Validation of food store environment secondary data source and the role of neighborhood deprivation in Appalachia, Kentucky.

PubMed

Gustafson, Alison A; Lewis, Sarah; Wilson, Corey; Jilcott-Pitts, Stephanie

2012-08-22

Based on the need for better measurement of the retail food environment in rural settings and to examine how deprivation may be unique in rural settings, the aims of this study were: 1) to validate one commercially available data source with direct field observations of food retailers; and 2) to examine the association between modified neighborhood deprivation and the modified retail food environment score (mRFEI). Secondary data were obtained from a commercial database, InfoUSA in 2011, on all retail food outlets for each census tract. In 2011, direct observation identifying all listed food retailers was conducted in 14 counties in Kentucky. Sensitivity and positive predictive values (PPV) were compared. Neighborhood deprivation index was derived from American Community Survey data. Multinomial regression was used to examine associations between neighborhood deprivation and the mRFEI score (indicator of retailers selling healthy foods such as low-fat foods and fruits and vegetables relative to retailers selling more energy dense foods). The sensitivity of the commercial database was high for traditional food retailers (grocery stores, supermarkets, convenience stores), with a range of 0.96-1.00, but lower for non-traditional food retailers; dollar stores (0.20) and Farmer's Markets (0.50). For traditional food outlets, the PPV for smaller non-chain grocery stores was 38%, and large chain supermarkets was 87%. Compared to those with no stores in their neighborhoods, those with a supercenter [OR 0.50 (95% CI 0.27. 0.97)] or convenience store [OR 0.67 (95% CI 0.51, 0.89)] in their neighborhood have lower odds of living in a low deprivation neighborhood relative to a high deprivation neighborhood. The secondary commercial database used in this study was insufficient to characterize the rural retail food environment. Our findings suggest that neighborhoods with high neighborhood deprivation are associated with having certain store types that may promote less healthy

Validation of food store environment secondary data source and the role of neighborhood deprivation in Appalachia, Kentucky

PubMed Central

2012-01-01

Background Based on the need for better measurement of the retail food environment in rural settings and to examine how deprivation may be unique in rural settings, the aims of this study were: 1) to validate one commercially available data source with direct field observations of food retailers; and 2) to examine the association between modified neighborhood deprivation and the modified retail food environment score (mRFEI). Methods Secondary data were obtained from a commercial database, InfoUSA in 2011, on all retail food outlets for each census tract. In 2011, direct observation identifying all listed food retailers was conducted in 14 counties in Kentucky. Sensitivity and positive predictive values (PPV) were compared. Neighborhood deprivation index was derived from American Community Survey data. Multinomial regression was used to examine associations between neighborhood deprivation and the mRFEI score (indicator of retailers selling healthy foods such as low-fat foods and fruits and vegetables relative to retailers selling more energy dense foods). Results The sensitivity of the commercial database was high for traditional food retailers (grocery stores, supermarkets, convenience stores), with a range of 0.96-1.00, but lower for non-traditional food retailers; dollar stores (0.20) and Farmer’s Markets (0.50). For traditional food outlets, the PPV for smaller non-chain grocery stores was 38%, and large chain supermarkets was 87%. Compared to those with no stores in their neighborhoods, those with a supercenter [OR 0.50 (95% CI 0.27. 0.97)] or convenience store [OR 0.67 (95% CI 0.51, 0.89)] in their neighborhood have lower odds of living in a low deprivation neighborhood relative to a high deprivation neighborhood. Conclusion The secondary commercial database used in this study was insufficient to characterize the rural retail food environment. Our findings suggest that neighborhoods with high neighborhood deprivation are associated with having certain

Sodium in Store and Restaurant Food Environments - Guam, 2015.

PubMed

Jackson, Sandra L; VanFrank, Brenna K; Lundeen, Elizabeth; Uncangco, Alyssa; Alam, Lawrence; King, Sallyann M Coleman; Cogswell, Mary E

2016-05-27

Compared with the United States overall, Guam has higher mortality rates from cardiovascular disease and stroke (1). Excess sodium intake can increase blood pressure and risk for cardiovascular disease (2,3). To determine the availability and promotion of lower-sodium options in the nutrition environment, the Guam Department of Public Health and Social Services (DPHSS) conducted an assessment in September 2015 using previously validated tools adapted to include sodium measures. Stores (N = 114) and restaurants (N = 63) were randomly sampled by region (north, central, and south). Data from 100 stores and 62 restaurants were analyzed and weighted to account for the sampling design. Across the nine product types assessed, lower-sodium products were offered less frequently than regular-sodium products (p<0.001) with <50% of stores offering lower-sodium canned vegetables, tuna, salad dressing, soy sauce, and hot dogs. Lower-sodium products were also less frequently offered in small stores than large (two or more cash registers) stores. Reduced-sodium soy sauce cost more than regular soy sauce (p<0.001) in stores offering both options in the same size bottle. Few restaurants engaged in promotion practices such as posting sodium information (3%) or identifying lower-sodium entrées (1%). Improving the availability and promotion of lower-sodium foods in stores and restaurants could help support healthier eating in Guam.

Neighborhood impact on healthy food availability and pricing in food stores.

PubMed

Krukowski, Rebecca A; West, Delia Smith; Harvey-Berino, Jean; Elaine Prewitt, T

2010-06-01

Availability and price of healthy foods in food stores has the potential to influence purchasing patterns, dietary intake, and weight status of individuals. This study examined whether demographic factors of the store neighborhood or store size have an impact on the availability and price of healthy foods in sample of grocery stores and supermarkets. The Nutrition Environment Measures Study-Store (NEMS-S) instrument, a standardized observational survey, was utilized to evaluate food stores (N = 42) in a multi-site (Vermont and Arkansas) study in 2008. Census data associated with store census tract (median household income and proportion African-American) were used to characterize store neighborhood and number of cash registers was used to quantify store size. Median household income was significantly associated with the NEMS healthy food availability score (r = 0.36, P < 0.05); neither racial composition (r = -0.23, P = 0.14) nor store size (r = 0.27, P = 0.09) were significantly related to the Availability score. Larger store size (r = 0.40, P < 0.01) was significantly associated with the NEMS-S Price scores, indicating more favorable prices for healthier items; neither racial composition nor median household income were significantly related to the Price score (P's > 0.05). Even among supermarkets, healthier foods are less available in certain neighborhoods, although, when available, the quality of healthier options did not differ, suggesting that targeting availability may offer promise for policy initiatives. Furthermore, increasing access to larger stores that can offer lower prices for healthier foods may provide another avenue for enhancing food environments to lower disease risk.

Convenience stores are the key food environment influence on nutrients available from household food supplies in Texas Border Colonias

PubMed Central

2013-01-01

Background Few studies have focused on the relationship between the retail food environment and household food supplies. This study examines spatial access to retail food stores, food shopping habits, and nutrients available in household food supplies among 50 Mexican-origin families residing in Texas border colonias. Methods The design was cross-sectional; data were collected in the home March to June 2010 by promotora-researchers. Ground-truthed methods enumerated traditional (supercenters, supermarkets, grocery stores), convenience (convenience stores and food marts), and non-traditional (dollar stores, discount stores) retail food stores. Spatial access was computed using the network distance from each participant’s residence to each food store. Data included survey data and two household food inventories (HFI) of the presence and amount of food items in the home. The Spanish language interviewer-administered survey included demographics, transportation access, food purchasing, food and nutrition assistance program participation, and the 18-item Core Food Security Module. Nutrition Data Systems for Research (NDS-R) was used to calculate HFI nutrients. Adult equivalent adjustment constants (AE), based on age and gender calorie needs, were calculated based on the age- and gender composition of each household and used to adjust HFI nutrients for household composition. Data were analyzed using bivariate analysis and linear regression models to determine the association of independent variables with the availability of each AE-adjusted nutrient. Results Regression models showed that households in which the child independently purchased food from a convenience store at least once a week had foods and beverages with increased amounts of total energy, total fat, and saturated fat. A greater distance to the nearest convenience store was associated with reduced amounts of total energy, vitamin D, total sugar, added sugar, total fat, and saturated fat. Participation in

Association between store food environment and customer purchases in small grocery stores, gas-marts, pharmacies and dollar stores.

PubMed

Caspi, Caitlin E; Lenk, Kathleen; Pelletier, Jennifer E; Barnes, Timothy L; Harnack, Lisa; Erickson, Darin J; Laska, Melissa N

2017-06-05

Purchases at small/non-traditional food stores tend to have poor nutritional quality, and have been associated with poor health outcomes, including increased obesity risk The purpose of this study was to examine whether customers who shop at small/non-traditional food stores with more health promoting features make healthier purchases. In a cross-sectional design, data collectors assessed store features in a sample of 99 small and non-traditional food stores not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Minneapolis/St. Paul, MN in 2014. Customer intercept interviews (n = 594) collected purchase data from a bag check and demographics from a survey. Store measures included fruit/vegetable and whole grain availability, an overall Healthy Food Supply Score (HFSS), healthy food advertisements and in-store placement, and shelf space of key items. Customer nutritional measures were analyzed using Nutrient Databases System for Research (NDSR), and included the purchase of ≥1 serving of fruits/vegetables; ≥1 serving of whole grains; and overall Healthy Eating Index-2010 (HEI-2010) score for foods/beverages purchased. Associations between store and customer measures were estimated in multilevel linear and logistic regression models, controlling for customer characteristics and store type. Few customers purchased fruits and vegetables (8%) or whole grains (8%). In fully adjusted models, purchase HEI-2010 scores were associated with fruit/vegetable shelf space (p = 0.002) and the ratio of shelf space devoted to healthy vs. less healthy items (p = 0.0002). Offering ≥14 varieties of fruit/vegetables was associated with produce purchases (OR 3.9, 95% CI 1.2-12.3), as was having produce visible from the store entrance (OR 2.3 95% CI 1.0 to 5.8), but whole grain availability measures were not associated with whole grain purchases. Strategies addressing both customer demand and the availability of healthy food

The Flint Food Store Survey: combining spatial analysis with a modified Nutrition Environment Measures Survey in Stores (NEMS-S) to measure the community and consumer nutrition environments.

PubMed

Shaver, Erika R; Sadler, Richard C; Hill, Alex B; Bell, Kendall; Ray, Myah; Choy-Shin, Jennifer; Lerner, Joy; Soldner, Teresa; Jones, Andrew D

2018-06-01

The goal of the present study was to use a methodology that accurately and reliably describes the availability, price and quality of healthy foods at both the store and community levels using the Nutrition Environment Measures Survey in Stores (NEMS-S), to propose a spatial methodology for integrating these store and community data into measures for defining objective food access. Two hundred and sixty-five retail food stores in and within 2 miles (3·2 km) of Flint, Michigan, USA, were mapped using ArcGIS mapping software. A survey based on the validated NEMS-S was conducted at each retail food store. Scores were assigned to each store based on a modified version of the NEMS-S scoring system and linked to the mapped locations of stores. Neighbourhood characteristics (race and socio-economic distress) were appended to each store. Finally, spatial and kernel density analyses were run on the mapped store scores to obtain healthy food density metrics. Regression analyses revealed that neighbourhoods with higher socio-economic distress had significantly lower dairy sub-scores compared with their lower-distress counterparts (β coefficient=-1·3; P=0·04). Additionally, supermarkets were present only in neighbourhoods with <60 % African-American population and low socio-economic distress. Two areas in Flint had an overall NEMS-S score of 0. By identifying areas with poor access to healthy foods via a validated metric, this research can be used help local government and organizations target interventions to high-need areas. Furthermore, the methodology used for the survey and the mapping exercise can be replicated in other cities to provide comparable results.

Small Convenience Stores and the Local Food Environment: An Analysis of Resident Shopping Behavior Using Multilevel Modeling.

PubMed

Ruff, Ryan Richard; Akhund, Ali; Adjoian, Tamar

2016-01-01

Local food environments can influence the diet and health of individuals through food availability, proximity to retail stores, pricing, and promotion. This study focused on how small convenience stores, known in New York City as bodegas, influence resident shopping behavior and the food environment. Using a cross-sectional design, 171 bodegas and 2118 shoppers were sampled. Small convenience stores in New York City. Any bodega shopper aged 18+ who purchased food or beverage from a participating store. Data collection consisted of a store assessment, a health and behavior survey given to exiting customers, and a bag check that recorded product information for all customer purchases. Descriptive statistics were generated for bodega store characteristics, shopper demographics, and purchase behavior. Multilevel models were used to assess the influence of product availability, placement, and advertising on consumer purchases of sugar-sweetened beverages (SSBs), water, and fruits and vegetables. Seventy-one percent of participants reported shopping at bodegas five or more times per week, and 35% reported purchasing all or most of their monthly food allotment at bodegas. Model results indicated that lower amounts of available fresh produce were significantly and independently associated with a higher likelihood of SSB purchases. A second, stratified multilevel model showed that the likelihood of purchasing an SSB increased with decreasing varieties of produce when produce was located at the front of the store. No significant effects were found for water placement and beverage advertising. Small convenience stores in New York City are an easily accessible source of foods and beverages. Bodegas may be suitable for interventions designed to improve food choice and diet.

Food Availability in School Stores in Seoul, South Korea After Implementation of Food- and Nutrient-Based Policies.

PubMed

Choi, Seul Ki; Frongillo, Edward A; Blake, Christine E; Thrasher, James F

2017-07-01

To improve school store food environments, the South Korean government implemented 2 policies restricting unhealthy food sales in school stores. A food-based policy enacted in 2007 restricts specific food sales (soft drinks); and a nutrient-based policy enacted in 2009 restricts energy-dense and nutrient-poor (EDNP) food sales. The purpose of the study was to assess how the 2 policies have changed the school store food environment. Foods sold in school stores in Seoul, South Korea were observed before (2006, 15 stores) and after (2013, 12 stores) implementation of the school store policies. Food availability in school stores in 2006 and 2013 was compared and EDNP food availability in 2013 was examined. When controlling the total number of foods sold in school stores and school characteristics, the mean number of soft drinks sold in a school store in 2013 (0.3 items) was significantly lower than in 2006 (1.9 items, p = .032). Soft drinks were still available in 50% of school stores observed in 2013, with all school stores selling EDNP foods in 2013. South Korean policies have had a modest influence on availability of unhealthy school store foods. Alternative strategies to improve school store food environments are needed. © 2017, American School Health Association.

Small food stores and availability of nutritious foods: a comparison of database and in-store measures, Northern California, 2009.

PubMed

Kersten, Ellen; Laraia, Barbara; Kelly, Maggi; Adler, Nancy; Yen, Irene H

2012-01-01

Small food stores are prevalent in urban neighborhoods, but the availability of nutritious food at such stores is not well known. The objective of this study was to determine whether data from 3 sources would yield a single, homogenous, healthful food store category that can be used to accurately characterize community nutrition environments for public health research. We conducted in-store surveys in 2009 on store type and the availability of nutritious food in a sample of nonchain food stores (n = 102) in 6 predominantly urban counties in Northern California (Alameda, Contra Costa, Marin, Sacramento, San Francisco, and Santa Clara). We compared survey results with commercial database information and neighborhood sociodemographic data by using independent sample t tests and classification and regression trees. Sampled small food stores yielded a heterogeneous group of stores in terms of store type and nutritious food options. Most stores were identified as convenience (54%) or specialty stores (22%); others were small grocery stores (19%) and large grocery stores (5%). Convenience and specialty stores were smaller and carried fewer nutritious and fresh food items. The availability of nutritious food and produce was better in stores in neighborhoods that had a higher percentage of white residents and a lower population density but did not differ significantly by neighborhood income. Commercial databases alone may not adequately categorize small food stores and the availability of nutritious foods. Alternative measures are needed to more accurately inform research and policies that seek to address disparities in diet-related health conditions.

Small Food Stores and Availability of Nutritious Foods: A Comparison of Database and In-Store Measures, Northern California, 2009

PubMed Central

Laraia, Barbara; Kelly, Maggi; Adler, Nancy; Yen, Irene H.

2012-01-01

Introduction Small food stores are prevalent in urban neighborhoods, but the availability of nutritious food at such stores is not well known. The objective of this study was to determine whether data from 3 sources would yield a single, homogenous, healthful food store category that can be used to accurately characterize community nutrition environments for public health research. Methods We conducted in-store surveys in 2009 on store type and the availability of nutritious food in a sample of nonchain food stores (n = 102) in 6 predominantly urban counties in Northern California (Alameda, Contra Costa, Marin, Sacramento, San Francisco, and Santa Clara). We compared survey results with commercial database information and neighborhood sociodemographic data by using independent sample t tests and classification and regression trees. Results Sampled small food stores yielded a heterogeneous group of stores in terms of store type and nutritious food options. Most stores were identified as convenience (54%) or specialty stores (22%); others were small grocery stores (19%) and large grocery stores (5%). Convenience and specialty stores were smaller and carried fewer nutritious and fresh food items. The availability of nutritious food and produce was better in stores in neighborhoods that had a higher percentage of white residents and a lower population density but did not differ significantly by neighborhood income. Conclusion Commercial databases alone may not adequately categorize small food stores and the availability of nutritious foods. Alternative measures are needed to more accurately inform research and policies that seek to address disparities in diet-related health conditions. PMID:22789445

Food and beverage purchases in corner stores, gas-marts, pharmacies and dollar stores.

PubMed

Caspi, Caitlin E; Lenk, Kathleen; Pelletier, Jennifer E; Barnes, Timothy L; Harnack, Lisa; Erickson, Darin J; Laska, Melissa N

2017-10-01

Little is known about customer purchases of foods and beverages from small and non-traditional food retailers (i.e. corner stores, gas-marts, dollar stores and pharmacies). The present study aimed to: (i) describe customer characteristics, shopping frequency and reasons for shopping at small and non-traditional food retailers; and (ii) describe food/beverage purchases and their nutritional quality, including differences across store type. Data were collected through customer intercept interviews. Nutritional quality of food/beverage purchases was analysed; a Healthy Eating Index-2010 (HEI-2010) score for purchases was created by aggregating participant purchases at each store. Small and non-traditional food stores that were not WIC-authorized in Minneapolis and St. Paul, MN, USA. Customers (n 661) from 105 food retailers. Among participants, 29 % shopped at the store at least once daily; an additional 44 % shopped there at least once weekly. Most participants (74 %) cited convenient location as the primary draw to the store. Customers purchased a median of 2262 kJ (540 kcal), which varied by store type (P=0·04). The amount of added sugar far surpassed national dietary recommendations. At dollar stores, participants purchased a median of 5302 kJ (1266 kcal) for a median value of $US 2·89. Sugar-sweetened beverages were the most common purchase. The mean HEI-2010 score across all stores was 36·4. Small and non-traditional food stores contribute to the urban food environment. Given the poor nutritional quality of purchases, findings support the need for interventions that address customer decision making in these stores.

Interventions in small food stores to change the food environment, improve diet, and reduce risk of chronic disease.

PubMed

Gittelsohn, Joel; Rowan, Megan; Gadhoke, Preety

2012-01-01

Many small-store intervention trials have been conducted in the United States and other countries to improve the food environment and dietary behaviors associated with chronic disease risk. However, no systematic reviews of the methods and outcomes of these trials have been published. The objective of this study was to identify small-store interventions and to determine their impact on food availability, dietary behaviors, and psychosocial factors that influence chronic disease risk. From May 2009 through September 2010, we used PubMed, web-based searches, and listservs to identify small-store interventions that met the following criteria: 1) a focus on small food stores, 2) a completed impact evaluation, and 3) English-written documentation (peer-reviewed articles or other trial documents). We initially identified 28 trials; 16 met inclusion criteria and were used for analysis. We conducted interviews with project staff to obtain additional information. Reviewers extracted and reported data in a table format to ensure comparability between data. Reviewed trials were implemented in rural and urban settings in 6 countries and primarily targeted low-income racial/ethnic minority populations. Common intervention strategies included increasing the availability of healthier foods (particularly produce), point-of-purchase promotions (shelf labels, posters), and community engagement. Less common strategies included business training and nutrition education. We found significant effects for increased availability of healthy foods, improved sales of healthy foods, and improved consumer knowledge and dietary behaviors. Trial impact appeared to be linked to the increased provision of both healthy foods (supply) and health communications designed to increase consumption (demand).

Examination of community and consumer nutrition, tobacco and physical activity environments at food and tobacco retail stores in three diverse North Carolina communities

PubMed Central

D'Angelo, Heather; Evenson, Kelly R.; Rose, Shyanika W.; Fleischhacker, Sheila; Myers, Allison E.; Ribisl, Kurt M.

2015-01-01

To advance our understanding of multiple health-related dimensions of the built environment, this study examined associations among nutrition, tobacco, and physical activity community and consumer environments. Community environment measures included supermarket access, tobacco outlet density, and physical activity resource density in store neighborhoods. Cross-sectional observations of the nutrition, tobacco and physical activity environments were conducted in 2011 at and around 303 food stores that sold tobacco products in three North Carolina counties. Pearson correlation coefficients and multiple linear regression were used to examine associations between community and consumer environments. Correlations between community nutrition, tobacco, and physical activity environments ranged from slight to fair (− 0.35 to 0.20) and from poor to fair (− 0.01 to − 0.38) between consumer environments. Significant relationships between consumer tobacco and nutrition environments were found after controlling for store and neighborhood characteristics. For example, stores with higher amounts of interior tobacco marketing had higher healthy food availability (p = 0.001), while stores with higher amounts of exterior tobacco marketing had lower healthy food availability (p = 0.02). Community and consumer environments for nutrition, tobacco, and physical activity were interrelated. Measures that assess single aspects of community or consumer environments could miss characteristics that may influence customer purchasing. Even chain supermarkets, typically regarded as healthful food sources compared to smaller food stores, may expose customers to tobacco marketing inside. Future research could explore combining efforts to reduce obesity and tobacco use by addressing tobacco marketing, healthy food availability and physical activity opportunities at retail food outlets. PMID:26516620

Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina

PubMed Central

Jilcott Pitts, Stephanie B.; Wu, Qiang; Truesdale, Kimberly P.; Laska, Melissa N.; Grinchak, Taras; McGuirt, Jared T.; Haynes-Maslow, Lindsey; Bell, Ronny A.; Ammerman, Alice S.

2017-01-01

In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose of this study was to examine associations between food store environments, shopping patterns, customer purchases, and dietary consumption among corner store customers. We surveyed 479 customers in 16 corner stores regarding demographics, food purchased, shopping patterns, and self-reported fruit, vegetable, and soda consumption. We objectively assessed fruit and vegetable consumption using a non-invasive reflection spectroscopy device to measure skin carotenoids. We examined associations between variables of interest, using Pearson’s correlation coefficients and adjusted linear regression analyses. A majority (66%) of participants were African American, with a mean age of 43 years, and a mean body mass index (BMI) of 30.0 kg/m2. There were no significant associations between the healthfulness of food store offerings, customer purchases, or dietary consumption. Participants who said they had purchased fruits and vegetables at the store previously reported higher produce intake (5.70 (4.29) vs. 4.60 (3.28) servings per day, p = 0.021) versus those who had not previously purchased fresh produce. The NC Legislature has allocated another $250,000 to the HFSRP for the 2018 fiscal year. Thus, evaluation results will be important to inform future healthy corner store policies and initiatives. PMID:28991156

Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina.

PubMed

Jilcott Pitts, Stephanie B; Wu, Qiang; Truesdale, Kimberly P; Laska, Melissa N; Grinchak, Taras; McGuirt, Jared T; Haynes-Maslow, Lindsey; Bell, Ronny A; Ammerman, Alice S

2017-10-07

In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose of this study was to examine associations between food store environments, shopping patterns, customer purchases, and dietary consumption among corner store customers. We surveyed 479 customers in 16 corner stores regarding demographics, food purchased, shopping patterns, and self-reported fruit, vegetable, and soda consumption. We objectively assessed fruit and vegetable consumption using a non-invasive reflection spectroscopy device to measure skin carotenoids. We examined associations between variables of interest, using Pearson's correlation coefficients and adjusted linear regression analyses. A majority (66%) of participants were African American, with a mean age of 43 years, and a mean body mass index (BMI) of 30.0 kg/m². There were no significant associations between the healthfulness of food store offerings, customer purchases, or dietary consumption. Participants who said they had purchased fruits and vegetables at the store previously reported higher produce intake (5.70 (4.29) vs. 4.60 (3.28) servings per day, p = 0.021) versus those who had not previously purchased fresh produce. The NC Legislature has allocated another $250,000 to the HFSRP for the 2018 fiscal year. Thus, evaluation results will be important to inform future healthy corner store policies and initiatives.

Observations of marketing on food packaging targeted to youth in retail food stores.

PubMed

Grigsby-Toussaint, Diana S; Moise, Imelda K; Geiger, Sarah D

2011-09-01

There is growing evidence that exposure to food marketing influences dietary preferences among youth. Few studies exploring this association, however, have focused on the retail food store environment where families negotiate the influence of food and beverage marketing on purchasing practices. Consequently, we sought to examine: (i) the extent to which foods marketed on the internet and television to youth are also available and marketed in retail food stores, and (ii) whether differences exist in the marketing practices across store types and by neighborhood racial composition. In 2008, a cross-sectional survey of 118 food stores was conducted in four Midwestern cities in the United States. Results showed that 82% of stores assessed carried items commonly marketed to youth via television or the internet. The items most likely to have some type of marketing technique were noncarbonated drinks (97.7%), fruit and cereal bars (76.9%), and soda (62.2%). Grocery stores were significantly more likely than convenience stores to have marketing for breads and pastries (34.6% vs. 17.9%), breakfast cereals (52.0% vs. 22.9%), cookies and crackers (54.2% vs. 25.3%), dairy (70.8% vs. 42.7%), and ice cream (23.8% vs. 9.8%). Stores located in black neighborhoods were significantly more likely to have marketing, in comparison to white neighborhoods, for breads and pastries (35.7% vs. 17.1%), breakfast cereals (44.4% vs. 25.0%), and cookies and crackers (48.1% vs. 26.3%). Our results highlight the importance of examining food marketing techniques in the retail food store environment, where visual cues from television and the internet may be reinforced.

Prepared Food Availability in U.S. Food Stores: A National Study.

PubMed

Zenk, Shannon N; Powell, Lisa M; Isgor, Zeynep; Rimkus, Leah; Barker, Dianne C; Chaloupka, Frank J

2015-10-01

Prepared, ready-to-eat foods comprise a significant part of Americans' diets and are increasingly obtained from food stores. Yet, little is known about the availability and healthfulness of prepared, ready-to-eat food offerings at stores. This study examines associations among community characteristics (racial/ethnic composition, poverty level, urbanicity) and availability of both healthier and less-healthy prepared foods in U.S. supermarkets, grocery stores, and convenience stores. Observational data were collected from 4,361 stores in 317 communities spanning 42 states in 2011 and 2012. Prepared food availability was assessed via one healthier food (salads or salad bar), three less-healthy items (pizza, hot dog/hamburger, taco/burrito/taquito), and one cold sandwich item. In 2014, multivariable generalized linear models were used to test associations with community characteristics. Overall, 63.6% of stores sold prepared foods, with 20.0% offering prepared salads and 36.4% offering at least one less-healthy item. Rural stores were 26% less likely to carry prepared salads (prevalence ratio [PR]=0.74, 95% CI=0.62, 0.88) and 14% more likely to carry at least one less-healthy prepared food item (PR=1.14, 95% CI=1.00, 1.30). Convenience stores in high-poverty communities were less likely to carry prepared salads than those in low-poverty communities (PR=0.64, 95% CI=0.47, 0.87). Among supermarkets, prepared salads were more likely to be carried in majority-white, low-poverty communities than in non-white, high-poverty communities. Increasing the healthfulness of prepared foods within stores may offer an important opportunity to improve the food environment. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Urban food environments and residents' shopping behaviors.

PubMed

Cannuscio, Carolyn C; Tappe, Karyn; Hillier, Amy; Buttenheim, Alison; Karpyn, Allison; Glanz, Karen

2013-11-01

Food environments may promote or undermine healthy behaviors, but questions remain regarding how individuals interact with their local food environments. This study incorporated an urban food environment audit as well as an examination of residents' food shopping behaviors within that context. In 2010, the research team audited the variety and healthfulness of foods available in 373 Philadelphia stores, using the validated Nutrition Environment Measures Survey in Stores (NEMS-S); higher scores indicate more diverse and healthful food inventories. The team also surveyed urban residents (n=514) regarding their food shopping. Descriptive and multivariate analyses (conducted in 2012) assessed variation in retail food environments and in shoppers' store choices. Corner and convenience stores were common (78.6% of food retail outlets) and had the lowest mean NEMS-S scores of any store type. Most participants (94.5%) did their primary food shopping at higher-scoring chain supermarkets, and the majority of participants did not shop at the supermarket closest to home. Supermarket offerings varied, with significantly fewer healthful foods at supermarkets closest to the homes of disadvantaged residents. In multivariate analyses, participants were significantly more likely to shop at supermarkets closest to home if those supermarkets had higher NEMS-S scores. These data suggest that, when possible, shoppers chose supermarkets that offered more variety and more healthful foods. Findings from this study also reinforce concern regarding unhealthy immediate food environments for disadvantaged residents, who disproportionately relied on nearby stores with more limited food items. Interventions to improve nutrition and health should address not only food store proximity but also diversity of healthful foods available. © 2013 American Journal of Preventive Medicine.

Food and Beverage Availability in Small Food Stores Located in Healthy Food Financing Initiative Eligible Communities.

PubMed

Singleton, Chelsea R; Li, Yu; Duran, Ana Clara; Zenk, Shannon N; Odoms-Young, Angela; Powell, Lisa M

2017-10-18

Food deserts are a major public health concern. This study aimed to assess food and beverage availability in four underserved communities eligible to receive funding from the Healthy Food Financing Initiative (HFFI). Data analyzed are part of a quasi-experimental study evaluating the impact of the HFFI on the retail food environment in selected Illinois communities. In 2015, 127 small grocery and limited service stores located in the four selected communities were audited. All communities had a large percentage of low-income and African-American residents. Differences in food and beverage item availability (e.g., produce, milk, bread, snack foods) were examined by store type and community location. Food stores had, on average, 1.8 fresh fruit and 2.9 fresh vegetable options. About 12% of stores sold low-fat milk while 86% sold whole milk. Only 12% of stores offered 100% whole wheat bread compared to 84% of stores offering white bread. Almost all (97%) stores offered soda and/or fruit juice. In summary, we found limited availability of healthier food and beverage items in the communities identified for HFFI support. Follow up findings will address how the introduction of new HFFI-supported supermarkets will affect food and beverage availability in these communities over time.

Food and Beverage Availability in Small Food Stores Located in Healthy Food Financing Initiative Eligible Communities

PubMed Central

Li, Yu; Duran, Ana Clara; Zenk, Shannon N.; Odoms-Young, Angela; Powell, Lisa M.

2017-01-01

Food deserts are a major public health concern. This study aimed to assess food and beverage availability in four underserved communities eligible to receive funding from the Healthy Food Financing Initiative (HFFI). Data analyzed are part of a quasi-experimental study evaluating the impact of the HFFI on the retail food environment in selected Illinois communities. In 2015, 127 small grocery and limited service stores located in the four selected communities were audited. All communities had a large percentage of low-income and African-American residents. Differences in food and beverage item availability (e.g., produce, milk, bread, snack foods) were examined by store type and community location. Food stores had, on average, 1.8 fresh fruit and 2.9 fresh vegetable options. About 12% of stores sold low-fat milk while 86% sold whole milk. Only 12% of stores offered 100% whole wheat bread compared to 84% of stores offering white bread. Almost all (97%) stores offered soda and/or fruit juice. In summary, we found limited availability of healthier food and beverage items in the communities identified for HFFI support. Follow up findings will address how the introduction of new HFFI-supported supermarkets will affect food and beverage availability in these communities over time. PMID:29057794

Changes in the Neighborhood Food Store Environment and Children's Body Mass Index at Peripuberty in the United States.

PubMed

Chen, Hsin-Jen; Wang, Youfa

2016-01-01

Little is known about the relationship between changes in food store environment and children's obesity risk in the United States. This study examines children's weight status associated with the changes in the quantity of food stores in their neighborhoods. A nationally representative cohort of schoolchildren in the United States was followed from fifth grade in 2004 to eighth grade in 2007 (n = 7,090). In 2004 and 2007, children's body mass index (BMI) was directly measured in schools. ZIP Code Business Patterns data from the Census Bureau in 2004 and 2007 characterized the numbers of food stores in every ZIP code area by type of store: supermarkets, limited-service restaurants, small-size grocery, and convenience stores. Baseline and change in the numbers of stores were the major exposures of interest. Girls living in neighborhoods with three or more supermarkets had a lower BMI 3 years later (by -.62 kg/m(2); 95% confidence interval = -1.05 to -.18) than did those living in neighborhoods without any supermarkets. Girls living in neighborhoods with many limited-service restaurants had a greater BMI 3 years later (by 1.02 kg/m(2); 95% confidence interval = .36-1.68) than did those living in neighborhoods with less than or equal to one limited-service restaurant. Exposure to a decreased quantity of small-size grocery stores in neighborhoods was associated with girls' lower BMI by eighth grade. The longitudinal association between neighborhood food environment and children's BMI differed by gender. For girls, supermarkets in neighborhoods seemed protective against obesity, whereas small-size grocery stores and limited-service restaurants in neighborhoods increased obesity risk. There was no significant longitudinal finding for boys. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Exploring sales data during a healthy corner store intervention in Toronto: the Food Retail Environments Shaping Health (FRESH) project.

PubMed

Minaker, Leia M; Lynch, Meghan; Cook, Brian E; Mah, Catherine L

2017-10-01

Population health interventions in the retail food environment, such as corner store interventions, aim to influence the kind of cues consumers receive so that they are more often directed toward healthier options. Research that addresses financial aspects of retail interventions, particularly using outcome measures such as store sales that are central to retail decision making, is limited. This study explored store sales over time and across product categories during a healthy corner store intervention in a lowincome neighbourhood in Toronto, Ontario. Sales data (from August 2014 to April 2015) were aggregated by product category and by day. We used Microsoft Excel pivot tables to summarize and visually present sales data. We conducted t-tests to examine differences in product category sales by "peak" versus "nonpeak" sales days. Overall store sales peaked on the days at the end of each month, aligned with the issuing of social assistance payments. Revenue spikes on peak sales days were driven predominantly by transit pass sales. On peak sales days, mean sales of nonnutritious snacks and cigarettes were marginally higher than on other days of the month. Finally, creative strategies to increase sales of fresh vegetables and fruits seemed to substantially increase revenue from these product categories. Store sales data is an important store-level metric of food environment intervention success. Furthermore, data-driven decision making by retailers can be important for tailoring interventions. Future interventions and research should consider partnerships and additional success metrics for retail food environment interventions in diverse Canadian contexts.

Exploring sales data during a healthy corner store intervention in Toronto: the Food Retail Environments Shaping Health (FRESH) project

PubMed Central

Leia M., Minaker; Meghan, Lynch; Brian E., Cook; Catherine L., Mah

2017-01-01

Abstract Introduction: Population health interventions in the retail food environment, such as corner store interventions, aim to influence the kind of cues consumers receive so that they are more often directed toward healthier options. Research that addresses financial aspects of retail interventions, particularly using outcome measures such as store sales that are central to retail decision making, is limited. This study explored store sales over time and across product categories during a healthy corner store intervention in a lowincome neighbourhood in Toronto, Ontario. Methods: Sales data (from August 2014 to April 2015) were aggregated by product category and by day. We used Microsoft Excel pivot tables to summarize and visually present sales data. We conducted t-tests to examine differences in product category sales by “peak” versus “nonpeak” sales days. Results: Overall store sales peaked on the days at the end of each month, aligned with the issuing of social assistance payments. Revenue spikes on peak sales days were driven predominantly by transit pass sales. On peak sales days, mean sales of nonnutritious snacks and cigarettes were marginally higher than on other days of the month. Finally, creative strategies to increase sales of fresh vegetables and fruits seemed to substantially increase revenue from these product categories. Conclusion: Store sales data is an important store-level metric of food environment intervention success. Furthermore, data-driven decision making by retailers can be important for tailoring interventions. Future interventions and research should consider partnerships and additional success metrics for retail food environment interventions in diverse Canadian contexts. PMID:29043761

Identifying rural food deserts: Methodological considerations for food environment interventions.

PubMed

Lebel, Alexandre; Noreau, David; Tremblay, Lucie; Oberlé, Céline; Girard-Gadreau, Maurie; Duguay, Mathieu; Block, Jason P

2016-06-09

Food insecurity in an important public health issue and affects 13% of Canadian households. It is associated with poor accessibility to fresh, diverse and affordable food products. However, measurement of the food environment is challenging in rural settings since the proximity of food supply sources is unevenly distributed. The objective of this study was to develop a methodology to identify food deserts in rural environments. In-store evaluations of 25 food products were performed for all food stores located in four contiguous rural counties in Quebec. The quality of food products was estimated using four indices: freshness, affordability, diversity and the relative availability. Road network distance between all residences to the closest food store with a favourable score on the four dimensions was mapped to identify residential clusters located in deprived communities without reasonable access to a "good" food source. The result was compared with the food desert parameters proposed by the US Department of Agriculture (USDA), as well as with the perceptions of a group of regional stakeholders. When food quality was considered, food deserts appeared more prevalent than when only the USDA definition was used. Objective measurements of the food environment matched stakeholders' perceptions. Food stores' characteristics are different in rural areas and require an in-store estimation to identify potential rural food deserts. The objective measurements of the food environment combined with the field knowledge of stakeholders may help to shape stronger arguments to gain the support of decision-makers to develop relevant interventions.

