Abstract
Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children’s diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children’s fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013–2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents’ perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = −0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households.
Highlights
Improved perception of produce availability at the neighborhood-level was associated with a higher produce availability at the household-level, which in turn was related to improved fruit and vegetable intake at the individual-level
Higher fruit and vegetable intake among children was associated with a lower body mass index (BMI), which has been found in previous studies with adults [23,24,25,26], but has been shown with mixed results in children [27]
The results are consistent with the M-TEENs study of 903 U.S adolescents, which found associations between home food availability and children’s diet, but no connections between the neighborhood food environment and children’s diet and BMI [30]
Summary
Very few children in the United States (U.S.) meet the recommended daily intake for produce: less than 50% of children consume enough fruits, and less than 12% consume enough vegetables [1]. A low intake of fruits and vegetables has been linked to obesity, hypertension, coronary heart disease, stroke, and cancer [2]. Many factors contribute to low fruit and vegetable intake and associated chronic diseases, which is why the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention recommend a multi-level approach to establishing healthy dietary patterns and preventing obesity, addressing the neighborhood and home food environments in addition to individual-level dietary factors [3,4]. The nature of the relationships between food environments, children’s fruit and vegetable intake, and weight status requires further investigation to identify the most promising strategies to optimize child health
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