Research Department of Epidemiology and Public Health, University College London, London, UK.
Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, London, UK.
Int J Obes (Lond). 2021 Jun;45(6):1215-1228. doi: 10.1038/s41366-021-00760-2. Epub 2021 Feb 17.
BACKGROUND/OBJECTIVE: Mexico has one of the highest rates of obesity and overweight worldwide, affecting 75% of the population. The country has experienced a dietary and food retail transition involving increased availability of high-calorie-dense foods and beverages. This study aimed to assess the relationship between the retail food environment and body mass index (BMI) in Mexico.
SUBJECTS/METHODS: Geographical and food outlet data were obtained from official statistics; anthropometric measurements and socioeconomic characteristics of adult participants (N = 22,219) came from the nationally representative 2012 National Health and Nutrition Survey (ENSANUT). Densities (store count/census tract area (CTA)) of convenience stores, restaurants, fast-food restaurants, supermarkets and fruit and vegetable stores were calculated. The association of retail food environment variables, sociodemographic data and BMI was tested using multilevel linear regression models.
Convenience store density was high (mean (SD) = 50.0 (36.9)/CTA) compared with other food outlets in Mexico. A unit increase in density of convenience stores was associated with a 0.003 kg/m (95% CI: 0.0006, 0.005, p = 0.011) increase in BMI, equivalent to 0.34 kg extra weight for an adult 1.60 m tall for every additional 10% store density increase (number of convenience stores per CTA (km)). Metropolitan areas showed the highest density of food outlet concentration and the highest associations with BMI (β = 0.01, 95% CI: 0.004-0.01, p < 0.001). A 10% store density increase in these areas would represent a 1 kg increase in weight for an adult 1.60 m tall.
Convenience store density was associated with higher mean BMI in Mexican adults. An excessive convenience store availability, that offers unhealthy food options, coupled with low access to healthy food resources or stores retailing healthy food, including fruits and vegetables, may increase the risk of higher BMI. This is the first study to assess the association of the retail food environment and BMI at a national level in Mexico.
背景/目的：墨西哥是全球肥胖和超重率最高的国家之一，有 75%的人口受到影响。该国经历了饮食和食品零售的转变，高卡路里、高能量密度的食品和饮料供应增加。本研究旨在评估墨西哥零售食品环境与体重指数（BMI）之间的关系。
研究对象/方法：地理和食品销售点数据来自官方统计数据；成年人的人体测量和社会经济特征（N=22219）来自具有全国代表性的 2012 年全国健康和营养调查（ENSANUT）。计算了便利店、餐馆、快餐店、超市和水果店的密度（商店数量/普查区面积（CTA））。使用多层线性回归模型检验零售食品环境变量、社会人口数据和 BMI 之间的关联。
与其他食品销售点相比，墨西哥的便利店密度较高（平均值（SD）=50.0（36.9）/CTA）。便利店密度每增加一个单位，BMI 就会增加 0.003kg/m（95%CI：0.0006，0.005，p=0.011），相当于身高 1.60 米的成年人每增加 10%的商店密度（每 CTA（km）的便利店数量），体重增加 0.34kg。大都市地区的食品销售点密度最高，与 BMI 的关联度也最高（β=0.01，95%CI：0.004-0.01，p<0.001）。在这些地区，商店密度增加 10%，身高 1.60 米的成年人的体重就会增加 1kg。
便利店密度与墨西哥成年人的平均 BMI 呈正相关。便利店过度供应不健康的食品选择，加上获取健康食品资源或销售健康食品（包括水果和蔬菜）的商店不足，可能会增加 BMI 升高的风险。这是首次在墨西哥全国范围内评估零售食品环境与 BMI 之间关联的研究。
