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Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity.

Authors :
Aris IM
Wu AJ
Lin PD
Zhang M
Farid H
Hedderson MM
Zhu Y
Ferrara A
Chehab RF
Barrett ES
Carnell S
Camargo CA Jr
Chu SH
Mirzakhani H
Kelly RS
Comstock SS
Strakovsky RS
O'Connor TG
Ganiban JM
Dunlop AL
Dabelea D
Breton CV
Bastain TM
Farzan SF
Call CC
Hartert T
Snyder B
Santarossa S
Cassidy-Bushrow AE
O'Shea TM
McCormack LA
Karagas MR
McEvoy CT
Alshawabkeh A
Zimmerman E
Wright RJ
McCann M
Wright RO
Coull B
Amutah-Onukagha N
Hacker MR
James-Todd T
Oken E
Source :
JAMA pediatrics [JAMA Pediatr] 2024 Nov 01; Vol. 178 (11), pp. 1172-1182.
Publication Year :
2024

Abstract

Importance: Limited access to healthy foods, resulting from residence in neighborhoods with low food access, is a public health concern. The contribution of this exposure in early life to child obesity remains uncertain.<br />Objective: To examine associations of neighborhood food access during pregnancy or early childhood with child body mass index (BMI) and obesity risk.<br />Design, Setting, and Participants: Data from cohorts participating in the US nationwide Environmental Influences on Child Health Outcomes consortium between January 1, 1994, and March 31, 2023, were used. Participant inclusion required a geocoded residential address in pregnancy (mean 32.4 gestational weeks) or early childhood (mean 4.3 years) and information on child BMI.<br />Exposures: Residence in low-income, low-food access neighborhoods, defined as low-income neighborhoods where the nearest supermarket is more than 0.5 miles for urban areas or more than 10 miles for rural areas.<br />Main Outcomes and Measures: BMI z score, obesity (age- and sex-specific BMI ≥95th percentile), and severe obesity (age- and sex-specific BMI ≥120% of the 95th percentile) from age 0 to 15 years.<br />Results: Of 28 359 children (55 cohorts; 14 657 [51.7%] male and 13 702 [48.3%] female; 590 [2.2%] American Indian, Alaska Native, Native Hawaiian, or Other Pacific Islander; 1430 [5.4%] Asian; 4034 [15.3%] Black; 17 730 [67.2%] White; and 2592 [9.8%] other [unspecified] or more than 1 race; 5754 [20.9%] Hispanic and 21 838 [79.1%] non-Hispanic) with neighborhood food access data, 23.2% resided in low-income, low-food access neighborhoods in pregnancy and 24.4% in early childhood. After adjusting for individual sociodemographic characteristics, residence in low-income, low-food access (vs non-low-income, low-food access) neighborhoods in pregnancy was associated with higher BMI z scores at ages 5 years (β, 0.07; 95% CI, 0.03-0.11), 10 years (β, 0.11; 95% CI, 0.06-0.17), and 15 years (β, 0.16; 95% CI, 0.07-0.24); higher obesity risk at 5 years (risk ratio [RR], 1.37; 95% CI, 1.21-1.55), 10 years (RR, 1.71; 95% CI, 1.37-2.12), and 15 years (RR, 2.08; 95% CI, 1.53-2.83); and higher severe obesity risk at 5 years (RR, 1.21; 95% CI, 0.95-1.53), 10 years (RR, 1.54; 95% CI, 1.20-1.99), and 15 years (RR, 1.92; 95% CI, 1.32-2.80). Findings were similar for residence in low-income, low-food access neighborhoods in early childhood. These associations were robust to alternative definitions of low income and low food access and additional adjustment for prenatal characteristics associated with child obesity.<br />Conclusions: Residence in low-income, low-food access neighborhoods in early life was associated with higher subsequent child BMI and higher risk of obesity and severe obesity. We encourage future studies to examine whether investments in neighborhood resources to improve food access in early life would prevent child obesity.

Details

Language :
English
ISSN :
2168-6211
Volume :
178
Issue :
11
Database :
MEDLINE
Journal :
JAMA pediatrics
Publication Type :
Academic Journal
Accession number :
39283628
Full Text :
https://doi.org/10.1001/jamapediatrics.2024.3459