Differences in healthy food supply and stocking practices between small grocery stores, gas-marts, pharmacies and dollar stores

PubMed Central

Caspi, Caitlin Eicher; Pelletier, Jennifer E.; Harnack, Lisa; Erikson, Darin J.; Laska, Melissa N.

2015-01-01

Objective Little is known about the practices for stocking and procuring healthy food in non-traditional food retailers (e.g., gas-marts, pharmacies). This study aimed to: (i) compare availability of healthy food items across small food store types, and (ii) examine owner/manager perceptions and stocking practices for healthy food across store types. Design Descriptive analyses were conducted among corner/small grocery stores, gas-marts, pharmacies, and dollar stores. Data from store inventories were used to examine availability of 12 healthy food types and an overall healthy food supply score. Interviews with managers assessed stocking practices and profitability. Setting Small stores in Minneapolis and St. Paul, MN not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Subjects 119 small food retailers and 71 store managers Results Availability of specific items varied across store types. Only corner/small grocery stores commonly sold fresh vegetables (63%, versus 8% of food-gas marts, 0% dollar stores, and 23% pharmacies). More than half of managers stocking produce relied on cash and carry practices to stock fresh fruit (53%) and vegetables (55%), instead of direct store delivery. Most healthy foods were perceived by managers to have at least average profitability. Conclusions Interventions to improve healthy food offerings in small stores should consider the diverse environments, stocking practices and supply mechanisms of small stores, particularly non-traditional food retailers. Improvements may require technical support, customer engagement, and innovative distribution practices. PMID:26411535

Differences in healthy food supply and stocking practices between small grocery stores, gas-marts, pharmacies and dollar stores.

PubMed

Caspi, Caitlin Eicher; Pelletier, Jennifer E; Harnack, Lisa; Erickson, Darin J; Laska, Melissa N

2016-02-01

Little is known about the practices for stocking and procuring healthy food in non-traditional food retailers (e.g., gas-marts, pharmacies). The present study aimed to: (i) compare availability of healthy food items across small food store types; and (ii) examine owner/manager perceptions and stocking practices for healthy food across store types. Descriptive analyses were conducted among corner/small grocery stores, gas-marts, pharmacies and dollar stores. Data from store inventories were used to examine availability of twelve healthy food types and an overall healthy food supply score. Interviews with managers assessed stocking practices and profitability. Small stores in Minneapolis and St. Paul, MN, USA, not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. One hundred and nineteen small food retailers and seventy-one store managers. Availability of specific items varied across store type. Only corner/small grocery stores commonly sold fresh vegetables (63% v. 8% of gas-marts, 0% of dollar stores and 23% of pharmacies). More than half of managers stocking produce relied on cash-and-carry practices to stock fresh fruit (53%) and vegetables (55%), instead of direct store delivery. Most healthy foods were perceived by managers to have at least average profitability. Interventions to improve healthy food offerings in small stores should consider the diverse environments, stocking practices and supply mechanisms of small stores, particularly non-traditional food retailers. Improvements may require technical support, customer engagement and innovative distribution practices.

Evaluating the use of in-store measures in retail food stores and restaurants in Brazil.

PubMed

Duran, Ana Clara; Lock, Karen; Latorre, Maria do Rosario D O; Jaime, Patricia Constante

2015-01-01

To assess inter-rater reliability, test-retest reliability, and construct validity of retail food store, open-air food market, and restaurant observation tools adapted to the Brazilian urban context. This study is part of a cross-sectional observation survey conducted in 13 districts across the city of Sao Paulo, Brazil in 2010-2011. Food store and restaurant observational tools were developed based on previously available tools, and then tested it. They included measures on the availability, variety, quality, pricing, and promotion of fruits and vegetables and ultra-processed foods. We used Kappa statistics and intra-class correlation coefficients to assess inter-rater and test-retest reliabilities in samples of 142 restaurants, 97 retail food stores (including open-air food markets), and of 62 restaurants and 45 retail food stores (including open-air food markets), respectively. Construct validity as the tool's abilities to discriminate based on store types and different income contexts were assessed in the entire sample: 305 retail food stores, 8 fruits and vegetable markets, and 472 restaurants. Inter-rater and test-retest reliability were generally high, with most Kappa values greater than 0.70 (range 0.49-1.00). Both tools discriminated between store types and neighborhoods with different median income. Fruits and vegetables were more likely to be found in middle to higher-income neighborhoods, while soda, fruit-flavored drink mixes, cookies, and chips were cheaper and more likely to be found in lower-income neighborhoods. The measures were reliable and able to reveal significant differences across store types and different contexts. Although some items may require revision, results suggest that the tools may be used to reliably measure the food stores and restaurant food environment in urban settings of middle-income countries. Such studies can help .inform health promotion interventions and policies in these contexts.

Evaluating the use of in-store measures in retail food stores and restaurants in Brazil

PubMed Central

Duran, Ana Clara; Lock, Karen; Latorre, Maria do Rosario D O; Jaime, Patricia Constante

2015-01-01

ABSTRACT OBJECTIVE To assess inter-rater reliability, test-retest reliability, and construct validity of retail food store, open-air food market, and restaurant observation tools adapted to the Brazilian urban context. METHODS This study is part of a cross-sectional observation survey conducted in 13 districts across the city of Sao Paulo, Brazil in 2010-2011. Food store and restaurant observational tools were developed based on previously available tools, and then tested it. They included measures on the availability, variety, quality, pricing, and promotion of fruits and vegetables and ultra-processed foods. We used Kappa statistics and intra-class correlation coefficients to assess inter-rater and test-retest reliabilities in samples of 142 restaurants, 97 retail food stores (including open-air food markets), and of 62 restaurants and 45 retail food stores (including open-air food markets), respectively. Construct validity as the tool’s abilities to discriminate based on store types and different income contexts were assessed in the entire sample: 305 retail food stores, 8 fruits and vegetable markets, and 472 restaurants. RESULTS Inter-rater and test-retest reliability were generally high, with most Kappa values greater than 0.70 (range 0.49-1.00). Both tools discriminated between store types and neighborhoods with different median income. Fruits and vegetables were more likely to be found in middle to higher-income neighborhoods, while soda, fruit-flavored drink mixes, cookies, and chips were cheaper and more likely to be found in lower-income neighborhoods. CONCLUSIONS The measures were reliable and able to reveal significant differences across store types and different contexts. Although some items may require revision, results suggest that the tools may be used to reliably measure the food stores and restaurant food environment in urban settings of middle-income countries. Such studies can help .inform health promotion interventions and policies in these

Food Availability in School Stores in Seoul, South Korea after Implementation of Food- and Nutrient-Based Policies

ERIC Educational Resources Information Center

Choi, Seul Ki; Frongillo, Edward A.; Blake, Christine E.; Thrasher, James F.

2017-01-01

Background: To improve school store food environments, the South Korean government implemented 2 policies restricting unhealthy food sales in school stores. A food-based policy enacted in 2007 restricts specific food sales (soft drinks); and a nutrient-based policy enacted in 2009 restricts energy-dense and nutrient-poor (EDNP) food sales. The…

Storing empty calories and chronic disease risk: snack-food products, nutritive content, and manufacturers in Philadelphia corner stores.

PubMed

Lucan, Sean C; Karpyn, Allison; Sherman, Sandy

2010-05-01

Corner stores are part of the urban food environment that may contribute to obesity and diet-related diseases, particularly for low-income and minority children. The snack foods available in corner stores may be a particularly important aspect of an urban child's food environment. Unfortunately, there is little data on exactly what snack foods corner stores stock, or where these foods come from. We evaluated snack foods in 17 Philadelphia corner stores, located in three ethnically distinct, low-income school neighborhoods. We recorded the manufacturer, calories, fat, sugar, and sodium for all snack items, excluding candy and prepared foods. We then compared the nutritive content of assessed snack items to established dietary recommendations and a school nutrition standard. In total, stores stocked 452 kinds of snacks, with only 15% of items common between all three neighborhoods. Total and unique snacks and snack food manufacturers varied by neighborhood, but distributions in snack type varied negligibly: overall, there were no fruit snacks, no vegetable snacks, and only 3.6% of all snacks (by liberal definition) were whole grain. The remainder (96.4% of snacks) was highly processed foods. Five of 65 manufacturers supplied 73.4% of all kinds of snack foods. Depending on serving size definition, 80.0-91.5% of snack foods were "unhealthy" (by the school nutrition standard), including seven of 11 wholegrain products. A single snack item could supply 6-14% of a day's recommended calories, fat, sugar, and sodium on average (or 56-169% at the extreme) for a "typical" child. We conclude that corner store snack food inventories are almost entirely unhealthful, and we discuss possible implications and next steps for research and intervention.

Healthful food availability in stores and restaurants--American Samoa, 2014.

PubMed

Lee-Kwan, Seung Hee; Kumar, Gayathri; Ayscue, Patrick; Santos, Marjorie; McGuire, Lisa C; Blanck, Heidi M; Nua, Motusa Tuileama

2015-03-20

American Samoa, one of the U.S.-affiliated Pacific Islands, has documented the highest prevalence of adults with obesity (75%) in the world. The nutritionally poor food and beverage environment of food retail venues has been suspected to be a contributing factor, although an evaluation of these venues in American Samoa has not been conducted. In January 2014, American Samoa established an Obesity Task Force to develop policies and strategies to combat obesity. To inform the efforts of the task force, the American Samoa Department of Health and CDC conducted a baseline assessment of the availability, pricing, and promotion of healthful foods at retail food venues. Previously validated food environment assessment tools were modified to incorporate American Samoa foods and administered in a geographically representative sample of 70 stores (nine grocery stores and 61 convenience stores) and 20 restaurants. In convenience stores, healthful items were not found as available as less healthful counterparts, and some healthful items were more expensive than their less healthful counterparts. For restaurants, 70% offered at least one healthful entrée, whereas only 30% had healthful side dishes, such as vegetables. Actions to promote healthy eating, such as providing calorie information, were rare among restaurants. Improving availability, affordability, and the promotion of healthful foods in American Samoa stores and restaurants could support healthy eating among American Samoa residents.

Nutrition Environment Measures Survey in stores (NEMS-S): development and evaluation.

PubMed

Glanz, Karen; Sallis, James F; Saelens, Brian E; Frank, Lawrence D

2007-04-01

Eating, or nutrition, environments are believed to contribute to obesity and chronic diseases. There is a need for valid, reliable measures of nutrition environments. This article reports on the development and evaluation of measures of nutrition environments in retail food stores. The Nutrition Environment Measures Study developed observational measures of the nutrition environment within retail food stores (NEMS-S) to assess availability of healthy options, price, and quality. After pretesting, measures were completed by independent raters to evaluate inter-rater reliability and across two occasions to assess test-retest reliability in grocery and convenience stores in four neighborhoods differing on income and community design in the Atlanta metropolitan area. Data were collected and analyzed in 2004 and 2005. Ten food categories (e.g., fruits) or indicator food items (e.g., ground beef) were evaluated in 85 stores. Inter-rater reliability and test-retest reliability of availability were high: inter-rater reliability kappas were 0.84 to 1.00, and test-retest reliabilities were .73 to 1.00. Inter-rater reliability for quality across fresh produce was moderate (kappas, 0.44 to 1.00). Healthier options were higher priced for hot dogs, lean ground beef, and baked chips. More healthful options were available in grocery than convenience stores and in stores in higher income neighborhoods. The NEMS-S tool was found to have a high degree of inter-rater and test-retest reliability, and to reveal significant differences across store types and neighborhoods of high and low socioeconomic status. These observational measures of nutrition environments can be applied in multilevel studies of community nutrition, and can inform new approaches to conducting and evaluating nutrition interventions.

Pricing of Staple Foods at Supermarkets versus Small Food Stores

PubMed Central

Caspi, Caitlin E.; Pelletier, Jennifer E.; Harnack, Lisa J.; Erickson, Darin J.; Laska, Melissa N.

2017-01-01

Prices affect food purchase decisions, particularly in lower-income communities, where access to a range of food retailers (including supermarkets) is limited. The aim of this study was to examine differences in staple food pricing between small urban food stores and the closest supermarkets, as well as whether pricing differentials varied based on proximity between small stores and larger retailers. In 2014, prices were measured for 15 staple foods during store visits in 140 smaller stores (corner stores, gas-marts, dollar stores, and pharmacies) in Minneapolis/St. Paul, MN and their closest supermarket. Mixed models controlling for store type were used to estimate the average price differential between: (a) smaller stores and supermarkets; (b) isolated smaller stores (>1 mile to closest supermarket) and non-isolated smaller stores; and (c) isolated smaller stores inside versus outside USDA-identified food deserts. On average, all items except white bread were 10–54% more expensive in smaller stores than in supermarkets (p < 0.001). Prices were generally not significantly different in isolated stores compared with non-isolated stores for most items. Among isolated stores, there were no price differences inside versus outside food deserts. We conclude that smaller food stores have higher prices for most staple foods compared to their closest supermarket, regardless of proximity. More research is needed to examine staple food prices in different retail spaces. PMID:28809795

Pricing of Staple Foods at Supermarkets versus Small Food Stores.

PubMed

Caspi, Caitlin E; Pelletier, Jennifer E; Harnack, Lisa J; Erickson, Darin J; Lenk, Kathleen; Laska, Melissa N

2017-08-15

Prices affect food purchase decisions, particularly in lower-income communities, where access to a range of food retailers (including supermarkets) is limited. The aim of this study was to examine differences in staple food pricing between small urban food stores and the closest supermarkets, as well as whether pricing differentials varied based on proximity between small stores and larger retailers. In 2014, prices were measured for 15 staple foods during store visits in 140 smaller stores (corner stores, gas-marts, dollar stores, and pharmacies) in Minneapolis/St. Paul, MN and their closest supermarket. Mixed models controlling for store type were used to estimate the average price differential between: (a) smaller stores and supermarkets; (b) isolated smaller stores (>1 mile to closest supermarket) and non-isolated smaller stores; and (c) isolated smaller stores inside versus outside USDA-identified food deserts. On average, all items except white bread were 10-54% more expensive in smaller stores than in supermarkets ( p < 0.001). Prices were generally not significantly different in isolated stores compared with non-isolated stores for most items. Among isolated stores, there were no price differences inside versus outside food deserts. We conclude that smaller food stores have higher prices for most staple foods compared to their closest supermarket, regardless of proximity. More research is needed to examine staple food prices in different retail spaces.

Snack food advertising in stores around public schools in Guatemala

PubMed Central

Chacon, Violeta; Letona, Paola; Villamor, Eduardo; Barnoya, Joaquin

2014-01-01

Obesity in school-age children is emerging as a public heath concern. Food marketing influences preferences and increases children's requests for food. This study sought to describe the type of snack foods advertised to children in stores in and around public schools and assess if there is an association between child-oriented snack food advertising and proximity to schools. All food stores located inside and within a 200 square meter radius from two preschools and two primary schools were surveyed. We assessed store type, number and type of snack food advertisements including those child-oriented inside and outside stores. We surveyed 55 stores and found 321 snack food advertisements. Most were on sweetened beverages (37%) and soft drinks (30%). Ninety-two (29%) were child-oriented. Atoles (100.0%), cereals (94.1%), and ice cream and frozen desserts (71.4%) had the greatest proportion of child-oriented advertising. We found more child-oriented advertisements in stores that were closer (<170 m) to schools compared to those farther away. In conclusion, the food industry is flooding the market, taking advantage of the lack of strict regulation in Guatemala. Child-oriented advertisements are available in almost all stores within a short walking distance from schools, exposing children to an obesogenic environment. PMID:25821350

Snack food advertising in stores around public schools in Guatemala.

PubMed

Chacon, Violeta; Letona, Paola; Villamor, Eduardo; Barnoya, Joaquin

Obesity in school-age children is emerging as a public heath concern. Food marketing influences preferences and increases children's requests for food. This study sought to describe the type of snack foods advertised to children in stores in and around public schools and assess if there is an association between child-oriented snack food advertising and proximity to schools. All food stores located inside and within a 200 square meter radius from two preschools and two primary schools were surveyed. We assessed store type, number and type of snack food advertisements including those child-oriented inside and outside stores. We surveyed 55 stores and found 321 snack food advertisements. Most were on sweetened beverages (37%) and soft drinks (30%). Ninety-two (29%) were child-oriented. Atoles (100.0%), cereals (94.1%), and ice cream and frozen desserts (71.4%) had the greatest proportion of child-oriented advertising. We found more child-oriented advertisements in stores that were closer (<170 m) to schools compared to those farther away. In conclusion, the food industry is flooding the market, taking advantage of the lack of strict regulation in Guatemala. Child-oriented advertisements are available in almost all stores within a short walking distance from schools, exposing children to an obesogenic environment.

Storing Empty Calories and Chronic Disease Risk: Snack-Food Products, Nutritive Content, and Manufacturers in Philadelphia Corner Stores

PubMed Central

Karpyn, Allison; Sherman, Sandy

2010-01-01

Corner stores are part of the urban food environment that may contribute to obesity and diet-related diseases, particularly for low-income and minority children. The snack foods available in corner stores may be a particularly important aspect of an urban child’s food environment. Unfortunately, there is little data on exactly what snack foods corner stores stock, or where these foods come from. We evaluated snack foods in 17 Philadelphia corner stores, located in three ethnically distinct, low-income school neighborhoods. We recorded the manufacturer, calories, fat, sugar, and sodium for all snack items, excluding candy and prepared foods. We then compared the nutritive content of assessed snack items to established dietary recommendations and a school nutrition standard. In total, stores stocked 452 kinds of snacks, with only 15% of items common between all three neighborhoods. Total and unique snacks and snack food manufacturers varied by neighborhood, but distributions in snack type varied negligibly: overall, there were no fruit snacks, no vegetable snacks, and only 3.6% of all snacks (by liberal definition) were whole grain. The remainder (96.4% of snacks) was highly processed foods. Five of 65 manufacturers supplied 73.4% of all kinds of snack foods. Depending on serving size definition, 80.0-91.5% of snack foods were “unhealthy” (by the school nutrition standard), including seven of 11 wholegrain products. A single snack item could supply 6-14% of a day’s recommended calories, fat, sugar, and sodium on average (or 56-169% at the extreme) for a “typical” child. We conclude that corner store snack food inventories are almost entirely unhealthful, and we discuss possible implications and next steps for research and intervention. PMID:20405225

Association between neighborhood need and spatial access to food stores and fast food restaurants in neighborhoods of colonias.

PubMed

Sharkey, Joseph R; Horel, Scott; Han, Daikwon; Huber, John C

2009-02-16

To determine the extent to which neighborhood needs (socioeconomic deprivation and vehicle availability) are associated with two criteria of food environment access: 1) distance to the nearest food store and fast food restaurant and 2) coverage (number) of food stores and fast food restaurants within a specified network distance of neighborhood areas of colonias, using ground-truthed methods. Data included locational points for 315 food stores and 204 fast food restaurants, and neighborhood characteristics from the 2000 U.S. Census for the 197 census block group (CBG) study area. Neighborhood deprivation and vehicle availability were calculated for each CBG. Minimum distance was determined by calculating network distance from the population-weighted center of each CBG to the nearest supercenter, supermarket, grocery, convenience store, dollar store, mass merchandiser, and fast food restaurant. Coverage was determined by calculating the number of each type of food store and fast food restaurant within a network distance of 1, 3, and 5 miles of each population-weighted CBG center. Neighborhood need and access were examined using Spearman ranked correlations, spatial autocorrelation, and multivariate regression models that adjusted for population density. Overall, neighborhoods had best access to convenience stores, fast food restaurants, and dollar stores. After adjusting for population density, residents in neighborhoods with increased deprivation had to travel a significantly greater distance to the nearest supercenter or supermarket, grocery store, mass merchandiser, dollar store, and pharmacy for food items. The results were quite different for association of need with the number of stores within 1 mile. Deprivation was only associated with fast food restaurants; greater deprivation was associated with fewer fast food restaurants within 1 mile. CBG with greater lack of vehicle availability had slightly better access to more supercenters or supermarkets, grocery

Association between neighborhood need and spatial access to food stores and fast food restaurants in neighborhoods of Colonias

PubMed Central

Sharkey, Joseph R; Horel, Scott; Han, Daikwon; Huber, John C

2009-01-01

Objective To determine the extent to which neighborhood needs (socioeconomic deprivation and vehicle availability) are associated with two criteria of food environment access: 1) distance to the nearest food store and fast food restaurant and 2) coverage (number) of food stores and fast food restaurants within a specified network distance of neighborhood areas of colonias, using ground-truthed methods. Methods Data included locational points for 315 food stores and 204 fast food restaurants, and neighborhood characteristics from the 2000 U.S. Census for the 197 census block group (CBG) study area. Neighborhood deprivation and vehicle availability were calculated for each CBG. Minimum distance was determined by calculating network distance from the population-weighted center of each CBG to the nearest supercenter, supermarket, grocery, convenience store, dollar store, mass merchandiser, and fast food restaurant. Coverage was determined by calculating the number of each type of food store and fast food restaurant within a network distance of 1, 3, and 5 miles of each population-weighted CBG center. Neighborhood need and access were examined using Spearman ranked correlations, spatial autocorrelation, and multivariate regression models that adjusted for population density. Results Overall, neighborhoods had best access to convenience stores, fast food restaurants, and dollar stores. After adjusting for population density, residents in neighborhoods with increased deprivation had to travel a significantly greater distance to the nearest supercenter or supermarket, grocery store, mass merchandiser, dollar store, and pharmacy for food items. The results were quite different for association of need with the number of stores within 1 mile. Deprivation was only associated with fast food restaurants; greater deprivation was associated with fewer fast food restaurants within 1 mile. CBG with greater lack of vehicle availability had slightly better access to more supercenters

Changes in the neighborhood food store environment and children’s body mass index at peri-puberty in the United States

PubMed Central

Chen, Hsin-Jen; Wang, Youfa

2015-01-01

Background Little is known about the relationship between changes in food store environment and children’s obesity risk in the US. This study examines children’s weight status associated with the changes in the quantity of food stores in their neighborhoods. Methods A nationally representative cohort of schoolchildren in the US was followed from 5th grade in 2004 to 8th grade in 2007 (n=7090). In 2004 and 2007, children’s body mass index (BMI) was directly measured in schools. ZIP-Code Business Patterns data from the Census Bureau in 2004 and 2007 characterized the numbers of food stores in every ZIP-code area by type of store: supermarkets, limited-service restaurants, small-size grocery and convenience stores. Baseline and change in the numbers of stores were the major exposures of interest. Results Girls living in neighborhoods with ≥ 3 supermarkets had a lower BMI three years later (by −0.62 kg/m2; 95% C.I.: −1.05, −0.18) than did those living in neighborhoods without any supermarkets. Girls living in neighborhoods with many limited-service restaurants had a greater BMI three years later (by 1.02 kg/m2; 95% C.I.: 0.36, 1.68) than did those living in neighborhoods with ≤1 limited-service restaurant. Exposure to a decreased quantity of small-size grocery stores in neighborhoods was associated with girls’ lower BMI by eighth grade. Conclusions The longitudinal association between neighborhood food environment and children’s BMI differed by gender. For girls, supermarkets in neighborhoods seemed protective against obesity, while small-size grocery stores and limited-service restaurants in neighborhoods increased obesity risk. There was no significant longitudinal finding for boys. PMID:26707233

Development and reliability testing of a food store observation form.

PubMed

Rimkus, Leah; Powell, Lisa M; Zenk, Shannon N; Han, Euna; Ohri-Vachaspati, Punam; Pugach, Oksana; Barker, Dianne C; Resnick, Elissa A; Quinn, Christopher M; Myllyluoma, Jaana; Chaloupka, Frank J

2013-01-01

To develop a reliable food store observational data collection instrument to be used for measuring product availability, pricing, and promotion. Observational data collection. A total of 120 food stores (26 supermarkets, 34 grocery stores, 54 gas/convenience stores, and 6 mass merchandise stores) in the Chicago metropolitan statistical area. Inter-rater reliability for product availability, pricing, and promotion measures on a food store observational data collection instrument. Cohen's kappa coefficient and proportion of overall agreement for dichotomous variables and intra-class correlation coefficient for continuous variables. Inter-rater reliability, as measured by average kappa coefficient, was 0.84 for food and beverage product availability measures, 0.80 for interior store characteristics, and 0.70 for exterior store characteristics. For continuous measures, average intra-class correlation coefficient was 0.82 for product pricing measures; 0.90 for counts of fresh, frozen, and canned fruit and vegetable options; and 0.85 for counts of advertisements on the store exterior and property. The vast majority of measures demonstrated substantial or almost perfect agreement. Although some items may require revision, results suggest that the instrument may be used to reliably measure the food store environment. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Healthful Nutrition of Foods in Navajo Nation Stores: Availability and Pricing.

PubMed

Kumar, Gayathri; Jim-Martin, Sonlatsa; Piltch, Emily; Onufrak, Stephen; McNeil, Carrie; Adams, Laura; Williams, Nancy; Blanck, Heidi M; Curley, Larry

2016-09-01

Low availability and affordability of healthier foods in food stores on the Navajo Nation (NN) may be a community-level risk factor for the high prevalence of obesity among the Navajo people. This study assessed the availability and pricing of foods and beverages in supermarkets and convenience stores throughout the NN. Descriptive study design using the Nutrition Environment Measurement Survey in Stores audit tool. Supermarkets (n = 13) and convenience stores (n = 50) on NN and border-town supermarkets (n = 9). Not applicable. Availability and pricing of healthy and less-healthy foods. Descriptive and χ(2) analyses. Navajo convenience stores offered fewer healthier food options compared to Navajo supermarkets. In Navajo convenience stores, 100% whole grain products, reduced-fat cheese, lean meats, reduced-fat chips, and fat-free or light hot dogs were available in fewer stores than their corresponding less-healthy versions (all with p < .05). In both Navajo supermarkets and convenience stores, 100% whole wheat bread, lean cold cuts, and reduced-fat cheese were all more expensive per unit than their corresponding less-healthy versions (all with p < .05). According to this study, healthier foods are not as readily available in Navajo convenience stores as they are in Navajo supermarkets. Improving access to and affordability of healthier foods in reservation stores of all sizes may support healthy eating among Navajo residents. © 2016 by American Journal of Health Promotion, Inc.

Leveraging Citizen Science for Healthier Food Environments: A Pilot Study to Evaluate Corner Stores in Camden, New Jersey.

PubMed

Chrisinger, Benjamin W; Ramos, Ana; Shaykis, Fred; Martinez, Tanya; Banchoff, Ann W; Winter, Sandra J; King, Abby C

2018-01-01

Over the last 6 years, a coordinated "healthy corner store" network has helped an increasing number of local storeowners stock healthy, affordable foods in Camden, New Jersey, a city with high rates of poverty and unemployment, and where most residents have little or no access to large food retailers. The initiative's funders and stakeholders wanted to directly engage Camden residents in evaluating this effort to increase healthy food access. In a departure from traditional survey- or focus group-based evaluations, we used an evidence-based community-engaged citizen science research model (called Our Voice ) that has been deployed in a variety of neighborhood settings to assess how different features of the built environment both affect community health and wellbeing, and empower participants to create change. Employing the Our Voice model, participants documented neighborhood features in and around Camden corner stores through geo-located photos and audio narratives. Eight adult participants who lived and/or worked in a predefined neighborhood of Camden were recruited by convenience sample and visited two corner stores participating in the healthy corner store initiative (one highly-engaged in the initiative and the other less-engaged), as well as an optional third corner store of their choosing. Facilitators then helped participants use their collected data (in total, 134 images and 96 audio recordings) to identify and prioritize issues as a group, and brainstorm and advocate for potential solutions. Three priority themes were selected by participants from the full theme list ( n  = 9) based on perceived importance and feasibility: healthy product selection and display, store environment, and store outdoor appearance and cleanliness. Participants devised and presented a set of action steps to community leaders, and stakeholders have begun to incorporate these ideas into plans for the future of the healthy corner store network. Key elements of healthy corner

Measuring potential access to food stores and food-service places in rural areas in the U.S.

PubMed

Sharkey, Joseph R

2009-04-01

Geographic access to healthy food resources remains a major focus of research that examines the contribution of the built environment to healthful eating. Methods used to define and measure spatial accessibility can significantly affect the results. Considering the implications for marketing, policy, and programs, adequate measurement of the food environment is important. Little of the published work on food access has focused on rural areas, where the burden of nutrition-related disease is greater. This article seeks to expand our understanding of the challenges to measurement of potential spatial access to food resources in rural areas in the U.S. Key challenges to the accurate measurement of the food environment in rural areas include: (1) defining the rural food environment while recognizing that market factors may be changing; (2) describing characteristics that may differentiate similar types of food stores and food-service places; and (3) determining location coordinates for food stores and food-service places. In order to enhance measurements in rural areas, "ground-truthed" methodology, which includes on-site observation and collection of GPS data, should become the standard for rural areas. Measurement must also recognize the emergence of new and changing store formats. Efforts should be made to determine accessibility, in terms of both proximity to a single location and variety of multiple locations within a specified buffer, from origins other than the home, and consider multipurpose trips and trip chaining. The measurement of food access will be critical for community-based approaches to meet dietary needs. Researchers must be willing to take the steps necessary for rigorous measurement of a dynamic food environment.

Does opening a supermarket in a food desert change the food environment?

PubMed

Ghosh-Dastidar, Madhumita; Hunter, Gerald; Collins, Rebecca L; Zenk, Shannon N; Cummins, Steven; Beckman, Robin; Nugroho, Alvin K; Sloan, Jennifer C; Wagner, La'Vette; Dubowitz, Tamara

2017-07-01

Improving access to healthy foods in low-income neighborhoods is a national priority. Our study evaluated the impact of opening a supermarket in a 'food desert' on healthy food access, availability and prices in the local food environment. We conducted 30 comprehensive in-store audits collecting information on healthy and unhealthy food availability, food prices and store environment, as well as 746 household surveys in two low-income neighborhoods before and after one of the two neighborhoods received a new supermarket. We found positive and negative changes in food availability, and an even greater influence on food prices in neighborhood stores. The supermarket opening in a 'food desert' caused little improvement in net availability of healthy foods, challenging the underpinnings of policies such as the Healthy Food Financing Initiative. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of Healthy2Go: A country store transformation project to improve the food environment and consumer choices in Appalachian Kentucky.

PubMed

Rushakoff, Joshua A; Zoughbie, Daniel E; Bui, Nancy; DeVito, Katerina; Makarechi, Leila; Kubo, Hitomi

2017-09-01

Rates of obesity and type 2 diabetes in Kentucky's Cumberland Valley region are among the highest in the United States and limited access to healthy food contributes to these epidemics. The aim of Healthy2Go (H2G), a country store transformation project launched by Spread the Health Appalachia (STHA), was to improve awareness and availability of healthy options in small, rural stores. Ten country stores participated in H2G and received training and technical assistance to increase availability and awareness of healthy foods. Stores made inventory changes; installed point-of-purchase educational and in-store marketing materials directing shoppers to healthier options; provided nutrition education such as healthy recipes; and altered the display and location of healthy items. To measure changes within stores and the potential impact on resident eating and purchasing habits, STHA used four instruments: a modified version of the Nutrition Environs Measures Survey - Corner Stores at baseline and follow-up, a bimonthly store inventory assessment, a final store owner survey, and a Community Nutrition Survey at baseline (n = 287) and follow-up (n = 281). The stores in the H2G program (n = 10) had a 40% increase in stocking fresh produce, a 20% increase in produce variety, and trends towards increasing healthy inventory. During the same period, surveyed residents reported a statistically significant increase in the frequency of healthy food consumption. Small store transformation programs can improve availability of and access to healthy food in rural settings and influence local purchasing patterns.

Leveraging Citizen Science for Healthier Food Environments: A Pilot Study to Evaluate Corner Stores in Camden, New Jersey

PubMed Central

Chrisinger, Benjamin W.; Ramos, Ana; Shaykis, Fred; Martinez, Tanya; Banchoff, Ann W.; Winter, Sandra J.; King, Abby C.

2018-01-01

Over the last 6 years, a coordinated “healthy corner store” network has helped an increasing number of local storeowners stock healthy, affordable foods in Camden, New Jersey, a city with high rates of poverty and unemployment, and where most residents have little or no access to large food retailers. The initiative’s funders and stakeholders wanted to directly engage Camden residents in evaluating this effort to increase healthy food access. In a departure from traditional survey- or focus group-based evaluations, we used an evidence-based community-engaged citizen science research model (called Our Voice) that has been deployed in a variety of neighborhood settings to assess how different features of the built environment both affect community health and wellbeing, and empower participants to create change. Employing the Our Voice model, participants documented neighborhood features in and around Camden corner stores through geo-located photos and audio narratives. Eight adult participants who lived and/or worked in a predefined neighborhood of Camden were recruited by convenience sample and visited two corner stores participating in the healthy corner store initiative (one highly-engaged in the initiative and the other less-engaged), as well as an optional third corner store of their choosing. Facilitators then helped participants use their collected data (in total, 134 images and 96 audio recordings) to identify and prioritize issues as a group, and brainstorm and advocate for potential solutions. Three priority themes were selected by participants from the full theme list (n = 9) based on perceived importance and feasibility: healthy product selection and display, store environment, and store outdoor appearance and cleanliness. Participants devised and presented a set of action steps to community leaders, and stakeholders have begun to incorporate these ideas into plans for the future of the healthy corner store network. Key elements of healthy

Neighborhood food environment role in modifying psychosocial stress-diet relationships

PubMed Central

Zenk, Shannon N.; Schulz, Amy J.; Izumi, Betty T.; Mentz, Graciela; Israel, Barbara A.; Lockett, Murlisa

2013-01-01

Exposure to highly palatable foods may increase eating in response to stress, but this behavioral response has not been examined in relation to the neighborhood food environment. This study examined whether the neighborhood food environment modified relationships between psychosocial stress and dietary behaviors. Probability-sample survey (n=460) and in-person food environment audit data were used. Dietary behaviors were measured using 17 snack food items and a single eating-out-of-home item. Chronic stress was derived from five subscales; major life events was a count of 9 items. The neighborhood food environment was measured as availability of large grocery stores, small grocery stores, and convenience stores, as well as proportion of restaurants that were fast food. Two-level hierarchical regression models were estimated. Snack food intake was positively associated with convenience store availability and negatively associated with large grocery store availability. The measures of chronic stress and major life events were generally not associated with either dietary behavior overall, although Latinos were less likely to eat out at high levels of major life events than African Americans. Stress-neighborhood food environment interactions were not statistically significant. Important questions remain regarding the role of the neighborhood food environment in the stress-diet relationship that warrant further investigation. PMID:23415977

Associations of neighborhood characteristics with the location and type of food stores.

PubMed

Moore, Latetia V; Diez Roux, Ana V

2006-02-01

We investigated associations between local food environment and neighborhood racial/ethnic and socioeconomic composition. Poisson regression was used to examine the association of food stores and liquor stores with racial/ethnic composition and income in selected census tracts in North Carolina, Maryland, and New York. Predominantly minority and racially mixed neighborhoods had more than twice as many grocery stores as predominantly White neighborhoods (for predominantly Black tracts, adjusted stores per population ratio [SR]=2.7; 95% confidence interval [CI]=2.2, 3.2; and for mixed tracts, SR=2.2; 95% CI=1.9, 2.7) and half as many supermarkets (for predominantly Black tracts, SR=0.5; 95% CI=0.3, 0.7; and for mixed tracts, SR=0.7; 95% CI=0.5, 1.0, respectively). Low-income neighborhoods had 4 times as many grocery stores as the wealthiest neighborhoods (SR=4.3; 95% CI=3.6, 5.2) and half as many supermarkets (SR=0.5; 95% CI=0.3, 0.8). In general, poorer areas and non-White areas also tended to have fewer fruit and vegetable markets, bakeries, specialty stores, and natural food stores. Liquor stores were more common in poorer than in richer areas (SR=1.3; 95% CI=1.0, 1.6). Local food environments vary substantially by neighborhood racial/ethnic and socioeconomic composition and may contribute to disparities in health.

What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California.

PubMed

Sanchez-Flack, Jennifer C; Baquero, Barbara; Linnan, Laura A; Gittelsohn, Joel; Pickrel, Julie L; Ayala, Guadalupe X

2016-01-01

To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers' grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and sociocultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers.

What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California

PubMed Central

Sanchez-Flack, Jennifer C.; Baquero, Barbara; Linnan, Laura A.; Gittelsohn, Joel; Pickrel, Julie L.; Ayala, Guadalupe X.

2016-01-01

To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers’ grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and socio-cultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers. PMID:26800243

Convenience stores surrounding urban schools: an assessment of healthy food availability, advertising, and product placement.

