Abstract
BackgroundFood environments have rapidly changed over the past years in China and children have more access to unhealthy food in convenience stores near schools. Since the studies on the association between convenience stores near schools and obesity had inconsistent results and no similar study in China, we conducted a study on the association in Beijing of China, which will provide scientific evidence for the intervention of childhood obesity.MethodsThe study included 2201 students at grade 4 of 37 primary schools in Dongcheng or Miyun district of Beijing. The food environment data was acquired from AMAP, the free web-based geospatial service provider. The numbers of convenience stores were captured within the 800-m network buffer near schools using Geographic Information System. The weight and height of each student were measured by trained health professionals. Students’ dietary and physical behaviors and other information associated with obesity were collected with questionnaires for students and their parents. The generalized linear mixed model (GLMM) was used to analyze the data.ResultsThe average age of the students was 10.2 years (Standard Deviation (SD) = 0.33). The prevalence of obesity in students was 14.9%. The median number of convenience stores within the 800-m network buffer near schools was 24 in two districts. The number of convenience stores near each school varied from 5 to 67 (median: 25) in Dongcheng district and from 1 to 57 (median: 22) in Miyun district. After adjusting for the confounding factors at the family and individual levels, the association between convenience stores and childhood obesity was statistically significant. Additional ten convenience stores near schools were associated with an increased risk of obesity (Odds Ratio (OR) = 1.13, 95% confidence interval (CI): 1.03,1.24, P = 0.011). Compared with less than 24 convenience stores near schools, the students with more than or equal to 24 convenience stores near schools had an increased risk of obesity (OR = 1.49, 95% CI: 1.09, 2.03, P = 0.013).ConclusionThe students with more convenience stores near their schools had an increased risk of obesity. The findings provided evidence for developing public health policy to restrict the number of convenience stores near schools to prevent and control childhood obesity.
Highlights
Food environments have rapidly changed over the past years in China and children have more access to unhealthy food in convenience stores near schools
The convenience stores near schools may be one of the obesogenic environments for students, because many unhealthy foods are sold in convenience stores, such as sugar-sweetened beverages and energy-dense snacks [14], and very limited healthy food are provided in convenience stores [15]
We found that additional ten convenience stores near schools were associated with an increased risk of obesity (OR = 1.13, 95% Confidence Interval (CI): 1.03,1.24)
Summary
Food environments have rapidly changed over the past years in China and children have more access to unhealthy food in convenience stores near schools. The convenience stores near schools may be one of the obesogenic environments for students, because many unhealthy foods are sold in convenience stores, such as sugar-sweetened beverages and energy-dense snacks [14], and very limited healthy food are provided in convenience stores [15]. A previous study found that students aged 10 to 14 years old bought snacks mostly in convenience stores rather than other types of food stores [16]. Many school-aged children would like to buy unhealthy food such as sugar-sweetened beverages and energy-dense snacks on the way to school and from school [17], which may increase the intake of energy. Energy intake that exceeds energy expenditure will result in childhood obesity
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