Does the local food environment around schools affect diet? Longitudinal associations in adolescents attending secondary schools in East London

BMC Public Health

Stephen Stansfeld³  Charlotte Clark³  Steven Cummins¹  Dianna Smith² 

[1] Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK;Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK;Centre for Psychiatry, Old Anatomy Building, Barts and The London School of Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK

关键词: Schools;    Adolescents;    Geographic information systems (GIS);    Diet;    Local food environment;   

Others  :  1162609
DOI  :  10.1186/1471-2458-13-70

 received in 2012-02-14, accepted in 2012-12-18,  发布年份 2013

【 摘 要 】

Background

The local retail food environment around schools may act as a potential risk factor for adolescent diet. However, international research utilising cross-sectional designs to investigate associations between retail food outlet proximity to schools and diet provides equivocal support for an effect. In this study we employ longitudinal perspectives in order to answer the following two questions. First, how has the local retail food environment around secondary schools changed over time and second, is this change associated with change in diet of students at these schools?

Methods

The locations of retail food outlets and schools in 2001 and 2005 were geo-coded in three London boroughs. Network analysis in a Geographic Information System (GIS) ascertained the number, minimum and median distances to food outlets within 400 m and 800 m of the school location. Outcome measures were ‘healthy’ and ‘unhealthy’ diet scores derived from adolescent self-reported data in the Research with East London Adolescents: Community Health Survey (RELACHS). Adjusted associations between distance from school to food retail outlets, counts of outlets near schools and diet scores were assessed using longitudinal (2001–2005 n=757) approaches.

Results

Between 2001 and 2005 the number of takeaways and grocers/convenience stores within 400 m of schools increased, with many more grocers reported within 800 m of schools in 2005 (p< 0.001). Longitudinal analyses showed a decrease of the mean healthy (−1.12, se 0.12) and unhealthy (−0.48, se 0.16) diet scores. There were significant positive relationships between the distances travelled to grocers and healthy diet scores though effects were very small (0.003, 95%CI 0.001 – 0.006). Significant negative relationships between proximity to takeaways and unhealthy diet scores also resulted in small parameter estimates.

Conclusions

The results provide some evidence that the local food environment around secondary schools may influence adolescent diet, though effects were small. Further research on adolescents’ food purchasing habits with larger samples in varied geographic regions is required to identify robust relationships between proximity and diet, as small numbers, because of confounding, may dilute effect food environment effects. Data on individual foods purchased in all shop formats may clarify the frequent, overly simple classification of grocers as ‘healthy’.