PubMed

Gebauer, Hilary; Laska, Melissa Nelson

2011-08-01

Adolescent obesity is a national public health problem, particularly among urban populations. Recent evidence has linked neighborhood food environments to health and nutrition status, with easier access to convenience stores being associated with increased risk for obesity. Little is known about the availability of healthy purchasing options within small, urban food stores, or the extent to which these factors are relevant to youth. The objective of this research was to characterize various features of the food environment within small convenience stores located nearby urban junior high and high schools. In-store audits were conducted in 63 stores located within 800 m of 36 urban Minnesota public secondary schools. Results indicated that a limited number of healthier beverages (i.e., water and 100% fruit juice) and snack options (i.e., nuts and pretzels) were available at most stores (≥85%). However, a wide range of healthy snack options were typically not available, with many specific items stocked in less than half of stores (e.g., low-fat yogurt in 27% of stores and low-fat granola bars in 43%). Overall, 51% of stores had fresh fruit and 49% had fresh vegetables. Few stores carried a range of healthier snack alternatives in single-serving packages. All stores had less healthful impulse purchase items available (e.g., candy) while only 46% carried healthier impulse items (e.g., fruit). Most stores (97%) had food/beverage advertising. Overall, convenience stores located in close proximity to secondary schools represent an important and understudied component of the youth food environment.

Neighborhood food environment role in modifying psychosocial stress-diet relationships.

PubMed

Zenk, Shannon N; Schulz, Amy J; Izumi, Betty T; Mentz, Graciela; Israel, Barbara A; Lockett, Murlisa

2013-06-01

Exposure to highly palatable foods may increase eating in response to stress, but this behavioral response has not been examined in relation to the neighborhood food environment. This study examined whether the neighborhood food environment modified relationships between psychosocial stress and dietary behaviors. Probability-sample survey (n=460) and in-person food environment audit data were used. Dietary behaviors were measured using 17 snack food items and a single eating-out-of-home item. Chronic stress was derived from five subscales; major life events was a count of nine items. The neighborhood food environment was measured as availability of large grocery stores, small grocery stores, and convenience stores, as well as proportion of restaurants that were fast food. Two-level hierarchical regression models were estimated. Snack food intake was positively associated with convenience store availability and negatively associated with large grocery store availability. The measures of chronic stress and major life events were generally not associated with either dietary behavior overall, although Latinos were less likely to eat out at high levels of major life events than African Americans. Stress-neighborhood food environment interactions were not statistically significant. Important questions remain regarding the role of the neighborhood food environment in the stress-diet relationship that warrant further investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Objective food environments and health outcomes.

PubMed

Minaker, Leia M; Raine, Kim D; Wild, T Cameron; Nykiforuk, Candace I J; Thompson, Mary E; Frank, Lawrence D

2013-09-01

Pathways by which food environments affect residents' diet-related outcomes are still unclear. Understanding pathways may help decision makers identify food environment strategies to promote healthy diets. To examine the hypothesis that residents' perceptions mediate the relationship between objective food environment and residents' diet quality and weight status. In the Waterloo Region, Ontario, objective food environment data were collected from 422 food stores and 912 restaurants using the Nutrition Environment Measure Survey in Stores and Restaurants, a shelf-space measure of fruits and vegetables, and the Retail Food Environment Index. Waterloo Region households (n=2223) completed a subjective food environment perception survey; household members (n=4102) self-reported weight, height, and waist circumference. A subsample (1170 individuals within 690 households) completed diet records. Food environment data were collected in 2010; respondent data were collected from 2009-2010; and data were analyzed in 2012. A series of gender-specific models were conducted to test mediation, adjusting for household income, car ownership, age, and education level. Residents' perceptions did not mediate the relationship between objective measures and diet-related outcomes; instead, results revealed the direct effect of several objectively measured factors of the food environment (notably food access and relative food affordability) on outcomes. Perceptions generally were not associated with diet-related outcomes. These results reveal that in this setting, strategies aimed at improving residents' perceptions may be less effective than those acting directly on food environments to improve food access and relative food affordability. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Neighbourhood food environments and obesity in southeast Louisiana.

PubMed

Hutchinson, Paul L; Nicholas Bodor, J; Swalm, Chris M; Rice, Janet C; Rose, Donald

2012-07-01

Supermarkets might influence food choices, and more distal outcomes like obesity, by increasing the availability of healthy foods. However, recent evidence about their effects is ambiguous, perhaps because supermarkets also increase the availability of unhealthy options. We develop an alternative measure of food environment quality that characterizes urban neighborhoods by the relative amounts of healthy (e.g. fruits and vegetables) to unhealthy foods (e.g. energy-dense snacks). Using data from 307 food stores and 1243 telephone interviews with residents in urban southeastern Louisiana, we estimate a multilevel multinomial logistic model for overweight status. We find that higher quality food environments - but not food store types - decrease the risk of obesity (RR 0.474, 95% CI 0.269-0.835) and overweight (RR 0.532, 95% CI 0.312-0.907). The findings suggest a need to move beyond a sole consideration of food store types to a more nuanced view of the food environment when planning for change. Copyright © 2012 Elsevier Ltd. All rights reserved.

Availability of more healthful food alternatives in traditional, convenience, and nontraditional types of food stores in two rural Texas counties.

PubMed

Bustillos, Brenda; Sharkey, Joseph R; Anding, Jenna; McIntosh, Alex

2009-05-01

Limited research has focused on the availability of more healthful food alternatives in traditional food stores (supermarkets and grocery stores) in rural areas. Current market trends suggest that food items may be available for purchase in stores other than traditional food stores. An observational survey was developed and used on-site to document the availability and variety of fruit and vegetables (fresh, canned, and frozen), meats (meat, poultry, fish, and eggs), dairy (milk, yogurt, and cheese), and grains (whole grains and refined grains) in all traditional food stores, convenience stores, and nontraditional food stores (dollar stores and mass merchandisers) in two rural Texas counties. Descriptive statistics and t tests identified that although the widest selection of more healthful food items was available in supermarkets, not all supermarkets carried all items. Grocery stores carried less variety of fresh fruits (8+/-0.7 vs 4.7+/-0.3; P<0.01) and vegetables (10.7+/-0.2 vs 6+/-0; P<0.001) than supermarkets. Fresh fruits and vegetables were not readily available in convenience or nontraditional food stores. Among convenience and nontraditional food stores, "dollar" stores offered the best variety of more healthful canned fruits and vegetables, whole-wheat bread, and whole-grain cereal. Mass merchandisers and dollar stores offered a greater variety of more healthful types of canned tuna and poultry, reduced-fat and skim milk, and low-fat tortillas. In these rural counties, traditional food stores offered greater availability of more healthful food choices across food groups. More healthful food choices in canned fruits and vegetables, canned meat and fish, milk, and grains were also available in dollar stores, mass merchandisers, and convenience stores. Results suggest that a complete understanding of the food environment, especially in rural areas, requires knowledge of the availability and variety of healthful food in all types of stores that are accessible

Small food store retailers’ willingness to implement healthy store strategies in rural North Carolina

PubMed Central

D’Angelo, Heather; Ammerman, Alice; Gordon-Larsen, Penny; Linnan, Laura; Lytle, Leslie; Ribisl, Kurt M.

2016-01-01

Access to supermarkets is lacking in many rural areas. Small food stores are often available, but typically lack healthy food items such as fresh produce. We assessed small food store retailer willingness to implement 12 healthy store strategies to increase the availability, display, and promotion of healthy foods and decrease the availability, display, and promotion of tobacco products. Interviews were conducted with 55 small food store retailers in three rural North Carolina counties concurrently with store observations assessing current practices related to the strategies. All stores sold low-calorie beverages, sugar-sweetened beverages, candy and cigarettes. Nearly all sold smokeless tobacco and cigars/cigarillos, and 72% sold e-cigarettes. Fresh fruits were sold at 30.2% of stores; only 9.4% sold fresh vegetables. Retailers reported being most willing to stock skim/low-fat milk, display healthy snacks near the register, and stock whole wheat bread. About 50% were willing to stock at least three fresh fruits and three fresh vegetables, however only 2% of stores currently stocked these foods. Nearly all retailers expressed unwillingness to reduce the availability of tobacco products or marketing. Our results show promise for working with retailers in rural settings to increase healthy food availability in small food stores. However, restrictions on retail tobacco sales and marketing may be more feasible through local tobacco control ordinances, or could be included with healthy foods ordinances that require stores to stock a minimum amount of healthy foods. PMID:27540735

Small Food Store Retailers' Willingness to Implement Healthy Store Strategies in Rural North Carolina.

PubMed

D'Angelo, Heather; Ammerman, Alice; Gordon-Larsen, Penny; Linnan, Laura; Lytle, Leslie; Ribisl, Kurt M

2017-02-01

Access to supermarkets is lacking in many rural areas. Small food stores are often available, but typically lack healthy food items such as fresh produce. We assessed small food store retailer willingness to implement 11 healthy store strategies to increase the availability, display, and promotion of healthy foods and decrease the availability, display, and promotion of tobacco products. Interviews were conducted with 55 small food store retailers in three rural North Carolina counties concurrently with store observations assessing current practices related to the strategies. All stores sold low-calorie beverages, sugar-sweetened beverages, candy and cigarettes. Nearly all sold smokeless tobacco and cigars/cigarillos, and 72 % sold e-cigarettes. Fresh fruits were sold at 30.2 % of stores; only 9.4 % sold fresh vegetables. Retailers reported being most willing to stock skim/low-fat milk, display healthy snacks near the register, and stock whole wheat bread. About 50 % were willing to stock at least three fresh fruits and three fresh vegetables, however only 2 % of stores currently stocked these foods. Nearly all retailers expressed unwillingness to reduce the availability of tobacco products or marketing. Our results show promise for working with retailers in rural settings to increase healthy food availability in small food stores. However, restrictions on retail tobacco sales and marketing may be more feasible through local tobacco control ordinances, or could be included with healthy foods ordinances that require stores to stock a minimum amount of healthy foods.

Price promotions for food and beverage products in a nationwide sample of food stores.

PubMed

Powell, Lisa M; Kumanyika, Shiriki K; Isgor, Zeynep; Rimkus, Leah; Zenk, Shannon N; Chaloupka, Frank J

2016-05-01

Food and beverage price promotions may be potential targets for public health initiatives but have not been well documented. We assessed prevalence and patterns of price promotions for food and beverage products in a nationwide sample of food stores by store type, product package size, and product healthfulness. We also assessed associations of price promotions with community characteristics and product prices. In-store data collected in 2010-2012 from 8959 food stores in 468 communities spanning 46 U.S. states were used. Differences in the prevalence of price promotions were tested across stores types, product varieties, and product package sizes. Multivariable regression analyses examined associations of presence of price promotions with community racial/ethnic and socioeconomic characteristics and with product prices. The prevalence of price promotions across all 44 products sampled was, on average, 13.4% in supermarkets (ranging from 9.1% for fresh fruits and vegetables to 18.2% for sugar-sweetened beverages), 4.5% in grocery stores (ranging from 2.5% for milk to 6.6% for breads and cereals), and 2.6% in limited service stores (ranging from 1.2% for fresh fruits and vegetables to 4.1% for breads and cereals). No differences were observed by community characteristics. Less-healthy versus more-healthy product varieties and larger versus smaller product package sizes generally had a higher prevalence of price promotion, particularly in supermarkets. On average, in supermarkets, price promotions were associated with 15.2% lower prices. The observed patterns of price promotions warrant more attention in public health food environment research and intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of a University Campus Food Environment, California, 2015.

PubMed

Tseng, Marilyn; DeGreef, Kelsey; Fishler, Madison; Gipson, Rachel; Koyano, Kelly; Neill, Dawn B

2016-02-04

University campuses offer an opportunity to study the extent to which modifying the food environment influences eating, but in-depth characterizations of campus food environments are needed to identify potential targets for intervention. The objective of this project was to describe the availability, accessibility, and quality of healthful food choices in dining venues and food stores at or near a public, 4-year university in California. Trained assessors used the Nutrition Environment Measures Survey for campus dining (NEMS-CD) to evaluate all 18 campus dining venues, and NEMS for stores (NEMS-S) to evaluate 2 on-campus and 37 off-campus food stores. We calculated prevalence of healthful and unhealthful constructs (eg, availability of selected food items, presence of signage encouraging healthful eating, pricing options that encourage healthful eating), based on the NEMS and compared scores across different types of venues. NEMS-CD scores ranged from 4 to 47 (mean [SD], 26.0 [14.4]) out of a possible maximum score of 97; 12% of entrées and 36% of main dish salads served in these venues were classified as healthful. NEMS-S score for the 2 on-campus food stores (24 for both) was intermediate between off-campus convenience stores (mean [SD], 12.0 [5.3]) and grocery/supermarket stores (mean [SD], 31.1 [10.0]), with a possible maximum score of 54. Standardized environmental evaluation provides insights into both positive and negative aspects of campus community food venues. Environmental assessment identifies potential targets for modification and baseline data for designing and implementing action-oriented research aimed at improving the campus food environment's support of healthful food choices for college students.

Disparities of food availability and affordability within convenience stores in Bexar County, Texas.

PubMed

Smith, Matthew Lee; Sunil, T S; Salazar, Camerino I; Rafique, Sadaf; Ory, Marcia G

2013-01-01

The American Diabetes Association (ADA) recommends healthful food choices; however, some geographic areas are limited in the types of foods they offer. Little is known about the role of convenience stores as viable channels to provide healthier foods in our "grab and go" society. The purposes of this study were to (1) identify foods offered within convenience stores located in two Bexar County, Texas, ZIP Codes and (2) compare the availability and cost of ADA-recommended foods including beverages, produce, grains, and oils/fats. Data were analyzed from 28 convenience store audits performed in two sociodemographically diverse ZIP Codes in Bexar County, Texas. Chi-squared tests were used to compare food availability, and t-tests were used to compare food cost in convenience stores between ZIP Codes. A significantly larger proportion of convenience stores in more affluent areas offered bananas (χ (2) = 4.17, P = 0.003), whole grain bread (χ (2) = 8.33, P = 0.004), and baked potato chips (χ (2) = 13.68, P < 0.001). On average, the price of diet cola (t = -2.12, P = 0.044) and certain produce items (e.g., bananas, oranges, tomatoes, broccoli, and cucumber) was significantly higher within convenience stores in more affluent areas. Convenience stores can play an important role to positively shape a community's food environment by stocking healthier foods at affordable prices.

Disparities of Food Availability and Affordability within Convenience Stores in Bexar County, Texas

PubMed Central

Smith, Matthew Lee; Sunil, T. S.; Salazar, Camerino I.; Rafique, Sadaf; Ory, Marcia G.

2013-01-01

The American Diabetes Association (ADA) recommends healthful food choices; however, some geographic areas are limited in the types of foods they offer. Little is known about the role of convenience stores as viable channels to provide healthier foods in our “grab and go” society. The purposes of this study were to (1) identify foods offered within convenience stores located in two Bexar County, Texas, ZIP Codes and (2) compare the availability and cost of ADA-recommended foods including beverages, produce, grains, and oils/fats. Data were analyzed from 28 convenience store audits performed in two sociodemographically diverse ZIP Codes in Bexar County, Texas. Chi-squared tests were used to compare food availability, and t-tests were used to compare food cost in convenience stores between ZIP Codes. A significantly larger proportion of convenience stores in more affluent areas offered bananas (χ 2 = 4.17, P = 0.003), whole grain bread (χ 2 = 8.33, P = 0.004), and baked potato chips (χ 2 = 13.68, P < 0.001). On average, the price of diet cola (t = −2.12, P = 0.044) and certain produce items (e.g., bananas, oranges, tomatoes, broccoli, and cucumber) was significantly higher within convenience stores in more affluent areas. Convenience stores can play an important role to positively shape a community's food environment by stocking healthier foods at affordable prices. PMID:23935645

The influence of local food environments on adolescents' food purchasing behaviors.

PubMed

He, Meizi; Tucker, Patricia; Gilliland, Jason; Irwin, Jennifer D; Larsen, Kristian; Hess, Paul

2012-04-01

This study examined the relationship between the neighborhood food environment and the food purchasing behaviors among adolescents. Grade 7 and 8 students (n = 810) at 21 elementary schools in London, Ontario, Canada completed a questionnaire assessing their food purchasing behaviors. Parents of participants also completed a brief questionnaire providing residential address and demographic information. A Geographic Information System (GIS) was used to assess students' home and school neighborhood food environment and land use characteristics. Logistic regression analysis was conducted to assess the influence of the home neighborhood food environment on students' food purchasing behaviors, while two-level Hierarchical Non-Linear Regression Models were used to examine the effects of school neighborhood food environment factors on students' food purchasing behaviors. The study showed that approximately 65% of participants reported self-purchasing foods from fast-food outlets or convenience stores. Close proximity (i.e., less than 1 km) to the nearest fast-food outlet or convenience store in the home neighborhood increased the likelihood of food purchasing from these food establishments at least once per week by adolescents (p < 0.05). High fast-food outlet density in both home and school neighborhoods was associated with increased fast-food purchasing by adolescents (i.e., at least once per week; p < 0.05). In conclusion, macro-level regulations and policies are required to amend the health-detracting neighborhood food environment surrounding children and youth's home and school.

The Influence of Local Food Environments on Adolescents’ Food Purchasing Behaviors

PubMed Central

He, Meizi; Tucker, Patricia; Gilliland, Jason; Irwin, Jennifer D.; Larsen, Kristian; Hess, Paul

2012-01-01

This study examined the relationship between the neighborhood food environment and the food purchasing behaviors among adolescents. Grade 7 and 8 students (n = 810) at 21 elementary schools in London, Ontario, Canada completed a questionnaire assessing their food purchasing behaviors. Parents of participants also completed a brief questionnaire providing residential address and demographic information. A Geographic Information System (GIS) was used to assess students’ home and school neighborhood food environment and land use characteristics. Logistic regression analysis was conducted to assess the influence of the home neighborhood food environment on students’ food purchasing behaviors, while two-level Hierarchical Non-Linear Regression Models were used to examine the effects of school neighborhood food environment factors on students’ food purchasing behaviors. The study showed that approximately 65% of participants reported self-purchasing foods from fast-food outlets or convenience stores. Close proximity (i.e., less than 1 km) to the nearest fast-food outlet or convenience store in the home neighborhood increased the likelihood of food purchasing from these food establishments at least once per week by adolescents (p < 0.05). High fast-food outlet density in both home and school neighborhoods was associated with increased fast-food purchasing by adolescents (i.e., at least once per week; p < 0.05). In conclusion, macro-level regulations and policies are required to amend the health-detracting neighborhood food environment surrounding children and youth’s home and school. PMID:22690205

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China.

PubMed

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. The findings suggested food environment disparities did exist in different cities of China.

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China

PubMed Central

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

Objective The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. Methods The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Results Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. Conclusions The findings suggested food environment disparities did exist in different cities of China. PMID:26938866

Exploring the influence of local food environments on food behaviours: a systematic review of qualitative literature.

PubMed

Pitt, Erin; Gallegos, Danielle; Comans, Tracy; Cameron, Cate; Thornton, Lukar

2017-09-01

Systematic reviews investigating associations between objective measures of the food environment and dietary behaviours or health outcomes have not established a consistent evidence base. The present paper aims to synthesise qualitative evidence regarding the influence of local food environments on food and purchasing behaviours. A systematic review in the form of a qualitative thematic synthesis. Urban localities. Adults. Four analytic themes were identified from the review including community and consumer nutrition environments, other environmental factors and individual coping strategies for shopping and purchasing decisions. Availability, accessibility and affordability were consistently identified as key determinants of store choice and purchasing behaviours that often result in less healthy food choices within community nutrition environments. Food availability, quality and food store characteristics within consumer nutrition environments also greatly influenced in-store purchases. Individuals used a range of coping strategies in both the community and consumer nutrition environments to make optimal purchasing decisions, often within the context of financial constraints. Findings from the current review add depth and scope to quantitative literature and can guide ongoing theory, interventions and policy development in food environment research. There is a need to investigate contextual influences within food environments as well as individual and household socio-economic characteristics that contribute to the differing use of and views towards local food environments. Greater emphasis on how individual and environmental factors interact in the food environment field will be key to developing stronger understanding of how environments can support and promote healthier food choices.

Food and eating environments: in Canadian schools.

PubMed

Browning, H Frances; Laxer, Rachel E; Janssen, Ian

2013-01-01

This national study was conducted to examine healthy eating programs, healthy eating education, and the food retail environments of schools. A total of 436 Canadian schools were studied. Administrators completed a questionnaire designed to assess school healthy eating programs, healthy eating education, and food retail environment. The number of chain fast food restaurants, chain cafés/coffee shops, and convenience stores within 1 km of schools was measured using geographic information systems food retailer measures from DMTI Spatial Inc. and the Yellow Pages. During the preceding year, 67% of schools had initiated healthy eating lunch programs while 18% had junk food-free days. The majority of schools offered cooking classes (59%) and healthy eating media literacy education (67%), while a minority offered gardening activities (15%) and field trips to farmers' markets (27%) and grocery stores (36%). Fifty-three percent had a school cafeteria, and most had a school tuck shop (75%) and pop/juice vending machines (76%). Fifty percent had a chain fast food restaurant, 33% had a chain café/coffee shop, and 41% had a convenience store within 1 km. An important aspect of addressing childhood obesity will be improving the food environments of schools and their surrounding neighbourhoods, and providing healthy eating education for all students.

Classification bias in commercial business lists for retail food stores in the U.S.

PubMed

Han, Euna; Powell, Lisa M; Zenk, Shannon N; Rimkus, Leah; Ohri-Vachaspati, Punam; Chaloupka, Frank J

2012-04-18

Aspects of the food environment such as the availability of different types of food stores have recently emerged as key modifiable factors that may contribute to the increased prevalence of obesity. Given that many of these studies have derived their results based on secondary datasets and the relationship of food stores with individual weight outcomes has been reported to vary by store type, it is important to understand the extent to which often-used secondary data correctly classify food stores. We evaluated the classification bias of food stores in Dun & Bradstreet (D&B) and InfoUSA commercial business lists. We performed a full census in 274 randomly selected census tracts in the Chicago metropolitan area and collected detailed store attributes inside stores for classification. Store attributes were compared by classification match status and store type. Systematic classification bias by census tract characteristics was assessed in multivariate regression. D&B had a higher classification match rate than InfoUSA for supermarkets and grocery stores, while InfoUSA was higher for convenience stores. Both lists were more likely to correctly classify large supermarkets, grocery stores, and convenience stores with more cash registers and different types of service counters (supermarkets and grocery stores only). The likelihood of a correct classification match for supermarkets and grocery stores did not vary systemically by tract characteristics whereas convenience stores were more likely to be misclassified in predominately Black tracts. Researches can rely on classification of food stores in commercial datasets for supermarkets and grocery stores whereas classifications for convenience and specialty food stores are subject to some systematic bias by neighborhood racial/ethnic composition.

Classification bias in commercial business lists for retail food stores in the U.S.

PubMed Central

2012-01-01

Background Aspects of the food environment such as the availability of different types of food stores have recently emerged as key modifiable factors that may contribute to the increased prevalence of obesity. Given that many of these studies have derived their results based on secondary datasets and the relationship of food stores with individual weight outcomes has been reported to vary by store type, it is important to understand the extent to which often-used secondary data correctly classify food stores. We evaluated the classification bias of food stores in Dun & Bradstreet (D&B) and InfoUSA commercial business lists. Methods We performed a full census in 274 randomly selected census tracts in the Chicago metropolitan area and collected detailed store attributes inside stores for classification. Store attributes were compared by classification match status and store type. Systematic classification bias by census tract characteristics was assessed in multivariate regression. Results D&B had a higher classification match rate than InfoUSA for supermarkets and grocery stores, while InfoUSA was higher for convenience stores. Both lists were more likely to correctly classify large supermarkets, grocery stores, and convenience stores with more cash registers and different types of service counters (supermarkets and grocery stores only). The likelihood of a correct classification match for supermarkets and grocery stores did not vary systemically by tract characteristics whereas convenience stores were more likely to be misclassified in predominately Black tracts. Conclusion Researches can rely on classification of food stores in commercial datasets for supermarkets and grocery stores whereas classifications for convenience and specialty food stores are subject to some systematic bias by neighborhood racial/ethnic composition. PMID:22512874

Convenience stores and the marketing of foods and beverages through product assortment.

PubMed

Sharkey, Joseph R; Dean, Wesley R; Nalty, Courtney

2012-09-01

Product assortment (presence and variety) is a key in-store marketing strategy to influence consumer choice. Quantifying the product assortment of healthier and less-healthy foods and beverages in convenience stores can inform changes in the food environment. To document product assortment (i.e., presence and variety of specific foods and beverages) in convenience stores. Observational survey data were collected onsite in 2011 by trained promotora-researchers in 192 convenience stores. Frequencies of presence and distributions of variety were calculated in 2012. Paired differences were examined using the Wilcoxon matched-pairs signed-rank test. Convenience stores displayed a large product assortment of sugar-sweetened beverages (median 86.5 unique varieties); candy (76 varieties); salty snacks (77 varieties); fried chips (44 varieties); cookies and pastries (19 varieties); and frozen sweets (21 varieties). This compared with 17 varieties of non-sugar sweetened beverages and three varieties of baked chips. The Wilcoxon signed-rank test confirmed a (p<0.001) greater variety of sugar-sweetened than non-sugar-sweetened beverages, and of fried chips compared with baked chips. Basic food items provided by convenience stores included milk (84% of stores); fresh fruit (33%); fresh vegetables (35%); canned vegetables (78%); white bread (71%); and deli-style packaged meat (57%). Healthier versions of milk, canned fruit, canned tuna, bread, and deli-style packaged meat were displayed in 17%-71% of convenience stores. Convenience stores in this area provide a greater assortment of less-healthy compared with healthier foods and beverages. There are opportunities to influence consumer food choice through programs that alter the balance between healthier and less-healthy foods and beverages in existing convenience stores that serve rural and underserved neighborhoods and communities. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights

Food Melt in Consumer Food Environments in Low-income Urban Neighborhoods.

PubMed

Trapl, Erika S; Pike, Stephanie N; Borawski, Elaine; Flocke, Susan A; Freedman, Darcy A; Walsh, Colleen C; Schneider, Christine; Yoder, Laura

2017-11-01

We systematically evaluated changes in availability, price, and quality of perishable food items from the beginning to the end of the month in lowincome, urban neighborhoods. The sample included grocery stores or supermarkets in Cleveland, Ohio, within neighborhoods with >30% of population receiving food assistance. We collected data for 2 sequential months during the first and fourth weeks of each month. Two coders evaluated stores, collecting measures of availability, price, and quality for 50 items. We examined difference in number and proportion of items available at the beginning of the month (BOM) to items remaining available at the end of the month (EOM), as well as quality and price of those items. Across 48 stores, availability at EOM was lower than BOM; as store size increased, reduction in availability (ie, food melt) was significantly (p < .01) less pronounced. Overall, items became less expensive at the EOM whereas quality remained consistent; we noted no statistically significant differences by store type for price or quality. Food melt differentially affects individuals in neighborhoods without grocery stores. Findings reveal composition of food environments is dynamic rather than static, influencing food-purchasing choices among lowincome consumers.

Distance to Store, Food Prices, and Obesity in Urban Food Deserts

PubMed Central

Ghosh-Dastidar, Bonnie; Cohen, Deborah; Hunter, Gerald; Zenk, Shannon N.; Huang, Christina; Beckman, Robin; Dubowitz, Tamara

2014-01-01

Background Lack of access to healthy foods may explain why residents of low-income neighborhoods and African Americans in the U.S. have high rates of obesity. The findings on where people shop and how that may influence health are mixed. However, multiple policy initiatives are underway to increase access in communities that currently lack healthy options. Few studies have simultaneously measured obesity, distance, and prices of the store used for primary food shopping. Purpose To examine the relationship among distance to store, food prices, and obesity. Methods The Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health study conducted baseline interviews with 1,372 households between May and December 2011 in two low-income, majority African American neighborhoods without a supermarket. Audits of 16 stores where participants reported doing their major food shopping were conducted. Data were analyzed between February 2012 and February 2013. Results Distance to store and prices were positively associated with obesity (p<0.05). When distance to store and food prices were jointly modeled, only prices remained significant (p<0.01), with higher prices predicting a lower likelihood of obesity. Although low- and high-price stores did not differ in availability, they significantly differed in their display and marketing of junk foods relative to healthy foods. Conclusions Placing supermarkets in food deserts to improve access may not be as important as simultaneously offering better prices for healthy foods relative to junk foods, actively marketing healthy foods, and enabling consumers to resist the influence of junk food marketing. PMID:25217097

Distance to store, food prices, and obesity in urban food deserts.

PubMed

Ghosh-Dastidar, Bonnie; Cohen, Deborah; Hunter, Gerald; Zenk, Shannon N; Huang, Christina; Beckman, Robin; Dubowitz, Tamara

2014-11-01

Lack of access to healthy foods may explain why residents of low-income neighborhoods and African Americans in the U.S. have high rates of obesity. The findings on where people shop and how that may influence health are mixed. However, multiple policy initiatives are underway to increase access in communities that currently lack healthy options. Few studies have simultaneously measured obesity, distance, and prices of the store used for primary food shopping. To examine the relationship among distance to store, food prices, and obesity. The Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health study conducted baseline interviews with 1,372 households between May and December 2011 in two low-income, majority African American neighborhoods without a supermarket. Audits of 16 stores where participants reported doing their major food shopping were conducted. Data were analyzed between February 2012 and February 2013. Distance to store and prices were positively associated with obesity (p<0.05). When distance to store and food prices were jointly modeled, only prices remained significant (p<0.01), with higher prices predicting a lower likelihood of obesity. Although low- and high-price stores did not differ in availability, they significantly differed in their display and marketing of junk foods relative to healthy foods. Placing supermarkets in food deserts to improve access may not be as important as simultaneously offering better prices for healthy foods relative to junk foods, actively marketing healthy foods, and enabling consumers to resist the influence of junk food marketing. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Neighbourhood food environment and area deprivation: spatial accessibility to grocery stores selling fresh fruit and vegetables in urban and rural settings.

PubMed

Smith, Dianna M; Cummins, Steven; Taylor, Mathew; Dawson, John; Marshall, David; Sparks, Leigh; Anderson, Annie S

2010-02-01

The 'deprivation amplification' hypothesis suggests that residents of deprived neighbourhoods have universally poorer access to high-quality food environments, which in turn contributes to the development of spatial inequalities in diet and diet-related chronic disease. This paper presents results from a study that quantified access to grocery stores selling fresh fruit and vegetables in four environmental settings in Scotland, UK. Spatial accessibility, as measured by network travel times, to 457 grocery stores located in 205 neighbourhoods in four environmental settings (island, rural, small town and urban) in Scotland was calculated using Geographical Information Systems. The distribution of accessibility by neighbourhood deprivation in each of these four settings was investigated. Overall, the most deprived neighbourhoods had the best access to grocery stores and grocery stores selling fresh produce. Stratified analysis by environmental setting suggests that the least deprived compared with the most deprived urban neighbourhoods have greater accessibility to grocery stores than their counterparts in island, rural and small town locations. Access to fresh produce is better in more deprived compared with less deprived urban and small town neighbourhoods, but poorest in the most affluent island communities with mixed results for rural settings. The results presented here suggest that the assumption of a universal 'deprivation amplification' hypothesis in studies of the neighbourhood food environment may be misguided. Associations between neighbourhood deprivation and grocery store accessibility vary by environmental setting. Theories and policies aimed at understanding and rectifying spatial inequalities in the distribution of neighbourhood exposures for poor diet need to be context specific.

School and residential neighborhood food environment and diet among California youth.

PubMed

An, Ruopeng; Sturm, Roland

2012-02-01

Various hypotheses link neighborhood food environments and diet. Greater exposure to fast-food restaurants and convenience stores is thought to encourage overconsumption; supermarkets and large grocery stores are claimed to encourage healthier diets. For youth, empirical evidence for any particular hypothesis remains limited. This study examines the relationship between school and residential neighborhood food environment and diet among youth in California. Data from 8226 children (aged 5-11 years) and 5236 adolescents (aged 12-17 years) from the 2005 and 2007 California Health Interview Survey were analyzed in 2011. The dependent variables are daily servings of fruits, vegetables, juice, milk, soda, high-sugar foods, and fast food, which were regressed on measures of food environments. Food environments were measured by counts and density of businesses, distinguishing fast-food restaurants, convenience stores, small food stores, grocery stores, and large supermarkets within a specific distance (varying from 0.1 to 1.5 miles) from a respondent's home or school. No robust relationship between food environment and consumption is found. A few significant results are sensitive to small modeling changes and more likely to reflect chance than true relationships. This correlational study has measurement and design limitations. Longitudinal studies that can assess links between environmental, dependent, and intervening food purchase and consumption variables are needed. Reporting a full range of studies, methods, and results is important as a premature focus on correlations may lead policy astray. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

7 CFR 278.2 - Participation of retail food stores.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 4 2013-01-01 2013-01-01 false Participation of retail food stores. 278.2 Section 278..., DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES, WHOLESALE FOOD CONCERNS AND INSURED FINANCIAL INSTITUTIONS § 278.2 Participation of retail food stores. (a...

7 CFR 278.2 - Participation of retail food stores.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 4 2012-01-01 2012-01-01 false Participation of retail food stores. 278.2 Section 278..., DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES, WHOLESALE FOOD CONCERNS AND INSURED FINANCIAL INSTITUTIONS § 278.2 Participation of retail food stores. (a...

The influence of neighborhood food stores on change in young girls' body mass index.

PubMed

Leung, Cindy W; Laraia, Barbara A; Kelly, Maggi; Nickleach, Dana; Adler, Nancy E; Kushi, Lawrence H; Yen, Irene H

2011-07-01

As the prevalence of childhood obesity has risen in past decades, more attention has been given to how the neighborhood food environment affects children's health outcomes. This exploratory study examined the relationship between the presence of neighborhood food stores within a girl's neighborhood and 3-year risk of overweight/obesity and change in BMI, in girls aged 6 or 7 years at baseline. A longitudinal analysis of participants in the Cohort Study of Young Girls' Nutrition, Environment and Transitions (CYGNET) was conducted from 2005 to 2008. Neighborhood food stores were identified from a commercial database and classified according to industry codes in 2006. Generalized linear and logistic models were used to examine how availability of food stores within 0.25-mile and 1.0-mile network buffers of a girl's residence were associated with BMI z-score change and risk of overweight or obesity, adjusting for baseline BMI/weight and family sociodemographic characteristics. Data were analyzed in 2010. Availability of convenience stores within a 0.25-mile network buffer of a girl's residence was associated with greater risk of overweight/obesity (OR=3.38, 95% CI=1.07, 10.68) and an increase in BMI z-score (β=0.13, 95% CI=0.00, 0.25). Availability of produce vendors/farmer's markets within a 1.0-mile network buffer of a girl's residence was inversely associated with overweight/obesity (OR=0.22, 95% CI=0.05, 1.06). A significant trend was observed between availability of produce vendors/farmer's markets and lower risk of overweight/obesity after 3 years. Although food store inventories were not assessed and food store indices were not created, the availability of neighborhood food stores may affect a young girl's weight trajectory over time. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Influence of Neighborhood Food Stores on Change in Young Girls’ Body Mass Index

PubMed Central

Leung, Cindy W.; Laraia, Barbara A.; Kelly, Maggi; Nickleach, Dana; Adler, Nancy E.; Kushi, Lawrence H.; Yen, Irene H.

2011-01-01

Background As the prevalence of childhood obesity has risen in past decades, more attention has been given to how the neighborhood food environment affects children’s health outcomes. Purpose This exploratory study examined the relationship between the presence of neighborhood food stores within a girl’s neighborhood and 3-year risk of overweight/obesity and change in BMI, in girls aged 6 or 7 years at baseline. Methods A longitudinal analysis of participants in the Cohort Study of Young Girls’ Nutrition, Environment and Transitions (CYGNET) was conducted from 2005–2008. Neighborhood food stores were identified from a commercial database and classified according to industry codes in 2006. Generalized linear and logistic models were used to examine how availability of food stores within 0.25-mile and 1.0-mile network buffers of a girl’s residence were associated with BMI z-score change and risk of overweight or obesity, adjusting for baseline BMI/weight and family sociodemographic characteristics. Data were analyzed in 2010. Results Availability of convenience stores within a 0.25-mile network buffer of a girl’s residence was associated with greater risk of overweight/obesity (OR 3.38, 95% CI 1.07, 10.68) and an increase in BMI z-score (β=0.13, 95% CI 0.00, 0.25). Availability of produce vendors/farmer’s markets within a 1.0-mile network buffer of a girl’s residence was inversely associated with overweight/ obesity (OR 0.22, 95% CI 0.05, 1.06). A significant trend was observed between availability of produce vendors/farmer’s markets and lower risk of overweight/obesity after 3 years. Conclusions Although food store inventories were not assessed and food store indices were not created, the availability of neighborhood food stores may affect a young girl’s weight trajectory over time. PMID:21665062

Assessment of a University Campus Food Environment, California, 2015

PubMed Central

DeGreef, Kelsey; Fishler, Madison; Gipson, Rachel; Koyano, Kelly; Neill, Dawn B.

