Study on the relationship between food environment and overweight and obesity of school children in urban and rural primary and middle schools of China
Objective To explore the influence of school neighborhood food environment(SNFE)on overweight and obesity of school children in urban and rural primary and middle schools of China,and provide the scientific basis for the construction of a supportive environment for the prevention and control of childhood obesity.Methods The children's data were from the China Nutrition and Health Surveillance(2015-2017).Children(6-17 years old)were selected as the objects,and their overweight and obesity status were collected.The data acquisition and evaluation method of SNFE established by the research team was used to analyze SNFE status within 800 m around urban and rural primary and secondary schools in China.The t test,x2 test and Wilcoxon test were used to analyze the data.A multivariate logistic regression model was used to analyze the effect of SNFE within 800 m around school on overweight and obesity in school-aged children.Results A total of 63 918 school-age children(6-17 years old)were included in the study from 31 provinces(autonomous regions and municipalities),the average age was(11.6±3.2)years old,and the prevalence of overweight and obesity was 18.7％.The results of the multivariate logistic regression analysis showed that the presence of convenience store(OR=1.09,95％CI:1.03-1.15),supermarket(OR=1.17,95％CI:1.10-1.23),wet market(OR=1.23,95％CI:1.16-1.29),fast-food restaurant(OR=1.17,95％CI:1.10-1.24),Chinese restaurant(OR=1.16,95％CI:1.09-1.24),foreign restaurant(OR=1.20,95％CI:1.15-1.26)and the dessert shop(OR=1.17,95％CI:1.12-1.22)within 800 m around the primary and secondary schools were all associated with a high risk of overweight and obesity in school-age children;supermarket(OR=1.17,95％CI:1.06-1.30)and foreign restaurant(OR=1.14,95％CI:1.08-1.22)were associated with high risk of overweight and obesity in urban school-age children;wet market(OR=1.13,95％CI:1.06-1.21)and dessert shop(OR=1.09,95％CI:1.02-1.16)were associated with high risk of overweight and obesity in rural school-age children(P＜0.05,P＜0.01).The SNFE within 800 m of primary and secondary schools with more convenience store(OR=1.07,95％CI:1.02-1.12),supermarket(OR=1.22,95％CI:1.17-1.28),wet market(OR=1.27,95％CI:1.21-1.32),fast food restaurant(OR=1.21,95％CI:1.16-1.27)and Chinese restaurant(OR=1.22,95％CI:1.17-1.28)were related with high risk of overweight and obesity in school-aged children;more supermarket(OR=1.21,95％CI:1.13-1.29),wet market(OR=1.18,95％CI:1.10-1.26),fast food restaurant(OR=1.12,95％CI:1.05-1.19)and Chinese restaurant(OR=1.14,95％CI:1.06-1.21)associated with the high risk of overweight and obesity in urban school-age children;more wet market(OR=1.11,95％CI:1.04-1.18),fast food restaurant(OR=1.08,95％CI:1.01-1.15)and Chinese restaurant(OR=1.09,95％CI:1.02-1.17)were related to the high risk of overweight and obesity in rural school-age children;while more convenience store(OR=0.91,95％CI:0.85-0.97)were associated with a low risk of overweight and obesity in rural children,P＜0.05,P＜0.01.Conclusion Convenience store,supermarket,wet market,fast food restaurant,Chinese restaurant,foreign restaurant and dessert shop within 800 m around Chinese primary and secondary schools are all associated with overweight and obesity among school-age children;the food shops associate with the risk of overweight and obesity in school-age children differed between urban and rural areas.For the SNFE,urban primary and secondary schools should focus on supermarket,wet market,Chinese restaurant,fast food restaurant and foreign restaurant,while rural primary and secondary schools should focus on wet market,Chinese restaurant,fast food restaurant and dessert shop.
School neighborhood food environmentOverweight and obesitySchool-age children
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