【 授权许可】

   
2013 Smith et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Cummins S, Smith D, Aitken Z, Dawson J, Marshall D, Sparks L, Anderson A: Neighbourhood deprivation and the price and availability of fruit and vegetables in Scotland. J Hum Nutr Diet 2010, 23(5):494-501.
• [2]Cummins S, Smith DM, Taylor M, Dawson J, Marshall D, Sparks L, Anderson AS: Variations in fresh fruit and vegetable quality by store type, urban–rural setting and neighbourhood deprivation in Scotland. Public Health Nutr 2009, 12(11):2044-2050.
• [3]Smith D, Cummins S, Taylor M, Dawson J, Marshall D, Sparks L, Anderson A: Neighbourhood food environment and area deprivation: spatial accessibility to grocery stores selling fresh fruit and vegetables in urban and rural settings. Int J Epidemiol 2010, 39:277-284.
• [4]Pearce J, Hiscock R, Blakely T, Witten K: The contextual effects of neighbourhood access to supermarkets and convenience stores on individual fruit and vegetable consumption. J Epidemiol Community Health 2008, 62:198-201.
• [5]Mooney C: Cost and availability of healthy food choices in a London health district. J Hum Nutr Diet 1990, 3:111-120.
• [6]Chung C, Myers SL: Do the poor pay more for food? An analysis of grocery store availability and food price disparities. J Consum Aff 1999, 33:276-296.
• [7]Donkin SJ, Dowler EA, Setevenson S, Turner SA: Mapping access to food at a local level. British Food Journal 1999, 101:554-564.
• [8]Wrigley N, Warm D, Margetts B: Deprivation, diet, and food-retail access: findings from the Leeds ‘food deserts’ study. Environment and Planning A 2003, 35:151-188.
• [9]Bodor J, Rose D, Farley T, Swalm C, Scott S: Neighbourhood fruit and vegetable availability and consumption: the role of small food stores in an urban environment. Public Health Nutr 2008, 11:413-420.
• [10]Sturm R: Disparities in the food environment surrounding US middle and high schools. Public Health 2008, 122(7):681-690.
• [11]Ruopeng A, Sturm R: School and residential neighborhood food environment and diet among California youth. Am J Prev Med 2012, 42(2):129-135.
• [12]Neckerman KM, Bader MDM, Richards CA, Purciel M, Quinn JW, Thomas JS, Warbelow C, Weiss CC, Lovasi GS, Rundle A: Disparities in the food environments of New York city public schools. Am J Prev Med 2010, 39(3):195-202.
• [13]Day PL, Pearce J: Obesity-promoting food environments and the spatial clustering of food outlets around schools. Am J Prev Med 2010, 40(2):113-121.
• [14]Simon PA, Kwan D, Angelescu A, Shih M, Fielding JE: Proximity of fast food restaurants to schools: do neighborhood income and type of school matter? Prev Med 2008, 47(3):284-288.
• [15]Kestens Y, Daniel M: Social inequalities in food exposure around schools in an urban area. Am J Prev Med 2010, 39(1):33-40.
• [16]van der Horst K, Timperio A, Crawford D, Roberts R, Brug J, Oenema A: The school food environment associations with adolescent soft drink and snack consumption. Am J Prev Med 2008, 35(3):217-223.
• [17]Zenk SN, Schulz AJ, Matthews SA, Odoms-Young A, Wilbur J, Wegrzyn L, Gibbs K, Gibbs K, Braunschweig C, Stokes C: Activity space environment and dietary and physical activity behaviors: a pilot study. Health Place 2011, 17:1150-1161.
• [18]Powell L, Auld M, Chaloupka F, O’Malley P, Johnston L: Associations between access to food stores and adolescent body mass index. Am J Prev Med 2007, 33:S301-S307.
• [19]Nelson M, Nicholas J, Wood L, Riley K, Russell S: Stastistical Release: Take up of school lunches in England, 2010–2011. London: School Food Trust & Local Authority Caterers Association; 2011.
• [20]Story M, Nanney MS, Schwartz MB: Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q 2009, 87(1):71-100.
• [21]Sinclair S, Winkler J: The School Fringe: What pupils buy and eat from shops surrounding secondary schools. London: Nutrition Policy Unit, London Metopolitan University; 2008.
• [22]Sodexho: The Sodexho School Meals and Lifestyle Survey 2005. Whyteleafe: Surrey; 2005.
• [23]Davis B, Carpenter C: Proximity of fast-food restaurants to schools and adolescent obesity. Am J Public Health 2009, 99(3):505-510.
• [24]Gordon-Larsen P, Guilkey DK, Popkin BM: An economic analysis of community-level fast food prices and individual-level fast food intake: a longitudinal study. Health Place 2011, 17(6):1235-1241.
• [25]Boone-Heinonen J, Gordon-Larsen P, Kiefe CI, Shikany JM, Lewis CE, Popkin BM: Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study. Arch Intern Med 2011, 171:1162-1170.
• [26]Macdonald L, Ellaway A, Ball K, Macintyre S: Is proximity to a food retail store associated with diet and BMI in Glasgow, Scotland? BMC Publ Health 2011, 11(1):464.
