Research findings on effects of food environments (FEs) on childhood obesity are mixed. We examined associations between residential FEs and childhood obesity and BMI changes, and variation of the associations by sex and urbanicity.


We used data from the US Early Childhood Longitudinal Study-Kindergarten Cohort (9,440 kindergarteners followed in 1998-2007) linked with measures of food environments. The Dun&Brad street commercial datasets in 1998 and 2007 were used to construct 12 FE measures of food environments, eg, changes in food outlet mix and density of supermarkets, convenience stores, full-service restaurants, fast food restaurants, fruit/vegetable (FV) markets, meat/fish markets. Mixed-effect models examined associations.


Decreased exposures to full-service restaurants, retail bakeries, FV markets, and beverage stores were generally obesogenic; decreased exposure to dairy-product stores was obesoprotective; the magnitude and statistical significance of the associations varied by sex and urbanicity. Higher obesity risk was associated with increased exposure to full-service restaurants among girls, and with decreased exposures to FV markets in urban children, beverage stores in suburban children, and health/dietetic food stores in rural children. Children lived in neighborhoods with candy stores (β=0.52, p<0.05) and meat/fish markets (β=0.58, p<0.01) in 1998 had higher BMI in 2007, than those without these food outlets in 1998. Higher BMI in 2007 was observed in those had decreased full-service restaurants (β=0.68, p<0.05) and constant retail bakeries (β=0.43, p<0.05) in their neighborhoods during 1998-2007 than those had an increase in these. The effects were stronger in girls (β=1.60; β=0.91) and suburban children (β=2.96; β=0.97; all p<0.05).


Food environments seem affect childhood obesity risks in the US. The associations varied by sex and urbanicity of residence. These can help guide future urban design and community-based obesity interventions.