Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA 9819, USA.
Am J Public Health. 2012 Aug;102(8):e74-80. doi: 10.2105/AJPH.2012.300660. Epub 2012 Jun 14.
We examined whether physical proximity to supermarkets or supermarket price was more strongly associated with obesity risk.
The Seattle Obesity Study (SOS) collected and geocoded data on home addresses and food shopping destinations for a representative sample of adult residents of King County, Washington. Supermarkets were stratified into 3 price levels based on average cost of the market basket. Sociodemographic and health data were obtained from a telephone survey. Modified Poisson regression was used to test the associations between obesity and supermarket variables.
Only 1 in 7 respondents reported shopping at the nearest supermarket. The risk of obesity was not associated with street network distances between home and the nearest supermarket or the supermarket that SOS participants reported as their primary food source. The type of supermarket, by price, was found to be inversely and significantly associated with obesity rates, even after adjusting for individual-level sociodemographic and lifestyle variables, and proximity measures (adjusted relative risk=0.34; 95% confidence interval=0.19, 0.63)
Improving physical access to supermarkets may be one strategy to deal with the obesity epidemic; improving economic access to healthy foods is another.
我们研究了与肥胖风险更密切相关的因素是靠近超市的物理距离还是超市价格。
西雅图肥胖研究（SOS）收集并对华盛顿州金县成年居民的家庭住址和食品购物目的地进行了地理编码。根据市场篮子的平均成本，将超市分为 3 个价格水平层。社会人口统计学和健康数据来自电话调查。采用修正泊松回归检验肥胖与超市变量之间的关联。
只有 1/7 的受访者表示在最近的超市购物。肥胖风险与家庭与最近的超市之间的街道网络距离或 SOS 参与者报告的主要食物来源的超市无关。按价格划分的超市类型与肥胖率呈显著负相关，即使在调整了个体社会人口统计学和生活方式变量以及接近度测量值后也是如此（调整后的相对风险=0.34；95%置信区间=0.19，0.63）。
改善超市的实际可达性可能是应对肥胖流行的一种策略；改善获得健康食品的经济机会则是另一种策略。