• [27]Moore L, Roux A, Nettleton J, Jacobs D: Associations of the local food environment with diet quality - a comparison of assessments based on surveys and geographic information systems. Am J Epidemiol 2008, 167:917-924.
• [28]Richardson A, Boone-Heinonen J, Popkin B, Gordon-Larsen P: Neighborhood fast food restaurants and fast food consumption: a national study. BMC Publ Health 2011, 11(1):543.
• [29]Block J, Christakis NA, O’Malley JA, Subramanian SV: Proximity to food establishments and body mass index in the framingham heart study offspring cohort over 30 years. Am J Epidemiol 2011, 174:1108-1114.
• [30]Currie J, DellaVigna S, Moretti E, Pathania V: The Effect of Fast Food Restaurants on Obesity and Weight Gain. Cambridge, MA: National Bureau of Economic Research; 2009.
• [31]Powell L, Bao Y: Food prices, access to food outlets and child weight. Econ Hum Biol 2009, 7:64-72.
• [32]Viner RM, Clark C, Taylor SJC, Bhui K, Klineberg E, Head J, Booy R, Stansfeld SA: Longitudinal risk factors for persistent fatigue in adolescents. Arch Pediatr Adolesc Med 2008, 162(5):469-475.
• [33]Taylor SJC, Viner R, Booy R, Head J, Tate H, Brentnall SL, Haines M, Bhui K, Hillier S, Stansfeld S: Ethnicity, socio-economic status, overweight and underweight in East London adolescents. Ethn Health 2005, 10(2):113-128.
• [34]Sterne JA, White IR, Carlin J, Spratt M, Royston P, Kenward MG, Wood AM, Carpenter JR: Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 2009, 339:157-160.
• [35]Wardle J, Robb K, Johnson F: Assessing socioeconomic status in adolescents: the validity of a home affluence scale. J Epidemiol Community Health 2002, 56(8):595-599.
• [36]Hobbs G, Vignoles A: Is children’s free school meal eligibility a good proxy for family income? British Education Research Journal 2009, 36:673-690.
• [37]Jacka F, Rothon C, Taylor S, Berk M, Stansfeld SA: Diet quality and mental health problems in adolescents from East London: a prospective study. Soc Psych Psych Epid 2012. epub ahead of print
• [38]Lake AA, Burgoine T, Greenhalgh F, Stamp E, Tyrrell R: The foodscape: classification and field validation of secondary data sources. Health Place 2010, 16(4):666-673.
• [39]Auchincloss A, Moore K, Moore L, Diez Roux A: Improving retrospective characterization of the food environment for a large region in the United States during a historic time period. Health Place 2012, 18(6):1341-1347.
• [40]Postal geography[http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/postal/index.html webcite]
• [41]UK Borders[http://edina.ac.uk/ukborders/ webcite]
• [42]Marmot M: Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England post-2010. London: The Marmot Review; 2010.
• [43]Improvement and Development Agency: The social determinants of health and the role of local government. Edited by Campbell F. London: Department of Health; 2010.
• [44]Pearson T, Russell J, Campbell M, Barker M: Do ‘food deserts’ influence fruit and vegetable consumption? - a cross-sectional study. Appetite 2005, 45:195-197.
• [45]Morland K, Wing S, Diez-Roux A: The contextual effect of the local food environment on residents’ diets: the atherosclerosis risk in communities study. Am J Public Health 2002, 92:1761-1767.
• [46]Rose D, Richards R: Food store access and household fruit and vegetable use among participants in the U.S. Food Stamp Program. Public Health Nutr 2004, 7:1081-1088.
• [47]Laska MN, Hearst MO, Forsyth A, Pasch KE, Lytle L: Neighbourhood food environments: are they associated with adolescent dietary intake, food purchases and weight status? Public Health Nutr 2010, 13(11):1757-1763.
• [48]The school foodshed: a report on schools and fast food outlets (FFOs) in Tower Hamlets  . [http://www.foodvision.gov.uk/pages/tower-hamlets-food-for-health-award-scheme webcite]
• [49]Thornton L, Cameron A, McNaughton S, Worsley A, Crawford D: The availability of snack food displays that may trigger impulse purchases in Melbourne supermarkets. BMC Publ Health 2012, 12(1):194.
• [50]Thompson C, Cummins S, Brown T, Kyle R: Understanding interactions with the food environment: an exploration of supermarket food shopping routines in deprived neighbourhoods. Health Place 2012, 19(1):116-123.
• [51]Pearce J, Witten K, Hiscock R, Blakely T: Are socially disadvantaged neighbourhoods deprived of health-related community resources? Int J Epidemiol 2007, 36(2):348-355.
• [52]Burns CM, Inglis AD: Measuring food access in Melbourne: access to healthy and fast foods by car, bus and foot in an urban municipality in Melbourne. Health Place 2007, 13(4):877-885.