The correlation between supermarket size and national obesity prevalence

BACKGROUND: Supermarkets provide healthy and affordable food options while simultaneously heavily promoting energy-dense, nutrient-poor foods and drinks. Store size may impact body weight via multiple mechanisms. Large stores encourage purchasing of more food in a single visit, and in larger packages. In addition they provide greater product choice (usually at lower prices) and allow greater exposure to foods of all types. These characteristics may promote purchasing and consumption. Our objective was to assess the relationship between supermarket size and obesity, which has rarely been assessed. RESULTS: Data on supermarket size (measured as total aisle length in metres) was from 170 stores in eight developed countries with Western-style diets. Data for national obesity prevalence was obtained from the UK National Obesity Observatory. We found a strong correlation between average store size and national obesity prevalence (r = 0.96). CONCLUSIONS: Explanations for the association between store size and national obesity prevalence may include larger and less frequent shopping trips and greater choice and exposure to foods in countries with larger stores. Large supermarkets may represent a food system that focuses on quantity ahead of quality and therefore may be an important and novel environmental indicator of a pattern of behaviour that encourages obesity

Does the availability of snack foods in supermarkets vary internationally?

BackgroundCross-country differences in dietary behaviours and obesity rates have been previously reported. Consumption of energy-dense snack foods and soft drinks are implicated as contributing to weight gain, however little is known about how the availability of these items within supermarkets varies internationally. This study assessed variations in the display of snack foods and soft drinks within a sample of supermarkets across eight countries.MethodsWithin-store audits were used to evaluate and compare the availability of potato chips (crisps), chocolate, confectionery and soft drinks. Displays measured included shelf length and the proportion of checkouts and end-of-aisle displays containing these products. Audits were conducted in a convenience sample of 170 supermarkets across eight developed nations (Australia, Canada, Denmark, Netherlands, New Zealand, Sweden, United Kingdom (UK), and United States of America (US)).ResultsThe mean total aisle length of snack foods (adjusted for store size) was greatest in supermarkets from the UK (56.4 m) and lowest in New Zealand (21.7 m). When assessed by individual item, the greatest aisle length devoted to chips, chocolate and confectionery was found in UK supermarkets while the greatest aisle length dedicated to soft drinks was in Australian supermarkets. Only stores from the Netherlands (41%) had less than 70% of checkouts featuring displays of snack foods or soft drinks.ConclusionWhilst between-country variations were observed, overall results indicate high levels of snack food and soft drinks displays within supermarkets across the eight countries. Exposure to snack foods is largely unavoidable within supermarkets, increasing the likelihood of purchases and particularly those made impulsively.<br /

Fruit and Vegetable Intake in Adolescents: Association with Socioeconomic Status and Exposure to Supermarkets and Fast Food Outlets

Background. We investigated differences in family social class associations between food outlet exposure and fruit and vegetable intake. Methods. We supplemented data from the 2006 Health Behavior in School Aged Children Study (n=6,096) with geocoded food outlet information surrounding schools (n=80). We used multilevel logistic regression to examine associations between infrequent fruit and vegetable intake and supermarket and fast food outlet concentration, stratified by family social class. Results. Boys and older children were most likely to eat fruit and vegetables infrequently. High fast food outlet exposure was marginally significant for low fruit intake in low social class children only. Children from middle and low social class backgrounds attending schools with combined high fast food outlet/low supermarket exposure were most likely to report infrequent fruit intake (ORlow=1.60; CI:  1.02–2.45; ORmid=1.40; CI:  1.03–190). Children from low social class backgrounds were also likely to report infrequent vegetable intake, given low supermarket and high fast food outlet exposure (OR=1.79; CI:  0.99–3.21). Conclusion. Our findings suggest social class modifies the relationship between intake and food outlet concentration. School interventions improving fruit and vegetable intake should consider neighborhood surroundings, targetting older children from low social class backgrounds

Secular trends in fruit intake among Danish schoolchildren, 1988 to 2006: Changing habits or methodological artefacts?

