Corner Stores a Threat to City Kids' Waistlines?

Most teachers who have worked in low-income urban areas have seen the corner store snack ritual, and likely thought it was unhealthy.

But for the first time, obesity researchers have attempted to quantify just how much city kids eat at corner stores after school.

A new study in the journal Pediatrics examined the after school snacking habits of 10, K-8 Philadelphia schools where 50 percent of students are eligible for free or reduced-price lunch.

The results showed that city kids consumed large amounts of high calorie, low costs foods. The findings largely confirmed doctors' ideas of how much and how often the kids snacked, but hardly any expert agreed on how to stop it.

"Pineapple soda and potato chips: every day after school, and before," said Ben Himowitz, a former school teacher.

When Himowitz transferred from an elementary school in Philadelphia to a middle school in the Bronx, he saw the same ritual bodega stops, but kids were just buying different foods.

"Often they'd get money from their parents to get a snack," he said. "Candy was also big -- they'd stand in front of those plastic walls with candy behind them and say 'give me one of those, and some of those,' and show how much money they could spend."

Many children went to the bodega, but Himowitz said going to McDonalds -- the other food store near the school -- became a trendy thing to do in the morning.

Just How Much Do City Kids Eat at Corner Stores?

The schools notified children that researchers would be standing nearby corner stores in identifiable T-shirts, and would be asking to look at what they bought.

From 833 "intercept" surveys of children outside 24 corner stores, researchers found that children usually ate chips, candy and sweetened drinks. They spend an average of $1 each visit and ate 350 calories worth of snacks at each visit.

Forty-two percent of the children said they went to the corner store twice a day, which would amount to eating over 3,500 calories from the corner store a week -- the number of excess calories needed to gain a pound.

"We were surprised primarily by the fact that one dollar can buy 360 calories," said Kelley Borradaile, lead author of the study and an assistant professor at the Center for Obesity Research and Education at Temple University in Philadelphia.

Considering those numbers, researchers say those corner store visits may very well be a big problem – especially in low-income urban areas where often 50 percent of children are overweight and 25 percent of children are obese.

How to Convince Kids to Eat Healthy Food

Borradaile said new efforts outside of school lunches should be made to steer children towards healthy eating.

"I think targeting some of the popular items that kids like and purchase most frequently would," said Borradaile, who suggested "moving from chips to baked chips" and making healthier items more attractive to children in school.

Borradaile is currently working with The Food Trust, a local non-profit, to help market healthy foods to children in new ways such as letting children create cool labels for bottles of water.

"These are things that are appealing to the children because the children created them," said Borradaile.

But other diet experts and researchers varied widely on recommendations to curb corner store snacking. In fact, many disagreed with one another.

"Please understand - this is not just an urban issue but a rural issue as well and even at the suburban convenience stores the kids eat the same high fat, high calorie, low-nutrient foods," said Marilyn K. Tanner-Blasiar, a registered dietitian and study coordinator at the Washington University School of Medicine in St. Louis.

Part of the disagreements on how to help children stem from disagreements about what causes the bad eating behavior – the structure of the city, the price of cheap food, parent's influence or the school.

In Borradaile's paper, she and her colleagues argued that cheap price of the unhealthy foods was part of what made them appealing to students.

"The popularity of inexpensive, energy-dense, low-nutritive foods and beverages presents several opportunities for future intervention targets," the authors wrote. "Alternative foods, however, may be more expense or unavailable in stores. Future research is necessary to understand how factors such as price and availability influence child and adolescent purchases."

Bad food is certainly cheap, but not everyone agrees that healthy food is too expensive.

Does Cost Lead to Unhealthy Eating?

"[Price] is significant," said Dr. David Katz, director of the Prevention Research Center at the Yale University School of Medicine and medical contributor to ABC News.

However in Katz's research, he found more nutritious foods in most product categories do not more.

"There is some urban legend in this," said Katz. "We need programs in school and for parents at home to help steer the kids to better choices, then need to make those choices accessible."

Still others aren't convinced an array of choices would change the way kids eat.

"They [unhealthy snacks] are easy cheap and tasty. I think you give any 9-year-old or 12-year-old $4 and free run in the bodega anywhere in the country and they'd buy the same thing," said Himowitz.

Keith-Thomas Ayoob, an associate professor in the department of pediatrics at the Albert Einstein College of Medicine in New York City, agreed kids already had some healthy choices in front of them.

"The cost for sugar-free sodas is the same, so a change in behavior is all that's needed," said Ayoob. "An apple is cheaper than a dollar, but if the kids could buy fresh fruit instead, would they?"

Ayoob had a much more uncomfortable explanation for why many kids continue to buy unhealthy snacks after school. As a dietary counselor in New York City, Ayoob works with urban children trying to lose weight on a daily basis.

"Where are they getting the money? These are low income youths but buying these unhealthy snacks is something they couldn't do if their parents weren't giving them money," said Ayoob. "Many of the children coming in to our clinic eating sugary beverages and chips are doing so because their parents bought these foods for them."

"Nobody wants to say that the parents are to blame, but many times the parents are in need of the (dietary) education and motivation," he added.

Dr. Mitchell Roslin, of Lenox Hill Hospital in New York City, thought that opportunity across these low-income neighborhoods might be the key to healthy eating.

"If you are excited about your future, than you are worried about your health, so you can enjoy the fruits of your labors. If each day is a struggle, than it is more difficult to sacrifice the present for the future," said Roslin.

"As our country's wealth has become more stratified, I believe so has its health," said Roslin. "To many extents, it is about hope and education. Until, these kids feel they have opportunity, it is going to be a difficult problem to solve."

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