Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity
Authors: Izzuddin M. Aris, Allison J. Wu, Pi-I D. Lin, Mingyu Zhang, Huma Farid, Monique M. Hedderson, Yeyi Zhu, Assiamira Ferrara, Rana F. Chehab, Emily S. Barrett, Susan Carnell, Carlos A. Camargo, Su H. Chu, Hooman Mirzakhani, Rachel S. Kelly, Sarah S. Comstock, Rita S. Strakovsky, Thomas G. O’Connor, Jody M. Ganiban, Anne L. Dunlop, Dana Dabelea, Carrie V. Breton, Theresa M. Bastain, Shohreh F. Farzan, Christine C. Call, Tina Hartert, Brittney Snyder, Sara Santarossa, Andrea E. Cassidy-Bushrow, T. Michael O’Shea, Lacey A. McCormack, Margaret R. Karagas, Cindy T. McEvoy, Akram Alshawabkeh, Emily Zimmerman, Rosalind J. Wright, Mariel McCann, Robert O. Wright, Brent Coull, Ndidiamaka Amutah-Onukagha, Michele R. Hacker, Tamarra James-Todd, Emily Oken, P Brian Smith, L Kristin Newby, Linda Adair, Lisa P. Jacobson, Diane Catellier, Monica McGrath, Christian Douglas, Priya Duggal, Emily Knapp, Amii Kress, Courtney K. Blackwell, Maxwell A. Mansolf, Jin-Shei Lai, Emily Ho, David Cella, Richard Gershon, Michelle L. Macy, Suman R. Das, Jane E. Freedman, Simon A. Mallal, John A. McLean, Ravi V. Shah, Meghan H. Shilts, Akram N. Alshawabkeh, Jose F. Cordero, John Meeker, Leonardo Trasande, Carlos A. Camargo, Kohei Hasegawa, Zhaozhong Zhu, Ashley F. Sullivan, Dana Dabelea, Wei Perng, Traci A. Bekelman, Greta Wilkening, Sheryl Magzamen, Brianna F. Moore, Anne P. Starling, Deborah J. Rinehart, Daphne Koinis Mitchell, Viren D'Sa, Sean C.L. Deoni, Hans-Georg Mueller, Cristiane S. Duarte, Catherine Monk, Glorisa Canino, Jonathan Posner, Tenneill Murray, Claudia Lugo-Candelas, Anne L. Dunlop, Patricia A. Brennan, Christine Hockett, Amy Elliott, Assiamira Ferrara, Lisa A. Croen, Monique M. Hedderson, John Ainsworth, Leonard B. Bacharier, Casper G. Bendixsen, James E. Gern, Diane R. Gold, Tina V. Hartert, Daniel J. Jackson, Christine C. Johnson, Christine  L.M. Joseph, Meyer Kattan, Gurjit K. Khurana Hershey, Robert F. Lemanske, Jr., Susan V. Lynch, Rachel L. Miller, George T. O’Connor, Carole Ober, Dennis Ownby, Katherine Rivera-Spoljaric, Patrick H. Ryan, Christine M. Seroogy, Anne Marie Singh, Robert A. Wood, Edward M. Zoratti, Rima Habre, Shohreh Farzan, Frank D. Gilliland, Irva Hertz-Picciotto, Deborah H. Bennett, Julie B. Schweitzer, Rebecca J. Schmidt, Janine M. LaSalle, Alison E. Hipwell, Kate E. Keenan, Catherine J. Karr, Nicole R. Bush, Kaja Z. LeWinn, Sheela Sathyanarayana, Qi Zhao, Frances Tylavsky, Kecia N. Carroll, Christine T. Loftus, Leslie D. Leve, Jody M. Ganiban, Jenae M. Neiderhiser, Scott T. Weiss, Augusto A. Litonjua, Cindy T. McEvoy, Eliot R. Spindel, Robert S. Tepper, Craig J. Newschaffer, Kristen Lyall, Heather E. Volk, Rebecca Landa, Sally Ozonoff, Joseph Piven, Heather Hazlett, Juhi Pandey, Robert Schultz, Steven Dager, Kelly Botteron, Daniel Messinger, Wendy Stone, Jennifer Ames, Thomas G. O'Connor, Richard K. Miller, Emily Oken, Michele R. Hacker, Tamarra James-Todd, T. Michael O'Shea, Rebecca C. Fry, Jean A. Frazier, Rachana Singh, Caitlin Rollins, Angela Montgomery, Ruben Vaidya, Robert M. Joseph, Lisa K. Washburn, Semsa Gogcu, Kelly Bear, Julie V. Rollins, Stephen R. Hooper, Genevieve Taylor, Wesley Jackson, Amanda Thompson, Julie Daniels, Michelle Hernandez, Kun Lu, Michael Msall, Madeleine Lenski, Rawad Obeid, Steven L. Pastyrnak, Elizabeth Jensen, Christina Sakai, Hudson Santos, Jean M. Kerver, Nigel Paneth, Charles J. Barone, Michael R. Elliott, Douglas M. Ruden, Chris Fussman, Julie B. Herbstman, Amy Margolis, Susan L. Schantz, Sarah Dee Geiger, Andrea Aguiar, Karen Tabb, Rita Strakovsky, Tracey Woodruff, Rachel Morello-Frosch, Amy Padula, Joseph B. Stanford, Christina A. Porucznik, Angelo P. Giardino, Rosalind J. Wright, Robert O. Wright, Brent Collett, Nicole Baumann-Blackmore, Ronald Gangnon, Chris G. McKennan, Jo Wilson, Matt Altman, Judy L. Aschner, Annemarie Stroustrup, Stephanie L. Merhar, Paul E. Moore, Gloria S. Pryhuber, Mark Hudak, Ann Marie Reynolds Lyndaker, Andrea L. Lampland, Burton Rochelson, Sophia Jan, Matthew J. Blitz, Michelle W. Katzow, Zenobia Brown, Codruta Chiuzan, Timothy Rafael, Dawnette Lewis, Natalie Meirowitz, Brenda Poindexter, Tebeb Gebretsadik, Sarah Osmundson, Jennifer K. Straughen, Amy Eapen, Andrea Cassidy-Bushrow, Ganesa