Advertisement

Osteoporosis International

, Volume 27, Issue 3, pp 1011–1019 | Cite as

Greater access to fast-food outlets is associated with poorer bone health in young children

  • C. VogelEmail author
  • C. Parsons
  • K. Godfrey
  • S. Robinson
  • N. C. Harvey
  • H. Inskip
  • C. Cooper
  • J. Baird
Original Article

Abstract

Summary

A healthy diet positively influences childhood bone health, but how the food environment relates to bone development is unknown. Greater neighbourhood access to fast-food outlets was associated with lower bone mass among infants, while greater access to healthy speciality stores was associated with higher bone mass at 4 years.

Introduction

Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long-term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children.

Methods

One thousand one hundred and seven children participating in the Southampton Women’s Survey, UK, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and 4 and/or 6 years by dual-energy X-ray absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant’s neighbourhood were used to derive three measures of the food environment: the counts of fast-food outlets, healthy speciality stores and supermarkets.

Results

Neighbourhood exposure to fast-food outlets was associated with lower BMD in infancy (β = −0.23 (z-score): 95 % CI −0.38, −0.08) and lower BMC after adjustment for bone area and confounding variables (β = −0.17 (z-score): 95 % CI −0.32, −0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at 4 and 6 years (β = 0.16(z-score): 95 % CI 0.00, 0.32 and β = 0.13(z-score): 95 % CI −0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at 4 years, but not at 6 years.

Conclusions

The neighbourhood food environment that pregnant mothers and young children are exposed may affect bone development during early childhood. If confirmed in future studies, action to reduce access to fast-food outlets could have benefits for childhood development and long-term bone health.

Keywords

Developmental modelling DXA Epidemiology General population studies Nutrition 

Notes

Acknowledgments

We thank the mothers who gave us their time and the team of dedicated research nurses and ancillary staff for their assistance. We also thank Miss Jamie Lawrence for her assistance ground-truthing the neighbourhood food environment. This work was supported by grants from the Medical Research Council, British Heart Foundation, Arthritis Research UK, Dunhill Medical Trust, Food Standards Agency, National Osteoporosis Society, International Osteoporosis Foundation, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust and the European Union’s Seventh Framework Programme (FP7/2007-2013), project EarlyNutrition under grant agreement no289346. Christina Vogel was supported by a UK National Institute for Health Research (NIHR) Doctoral Research Fellowship. The views in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health or other funders.

Conflicts of interest

Christina Vogel, Camille Parsons, Sian Robinson and Hazel Inskip have no conflicts of interests to declare. Janis Baird has received grant research support from Danone Nutricia Early Life Nutrition; however, the study in this manuscript is not related to this relationship. Keith Godfrey has received reimbursement for speaking at conferences sponsored by companies selling nutritional products and is part of an academic consortium that has received research funding from Abbott Nutrition, Nestec and Danone. Nicholas Harvey has received consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, Consilient Healthcare and Internis Pharma. Cyrus Cooper has received consultancy, lecture fees and honoraria from AMGEN, GSK, Alliance for Better Bone Health, MSD, Eli Lilly, Pfizer, Novartis, Servier, Medtronic and Roche.

