceived safety, availability/quantity of parks) on childhood obesity. This cross-sectional observational study explored whether parents education and income level, built environment, and food environment can affect children with obesity. Participants were selected from 3 separate elementary schools located in an urban community with higher risk to have children with obesity in Montclair, California. Children living in families with low incomes have 2.31 times greater odds to be affected by obesity than children living in higher income homes. Children whose parents did not feel safe in their neighborhoods had odds of obesity 2.23 times greater than those who reported their neighborhoods as safe. Age also appeared to be a risk factor, and the odds of children affected by obesity among children 8 to 9 years was 0.79, and the odds of being affected by obesity among children 10 to 11 years of age was 0.36, when compared to children 6 to 7 years old. Findings suggest that low family income, perceptions of neighborhoods as unsafe, and young age are associated with higher body mass index (BMI) percentiles among children living in poor neighborhoods in Montclair, California.

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Law No 1355 for the Prevention of Obesity in Colombia: Influence of School Food Environment Interventions on Children Body Weight and Diet Quality Trends Between 2005 and 2015

Current Developments in Nutrition ◽

10.1093/cdn/nzaa064_014 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1724-1724

Author(s):

Gustavo Mora-Garcia ◽

Vanessa Garcia-Larsen ◽

Antonio Trujillo

Keyword(s):

Body Weight ◽

Healthy Eating ◽

Diet Quality ◽

Food Environment ◽

Healthy Eating Index ◽

Overweight And Obesity ◽

School Food ◽

School Food Environment ◽

Using Data ◽

The Impact

Abstract Objectives To study the impact of the school food environment interventions motivated by the obesity prevention policy reform (Law No 1355, Colombia 2009) on body weight and diet quality trends of schoolchildren. Methods Schoolchildren from six provinces that had implemented the law (‘intervened schools’), and from 26 that had not, were studied using data from the National Nutrition Surveys (ENSIN). A total of 48,936 children aged 6–17y were included (2005, n = 16,193; 2010, n = 9,907; 2015, n = 22,836). Body mass index (log-transformed z-score; zBMI) and bodyweight excess (BWE; i.e., zBMI ≥ 1.0) were the primary outcomes. The Alternative Healthy-Eating Index (AHEI; log-transformed) was derived to measure diet quality, using data from single 24 h recall questionnaires administered in 2005 and 2015. A difference-in-difference analysis (diff-in-diff) was carried out using two waves of data before (ENSIN 2005 and 2010), and one wave 4 years after the policy implementation (ENSIN 2015). The identification strategy relies on variability across time and provinces. Results A total of 11,113 schoolchildren were in the intervened provinces (2005: 4,087; 2010: 2,861; 2015: 4,165). Overall, the percentage of children with BWE in 2005, 2010, and 2010 was 16.5%, 20.2%, and 25.0%, respectively. Between 2005 and 2015, the prevalence of BWE increased from 15.5% to 27.3% in the intervened schools, and from 16.9% to 24.4% in the non-intervened schools. The mean AHEI score was 46.2 ± 10.5 in 2005 and 43.7 ± 11.1 in 2015, with a decrease of 2.29 points in the sample of children from the intervened schools, and of 2.32 points in those from the non-intervened schools. The diff-in-diff analyses showed that the interventions were associated with a 4% increase in zBMI (P < 0.05), and a 2% increase in BWE prevalence (P < 0.001). The changes in diet quality were not statistically significant. Conclusions Diet quality and trends of overweight and obesity in schoolchildren did not improve in the schools that implemented Law No1355. The observed decline in diet quality in all children studied suggest that implementation of food policies to promote healthy eating should not be limited to efforts centered in the school environment. Funding Sources GMG was supported by COLCIENCIAS (Fondo para Investigación en Salud-FIS-).

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Ambiente alimentar e excesso de peso em adultos: uma revisão integrativa

Comunicação em Ciências da Saúde ◽

10.51723/ccs.v32isuppl1.998 ◽

2021 ◽

Vol 32 (Suppl1) ◽

Author(s):

Fernanda Maria Oliveira da Silva ◽

Taiane Gonçalves Novaes ◽

Fernanda Bezerra Queiróz de Farias ◽

Milene Cristine Pessoa

Keyword(s):

Food Intake ◽

Built Environment ◽

Food Consumption ◽

Food Environment ◽

Fast Food

Objetivo: Analisar estudos que avaliaram a relação do ambiente alimentar com o excesso de peso em adultos. Metodologia: Os artigos foram selecionados por meio da busca no Pubmed utilizando os descritores e suas combinações: “obesity”, “built environment”, “food environment”, “food intake” e “food consumption”. Os critérios de inclusão foram: artigos originais realizados com adultos, em zona urbana e publicados nos últimos 10 anos. A decisão de inclusão ou exclusão dos artigos, de acordo com os critérios de elegibilidade, foi realizada, separadamente, por dois avaliadores e adotada reavaliação para os resultados divergentes, sendo selecionados 25 artigos que avaliaram quantitativamente o ambiente alimentar e sua relação com o excesso de peso em adultos. Resultados: Os estudos revisados utilizaram desenho transversal e, na sua maioria, com dados obtidos por fontes secundárias e buffer como unidade de vizinhança. A prevalência do excesso de peso variou de 41,7 a 62,3% e os fatores ambientais associados à essa maior prevalência foram as mercearias, os restaurantes fast food, as lojas de doces e os comércios de alimentos não saudáveis. Conclusão: A heterogeneidade na definição de vizinhança e na obtenção dos dados individuais e do ambiente dificultam a comparação entre os resultados dos estudos e pode explicar as associações divergentes encontradas. Mais estudos são necessários para avaliar aspectos do ambiente alimentar do trabalho, do acesso, do custo dos alimentos e dos hábitos alimentares da população para que seja estabelecida uma associação mais consistente entre o excesso de peso e o ambiente alimentar.