2016-01-01

Introduction University campuses offer an opportunity to study the extent to which modifying the food environment influences eating, but in-depth characterizations of campus food environments are needed to identify potential targets for intervention. The objective of this project was to describe the availability, accessibility, and quality of healthful food choices in dining venues and food stores at or near a public, 4-year university in California. Methods Trained assessors used the Nutrition Environment Measures Survey for campus dining (NEMS-CD) to evaluate all 18 campus dining venues, and NEMS for stores (NEMS-S) to evaluate 2 on-campus and 37 off-campus food stores. We calculated prevalence of healthful and unhealthful constructs (eg, availability of selected food items, presence of signage encouraging healthful eating, pricing options that encourage healthful eating), based on the NEMS and compared scores across different types of venues. Results NEMS-CD scores ranged from 4 to 47 (mean [SD], 26.0 [14.4]) out of a possible maximum score of 97; 12% of entrées and 36% of main dish salads served in these venues were classified as healthful. NEMS-S score for the 2 on-campus food stores (24 for both) was intermediate between off-campus convenience stores (mean [SD], 12.0 [5.3]) and grocery/supermarket stores (mean [SD], 31.1 [10.0]), with a possible maximum score of 54. Conclusion Standardized environmental evaluation provides insights into both positive and negative aspects of campus community food venues. Environmental assessment identifies potential targets for modification and baseline data for designing and implementing action-oriented research aimed at improving the campus food environment’s support of healthful food choices for college students. PMID:26851337

Development and evaluation of a food environment survey in three urban environments of Kunming, China

PubMed Central

2014-01-01

Background Given the rapid pace of urbanization and Westernization and the increasing prevalence of obesity, there is a need for research to better understand the influence of the built environment on overweight and obesity in world’s developing regions. Culturally-specific food environment survey instruments are important tools for studying changing food availability and pricing. Here, we present findings from an effort to develop and evaluate food environment survey instruments for use in a rapidly developing city in southwest China. Methods We developed two survey instruments (for stores and restaurants), each designed to be completed within 10 minutes. Two pairs of researchers surveyed a pre-selected 1-km stretch of street in each of three socio-demographically different neighborhoods to assess inter-rater reliability. Construct validity was assessed by comparing the food environments of the neighborhoods to cross-sectional height and weight data obtained on 575 adolescents in the corresponding regions of the city. Results 273 food establishments (163 restaurants and 110 stores) were surveyed. Sit-down, take-out, and fast food restaurants accounted for 40%, 21% and 19% of all restaurants surveyed. Tobacco and alcohol shops, convenience stores and supermarkets accounted for 25%, 12% and 11%, respectively, of all stores surveyed. We found a high percentage of agreement between teams (>75%) for all categorical variables with moderate kappa scores (0.4-0.6), and no statistically significant differences between teams for any of the continuous variables. More developed inner city neighborhoods had a higher number of fast food restaurants and convenience stores than surrounding neighborhoods. Adolescents who lived in the more developed inner neighborhoods also had a higher percentage of overweight, indicating well-founded construct validity. Depending on the cutoff used, 19% to 36% of male and 10% to 22% of female 16-year old adolescents were found to be overweight

Development and evaluation of a food environment survey in three urban environments of Kunming, China.

PubMed

Hua, Jenna; Seto, Edmund; Li, Yan; Wang, May C

2014-03-06

Given the rapid pace of urbanization and Westernization and the increasing prevalence of obesity, there is a need for research to better understand the influence of the built environment on overweight and obesity in world's developing regions. Culturally-specific food environment survey instruments are important tools for studying changing food availability and pricing. Here, we present findings from an effort to develop and evaluate food environment survey instruments for use in a rapidly developing city in southwest China. We developed two survey instruments (for stores and restaurants), each designed to be completed within 10 minutes. Two pairs of researchers surveyed a pre-selected 1-km stretch of street in each of three socio-demographically different neighborhoods to assess inter-rater reliability. Construct validity was assessed by comparing the food environments of the neighborhoods to cross-sectional height and weight data obtained on 575 adolescents in the corresponding regions of the city. 273 food establishments (163 restaurants and 110 stores) were surveyed. Sit-down, take-out, and fast food restaurants accounted for 40%, 21% and 19% of all restaurants surveyed. Tobacco and alcohol shops, convenience stores and supermarkets accounted for 25%, 12% and 11%, respectively, of all stores surveyed. We found a high percentage of agreement between teams (>75%) for all categorical variables with moderate kappa scores (0.4-0.6), and no statistically significant differences between teams for any of the continuous variables. More developed inner city neighborhoods had a higher number of fast food restaurants and convenience stores than surrounding neighborhoods. Adolescents who lived in the more developed inner neighborhoods also had a higher percentage of overweight, indicating well-founded construct validity. Depending on the cutoff used, 19% to 36% of male and 10% to 22% of female 16-year old adolescents were found to be overweight. The prevalence of

The Good Food Junction: a Community-Based Food Store Intervention to Address Nutritional Health Inequities

PubMed Central

Muhajarine, Nazeem; Ridalls, Tracy; Abonyi, Sylvia; Vatanparast, Hassan; Whiting, Susan; Walker, Ryan

2016-01-01

knowledge this is the first large-scale study of a full-service grocery store intervention in a former food desert in Canada that has used multiple data sources, as well as longitudinal analyses, to examine its effects. Its findings will contribute significantly to the knowledge base on food environment interventions. PMID:27079140

Store type and demographic influence on the availability and price of healthful foods, Leon County, Florida, 2008.

PubMed

Leone, Angela F; Rigby, Samantha; Betterley, Connie; Park, Sohyun; Kurtz, Hilda; Johnson, Mary Ann; Lee, Jung Sun

2011-11-01

The availability of healthful foods varies by neighborhood. We examined the availability and price of more healthful foods by store type, neighborhood income level, and racial composition in a community with high rates of diet-related illness and death. We used the modified Nutrition Environment Measures Survey in Stores to conduct this cross-sectional study in 2008. We surveyed 73 stores (29% supermarkets, 11% grocery stores, and 60% convenience stores) in Leon County, Florida. We analyzed the price and availability of foods defined by the 2005 Dietary Guidelines for Americans as "food groups to encourage." We used descriptive statistics, t tests, analysis of variance, and χ(2) tests in the analysis. Measures of availability for all more healthful foods differed by store type (P < .001). Overall, supermarkets provided the lowest price for most fresh fruits and vegetables, low-fat milk, and whole-wheat bread. Availability of 10 of the 20 fruits and vegetables surveyed, shelf space devoted to low-fat milk, and varieties of whole-wheat bread differed by neighborhood income level (P < .05), but no trends were seen for the availability or price of more healthful foods by neighborhood racial composition. Store type affects the availability and price of more healthful foods. In particular, people without access to supermarkets may have limited ability to purchase healthful foods. Nutrition environment studies such as this one can be used to encourage improvements in neighborhoods that lack adequate access to affordable, healthful food, such as advocating for large retail stores, farmer's markets, and community gardens in disadvantaged neighborhoods.

Para I Famagu'on-Ta: Fruit and Vegetable Intake, Food Store Environment, and Childhood Overweight/Obesity in the Children's Healthy Living Program on Guam

PubMed Central

Matanane, Lenora; Silva, Joshua; Li, Fenfang; Nigg, Claudio; Leon Guerrero, Rachael T; Novotny, Rachel

2017-01-01

This cross-sectional study examined the: (1) association between food store environment (FSE), fruit and vegetable (FV) availability and access, and prevalence of early childhood overweight/obesity (COWOB); and (2) influence of young child actual FV intake on the relationship between the FSE and early COWOB prevalence. Anthropometric and socio-demographic data of children (2 to 8 years; N=466) in baseline communities on Guam participating in the Children's Healthy Living (CHL) Program community trial were included. CDC year 2000 growth charts were used to calculate BMI z-scores and categories. FSE factors (fresh FV scores, store type) were assessed using the CX3 Food Availability and Marketing Survey amended for CHL. ArcGIS maps were constructed with geographic coordinates of participant residences and food stores to calculate food store scores within 1 mile of participant's residences. A sub-sample of participants (n = 355) had Food and Activity Log data to calculate FV and energy intakes. Bivariate correlations and logistic regression evaluated associations. Of 111 stores surveyed, 73% were small markets, 16% were convenience stores, and 11% were large grocery/supermarkets. Supermarkets/large grocery stores averaged the highest FV scores. Most participants did not meet FV intake recommendations while nearly half exceeded energy intake recommendations. Living near a small market was negatively correlated with BMI z-score (r = - 0.129, P < .05) while living near a convenience store was positively correlated with BMI z-score (r = 0.092, P < .05). Logistic regression analysis yielded non-significant associations. The high density of small markets may be an opportunity for FSE intervention but further investigation of Guam's FSE influence on health is needed. PMID:28808612

Para I Famagu'on-Ta: Fruit and Vegetable Intake, Food Store Environment, and Childhood Overweight/Obesity in the Children's Healthy Living Program on Guam.

PubMed

Matanane, Lenora; Fialkowski, Marie Kainoa; Silva, Joshua; Li, Fenfang; Nigg, Claudio; Leon Guerrero, Rachael T; Novotny, Rachel

2017-08-01

This cross-sectional study examined the: (1) association between food store environment (FSE), fruit and vegetable (FV) availability and access, and prevalence of early childhood overweight/obesity (COWOB); and (2) influence of young child actual FV intake on the relationship between the FSE and early COWOB prevalence. Anthropometric and socio-demographic data of children (2 to 8 years; N=466) in baseline communities on Guam participating in the Children's Healthy Living (CHL) Program community trial were included. CDC year 2000 growth charts were used to calculate BMI z-scores and categories. FSE factors (fresh FV scores, store type) were assessed using the CX3 Food Availability and Marketing Survey amended for CHL. ArcGIS maps were constructed with geographic coordinates of participant residences and food stores to calculate food store scores within 1 mile of participant's residences. A sub-sample of participants (n = 355) had Food and Activity Log data to calculate FV and energy intakes. Bivariate correlations and logistic regression evaluated associations. Of 111 stores surveyed, 73% were small markets, 16% were convenience stores, and 11% were large grocery/supermarkets. Supermarkets/large grocery stores averaged the highest FV scores. Most participants did not meet FV intake recommendations while nearly half exceeded energy intake recommendations. Living near a small market was negatively correlated with BMI z-score (r = - 0.129, P < .05) while living near a convenience store was positively correlated with BMI z-score (r = 0.092, P < .05). Logistic regression analysis yielded non-significant associations. The high density of small markets may be an opportunity for FSE intervention but further investigation of Guam's FSE influence on health is needed.

Obesogenic neighbourhoods: the impact of neighbourhood restaurants and convenience stores on adolescents' food consumption behaviours.

PubMed

He, Meizi; Tucker, Patricia; Irwin, Jennifer D; Gilliland, Jason; Larsen, Kristian; Hess, Paul

2012-12-01

To examine the relationship between the neighbourhood food environment and dietary intake among adolescents. Cross-sectional design using: (i) a geographic information system to assess characteristics of the neighbourhood food environment and neighbourhood socio-economic status; (ii) the modified Healthy Eating Index (HEI) to assess participants' overall diet quality; and (iii) generalized linear models to examine associations between HEI and home and school food environmental correlates. Mid-sized Canadian city in Ontario, Canada. Participants Grade 7 and 8 students (n 810) at twenty-one elementary schools. Students living in neighbourhoods with a lower diversity of land-use types, compared with their higher diversity counterparts, had higher HEI scores (P < 0.05). Students with more than 1 km between their home and the nearest convenience store had higher HEI scores than those living within 1 km (P < 0.01). Students attending schools with a distance further than 1 km from the nearest convenience store (P < 0.01) and fast-food outlet (P < 0.05) had higher HEI scores than those within 1 km. Those attending schools with three or more fast-food outlets within 1 km had lower HEI scores than those attending schools with no fast-food outlet in the school surroundings (P < 0.05). Close proximity to convenience stores in adolescents' home environments is associated with low HEI scores. Within adolescents' school environments, close proximity to convenience and fast-food outlets and a high density of fast-food outlets are associated with low HEI scores.

The Association between Food Security and Store-Specific and Overall Food Shopping Behaviors.

PubMed

Ma, Xiaonan; Liese, Angela D; Hibbert, James; Bell, Bethany A; Wilcox, Sara; Sharpe, Patricia A

2017-12-01

Food security is a severe problem in the United States. Few studies have examined its relationship with food shopping behaviors. This study aimed to examine the association between food security and store-specific and overall food shopping among residents of low-income neighborhoods. We conducted a cross-sectional study. Five hundred twenty-seven households were recruited from two counties in South Carolina from November 2013 to May 2014, and 474 households were included in the final analysis. Food security was assessed using the 18-item US-Household Food Security Module questionnaire, and classified into three categories: high or marginal food security (FS), low food security (LFS), and very low food security (VLFS). Store-specific shopping behaviors including frequency, store type, and transportation were queried via in-person interview for the three most-frequented grocery stores. Distance from participants' homes to their reported stores was calculated using Geographic Information Systems. Multivariate linear regression for analyses of distance and frequency and multinomial/ordinary logistic regression for analyses of store type and transportation were used. Compared to FS participants, a significantly higher proportion of VLFS participants reported a convenience/dollar store as their most-frequented store (odds ratio [OR] 2.31, 95% CI 1.08 to 4.95) or a lack of transportation (OR 2.04, 95% CI 1.25 to 3.33). They also shopped less frequently (b=-.31, P=0.03) at their third most-frequented store and traveled fewer total miles for shopping (b=-4.71, P=0.04). In analyses considering all stores jointly, LFS participants had lower odds of shopping at both supermarkets and convenience/dollar stores (OR 0.44, 95% CI 0.21 to 0.91) compared to food-secure residents. The current findings suggest that households with VLFS tend to shop more frequently in stores that have less-healthful options, such as convenience/dollar stores. These findings lend support to ongoing

Field validation of food outlet databases: the Latino food environment in North Carolina, USA.

PubMed

Rummo, Pasquale E; Albrecht, Sandra S; Gordon-Larsen, Penny

2015-04-01

Obtaining valid, reliable measures of food environments that serve Latino communities is important for understanding barriers to healthy eating in this at-risk population. The primary aim of the study was to examine agreement between retail food outlet data from two commercial databases, Nielsen TDLinx (TDLinx) for food stores and Dun & Bradstreet (D&B) for food stores and restaurants, relative to field observations of food stores and restaurants in thirty-one census tracts in Durham County, NC, USA. We also examined differences by proportion of Hispanic population (food stores and 337 restaurants in Durham County, NC, USA. We found that overall sensitivity of food store listings in TDLinx was higher (64 %) than listings in D&B (55 %). Twenty-five food stores were characterized by auditors as Latino food stores, with 20 % identified in TDLinx, 52 % in D&B and 56 % in both sources. Overall sensitivity of restaurants (68 %) was higher than sensitivity of Latino restaurants (38 %) listed in D&B. Sensitivity did not differ substantially by Hispanic composition of neighbourhoods. Our findings suggest that while TDLinx and D&B commercial data sources perform well for total food stores, they perform less well in identifying small and independent food outlets, including many Latino food stores and restaurants.

Characterization of the School Neighborhood Food Environment in Three Mexican Cities.

PubMed

Soltero, Erica G; Ortiz Hernández, Luis; Jauregui, Edtna; Lévesque, Lucie; Lopez Y Taylor, Juan; Barquera, Simón; Lee, Rebecca E

2017-01-01

Food resources in school neighborhoods can negatively influence diet; however, this environment is understudied. This study characterized the school neighborhood food environment in Guadalajara (n=11), Puerto Vallarta (n=7), and Mexico City (n=14). Convenience stores, table-service restaurants, and taco stands were highly available in all three cities. Grocery stores were highly available in Mexico City school neighborhoods, yet less frequently observed in Guadalajara and Puerto Vallarta. Socioeconomic differences in food cart and grocery store availability were observed in Guadalajara and Puerto Vallarta. Policy and intervention strategies are needed to address the saturation of food resources in Mexico school neighborhoods.

Is the objective food environment associated with perceptions of the food environment?

PubMed

Williams, Lauren K; Thornton, Lukar; Ball, Kylie; Crawford, David

2012-02-01

The present study examined whether objective measures of the food environment are associated with perceptions of the food environment and whether this relationship varies by socio-economic disadvantage. The study is a cross-sectional analysis of self-report surveys and objective environment data. Women reported their perceptions on the nutrition environment. Participants' homes and food stores were geocoded to measure the objective community nutrition environment. Data on the average price and variety of fruit and vegetables were used to measure the objective consumer nutrition environment. The study was conducted in Melbourne, Australia, in 2003-2004. Data presented are from a sample of 1393 women aged 18-65 years. Overall the match between the perceived and objective environment was poor, underscoring the limitations in using perceptions of the environment as a proxy for the objective environment. Socio-economic disadvantage had limited impact on the relationship between perceived and objective nutrition environment. Further research is needed to understand the determinants of perceptions of the nutrition environment to enhance our understanding of the role of perceptions in nutrition choices and drivers of socio-economic inequalities in nutrition.

An urban food store intervention positively affects food-related psychosocial variables and food behaviors.

PubMed

Gittelsohn, Joel; Song, Hee-Jung; Suratkar, Sonali; Kumar, Mohan B; Henry, Elizabeth G; Sharma, Sangita; Mattingly, Megan; Anliker, Jean A

2010-06-01

Obesity and other diet-related chronic diseases are more prevalent in low-income urban areas, which commonly have limited access to healthy foods. The authors implemented an intervention trial in nine food stores, including two supermarkets and seven corner stores, in a low-income, predominantly African American area of Baltimore City, with a comparison group of eight stores in another low-income area of the city. The intervention (Baltimore Healthy Stores; BHS) included an environmental component to increase stocks of more nutritious foods and provided point-of-purchase promotions including signage for healthy choices and interactive nutrition education sessions. Using pre- and postassessments, the authors evaluated the impact of the program on 84 respondents sampled from the intervention and comparison areas. Exposure to intervention materials was modest in the intervention area, and overall healthy food purchasing scores, food knowledge, and self-efficacy did not show significant improvements associated with intervention status. However, based on adjusted multivariate regression results, the BHS program had a positive impact on healthfulness of food preparation methods and showed a trend toward improved intentions to make healthy food choices. Respondents in the intervention areas were significantly more likely to report purchasing promoted foods because of the presence of a BHS shelf label. This is the first food store intervention trial in low-income urban communities to show positive impacts at the consumer level.

Reduced-Item Food Audits Based on the Nutrition Environment Measures Surveys.

PubMed

Partington, Susan N; Menzies, Tim J; Colburn, Trina A; Saelens, Brian E; Glanz, Karen

2015-10-01

The community food environment may contribute to obesity by influencing food choice. Store and restaurant audits are increasingly common methods for assessing food environments, but are time consuming and costly. A valid, reliable brief measurement tool is needed. The purpose of this study was to develop and validate reduced-item food environment audit tools for stores and restaurants. Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed in 820 stores and 1,795 restaurants in West Virginia, San Diego, and Seattle. Data mining techniques (correlation-based feature selection and linear regression) were used to identify survey items highly correlated to total survey scores and produce reduced-item audit tools that were subsequently validated against full NEMS surveys. Regression coefficients were used as weights that were applied to reduced-item tool items to generate comparable scores to full NEMS surveys. Data were collected and analyzed in 2008-2013. The reduced-item tools included eight items for grocery, ten for convenience, seven for variety, and five for other stores; and 16 items for sit-down, 14 for fast casual, 19 for fast food, and 13 for specialty restaurants-10% of the full NEMS-S and 25% of the full NEMS-R. There were no significant differences in median scores for varying types of retail food outlets when compared to the full survey scores. Median in-store audit time was reduced 25%-50%. Reduced-item audit tools can reduce the burden and complexity of large-scale or repeated assessments of the retail food environment without compromising measurement quality. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Availability and Promotion of Healthful Foods in Stores and Restaurants - Guam, 2015.

PubMed

Lundeen, Elizabeth A; VanFrank, Brenna K; Jackson, Sandra L; Harmon, Brittani; Uncangco, Alyssa; Luces, Patrick; Dooyema, Carrie; Park, Sohyun

2017-07-13

Chronic disease, which is linked to unhealthy nutrition environments, is highly prevalent in Guam. The nutrition environment was assessed in 114 stores and 63 restaurants in Guam. Stores had limited availability of some healthier foods such as lean ground meat (7.5%) and 100% whole-wheat bread (11.4%), while fruits (81.0%) and vegetables (94.8%) were more commonly available; 43.7% of restaurants offered a healthy entrée or main dish salad, 4.1% provided calorie information, and 15.7% denoted healthier choices on menus. Improving the nutrition environment could help customers make healthier choices.

Grocery store interventions to change food purchasing behaviors: a systematic review of randomized controlled trials.

PubMed

Hartmann-Boyce, Jamie; Bianchi, Filippo; Piernas, Carmen; Riches, Sarah Payne; Frie, Kerstin; Nourse, Rebecca; Jebb, Susan A

2018-06-01

Diet is an important determinant of health, and food purchasing is a key antecedent to consumption. We set out to evaluate the effectiveness of grocery store interventions to change food purchasing, and to examine whether effectiveness varied based on intervention components, setting, or socioeconomic status. We conducted a systematic review of randomized controlled trials (search performed June 2017). Studies must have: aimed to change food purchasing; been implemented in grocery stores (real or simulated); reported purchasing; and had a minimal control or compared interventions fulfilling our criteria. Searching, screening, bias assessment, and data extraction followed Cochrane methods. We grouped studies by intervention type (economic, environmental, swaps, and/or education), synthesized results narratively, and conducted an exploratory qualitative comparative analysis. We included 35 studies representing 89 interventions, >20,000 participants, and >800 stores. Risk of bias was mixed. Economic interventions showed the most promise, with 8 of the 9 studies in real stores and all 6 in simulated environments detecting an effect on purchasing. Swap interventions appeared promising in the 2 studies based in real stores. Store environment interventions showed mixed effects. Education-only interventions appeared effective in simulated environments but not in real stores. Available data suggested that effects of economic interventions did not differ by socioeconomic status, whereas for other interventions impact was variable. In our qualitative comparative analysis, economic interventions (regardless of setting) and environmental and swap interventions in real stores were associated with statistically significant changes in purchasing in the desired direction for ≥1 of the foods targeted by the intervention, whereas education-only interventions in real stores were not. Findings suggest that interventions implemented in grocery stores-particularly ones that manipulate

Validating self-reported food expenditures against food store and eating-out receipts.

PubMed

Tang, W; Aggarwal, A; Liu, Z; Acheson, M; Rehm, C D; Moudon, A V; Drewnowski, A

2016-03-01

To compare objective food store and eating-out receipts with self-reported household food expenditures. The Seattle Obesity Study II was based on a representative sample of King County adults, Washington, USA. Self-reported household food expenditures were modeled on the Flexible Consumer Behavior Survey (FCBS) Module from 2007 to 2009 National Health and Nutrition Examination Survey (NHANES). Objective food expenditure data were collected using receipts. Self-reported food expenditures for 447 participants were compared with receipts using paired t-tests, Bland-Altman plots and κ-statistics. Bias by sociodemographics was also examined. Self-reported expenditures closely matched with objective receipt data. Paired t-tests showed no significant differences between receipts and self-reported data on total food expenditures, expenditures at food stores or eating out. However, the highest-income strata showed weaker agreement. Bland-Altman plots confirmed no significant bias across both methods-mean difference: 6.4; agreement limits: -123.5 to 143.4 for total food expenditures, mean difference 5.7 for food stores and mean difference 1.7 for eating out. The κ-statistics showed good agreement for each (κ 0.51, 0.41 and 0.49 respectively. Households with higher education and income had significantly more number of receipts and higher food expenditures. Self-reported food expenditures using NHANES questions, both for food stores and eating out, serve as a decent proxy for objective household food expenditures from receipts. This method should be used with caution among high-income populations, or with high food expenditures. This is the first validation of the FCBS food expenditures question using food store and eating-out receipts.

Validating self-reported food expenditures against food store and eating-out receipts

PubMed Central

Tang, Wesley; Aggarwal, Anju; Liu, Zhongyuan; Acheson, Molly; Rehm, Colin D; Moudon, Anne Vernez; Drewnowski, Adam

2015-01-01

Objectives To compare objective food store and eating-out receipts with self-reported household food expenditures. Design and setting The Seattle Obesity Study (SOS II) was based on a representative sample of King County adults, Washington, USA. Self-reported household food expenditures were modeled on the Flexible Consumer Behavior Survey (FCBS) Module from 2007–2009 National Health and Nutrition Examination Survey (NHANES). Objective food expenditure data were collected using receipts. Self-reported food expenditures for 447 participants were compared to receipts using paired t-tests, Bland-Altman plots, and kappa statistics. Bias by socio-demographics was also examined. Results Self-reported expenditures closely matched with objective receipt data. Paired t-tests showed no significant differences between receipts and self-reported data on total food expenditures, expenditures at food stores, or eating out. However, the highest income strata showed weaker agreement. Bland Altman plots confirmed no significant bias across both methods - mean difference: 6.4; agreement limits: −123.5, 143.4 for total food expenditures, mean difference 5.7 for food stores, and mean difference 1.7 for eating-out. Kappa statistics showed good agreement for each (kappa 0.51, 0.41 and 0.49 respectively. Households with higher education and income had significantly more number of receipts and higher food expenditures. Conclusion Self-reported food expenditures using NHANES questions, both for food stores and eating-out, serve as a decent proxy for objective household food expenditures from receipts. This method should be used with caution among high income populations, or with high food expenditures. This is the first validation of the FCBS food expenditures question using food store and eating-out receipts. PMID:26486299

The rationale behind small food store interventions in low-income urban neighborhoods: insights from New Orleans.

PubMed

Bodor, J Nicholas; Ulmer, Vanessa M; Dunaway, Lauren Futrell; Farley, Thomas A; Rose, Donald

2010-06-01

Environmental approaches to the obesity problem in the US have garnered favor due to growing evidence that changes to the environment are at the root of the epidemic. Low-income urban neighborhoods, where obesity rates are disproportionately high, typically lack supermarkets yet have a high density of small food stores. This may increase the risk for unhealthy diets and obesity for neighborhood residents, because small stores carry mostly energy-dense foods and few fruits and vegetables. This paper pulls together various studies and pilot work conducted in New Orleans to explore the rationale behind small store interventions. Many low-income residents in New Orleans live within walking distance of small food stores and shop at them frequently. Marketing research has documented that changes to in-store shelf space and displays of specific foods affect the sales of these foods. Initiatives in New Orleans and elsewhere have demonstrated some success with improving healthy food availability in small stores, and an intercept survey of customers at small stores suggests that customers would purchase more fruits and vegetables if available. Efforts to encourage small store operators to offer a healthier mix of foods may, in the end, depend on the profitability of such changes. Evidence from a typical small store in New Orleans indicates that a greater percentage of gross profits come from snack foods and beverages than from fruits and vegetables. More research is needed to better understand the financial operations of small food stores and whether altering the mix of foods is economically feasible.

Characterizing the food environment: Pitfalls and future directions

PubMed Central

Vernez Moudon, Anne; Drewnowski, Adam; Duncan, Glen E; Hurvitz, Philip M; Saelens, Brian E; Scharnhorst, Eric

2014-01-01

Objective: To assess a county population’s exposure to different types of food sources reported to affect both diet quality and obesity rates. Design: Food permit records obtained from the local health department served to establish the full census of food stores and restaurants. Employing prior categorization schemes which classified the relative healthfulness of food sources based on establishment type (i.e. supermarkets versus convenience stores, or full-service versus fast food restaurants), food establishments were assigned to the healthy, unhealthy, or undetermined groups. Setting: King County, WA. Subjects: Full census of food sources. Results: According to all categorization schemes, most food establishments in King County fell into the unhealthy and undetermined groups. The use of the food permit data showed that large stores, which included supermarkets as healthy food establishments, contained a sizeable number of bakery/delis, fish/meat, ethnic and standard quick service restaurants, and coffee shops, all food sources that, when housed in a separate venue or owned by a different business establishment, were classified as either unhealthy or of undetermined value to health. Conclusions: To fully assess the potential health effects of exposure to the extant food environment, future research would need to establish the health value of foods in the many such common establishments as individually owned grocery stores and ethnic food stores and restaurants. Within- venue exposure to foods should also be investigated. PMID:23570695

Association of food environment and food retailers with obesity in US adults.

PubMed

Yan, Renfei; Bastian, Nathaniel D; Griffin, Paul M

2015-05-01

The food environment has been shown to be a factor affecting the obesity rate. We studied the association of density of food retailer type with obesity rate in U.S. adults in local regions controlling for socioeconomic factors. Parametric nonlinear regression was used on publically available data (year=2009) at the county level. We used the results of this association to estimate the impact of the addition of a new food retailer type in a geographic region. Obesity rate increased in supercenters (0.25-0.28%) and convenience stores (0.05%) and decreased in grocery stores (0.08%) and specialized food stores (0.27-0.36%). The marginal measures estimated in this work could be useful in identifying regions where interventions based on food retailer type would be most effective. Copyright © 2015 Elsevier Ltd. All rights reserved.

Retail Food Store Access in Rural Appalachia: A Mixed Methods Study.

PubMed

Thatcher, Esther; Johnson, Cassandra; Zenk, Shannon N; Kulbok, Pamela

2017-05-01

To describe how characteristics of food retail stores (potential access) and other factors influence self-reported food shopping behavior (realized food access) among low-income, rural Central Appalachian women. Cross-sectional descriptive. Potential access was assessed through store mapping and in-store food audits. Factors influencing consumers' realized access were assessed through in-depth interviews. Results were merged using a convergent parallel mixed methods approach. Food stores (n = 50) and adult women (n = 9) in a rural Central Appalachian county. Potential and realized food access were described across five dimensions: availability, accessibility, affordability, acceptability, and accommodation. Supermarkets had better availability of healthful foods, followed by grocery stores, dollar stores, and convenience stores. On average, participants lived within 10 miles of 3.9 supermarkets or grocery stores, and traveled 7.5 miles for major food shopping. Participants generally shopped at the closest store that met their expectations for food availability, price, service, and atmosphere. Participants' perceptions of stores diverged from each other and from in-store audit findings. Findings from this study can help public health nurses engage with communities to make affordable, healthy foods more accessible. Recommendations are made for educating low-income consumers and partnering with food stores. © 2016 Wiley Periodicals, Inc.

Grocery store interventions to change food purchasing behaviors: a systematic review of randomized controlled trials

PubMed Central

Hartmann-Boyce, Jamie; Bianchi, Filippo; Piernas, Carmen; Riches, Sarah Payne; Frie, Kerstin; Nourse, Rebecca; Jebb, Susan A

2018-01-01

ABSTRACT Background Diet is an important determinant of health, and food purchasing is a key antecedent to consumption. Objective We set out to evaluate the effectiveness of grocery store interventions to change food purchasing, and to examine whether effectiveness varied based on intervention components, setting, or socioeconomic status. Design We conducted a systematic review of randomized controlled trials (search performed June 2017). Studies must have: aimed to change food purchasing; been implemented in grocery stores (real or simulated); reported purchasing; and had a minimal control or compared interventions fulfilling our criteria. Searching, screening, bias assessment, and data extraction followed Cochrane methods. We grouped studies by intervention type (economic, environmental, swaps, and/or education), synthesized results narratively, and conducted an exploratory qualitative comparative analysis. Results We included 35 studies representing 89 interventions, >20,000 participants, and >800 stores. Risk of bias was mixed. Economic interventions showed the most promise, with 8 of the 9 studies in real stores and all 6 in simulated environments detecting an effect on purchasing. Swap interventions appeared promising in the 2 studies based in real stores. Store environment interventions showed mixed effects. Education-only interventions appeared effective in simulated environments but not in real stores. Available data suggested that effects of economic interventions did not differ by socioeconomic status, whereas for other interventions impact was variable. In our qualitative comparative analysis, economic interventions (regardless of setting) and environmental and swap interventions in real stores were associated with statistically significant changes in purchasing in the desired direction for ≥1 of the foods targeted by the intervention, whereas education-only interventions in real stores were not. Conclusions Findings suggest that interventions

Fruit and vegetable purchasing and the relative density of healthy and unhealthy food stores: evidence from an Australian multilevel study.

PubMed

Mason, Kate E; Bentley, Rebecca J; Kavanagh, Anne M

2013-03-01

Evidence of a relationship between residential retail food environments and diet-related outcomes is inconsistent. One reason for this may be that food environments are typically defined in terms of the absolute number of particular store types in an area, whereas a measure of the relative number of healthy and unhealthy stores may be more appropriate. Using cross-sectional data from the VicLANES study conducted in Melbourne, Australia, multilevel logistic regression analysis was used to estimate the independent associations between absolute measures (numbers of healthy and unhealthy stores) and a relative measure (relative density of healthy stores) of the food environment, and self-reported variety of fruit and vegetable purchasing in local households. Purchasing behaviour was measured as the odds of purchasing above the median level of fruit and vegetables. Compared to households in areas where healthy food stores made up no more than 10% of all healthy and unhealthy stores, households in areas with 10.1-15.0% healthy food stores and >15% healthy stores had increased odds of healthier purchasing (OR=1.48 (95% CI 1.12 to 1.96) and OR=1.45 (95% CI 1.09 to 1.91), respectively). There was less evidence of an association between absolute numbers of healthy or unhealthy stores and fruit and vegetable purchasing. We found strong evidence of healthier fruit and vegetable purchasing in households located in areas where the proportion of food stores that were healthy was greater. Policies aimed at improving the balance between healthy and unhealthy stores within areas may therefore be effective in promoting greater consumption of fruit and vegetables.

Evaluation of a pilot healthy eating intervention in restaurants and food stores of a rural community: a randomized community trial.

PubMed

Martínez-Donate, Ana P; Riggall, Ann Josie; Meinen, Amy M; Malecki, Kristen; Escaron, Anne L; Hall, Bev; Menzies, Anne; Garske, Gary; Nieto, F Javier; Nitzke, Susan

2015-02-12

Research suggests that the food environment influences individual eating practices. To date, little is known about effective interventions to improve the food environment of restaurants and food stores and promote healthy eating in rural communities. We tested "Waupaca Eating Smart " (WES), a pilot intervention to improve the food environment and promote healthy eating in restaurants and supermarkets of a rural community. WES focused on labeling, promoting, and increasing the availability of healthy foods. We conducted a randomized community trial, with two Midwestern U.S. communities randomly assigned to serve as intervention or control site. We collected process and outcome data using baseline and posttest owner and customer surveys and direct observation methods. The RE-AIM framework was used to guide the evaluation and organize the results. Seven of nine restaurants and two of three food stores invited to participate in WES adopted the intervention. On a 0-4 scale, the average level of satisfaction with WES was 3.14 (SD=0.69) for restaurant managers and 3 (SD=0.0) for store managers. On average, 6.3 (SD=1.1) out of 10 possible intervention activities were implemented in restaurants and 9.0 (SD=0.0) out of 12 possible activities were implemented in food stores. One month after the end of the pilot implementation period, 5.4 (SD=1.6) and 7.5 (SD=0.7) activities were still in place at restaurants and food stores, respectively. The intervention reached 60% of customers in participating food outlets. Restaurant food environment scores improved from 13.4 to 24.1 (p < 0.01) in the intervention community and did not change significantly in the control community. Food environment scores decreased slightly in both communities. No or minimal changes in customer behaviors were observed after a 10-month implementation period. The intervention achieved high levels of reach, adoption, implementation, and maintenance, suggesting the feasibility and acceptability of

7 CFR 278.2 - Participation of retail food stores.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 4 2014-01-01 2014-01-01 false Participation of retail food stores. 278.2 Section 278.2 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES...

Comparing Perception-Based and Geographic Information System (GIS)-based characterizations of the local food environment.

PubMed

Moore, Latetia V; Diez Roux, Ana V; Brines, Shannon

2008-03-01

Measuring features of the local food environment has been a major challenge in studying the effect of the environment on diet. This study examined associations between alternate ways of characterizing the local food environment by comparing Geographic Information System (GIS)-derived densities of various types of stores to perception-based measures of the availability of healthy foods. Survey questions rating the availability of produce and low-fat products in neighborhoods were aggregated into a healthy food availability score for 5,774 residents of North Carolina, Maryland, and New York. Densities of supermarkets and smaller stores per square mile were computed for 1 mile around each respondent's residence using kernel estimation. The number of different store types in the area was used to measure variety in the food environment. Linear regression was used to examine associations of store densities and variety with reported availability. Respondents living in areas with lower densities of supermarkets rated the selection and availability of produce and low-fat foods 17% lower than those in areas with the highest densities of supermarkets (95% CL, -18.8, -15.1). In areas without supermarkets, low densities of smaller stores and less store variety were associated with worse perceived availability of healthy foods only in North Carolina (8.8% lower availability, 95% CL, -13.8, -3.4 for lowest vs. highest small-store density; 10.5% lower 95% CL, -16.0, -4.7 for least vs. most store variety). In contrast, higher smaller store densities and more variety were associated with worse perceived healthy food availability in Maryland. Perception- and GIS-based characterizations of the environment are associated but are not identical. Combinations of different types of measures may yield more valid measures of the environment.

