Importance The establishment and renovation of supermarkets may promote healthy diet practices among youth by increasing retail infrastructure for fresh foods. Objective To estimate the association between the Food Retail Expansion to Support Health (FRESH) program and the weight status of children and adolescents. Design, Setting, and Participants Using a difference-in-differences (DiD) design and including 12 months before and after a FRESH supermarket opened, data were analyzed for residentially stable public school students in kindergarten through 12th grade with objectively measured height and weight data from the academic years 2009 through 2016. Of the 8 FRESH-subsidized supermarkets in residential neighborhoods in New York City, New York, 5 were new and 3 were renovation projects between December 2011 and June 2014. Data were analyzed from June 2021 to January 2022. Interventions The treatment group included students who resided within 0.50 miles of a FRESH-subsidized supermarket and had at least 1 body mass index (BMI) measurement within 12 months before and 3 to 12 months after the month a FRESH supermarket opened (n = 22 712 student-year observations). A 2-stage matching-weighting approach was used to construct a control group of students who resided more than 0.50 miles from a FRESH supermarket in a FRESH-eligible area (n = 86 744 student-year observations). Main Outcomes and Measures BMI z score was calculated using objectively measured height and weight data from FITNESSGRAM, an annual, school-based, standardized fitness assessment of every New York City public school student. Obesity was defined as 95th percentile or greater of the BMI z score using Centers for Disease Control and Prevention growth charts. Results The treatment group in the analytic sample had 11 356 students (22 712 student-year observations), and the control group had 43 372 students (86 744 student-year observations). The students were predominately Black (18.8%) and Hispanic and Latino (68.5%) and eligible for free or reduced-priced lunch (84.6%). There was a significant decrease in BMI z score among students who resided within 0.50 miles of a FRESH supermarket (vs control group students) in the 3- to 12-month follow-up period (DiD, -0.04; 95% CI, -0.06 to -0.02). This was true for those exposed to supermarkets that were either new (DiD, -0.07; 95% CI, -0.11 to -0.03) or renovated (DiD, -0.03; 95% CI, -0.06 to -0.01). A statistically significant decrease was also observed in the likelihood of obesity (DiD, -0.01; 95% CI, -0.02 to -0.002). Conclusions and Relevance Government-subsidized supermarkets may contribute to a small decrease in obesity risk among children residing near those supermarkets, if part of a comprehensive policy approach.

中文翻译：

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补贴服务欠缺地区超市的政策与儿童肥胖风险之间的关联。

重要性 超市的建立和改造可以通过增加新鲜食品的零售基础设施来促进青年人的健康饮食习惯。目的 评估食品零售扩展支持健康 (FRESH) 计划与儿童和青少年体重状况之间的关联。设计、设置和参与者 采用双差分法 (DiD) 设计，包括 FRESH 超市开业前后 12 个月的数据，分析了从幼儿园到 12 年级的居住稳定的公立学校学生的数据，这些学生的身高和体重数据是客观测量的从2009学年到2016学年，纽约市居民区的8家FRESH补贴超市中，有5家是2011年12月到2014年6月期间新建的，3家是改造项目。分析了 2021 年 6 月至 2022 年 1 月的数据。 干预措施 治疗组包括居住在 FRESH 补贴超市 0.50 英里范围内并且在活动开始前 12 个月和活动结束后 3 至 12 个月内至少测量过 1 次体重指数 (BMI) 的学生月 FRESH 超市开业（n = 22 712 学生年度观察）。使用 2 阶段匹配加权方法构建一个对照组学生，他们居住在符合 FRESH 条件的地区，距离 FRESH 超市超过 0.50 英里（n = 86 744 学生年观察）。主要成果和措施 BMI z 分数是使用来自 FITNESSGRAM 的客观测量的身高和体重数据计算的，FITNESSGRAM 是一项针对纽约市公立学校学生的年度、基于学校​​的标准化健康评估。使用疾病控制和预防中心生长图表，肥胖被定义为 BMI z 分数的第 95 个百分位或更高。结果 分析样本中的治疗组有 11 356 名学生（22 712 名学生年观察值），对照组有 43 372 名学生（86 744 名学生年观察值）。学生主要是黑人 (18.8%) 以及西班牙裔和拉丁裔 (68.5%)，并且有资格享用免费或减价午餐 (84.6%)。在 3 至 12 个月的随访期内，居住在 FRESH 超市 0.50 英里范围内的学生（与对照组学生相比）的 BMI z 分数显着下降（DiD，-0.04；95% CI，-0.06到 -0.02）。对于那些接触过新超市（DiD，-0.07；95% CI，-0.11 至 -0.03）或翻新超市（DiD，-0.03；95% CI，-0.06 至 -0.01）的人来说，情况确实如此。肥胖的可能性也有统计学意义的显着降低（DiD，-0.01；95% CI，-0.02 至 -0.002）。结论和相关性 如果作为综合政策方法的一部分，政府补贴的超市可能有助于小幅降低居住在这些超市附近的儿童的肥胖风险。