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Contributions of Multiple Built Environment Features to 10-Year Change in Body Mass Index and Waist Circumference in a South Australian Middle-Aged Cohort

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17030870 ◽

2020 ◽

Vol 17 (3) ◽

pp. 870

Author(s):

Suzanne J. Carroll ◽

Michael J. Dale ◽

Anne W. Taylor ◽

Mark Daniel

Keyword(s):

Body Mass Index ◽

Waist Circumference ◽

Built Environment ◽

Body Mass ◽

Food Environment ◽

Fast Food ◽

Growth Models ◽

Protective Effects ◽

Residential Areas ◽

North West

Residential areas may shape health, yet few studies are longitudinal or concurrently test relationships between multiple residential features and health. This longitudinal study concurrently assessed the contributions of multiple environmental features to 10-year change in clinically measured body mass index (BMI) and waist circumference (WC). Longitudinal data for adults (18+ years of age, n = 2253) from the north-west of Adelaide, Australia were linked to built environment measures representing the physical activity and food environment (expressed for residence-based 1600 m road-network buffers) and area education. Associations were concurrently estimated using latent growth models. In models including all environmental exposure measures, area education was associated with change in BMI and WC (protective effects). Dwelling density was associated with worsening BMI and WC but also highly correlated with area education and moderately correlated with count of fast food outlets. Public open space (POS) area was associated with worsening WC. Intersection density, land use mix, greenness, and a retail food environment index were not associated with change in BMI or WC. This study found greater dwelling density and POS area exacerbated increases in BMI and WC. Greater area education was protective against worsening body size. Interventions should consider dwelling density and POS, and target areas with low SES.

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Psychosocial Consequences of Body Weight and Obesity

The Oxford Handbook of Integrative Health Science ◽

10.1093/oxfordhb/9780190676384.013.15 ◽

2018 ◽

pp. 274-286

Author(s):

Deborah Carr ◽

Vera K. Tsenkova

Keyword(s):

Body Weight ◽

Interpersonal Relationships ◽

Large Scale ◽

Well Being ◽

The United States ◽

Overweight And Obesity ◽

The Body ◽

Integrative Health ◽

Psychosocial Consequences ◽

Adults And Children

The body weight of U.S. adults and children has risen markedly over the past three decades. The physical health consequences of obesity are widely documented, and emerging research from the Midlife in the United States study and other large-scale surveys reveals the harmful impact of obesity on adults’ psychosocial and interpersonal well-being. This chapter synthesizes recent research on the psychosocial implications of body weight, with attention to explanatory mechanisms and subgroup differences in these patterns. A brief statistical portrait of body weight is provided, documenting rates and correlates of obesity, with a focus on race, gender, and socioeconomic status disparities. The consequences of body weight for three main outcomes are described: institutional and everyday discrimination, interpersonal relationships, and psychological well-being. The chapter concludes with a discussion of the ways that recent integrative health research on the psychosocial consequences of overweight and obesity inform our understanding of population health.

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A Time-Based Objective Measure of Exposure to the Food Environment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16071180 ◽

2019 ◽

Vol 16 (7) ◽

pp. 1180 ◽

Cited By ~ 2

Author(s):

Jason Scully ◽

Anne Moudon ◽

Philip Hurvitz ◽

Anju Aggarwal ◽

Adam Drewnowski

Keyword(s):

Food Environment ◽

Fast Food ◽

Objective Measure ◽

Mobility Patterns ◽

Time Duration ◽

Positioning Systems ◽

Global Positioning ◽

Fast Food Restaurants ◽

Logistic Regressions ◽

The Relationship

Exposure to food environments has mainly been limited to counting food outlets near participants’ homes. This study considers food environment exposures in time and space using global positioning systems (GPS) records and fast food restaurants (FFRs) as the environment of interest. Data came from 412 participants (median participant age of 45) in the Seattle Obesity Study II who completed a survey, wore GPS receivers, and filled out travel logs for seven days. FFR locations were obtained from Public Health Seattle King County and geocoded. Exposure was conceptualized as contact between stressors (FFRs) and receptors (participants’ mobility records from GPS data) using four proximities: 21 m, 100 m, 500 m, and ½ mile. Measures included count of proximal FFRs, time duration in proximity to ≥1 FFR, and time duration in proximity to FFRs weighted by FFR counts. Self-reported exposures (FFR visits) were excluded from these measures. Logistic regressions tested associations between one or more reported FFR visits and the three exposure measures at the four proximities. Time spent in proximity to an FFR was associated with significantly higher odds of FFR visits at all proximities. Weighted duration also showed positive associations with FFR visits at 21-m and 100-m proximities. FFR counts were not associated with FFR visits. Duration of exposure helps measure the relationship between the food environment, mobility patterns, and health behaviors. The stronger associations between exposure and outcome found at closer proximities (<100 m) need further research.

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