Brooklyn, New York foodscape 2007-2011: a five-year analysis of stability in food retail environments.

PubMed

Filomena, Susan; Scanlin, Kathleen; Morland, Kimberly B

2013-04-09

Food retail studies have focused on the availability of food stores, and on disparities in food access by neighborhood race and income level. Previous research does not address possible changes in local food environments over time, because little is known about the extent to which food environments fluctuate. Records of stores licensed to sell food with the New York State Department of Agriculture and Markets from 2007-2011 were compared to detect differences in the total number of food stores and supermarkets annually, as well as the total change for the five-year period. Food stores and supermarkets per 10,000 persons were also calculated. Food retail stability - how many individual food stores opened and closed - was also calculated for total stores and supermarkets. All results were stratified by income level and racial characteristics of 2000 Census Bureau census tracts. There was an overall increase in all food stores, as well as in supermarkets specifically. However, stability - the proportion of stores that remained open for five years - was greater in higher-wealth and predominantly white areas. Supermarkets remained open in greater proportion than total stores in all racial/ethnic and income areas, but areas with the highest wealth had the greatest supermarket stability. Those areas also had slightly more supermarkets per 10,000 persons, and had no permanent closures of supermarkets. The proportion of new store locations was similar between areas, but lowest-income areas had the greatest proportion of new supermarket locations. These data suggest that food retail environments change over short periods of time. Stability of food retail environments varies between neighborhoods by race and income. Fluctuations may need to be studied further to understand their impact on food behaviors and health of residents. Finally, the dynamic nature of food retail environments suggests opportunities for policymakers and community organizations to create programs that

Food venue choice, consumer food environment, but not food venue availability within daily travel patterns are associated with dietary intake among adults, Lexington Kentucky 2011.

PubMed

Gustafson, Alison; Christian, Jay W; Lewis, Sarah; Moore, Kate; Jilcott, Stephanie

2013-01-29

The retail food environment may be one important determinant of dietary intake. However, limited research focuses on individuals' food shopping behavior and activity within the retail food environment. This study's aims were to determine the association between six various dietary indicators and 1) food venue availability; 2) food venue choice and frequency; and 3) availability of healthy food within food venue. In Fall, 2011, a cross-sectional survey was conducted among adults (n=121) age 18 years and over in Lexington, Kentucky. Participants wore a global position system (GPS) data logger for 3-days (2 weekdays and 1 weekend day) to track their daily activity space, which was used to assess food activity space. They completed a survey to assess demographics, food shopping behaviors, and dietary outcomes. Food store audits were conducted using the Nutrition Environment Measurement Survey-Store Rudd (NEMS-S) in stores where respondents reported purchasing food (n=22). Multivariate logistic regression was used to examine associations between six dietary variables with food venue availability within activity space; food venue choice; frequency of shopping; and availability of food within food venue. 1) Food venue availability within activity space - no significant associations. 2) Food Venue Choice - Shopping at farmers' markets or specialty grocery stores reported higher odds of consuming fruits and vegetables (OR 1.60 95% CI [1.21, 2.79]). Frequency of shopping - Shopping at a farmers' markets and specialty stores at least once a week reported higher odds of consumption of fruits and vegetables (OR 1.55 95% CI [1.08, 2.23]). Yet, shopping frequently at a super market had higher odds of consuming sugar-sweetened beverages (OR 1.39 95% CI [1.03, 1.86]). 3) Availability of food within store - those who shop in supermarkets with high availability of healthy food has lower odds of consuming sugar-sweetened beverages (OR 0.65 95% CI [0.14, 0.83]). Interventions aimed at

Food marketing targeting youth and families: what do we know about stores where moms actually shop?

PubMed

Grigsby-Toussaint, Diana S; Rooney, Mary R

2013-01-01

Although efforts are underway to examine marketing that targets the youth and families in the retail food store environment, few studies have specifically focused on stores that families identify as their primary sites for food shopping. Between November 2011 and April 2012, we examined the frequency and types of marketing techniques of 114 packaged and nonpackaged items in 24 food stores that mothers of young children in Champaign County, IL, said they commonly frequented. Chi-square tests were used to determine whether significant differences existed between items with regard to marketing by store type, store food-assistance-program acceptance (i.e., WIC), and claims. Overall, stores accepting WIC and convenience stores had higher frequencies of marketing compared to non-WIC and grocery stores. Fruits and vegetables had the lowest frequency of any marketing claim, while salty snacks and soda had the highest frequency of marketing claims. Nutrition claims were the most common across all items, followed by taste, suggested use, fun, and convenience. Television tie-ins and cartoons were observed more often than movie tie-ins and giveaways. Our results suggest an opportunity to promote healthful items more efficiently by focusing efforts on stores where mothers actually shop.

Availability and Promotion of Healthful Foods in Stores and Restaurants ― Guam, 2015

PubMed Central

VanFrank, Brenna K.; Jackson, Sandra L.; Harmon, Brittani; Uncangco, Alyssa; Luces, Patrick; Dooyema, Carrie; Park, Sohyun

2017-01-01

Chronic disease, which is linked to unhealthy nutrition environments, is highly prevalent in Guam. The nutrition environment was assessed in 114 stores and 63 restaurants in Guam. Stores had limited availability of some healthier foods such as lean ground meat (7.5%) and 100% whole-wheat bread (11.4%), while fruits (81.0%) and vegetables (94.8%) were more commonly available; 43.7% of restaurants offered a healthy entrée or main dish salad, 4.1% provided calorie information, and 15.7% denoted healthier choices on menus. Improving the nutrition environment could help customers make healthier choices. PMID:28704176

The food environment and adult obesity in US metropolitan areas.

PubMed

Michimi, Akihiko; Wimberly, Michael C

2015-11-26

This research examines the larger-scale associations between obesity and food environments in metropolitan areas in the United States (US). The US Census County Business Patterns dataset for 2011 was used to construct various indices of food environments for selected metropolitan areas. The numbers of employees engaged in supermarkets, convenience stores, full service restaurants, fast food restaurants, and snack/coffee shops were standardised using the location quotients, and factor analysis was used to produce two uncorrelated factors measuring food environments. Data on obesity were obtained from the 2011 Behavioral Risk Factor Surveillance System. Individual level obesity measures were linked to the metropolitan area level food environment factors. Models were fitted using generalised estimating equations to control for metropolitan area level intra-correlation and individual level sociodemographic characteristics. It was found that adults residing in cities with a large share of supermarket and full-service restaurant workers were less likely to be obese, while adults residing in cities with a large share of convenience store and fast food restaurant workers were more likely to be obese. Supermarkets and full-service restaurant workers are concentrated in the Northeast and West of the US, where obesity prevalence is relatively lower, while convenience stores and fast-food restaurant workers are concentrated in the South and Midwest, where obesity prevalence is relatively higher. The food environment landscapes measured at the metropolitan area level explain the continental-scale patterns of obesity prevalence. The types of food that are readily available and widely served may translate into obesity disparities across metropolitan areas.

Healthy food availability in small urban food stores: a comparison of four US cities.

PubMed

Laska, Melissa Nelson; Borradaile, Kelley E; Tester, June; Foster, Gary D; Gittelsohn, Joel

2010-07-01

Given that small food stores may be important retail food sources in low-income urban communities, our objective was to examine cross-city comparative data documenting healthy food availability within such facilities, particularly those located in low-income areas and nearby schools. Food stores in Baltimore, Maryland; Minneapolis/St. Paul, Minnesota; Oakland, California; and Philadelphia, Pennsylvania were selected for assessment based on proximity to low-income schools. Stores were defined as: (i) single-aisle (n 45); (ii) small (2-5 aisles; n 52); and (iii) large (> or = 6 aisles; n 8). Staff conducted in-store audits to assess the presence/absence of twenty-eight healthy items, organized within five categories: (i) fresh fruits/vegetables, (ii) processed fruits/vegetables, (iii) healthy beverages/low-fat dairy, (iv) healthy snacks and (v) other healthy staple foods. The availability of healthy food items was low, particularly in single-aisle and small stores, and there was significant cross-site variability in the availability of healthy snacks (P < 0.0001) and other healthy staple foods (P < 0.0001). No cross-site differences existed for fruits/vegetables or healthy beverages/low-fat dairy availability. Healthy food availability scores increased significantly with store size for nearly all food/beverage categories (P < 0.01). Overall, healthy food availability in these venues was limited. Region-specific factors may be important to consider in understanding factors influencing healthy food availability in small urban markets. Data suggest that efforts to promote healthy diets in low-income communities may be compromised by a lack of available healthy foods. Interventions targeting small stores need to be developed and tailored for use in urban areas across the USA.

Beyond Neighborhood Food Environments: Distance Traveled to Food Establishments in 5 US Cities, 2009–2011

PubMed Central

Han, Bing; Cohen, Deborah A.

2015-01-01

Introduction Accurate conceptualizations of neighborhood environments are important in the design of policies and programs aiming to improve access to healthy food. Neighborhood environments are often defined by administrative units or buffers around points of interest. An individual may eat and shop for food within or outside these areas, which may not reflect accessibility of food establishments. This article examines the relevance of different definitions of food environments. Methods We collected data on trips to food establishments using a 1-week food and travel diary and global positioning system devices. Spatial-temporal clustering methods were applied to identify homes and food establishments visited by study participants. Results We identified 513 visits to food establishments (sit-down restaurants, fast-food/convenience stores, malls or stores, groceries/supermarkets) by 135 participants in 5 US cities. The average distance between the food establishments and homes was 2.6 miles (standard deviation, 3.7 miles). Only 34% of the visited food establishments were within participants’ neighborhood census tract. Buffers of 1 or 2 miles around the home covered 55% to 65% of visited food establishments. There was a significant difference in the mean distances to food establishments types (P = .008). On average, participants traveled the longest distances to restaurants and the shortest distances to groceries/supermarkets. Conclusion Many definitions of the neighborhood food environment are misaligned with individual travel patterns, which may help explain the mixed findings in studies of neighborhood food environments. Neighborhood environments defined by actual travel activity may provide more insight on how the food environment influences dietary and food shopping choices. PMID:26247426

An Urban Food Store Intervention Positively Affects Food-Related Psychosocial Variables and Food Behaviors

ERIC Educational Resources Information Center

Gittelsohn, Joel; Song, Hee-Jung; Suratkar, Sonali; Kumar, Mohan B.; Henry, Elizabeth G.; Sharma, Sangita; Mattingly, Megan; Anliker, Jean A.

2010-01-01

Obesity and other diet-related chronic diseases are more prevalent in low-income urban areas, which commonly have limited access to healthy foods. The authors implemented an intervention trial in nine food stores, including two supermarkets and seven corner stores, in a low-income, predominantly African American area of Baltimore City, with a…

The association between obesity and urban food environments.

PubMed

Bodor, J Nicholas; Rice, Janet C; Farley, Thomas A; Swalm, Chris M; Rose, Donald

2010-09-01

Several studies have examined associations between the food retail environment and obesity, though virtually no work has been done in the urban South, where obesity rates are among the highest in the country. This study assessed associations between access to food retail outlets and obesity in New Orleans. Data on individual characteristics and body weight were collected by telephone interviews from a random sample of adults (N = 3,925) living in New Orleans in 2004-2005. The neighborhood of each individual was geo-mapped by creating a 2-km buffer around the center point of the census tract in which they lived. Food retailer counts were created by summing the total number of each food store type and fast food establishment within this 2-km neighborhood. Hierarchical linear models assessed associations between access to food retailers and obesity status. After adjusting for individual characteristics, each additional supermarket in a respondent's neighborhood was associated with a reduced odds for obesity (OR 0.93, 95% CI 0.88-0.99). Fast food restaurant (OR 1.01, 95% CI 1.00-1.02) and convenience store (OR 1.01, 95% CI 1.00-1.02) access were each predictive of greater obesity odds. An individual's access to food stores and fast food restaurants may play a part in determining weight status. Future studies with longitudinal and experimental designs are needed to test whether modifications in the food environment may assist in the prevention of obesity.

Brooklyn, New York foodscape 2007–2011: a five-year analysis of stability in food retail environments

PubMed Central

2013-01-01

Background Food retail studies have focused on the availability of food stores, and on disparities in food access by neighborhood race and income level. Previous research does not address possible changes in local food environments over time, because little is known about the extent to which food environments fluctuate. Methods Records of stores licensed to sell food with the New York State Department of Agriculture and Markets from 2007–2011 were compared to detect differences in the total number of food stores and supermarkets annually, as well as the total change for the five-year period. Food stores and supermarkets per 10,000 persons were also calculated. Food retail stability – how many individual food stores opened and closed – was also calculated for total stores and supermarkets. All results were stratified by income level and racial characteristics of 2000 Census Bureau census tracts. Results There was an overall increase in all food stores, as well as in supermarkets specifically. However, stability – the proportion of stores that remained open for five years – was greater in higher-wealth and predominantly white areas. Supermarkets remained open in greater proportion than total stores in all racial/ethnic and income areas, but areas with the highest wealth had the greatest supermarket stability. Those areas also had slightly more supermarkets per 10,000 persons, and had no permanent closures of supermarkets. The proportion of new store locations was similar between areas, but lowest-income areas had the greatest proportion of new supermarket locations. Conclusions These data suggest that food retail environments change over short periods of time. Stability of food retail environments varies between neighborhoods by race and income. Fluctuations may need to be studied further to understand their impact on food behaviors and health of residents. Finally, the dynamic nature of food retail environments suggests opportunities for policymakers and

Food Store Choice Among Urban Slum Women Is Associated With Consumption of Energy-Dense Food.

PubMed

Anggraini, Roselynne; Februhartanty, Judhiastuty; Bardosono, Saptawati; Khusun, Helda; Worsley, Anthony

2016-07-01

The aim of this study was to examine the associations of food store choice with food consumption among urban slum women. A cross-sectional survey was carried out among 188 urban slum women (19-50 years old) in Jakarta, Indonesia. A semiquantitative food frequency questionnaire was used to assess food consumption. Associations between food consumption and food store choice were tested by linear regression. This study found that frequencies of buying food from small shops (warung), street food vendors, and modern food stores were significantly associated with consumption of snacks, mixed dishes, and fruit respectively. In addition, buying food from traditional markets and small cafes (warung makan) was not significantly associated with particular types of food consumption. As modern food stores are rarely utilized by these women, small shops (warung) and street food vendors are likely to be important channels to improve slum dwellers' diet. © 2016 APJPH.

7 CFR 278.9 - Implementation of amendments relating to the participation of retail food stores, wholesale food...

Code of Federal Regulations, 2013 CFR

2013-01-01

... participation of retail food stores, wholesale food concerns and insured financial institutions. 278.9 Section..., DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES... the participation of retail food stores, wholesale food concerns and insured financial institutions...

7 CFR 278.9 - Implementation of amendments relating to the participation of retail food stores, wholesale food...

Code of Federal Regulations, 2011 CFR

2011-01-01

... participation of retail food stores, wholesale food concerns and insured financial institutions. 278.9 Section..., DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES... the participation of retail food stores, wholesale food concerns and insured financial institutions...

7 CFR 278.9 - Implementation of amendments relating to the participation of retail food stores, wholesale food...

Code of Federal Regulations, 2014 CFR

2014-01-01

... participation of retail food stores, wholesale food concerns and insured financial institutions. 278.9 Section..., DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES... the participation of retail food stores, wholesale food concerns and insured financial institutions...

7 CFR 278.9 - Implementation of amendments relating to the participation of retail food stores, wholesale food...

Code of Federal Regulations, 2012 CFR

2012-01-01

... participation of retail food stores, wholesale food concerns and insured financial institutions. 278.9 Section..., DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES... the participation of retail food stores, wholesale food concerns and insured financial institutions...

Discrete Choice Model of Food Store Trips Using National Household Food Acquisition and Purchase Survey (FoodAPS).

PubMed

Hillier, Amy; Smith, Tony E; Whiteman, Eliza D; Chrisinger, Benjamin W

2017-09-27

Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and chronic disease. We analyzed data from the National Household Food Acquisition and Purchase Survey (FoodAPS) using a conditional logit model to determine where participants shop for food to be prepared and eaten at home and how individual and household characteristics of food shoppers interact with store characteristics and distance from home in determining store choice. Store size, whether or not it was a full-service supermarket, and the driving distance from home to the store constituted the three significant main effects on store choice. Overall, participants were more likely to choose larger stores, conventional supermarkets rather than super-centers and other types of stores, and stores closer to home. Interaction effects show that participants receiving Supplemental Nutrition Assistance Program (SNAP) were even more likely to choose larger stores. Hispanic participants were more likely than non-Hispanics to choose full-service supermarkets while White participants were more likely to travel further than non-Whites. This study demonstrates the value of explicitly spatial discrete choice models and provides evidence of national trends consistent with previous smaller, local studies.

Discrete Choice Model of Food Store Trips Using National Household Food Acquisition and Purchase Survey (FoodAPS)

PubMed Central

Hillier, Amy; Smith, Tony E.; Whiteman, Eliza D.

2017-01-01

Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and chronic disease. We analyzed data from the National Household Food Acquisition and Purchase Survey (FoodAPS) using a conditional logit model to determine where participants shop for food to be prepared and eaten at home and how individual and household characteristics of food shoppers interact with store characteristics and distance from home in determining store choice. Store size, whether or not it was a full-service supermarket, and the driving distance from home to the store constituted the three significant main effects on store choice. Overall, participants were more likely to choose larger stores, conventional supermarkets rather than super-centers and other types of stores, and stores closer to home. Interaction effects show that participants receiving Supplemental Nutrition Assistance Program (SNAP) were even more likely to choose larger stores. Hispanic participants were more likely than non-Hispanics to choose full-service supermarkets while White participants were more likely to travel further than non-Whites. This study demonstrates the value of explicitly spatial discrete choice models and provides evidence of national trends consistent with previous smaller, local studies. PMID:28953221

Food Marketing Targeting Youth and Families: What Do We Know about Stores Where Moms Actually Shop?

PubMed Central

Grigsby-Toussaint, Diana S.; Rooney, Mary R.

2013-01-01

Although efforts are underway to examine marketing that targets the youth and families in the retail food store environment, few studies have specifically focused on stores that families identify as their primary sites for food shopping. Between November 2011 and April 2012, we examined the frequency and types of marketing techniques of 114 packaged and nonpackaged items in 24 food stores that mothers of young children in Champaign County, IL, said they commonly frequented. Chi-square tests were used to determine whether significant differences existed between items with regard to marketing by store type, store food-assistance-program acceptance (i.e., WIC), and claims. Overall, stores accepting WIC and convenience stores had higher frequencies of marketing compared to non-WIC and grocery stores. Fruits and vegetables had the lowest frequency of any marketing claim, while salty snacks and soda had the highest frequency of marketing claims. Nutrition claims were the most common across all items, followed by taste, suggested use, fun, and convenience. Television tie-ins and cartoons were observed more often than movie tie-ins and giveaways. Our results suggest an opportunity to promote healthful items more efficiently by focusing efforts on stores where mothers actually shop. PMID:24163701

Associations between the local food environment and the severity of food insecurity among new families using community food security interventions in Montreal.

PubMed

Pérez, Elsury; Roncarolo, Federico; Potvin, Louise

2017-04-20

To examine the association between the local food environment and the severity of food insecurity among new families using community food security interventions in Montreal. In this cross-sectional study, we analyzed baseline data from 785 adults aged 18-65 years enrolled in the evaluation of the effects of organizations delivering community food security interventions in Montreal. The dependent variable was household food insecurity, while the independent variable was the local food environment, assessed through: location of the most frequently used grocery store, distance between the participant's residence and the community organization used, mode of transportation, walking time to the most frequently used grocery store, satisfaction with the acceptability and affordability of food available at the most frequently used grocery store, and self-reported difficulties in accessing food. We used polytomous logistic regression to estimate the association between household food insecurity and the local food environment. In all the models, we coded food security status in three categories: food security, moderate food insecurity and severe food insecurity. The last group was used as a reference group. Our data suggest that compared to households with severe food insecurity, those with moderate food insecurity (OR = 0.43, 95% CI: 0.28-0.62) and those with food security (OR = 0.13, 95% CI: 0.06-0.26) were less likely to report difficulties in accessing food due to food affordability. Food-secure households also had lower odds of reporting difficulties in accessing food due to transportation constraints (OR = 0.18, 95% CI: 0.06-0.55) compared with severe food-insecure households. Living a distance of between 1 and 2 km from the organization used was significantly correlated with moderate food insecurity (OR = 1.80, 95% CI: 1.12-2.88). The local food environment is associated with severity of household food insecurity among new families using community food security

Food venue choice, consumer food environment, but not food venue availability within daily travel patterns are associated with dietary intake among adults, Lexington Kentucky 2011

PubMed Central

2013-01-01

Objective The retail food environment may be one important determinant of dietary intake. However, limited research focuses on individuals’ food shopping behavior and activity within the retail food environment. This study’s aims were to determine the association between six various dietary indicators and 1) food venue availability; 2) food venue choice and frequency; and 3) availability of healthy food within food venue. Methods In Fall, 2011, a cross-sectional survey was conducted among adults (n=121) age 18 years and over in Lexington, Kentucky. Participants wore a global position system (GPS) data logger for 3-days (2 weekdays and 1 weekend day) to track their daily activity space, which was used to assess food activity space. They completed a survey to assess demographics, food shopping behaviors, and dietary outcomes. Food store audits were conducted using the Nutrition Environment Measurement Survey-Store Rudd (NEMS-S) in stores where respondents reported purchasing food (n=22). Multivariate logistic regression was used to examine associations between six dietary variables with food venue availability within activity space; food venue choice; frequency of shopping; and availability of food within food venue. Results 1) Food venue availability within activity space – no significant associations. 2) Food Venue Choice – Shopping at farmers’ markets or specialty grocery stores reported higher odds of consuming fruits and vegetables (OR 1.60 95% CI [1.21, 2.79]). Frequency of shopping - Shopping at a farmers’ markets and specialty stores at least once a week reported higher odds of consumption of fruits and vegetables (OR 1.55 95% CI [1.08, 2.23]). Yet, shopping frequently at a super market had higher odds of consuming sugar-sweetened beverages (OR 1.39 95% CI [1.03, 1.86]). 3) Availability of food within store – those who shop in supermarkets with high availability of healthy food has lower odds of consuming sugar-sweetened beverages (OR 0.65 95

Race and food store availability in an inner-city neighbourhood.

PubMed

Galvez, Maida P; Morland, Kimberly; Raines, Cherita; Kobil, Jessica; Siskind, Jodi; Godbold, James; Brenner, Barbara

2008-06-01

A growing body of research has shown that disparities in resources, including food stores, exist at the neighbourhood level and the greatest disparities are seen in minority neighbourhoods, the same neighbourhoods at increased risk of obesity and diabetes. Less is known about whether differences in availability of resources by African American or Latino race/ethnicity exist within a single minority community. The present study examined whether census blocks either 75% African American (AA) or 75% Latino (L) are associated with food store availability, as compared with racially mixed (RM) census blocks, in East Harlem, New York. A cross-sectional study utilising a walking survey of East Harlem was performed. Food stores were classified into: supermarkets, grocery stores, convenience stores, specialty stores, full-service restaurants and fast-food stores. One hundred and sixty-five East Harlem census blocks were examined; 17 were AA, 34 were L and 114 were RM. Of AA census blocks, 100% had neither supermarkets nor grocery stores. AA census blocks were less likely to have convenience stores (prevalence ratio (PR) = 0.25, 95% confidence interval (CI) 0.07-0.86) compared with RM census blocks. In contrast, predominantly L census blocks were more likely to have convenience stores (PR = 1.8, 95% CI 1.20-2.70), specialty food stores (PR = 3.74, 95% CI 2.06-7.15), full-service restaurants (PR = 1.87, 95% CI 1.04-3.38) and fast-food restaurants (PR = 2.14, 95% CI 1.33-3.44) compared with RM census blocks. We found that inequities in food store availability exist by race/ethnicity in East Harlem, New York. This has implications for racial/ethnic differences in dietary quality, obesity and obesity-related disorders.

Urban Latino Families' Food Built Environment and Young Children's Produce Consumption.

PubMed

Mathieu, Ne P; Sommer, Evan C; Mitchell, Stephanie J; Barkin, Shari L

2016-01-01

This study explored the association between objective and subjective ratings of the food environment and child produce consumption for Latino preschoolers at-risk for obesity. Parental surveys (N = 115) assessed perceptions of food availability, affordability, and acceptability. Comparable factors were objectively rated by a trained observer, using the Nutrition Environment Measures Survey for Stores (NEMS-S), in commonly frequented grocery stores cited by participants. There were no significant correlations between objective and subjective measures of food availability, affordability, and acceptability. Greater household income was associated with higher participant perceptions of food acceptability (r = .33, p = .003) and affordability (r = .22, p = .04). Participant-perceived affordability of food was correlated with more frequent child fruit and vegetable consumption (r = .21, p = .03). These findings support that parental subjective ratings of the food environment affects their child's eating behaviors more than objective ratings.

Distance to food stores & adolescent male fruit and vegetable consumption: mediation effects

USDA-ARS?s Scientific Manuscript database

The physical environments in which adolescents reside and their access to food stores may influence their consumption of fruit and vegetables. This association could either be direct or mediated via psychosocial variables or home availability of fruit and vegetables. A greater understanding of these...

Food environments of young people: linking individual behaviour to environmental context.

PubMed

Tyrrell, Rachel L; Greenhalgh, Fiona; Hodgson, Susan; Wills, Wendy J; Mathers, John C; Adamson, Ashley J; Lake, Amelia A

2017-03-01

We aimed to identify and characterize the food environments from which young people obtain food and to explore associations between the type of food environment and food intakes. Young people (n = 86, mean age 17 years; combined data of two sequential pilot studies (collected in 2008-09) and a study conducted in 2011-12) recorded in 4-day self-complete food diaries what food they consumed and where food was sourced. Nutrient, fruit and vegetable intake was calculated according to the source of food, categorized using a food environment classification tool. Over 4 days, respondents sourced food from an average of 4.3 different food environments. Home food was used daily and was more favourable in terms of nutrient profile than out-of-home food. Food sourced from specialist outlets, convenience stores and retail bakers had the highest energy density. Food from retail bakers and 'takeaway and fast food' outlets were the richest sources of fat while vending machines and convenience stores had the highest percentage of energy from sugar. This work provides details of 'where' young people obtain food and the nutritional consequences of choosing those food environments. While home food was a significant contributor to total dietary intake, food was obtained from a broad range of environments; particularly takeaway, fast food and education establishments. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Built Food Environment and Dietary Intake among African-American Adults

PubMed Central

Reitzel, Lorraine R.; Okamoto, Hiroe; Hernandez, Daphne C.; Regan, Seann D.; McNeill, Lorna H.; Obasi, Ezemenari M.

2016-01-01

Objectives The built food environment surrounding people's homes may influence their dietary intake. This exploratory study examined how the density of different sources of food in the residential environment was associated with dietary consumption among 77 African-American adults in Houston, Texas. Methods The number of fast-food-type restaurants, large grocery stores, and convenience-type stores within 2- and 5-mile residential buffers were divided by the respective areas to obtain food environment density variables. Intake of fruit and vegetables [FV], fiber [FI], and percent energy from fat [PEF] was assessed using National Health Interview Survey items. Covariate-adjusted regressions were used to assess relations of interest. Results Greater density of fast-food-type restaurants within 2 miles was associated with greater FV, FI, and PEF (ps ≤ .012); and for FV and FI within 5 miles (ps < .004). Density of large grocery stores was unrelated to intake. Greater density of convenience-type stores within 2 miles was negatively associated with FV and FI (ps ≤ .03); results became marginal at 5 miles for FV (p = .10) but not FI (p = .03). Conclusion Maximizing healthy offerings in venue-rich metropolitan areas might provide direction for policies to reduce obesity. PMID:26685808

Understanding differences in the local food environment across countries: A case study in Madrid (Spain) and Baltimore (USA).

PubMed

Díez, Julia; Bilal, Usama; Cebrecos, Alba; Buczynski, Amanda; Lawrence, Robert S; Glass, Thomas; Escobar, Francisco; Gittelsohn, Joel; Franco, Manuel

2016-08-01

Places where we buy food influence dietary patterns, making local food environments a good example of a mass influence on population diets. Cross-cultural studies, using reliable methods, may help understanding the relationship between food environments and diet-related health outcomes. We aimed to understand cross-national differences in the local food environment between Madrid and Baltimore by comparing an average neighborhood in each city in terms of food store types, healthy food availability, and residents' pedestrian access. During 2012-2013, we assessed one neighborhood (~15,000 residents) in each city selecting median areas in terms of socio-demographic characteristics (segregation, education, aging, and population density). We collected on-field data on (a) number and types of all food stores, (b) overall healthy food availability and (c) specific availability of fruits & vegetables. Throughout a street network analysis (200m, 400m and 800m) of food stores with high healthy food availability, we estimated residents' pedestrian accessibility. We found 40 stores in Madrid and 14 in Baltimore. Small food stores carrying fresh foods in Madrid contrasted with the high presence of corner and chain convenience stores in Baltimore. In Madrid, 77% of the residents lived within less than 200m from a food store with high healthy food availability. In contrast, 95% of Baltimore's residents lived further than 400m from these stores. Our results may help promoting interventions from local city agencies to allocate resources to existing small-sized food stores, and to improve walkable urban environments. These actions may influence food choices, especially for those residents lacking access to private vehicles. Copyright © 2016 Elsevier Inc. All rights reserved.

Obesity-promoting food environments and the spatial clustering of food outlets around schools.

PubMed

Day, Peter L; Pearce, Jamie

2011-02-01

The increasing prevalence of overweight and obesity in school-aged children is potentially linked to contextual influences such as the food environment around schools. The proximity of fast-food and convenience stores to schools may enhance access to unhealthy foods and have a negative impact on diet. This study used spatial cluster analysis to determine whether food outlets are clustered around schools and evaluated the extent of food outlet clustering by school and school neighborhood sociodemographic characteristics. The locations in 2008 of all schools, fast-food outlets, and convenience stores in five urban regions across New Zealand were geocoded. Using GIS analysis conducted in 2009, the number and proportion of outlets within 400-m and 800-m road distance around each school was calculated. The spatial clustering of food outlets within 1.5 km of schools was determined using a multi-type K-function. Food outlet type, school level, SES, the degree of population density, and commercial land use zoning around each school were compared. Primary/intermediate schools had a total proportion of 19.3 outlets per 1000 students within 800 m compared to 6.6 for secondary schools. The most socially deprived quintile of schools had three times the number and proportion of food outlets compared to the least-deprived quintile. There was a high degree of clustering of food outlets around schools, with up to 5.5 times more outlets than might be expected. Outlets were most clustered up to 800 m from schools and around secondary schools, socially deprived schools, and schools in densely populated and commercially zoned areas. Food environments in New Zealand within walking proximity to schools are characterized by a high density of fast-food outlets and convenience stores, particularly in more-socially deprived settings. These obesogenic environments provide ready access to obesity-promoting foods that may have a negative impact on student diet and contribute to inequalities in

Walkable home neighbourhood food environment and children's overweight and obesity: Proximity, density or price?

PubMed

Le, Ha; Engler-Stringer, Rachel; Muhajarine, Nazeem

2016-06-09

To identify characteristics of the food environment associated with child overweight/obesity that could, if subjected to intervention, mitigate the risk of childhood overweight/obesity. We examined whether the proximity to or density of grocery and convenience stores or fast food restaurants, or the prices of healthy food options were more strongly associated with overweight/obesity risk in children. We collected geocoded data by residential addresses for 1,469 children aged 10-14 years and conducted a census of all food outlets in Saskatoon. The Nutrition Environment Measures Survey (NEMS)-Stores and the NEMS-Restaurants were used to measure availability, quality and relative price of healthy food items in stores and restaurants. Children's weight status was calculated on the basis of measured height and weight. Logistic regression was used to test the associations between overweight/obesity and food environment variables. Within an 800 m walking distance from home, 76% of children did not have access to a grocery store; 58% and 32% had access to at least one convenience store or one fast-food restaurant respectively. A significantly lower odds of overweight/obesity was associated with lower price of healthy food items/options in grocery stores (odds ratio [OR] = 0.87, 95% confidence interval [CI] 0.77-0.99) and fast-food restaurants (OR = 0.97, 95% CI 0.95-0.99) within walking distance of home. Neither the distance to the closest food outlet nor the density of food outlets around children's homes was associated with odds of overweight/obesity. Improving economic access to healthy food in food outlets or fast-food restaurants is one strategy to counter childhood overweight/ obesity.

Healthy food availability and participation in WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) in food stores around lower- and higher-income elementary schools.

PubMed

Tester, June M; Yen, Irene H; Pallis, Lauren C; Laraia, Barbara A

2011-06-01

The nutritional intake of schoolchildren is affected not only by what is consumed at school but also by what is available in food outlets near schools. The present study surveys the range of food outlets around schools and examines how the availability of healthy food in the food stores encountered varies by income status of the school and by store participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food assistance programme. Network buffer zones were created to reflect a quarter-mile (400 m) walk from elementary schools with lower- and higher-income student populations in Oakland, CA, USA. All food outlets within these zones were categorised by type, and audits were conducted within food stores using a checklist to assess for the presence or absence of twenty-eight healthy items (in five domains). Mid-sized city in the USA. Food outlets near public elementary schools. There were considerably more food outlets around lower-income schools. Food stores near higher-income schools had higher scores in two of the five domains (healthy beverages/low-fat dairy and healthy snacks). However, there were more food stores near lower-income schools that accepted WIC vouchers. Stratification showed that WIC stores scored higher than non-WIC stores on four of the five domains. Although higher-income students have more access to healthy food in the environment surrounding their school, this disparity appears to be mitigated by stores that accept WIC and offer more healthy snacking options. Federal programmes such as this may be particularly valuable for children in lower-income areas.

Is there a robust relationship between neighbourhood food environment and childhood obesity in the USA?

PubMed

Shier, V; An, R; Sturm, R

2012-09-01

To examine the robustness of the relationship between neighbourhood food environment and youth body mass index (BMI) percentile using alternative measures of food environment and model specifications. Observational study using individual-level longitudinal survey data of children in fifth and eighth grades merged with food outlet data based on student residential census tracts. The relationship between food environment and BMI was examined with two individual outcomes (BMI percentile in eighth grade and change in BMI percentile from fifth to eighth grade) and three alternative measures of food environment (per-capita counts of a particular outlet type, food environment indices, and indicators for specific combinations of outlet types). No consistent evidence was found across measures (counts of a particular type of food outlet per population, food environment indices, and indicators for the presence of specific combinations of types of food stores) and outcomes to support the hypothesis that improved access to large supermarkets results in lower youth BMI; or that greater exposure to fast food restaurants, convenience stores and small food stores increases BMI. To the extent that there is an association between food environment and youth BMI, the existence of more types of food outlets in an area, including supermarkets, is associated with higher BMI. Copyright © 2012 The Royal Society for Public Health. All rights reserved.

The Rationale behind Small Food Store Interventions in Low-Income Urban Neighborhoods: Insights from New Orleans1–3

PubMed Central

Bodor, J. Nicholas; Ulmer, Vanessa M.; Futrell Dunaway, Lauren; Farley, Thomas A.; Rose, Donald

2010-01-01

Environmental approaches to the obesity problem in the US have garnered favor due to growing evidence that changes to the environment are at the root of the epidemic. Low-income urban neighborhoods, where obesity rates are disproportionately high, typically lack supermarkets yet have a high density of small food stores. This may increase the risk for unhealthy diets and obesity for neighborhood residents, because small stores carry mostly energy-dense foods and few fruits and vegetables. This paper pulls together various studies and pilot work conducted in New Orleans to explore the rationale behind small store interventions. Many low-income residents in New Orleans live within walking distance of small food stores and shop at them frequently. Marketing research has documented that changes to in-store shelf space and displays of specific foods affect the sales of these foods. Initiatives in New Orleans and elsewhere have demonstrated some success with improving healthy food availability in small stores, and an intercept survey of customers at small stores suggests that customers would purchase more fruits and vegetables if available. Efforts to encourage small store operators to offer a healthier mix of foods may, in the end, depend on the profitability of such changes. Evidence from a typical small store in New Orleans indicates that a greater percentage of gross profits come from snack foods and beverages than from fruits and vegetables. More research is needed to better understand the financial operations of small food stores and whether altering the mix of foods is economically feasible. PMID:20410086

Does transportation mode modify associations between distance to food store, fruit and vegetable consumption, and BMI in low-income neighborhoods?

