Neighborhood and Home Food Environment and Children's Diet and Obesity: Evidence From Military Personnel's Installation Assignment

Authors
Shier, V. Nicosia, N. Datar, A.
Publication year
2016
Citation Title
Neighborhood and home food environment and children’s diet and obesity: Evidence from military personnel’s installation assignment
Journal Name
Social Science & Medicine
Journal Volume
158
Issue Number
2
Page Numbers
122-131
DOI
10.1016/j.socscimed.2016.03.043
Summary
Researchers used previous data from The Military Teenagers' Environments, Exercise, and Nutrition Study (M-TEENS) to determine an association between the neighborhood food environment and children's dietary behaviors, body mass index, and weight gain in Army families. Results indicated that focusing only on the neighborhood food environment may ignore important factors that influence children's dietary behaviors.
Key Findings
Results suggested that neither the actual nor the perceived availability of particular food outlets in the neighborhood was associated with children's diet or body mass index.
The availability of supermarkets and convenience stores in the neighborhood was not associated with where families shop for food or children's dietary behaviors.
The healthiness of food available at home was associated with healthy dietary behaviors while eating at fast food outlets and restaurants were associated with unhealthy dietary behaviors in children.
Parental supervision, including limits on snack foods and meals eaten as a family, was associated with healthy dietary behaviors.
Implications for Program Leaders
Provide supportive classes for parents, offering them skills to engage with their children in ways that strengthen conversation on healthy eating
Collaborate with community-based agencies that specialize in nutrition to better assist military parents with the importance of healthy dietary behaviors both inside and outside of the installation
Develop online modules that focus on healthy activities military parents can engage in with their children
Implications for Policy Makers
Support training of professionals who work with military families to ensure opportunities and accessibility to healthy food
Develop health incentive plans for military families and their children to motivate healthy food environments
Recommend installations include healthy eating opportunities, and in general, healthy eating environments
Methods
Recruitment was conducted March to December 2013 via emails to the Service members' military email and mailings sent to their home address, which were obtained from the Defense Manpower Data Center.
Participants completed surveys on measurements that included: body mass index, overweight factors, dietary behaviors, objective and perceived neighborhood food environment, family’s access to food, home food environment, and parental supervision.
Through the data analyses, researchers also included other contextual variables that may influence dietary behaviors such as education level of both parents, number of children in the household, and residential location preference.
Participants
Participants were Active Duty Service members in the Army, along with their teenage children. A total of 903 parent-child pairs were contacted and sampled from a previous study.
Almost 41% of the sample were White (40.8%), 20.7% were Black, 24.6% were Latino, and 13.9% were other.
The mean age of children was 13.2 years. There were no data given on parental age.
Limitations
This study focused on a sample of Active Duty Army personnel and their children, and the findings may not generalize to the children of Service members in other branches of the military.
There is not an in-text definition for ‘healthier food environments’ within the study, which may limit the understanding and generalizability of the study.
Only 58% of the sample had height and weight measurements completed which could skew the body mass index or obesity scales that were used within the study.
Avenues for Future Research
Consider how families make decisions about what food to purchase, where to shop for food, how closely to monitor their children's food intake, and, ultimately how these decisions impact children's outcomes
Explore and compare how families make decisions about what food is eaten at home when parental supervision is low and how this impacts children’s eating habits
Examine the differences and similarities between other branches of the military to measure installation accessibility to healthy food options
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Research and policy initiatives are increasingly focused on the role of neighborhood food environment in children's diet and obesity. However, existing evidence relies on observational data that is limited by neighborhood selection bias. The Military Teenagers' Environments, Exercise, and Nutrition Study (M-TEENS) leverages the quasi-random variation in neighborhood environment generated by military personnel's assignment to installations to examine whether neighborhood food environments are associated with children's dietary behaviors and BMI. Our results suggest that neither the actual nor the perceived availability of particular food outlets in the neighborhood is associated with children's diet or BMI. The availability of supermarkets and convenience stores in the neighborhood was not associated with where families shop for food or children's dietary behaviors. Further, the type of store that families shop at was not associated with the healthiness of food available at home. Similarly, availability of fast food and restaurants was unrelated to children's dietary behaviors or how often children eat fast food or restaurant meals. However, the healthiness of food available at home was associated with healthy dietary behaviors while eating at fast food outlets and restaurants were associated with unhealthy dietary behaviors in children. Further, parental supervision, including limits on snack foods and meals eaten as a family, was associated with dietary behaviors. These findings suggest that focusing only on the neighborhood food environment may ignore important factors that influence children's outcomes. Future research should also consider how families make decisions about what foods to purchase, where to shop for foods and eating out, how closely to monitor their children's food intake, and, ultimately how these decisions collectively impact children's outcomes.
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