<p>Abstract</p> <p>Background</p> <p>Intermittent monitoring of fruit and vegetable intake at the population level is essential for the evaluation and planning of national dietary interventions. Yet, only a limited number of studies on time trends in fruit and vegetable intake among children and adolescents have been published internationally. In Denmark, national comprehensive campaigns to enhance fruit and vegetable consumption were initiated in 2001. This paper describes secular trends in fruit intake among Danish adolescents by six comparable school surveys from 1988 to 2006. The paper demonstrates and discusses the consequences of measurement changes introduced in long-term trend analyses.</p> <p>Methods</p> <p>We used Danish data from the international Health Behaviour in School-aged Children (HBSC) study collected in 1988, 1991, 1994, 1998, 2002 and 2006. Analyses were conducted on comparable questionnaire-based data from students aged 11, 13 and 15 total (n = 23,871) from a random sample of schools. Data on fruit intake were measured by a food frequency questionnaire. Due to changes in number of response categories beween surveys, different cut-points were analysed.</p> <p>Results</p> <p>The prevalence of students eating fruit at least once daily ranged from 78.3% among 13-year-old girls in 1988 to 17.3% among 15-year-old boys in 2002. Based on the six data collections, analyses of trends showed a significant decrease in prevalence of students eating fruit at least once daily from 1988 to 2002 (all p-values < 0.0001). In all age and gender groups, a significant increase in intake occurred between 2002 and 2006 (all p-values < 0.0065). Analyses of alternative cut-points revealed similar results.</p> <p>Conclusion</p> <p>Fruit consumption among Danish schoolchildren decreased from 1988 to 2002 with an increase since 2002. We suggest that the increase may be attributable to a nation-wide initiative conducted in Denmark since 2001 to increase the intake of fruit and vegetables in the population. Still, the results imply that a substantial proportion of Danish schoolchildren do not meet the nationally recommended daily intake of fruit. Our analyses indicate that the observed trends are not solely caused by methodological biases related to changes in measurements.</p

Dobre praktyki w zakresie szkolnej aktywności fizycznej w Europie

Background. Despite the known benefits of physical activity for children, inactivity levels remain high in Europe. Schools are considered ideal settings for promoting physical activity. Nonetheless, they often fail to achieve their full potential in increasing the levels of exercise among students. This study aimed to examine the current evidence regarding physical activity promotion in the European Union school context, and to understand how key scientific evidence and World Health Organization (WHO) guidance are used. Material and methods. Representatives of all 28 European Union Member States were asked to complete a survey to understand their national school-based physical activity practices. Results. Responses from 22 countries were received. Of all the initiatives, most included fostering of positive attitudes to physical activity or health, while a few incorporated genderbased considerations in their design. Lastly, intersectoral collaboration in the creation of the physical education curricula is yet to be fully integrated among European Union Member States. Conclusions. There is a substantial focus on physical activity promotion in schools across the European Union, although the school context could be utilized to a greater degree. In general, further efforts in this area are required in order to have a stronger positive effect on physical activity levels in European Union children.Wprowadzenie. Pomimo powszechnie znanych korzyści wynikających z aktywności fizycznej dzieci, jej poziom w Europie nadal pozostaje niski. Szkoły są uważane za idealne miejsca do promowania aktywności fizycznej, jednak ich potencjał często nie jest w pełni wykorzystywany. Celem tego badania jest analiza aktualnych danych dotyczących promowania aktywności fizycznej w szkołach w Unii Europejskiej oraz zrozumienie sposobów wykorzystywania kluczowych dowodów naukowych oraz wytycznych WHO. Materiał i metody. Reprezentantów wszystkich 28 państw członkowskich Unii Europejskiej poproszono o wypełnienie ankiety, której celem było poznanie szkolnych praktyk w zakresie aktywności fizycznej. Wyniki. Otrzymano odpowiedzi z 22 krajów. Spośród przedstawionych inicjatyw większość obejmowała promowanie pozytywnego nastawienia do aktywności fizycznej i zdrowia. Tylko w niewielu przypadkach uwzględniono aspekty związane z płcią. Okazało się, że międzysektorowa współpraca w tworzeniu programów nauczania wychowania fizycznego nie jest jeszcze w pełni zintegrowana wśród państw członkowskich Unii Europejskiej. Wnioski. W całej Unii Europejskiej kładzie się duży nacisk na promowanie aktywności fizycznej w szkołach, choć rola szkoły w tym zakresie powinna być wykorzystana w większym stopniu. Reasumując, należy podjąć dalsze działania, które mogą podnieść poziom aktywności fizycznej dzieci w Unii Europejskiej