PubMed

Fuller, Daniel; Cummins, Steven; Matthews, Stephen A

2013-01-01

A consistent body of research has shown that the neighborhood food environment is associated with fruit and vegetable (F&V) consumption and obesity in deprived neighborhoods in the United States. However, these studies have often neglected to consider how transportation can moderate associations between food accessibility and diet-related outcomes. This study examined associations between distance to primary food store, fruit and vegetable consumption, and BMI and whether mode of transportation to the primary food store moderates this relation. Cross-sectional data from the baseline wave of the Philadelphia Neighborhood Food Environment Study were used. A telephone survey of adult (≥18 y of age) household primary food shoppers residing in 2 Philadelphia neighborhoods was conducted (n = 1440). In a bivariate linear regression analysis, distance to primary food store did not predict F&V consumption (β = 0.04; 95% CI: -0.00, 0.09). Linear regression analysis stratified by transportation mode to the main F&V store showed no difference in F&V consumption between car, public, and multimodal transportation users. Compared with respondents using multimodal transportation, those using public transit had a significantly lower BMI (β = -1.31; 95% CI: -2.50, -0.10), whereas those using an automobile did not (β = -0.41; 95% CI: -1.36, 0.54). The assumption that using an automobile to access food stores results in increased F&V consumption was not confirmed. Significant associations were found for the relation between transportation mode and BMI. Theory-based mechanisms explaining relationships between the primary transportation mode used to access food stores and BMI should be further explored.

Availability of Foods and Beverages in Supplemental Nutrition Assistance Program-Authorized Dollar Stores in a Region of North Carolina.

PubMed

Racine, Elizabeth F; Batada, Ameena; Solomon, Corliss A; Story, Mary

2016-10-01

There are >25,000 Supplemental Nutrition Assistance Program (SNAP)-authorized dollar stores throughout the United States; many are located in lower-income neighborhoods and provide an accessible food and beverage source for area residents. The purpose of this research was to determine the percent of food deserts within 16 counties in North Carolina that include a SNAP dollar store; examine the types of foods and beverages at SNAP dollar stores in these counties; test whether the foods and beverages offered vary by SNAP dollar store chain; and test whether the foods and beverages available differ by rural and urban location. This cross-sectional study used a combination of publicly available data and primary data to investigate the research questions. Secondary data sources were obtained from the US Department of Agriculture's SNAP retailer locator, the US Census, and the US Department of Agriculture's Food Access Research Atlas. Availability of foods and beverages was assessed among a sample of 90 SNAP dollar stores in 16 counties in southern and western sections of North Carolina. Data were collected in June 2014. About half (52%) of the food deserts in the research area included a SNAP dollar store. Most of the sampled stores sold healthier food staples, such as frozen meats, brown rice, 100% whole-wheat bread, and dried beans. None of the stores sold fresh fruits or vegetables. Some of the foods and beverages offered (eg, frozen fruit, frozen unseasoned vegetables, nonfat or low-fat milk, frozen ground beef) varied by SNAP dollar store chain. The foods and beverages offered did not differ by rural or urban county location. SNAP dollar stores offer a number of healthy food staples; however, they do not sell fresh fruits or vegetables. Further food environment research should include dollar stores. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

7 CFR 278.6 - Disqualification of retail food stores and wholesale food concerns, and imposition of civil money...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 4 2013-01-01 2013-01-01 false Disqualification of retail food stores and wholesale..., DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES, WHOLESALE FOOD CONCERNS AND INSURED FINANCIAL INSTITUTIONS § 278.6 Disqualification of retail food stores...

A national study of the association between food environments and county-level health outcomes.

PubMed

Ahern, Melissa; Brown, Cheryl; Dukas, Stephen

2011-01-01

This national, county-level study examines the relationship between food availability and access, and health outcomes (mortality, diabetes, and obesity rates) in both metro and non-metro areas. This is a secondary, cross-sectional analysis using Food Environment Atlas and CDC data. Linear regression models estimate relationships between food availability and access variables (direct-to-consumer farm sales, per capita grocery stores, full-service restaurants, fast food restaurants, and convenience stores) with health outcomes. Controls include smoking, race/ethnicity, gender, age, education, poverty, primary care availability, recreational facility availability, and mobility/distance-from-grocery-store. Non-metro findings: Lower adjusted mortality rates were associated with more per capita full-service restaurants and grocery stores, and greater per capita direct farm sales. Lower adjusted diabetes rates were associated with a lower per capita supply of fast food restaurants and convenience stores, and more per capita full-service restaurants and grocery stores. Lower adjusted obesity rates were associated with more per capita full-service restaurants and grocery stores. Unexpectedly, obesity rates were positively associated with per capita grocery stores and negatively associated with fast food restaurants. Metro findings: More per capita full-service restaurants, grocery stores, and direct farm sales are associated with positive health outcomes; fast food restaurants and convenience stores are associated with negative health outcomes. The food access/availability environment is an important determinant of health outcomes in metro and non-metro areas. Future research should focus on more refined specifications that capture variability across non-metro settings. © 2011 National Rural Health Association.

Reliability of a Retail Food Store Survey and Development of an Accompanying Retail Scoring System to Communicate Survey Findings and Identify Vendors for Healthful Food and Marketing Initiatives

ERIC Educational Resources Information Center

Ghirardelli, Alyssa; Quinn, Valerie; Sugerman, Sharon

2011-01-01

Objective: To develop a retail grocery instrument with weighted scoring to be used as an indicator of the food environment. Participants/Setting: Twenty six retail food stores in low-income areas in California. Intervention: Observational. Main Outcome Measure(s): Inter-rater reliability for grocery store survey instrument. Description of store…

The food environment and student weight status, Los Angeles County, 2008-2009.

PubMed

Langellier, Brent A

2012-01-01

One factor believed to affect overweight status is the food environment, or the distribution of outlets that serve healthful or unhealthful foods in residential areas, workplaces, and schools. Few studies have investigated the association between the food environment and the prevalence of overweight among children and adolescents. The objective of this study was to investigate the association between the distribution of corner stores and fast food restaurants around Los Angeles County public schools and the prevalence of overweight among students. Hierarchical linear models were used to assess the association between the presence of corner stores or fast food restaurants within a half-mile of Los Angeles County schools (N = 1,694) and overweight prevalence among students in grades 5, 7, and 9. The presence of corner stores and fast food restaurants varied significantly by schools' racial/ethnic composition, Title 1 eligibility, and rural/suburban vs urban location. After adjustment for other factors, overweight prevalence was 1.6 percentage points higher at majority-Latino schools that had at least 1 corner store within a half-mile than at majority-Latino schools that did not have a corner store within a half-mile. The association between corner stores and overweight prevalence varied significantly between majority-Latino schools and schools that were majority-white or that had no racial/ethnic majority. The presence of fast food restaurants within a half-mile of schools was not associated with overweight prevalence among students. This study underscores the importance of interventions that seek to improve the healthfulness of corner store inventories and of student purchases.

Association between fast food purchasing and the local food environment.

PubMed

Thornton, Lukar E; Kavanagh, A M

2012-12-03

In this study, an instrument was created to measure the healthy and unhealthy characteristics of food environments and investigate associations between the whole of the food environment and fast food consumption. In consultation with other academic researchers in this field, food stores were categorised to either healthy or unhealthy and weighted (between +10 and -10) by their likely contribution to healthy/unhealthy eating practices. A healthy and unhealthy food environment score (FES) was created using these weightings. Using a cross-sectional study design, multilevel multinomial regression was used to estimate the effects of the whole food environment on the fast food purchasing habits of 2547 individuals. Respondents in areas with the highest tertile of the healthy FES had a lower likelihood of purchasing fast food both infrequently and frequently compared with respondents who never purchased, however only infrequent purchasing remained significant when simultaneously modelled with the unhealthy FES (odds ratio (OR) 0.52; 95% confidence interval (CI) 0.32-0.83). Although a lower likelihood of frequent fast food purchasing was also associated with living in the highest tertile of the unhealthy FES, no association remained once the healthy FES was included in the models. In our binary models, respondents living in areas with a higher unhealthy FES than healthy FES were more likely to purchase fast food infrequently (OR 1.35; 95% CI 1.00-1.82) however no association was found for frequent purchasing. Our study provides some evidence to suggest that healthier food environments may discourage fast food purchasing.

Association between fast food purchasing and the local food environment

PubMed Central

Thornton, Lukar E; Kavanagh, A M

2012-01-01

Objective: In this study, an instrument was created to measure the healthy and unhealthy characteristics of food environments and investigate associations between the whole of the food environment and fast food consumption. Design and subjects: In consultation with other academic researchers in this field, food stores were categorised to either healthy or unhealthy and weighted (between +10 and −10) by their likely contribution to healthy/unhealthy eating practices. A healthy and unhealthy food environment score (FES) was created using these weightings. Using a cross-sectional study design, multilevel multinomial regression was used to estimate the effects of the whole food environment on the fast food purchasing habits of 2547 individuals. Results: Respondents in areas with the highest tertile of the healthy FES had a lower likelihood of purchasing fast food both infrequently and frequently compared with respondents who never purchased, however only infrequent purchasing remained significant when simultaneously modelled with the unhealthy FES (odds ratio (OR) 0.52; 95% confidence interval (CI) 0.32–0.83). Although a lower likelihood of frequent fast food purchasing was also associated with living in the highest tertile of the unhealthy FES, no association remained once the healthy FES was included in the models. In our binary models, respondents living in areas with a higher unhealthy FES than healthy FES were more likely to purchase fast food infrequently (OR 1.35; 95% CI 1.00–1.82) however no association was found for frequent purchasing. Conclusion: Our study provides some evidence to suggest that healthier food environments may discourage fast food purchasing. PMID:23208414

Qualitative study of influences on food store choice

PubMed Central

Krukowski, Rebecca A.; McSweeney, Jean; Sparks, Carla; West, Delia Smith

2012-01-01

Previous research indicates food store choice influences dietary intake and may contribute to health disparities. However, there is limited knowledge about the reasons which prompt the choice of a primary food store, particularly among populations vulnerable to obesity and chronic diseases (e.g., individuals living in rural locations and African-Americans). Purposive sampling was used to select rural and urban communities (3 African-American and 2 Caucasian focus groups; n=48) in Arkansas from June to November 2010, allowing examination of potential racial or rurality differences. Primary household food shoppers (n=48) (96% female, 63% African-American, mean age=48.1±13.9 years old, mean BMI=30.5±7.8) discussed reasons for choosing their primary store. Qualitative analysis techniques—content analysis and constant comparison—were used to identify themes. Four themes emerged: proximity to home or work, financial considerations and strategies, availability/quality of fruits, vegetables, and meat, and store characteristics (e.g., safety, cleanliness/smell, customer service, nonfood merchandise availability, and brand availability). While there were persistent rurality differences, the relevant factors were similar between African-American and Caucasian participants. These findings have important implications for future policies and programs promoting environmental changes related to dietary intake and obesity, particularly in rural areas that appear to have significant challenges in food store choice. PMID:22771756

7 CFR 278.7 - Determination and disposition of claims-retail food stores and wholesale food concerns.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Determination and disposition of claims-retail food... PROGRAM PARTICIPATION OF RETAIL FOOD STORES, WHOLESALE FOOD CONCERNS AND INSURED FINANCIAL INSTITUTIONS § 278.7 Determination and disposition of claims—retail food stores and wholesale food concerns. (a...

7 CFR 278.7 - Determination and disposition of claims-retail food stores and wholesale food concerns.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 4 2013-01-01 2013-01-01 false Determination and disposition of claims-retail food... PROGRAM PARTICIPATION OF RETAIL FOOD STORES, WHOLESALE FOOD CONCERNS AND INSURED FINANCIAL INSTITUTIONS § 278.7 Determination and disposition of claims—retail food stores and wholesale food concerns. (a...

7 CFR 278.7 - Determination and disposition of claims-retail food stores and wholesale food concerns.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 4 2014-01-01 2014-01-01 false Determination and disposition of claims-retail food... PROGRAM PARTICIPATION OF RETAIL FOOD STORES, WHOLESALE FOOD CONCERNS AND INSURED FINANCIAL INSTITUTIONS § 278.7 Determination and disposition of claims—retail food stores and wholesale food concerns. (a...

7 CFR 278.7 - Determination and disposition of claims-retail food stores and wholesale food concerns.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 4 2012-01-01 2012-01-01 false Determination and disposition of claims-retail food... PROGRAM PARTICIPATION OF RETAIL FOOD STORES, WHOLESALE FOOD CONCERNS AND INSURED FINANCIAL INSTITUTIONS § 278.7 Determination and disposition of claims—retail food stores and wholesale food concerns. (a...

Who is behind the stocking of energy-dense foods and beverages in small stores? The importance of food and beverage distributors.

PubMed

Ayala, Guadalupe X; D'Angelo, Heather; Gittelsohn, Joel; Horton, Lucy; Ribisl, Kurt; Sindberg, Lesley Schmidt; Olson, Christina; Kharmats, Anna; Laska, Melissa N

2017-12-01

The present study examined food and beverage distributors' sourcing, placement and promotion of obesogenic (energy-dense, nutrient-poor) product categories from the perspective of small food store owners/managers. The obesogenic product categories of interest were savoury snacks, sugary beverages, sweet snacks, confectionery and frozen treats. Specifically, we examined how frequently distributors sourced these products, and the types of agreements and expectations they had for their placement and promotion. Differences were explored by store size and ethnicity. Fresh produce was used as a comparison when examining differences in frequency of sourcing only, with implications for healthy food access. Survey research involving in-person interviews. Four urban areas in the USA: Baltimore, MD; Durham, NC; Minneapolis/St. Paul, MN; and San Diego, CA. Seventy-two small food store owners/managers, 65 % consent rate. Most distributors sourced obesogenic products weekly. Agreements to place products were predominantly informal (e.g. handshake) with sweet snack, confectionery and frozen treat distributors, and formal (e.g. contract) with savoury snack and sugary beverage distributors. Free-standing displays were the most common incentive provided by distributors and they expected some control over their placement and pricing. Free/discounted products and signage were also common incentives but slotting fees were not. Smaller stores and ethnic stores were less likely to receive various incentives, but among sweet snack distributors, they were more likely to control the price in ethnic v. non-ethnic stores. Obesogenic products are ubiquitous. Influencing what is made available to consumers in the retail food environment needs to consider the distributor.

Development, reliability and use of a food environment assessment tool in supermarkets of four neighbourhoods in Montréal, Canada.

PubMed

Jalbert-Arsenault, Élise; Robitaille, Éric; Paquette, Marie-Claude

2017-09-01

The food environment is a promising arena in which to influence people's dietary habits. This study aimed to develop a comprehensive food environment assessment tool for businesses and characterize the food environment of a low-tomedium income area of Montréal, Canada. We developed a tool, Mesure de l'environnement alimentaire du consommateur dans les supermarchés (MEAC-S), and tested it for reliability. We used the MEAC-S to assess the consumer food environment of 17 supermarkets in four neighbourhoods of Montréal. We measured the shelf length, variety, price, display counts and in-store positions of fruits and vegetables (FV) and ultra-processed food products (UPFPs). We also assessed fresh FV for quality. Store size was estimated using the total measured shelf length for all food categories. We conducted Spearman correlations between these indicators of the food environment. Reliability analyses revealed satisfactory results for most indicators. Characterization of the food environment revealed high variability in shelf length, variety and price of FV between supermarkets and suggested a disproportionate promotion of UPFPs. Display counts of UPFPs outside their normal display location ranged from 7 to 26, and they occupied 8 to 33 strategic in-store positions, whereas the number of display counts of fresh FV outside their normal display location exceeded 1 in only 2 of the 17 stores surveyed, and they occupied a maximum of 2 strategic in-store positions per supermarket. Price of UPFPs was inversely associated with their prominence (p < .005) and promotion (p < .003). Store size was associated with display counts and strategic in-store positioning of UPFPs (p < .001), but not FV, and was inversely associated with the price of soft drinks (p < .003). This study illustrates the variability of the food environment between supermarkets and underscores the importance of measuring in-store characteristics to adequately picture the consumer food environment.

There's more to food store choice than proximity: a questionnaire development study.

PubMed

Krukowski, Rebecca A; Sparks, Carla; DiCarlo, Marisha; McSweeney, Jean; West, Delia Smith

2013-06-17

Proximity of food stores is associated with dietary intake and obesity; however, individuals frequently shop at stores that are not the most proximal. Little is known about other factors that influence food store choice. The current research describes the development of the Food Store Selection Questionnaire (FSSQ) and describes preliminary results of field testing the questionnaire. Development of the FSSQ involved a multidisciplinary literature review, qualitative analysis of focus group transcripts, and expert and community reviews. Field testing consisted of 100 primary household food shoppers (93% female, 64% African American), in rural and urban Arkansas communities, rating FSSQ items as to their importance in store choice and indicating their top two reasons. After eliminating 14 items due to low mean importance scores and high correlations with other items, the final FSSQ questionnaire consists of 49 items. Items rated highest in importance were: meat freshness; store maintenance; store cleanliness; meat varieties; and store safety. Items most commonly rated as top reasons were: low prices; proximity to home; fruit/vegetable freshness; fruit/vegetable variety; and store cleanliness. The FSSQ is a comprehensive questionnaire for detailing key reasons in food store choice. Although proximity to home was a consideration for participants, there were clearly other key factors in their choice of a food store. Understanding the relative importance of these different dimensions driving food store choice in specific communities may be beneficial in informing policies and programs designed to support healthy dietary intake and obesity prevention.

Microwave Heating as an Alternative Quarantine Method for Disinfestation of Stored Food Grains

PubMed Central

Kumar, Girish; Shah, Narendra G.

2013-01-01

Insects and pests constitute a major threat to food supplies all over the world. Some estimates put the loss of food grains because of infestation to about 40% of the world production. Contemporary disinfestation methods are chemical fumigation, ionizing radiation, controlled atmosphere, conventional hot air treatment, and dielectric heating, that is, radio frequency and microwave energy, and so forth. Though chemical fumigation is being used extensively in stored food grains, regulatory issues, insect resistance, and environmental concerns demand technically effective and environmentally sound quarantine methods. Recent studies have indicated that microwave treatment is a potential means of replacing other techniques because of selective heating, pollution free environment, equivalent or better quality retention, energy minimization, and so forth. The current paper reviews the recent advances in Microwave (MW) disinfestation of stored food products and its principle and experimental results from previous studies in order to establish the usefulness of this technology. PMID:26904615

Spatial-Temporal Modeling of Neighborhood Sociodemographic Characteristics and Food Stores

PubMed Central

Lamichhane, Archana P.; Warren, Joshua L.; Peterson, Marc; Rummo, Pasquale; Gordon-Larsen, Penny

2015-01-01

The literature on food stores, neighborhood poverty, and race/ethnicity is mixed and lacks methods of accounting for complex spatial and temporal clustering of food resources. We used quarterly data on supermarket and convenience store locations from Nielsen TDLinx (Nielsen Holdings N.V., New York, New York) spanning 7 years (2006–2012) and census tract-based neighborhood sociodemographic data from the American Community Survey (2006–2010) to assess associations between neighborhood sociodemographic characteristics and food store distributions in the Metropolitan Statistical Areas (MSAs) of 4 US cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and San Francisco, California). We fitted a space-time Poisson regression model that accounted for the complex spatial-temporal correlation structure of store locations by introducing space-time random effects in an intrinsic conditionally autoregressive model within a Bayesian framework. After accounting for census tract–level area, population, their interaction, and spatial and temporal variability, census tract poverty was significantly and positively associated with increasing expected numbers of supermarkets among tracts in all 4 MSAs. A similar positive association was observed for convenience stores in Birmingham, Minneapolis, and San Francisco; in Chicago, a positive association was observed only for predominantly white and predominantly black tracts. Our findings suggest a positive association between greater numbers of food stores and higher neighborhood poverty, with implications for policy approaches related to food store access by neighborhood poverty. PMID:25515169

The influence of the WIC food package changes on the retail food environment in New Orleans.

PubMed

Rose, Donald; O'Malley, Keelia; Dunaway, Lauren Futrell; Bodor, J Nicholas

2014-01-01

To examine the effect of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package changes on availability of healthy foods in small stores. Pre-post comparison group design with repeat in-store observations. New Orleans. Small stores (n = 102; 77% of total) were visited in 2009. Of these, 91% were observed again in 2010, including both WIC (n = 27) and non-WIC (n = 66) stores. The 2009 WIC food package changes to include healthier foods. Change in store availability of fruits, vegetables, lower-fat milks, whole wheat bread, and brown rice. Change in number of varieties and shelf length of fruits and vegetables. Difference-in-differences analysis using logit models for change in availability and regression models for change in number of varieties or shelf length. The WIC stores were more likely to improve availability of lower-fat milks than non-WIC stores (adjusted odds ratio, 5.0, 95% confidence interval, 1.2-21.0). An even greater relative improvement was seen with whole grains. The WIC stores showed a relative increase in number of varieties of fresh fruits (0.9 ± 0.3; P < .01) and shelf length of vegetables (1.2 ± 0.4 meters; P < .01). Results suggest that WIC changes improved the availability of healthy foods in small stores in New Orleans. Similar changes throughout the country could have a significant impact on neighborhood food environments. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

7 CFR 278.9 - Implementation of amendments relating to the participation of retail food stores, wholesale food...

Code of Federal Regulations, 2010 CFR

2010-01-01

... participation of retail food stores, wholesale food concerns and insured financial institutions. 278.9 Section 278.9 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PARTICIPATION OF RETAIL FOOD STORES...

Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally.

PubMed

Ni Mhurchu, C; Vandevijvere, S; Waterlander, W; Thornton, L E; Kelly, B; Cameron, A J; Snowdon, W; Swinburn, B

2013-10-01

Retail food environments are increasingly considered influential in determining dietary behaviours and health outcomes. We reviewed the available evidence on associations between community (type, availability and accessibility of food outlets) and consumer (product availability, prices, promotions and nutritional quality within stores) food environments and dietary outcomes in order to develop an evidence-based framework for monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in retail food environments. Current evidence is suggestive of an association between community and consumer food environments and dietary outcomes; however, substantial heterogeneity in study designs, methods and measurement tools makes it difficult to draw firm conclusions. The use of standardized tools to monitor local food environments within and across countries may help to validate this relationship. We propose a step-wise framework to monitor and benchmark community and consumer retail food environments that can be used to assess density of healthy and unhealthy food outlets; measure proximity of healthy and unhealthy food outlets to homes/schools; evaluate availability of healthy and unhealthy foods in-store; compare food environments over time and between regions and countries; evaluate compliance with local policies, guidelines or voluntary codes of practice; and determine the impact of changes to retail food environments on health outcomes, such as obesity. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

The nutrient content of US household food purchases by store types

PubMed Central

Stern, Dalia; Ng, Shu Wen; Popkin, Barry M

2015-01-01

Introduction Little is known about where households shop for packaged foods, what foods and beverages they purchase, and the nutrient content of these purchases. The objectives are to describe volume trends and nutrient content (food groups and nutrient profiles) of household packaged foods purchases (PFP) by store-type. Methods Cross-sectional analysis of US households’ food purchases (Nielsen Homescan) from 2000 to 2012 (n=652,023 household-year observations) with survey weights used for national representativeness. Household PFP trends (% volume) by store-type, household purchases of key food and beverage groups based on caloric contribution by store-type, and mean caloric and nutrient densities (sugars, saturated fat and sodium) of household PFP by store-type are analyzed. Data were collected from 2000–2012. Analyses were conducted in 2014–2015. Results The proportion of total volume of household PFP significantly increased from 2000 to 2012 for mass-merchandisers (13.1 to 23.9%), convenience-stores (3.6 to 5.9%) and warehouse-club (6.2 to 9.8%), and significantly decreased for grocery-chains (58.5 to 46.3%) and non-chain grocerys (10.3 to 5.2%). Top common sources of calories (%) from household PFP by food/beverage group include: savory snacks, grain-based desserts and regular soft-drinks. The energy, total sugar, sodium and saturated fat densities of household PFP from mass-merchandisers, warehouse-club and convenience-stores were higher, compared to grocery-stores. Conclusions PFP from stores with poorer nutrient density (more energy, total sugar, sodium and saturated fat-dense), such as warehouse-club, mass-merchandisers and convenience-stores are growing, representing a potential US public health concern. PMID:26437868

The Local Food Environment and Body Mass Index among the Urban Poor in Accra, Ghana.

PubMed

Dake, Fidelia A A; Thompson, Amanda L; Ng, Shu Wen; Agyei-Mensah, Samuel; Codjoe, Samuel N A

2016-06-01

Obesity in the sub-Saharan Africa region has been portrayed as a problem of affluence, partly because obesity has been found to be more common in urban areas and among the rich. Recent findings, however, reveal rising prevalence among the poor particularly the urban poor. A growing body of literature mostly in Western countries shows that obesity among the poor is partly the result of an obesogenic-built environment. Such studies are lacking in the African context. This study examines the characteristics of the local food environment in an urban poor setting in Accra, Ghana and further investigates the associated risk of obesity for residents. Data on the local food environment was collected using geographic positioning system (GPS) technology. The body mass indices (BMI) of females (15-49 years) and males (15-59 years) were calculated from measured weight and height. Data on the socio-demographic characteristics and lifestyle behaviors of respondents was also collected through a household survey. Spatial analysis tools were used to examine the characteristics of the local food environment while the influence of the food environment on BMI was examined using a two-level multilevel model. The measures of the food environment constituted the level 2 factors while individual socio-demographic characteristics and lifestyle behaviors constituted the level 1 factors. The local food environment in the study communities is suggestive of an obesogenic food environment characterized by an abundance of out-of-home cooked foods, convenience stores, and limited fruits and vegetables options. The results of the multilevel analysis reveal a 0.2 kg/m(2) increase in BMI for every additional convenience store and a 0.1 kg/m(2) reduction in BMI for every out-of-home cooked food place available in the study area after controlling for individual socio-demographic characteristics, lifestyle behaviors, and community characteristics. The findings of this study indicate that the local

The impact of parameters of store illumination on food shopper response.

PubMed

Berčík, Jakub; Horská, Elena; Wang, Regina W Y; Chen, Ying-Chun

2016-11-01

Customer behavior in sales areas is strongly influenced by the perception of surroundings and feelings of well-being. By using dynamic retail solutions of basic, accent and dramatic lighting it is possible to attract attention, create a unique in-store environment and give customers a reason to stay and return to the store. The simplest and also the most successful method to reach customer attention in food selection (buying) process is through eye-catchingly illuminated visuals of products. Visual senses has evolved to top ranks in the sensory hierarchy, therefore visual stimuli have a tendency to overcome all other senses. The paper deals with a comprehensive interdisciplinary research of the influence of light and color on the emotional state of consumers (valence) on the food market. It integrates the measurement of light intensity, color temperature or emitted color spectrum in grocery stores, recognition of emotional response and the time of its occurrence among respondents due to different lighting types and color in simulated laboratory conditions. The research is focused on accent lighting in the segment of fresh unpackaged food. Using a mobile 16-channel electroencephalograph (EEG equipment) from EPOC company and a mini camera we observed the response time and the emotional status (valence), in order to reveal true consumer preferences in different lighting conditions (color temperature and color rendering index) and their non-traditional color (yellow, purple, red, blue and green) for the selected food type. The paper suggests possibilities for rational combination of the effective, efficient and energy-saving accent lighting, by which the retailer can achieve not only an eye-catching and attractive presentation of merchandised products, but also significant savings within operating their stores. Copyright © 2016 Elsevier Ltd. All rights reserved.

Neighbourhood food environment and gestational diabetes in New York City.

PubMed

Janevic, Teresa; Borrell, Luisa N; Savitz, David A; Herring, Amy H; Rundle, Andrew

2010-05-01

The association between neighbourhood characteristics and gestational diabetes has not been examined previously. We investigated the relationship between the number of healthy food outlets (supermarkets; fruit/vegetable and natural food stores), and unhealthy food outlets (fast food; pizza; bodegas; bakeries; convenience, candy/nut and meat stores) in census tract of residence, and gestational diabetes in New York City. Gestational diabetes, census tract and individual-level covariates were ascertained from linked birth-hospital data for 210 926 singleton births from 2001 to 2002 and linked to commercial data on retail food outlets. Adjusted odds ratios (aOR) were estimated using a multilevel logistic model. No association between food environment measures and gestational diabetes was found, with aORs ranging from 0.95 to 1.04. However, an increased odds of pre-pregnancy weight >200 lbs for women living in a given neighbourhood with no healthy food outlets [aOR = 1.14, 95% CI 1.07, 1.21] or only one healthy food place [aOR = 1.10, 95% CI 1.04, 1.18] relative to two or more healthy food outlets was found. Due to probable misclassification of neighbourhood food environment and pre-pregnancy obesity results are likely to be biased towards the null. Future research, including validity studies, on the neighbourhood food environment, obesity during pregnancy and gestational diabetes is warranted.

Exploring the Role of the Food Environment on Food Shopping Patterns in Philadelphia, PA, USA: A Semiquantitative Comparison of Two Matched Neighborhood Groups

PubMed Central

Hirsch, Jana A.; Hillier, Amy

2013-01-01

Increasing research has focused on the built food environment and nutrition-related outcomes, yet what constitutes a food environment and how this environment influences individual behavior still remain unclear. This study assesses whether travel mode and distance to food shopping venues differ among individuals in varying food environments and whether individual- and household-level factors are associated with food shopping patterns. Fifty neighbors who share a traditionally defined food environment (25 in an unfavorable environment and 25 in a favorable environment) were surveyed using a mix of close- and open-ended survey questions. Food shopping patterns were mapped using Geographic Information Systems (GIS). Stores visited were beyond the 0.5-mile (805 meters) radius traditionally used to represent the extent of an individual’s food environment in an urban area. We found no significant difference in shopping frequency or motivating factor behind store choice between the groups. No differences existed between the two groups for big food shopping trips. For small trips, individuals in the favorable food environment traveled shorter distances and were more likely to walk than drive. Socioeconomic status, including car ownership, education, and income influenced distance traveled. These findings highlight the complexities involved in the study and measurement of food environments. PMID:23343984

Exploring the role of the food environment on food shopping patterns in Philadelphia, PA, USA: a semiquantitative comparison of two matched neighborhood groups.

PubMed

Hirsch, Jana A; Hillier, Amy

2013-01-14

Increasing research has focused on the built food environment and nutrition-related outcomes, yet what constitutes a food environment and how this environment influences individual behavior still remain unclear. This study assesses whether travel mode and distance to food shopping venues differ among individuals in varying food environments and whether individual- and household-level factors are associated with food shopping patterns. Fifty neighbors who share a traditionally defined food environment (25 in an unfavorable environment and 25 in a favorable environment) were surveyed using a mix of close- and open-ended survey questions. Food shopping patterns were mapped using Geographic Information Systems (GIS). Stores visited were beyond the 0.5-mile (805 meters) radius traditionally used to represent the extent of an individual's food environment in an urban area. We found no significant difference in shopping frequency or motivating factor behind store choice between the groups. No differences existed between the two groups for big food shopping trips. For small trips, individuals in the favorable food environment traveled shorter distances and were more likely to walk than drive. Socioeconomic status, including car ownership, education, and income influenced distance traveled. These findings highlight the complexities involved in the study and measurement of food environments.

Food at checkouts in non-food stores: a cross-sectional study of a large indoor shopping mall.

PubMed

Wright, James; Kamp, Erin; White, Martin; Adams, Jean; Sowden, Sarah

2015-10-01

To investigate the display of food at non-food store checkouts; and to classify foods by type and nutrient content, presence of price promotions and whether food was at child height. Cross-sectional survey of checkout displays at non-food stores. Foods were classified as 'less healthy' or healthier using the UK Food Standards Agency's Nutrient Profile Model. Written price promotions were recorded. Child height was defined as the sight line of an 11-year-old approximated from UK growth charts. A large indoor shopping mall, Gateshead, UK, February-March 2014. Two hundred and five out of 219 non-food stores in the shopping mall directory which were open for trading. Thirty-two (15·6%) of 205 non-food stores displayed food at the checkout. All displayed less healthy foods, and fourteen (43·8%) had healthier foods. Overall, 5911 checkout foods were identified. Of these, 4763 (80·6%) were 'less healthy'. No fruits, vegetables, nuts or seeds were found. Of 4763 less healthy foods displayed, 195 (4·1%) were subject to price promotions, compared with twelve of 1148 (1·0%) healthier foods (χ 2(df=1)=25·4, P<0·0001). There was no difference in the proportion of less healthy (95·1%) and healthier (96·2%) foods displayed at child height. Almost one-sixth of non-food stores displayed checkout food, the majority of which was 'less healthy' and displayed at child height. Less healthy food was more likely to be subject to a written price promotion than healthier food. Further research into the drivers and consequences of checkout food in non-food stores is needed. Public health regulation may be warranted.

Development, reliability and use of a food environment assessment tool in supermarkets of four neighbourhoods in Montréal, Canada

PubMed Central

Élise, Jalbert-Arsenault; Éric, Robitaille; Marie-Claude, Paquette

2017-01-01

Abstract Introduction: The food environment is a promising arena in which to influence people’s dietary habits. This study aimed to develop a comprehensive food environment assessment tool for businesses and characterize the food environment of a low-tomedium income area of Montréal, Canada. Methods: We developed a tool, Mesure de l’environnement alimentaire du consommateur dans les supermarchés (MEAC-S), and tested it for reliability. We used the MEAC-S to assess the consumer food environment of 17 supermarkets in four neighbourhoods of Montréal. We measured the shelf length, variety, price, display counts and in-store positions of fruits and vegetables (FV) and ultra-processed food products (UPFPs). We also assessed fresh FV for quality. Store size was estimated using the total measured shelf length for all food categories. We conducted Spearman correlations between these indicators of the food environment. Results: Reliability analyses revealed satisfactory results for most indicators. Characterization of the food environment revealed high variability in shelf length, variety and price of FV between supermarkets and suggested a disproportionate promotion of UPFPs. Display counts of UPFPs outside their normal display location ranged from 7 to 26, and they occupied 8 to 33 strategic in-store positions, whereas the number of display counts of fresh FV outside their normal display location exceeded 1 in only 2 of the 17 stores surveyed, and they occupied a maximum of 2 strategic in-store positions per supermarket. Price of UPFPs was inversely associated with their prominence (p < .005) and promotion (p < .003). Store size was associated with display counts and strategic in-store positioning of UPFPs (p < .001), but not FV, and was inversely associated with the price of soft drinks (p < .003). Conclusion: This study illustrates the variability of the food environment between supermarkets and underscores the importance of measuring in-store characteristics to

Shopping for fruits and vegetables. Food and retail qualities of importance to low-income households at the grocery store.

PubMed

Webber, Caroline B; Sobal, Jeffery; Dollahite, Jamie S

2010-04-01

Purchasing fruits and vegetables is an integral part of managing food consumption and dietary quality. This study examined how low-income adults who had primary responsibility for household food purchases considered retail produce decisions. We used a qualitative research approach based on grounded theory and an ecological conceptual framework. Twenty-eight low-income rural, village, and inner city heads of households in upstate New York, USA, were selected by purposive and theoretical sampling and interviewed about fruit and vegetable shopping habits, attitudes toward local food stores, and where and how they would prefer to buy produce. Analyses revealed their concerns were organized around five themes: store venue; internal store environment; product quality; product price; relationships with the stores. An unanticipated finding was the differing social relations that appear to exist between participant consumers, store employees and management, and the store itself as a representation of the larger retail food system. Attitudes toward retail food stores in this study are described as passive or fatalistic indifference, supportive, opportunistic, and confrontational (change agents). These attitudes are related to how shoppers considered retail fruit and vegetable choice, access, and availability. These findings suggest ways to individualize nutrition education and consumer education messages. Copyright 2009 Elsevier Ltd. All rights reserved.

Spatial-temporal modeling of neighborhood sociodemographic characteristics and food stores.

PubMed

Lamichhane, Archana P; Warren, Joshua L; Peterson, Marc; Rummo, Pasquale; Gordon-Larsen, Penny

2015-01-15

The literature on food stores, neighborhood poverty, and race/ethnicity is mixed and lacks methods of accounting for complex spatial and temporal clustering of food resources. We used quarterly data on supermarket and convenience store locations from Nielsen TDLinx (Nielsen Holdings N.V., New York, New York) spanning 7 years (2006-2012) and census tract-based neighborhood sociodemographic data from the American Community Survey (2006-2010) to assess associations between neighborhood sociodemographic characteristics and food store distributions in the Metropolitan Statistical Areas (MSAs) of 4 US cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and San Francisco, California). We fitted a space-time Poisson regression model that accounted for the complex spatial-temporal correlation structure of store locations by introducing space-time random effects in an intrinsic conditionally autoregressive model within a Bayesian framework. After accounting for census tract-level area, population, their interaction, and spatial and temporal variability, census tract poverty was significantly and positively associated with increasing expected numbers of supermarkets among tracts in all 4 MSAs. A similar positive association was observed for convenience stores in Birmingham, Minneapolis, and San Francisco; in Chicago, a positive association was observed only for predominantly white and predominantly black tracts. Our findings suggest a positive association between greater numbers of food stores and higher neighborhood poverty, with implications for policy approaches related to food store access by neighborhood poverty. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Food-purchasing patterns for home: a grocery store-intercept survey.

