Is store density associated with sugar-sweetened beverages consumption and overweight or obesity in Mexican adolescents?

Background The consumption of sugar-sweetened beverages (SSBs) is a risk factor for obesity. In Mexico, SSBs are widely available and consumed daily by adolescents. Objectives The purpose of this study was to estimate the indirect association between store density (including grocery, convenience, non-alcoholic beverage stores and supermarkets) and overweight or obesity (OW/O) among Mexican adolescents, using SSB consumption as a mediator. Methods We used cross-sectional data on adolescent SSB consumption, weight status (body mass index for age [BMI for age]), physical activity, screen time and sociodemographic factors from the 2016 Mexican Midway National Health and Nutrition Survey (ENSANUT MC 2016). The National Statistical Directory of Economic Units provided information on stores selling SSBs. We estimated structural equations models to test associations between store density and OW/O, using SSB consumption as a mediator. Results We found a direct positive association between store density and SSB intake in adolescents (beta =1.229), including density of supermarkets (beta = 132.07), grocery stores (beta = 1.170) and non-alcoholic beverage stores (beta = 1.537). No significant association was observed for convenience stores. Direct association between store density and OW/O was strongest for supermarket density (beta = 0.426). In addition, SSB intake was significantly associated with OW/O (p = 0.033). No significant indirect association between density of any store and OW/O was found. Conclusions Store density was directly associated with SSB consumption but not indirectly associated with OW/O mediated by SSB. Further research on food environment is required in order to design evidence-based strategies aimed at reducing SSB intake and OW/O in adolescents.