References

  1. 1.
    Caspi CE, Sorensen G, Subramanian SV, Kawachi I (2012) The local food environment and diet: a systematic review. Health Place 18(5):1172–1187. doi: 10.1016/j.healthplace.2012.05.006 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Holsten JE (2009) Obesity and the community food environment: a systematic review. Public Health Nutr 12(3):397–405PubMedGoogle Scholar
  3. 3.
    Black C, Moon G, Baird J (2014) Dietary inequalities: what is the evidence for the effect of the neighbourhood food environment? Health Place 27:229–242. doi: 10.1016/j.healthplace.2013.09.015 CrossRefPubMedGoogle Scholar
  4. 4.
    Fraser LK, Edwards KL, Cade J, Clarke GP (2010) The geography of fast food outlets: a review. Int J Environ Res Public Health 7(5):2290–2308. doi: 10.3390/ijerph7052290 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Cetateanu A, Jones A (2014) Understanding the relationship between food environments, deprivation and childhood overweight and obesity: evidence from a cross sectional England-wide study. Health Place 27C:68–76. doi: 10.1016/j.healthplace.2014.01.007 CrossRefGoogle Scholar
  6. 6.
    Department of Health UK (2010) Healthy lives, healthy people: our strategy for public health in England. LondonGoogle Scholar
  7. 7.
    Department of Health UK (2013) Reducing obesity and improving diet. https://www.gov.uk/government/policies/reducing-obesity-and-improving-diet. Accessed 10 June 2013
  8. 8.
    US National Institutes of Health (2011) Strategic Plan for NIH Obesity Research. Washington DCGoogle Scholar
  9. 9.
    Northstone K, Emmett PM (2008) Are dietary patterns stable throughout early and mid-childhood? A birth cohort study. Br J Nutr 100(5):1069–1076. doi: 10.1017/S0007114508968264 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Mikkila V, Rasanen L, Raitakari OT, Pietinen P, Viikari J (2005) Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study. Br J Nutr 93(6):923–931CrossRefPubMedGoogle Scholar
  11. 11.
    World Health Organisation (2003) Diet, Nutrition and the Prevention of Chronic Disease: Report of a joint WHO/FAO Expert Consultation. WHO Technical Report Series. GenevaGoogle Scholar
  12. 12.
    World Health Organisation European Ministerial Conference (2013) Vienna Declaration on Nutrition and Noncommunicable Diseases in the Context of Health 2020. Regional Office for EuropeGoogle Scholar
  13. 13.
    Levis S, Lagari VS (2012) The role of diet in osteoporosis prevention and management. Curr Osteoporos Rep 10(4):296–302. doi: 10.1007/s11914-012-0119-y CrossRefPubMedGoogle Scholar
  14. 14.
    Devlin MJ, Bouxsein ML (2012) Influence of pre- and peri-natal nutrition on skeletal acquisition and maintenance. Bone 50(2):444–451. doi: 10.1016/j.bone.2011.06.019 CrossRefPubMedGoogle Scholar
  15. 15.
    Cole ZA, Gale CR, Javaid MK, Robinson SM, Law C, Boucher BJ, Crozier SR, Godfrey KM, Dennison EM, Cooper C (2009) Maternal dietary patterns during pregnancy and childhood bone mass: a longitudinal study. J Bone Mineral Res: Off J Am Soc Bone Mineral Res 24(4):663–668. doi: 10.1359/jbmr.081212 CrossRefGoogle Scholar
  16. 16.
    Cashman KD (2007) Diet, nutrition, and bone health. J Nutr 137(11 Suppl):2507S–2512SPubMedGoogle Scholar
  17. 17.
    Cooper C, Cawley M, Bhalla A, Egger P, Ring F, Morton L, Barker D (1995) Childhood growth, physical activity, and peak bone mass in women. J Bone Miner Res 10(6):940–947. doi: 10.1002/jbmr.5650100615 CrossRefPubMedGoogle Scholar
  18. 18.
    Dennison EM, Syddall HE, Sayer AA, Gilbody HJ, Cooper C (2005) Birth weight and weight at 1 year are independent determinants of bone mass in the seventh decade: the Hertfordshire cohort study. Pediatr Res 57(4):582–586. doi: 10.1203/01.PDR.0000155754.67821.CA CrossRefPubMedGoogle Scholar
  19. 19.
    Hernandez CJ, Beaupre GS, Carter DR (2003) A theoretical analysis of the relative influences of peak BMD, age-related bone loss and menopause on the development of osteoporosis. OsteoporosInt 14(10):843–847. doi: 10.1007/s00198-003-1454-8 CrossRefGoogle Scholar
  20. 20.
    Robinson SM, Crozier SR, Borland SE, Hammond J, Barker DJ, Inskip HM (2004) Impact of educational attainment on the quality of young women’s diets. Eur J Clin Nutr 58(8):1174–1180CrossRefPubMedGoogle Scholar
  21. 21.
    Inskip HM, Godfrey KM, Robinson SM, Law CM, Barker DJ, Cooper C (2006) Cohort profile: the Southampton women’s survey. Int J Epidemiol 35(1):42–48. doi: 10.1093/ije/dyi202 CrossRefPubMedGoogle Scholar
  22. 22.
    Harvey NC, Javaid MK, Poole JR, Taylor P, Robinson SM, Inskip HM, Godfrey KM, Cooper C, Dennison EM (2008) Paternal skeletal size predicts intrauterine bone mineral accrual. J Clin Endocrinol Metab 93(5):1676–1681. doi: 10.1210/jc.2007-0279 CrossRefPubMedGoogle Scholar
  23. 23.
