Children’s Community Nutrition Environment, Food and Drink Purchases and Consumption on Journeys between Home and School: A Wearable Camera Study

Abstract

Children’s community nutrition environments are an important contributor to childhood obesity rates worldwide. This study aimed to measure the type of food outlets on children’s journeys to or from school, children’s food purchasing and consumption, and to determine differences by ethnicity and socioeconomic status. In this New Zealand study, we analysed photographic images of the journey to or from school from a sample of 147 children aged 11–13 years who wore an Autographer camera which recorded images every 7 s. A total of 444 journeys to or from school were included in the analysis. Camera images captured food outlets in 48% of journeys that had a component of active travel and 20% of journeys by vehicle. Children who used active travel modes had greater odds of exposure to unhealthy food outlets than children who used motorised modes; odds ratio 4.2 (95% CI 1.2–14.4). There were 82 instances of food purchases recorded, 84.1% of which were for discretionary foods. Of the 73 food and drink consumption occasions, 94.5% were for discretionary food or drink. Children on their journeys to or from school are frequently exposed to unhealthy food outlets. Policy interventions are recommended to limit the availability of unhealthy food outlets on school routes.

Trends and determinants of active school travel among Australian secondary school students: national cross‐sectional data from 2009 to 2018

“…Australian children are exposed to high levels of outdoor advertising for unhealthy food and drink on school routes, 32 with exposure to unhealthy food advertising known to encourage a preference for and purchasing of unhealthy foods by children 33 . International studies have found that among adolescents, active travel is associated with an increased likelihood of consumption of fast food compared to car travel, related to higher fast‐food purchasing opportunities 34 , 35 . Secondary students with pocket money are more likely to consume fast food (overall) than those with no pocket money 36 .…”

“…33 International studies have found that among adolescents, active travel is associated with an increased likelihood of consumption of fast food compared to car travel, related to higher fast-food purchasing opportunities. 34,35 Secondary students with pocket money are more likely to consume fast food (overall) than those with no pocket money. 36 Interventions to increase active travel should also mitigate the potential unintended consequences related to increased exposure to unhealthy food marketing and environments along the school journey.…”

“…37 There is recent momentum regarding active school travel in Australia, including through the Australian Health Policy Collaboration's 'Active Travel: Pathways to a Healthy Future' report, 38 the Obesity Policy Coalition and Deakin University's Global Obesity Centre's 'Tipping the Scales' consensus statement, 39 and the Australian Government's 'National Obesity Prevention Strategy' . 40 Among the actions called for include: increased investment in facilitating infrastructure; 36 incentivisation of active travel; 37 the establishment of a virtual knowledge hub to promote information exchange; 35 dedicated funding to create safe, active zones around schools; 35 and coordinated national, state and council policies. 35 Promoting partial active travel (such as disembarkation from public transport a few stops early, or parking some distance from school) is important, particularly for students attending independent/Catholic schools who may live further from the school.…”

“…40 Among the actions called for include: increased investment in facilitating infrastructure; 36 incentivisation of active travel; 37 the establishment of a virtual knowledge hub to promote information exchange; 35 dedicated funding to create safe, active zones around schools; 35 and coordinated national, state and council policies. 35 Promoting partial active travel (such as disembarkation from public transport a few stops early, or parking some distance from school) is important, particularly for students attending independent/Catholic schools who may live further from the school.…”

Healthy Diet Promotion through Evidence-Informed Policies

“…explore the relationship between the food environment, purchasing patterns, and dietary behavior. These studies underscore the importance of considering geographic and economic factors when designing interventions to improve access to healthy foods [5][6][7][8][9]. In particular, Salvo et al highlight the potential impact of policies that jointly increase geographic and economic access to fruit and vegetables among low-income, predominantly Latino urban residents [9].…”