Objective: Poor diet in childhood increases risk of obesity but the relationship between access to food and children's food choice is underexplored. We determined relationships between distance to and density of food outlets on children's food choice.
Design: Children (n 1721) aged 9-10 years who participated in a cross-sectional study from a sample of state and private schools across urban and rural areas. Food consumption was reported using a short validated FFQ. A Geographic Information System was used to determine proximity to local food outlets. Multivariable regression analyses were performed to determine associations between food consumption and distance to and density of local food outlets.
Setting: Norfolk, England.
Subjects: Boys (n 754) and girls (n 967) aged 9-10 years.
Results: The impact of distance to or density of food outlets on food choice was small after adjustment. Living further away from a supermarket increased portions of fruit (0.11 portions/week per 1 km increase in distance to nearest supermarket, P < 0.05) and vegetables (0.11 portions/week, P < 0.05) consumed. Living closer to convenience stores was also associated with an increased consumption of crisps, chocolate and white bread. Density of supermarkets was associated with both an increase in vegetable intake (0.31 portions/week, P < 0.05) and unhealthy foods.
Conclusions: Distance to and density of food outlets are both associated with children's food choice, although the impact appears to be small and the relationship is complex. However, the effects of individual foods combined could be important, particularly as even small differences in intake can impact on body weight over time.