    Crozier SR, Harvey NC, Inskip HM, Godfrey KM, Cooper C, Robinson SM (2012) Maternal vitamin D status in pregnancy is associated with adiposity in the offspring: findings from the Southampton Women’s Survey. Am J Clin Nutr 96(1):57–63CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Harvey NC, Mahon PA, Kim M, Cole ZA, Robinson SM, Javaid K, Inskip HM, Godfrey KM, Dennison EM, Cooper C (2012) Intrauterine growth and postnatal skeletal development: findings from the Southampton Women’s Survey. Paediatr Perinat Epidemiol 26(1):34–44. doi: 10.1111/j.1365-3016.2011.01237.x CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Rundle A, Neckerman KM, Freeman L, Lovasi GS, Purciel M, Quinn J, Richards C, Sircar N, Weiss C (2009) Neighborhood food environment and walkability predict obesity in New York City. Environ Health Perspect 117(3):442–447. doi: 10.1289/ehp.11590 CrossRefPubMedGoogle Scholar
  26. 26.
    Noble M, McLennan D, Wilkinson K, Whitworth A, Barnes H, Dibben C (2008) English indices of deprivation 2007. LondonGoogle Scholar
  27. 27.
    Statacorp (2013) Stata statistical software: release 13. 11 edn. College Station, TexasGoogle Scholar
  28. 28.
    Timperio A, Ball K, Roberts R, Campbell K, Andrianopoulos N, Crawford D (2008) Children’s fruit and vegetable intake: associations with the neighbourhood food environment. Prev Med 46(4):331–335. doi: 10.1016/j.ypmed.2007.11.011 CrossRefPubMedGoogle Scholar
  29. 29.
    Sturm R, Datar A (2005) Body mass index in elementary school children, metropolitan area food prices and food outlet density. Public Health 119(12):1059–1068. doi: 10.1016/j.puhe.2005.05.007 CrossRefPubMedGoogle Scholar
  30. 30.
    Skidmore P, Welch A, van Sluijs E, Jones A, Harvey I, Harrison F, Griffin S, Cassidy A (2010) Impact of neighbourhood food environment on food consumption in children aged 9–10 years in the UK SPEEDY (sport, physical activity and eating behaviour: environmental determinants in young people) study. Public Health Nutr 13(7):1022–1030. doi: 10.1017/S1368980009992035 CrossRefPubMedGoogle Scholar
  31. 31.
    Perchoux C, Chaix B, Cummins S, Kestens Y (2013) Conceptualization and measurement of environmental exposure in epidemiology: accounting for activity space related to daily mobility. Health Place 21:86–93. doi: 10.1016/j.healthplace.2013.01.005 CrossRefPubMedGoogle Scholar
  32. 32.
    Diez Roux AV (2008) Next steps in understanding the multilevel determinants of health. J Epidemiol Community Health 62(11):957–959. doi: 10.1136/jech.2007.064311 CrossRefPubMedGoogle Scholar
  33. 33.
    Ball K, Thornton L (2013) Food environments: measuring, mapping, monitoring and modifying. Public Health Nutr 16(7):1147–1150. doi: 10.1017/S1368980013001304 CrossRefPubMedGoogle Scholar
  34. 34.
    Chaix B, Merlo J, Evans D, Leal C, Havard S (2009) Neighbourhoods in eco-epidemiologic research: delimiting personal exposure areas. A response to Riva, Gauvin. Apparicio Brodeur Soc Sci Med 69(9):1306–1310. doi: 10.1016/j.socscimed.2009.07.018 CrossRefPubMedGoogle Scholar
  35. 35.
    Cummins S, Curtis S, Diez-Roux AV, Macintyre S (2007) Understanding and representing ‘place’ in health research: a relational approach. Soc Sci Med 65(9):1825–1838. doi: 10.1016/j.socscimed.2007.05.036 CrossRefPubMedGoogle Scholar
  36. 36.
    Charreire H, Casey R, Salze P, Simon C, Chaix B, Banos A, Badariotti D, Weber C, Oppert JM (2010) Measuring the food environment using geographical information systems: a methodological review. Public Health Nutr 13(11):1773–1785. doi: 10.1017/S1368980010000753 CrossRefPubMedGoogle Scholar
  37. 37.
    Burgoine T, Lake AA, Stamp E, Alvanides S, Mathers JC, Adamson AJ (2009) Changing foodscapes 1980–2000, using the ASH30 Study. Appetite 53(2):157–165. doi: 10.1016/j.appet.2009.05.012 CrossRefPubMedGoogle Scholar
  38. 38.
    Public Health England (2013) Obesity and the environment: regulating the growth of fast food outlets. LondonGoogle Scholar
  39. 39.
    Burgoine T, Forouhi NG, Griffin SJ, Wareham NJ, Monsivais P (2014) Associations between exposure to takeaway food outlets, takeaway food consumption, and body weight in Cambridgeshire, UK: population based, cross sectional study. BMJ 348:g1464CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Ni Mhurchu C, Vandevijvere S, Waterlander W, Thornton LE, Kelly B, Cameron AJ, Snowdon W, Swinburn B (2013) Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally. Obes Rev 14(Suppl 1):108–119. doi: 10.1111/obr.12080 CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2015

Authors and Affiliations

  • C. Vogel
    • 1
    Email author
  • C. Parsons
    • 1
  • K. Godfrey
    • 1
    • 2
  • S. Robinson
    • 1
    • 2
  • N. C. Harvey
    • 1
  • H. Inskip
    • 1
    • 2
  • C. Cooper
    • 1
    • 2
    • 3
  • J. Baird
    • 1
  1. 1.Medical Research Council Lifecourse Epidemiology UnitUniversity of Southampton, Southampton General HospitalSouthamptonUK
  2. 2.NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of SouthamptonSouthamptonUK
  3. 3.NIHR Oxford Musculoskeletal Biomedical Research UnitUniversity of Oxford, Nuffield Orthopaedic CentreOxfordUK

Personalised recommendations