PubMed

Yoo, Sunmi; Baranowski, Tom; Missaghian, Mariam; Baranowski, Janice; Cullen, Karen; Fisher, Jennifer O; Watson, Kathy; Zakeri, Issa F; Nicklas, Theresa

2006-05-01

To identify the most common frequency of food-purchasing patterns and relate this pattern to characteristics of individuals and families. A customer-intercept survey was conducted in the greater Houston area, Texas, USA, in 2002. The frequency of food shopping at supermarkets, convenience stores and restaurants to buy food for eating at home was assessed. A total of 823 adults (78.5% female; mean age 37.4 years) who went to any of several grocery or convenience stores, including European, Hispanic and African Americans, and Asian/Pacific Islanders. Major food-shopping patterns were a weekly big trip with a few small trips (34.9%), biweekly big trips with a few small trips (21.9%), no big shopping trips (15.4%), a weekly big trip without small trips (13.9%), a monthly big trip (8.3%), and biweekly big trips without small trips (6.4%). While 61.1% of participants never went to convenience stores to buy fruit and vegetables (F&V) for eating at home, 67% went to restaurants for F&V. African American families shopped for food least frequently, while Asian American families shopped for food most frequently. Educational level was negatively associated with the use of convenience stores and positively associated with take-away from restaurants. There is substantial variability in the frequency of food shopping. Future research on food shopping should incorporate this variable.

Chemical Effects in Food Stored at Room Temperature.

ERIC Educational Resources Information Center

Karel, Marcus

1984-01-01

Nonenzymatic browning and lipid oxidation, two important chemical deteriorative mechanisms, are discussed. The first is the major cause of darkening of concentrated and dehydrated stored foods and is also the cause of various cooked and stale flavors in food. The second is the major cause of rancidity in foods. (JN)

There’s more to food store choice than proximity: a questionnaire development study

PubMed Central

2013-01-01

Background Proximity of food stores is associated with dietary intake and obesity; however, individuals frequently shop at stores that are not the most proximal. Little is known about other factors that influence food store choice. The current research describes the development of the Food Store Selection Questionnaire (FSSQ) and describes preliminary results of field testing the questionnaire. Methods Development of the FSSQ involved a multidisciplinary literature review, qualitative analysis of focus group transcripts, and expert and community reviews. Field testing consisted of 100 primary household food shoppers (93% female, 64% African American), in rural and urban Arkansas communities, rating FSSQ items as to their importance in store choice and indicating their top two reasons. After eliminating 14 items due to low mean importance scores and high correlations with other items, the final FSSQ questionnaire consists of 49 items. Results Items rated highest in importance were: meat freshness; store maintenance; store cleanliness; meat varieties; and store safety. Items most commonly rated as top reasons were: low prices; proximity to home; fruit/vegetable freshness; fruit/vegetable variety; and store cleanliness. Conclusions The FSSQ is a comprehensive questionnaire for detailing key reasons in food store choice. Although proximity to home was a consideration for participants, there were clearly other key factors in their choice of a food store. Understanding the relative importance of these different dimensions driving food store choice in specific communities may be beneficial in informing policies and programs designed to support healthy dietary intake and obesity prevention. PMID:23773428

Relation between local food environments and obesity among adults

PubMed Central

Spence, John C; Cutumisu, Nicoleta; Edwards, Joy; Raine, Kim D; Smoyer-Tomic, Karen

2009-01-01

Background Outside of the United States, evidence for associations between exposure to fast-food establishments and risk for obesity among adults is limited and equivocal. The purposes of this study were to investigate whether the relative availability of different types of food retailers around people's homes was associated with obesity among adults in Edmonton, Canada, and if this association varied as a function of distance between food locations and people's homes. Methods Data from a population health survey of 2900 adults (18 years or older) conducted in 2002 was linked with geographic measures of access to food retailers. Based upon a ratio of the number of fast-food restaurants and convenience stores to supermarkets and specialty food stores, a Retail Food Environment Index (RFEI) was calculated for 800 m and 1600 m buffers around people's homes. In a series of logistic regressions, associations between the RFEI and the level of obesity among adults were examined. Results The median RFEI for adults in Edmonton was 4.00 within an 800 m buffer around their residence and 6.46 within a 1600 m buffer around their residence. Approximately 14% of the respondents were classified as being obese. The odds of a resident being obese were significantly lower (OR = 0.75, 95%CI 0.59 – 0.95) if they lived in an area with the lowest RFEI (below 3.0) in comparison to the highest RFEI (5.0 and above). These associations existed regardless of the covariates included in the model. No significant associations were observed between RFEI within a 1600 m buffer of the home and obesity. Conclusion The lower the ratio of fast-food restaurants and convenience stores to grocery stores and produce vendors near people's homes, the lower the odds of being obese. Thus the proximity of the obesogenic environment to individuals appears to be an important factor in their risk for obesity. PMID:19538709

Neighbourhood and consumer food environment is associated with dietary intake among Supplemental Nutrition Assistance Program (SNAP) participants in Fayette County, Kentucky.

PubMed

Gustafson, Alison; Lewis, Sarah; Perkins, Sarah; Wilson, Corey; Buckner, Elizabeth; Vail, Ann

2013-07-01

The aim of the study was to determine the association between dietary outcomes and the neighbourhood food environment (street network distance from home to stores) and consumer food environment (Nutrition Environment Measurement Survey-Stores (NEMS-S) audit). The neighbourhood food environment was captured by creating 0?5-mile and 1-mile network distance (street distance) around each participant’s home and the nearest food venue (convenience store, grocery store, supermarket, farmers’ market and produce stand). The consumer food environment was captured by conducting NEMS-S in all grocery stores/supermarkets within 0?5 and 1 mile of participants’ homes. Fayette County, KY, USA. Supplemental Nutrition Assessment Program (SNAP) participants, n 147. SNAP participants who lived within 0?5 mile of at least one farmers’ market/produce stand had higher odds of consuming one serving or more of vegetables (OR56?92; 95% CI 4?09, 11?69), five servings or more of grains (OR51?76; 95% CI 1?01, 3?05) and one serving or more of milk (OR53?79; 95% CI 2?14, 6?71) on a daily basis. SNAP participants who lived within 0?5 mile of stores receiving a high score on the NEMS-S audit reported higher odds of consuming at least one serving of vegetables daily (OR53?07; 95% CI 1?78, 5?31). Taken together, both the neighbourhood food environment and the consumer food environment are associated with a healthy dietary intake among SNAP participants.

Estimating population food and nutrient exposure: a comparison of store survey data with household panel food purchases.

PubMed

Eyles, Helen; Neal, Bruce; Jiang, Yannan; Ni Mhurchu, Cliona

2016-05-28

Population exposure to food and nutrients can be estimated from household food purchases, but store surveys of foods and their composition are more available, less costly and might provide similar information. Our aim was to compare estimates of nutrient exposure from a store survey of packaged food with those from household panel food purchases. A cross-sectional store survey of all packaged foods for sale in two major supermarkets was undertaken in Auckland, New Zealand, between February and May 2012. Longitudinal household food purchase data (November 2011 to October 2012) were obtained from the nationally representative, population-weighted New Zealand Nielsen HomeScan® panel. Data on 8440 packaged food and non-alcoholic beverage products were collected in the store survey. Food purchase data were available for 1229 households and 16 812 products. Store survey data alone produced higher estimates of exposure to Na and sugar compared with estimates from household panel food purchases. The estimated mean difference in exposure to Na was 94 (95 % CI 72, 115) mg/100 g (20 % relative difference; P<0·01), to sugar 1·6 (95 % CI 0·8, 2·5) g/100 g (11 %; P<0·01), to SFA -0·3 (95 % CI -0·8, 0·3) g/100 g (6 %; P=0·3) and to energy -18 (-71, 35) kJ/100 g (2 %; P=0·51). Compared with household panel food purchases, store survey data provided a reasonable estimate of average population exposure to key nutrients from packaged foods. However, caution should be exercised in using such data to estimate population exposure to Na and sugar and in generalising these findings to other countries, as well as over time.

Associations between children's diets and features of their residential and school neighbourhood food environments.

PubMed

Van Hulst, Andraea; Barnett, Tracie A; Gauvin, Lise; Daniel, Mark; Kestens, Yan; Bird, Madeleine; Gray-Donald, Katherine; Lambert, Marie

2012-07-26

Among studies of the built environment, few examine neighbourhood food environments in relation to children's diets. We examined the associations of residential and school neighbourhood access to different types of food establishments with children's diets. Data from QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), an ongoing study on the natural history of obesity in 630 Quebec youth aged 8-10 years with a parental history of obesity, were analyzed (n=512). Three 24-hour diet recalls were used to assess dietary intake of vegetables and fruit, and sugar-sweetened beverages. Questionnaires were used to determine the frequency of eating/snacking out and consumption of delivered/take-out foods. We characterized residential and school neighbourhood food environments by means of a Geographic Information System. Variables included distance to the nearest supermarket, fast-food restaurant and convenience store, and densities of each food establishment type computed for 1 km network buffers around each child's residence and school. Retail Food Environment indices were also computed. Multivariable logistic regressions (residential access) and generalized estimating equations (school access) were used for analysis. Residential and school neighbourhood access to supermarkets was not associated with children's diets. Residing in neighbourhoods with lower access to fast-food restaurants and convenience stores was associated with a lower likelihood of eating and snacking out. Children attending schools in neighbourhoods with a higher number of unhealthful relative to healthful food establishments scored most poorly on dietary outcomes. Further investigations are needed to inform policies aimed at shaping neighbourhood-level food purchasing opportunities, particularly for access to fast-food restaurants and convenience stores.

Inter-rater reliability of a food store checklist to assess availability of healthier alternatives to the energy-dense snacks and beverages commonly consumed by children.

PubMed

Izumi, Betty T; Findholt, Nancy E; Pickus, Hayley A; Nguyen, Thuan; Cuneo, Monica K

2014-06-01

Food stores have gained attention as potential intervention targets for improving children's eating habits. There is a need for valid and reliable instruments to evaluate changes in food store snack and beverage availability secondary to intervention. The aim of this study was to develop a valid, reliable, and resource-efficient instrument to evaluate the healthfulness of food store environments faced by children. The SNACZ food store checklist was developed to assess availability of healthier alternatives to the energy-dense snacks and beverages commonly consumed by children. After pretesting, two trained observers independently assessed the availability of 48 snack and beverage items in 50 food stores located near elementary and middle schools in Portland, Oregon, over a 2-week period in summer 2012. Inter-rater reliability was calculated using the kappa statistic. Overall, the instrument had mostly high inter-rater reliability. Seventy-three percent of items assessed had almost perfect or substantial reliability. Two items had moderate reliability (0.41-0.60), and no items had a reliability score less than 0.41. Eleven items occurred too infrequently to generate a kappa score. The SNACZ food store checklist is a first-step toward developing a valid and reliable tool to evaluate the healthfulness of food store environments faced by children. The tool can be used to compare availability of healthier snack and beverage alternatives across communities and measure change secondary to intervention. As a wider variety of healthier snack and beverage alternatives become available in food stores, the checklist should be updated.

Creating healthy food and eating environments: policy and environmental approaches.

PubMed

Story, Mary; Kaphingst, Karen M; Robinson-O'Brien, Ramona; Glanz, Karen

2008-01-01

Food and eating environments likely contribute to the increasing epidemic of obesity and chronic diseases, over and above individual factors such as knowledge, skills, and motivation. Environmental and policy interventions may be among the most effective strategies for creating population-wide improvements in eating. This review describes an ecological framework for conceptualizing the many food environments and conditions that influence food choices, with an emphasis on current knowledge regarding the home, child care, school, work site, retail store, and restaurant settings. Important issues of disparities in food access for low-income and minority groups and macrolevel issues are also reviewed. The status of measurement and evaluation of nutrition environments and the need for action to improve health are highlighted.

If you stock it, will they buy it? Healthy food availability and customer purchasing behaviour within corner stores in Hartford, CT, USA.

PubMed

Martin, Katie S; Havens, Erin; Boyle, Katie E; Matthews, Gregory; Schilling, Elizabeth A; Harel, Ofer; Ferris, Ann M

2012-10-01

Literature on food environments has expanded rapidly, yet most research focuses on stores and community characteristics without integrating customer-level data. The present study combines customer shopping behaviour with store food inventory data. Face-to-face interviews were conducted with customers shopping in corner stores to measure food shopping behaviour, household food security and demographics. Store inventories were conducted to measure availability of healthy food in corner stores. Multilevel logistic regression models estimated the probability of customers purchasing a food item given the availability of that item in the store. Nineteen corner stores in Hartford, CT, USA, average size 669 ft(2) (62.15 m(2)). Sample of 372 customers. The majority of customers were Black or Hispanic (54 % and 40 %, respectively) and 61 % experienced food insecurity. For each additional type of fruits or vegetables available in the store, the estimated odds of a customer purchasing fruits increased by 12 % (P = 0.03) and the odds for purchasing vegetables increased by 15 % (P = 0.01). Customers receiving the Supplemental Nutrition Assistance Program (SNAP) were 1.7 times as likely to purchase fruit as those not receiving SNAP (P = 0.04). Greater availability of reduced-fat milk was not associated with increased likelihood of customers purchasing reduced-fat milk. There is a positive association between fruit and vegetable variety and the probability that a customer purchases fruits and vegetables. Increasing the selection of produce in corner stores may increase their consumption by food-insecure and low-income residents at risk for health disparities. These findings have implications for future store interventions and food policies.

Feasibility of increasing access to healthy foods in neighborhood corner stores.

PubMed

O'Malley, Keelia; Gustat, Jeanette; Rice, Janet; Johnson, Carolyn C

2013-08-01

The feasibility of working with neighborhood corner stores to increase the availability of fresh fruit and vegetables in low-income neighborhoods in New Orleans was assessed. Household interviews and 24-hour dietary recalls (n = 97), corner store customer intercept interviews (n = 60) and interviews with corner store operators (owners/managers) (n = 12) were conducted in three neighborhoods without supermarkets. Regional produce wholesalers were contacted by phone. Results indicated that the majority of neighborhood residents use supermarkets or super stores as their primary food source. Those who did shop at corner stores typically purchased prepared foods and/or beverages making up nearly one third of their daily energy intake. Most individuals would be likely to purchase fresh fruit and vegetables from the corner stores if these foods were offered. Store operators identified cost, infrastructure and lack of customer demand as major barriers to stocking more fresh produce. Produce wholesalers did not see much business opportunity in supplying fresh produce to neighborhood corner stores on a small scale. Increasing availability of fresh fruit and vegetables in corner stores may be more feasible with the addition of systems changes that provide incentives and make it easier for neighborhood corner stores to stock and sell fresh produce.

Obesity and the community food environment: a systematic review.

PubMed

Holsten, Joanna E

2009-03-01

To examine the relationship between obesity and the community and/or consumer food environment. A comprehensive literature search of multiple databases was conducted and seven studies were identified for review. Studies were selected if they measured BMI and environmental variables related to food outlets. Environmental variables included the geographic arrangement of food stores or restaurants in communities and consumer conditions such as food price and availability within each outlet. The study designs, methods, limitations and results related to obesity and the food environment were reviewed, and implications for future research were synthesized. The reviewed studies used cross-sectional designs to examine the community food environment defined as the number per capita, proximity or density of food outlets. Most studies indirectly identified food outlets through large databases. The studies varied substantially in sample populations, outcome variables, units of measurement and data analysis. Two studies did not find any significant association between obesity rates and community food environment variables. Five studies found significant results. Many of the studies were subject to limitations that may have mitigated the validity of the results. Research examining obesity and the community or consumer food environment is at an early stage. The most pertinent gaps include primary data at the individual level, direct measures of the environment, studies examining the consumer environment and study designs involving a time sequence. Future research should directly measure multiple levels of the food environment and key confounders at the individual level.

Community food environment measures in the Alabama Black Belt: Implications for cancer risk reduction

PubMed Central

Gyawu, Rebecca; Quansah, Joseph E.; Fall, Souleymane; Gichuhi, Peter N.; Bovell-Benjamin, Adelia C.

2015-01-01

In-store measures were utilized to evaluate the availability of healthy food choices and nutrition/health promotion messages for cancer risk reduction in the selected Alabama Black Belt counties/cities. Sixty one retail food outlets (RFOs) were audited in 12 Alabama Black Belt cities. Store types included convenience stores (49.2%), restaurants (19.7%), fast food restaurants (16.4%), small supermarkets (8.2%), and large supermarket and farmers' markets (3.3 %), respectively. Although there were low numbers of farmers' markets/street stands and large supermarkets, these had significantly (p < 0.0001) higher health scores than the other store types. A few health promotion messages were highly visible or obscurely positioned in some RFOs. The Alabama Black Belt food environment had limited opportunities for healthy food choices. PMID:26844138

Retail food environments research in Canada: A scoping review.

PubMed

Minaker, Leia M; Shuh, Alanna; Olstad, Dana L; Engler-Stringer, Rachel; Black, Jennifer L; Mah, Catherine L

2016-06-09

The field of retail food environments research is relatively new in Canada. The objective of this scoping review is to provide an overview of retail food environments research conducted before July 2015 in Canada. Specifically, this review describes research foci and key findings, identifies knowledge gaps and suggests future directions for research. A search of published literature concerning Canadian investigations of retail food environment settings (food stores, restaurants) was conducted in July 2015 using PubMed, Web of Science, Scopus, PsychInfo and ERIC. Studies published in English that reported qualitative or quantitative data on any aspect of the retail food environment were included, as were conceptual papers and commentaries. Eighty-eight studies were included in this review and suggest that the field of retail food environments research is rapidly expanding in Canada. While only 1 paper was published before 2005, 66 papers were published between 2010 and 2015. Canadian food environments research typically assessed either the socio-economic patterning of food environments (n = 28) or associations between retail food environments and diet, anthropometric or health outcomes (n = 33). Other papers profiled methodological research, qualitative studies, intervention research and critical commentaries (n = 27). Key gaps in the current literature include measurement inconsistency among studies and a lack of longitudinal and intervention studies. Retail food environments are a growing topic of research, policy and program development in Canada. Consistent methods (where appropriate), longitudinal and intervention research, and close partnerships between researchers and key stakeholders would greatly advance the field of retail food environments research in Canada.

Childhood Obesity and Neighborhood Food Store Availability in an Inner City Community

PubMed Central

Galvez, Maida P.; Hong, Lu; Choi, Elizabeth; Liao, Laura; Godbold, James; Brenner, Barbara

2009-01-01

Background Prior studies have shown an association between fast food restaurants and adolescent body size. Less is known about the influence of neighborhood food stores on a child's body size. We hypothesized that in the inner-city, minority community of East Harlem, New York, the presence of convenience stores and fast food restaurants near a child's home is associated with increased risk for childhood obesity as measured by body mass index (BMI). Design/Methods Baseline data of 6-8 year old East Harlem boys and girls (n=323) were utilized. Anthropometry (height and weight) were conducted with a standardized protocol. Food store data were collected via a walking survey. Stores located within the same Census block as the child's home address were identified using ArcGIS 8.3. We computed age- and sex-specific BMI-percentiles using CDC national norms. Using odds ratios, we estimated risk of a child's BMI-percentile being in the top tertile based on number and types of food stores on their Census blocks. Results Convenience stores were present in 55% of the surveyed blocks in which a study participant lived, and fast food restaurants were present in 41%. Children (n=177) living on a block with one or more convenience stores (range 1-6) were more likely to have a BMI-percentile in the top tertile (odds ratio 1.90, 95% CI 1.15-3.15), compared with children having no convenience stores (n=146). Conclusions The presence of convenience stores near a child's residence was associated with a higher BMI-percentile. This has potential implications for both child and neighborhood level childhood obesity interventions. PMID:19560992

CENTRAL FOOD STORE FACILITIES FOR COLLEGES AND UNIVERSITIES.

ERIC Educational Resources Information Center

BLOOMFIELD, BYRON C.

INSPECTION OF A NUMBER OF INSTALLATIONS WAS ORIENTED TOWARD ARCHITECTURAL AND PLANNING QUESTIONS INVOLVING ECONOMICS AND SERVICES OF CENTRAL FOOD STORE FACILITIES. COMMENCING WITH THE PURCHASING PHILOSOPHY WHICH OVERVIEWS THE ORGANIZATION OF FOODS PURCHASING, SELECTION OF PERSONNEL, SPECIFICATIONS FOR PURCHASING, TECHNIQUES FOR PURCHASING, AND…

Healthy versus Unhealthy Suppliers in Food Desert Neighborhoods: A Network Analysis of Corner Stores' Food Supplier Networks.

PubMed

Mui, Yeeli; Lee, Bruce Y; Adam, Atif; Kharmats, Anna Y; Budd, Nadine; Nau, Claudia; Gittelsohn, Joel

2015-11-30

Products in corner stores may be affected by the network of suppliers from which storeowners procure food and beverages. To date, this supplier network has not been well characterized. Using network analysis, we examined the connections between corner stores (n = 24) in food deserts of Baltimore City (MD, USA) and their food/beverage suppliers (n = 42), to determine how different store and supplier characteristics correlated. Food and beverage suppliers fell into two categories: Those providing primarily healthy foods/beverages (n = 15) in the healthy supplier network (HSN) and those providing primarily unhealthy food/beverages (n = 41) in the unhealthy supplier network (UHSN). Corner store connections to suppliers in the UHSN were nearly two times greater (t = 5.23, p < 0.001), and key suppliers in the UHSN core were more diverse, compared to the HSN. The UHSN was significantly more cohesive and densely connected, with corner stores sharing a greater number of the same unhealthy suppliers, compared to HSN, which was less cohesive and sparsely connected (t = 5.82; p < 0.001). Compared to African Americans, Asian and Hispanic corner storeowners had on average -1.53 (p < 0.001) fewer connections to suppliers in the HSN (p < 0.001). Our findings indicate clear differences between corner stores' HSN and UHSN. Addressing ethnic/cultural differences of storeowners may also be important to consider.

Understanding interactions with the food environment: an exploration of supermarket food shopping routines in deprived neighbourhoods.

PubMed

Thompson, Claire; Cummins, Steven; Brown, Tim; Kyle, Rosemary

2013-01-01

Despite a sustained academic interest in the environmental determinants of diet, relatively little is known about the ways in which individuals interact with their neighbourhood food environment and the use of its most important element, the supermarket. This qualitative study explores how residents of deprived neighbourhoods shop for food and how the supermarket environment influences their choices. Go-along interviews were conducted with 26 residents of Sandwell, a uniformly deprived metropolitan borough in the West Midlands, UK. Routine approaches to food shopping are characterised in terms of planning and reliance on the supermarket environment. Four distinct routines are identified: chaotic and reactive; working around the store; item-by-item; and restricted and budgeted. This suggests that residents of deprived neighbourhoods do not have uniform responses to food environments. Responses to supermarket environments appear to be mediated by levels of individual autonomy. A better understanding of how residents of deprived neighbourhoods interact with their food environment may help optimise environmental interventions aimed at improving physical access to food in these places. Copyright © 2012 Elsevier Ltd. All rights reserved.

Determinants of diet quality in pregnancy: sociodemographic, pregnancy-specific, and food environment influences.

PubMed

Nash, Danielle M; Gilliland, Jason A; Evers, Susan E; Wilk, Piotr; Campbell, M Karen

2013-01-01

To advance the knowledge of determinants of diet quality in pregnancy by focusing on both personal characteristics and the food environment. Cross-sectional study in which participants from the Prenatal Health Project were linked to a geographic dataset by home address. Access to fast food, convenience stores, and grocery stores was measured using a geographic information system (ArcGIS9.3). Pregnant women (n = 2,282) were recruited between 2002 and 2005 in London, Ontario, Canada. Dietary quality was measured using a validated food frequency questionnaire and the Canadian Diet Quality Index for Pregnancy. Univariate and multivariate linear regressions were calculated with the predictor variables on the Canadian Diet Quality Index for Pregnancy. Pregnant women who were born in Canada, common-law, nulliparous, less physically active, smokers, more anxious, or lacking family support had lower diet quality on average. Presence of fast-food restaurants, convenience stores, and grocery stores within 500 m of participants' homes was not associated with diet quality after controlling for personal variables. The food environment does not seem to have a large influence on diet quality in pregnancy. Further research is needed to determine other potential reasons for low diet quality among pregnant women. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Reliability of a retail food store survey and development of an accompanying retail scoring system to communicate survey findings and identify vendors for healthful food and marketing initiatives.

PubMed

Ghirardelli, Alyssa; Quinn, Valerie; Sugerman, Sharon

2011-01-01

To develop a retail grocery instrument with weighted scoring to be used as an indicator of the food environment. Twenty six retail food stores in low-income areas in California. Observational. Inter-rater reliability for grocery store survey instrument. Description of store scoring methodology weighted to emphasize availability of healthful food. Type A intra-class correlation coefficients (ICC) with absolute agreement definition or a κ test for measures using ranges as categories. Measures of availability and price of fruits and vegetables performed well in reliability testing (κ = 0.681-0.800). Items for vegetable quality were better than for fruit (ICC 0.708 vs 0.528). Kappa scores indicated low to moderate agreement (0.372-0.674) on external store marketing measures and higher scores for internal store marketing. "Next to" the checkout counter was more reliable than "within 6 feet." Health departments using the store scoring system reported it as the most useful communication of neighborhood findings. There was good reliability of the measures among the research pairs. The local store scores can show the need to bring in resources and to provide access to fruits and vegetables and other healthful food. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Challenges in assessing food environments in northern and remote communities in Canada.

PubMed

Skinner, Kelly; Burnett, Kristin; Williams, Patricia; Martin, Debbie; Stothart, Christopher; LeBlanc, Joseph; Veeraraghavan, Gigi; Sheedy, Amanda

2016-06-09

Effective tools for retail food environments in northern and remote communities are lacking. This paper examines the challenges of conducting food environment assessments in northern and remote communities in Canada encountered during our experience with a food costing project. One of the goals of the Paying for Nutrition in the North project is to develop guidelines to improve current food costing tools for northern Canada. Paying for Nutrition illustrates the complex context of measuring food environments in northern and remote communities. Through the development of a food costing methodology guide to assess northern food environments, several contextual issues emerged, including retail store oligopolies in communities; the importance of assessing food quality; informal social food economies; and the challenge of costing the acquisition and consumption of land- and water-based foods. Food environment measures designed for northern and remote communities need to reflect the geographic context in which they are being employed and must include input from local residents.

Memory and the hippocampus in food-storing birds: a comparative approach.

PubMed

Clayton, N S

1998-01-01

Comparative studies provide a unique source of evidence for the role of the hippocampus in learning and memory. Within birds and mammals, the hippocampal volume of scatter-hoarding species that cache food in many different locations is enlarged, relative to the remainder of the telencephalon, when compared with than that of species which cache food in one larder, or do not cache at all. Do food-storing species show enhanced memory function in association with the volumetric enlargement of the hippocampus? Comparative studies within the parids (titmice and chickadees) and corvids (jays, nutcrackers and magpies), two families of birds which show natural variation in food-storing behavior, suggest that there may be two kinds of memory specialization associated with scatter-hoarding. First, in terms of spatial memory, several scatter-hoarding species have a more accurate and enduring spatial memory, and a preference to rely more heavily upon spatial cues, than that of closely related species which store less food, or none at all. Second, some scatter-hoarding parids and corvids are also more resistant to memory interference. While the most critical component about a cache site may be its spatial location, there is mounting evidence that food-storing birds remember additional information about the contents and status of cache sites. What is the underlying neural mechanism by which the hippocampus learns and remembers cache sites? The current mammalian dogma is that the neural mechanisms of learning and memory are achieved primarily by variations in synaptic number and efficacy. Recent work on the concomitant development of food-storing, memory and the avian hippocampus illustrates that the avian hippocampus may swell or shrivel by as much as 30% in response to presence or absence of food-storing experience. Memory for food caches triggers a dramatic increase in the total number of number of neurons within the avian hippocampus by altering the rate at which these cells

Assessing the food environment of a rural community: baseline findings from the heart of New Ulm project, Minnesota, 2010-2011.

PubMed

Pereira, Raquel F; Sidebottom, Abbey C; Boucher, Jackie L; Lindberg, Rebecca; Werner, Rebecca

2014-03-06

Changes in the food environment in the United States during the past few decades have contributed to increased rates of obesity, diabetes, and heart disease. Improving the food environment may be an effective primary prevention strategy to address these rising disease rates. The purpose of this study was to assess the consumer food environment of a rural community with high rates of obesity and low levels of fruit and vegetable consumption. Findings were used to identify food environment intervention strategies to be implemented as part of a larger community-based heart disease prevention program. We used the Nutrition Environment Measures Survey for Restaurants (NEMS-R) and Stores (NEMS-S) to assess 34 restaurants, 3 grocery stores, and 5 convenience stores in New Ulm, Minnesota. At least half of the restaurants offered nonfried vegetables and 100% fruit juice. Only 32% had at least 1 entrée or 1 main dish salad that met standards for "healthy." Fewer than half (41%) had fruit available and under one-third offered reduced-size portions (29%) or whole-grain bread (26%). Grocery stores had more healthful items available, but findings were mixed on whether these items were made available at a lower price than less healthful items. Convenience stores were less likely to have fruits and vegetables and less likely to carry more healthful products (except milk) than grocery stores. Baseline findings indicated opportunities to improve availability, quality, and price of foods to support more healthful eating. A community-wide food environment assessment can be used to strategically plan targeted interventions.

Healthfulness of Foods Advertised in Small and Nontraditional Urban Stores in Minneapolis-St. Paul, Minnesota, 2014.

PubMed

Barnes, Timothy L; Pelletier, Jennifer E; Erickson, Darin J; Caspi, Caitlin E; Harnack, Lisa J; Laska, Melissa N

2016-11-10

Shopping at small food stores, such as corner stores and convenience stores, is linked with unhealthful food and beverage purchases, poor diets, and high risk of obesity. However, information on how foods and beverages are marketed at small stores is limited. The objective of this study was to examine advertisements and product placements for healthful and less healthful foods and beverages at small stores in Minneapolis-St. Paul, Minnesota. We conducted in-store audits of 119 small and nontraditional food retailers (corner/small grocery stores, food-gas marts, pharmacies, and dollar stores) randomly selected from licensing lists in Minneapolis-St. Paul in 2014. We analyzed data on exterior and interior advertisements of foods and beverages and product placement. Exterior and interior advertisements for healthful foods and beverages were found in less than half of stores (exterior, 37% [44 of 119]; interior, 20% [24 of 119]). Exterior and interior advertisements for less healthful items were found in approximately half of stores (exterior, 46% [55 of 119]); interior, 66% [78 of 119]). Of the 4 store types, food-gas marts were most likely to have exterior and interior advertisements for both healthful and less healthful items. Corner/small grocery stores and dollar stores had fewer advertisements of any type. Most stores (77%) had at least 1 healthful item featured as an impulse buy (ie, an item easily reached at checkout), whereas 98% featured at least 1 less healthful item as an impulse buy. Findings suggest imbalanced advertising and product placement of healthful and less healthful foods and beverages at small food stores in Minneapolis-St. Paul; less healthful items were more apt to be featured as impulse buys. Future interventions and polices should encourage reductions in advertisements and impulse-buy placements of unhealthful products, particularly in food-gas marts, and encourage advertisements of healthful products.

Baltimore City Stores Increased The Availability Of Healthy Food After WIC Policy Change.

PubMed

Cobb, Laura K; Anderson, Cheryl A M; Appel, Lawrence; Jones-Smith, Jessica; Bilal, Usama; Gittelsohn, Joel; Franco, Manuel

2015-11-01

As part of a 2009 revision to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, the Department of Agriculture required WIC-authorized stores to stock additional varieties of healthy food. The long-term effects of this policy on access to healthy food are unknown. Using surveys conducted in 118 Baltimore City, Maryland, food stores in 2006 and 2012, we examined associations of the change in healthy food availability with store type, neighborhood demographics, and the 2009 WIC policy change. Overall, healthy food availability improved significantly between 2006 and 2012, with the greatest increases in corner stores and in census tracts with more than 60 percent black residents. On an 11-point scale measuring availability of fruit (3 points), vegetables (4 points), bread (2 points), and milk (2 points), the WIC policy change was associated with a 0.72-point increase in WIC-relevant healthy food availability, while joining WIC was associated with a 0.99-point increase. Stores that carry a limited variety of food items may be more receptive to stocking healthier food than previously thought, particularly within neighborhoods with a majority of black residents. Policies targeting healthy food availability have the potential to increase availability and decrease health disparities. Project HOPE—The People-to-People Health Foundation, Inc.

School food environments associated with adiposity in Canadian children.

PubMed

Fitzpatrick, C; Datta, G D; Henderson, M; Gray-Donald, K; Kestens, Y; Barnett, T A

2017-07-01

Targeting obesogenic features of children's environment that are amenable to change represents a promising strategy for health promotion. The school food environment, defined as the services and policies regarding nutrition and the availability of food in the school and surrounding neighborhood, is particularly important given that students travel through the school neighborhood almost daily and that they consume a substantial proportion of their calories at school. As part of the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) cohort study, we assessed features of school indoor dietary environment and the surrounding school neighborhoods, when children were aged 8-10 years (2005-2008). School principals reported on food practices and policies within the schools. The density of convenience stores and fast-food outlets surrounding the school was computed using a Geographical Information System. Indicators of school neighborhood deprivation were derived from census data. Adiposity outcomes were measured in a clinical setting 2 years later, when participants were aged 10-12 years (2008-2011). We conducted cluster analyses to identify school food environment types. Associations between school types and adiposity were estimated in linear regression models. Cluster analysis identified three school types with distinct food environments. Schools were characterized as: overall healthful (45%); a healthful food environment in the surrounding neighborhood, but an unhealthful indoor food environment (22%); or overall unhealthful (33%). Less healthful schools were located in more deprived neighborhoods and were associated with greater child adiposity. Despite regulatory efforts to improve school food environments, there is substantial inequity in dietary environments across schools. Ensuring healthful indoor and outdoor food environments across schools should be included in comprehensive efforts to reduce obesity-related health disparities.

Fast food restaurants and food stores: longitudinal associations with diet in young adults: The CARDIA Study

PubMed Central

Boone-Heinonen, Janne; Gordon-Larsen, Penny; Kiefe, Catarina I.; Shikany, James M.; Lewis, Cora E.; Popkin, Barry M.

2011-01-01

Background A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts – neighborhoods with little or no access to healthy foods – by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. Methods We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of U.S. young adults (n=5,115, 18–30 years at baseline), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from four examination periods (n=15,854 person-exam observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and meeting fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within 1 kilometer (km), 1–2.9km, 3–4.9km, and 5–8km of respondents’ homes. Models were sex-stratified, controlled for individual sociodemographics and neighborhood poverty, and tested for interaction by individual-level income. Results Fast food consumption was related to fast food availability in low-income respondents, particularly within 1–2.9km of homes among men [coefficient (95% CI) up to: 0.34 (0.16, 0.51)]. Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake and relationships between grocery store availability and diet outcomes were mixed. Conclusions Our findings provide some evidence for zoning restrictions on fast food restaurants within 3km of low-income residents, but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change. PMID:21747011

The Neighborhood Food Resource Environment and the Health of Residents with Chronic Conditions

PubMed Central

Vargas, Roberto B.; Ang, Alfonso; Pebley, Anne R.

2008-01-01

Background Residence in disadvantaged neighborhoods is associated with poorer access to healthy foods. Objective To understand associations between the neighborhood food resource environment and residents’ health status and body mass index (BMI) for adults with and without chronic conditions. Design Cross-sectional multilevel analysis. Participants 2,536 adults from the 2000–2001 Los Angeles Family and Neighborhood Survey. Measurements The food resource environment was defined as the number of chain supermarkets, independent supermarkets, small markets, or convenience stores per roadway miles in the census tract. The main dependent variables were self-rated health, dichotomized as excellent or fair/poor, and body mass index (BMI). Multilevel regression models examined the association between the food resource environment and both BMI and the odds of reporting excellent health after adjustment for neighborhood SES and individual characteristics. Results More chain supermarkets per roadway mile in a census tract was associated with higher adjusted rates of reporting excellent health (33%, 38%, and 43% for those in the lowest, middle, and highest tertiles of chain supermarkets) and lower adjusted mean BMI (27, 26, and 25 kg/m2) for residents without a chronic condition, but not those with a chronic condition. In contrast, having more convenience stores per roadway mile was associated with lower health ratings only among adults with a chronic condition (39%, 32%, and 27% for the lowest to highest tertile of convenience stores). Conclusion Health status and BMI are associated with the local food environment, but the associations differ by type of market and presence of a chronic condition. PMID:18483833

Presence of Candy and Snack Food at Checkout in Chain Stores: Results of a Pilot Study.

PubMed

Basch, Corey H; Kernan, William D; Menafro, Anthony

2016-10-01

Community health professionals must use multiple strategies to address the rising rates of childhood obesity in the United States. One such strategy is to address the underlying causes of childhood obesity, including lack of exercise and the consumption of calorically-dense snack foods. This study examines the presence of candy and snack food in the checkout lines of all retail chain stores in a selected community to determine the presence of these products, the ways in which these products are promoted, and the type of physical environment through which customers navigate during the checkout process. The findings confirm that candy, soft drinks, snacks, and ice cream were present in a large majority of these retail stores. Further, this pilot study found that many of these stores "corral" customers through the check-out line in such a way that it is necessary to pass these snack foods directly. Three themes for discussion emerged from the review of the data collected, including product marketing, product packaging, and product placement. Implications for childhood health are presented in the context of these marketing strategies. The results and subsequent discussion provide important insight into the ways in which the presence of candy and snack food at checkout lines might contribute to childhood obesity rates.

