Public Health Nutrition


The association between the food environment and weight status among eastern North Carolina youth

Stephanie B Jilcotta1 c1, Scott Wadea2, Jared T McGuirta1, Qiang Wua3, Suzanne Lazoricka1a4 and Justin B Moorea1

a1 Department of Public Health, Brody School of Medicine, East Carolina University, 1709 West Sixth Street, Greenville, NC 27834, USA

a2 Y.H. Kim Computing Lab, ECU Center for GIScience, Department of Geography, East Carolina University, Greenville, NC, USA

a3 Department of Biostatistics, East Carolina University, Greenville, NC, USA

a4 Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA


Objective To examine associations between various measures of the food environment and BMI percentile among youth.

Design Cross-sectional, observational.

Setting Pitt County, eastern North Carolina.

Subjects We extracted the electronic medical records for youth receiving well child check-ups from January 2007 to June 2008. We obtained addresses for food venues from two secondary sources and ground-truthing. A geographic information systems database was constructed by geocoding home addresses of 744 youth and food venues. We quantified participants’ accessibility to food venues by calculating ‘coverage’, number of food venues in buffers of 0·25, 0·5, 1 and 5 miles (0·4, 0·8, 1·6 and 8·0 km) and by calculating ‘proximity’ or distance to the closest food venue. We examined associations between BMI percentile and food venue accessibility using correlation and regression analyses.

Results There were negative associations between BMI percentile and coverage of farmers’ markets/produce markets in 0·25 and 0·5 mile Euclidean and 0·25, 0·5 and 1 mile road network buffers. There were positive associations between BMI percentile and coverage of fast-food and pizza places in the 0·25 mile Euclidean and network buffers. In multivariate analyses adjusted for race, insurance status and rural/urban residence, proximity (network distance) to convenience stores was negatively associated with BMI percentile and proximity to farmers’ markets was positively associated with BMI percentile.

Conclusions Accessibility to various types of food venues is associated with BMI percentile in eastern North Carolina youth. Future longitudinal work should examine correlations between accessibility to and use of traditional and non-traditional food venues.

(Received September 27 2010)

(Accepted February 20 2011)

(Online publication April 13 2011)


c1 Corresponding author: Email