Public Release: 

Impact of a supermarket on children's diets

Proximity to full-service supermarkets may not significantly impact dietary habits

NYU Langone Medical Center / New York University School of Medicine

New York City (February 26, 2015) - Locating full-service supermarkets within neighborhoods considered to be "food deserts" may not result in healthful dietary habits or reductions in childhood obesity -- at least in the short term, according to a new study by NYU Langone Medical Center researchers in the February 26th online edition of the journal Public Health Nutrition.

Researcher Brian D. Elbel, PhD, MPH, associate professor of Population Health and colleagues compared two neighborhoods in the Bronx: Morrisania, where a new, government supported, full-service supermarket was placed, and Highbridge, where no new market was built. Caregivers of young children 3 years to 10 years old and living in those neighborhoods were surveyed. Shopping and consumption information was collected from them prior to the opening of the market, five weeks after it opened, and again one year after the store opened.

The researchers analyzed 2,172 street intercept surveys and 363 dietary recalls from a sample of predominantly low-income minorities. They found that while there were small, inconsistent changes in diet over the time periods, there were no appreciable differences in availability of healthful or unhealthful foods at home, or in children's dietary intake as a result of the presence of the supermarket.

Low-income and minority children are disproportionately affected by obesity, and children residing in low-income and minority neighborhoods are less likely to have access to healthful food options than children living in wealthier neighborhoods. Full-service supermarkets, which tend to offer greater varieties of fresh, affordable fruit and vegetables, are less available in low-income communities. However fast food restaurants, small grocers and bodegas that generally sell higher calorie, nutritionally - poor foods and beverages are more prevalent in poorer neighborhoods than in wealthier ones.

Many have hoped that greater access to healthful food retail outlets could reduce the incidence of childhood obesity. However these efforts have not been evaluated for their impact on household food availability or for changes in dietary patterns amongst children residing in the target communities. This is the first controlled study (including a comparison group) to evaluate the impact of a government-subsidized supermarket on food consumption for children.

According to the research findings, the introduction of a government-subsidized supermarket did not result in significant changes in household food availability or children's dietary intake, at least one year after opening for the neighborhood as a whole.

"Low-income and ethnic minority neighborhoods are underserved by supermarkets relative to their higher-income counterparts, and it would appear to be logical that increasing availability of healthful foods could improve diets," said Dr. Elbel. "However, we do not yet know whether or under what circumstances these stores will improve diet and health. Food choice is complex, and the easy availability of lower-priced processed foods and pervasiveness of junk food marketing have implications for behavior change as well. New supermarkets may play an important role, and further work is needed to determine how these policies might be best structured."

Dr. Elbel points out that further research is needed to determine whether healthy food retail expansion can improve food choices of children and their families, including where best to place these stores, under what circumstances they will be successful, and with what other policies or programs they should be coupled.

New York City (February 26, 2015) - Locating full-service supermarkets within neighborhoods considered to be "food deserts" may not result in healthful dietary habits or reductions in childhood obesity -- at least in the short term, according to a new study by NYU Langone Medical Center researchers in the February 26th online edition of the journal Public Health Nutrition.

Researcher Brian D. Elbel, PhD, MPH, associate professor of Population Health and colleagues compared two neighborhoods in the Bronx: Morrisania, where a new, government supported, full-service supermarket was placed, and Highbridge, where no new market was built. Caregivers of young children 3 years to 10 years old and living in those neighborhoods were surveyed. Shopping and consumption information was collected from them prior to the opening of the market, five weeks after it opened, and again one year after the store opened.

The researchers analyzed 2,172 street intercept surveys and 363 dietary recalls from a sample of predominantly low-income minorities. They found that while there were small, inconsistent changes in diet over the time periods, there were no appreciable differences in availability of healthful or unhealthful foods at home, or in children's dietary intake as a result of the presence of the supermarket.

Low-income and minority children are disproportionately affected by obesity, and children residing in low-income and minority neighborhoods are less likely to have access to healthful food options than children living in wealthier neighborhoods. Full-service supermarkets, which tend to offer greater varieties of fresh, affordable fruit and vegetables, are less available in low-income communities. However fast food restaurants, small grocers and bodegas that generally sell higher calorie, nutritionally - poor foods and beverages are more prevalent in poorer neighborhoods than in wealthier ones.

Many have hoped that greater access to healthful food retail outlets could reduce the incidence of childhood obesity. However these efforts have not been evaluated for their impact on household food availability or for changes in dietary patterns amongst children residing in the target communities. This is the first controlled study (including a comparison group) to evaluate the impact of a government-subsidized supermarket on food consumption for children.

According to the research findings, the introduction of a government-subsidized supermarket did not result in significant changes in household food availability or children's dietary intake, at least one year after opening for the neighborhood as a whole.

"Low-income and ethnic minority neighborhoods are underserved by supermarkets relative to their higher-income counterparts, and it would appear to be logical that increasing availability of healthful foods could improve diets," said Dr. Elbel. "However, we do not yet know whether or under what circumstances these stores will improve diet and health. Food choice is complex, and the easy availability of lower-priced processed foods and pervasiveness of junk food marketing have implications for behavior change as well. New supermarkets may play an important role, and further work is needed to determine how these policies might be best structured."

Dr. Elbel points out that further research is needed to determine whether healthy food retail expansion can improve food choices of children and their families, including where best to place these stores, under what circumstances they will be successful, and with what other policies or programs they should be coupled.

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Authors: Brian Elbel1,2, Alyssa Moran3, L. Beth Dixon3, Kamila Kiszko1, Jonathan Cantor2, Courtney Abrams1, Tod Mijanovich2

Author affiliations: 1. New York University School of Medicine, Department of Population Health, 227 E. 30th Street New York, NY 10016, 2. New York University Wagner School of Public Service, 295 Lafayette Street, New York, NY 10012, 3. New York University, Steinhardt School of Culture, Education, and Human Development, 82 Washington Square East New York, NY 10003,

Acknowledgements: The authors would like to thank Markus Kessler, Olivia Martinez, the study's data collectors and the three anonymous reviewers for their assistance with this project.

Financial support: This research was supported by the Robert Wood Johnson Foundation Healthy Eating Research Program (grant #68236) and the Aetna Foundation (grant #4036366). Robert Wood Johnson Foundation and Aetna Foundation had no role in the design, analysis or writing of this article.

Conflicts of interest: The Authors cite no conflicts of interest.

Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the Institutional Review Board at New York University School of Medicine.

About NYU Langone Medical Center

NYU Langone Medical Center, a world-class, patient-centered, integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals--Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center's dedicated inpatient orthopaedic hospital; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the Medical Center--plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The Medical Center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research. For more information, go to http://www.NYULangone.org, and interact with us on Facebook, Twitter, and YouTube.

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