Proximity to supermarkets associated with higher body mass index among overweight and obese preschool-age children.

Abstract

The objective of this study is to examine associations of proximity to food establishments with body mass index (BMI) among preschool-age children. We used baseline data from 438 children ages 2-6.9 years with a BMI ≥ 85th percentile participating in a RCT in Massachusetts from 2006 to 2009. We used a geographic information system to determine proximity to six types of food establishments: 1) convenience stores, 2) bakeries, coffee shops, candy stores, 3) full service restaurants, 4) large supermarkets, 5) small supermarkets, and 6) fast-food restaurants. The main outcome was child's BMI. Children's mean (SD) BMI was 19.2 (2.4)kg/m(2); 35% lived ≤ 1 mile from a large supermarket, 42% lived >1 to 2 miles, and 22% lived >2 miles. Compared to children living >2 miles from a large supermarket, those who lived within 1 mile had a BMI 1.06 kg/m(2) higher. Adjustment for socioeconomic characteristics and distance to fast-food restaurants attenuated this estimate to 0.77 kg/m(2). Living in any other distance category from a large supermarket and proximity to other food establishments were not associated with child BMI. Living closer to a large supermarket was associated with higher BMI among preschool-age children who were overweight or obese.