Home and Neighborhood Food Environment Measures and Weight-for-Age z-Scores Among Children Aged 1-5 Years: An Exploratory Cross-Sectional Analysis.

Background/Objectives: Childhood obesity is prevalent in the United States, and although food environments (FEs) may be related to child weight, findings remain inconsistent. This study evaluated neighborhood and home FEs' associations with children's weight and explored interactive effects of the neighborhood and home FEs on child weight. We hypothesized that children exposed to less healthy neighborhood and home FEs would have higher weight. Methods: This secondary analysis leveraged baseline data from caregiver-child dyads (n = 115) enrolled in an obesity intervention trial (HABITS). The Modified Retail Food Environment Index (mRFEI) was calculated as the proportion of healthy versus unhealthy food vendors within a 4-mile buffer of participants' homes using food retailer data from business directories and geographic information systems software. Caregivers reported fruit, vegetable, and sugary beverage availability at home. Child weight was measured and used to determine weight-for-age z-scores (WAZs). Linear regression models were used to examine neighborhood FE, home FE, and their interactions as predictors of child WAZs. Results: Participants were majority non-Hispanic Black (77%) with household incomes of <$30,000/year (73%). Children were 3.0 ± 1.0 years old. Child WAZs were negatively associated with home fruit availability (β = -0.07, 95% CI: -0.14 to -0.01, p = 0.02), with no associations observed for the neighborhood FE or other home FE factors and no interaction between neighborhood and home FEs on weight. Conclusions: There were no significant associations between neighborhood FEs and weight among young children, while within the home FE, only the availability of fruit was associated with child weight.