Wegienka, Alex Sitarik, Kim Woodcroft, Audrey Urquhart, Albert Levin, Tisa Johnson-Hooper, Brent Davidson, Tengfei Ma, Emily S. Barrett, Martin J. Blaser, Maria Gloria Dominguez-Bello, Daniel B. Horton, Manuel Jimenez, Todd Rosen, Kristy Palomares, Lyndsay A. Avalos, Yeyi Zhu, Kelly J . Hunt, Roger B. Newman, Michael S. Bloom, Mallory H. Alkis, James R. Roberts, Sunni L. Mumford, Heather H. Burris, Sara B. DeMauro, Lynn M. Yee, Aaron Hamvas, Antonia F. Olidipo, Andrew S. Haddad, Lisa R. Eiland, Nicole T. Spillane, Kirin N. Suri, Stephanie A. Fisher, Jeffrey A. Goldstein, Leena B. Mithal, Raye-Ann O. DeRegnier, Nathalie L. Maitre, Ruby H.N. Nguyen, Meghan  M. JaKa, Abbey C. Sidebottom, Michael J. Paidas, JoNell E. Potter, Natale Ruby, Lunthita Duthely, Arumugam Jayakumar, Karen Young, Isabel Maldonado, Meghan Miller, Jonathan L. Slaughter, Sarah A. Keim, Courtney D. Lynch, Kartik K. Venkatesh, Kristina W. Whitworth, Elaine Symanski, Thomas F. Northrup, Hector Mendez-Figueroa, Ricardo A. Mosquera, Margaret R. Karagas, Juliette  C. Madan, Debra M. MacKenzie, Johnnye L. Lewis, Brandon J. Rennie, Bennett L. Leventhal, Young Shin Kim, Somer Bishop, Sara S. Nozadi, Li Luo, Barry M. Lester, Carmen J. Marsit, Todd Everson, Cynthia M. Loncar, Elisabeth C. McGowan, Stephen J. Sheinkopf, Brian S. Carter, Jennifer Check, Jennifer B. Helderman, Charles R. Neal, Lynne M. Smith
Journal: JAMA Pediatrics (2024)

Importance Limited access to healthy foods, resulting from residence in neighborhoods with low food access, is a public health concern. The contribution of this exposure in early life to child obesity remains uncertain. Objective To examine associations of neighborhood food access during pregnancy or early childhood with child body mass index (BMI) and obesity risk. Design, Setting, and Participants Data from cohorts participating in the US nationwide Environmental Influences on Child Health Outcomes consortium between January 1, 1994, and March 31, 2023, were used. Participant inclusion required a geocoded residential address in pregnancy (mean 32.4 gestational weeks) or early childhood (mean 4.3 years) and information on child BMI. Exposures Residence in low-income, low–food access neighborhoods, defined as low-income neighborhoods where the nearest supermarket is more than 0.5 miles for urban areas or more than 10 miles for rural areas. Main Outcomes and Measures BMI z score, obesity (age- and sex-specific BMI ≥95th percentile), and severe obesity (age- and sex-specific BMI ≥120% of the 95th percentile) from age 0 to 15 years. Results Of 28 359 children (55 cohorts; 14 657 [51.7%] male and 13 702 [48.3%] female; 590 [2.2%] American Indian, Alaska Native, Native Hawaiian, or Other Pacific Islander; 1430 [5.4%] Asian; 4034 [15.3%] Black; 17 730 [67.2%] White; and 2592 [9.8%] other [unspecified] or more than 1 race; 5754 [20.9%] Hispanic and 21 838 [79.1%] non-Hispanic) with neighborhood food access data, 23.2% resided in low-income, low–food access neighborhoods in pregnancy and 24.4% in early childhood. After adjusting for individual sociodemographic characteristics, residence in low-income, low–food access (vs non–low-income, low–food access) neighborhoods in pregnancy was associated with higher BMI z scores at ages 5 years (β, 0.07; 95% CI, 0.03-0.11), 10 years (β, 0.11; 95% CI, 0.06-0.17), and 15 years (β, 0.16; 95% CI, 0.07-0.24); higher obesity risk at 5 years (risk ratio [RR], 1.37; 95% CI, 1.21-1.55), 10 years (RR, 1.71; 95% CI, 1.37-2.12), and 15 years (RR, 2.08; 95% CI, 1.53-2.83); and higher severe obesity risk at 5 years (RR, 1.21; 95% CI, 0.95-1.53), 10 years (RR, 1.54; 95% CI, 1.20-1.99), and 15 years (RR, 1.92; 95% CI, 1.32-2.80). Findings were similar for residence in low-income, low–food access neighborhoods in early childhood. These associations were robust to alternative definitions of low income and low food access and additional adjustment for prenatal characteristics associated with child obesity. Conclusions Residence in low-income, low–food access neighborhoods in early life was associated with higher subsequent child BMI and higher risk of obesity and severe obesity. We encourage future studies to examine whether investments in neighborhood resources to improve food access in early life would prevent child obesity.