title: Local food outlets, weight status, and dietary intake: associations in children aged 9-10 years.
abstract: BACKGROUND
  The rising prevalence of childhood obesity is a key public health issue worldwide. Limited evidence suggests that there may be interactions between environmental factors at a neighborhood level and the development of obesity, with the availability and accessibility of food outlets being potentially important.
  
  
  OBJECTIVE
  To examine how the weight status and dietary intake of 1669 children aged 9-10 years was associated with neighborhood food outlets in a cross-sectional study.
  
  
  METHODS
  Availability of food outlets was computed from GIS data for each child's unique neighborhood. Outlets were grouped into BMI-healthy, BMI-unhealthy, or BMI-intermediate categories according to food type sold. Weight status measurements were objectively collected, and food intake was recorded using 4-day food diaries. Data were collected in 2007 and analyzed in 2009.
  
  
  RESULTS
  Availability of BMI-healthy outlets in neighborhoods was associated with lower body weight (1.3 kg, p=0.03); BMI (0.5 kg/m(2), p=0.02); BMI z-score (0.20, p=0.02); waist circumference (1.3 cm, p=0.02); and percentage body fat (1.1%, p=0.03) compared to no availability. In contrast, neighborhood availability of BMI-unhealthy outlets was inversely associated with body weight (1.3 kg, p=0.02); BMI (0.4 kg/m(2), p=0.05); BMI z-score (0.15, p=0.05); waist circumference (1.1 cm, p=0.04); and percentage body fat (1.0%, p=0.03). Unhealthy food intake (fizzy drinks 15.3%, p=0.04, and noncarbonated "fruit" drinks 11.8%, p=0.03) was also associated with availability of BMI-unhealthy food outlets.
  
  
  CONCLUSIONS
  Features of the built environment relating to food purchasing opportunities are correlated with weight status in children.
authors.affiliation: School of Medicine and School of Environmental Sciences, University of East Anglia, Norwich, United Kingdom.
authors.forename: Amy
authors.initials: A
authors.lastname: Jennings
authors.forename: Ailsa
authors.initials: A
authors.lastname: Welch
authors.forename: Andy P
authors.initials: AP
authors.lastname: Jones
authors.forename: Flo
authors.initials: F
authors.lastname: Harrison
authors.forename: Graham
authors.initials: G
authors.lastname: Bentham
authors.forename: Esther M F
authors.initials: EM
authors.lastname: van Sluijs
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
authors.forename: Aedín
authors.initials: A
authors.lastname: Cassidy
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003132:Commerce; D003430:Cross-Sectional Studies; D004032:Diet; D015930:Diet Records; D004739:England; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology; D012111:Residence Characteristics; D012147:Restaurants / Q000706:statistics & numerical data*