title: Associations of supermarket characteristics with weight status and body fat: a multilevel analysis of individuals within supermarkets (RECORD study).
abstract: OBJECTIVE
  Previous research on the influence of the food environment on weight status has often used impersonal measures of the food environment defined for residential neighborhoods, which ignore whether people actually use the food outlets near their residence. To assess whether supermarkets are relevant contexts for interventions, the present study explored between-residential neighborhood and between-supermarket variations in body mass index (BMI) and waist circumference (WC), and investigated associations between brands and characteristics of supermarkets and BMI or WC, after adjustment for individual and residential neighborhood characteristics.
  
  
  METHODS
  Participants in the RECORD Cohort Study (Paris Region, France, 2007-2008) were surveyed on the supermarket (brand and exact location) where they conducted their food shopping. Overall, 7 131 participants shopped in 1 097 different supermarkets. Cross-classified multilevel linear models were estimated for BMI and WC.
  
  
  RESULTS
  Just 11.4% of participants shopped for food primarily within their residential neighborhood. After accounting for participants' residential neighborhood, people shopping in the same supermarket had a more comparable BMI and WC than participants shopping in different supermarkets. After adjustment for individual and residential neighborhood characteristics, participants shopping in specific supermarket brands, in hard discount supermarkets (especially if they had a low education), and in supermarkets whose catchment area comprised low educated residents had a higher BMI/WC.
  
  
  CONCLUSIONS
  A public health strategy to reduce excess weight may be to intervene on specific supermarkets to change food purchasing behavior, as supermarkets are where dietary preferences are materialized into definite purchased foods.
authors.affiliation: Inserm, U707, Paris, France. chaix@u707.jussieu.fr
authors.forename: Basile
authors.initials: B
authors.lastname: Chaix
authors.forename: Kathy
authors.initials: K
authors.lastname: Bean
authors.forename: Mark
authors.initials: M
authors.lastname: Daniel
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Zenk
authors.forename: Yan
authors.initials: Y
authors.lastname: Kestens
authors.forename: Hélène
authors.initials: H
authors.lastname: Charreire
authors.forename: Cinira
authors.initials: C
authors.lastname: Leal
authors.forename: Frédérique
authors.initials: F
authors.lastname: Thomas
authors.forename: Noëlla
authors.initials: N
authors.lastname: Karusisi
authors.forename: Christiane
authors.initials: C
authors.lastname: Weber
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.forename: Chantal
authors.initials: C
authors.lastname: Simon
authors.forename: Juan
authors.initials: J
authors.lastname: Merlo
authors.forename: Bruno
authors.initials: B
authors.lastname: Pannier
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D004032:Diet; D004522:Educational Status; D005260:Female; D005523:Food Supply; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D055105:Waist Circumference