Body mass index in elementary school children, metropolitan area food prices and food outlet density
Abstract
Objective The aim of this study was to examine the association between food prices and food outlet density and changes in the body mass index (BMI) among elementary school children in the USA.Methods The Early Childhood Longitudinal Study followed a nationally representative sample of kindergarten children over 4 years. We merged individual-level data to (a) metropolitan data on food prices and (b) per capita number of restaurants, grocery stores and convenience stores in the child's home and school zip code. The dependent variables were BMI changes over 1 and 3 years. We analysed mean changes with least-squares regression, and median changes and 85th percentile changes with quantile regression. We controlled for baseline BMI, age, real family income and sociodemographic characteristics.Results Lower real prices for vegetables and fruits were found to predict a significantly lower gain in BMI between kindergarten and third grade; half of that effect was found between kindergarten and first grade. Lower meat prices had the opposite effect, although this effect was generally smaller in magnitude and was insignificant for BMI gain over 3 years. Differences across subgroups were not statistically significant due to smaller sample sizes in subgroup analyses, but the estimated effects were meaningfully larger for children in poverty, children already at risk for overweight or overweight in kindergarten, and Asian and Hispanic children. There were no significant effects for dairy or fast-food prices, nor for outlet density, once we had controlled for individual characteristics and random intercepts to adjust standard errors for the sampling design.Discussion The geographic variation in fruit and vegetable prices is large enough to explain a meaningful amount of the differential gain in BMI among elementary school children across metropolitan areas. However, as consumption information was not available, we cannot confirm that this is the actual pathway. We found no effects of food outlet density at the neighbourhood level, possibly because availability is not an issue in metropolitan areas.
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Among studies evaluating accessibility to grocery stores, 1 small study found no associations with fruit or vegetable consumption, and 5 of 6 studies, including 1 longitudinal study, found no associations with adiposity.
“Among studies evaluating accessibility to grocery stores, 1 small study found no associations with fruit or vegetable consumption,288 and 5 of 6 studies, including 1 longitudinal study, found no associations with adiposity.173,290,292,293, 298,300”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [173]
Four of 6 studies, including 1 longitudinal study, found greater accessibility to a neighborhood convenience store was associated with more adiposity or diabetes.
“Four of 6 studies, including 1 longitudinal study, found that greater accessibility to a neighborhood convenience store was associated with more adiposity or diabetes.173,290,292,293,298,299”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [173]
Most studies did not find any significant relation between neighborhood accessibility to fast-food restaurants and prevalence of adiposity in either adults or children.
“Most did not find any significant relation between neighborhood accessibility (number, distance, or density) to fast-food restaurants and prevalence of adiposity in either adults or children.173,291,293, 294,299,303–305”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [173]
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- Authors
- Sturm, R., & Datar, A.
- Affiliations
- RAND Corporation (US)
- Corresponding author
- Sturm, R.
- ORCID
- Datar, A.
- Venue
- Public Health
- Publisher
- Elsevier BV
- Published
- 2005-12
- Volume
- 119
- Issue
- 12
- Pages
- 1059-1068
- ISSN
- 0033-3506 (ISSN-L)
- OpenAlex
- W1993311882
- Cited by
- 380
- References
- 17
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 10 · 2020: 16 · 2019: 8 · 2018: 16 · 2017: 13 · 2016: 16 · 2015: 17 · 2014: 31 · 2013: 28 · 2012: 39
- FWCI
- 21.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Public Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
- Keywords
- body mass index, childhood obesity, food prices, food outlet density, elementary school students, fruit and vegetable prices, meat prices, food environment, metropolitan areas, child poverty, overweight risk, Early Childhood Longitudinal Study
- MeSH terms
- Child, Costs and Cost Analysis, Ethnicity, Female, Food, Humans, Longitudinal Studies, Male, Socioeconomic Factors, Students, Body Mass Index
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