Poor diet is an important modifiable contributor to many chronic diseases including childhood obesity (Han, Lawlor, & Kimm; World Health Organization, 2004). Understanding the determinants of dietary behaviour during childhood is important as poor dietary behaviours track from childhood to adulthood (Craigie, Lake, Kelly, Adamson, & Mathers, 2011). Children\’s diet is influenced by individual preferences as well as the wider shared family, social and physical environment, as highlighted by ecological models of health behaviour (Bronfenbrenner, 1997). The contribution of the local food environment to a poor diet is a relatively new area of research. To date, findings are inconsistent and this may be due to conceptual and methodological issues associated with measuring the food environment (Caspi, Sorensen, Subramanian, & Kawachi, 2012; Feng, Glass, Curriero, Stewart, & Schwartz, 2010; Holsten, 2009; Mackenbach et al., 2014).
The food environment is multidimensional (Glanz, Sallis, Saelens, & Frank, 2005) and the availability of food outlets is one important aspect of the local food environment. Research has found that smaller food outlets including convenience stores tend to stock a higher proportion of processed foods, a smaller range of Obeticholic Acid and vegetables, and charge higher prices for food than supermarkets, especially in poorer areas (Kaufman, MacDonald, Lutz, & Smallwood, 1997; MacDonald & Nelson, 1991; Rose & Richards, 2004). Shorter distances to a supermarket and a higher number of local supermarkets are consistently associated with a higher dietary quality in North America, particularly among low income households (Rose & Richards, 2004). Evidence from Europe and Australia is less consistent (Black, Moon, & Baird, 2013) with recent studies finding no difference in food availability between better and worse off communities (Cummins & Macintyre, 1999, 2002), particularly for supermarkets (Maguire, Burgoine, & Monsivais, 2015).
Research on the association between the food environment around children\’s homes and diet is sparse and inconclusive. Engler-Stringer, Le, Gerrard, and Muhajarine (2014) conducted a systematic review which examined the influence of location and accessibility of food outlets on children\’s diet (). Though there was much heterogeneity between studies, the review found some moderate evidence to suggest that the local food environment around households may influence children\’s diet. However, the effect sizes in many of the included studies were small (Engler-Stringer et al., 2014). For example, a study from the UK reported that increasing distance to a convenience store was associated with a slightly lower intake of foods such as chocolate and crisps (Skidmore et al., 2010). Furthermore, in the UK, availability of ‘unhealthy’ food outlets was associated with a higher body mass index (BMI) which is a more distal outcome than diet (Jennings et al., 2011). Leung, Gregorich, Laraia, Kushi, & Yen, 2010 reported an inverse association between the prevalence of food/retail destinations in the neighbourhood environment and total energy intake in girls aged 6–8 years from the USA (Leung et al., 2010). However, there have also been null findings for the association between the local food environment and diet in children (An & Sturm, 2012).
Increasingly, policymakers recognise the potential role of the food environment to curb chronic diseases including obesity and also to encourage healthy eating. Thus, a better understanding of the relationship between local area food availability and dietary quality in children is needed. In 2007, 89% of all eating occasions for Irish children aged 5–12 years occurred at home (Burke et al., 2007) suggesting that food availability around households is important. For the current paper, we hypothesised that greater access to food outlets (closer proximity and the number of supermarkets) would be associated with a higher dietary quality in children. As children may have limited autonomy over food purchase and eating behaviours, we control for family level socio-economic factors to capture aspects of the shared home environment. This paper explores if distance to and the number of food outlets (supermarkets and convenience stores) in the local environment around households are associated with dietary quality in a nationally representative sample of nine year old children controlling for family level socio-economic factors.