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. 2011 Nov 15;174(10):1108-14.
doi: 10.1093/aje/kwr244. Epub 2011 Sep 30.

Proximity to food establishments and body mass index in the Framingham Heart Study offspring cohort over 30 years

Jason P Block  1 , Nicholas A Christakis, A James O'Malley, S V Subramanian
Affiliations

Proximity to food establishments and body mass index in the Framingham Heart Study offspring cohort over 30 years

Jason P Block et al. Am J Epidemiol. .

Abstract

Existing evidence linking residential proximity to food establishments with body mass index (BMI; weight (kg)/height (m)(2)) has been inconclusive. In this study, the authors assessed the relation between BMI and proximity to food establishments over a 30-year period among 3,113 subjects in the Framingham Heart Study Offspring Cohort living in 4 Massachusetts towns during 1971-2001. The authors used novel data that included repeated measures of BMI and accounted for residential mobility and the appearance and disappearance of food establishments. They calculated proximity to food establishments as the driving distance between each subject's residence and nearby food establishments, divided into 6 categories. The authors used cross-classified linear mixed models to account for time-varying attributes of individuals and residential neighborhoods. Each 1-km increase in distance to the closest fast-food restaurant was associated with a 0.11-unit decrease in BMI (95% credible interval: -0.20, -0.04). In sex-stratified analyses, this association was present only for women. Other aspects of the food environment were either inconsistently associated or not at all associated with BMI. Contrary to much prior research, the authors did not find a consistent relation between access to fast-food restaurants and individual BMI, necessitating a reevaluation of policy discussions on the anticipated impact of the food environment on weight gain.

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Figures

Figure 1.
Figure 1.
Selection of subjects and observations for an analysis of proximity to food establishments and body mass index (BMI), Framingham Heart Study Offspring Cohort, 1971–2001. A total of 5,124 subjects were enrolled in the Framingham Heart Study Offspring Cohort from 1971 to 1975, and subjects have been examined and surveyed repeatedly. The current study included completed observations made when subjects were living in Framingham, Natick, Ashland, and Holliston, Massachusetts, from 1971 to 2001. The final sample included 13,423 observations from 3,113 subjects.
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