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Greater access to healthy food outlets in the home and school environment is associated with better dietary quality in young children

  • Millie Barrett (a1), Sarah Crozier (a2), Daniel Lewis (a3), Keith Godfrey (a1) (a2), Sian Robinson (a1) (a2), Cyrus Cooper (a1) (a2) (a4), Hazel Inskip (a1) (a2), Janis Baird (a2) and Christina Vogel (a2)...

Abstract

Objective

To explore associations between dietary quality and access to different types of food outlets around both home and school in primary school-aged children.

Design

Cross-sectional observational study.

Setting

Hampshire, UK.

Subjects

Children (n 1173) in the Southampton Women’s Survey underwent dietary assessment at age 6 years by FFQ and a standardised diet quality score was calculated. An activity space around each child’s home and school was created using ArcGIS. Cross-sectional observational food outlet data were overlaid to derive four food environment measures: counts of supermarkets, healthy specialty stores (e.g. greengrocers), fast-food outlets and total number of outlets, and a relative measure representing healthy outlets (supermarkets and specialty stores) as a proportion of total retail and fast-food outlets.

Results

In univariate multilevel linear regression analyses, better diet score was associated with exposure to greater number of healthy specialty stores (β=0·025 sd/store: 95 % CI 0·007, 0·044) and greater exposure to healthy outlets relative to all outlets in children’s activity spaces (β=0·068 sd/10 % increase in healthy outlets as a proportion of total outlets, 95 % CI 0·018, 0·117). After adjustment for mothers’ educational qualification and level of home neighbourhood deprivation, the relationship between diet and healthy specialty stores remained robust (P=0·002) while the relationship with the relative measure weakened (P=0·095). Greater exposure to supermarkets and fast-food outlets was associated with better diet only in the adjusted models (P=0·017 and P=0·014, respectively).

Conclusions

The results strengthen the argument for local authorities to increase the number of healthy food outlets to which young children are exposed.

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Copyright

Corresponding author

* Corresponding author: Email cv@mrc.soton.ac.uk

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