title: The Toxic Food Environment Around Elementary Schools and Childhood Obesity in Mexican Cities.
abstract: The childhood obesity epidemic is a global concern. There is limited evidence in Mexico linking the local food environment to obesity. The purpose of this study is to describe the links between the local food environment around elementary schools and schoolchildren's BMI in two Mexican cities.
  
  
  
  Cross-sectional surveys were conducted in 60 elementary schools in two Mexican cities (i.e., Cuernavaca and Guadalajara) in 2012-2013. Anthropometric measurements on schoolchildren were collected, as well as environmental direct audits and observations in a 100-m buffer around schools. Children's BMI was evaluated according to WHO-recommended procedures. In BMI models, the explanatory variable was the number of retail food sources. These models were adjusted for child's characteristics, schools' socioeconomic background, compliance with federal guidelines concerning unhealthy foods within schools' facilities, and corresponding city. Analysis was conducted in 2014.
  
  
  
  The number of mobile food vendors was higher around public schools than outside private schools (p<0.05). Linear regression procedures showed a significant positive statistical association between children's BMI and the number of mobile food vendors around schools. Schoolchildren from the highest tertile of mobile food vendors showed 6.8% higher BMI units than those from the lowest tertile. Children attending schools within the highest tertile of food stores also had 4.7% higher BMI units than children from schools in the lowest tertile.
  
  
  
  Health policy in Mexico should target the obesogenic environment surrounding elementary schools, where children may be more exposed to unhealthy foods.
authors.affiliation: Nutrition and Health Research Center, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Lucia Hernandez
authors.initials: LH
authors.lastname: Barrera
authors.affiliation: Center for Research in Population Health, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Rothenberg
authors.affiliation: Nutrition and Health Research Center, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Simon
authors.initials: S
authors.lastname: Barquera
authors.affiliation: Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts. Electronic address: ecifuent@gmail.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: Cifuentes
mesh_terms: D015992:Body Mass Index; D002648:Child; D002947:Cities; D003430:Cross-Sectional Studies; D004777:Environment; D057140:Fast Foods / Q000600:supply & distribution; D005260:Female; D005522:Food Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology*; D012574:Schools; D012959:Socioeconomic Factors