Greater access to fast-food outlets is associated with poorer bone health in young children.

ABSTRACT

SUMMARY: A healthy diet positively influences childhood bone health, but how the food environment relates to bone development is unknown. Greater neighbourhood access to fast-food outlets was associated with lower bone mass among infants, while greater access to healthy speciality stores was associated with higher bone mass at 4 years. INTRODUCTION: Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long-term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children. METHODS: One thousand one hundred and seven children participating in the Southampton Women's Survey, UK, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and 4 and/or 6 years by dual-energy X-ray absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant's neighbourhood were used to derive three measures of the food environment the counts of fast-food outlets, healthy speciality stores and supermarkets. RESULTS: Neighbourhood exposure to fast-food outlets was associated with lower BMD in infancy (ß = -0.23 (z-score) 95% CI -0.38, -0.08) and lower BMC after adjustment for bone area and confounding variables (ß = -0.17 (z-score) 95% CI -0.32, -0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at 4 and 6 years (ß = 0.16(z-score) 95% CI 0.00, 0.32 and ß = 0.13(z-score) 95% CI -0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at 4 years, but not at 6 years. CONCLUSIONS: The neighbourhood food environment that pregnant mothers and young children are exposed may affect bone development during early childhood. If confirmed in future studies, action to reduce access to fast-food outlets could have benefits for childhood development and long-term bone health.