title: Proximity to supermarkets associated with higher body mass index among overweight and obese preschool-age children.
abstract: OBJECTIVE
  The objective of this study is to examine associations of proximity to food establishments with body mass index (BMI) among preschool-age children.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Living closer to a large supermarket was associated with higher BMI among preschool-age children who were overweight or obese.
authors.affiliation: Department of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Fiechtner
authors.forename: Jason
authors.initials: J
authors.lastname: Block
authors.forename: Dustin T
authors.initials: DT
authors.lastname: Duncan
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.forename: Steven L
authors.initials: SL
authors.lastname: Gortmaker
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Melly
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Rifas-Shiman
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008404:Massachusetts; D050177:Overweight / Q000453:epidemiology*; D012111:Residence Characteristics