Public Health Nutrition

Research Paper

Changes in neighbourhood food store environment, food behaviour and body mass index, 1981–1990

May C Wanga1 c1, Catherine Cubbina2a3a4, Dave Ahna4 and Marilyn A Winklebya4

a1 School of Public Health and the Center for Weight and Health, University of California at Berkeley, 2180 Dwight Way – Unit C, Berkeley, CA 94704, USA

a2 Center on Social Disparities in Health, University of California at San Francisco, San Francisco, CA, USA

a3 Population Research Center, University of Texas at Austin, Austin, TX, USA

a4 Stanford Center for Prevention Research, Stanford University School of Medicine, Stanford, CA, USA


Objective This paper examines trends in the neighbourhood food store environment (defined by the number and geographic density of food stores of each type in a neighbourhood), and in food consumption behaviour and overweight risk of 5779 men and women.

Design The study used data gathered by the Stanford Heart Disease Prevention Program in four cross-sectional surveys conducted from 1981 to 1990.

Setting Four mid-sized cities in agricultural regions of California.

Subjects In total, 3154 women and 2625 men, aged 25–74 years.

Results From 1981 to 1990, there were large increases in the number and density of neighbourhood stores selling sweets, pizza stores, small grocery stores and fast-food restaurants. During this period, the percentage of women and men who adopted healthy food behaviours increased but so did the percentage who adopted less healthy food behaviours. The percentage who were obese increased by 28% in women and 24% in men.

Conclusion Findings point to increases in neighbourhood food stores that generally offer mostly unhealthy foods, and also to the importance of examining other food pattern changes that may have a substantial impact on obesity, such as large increases in portion sizes during the 1980s.

(Received December 28 2006)

(Accepted July 23 2007)


c1 Corresponding author: Email