Background: Evidence from well-designed longitudinal studies is needed to assess the impact of the food environment on changes in children’s weight status.

Methods: A cohort of predominantly low-income African American and Hispanic 3-15-year-old children from four New Jersey cities was monitored over two-to-five year periods. Changes in the children’s food environment were tracked using systematic protocols and geospatial measures. Changes in Body Mass Index (BMI) Z-scores were grouped into three categories: (i) negative change, (ii) minimal change, and (iii) positive change. Multivariable analyses examined the impact of exposure to changes in food environments over varying periods of time (12, 18, 24 months) and over varying distances (¼, ½ and 1 mile) on odds of belonging to one of the three BMI Z-score change categories. Complete data were available for 450 children.

Results: 34% of the sample experienced a negative change in BMI-Z score, 25% experienced a positive change, and 41% experienced minimal change. In ordered logistic regression analysis, increased exposure to convenience stores, over varying lengths of time and distances, showed consistently higher odds of an increase in children’s BMI z-score. Conversely, children exposed to more small grocery stores selling healthier products showed a consistent pattern of decreased BMI Z-scores. Further examination by child age, sex, and race revealed significant differences.

Conclusions: Food environments play a critical role in determining children’s weight status over time. Interventions are needed to improve access to small grocery stores in children’s immediate neighborhoods and diminish the influence of convenience stores.

Introduction: Disparities have been documented across racial/ethnic groups for unhealthful dietary behaviors and obesity. Our objective is to examine these outcomes and access to healthful foods across racial/ethnic groups for mothers and children from low-income households throughout California.

Methods: Mothers and children were recruited from randomly-sampled households with incomes ≤185% of the federal poverty level. Dietary outcomes were assessed via telephone interviews using a validated 24-hour recall assessment (ASA24). Supplemental items assessed height and weight; demographics; the availability of fruits and vegetables (FV), and healthy foods overall, in one’s neighborhood; and the availability of FV to household family members. Mothers with a BMI ≥30 were classified as obese; BMI-for- age-and-gender percentile rankings were used for children.

Results: The obesity rate was higher for African American (53.5%) than Latino (45.7%) or white (44.0%) mothers; and higher for African American (31.8%) and Latino (28.8%) compared with white (22.3%) children. African Americans mothers consumed more added sugar. Finally, compared with white mothers, fewer African American mothers reported that FV or healthy foods overall were readily available in their neighborhood. Accordingly, African American mothers were less likely to say that FV were available for family snacks or meals.

Discussion: Over half of low-income African American mothers in California are obese. These mothers and their children have restricted access to healthier foods compared with white families. The focus of obesity prevention efforts must be on African American families, and should include addressing environmental factors related to the increased risk of elevated body mass.

introduction: Previous research has found that the 2009 WIC food package change was associated with lower obesity risk at age 4 years among WIC-participating children in Los Angeles County. The objective of this study was to determine whether this association differed across levels of income-eligibility.

methods: Los Angeles County WIC administrative data were analyzed for children continuously enrolled from birth through age 4 years immediately before (2003-2009; N=39,751) and after (2010-2016; N=39,751) the 2009 WIC food package change. Gender-stratified Poisson regression was used to assess effect modification of the association between the food package received (new vs. old) and obesity at age 4 (BMI-for-age ≥95^th percentile) by category of family income classified by federal poverty level (FPL) as <50% FPL (very low), 50 to <100% FPL (low), and 100 to 185% FPL (above FPL), while accounting for child age, race/ethnicity, and initial weight status, and maternal education and language preference.

results: Compared to boys receiving the old food package, boys receiving the new WIC food package had a 15%, 13%, and 18% lower obesity risk at age 4 years if they lived in very-low-income, low-income, and above FPL households, respectively. The corresponding numbers for girls were 12%, 7%, and 12%. The observed associations were statistically significant in all income strata, with no significant modification by family income.

conclusions: The WIC food package revisions were associated with reduced childhood obesity risk among all WIC-participating families in Los Angeles County, across all levels of income-eligibility.

Background: In lower-income areas, WIC-authorized stores can improve community food environments by stocking a minimum number of healthy foods in accordance with WIC food package guidelines. However, whether proximity to WIC stores is associated with improvements in children’s dietary patterns or obesity risk is not well understood.

Design: Secondary analysis of cross-sectional data collected in 2009-2010 and 2014 for the New Jersey Child Health Study (NJCHS). Surveys from 2,211 households with 3-18-year-old children residing in one of four New Jersey cities: Newark, New Brunswick, Camden, and Trenton. Proximity to WIC stores was determined through geo-coding of store and household addresses. Associations with child food consumption and obesity status were examined, first for the full sample, then by household WIC participation status.

Results: Children 5 and under who lived in WIC households had 20% lower odds of being obese for each additional WIC store located within half mile (p=.001) of their homes. While a similar trend was seen for 6-11-year-old children, it was not statistically significant (p=.146) and disappeared by age 12. No associations were observed for children from non-WIC households. Consumption behaviors of children revealed consistent, but in most cases, non-significant trends where, for every additional WIC store, children from WIC households consumed more fruits/vegetables and fewer energy dense snacks than children from non-WIC households.

Conclusions: Living in close proximity to WIC stores can improve weight outcomes through access to healthier foods. Benefits of improved access were observed in children living in WIC households, particularly among those 5 and under.