Socio-economic correlates of childhood obesity in urban and rural England.

OBJECTIVE: Physical access to food may affect diet and thus obesity rates. We build upon existing work to better understand how socio-economic characteristics of locations are associated with childhood overweight. DESIGN: Using cross-sectional design and publicly available data, the study specifically compares rural and urban areas, including interactions of distance from supermarkets with income and population density. SETTING: We examine cross-sectional associations with obesity prevalence both in the national scale and across urban and rural areas differing in household wealth. PARTICIPANTS: Children in reception class (aged 4-5) from all state-maintained schools in England taking part in the National Child Measurement Programme (n 6772). RESULTS: Income was the main predictor of childhood obesity (adj. R-sq=.316, p<.001), whereas distance played only a marginal role (adj. R-sq=.01, p<.001). In urban areas, distance and density correlate with obesity directly and conditionally. Urban children were slightly more obese, but the opposite was true for children in affluent areas. Association between income poverty and obesity rates was stronger in urban areas (7·59 %) than rural areas (4·95 %), the former which also showed stronger association between distance and obesity. CONCLUSIONS: Obesogenic environments present heightened risks in deprived urban and affluent rural areas. The results have potential value for policy making as for planning and targeting of services for vulnerable groups.

Quantifying the Impact of Supermarket Distance on Childhood Obesity in Greater London, United Kingdom: Exploring Different Access Measures and Modification Effects of Transportation.

Background: Healthy food access may be relevant for predicting trends in childhood obesity. The goal was to determine associations between childhood overweight (including obesity) and distance to three nearest supermarkets stratified by transportation modes (walking, cycling, driving). Methods: Bivariate and multivariate linear regressions examine the relationship with obesity, including interacting active and inactive modes. Results: Proximity to at least three supermarkets shows small but significant positive association with obesity. Walking mode showed higher obesity rates than driving, and distance was not related to the mode of travel. Conclusions: Disparities in healthy food access may not contribute meaningfully to childhood obesity, as other individual factors may be largely at play.

Parental Perspectives of the Impact of COVID-19 Lockdown on Food-Related Behaviors: Systematic Review.

Home confinement during the COVID-19 pandemic has been accompanied by dramatic changes in household food dynamics that can significantly influence health. This systematic literature review presents parental perspectives of the impact of COVID-19 lockdown (up to 30 June 2022) on food preparation and meal routines, as well as other food-related behaviors, capturing both favorable and unfavorable changes in the household food environment. Themes and trends are identified and associations with other lifestyle factors are assessed. Overall, families enjoyed more time together around food, including planning meals, cooking, and eating together. Eating more diverse foods and balanced home-cooked meals (e.g., fresh fruit and vegetables) was combined with overeating and increased snacking (e.g., high-calorie snacks, desserts, and sweets), as parents became more permissive towards food; however, food insecurity increased among families with the lowest income. Adoption of meal planning skills and online shopping behavior emerged alongside behaviors aimed at self-sufficiency, such as bulk purchasing and stockpiling of non-perishable processed foods. These results are an important first step in recognizing how this pandemic may be affecting the family food environment, including low-income families. Future obesity prevention and treatment initiatives, but also ongoing efforts to address food management, parental feeding practices, and food insecurity, can account for these changes moving forward.

Assessing physical access to healthy food across United Kingdom: A systematic review of measures and findings.

Background: Existing research suggests that physical access to food can affect diet quality and thus obesity rates. When defining retail food environment (RFE) quantitatively, there is a little agreement on how to measure "lack of healthy food" and what parameters to use, resulting in a heterogeneity of study designs and outcome measures. In turn, this leads to a conflicting evidence base being one of the many barriers to using evidence in policy-making. Aims: This systematic review aimed to identify and describe methods used to assess food accessibility in the United Kingdom (UK) to overcome heterogeneity by providing a classification of measures. Materials & Methods: The literature search included electronic and manual searches of peer-reviewed literature and was restricted to studies published in English between January 2010 and March 2021. A total of 9365 articles were assessed for eligibility, of which 44 articles were included in the review. All included studies were analysed with regards to their main characteristics (e.g., associations between variables of interest, setting, sample, design, etc.) and definition of RFE and its metrics. When defining these metrics, the present review distinguishes between a point of origin (centroid, address) from which distance was calculated, summary statistic of accessibility (proximity, buffer, Kernel), and definition of distance (Euclidean, network distance). Trends, gaps and limitations are identified and recommendations made for food accessibility research in UK. Results: Multiple theoretical and methodological constructs are currently used, mostly quantifying distance by means of Euclidean and ring-buffer distance, using both proximity- and density-based approaches, and ranging from absolute to relative measures. The association between RFE and diet and health in rural areas, as well as a spatiotemporal domain of food access, remains largely unaccounted. Discussion: Evidence suggests that the duration of exposure may bear a greater importance than the level of exposure and that density-based measures may better capture RFE when compared with proximity-based measures, however, using more complex measures not necessarily produce better results. To move the field forward, studies have called for a greater focus on causality, individual access and the use of various measures, neighbourhood definitions and potential confounders to capture different aspects and dimensions of the RFE, which requires using univariate measures of accessibility and considering the overall context in terms of varying types of neighbourhoods. Conclusion: In order to render ongoing heterogeneity in measuring RFE, researchers should prioritise measures that may provide a more accurate and realistic account of people's lives and follow an intuitive approach based on convergence of results until consensus could be reached on using some useful standards.