Healthfulness of Foods Advertised in Small and Nontraditional Urban Stores in Minneapolis–St. Paul, Minnesota, 2014

PubMed Central

Pelletier, Jennifer E.; Erickson, Darin J.; Caspi, Caitlin E.; Harnack, Lisa J.; Laska, Melissa N.

2016-01-01

Introduction Shopping at small food stores, such as corner stores and convenience stores, is linked with unhealthful food and beverage purchases, poor diets, and high risk of obesity. However, information on how foods and beverages are marketed at small stores is limited. The objective of this study was to examine advertisements and product placements for healthful and less healthful foods and beverages at small stores in Minneapolis–St. Paul, Minnesota. Methods We conducted in-store audits of 119 small and nontraditional food retailers (corner/small grocery stores, food–gas marts, pharmacies, and dollar stores) randomly selected from licensing lists in Minneapolis–St. Paul in 2014. We analyzed data on exterior and interior advertisements of foods and beverages and product placement. Results Exterior and interior advertisements for healthful foods and beverages were found in less than half of stores (exterior, 37% [44 of 119]; interior, 20% [24 of 119]). Exterior and interior advertisements for less healthful items were found in approximately half of stores (exterior, 46% [55 of 119]); interior, 66% [78 of 119]). Of the 4 store types, food–gas marts were most likely to have exterior and interior advertisements for both healthful and less healthful items. Corner/small grocery stores and dollar stores had fewer advertisements of any type. Most stores (77%) had at least 1 healthful item featured as an impulse buy (ie, an item easily reached at checkout), whereas 98% featured at least 1 less healthful item as an impulse buy. Conclusion Findings suggest imbalanced advertising and product placement of healthful and less healthful foods and beverages at small food stores in Minneapolis–St. Paul; less healthful items were more apt to be featured as impulse buys. Future interventions and polices should encourage reductions in advertisements and impulse-buy placements of unhealthful products, particularly in food–gas marts, and encourage advertisements of

Comparing nutrition environments in bodegas and fast food restaurants

PubMed Central

Lovasi, Laszlo; Yousefzadeh, Paulette; Sheehan, Daniel; Milinkovic, Karla; Baecker, Aileen; Bader, Michael D. M.; Weiss, Christopher; Lovasi, Gina S.; Rundle, Andrew

2015-01-01

Many small grocery stores or “bodegas” sell prepared or ready-to-eat items, filling a similar niche in the food environment as fast food restaurants. However, little comparative information is available about the nutrition environments of bodegas and fast food outlets. This study compared the nutrition environments of bodegas and national chain fast food restaurants using a common audit instrument, the Nutrition Environment Measures Study in Restaurants (NEMS-R) protocol. The analytic sample included 109 bodegas and 107 fast food restaurants located in New York City neighborhoods in the upper third and lower third of the census tract poverty rate distribution. Inter-rater reliability was evaluated in 102 food outlets including 31 from the analytic sample and 71 from a supplementary convenience sample. The analysis compared scores on individual NEMS-R items, a total summary score, and sub-scores indicating healthy food availability, nutrition information, promotions of healthy or unhealthy eating, and price incentives for healthy eating, using t-tests and chi-square statistics to evaluate differences by outlet type and neighborhood poverty. Fast food restaurants were more likely to provide nutritional information, while bodegas scored higher on healthy food availability, promotions, and pricing. Bodegas and fast food restaurants had similar NEMS-R total scores (bodegas: 13.09, fast food: 14.31, p=0.22). NEMS-R total scores were higher (indicating healthier environments) in low- than high-poverty neighborhoods among both bodegas (14.79 vs. 11.54, p=0.01) and fast food restaurants (16.27 vs. 11.60, p<.01). Results imply different policy measures to improve nutrition environments in the two types of food outlets. PMID:24035459

Store-directed price promotions and communications strategies improve healthier food supply and demand: impact results from a randomized controlled, Baltimore City store-intervention trial.

PubMed

Budd, Nadine; Jeffries, Jayne K; Jones-Smith, Jessica; Kharmats, Anna; McDermott, Ann Yelmokas; Gittelsohn, Joel

2017-12-01

Small food store interventions show promise to increase healthy food access in under-resourced areas. However, none have tested the impact of price discounts on healthy food supply and demand. We tested the impact of store-directed price discounts and communications strategies, separately and combined, on the stocking, sales and prices of healthier foods and on storeowner psychosocial factors. Factorial design randomized controlled trial. Twenty-four corner stores in low-income neighbourhoods of Baltimore City, MD, USA. Stores were randomized to pricing intervention, communications intervention, combined pricing and communications intervention, or control. Stores that received the pricing intervention were given a 10-30 % price discount by wholesalers on selected healthier food items during the 6-month trial. Communications stores received visual and interactive materials to promote healthy items, including signage, taste tests and refrigerators. All interventions showed significantly increased stock of promoted foods v. There was a significant treatment effect for daily unit sales of healthy snacks (β=6·4, 95 % CI 0·9, 11·9) and prices of healthy staple foods (β=-0·49, 95 % CI -0·90, -0·03) for the combined group v. control, but not for other intervention groups. There were no significant intervention effects on storeowner psychosocial factors. All interventions led to increased stock of healthier foods. The combined intervention was effective in increasing sales of healthier snacks, even though discounts on snacks were not passed to the consumer. Experimental research in small stores is needed to understand the mechanisms by which store-directed price promotions can increase healthy food supply and demand.

Store-directed price promotions and communications strategies improve healthier food supply and demand: impact results from a randomized controlled, Baltimore City store-intervention trial

PubMed Central

Budd, Nadine; Jeffries, Jayne K; Jones-Smith, Jessica; Kharmats, Anna; McDermott, Ann Yelmokas; Gittelsohn, Joel

2017-01-01

Objective Small food store interventions show promise to increase healthy food access in under-resourced areas. However, none have tested the impact of price discounts on healthy food supply and demand. We tested the impact of store-directed price discounts and communications strategies, separately and combined, on the stocking, sales and prices of healthier foods and on storeowner psychosocial factors. Design Factorial design randomized controlled trial. Setting Twenty-four corner stores in low-income neighbourhoods of Baltimore City, MD, USA. Subjects Stores were randomized to pricing intervention, communications intervention, combined pricing and communications intervention, or control. Stores that received the pricing intervention were given a 10–30% price discount by wholesalers on selected healthier food items during the 6-month trial. Communications stores received visual and interactive materials to promote healthy items, including signage, taste tests and refrigerators. Results All interventions showed significantly increased stock of promoted foods υ. control. There was a significant treatment effect for daily unit sales of healthy snacks (β = 6·4, 95% CI 0·9, 11·9) and prices of healthy staple foods (β = −0·49, 95% CI −0·90, −0·03) for the combined group υ. control, but not for other intervention groups. There were no significant intervention effects on storeowner psychosocial factors. Conclusions All interventions led to increased stock of healthier foods. The combined intervention was effective in increasing sales of healthier snacks, even though discounts on snacks were not passed to the consumer. Experimental research in small stores is needed to understand the mechanisms by which store-directed price promotions can increase healthy food supply and demand. PMID:28222818

Availability of food stores and consumption of fruit, legumes and vegetables in a Brazilian urban area.

PubMed

Cristine Pessoa, Milene; Loures Mendes, Larissa; Teixeira Caiaffa, Waleska; Carvalho Malta, Deborah; Velásquez-Meléndez, Gustavo

2014-12-17

The food environment can have an important influence on the availability of and access to food, which plays a significant role in the health of individuals. The goal of this study was to compare the consumption of fruits, legumes and vegetables (FLV) by adults and the availability of food stores in the context of socioeconomic and geographic space connected to basic health units in a Brazilian capital city. The study was developed from information obtained through the Risk Factors Surveillance for Non-Communicable Diseases Prevention by Telephone Survey (VIGITEL), using samples from Belo Horizonte from the years 2008 to 2010. A total of 5611 records were geocoded based on the postal code. A score was created based on the weekly and daily frequency of FLV intake of individuals. The coverage area of basic health units was used as a neighborhood unit. Georeferenced data on food stores in the city and neighborhood income were used. As neighborhood income increased, there was an increase in the distribution of food establishments for all of the studied categories. The highest FLV intake scores were observed in areas with higher income levels. The highest concentration of food stores, regardless of supply quality, was observed in geographic areas with higher purchasing power and in those where there was a greater concentration of other types of businesses and services, a different pattern from that found in other countries. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

An introduction to the healthy corner store intervention model in Canada.

PubMed

Mah, Catherine L; Minaker, Leia M; Jameson, Kristie; Rappaport, Lissie; Taylor, Krystal; Graham, Marketa; Moody, Natalie; Cook, Brian

2017-09-14

The majority of Canadians' food acquisition occurs in retail stores. Retail science has become increasingly sophisticated in demonstrating how consumer environments influence population-level diet quality and health status. The retail food environment literature is new but growing rapidly in Canada, and there is a relative paucity of evidence from intervention research implemented in Canada. The healthy corner store model is a comprehensive complex population health intervention in small retail stores, intended to transform an existing business model to a health-promoting one through intersectoral collaboration. Healthy corner store interventions typically involve conversions of existing stores with the participation of health, community, and business sector partners, addressing business fundamentals, merchandising, and consumer demand. This article introduces pioneering experiences with the healthy corner store intervention in Canada. First, we offer a brief overview of the state of evidence within and outside Canada. Second, we discuss three urban and one rural healthy corner store initiatives, led through partnerships among community food security organizations, public health units, academics, and business partners, in Manitoba, Ontario, and Newfoundland and Labrador. Third, we synthesize the promising practices from these local examples, including aspects of both intervention science (e.g., refinements in measuring the food environment) and community-based practice (e.g., dealing with unhealthy food items and economic impact for the retailer). This article will synthesize practical experiences with healthy corner stores in Canada. It offers a baseline assessment of promising aspects of this intervention for health and health equity, and identifies opportunities to strengthen both science and practice in this area of retail food environment work.

Assessing the Food Environment of a Rural Community: Baseline Findings From the Heart of New Ulm Project, Minnesota, 2010–2011

PubMed Central

Sidebottom, Abbey C.; Boucher, Jackie L.; Lindberg, Rebecca; Werner, Rebecca

2014-01-01

Introduction Changes in the food environment in the United States during the past few decades have contributed to increased rates of obesity, diabetes, and heart disease. Improving the food environment may be an effective primary prevention strategy to address these rising disease rates. The purpose of this study was to assess the consumer food environment of a rural community with high rates of obesity and low levels of fruit and vegetable consumption. Findings were used to identify food environment intervention strategies to be implemented as part of a larger community-based heart disease prevention program. Methods We used the Nutrition Environment Measures Survey for Restaurants (NEMS-R) and Stores (NEMS-S) to assess 34 restaurants, 3 grocery stores, and 5 convenience stores in New Ulm, Minnesota. Results At least half of the restaurants offered nonfried vegetables and 100% fruit juice. Only 32% had at least 1 entrée or 1 main dish salad that met standards for “healthy.” Fewer than half (41%) had fruit available and under one-third offered reduced-size portions (29%) or whole-grain bread (26%). Grocery stores had more healthful items available, but findings were mixed on whether these items were made available at a lower price than less healthful items. Convenience stores were less likely to have fruits and vegetables and less likely to carry more healthful products (except milk) than grocery stores. Conclusion Baseline findings indicated opportunities to improve availability, quality, and price of foods to support more healthful eating. A community-wide food environment assessment can be used to strategically plan targeted interventions. PMID:24602590

7 CFR 278.7 - Determination and disposition of claims-retail food stores and wholesale food concerns.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Determination and disposition of claims-retail food stores and wholesale food concerns. 278.7 Section 278.7 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION...

Changes in the food environment over time: examining 40 years of data in the Framingham Heart Study.

PubMed

James, Peter; Seward, Michael W; James O'Malley, A; Subramanian, S V; Block, Jason P

2017-06-24

Research has explored associations between diet, body weight, and the food environment; however, few studies have examined historical trends in food environments. In the Framingham Heart Study Offspring (N = 3321) and Omni (N = 447) cohorts, we created food environment metrics in four Massachusetts towns utilizing geocoded residential, workplace, and food establishment addresses from 1971 to 2008. We created multilevel models adjusted for age, sex, education, and census tract poverty to examine trends in home, workplace, and commuting food environments. Proximity to and density of supermarkets, fast-food, full service restaurants, convenience stores, and bakeries increased over time for residential, workplace, and commuting environments; exposure to grocery stores decreased. The greatest increase in access was for supermarkets, with residential distance to the closest supermarket 1406 m closer (95% CI 1303 m, 1508 m) by 2005-2008 than in 1971-1975. Although poorer census tracts had higher access to fast-food restaurants consistently across follow-up, this disparity dissipated over time, due to larger increases in proximity to fast-food in wealthier neighborhoods. Access to most food establishment types increased over time, with similar trends across home, workplace, and commuter environments.

Retail food environments, shopping experiences, First Nations and the provincial Norths.

PubMed

Burnett, Kristin; Skinner, Kelly; Hay, Travis; LeBlanc, Joseph; Chambers, Lori

2017-10-01

This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.

Use of point-of-sale data to assess food and nutrient quality in remote stores.

PubMed

Brimblecombe, Julie; Liddle, Robyn; O'Dea, Kerin

2013-07-01

To examine the feasibility of using point-of-sale data to assess dietary quality of food sales in remote stores. A multi-site cross-sectional assessment of food and nutrient composition of food sales. Point-of-sale data were linked to Australian Food and Nutrient Data and compared across study sites and with nutrient requirements. Remote Aboriginal Australia. Six stores. Point-of-sale data were readily available and provided a low-cost, efficient and objective assessment of food and nutrient sales. Similar patterns in macronutrient distribution, food expenditure and key food sources of nutrients were observed across stores. In all stores, beverages, cereal and cereal products, and meat and meat products comprised approximately half of food sales (range 49–57 %). Fruit and vegetable sales comprised 10.4 (SD 1.9) % on average. Carbohydrate contributed 54.4 (SD 3.0) % to energy; protein 13.5 (SD 1.1) %; total sugars 28.9 (SD 4.3) %; and the contribution of total saturated fat to energy ranged from 11.0 to 14.4% across stores. Mg, Ca, K and fibre were limiting nutrients, and Na was four to five times higher than the midpoint of the average intake range. Relatively few foods were major sources of nutrients. Point-of-sale data enabled an assessment of dietary quality within stores and across stores with no burden on communities and at no cost, other than time required for analysis and reporting. Similar food spending patterns and nutrient profiles were observed across the six stores. This suggests potential in using point-of-sale data to monitor and evaluate dietary quality in remote Australian communities.

Assessing reliability and validity of the GroPromo audit tool for evaluation of grocery store marketing and promotional environments.

PubMed

Kerr, Jacqueline; Sallis, James F; Bromby, Erica; Glanz, Karen

2012-01-01

To evaluate reliability and validity of a new tool for assessing the placement and promotional environment in grocery stores. Trained observers used the GroPromo instrument in 40 stores to code the placement of 7 products in 9 locations within a store, along with other promotional characteristics. To test construct validity, customers' receipts were coded for percentage of food purchases in each of the categories. Of the 22 categories tested, 21 demonstrated moderate to high interrater reliability (intraclass correlation ≥ 0.61). When more unhealthy items were placed in prominent locations, a higher percentage of money was spent on less-healthy items, and a lower percentage of food dollars were spent on fruits and vegetables. The prominence of locations was more important than the number of locations. The GroPromo tool can be used to assess promotional practices in stores. Data may help advocates campaign for more healthy food items in key promotional locations. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Comparing nutrition environments in bodegas and fast-food restaurants.

PubMed

Neckerman, Kathryn M; Lovasi, Laszlo; Yousefzadeh, Paulette; Sheehan, Daniel; Milinkovic, Karla; Baecker, Aileen; Bader, Michael D M; Weiss, Christopher; Lovasi, Gina S; Rundle, Andrew

2014-04-01

Many small grocery stores or "bodegas" sell prepared or ready-to-eat items, filling a niche in the food environment similar to fast-food restaurants. However, little comparative information is available about the nutrition environments of bodegas and fast-food outlets. This study compared the nutrition environments of bodegas and national chain fast-food restaurants using a common audit instrument, the Nutrition Environment Measures Study in Restaurants (NEMS-R) protocol. The analytic sample included 109 bodegas and 107 fast-food restaurants located in New York City neighborhoods in the upper third and lower third of the census tract poverty rate distribution. Inter-rater reliability was evaluated in 102 food outlets, including 31 from the analytic sample and 71 from a supplementary convenience sample. The analysis compared scores on individual NEMS-R items, a total summary score, and subscores indicating healthy food availability, nutrition information, promotions of healthy or unhealthy eating, and price incentives for healthy eating, using t tests and χ(2) statistics to evaluate differences by outlet type and neighborhood poverty. Fast-food restaurants were more likely to provide nutrition information, and bodegas scored higher on healthy food availability, promotions, and pricing. Bodegas and fast-food restaurants had similar NEMS-R total scores (bodegas 13.09, fast food 14.31; P=0.22). NEMS-R total scores were higher (indicating healthier environments) in low- than high-poverty neighborhoods among both bodegas (14.79 vs 11.54; P=0.01) and fast-food restaurants (16.27 vs 11.60; P<0.01). Results imply different policy measures to improve nutrition environments in the two types of food outlets. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Development of object permanence in food-storing magpies (Pica pica).

PubMed

Pollok, B; Prior, H; Güntürkün, O

2000-06-01

The development of object permanence was investigated in black-billed magpies (Pica pica), a food-storing passerine bird. The authors tested the hypothesis that food-storing development should be correlated with object-permanence development and that specific stages of object permanence should be achieved before magpies become independent. As predicted, Piagetian Stages 4 and 5 were reached before independence was achieved, and the ability to represent a fully hidden object (Piagetian Stage 4) emerged by the age when magpies begin to retrieve food. Contrary to psittacine birds and humans, but as in dogs and cats, no "A-not-B error" occurred. Although magpies also mastered 5 of 6 invisible displacement tasks, evidence of Piagetian Stage 6 competence was ambiguous.

Young adult eating and food-purchasing patterns food store location and residential proximity.

PubMed

Laska, Melissa Nelson; Graham, Dan J; Moe, Stacey G; Van Riper, David

2010-11-01

Young adulthood is a critical age for weight gain, yet scant research has examined modifiable contextual influences on weight that could inform age-appropriate interventions. The aims of this research included describing where young adults eat and purchase food, including distance from home, and estimating the percentage of eating/purchasing locations contained within GIS-generated buffers traditionally used in research. Forty-eight participants (aged 18-23 years, n=27 women) represented diverse lifestyle groups. Participants logged characteristics of all eating/drinking occasions (including location) occurring over 7 days (n=1237) using PDAs. In addition, they recorded addresses for stores where they purchased food to bring home. Using GIS, estimates were made of distances between participants' homes and eating/purchasing locations. Data collection occurred in 2008-2009 and data analysis occurred in 2010. Among participants living independently or with family (n=36), 59.1% of eating occasions were at home. Away-from-home eating locations averaged 6.7 miles from home; food-shopping locations averaged 3.1 miles from home. Only 12% of away-from-home eating occasions fell within -mile residential buffers, versus 17% within 1 mile and 34% within 2 miles. In addition, 12%, 19%, and 58% of shopping trips fell within these buffers, respectively. Results were similar for participants residing in dormitories. Young adults often purchase and eat food outside of commonly used GIS-generated buffers around their homes. This suggests the need for a broader understanding of their food environments. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

School Breakfast Program Participation and Rural Adolescents' Purchasing Behaviors in Food Stores and Restaurants.

PubMed

Caspi, Caitlin Eicher; Wang, Qi; Shanafelt, Amy; Larson, Nicole; Wei, Susan; Hearst, Mary O; Nanney, Marilyn S

2017-10-01

Little is known about adolescents' food purchasing behaviors in rural areas. This study examined whether purchasing food at stores/restaurants around schools was related to adolescents' participation in school breakfast programs and overall diet in rural Minnesota. Breakfast-skippers enrolled in a group-randomized intervention in 2014 to 2015 (N = 404 from 8 schools) completed 24-hour dietary recalls and pre/post surveys assessing food establishment purchase frequency. Healthy Eating Index Scores (HEI-2010) were calculated for each student. Student-level school breakfast participation (SBP) was obtained from school food service records. Mixed-effects regression models estimated: (1) whether SBP was associated with store/restaurant use at baseline, (2) whether an increase in SBP was associated with a decrease in store/restaurant use, and (3) whether stores/restaurant use was associated with HEI-2010 scores at baseline. Students with increased SBP were more likely to decrease fast-food restaurant purchases on the way home from school (OR 1.017, 95% CI 1.005, 1.029), but were less likely to decrease purchases at food stores for breakfast (OR 0.979, 95% CI 0.959, 0.999). Food establishment use was associated with lower HEI-2010 dairy component scores (p = .017). Increasing participation in school breakfast may result in modest changes in purchases at food establishments. © 2017, American School Health Association.

Fast-food outlets and grocery stores near school and adolescents' eating habits and overweight in Finland.

PubMed

Virtanen, Marianna; Kivimäki, Hanne; Ervasti, Jenni; Oksanen, Tuula; Pentti, Jaana; Kouvonen, Anne; Halonen, Jaana I; Kivimäki, Mika; Vahtera, Jussi

2015-08-01

Environmental factors may affect adolescents' eating habits and thereby body weight. However, the contribution of school neighbourhood environment is poorly understood. This study examined the association between proximity of a fast-food outlet or grocery store to school and adolescents' eating habits and overweight. Participants were 23 182 adolescents (mean age 15 years) who responded to a classroom survey in 181 lower secondary schools in Finland (2008-09). School location was linked to data on distance from school to the nearest fast-food outlet or grocery store (≤100 m, 101-500 m, >500 m) using global positioning system-coordinate databases. Outcomes were irregular eating habits (skipping breakfast, skipping free school lunch, skipping free school-provided snacks and not having family dinners), the accumulation of these habits and overweight, including obesity (body mass index ≥ 25 kg/m(2)). Thirteen percentage of the participants were overweight. Having a fast-food outlet or grocery store near school was associated with skipping often breakfast and free school lunch, and the accumulation of irregular eating habits. The proximity of a fast-food outlet or grocery store was associated with a 1.25-fold (95% confidence interval 1.03-1.52) risk of overweight among adolescent with a low socioeconomic status but not among those with higher socioeconomic status. This association was partly (12%) explained by the accumulation of irregular eating habits. Among adolescents from low socioeconomic background, the presence of fast-food retailers near schools is associated with accumulation of irregular eating habits and greater overweight. These findings suggest that obesogenic school neighbourhoods may contribute to social inequalities in overweight. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Lessons learned from small store programs to increase healthy food access.

PubMed

Gittelsohn, Joel; Laska, Melissa N; Karpyn, Allison; Klingler, Kristen; Ayala, Guadalupe X

2014-03-01

To document implementation challenges and opportunities associated with small store interventions. Case study analysis of small store interventions conducted in 4 regions of the US. We systematically generated matrices to compare and contrast lessons learned to advance implementation science. Seven thematic areas were identified including: establishing relationships with stores, store owner and customer relationships, selection of intervention approaches, stocking healthier foods, evaluation, maintenance of changes, and dissemination. This information provides guidance to researchers and practitioners wishing to design, implement, and evaluate small store interventions.

Location of food stores near schools does not predict the weight status of Maine high school students.

PubMed

Harris, David E; Blum, Janet Whatley; Bampton, Matthew; O'Brien, Liam M; Beaudoin, Christina M; Polacsek, Michele; O'Rourke, Karen A

2011-01-01

To examine the relationship between stores selling calorie-dense food near schools and student obesity risk, with the hypothesis that high availability predicts increased risk. Mail surveys determined height, weight, and calorie-dense food consumption for 552 students at 11 Maine high schools. Driving distance from all food stores within 2 km (1.24 miles) of schools (or the closest store) was computed, and the impact of food store density and proximity to schools on student body mass index was determined by logistic regression. Ten schools had ≥ 1 store selling soda, and 8 schools had ≥1 fast-food restaurant within 1 km (0.62 miles). There were no significant relationships between the proximity or density of food stores around schools and student obesity risk. Students obtained sugar-sweetened beverages in many locations including at school. Unhealthful food choices are ubiquitous. Consequently, stores selling these food items near schools have no significant affect on student obesity. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Retail food environments, shopping experiences, First Nations and the provincial Norths

PubMed Central

Kristin, Burnett; Kelly, Skinner; Travis, Hay; Joseph, LeBlanc; Lori, Chambers

2017-01-01

Abstract Introduction: This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. Methods: We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Results: Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. Conclusion: There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition. PMID:29043760

Lessons Learned From Small Store Programs to Increase Healthy Food Access

PubMed Central

Gittelsohn, Joel; Laska, Melissa N.; Karpyn, Allison; Klingler, Kristen; Ayala, Guadalupe X.

2013-01-01

Objectives To document implementation challenges and opportunities associated with small store interventions. Methods Case study analysis of small store interventions conducted in 4 regions of the US. We systematically generated matrices to compare and contrast lessons learned to advance implementation science. Results Seven thematic areas were identified including: establishing relationships with stores, store owner and customer relationships, selection of intervention approaches, stocking healthier foods, evaluation, maintenance of changes, and dissemination. Conclusions This information provides guidance to researchers and practitioners wishing to design, implement, and evaluate small store interventions. PMID:24629559

Do GIS-derived measures of fast food retailers convey perceived fast food opportunities? Implications for food environment assessment

PubMed Central

Barnes, Timothy L.; Colabianchi, Natalie; Freedman, Darcy A.; Bell, Bethany A.; Liese, Angela D.

2018-01-01

Purpose Geographic information systems (GISs) have been used to define fast food availability, with higher availability perhaps promoting poorer quality diets. Alternative measures involve perceptions; however, few studies have examined associations between GIS-derived and perceived measures of the food environment. Methods Telephone surveys of 705 participants within an eight-county region in South Carolina were analyzed using logistic regression to examine relationships between geographic presence of and distance to various types of food retailers and perceived fast food availability. Results The mean distance to the nearest fast food restaurant was 6.1 miles, with 16% of participants having a fast food restaurant within 1 mile of home. The geographic presence of and distance to all food retailer types were significantly associated with perceived availability of fast food in unadjusted models. After adjustment, only the presence of a fast food restaurant or pharmacy was significantly associated with greater odds of higher perceived availability of fast food. Greater odds of lower perceived availability of fast food were observed with the presence of a dollar store and increasing distance to the nearest supermarket or pharmacy. Conclusions Measures of fast food availability, whether objective or perceived, may not be interchangeable. Researchers should carefully decide on the appropriate measurement tool—GIS-derived or perceived—in food environment studies. PMID:27617371

Do GIS-derived measures of fast food retailers convey perceived fast food opportunities? Implications for food environment assessment.

PubMed

Barnes, Timothy L; Colabianchi, Natalie; Freedman, Darcy A; Bell, Bethany A; Liese, Angela D

2017-01-01

Geographic information systems (GISs) have been used to define fast food availability, with higher availability perhaps promoting poorer quality diets. Alternative measures involve perceptions; however, few studies have examined associations between GIS-derived and perceived measures of the food environment. Telephone surveys of 705 participants within an eight-county region in South Carolina were analyzed using logistic regression to examine relationships between geographic presence of and distance to various types of food retailers and perceived fast food availability. The mean distance to the nearest fast food restaurant was 6.1 miles, with 16% of participants having a fast food restaurant within 1 mile of home. The geographic presence of and distance to all food retailer types were significantly associated with perceived availability of fast food in unadjusted models. After adjustment, only the presence of a fast food restaurant or pharmacy was significantly associated with greater odds of higher perceived availability of fast food. Greater odds of lower perceived availability of fast food were observed with the presence of a dollar store and increasing distance to the nearest supermarket or pharmacy. Measures of fast food availability, whether objective or perceived, may not be interchangeable. Researchers should carefully decide on the appropriate measurement tool-GIS-derived or perceived-in food environment studies. Copyright © 2016 Elsevier Inc. All rights reserved.

Consumer Perceptions of the Safety of Ready-to-Eat Foods in Retail Food Store Settings.

PubMed

Levine, Katrina; Yavelak, Mary; Luchansky, John B; Porto-Fett, Anna C S; Chapman, Benjamin

2017-08-01

To better understand how consumers perceive food safety risks in retail food store settings, a survey was administered to 1,041 nationally representative participants who evaluated possible food safety risks depicted in selected photographs and self-reported their perceptions, attitudes, and behaviors. Participants were shown 12 photographs taken at retail stores portraying either commonly perceived or actual food safety contributing factors, such as cross-contamination, product and equipment temperatures, worker hygiene, and/or store sanitation practices. Participants were then asked to specifically identify what they saw, comment as to whether what they saw was safe or unsafe, and articulate what actions they would take in response to these situations. In addition to the survey, focus groups were employed to supplement survey findings with qualitative data. Survey respondents identified risk factors for six of nine actual contributing factor photographs >50% of the time: poor produce storage sanitation (86%, n = 899), cross-contamination during meat slicing (72%, n = 750), bare-hand contact of ready-to-eat food in the deli area (67%, n = 698), separation of raw and ready-to-eat food in the seafood case (63%, n = 660), cross-contamination from serving utensils in the deli case (62%, n = 644), and incorrect product storage temperature (51%, n = 528). On a scale of 1 to 5, where 1 was very unsafe and 5 was very safe, a significant difference was found between average risk perception scores for photographs of actual contributing factors (score of ca. 2.5) and scores for photographs of perceived contributing factors (score of ca. 2.0). Themes from the focus groups supported the results of the survey and provided additional insight into consumer food safety risk perceptions. The results of this study inform communication interventions for consumers and retail food safety professionals aimed at improving hazard identification.

Monitoring sodium in commercially processed foods from stores and restaurants

USDA-ARS?s Scientific Manuscript database

Most of the sodium we eat comes from commercially processed foods from stores and restaurants. Sodium reduction in these foods is a key component of several recent public health efforts. Agricultural Research Service (ARS) of USDA, CDC and FDA have launched a collaborative program to monitor sodium ...

Reported Influences on Restaurant-Type Food Selection Decision Making in a Grocery Store Chain.

PubMed

Bachman, Jessica Lynne; Arigo, Danielle

2018-06-01

To examine food decision-making priorities for restaurant-type foods at grocery stores and determine whether adding calorie information, as required by federal menu labeling laws, affected decision-making priorities. Natural experiment: intervention and control groups with baseline and follow-up. Regional grocery store chain with 9 locations. Participants (n = 393; mean age, 54.8 ± 15.1 years) were primarily women (71%) and Caucasian (95%). Data were collected before and after calorie information was added to restaurant-type foods at 4 intervention locations. Primary influencers of food selection decision making for restaurant-type foods and frequency of use of nutrition information. Quantitative analysis examined the top 3 influencers of food selections and chi-square goodness of fit test determined whether the calorie labeling intervention changed food decision-making priorities. Qualitative data were used to describe responses. Taste, cost, and convenience were the most frequently reported influencers of restaurant-type food selections; 20% of participants rated calories as influential. Calorie labeling did not affect food selection decision making; 16% of participants in intervention stores noticed calorie labels. Qualitative explanations confirmed these findings. Menu labeling laws increase access to calorie information; however, use of this information is limited. Additional interventions are needed to encourage healthier restaurant-type food selections in grocery stores. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Disparities in the food environment surrounding US middle and high schools

PubMed Central

Sturm, Roland

2010-01-01

Summary Background Disparities in the type and density of food retail outlets have been hypothesized as a possible cause of differential obesity rates across racial/ethnic and income groups. Several local studies have documented differences in business environments by sociodemographic neighbourhood characteristics, but no data specific for youth have been published. This study analyses the food environment surrounding all public middle and high schools in the USA. Methods Buffers were calculated with a radius of 400 and 800 m from the main entrance of public secondary schools in the USA (n = 31,622), and business establishments within those buffers were identified using InfoUSA proprietary business listings. Indicators of any convenience store, limited-service restaurant, snack store or off-licences/liquor store and counts of businesses were regressed on the proportion of students eligible for free school meals, Title I eligibility of the school, racial/ethnic composition, location and student/teacher ratio. Results Hispanic youth are particularly likely to attend schools that are surrounded by convenience stores, restaurants, snack stores or off-licences. This effect is independent and in addition to poverty (i.e. students eligible for free school meals or schools that are Title I eligible) or location (urban core, suburban, town, rural). The association between other racial groups and nearby businesses is weaker, with the exception of off-licences, where a higher proportion of minority groups increases the probability of off-licences in close proximity to the school. Middle schools have fewer surrounding businesses than high schools, and larger schools have fewer surrounding businesses than smaller schools. Conclusions Easy availability of snacks, sodas and fast food in the immediate vicinity of a school could easily negate school food policies, especially among students who can leave campus. Surrounding food outlets could also lower the effectiveness of health

Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011

PubMed Central

Lightstone, Amy S.; Basurto-Davila, Ricardo; Morales, Douglas M.; Sturm, Roland

2015-01-01

Introduction The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. Methods We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents’ residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m2) or obese (BMI ≥30.0 kg/m2). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Results Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Discussion Little evidence was found for associations between proximity of respondents’ homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation. PMID:26334715

Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011.

PubMed

Mejia, Nelly; Lightstone, Amy S; Basurto-Davila, Ricardo; Morales, Douglas M; Sturm, Roland

2015-09-03

The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents' residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m(2)) or obese (BMI ≥30.0 kg/m(2)). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Little evidence was found for associations between proximity of respondents' homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation.

Finding Food Deserts: A Comparison of Methods Measuring Spatial Access to Food Stores.

PubMed

Jaskiewicz, Lara; Block, Daniel; Chavez, Noel

2016-05-01

Public health research has increasingly focused on how access to resources affects health behaviors. Mapping environmental factors, such as distance to a supermarket, can identify intervention points toward improving food access in low-income and minority communities. However, the existing literature provides little guidance on choosing the most appropriate measures of spatial access. This study compared the results of different measures of spatial access to large food stores and the locations of high and low access identified by each. The data set included U.S. Census population data and the locations of large food stores in the six-county area around Chicago, Illinois. Six measures of spatial access were calculated at the census block group level and the results compared. The analysis found that there was little agreement in the identified locations of high or low access between measures. This study illustrates the importance of considering the access measure used when conducting research, interpreting results, or comparing studies. Future research should explore the correlation of different measures with health behaviors and health outcomes. © 2015 Society for Public Health Education.

Neighborhood and home food environment and children's diet and obesity: Evidence from military personnel's installation assignment.

PubMed

Shier, Victoria; Nicosia, Nancy; Datar, Ashlesha

2016-06-01

Research and policy initiatives are increasingly focused on the role of neighborhood food environment in children's diet and obesity. However, existing evidence relies on observational data that is limited by neighborhood selection bias. The Military Teenagers' Environments, Exercise, and Nutrition Study (M-TEENS) leverages the quasi-random variation in neighborhood environment generated by military personnel's assignment to installations to examine whether neighborhood food environments are associated with children's dietary behaviors and BMI. Our results suggest that neither the actual nor the perceived availability of particular food outlets in the neighborhood is associated with children's diet or BMI. The availability of supermarkets and convenience stores in the neighborhood was not associated with where families shop for food or children's dietary behaviors. Further, the type of store that families shop at was not associated with the healthiness of food available at home. Similarly, availability of fast food and restaurants was unrelated to children's dietary behaviors or how often children eat fast food or restaurant meals. However, the healthiness of food available at home was associated with healthy dietary behaviors while eating at fast food outlets and restaurants were associated with unhealthy dietary behaviors in children. Further, parental supervision, including limits on snack foods and meals eaten as a family, was associated with dietary behaviors. These findings suggest that focusing only on the neighborhood food environment may ignore important factors that influence children's outcomes. Future research should also consider how families make decisions about what foods to purchase, where to shop for foods and eating out, how closely to monitor their children's food intake, and, ultimately how these decisions collectively impact children's outcomes. Copyright © 2016. Published by Elsevier Ltd.

Neighborhood food environment and body mass index among Japanese older adults: results from the Aichi Gerontological Evaluation Study (AGES)

PubMed Central

2011-01-01

Background The majority of studies of the local food environment in relation to obesity risk have been conducted in the US, UK, and Australia. The evidence remains limited to western societies. The aim of this paper is to examine the association of local food environment to body mass index (BMI) in a study of older Japanese individuals. Methods The analysis was based on 12,595 respondents from cross-sectional data of the Aichi Gerontological Evaluation Study (AGES), conducted in 2006 and 2007. Using Geographic Information Systems (GIS), we mapped respondents' access to supermarkets, convenience stores, and fast food outlets, based on a street network (both the distance to the nearest stores and the number of stores within 500 m of the respondents' home). Multiple linear regression and logistic regression analyses were performed to examine the association between food environment and BMI. Results In contrast to previous reports, we found that better access to supermarkets was related to higher BMI. Better access to fast food outlets or convenience stores was also associated with higher BMI, but only among those living alone. The logistic regression analysis, using categorized BMI, showed that the access to supermarkets was only related to being overweight or obese, but not related to being underweight. Conclusions Our findings provide mixed support for the types of food environment measures previously used in western settings. Importantly, our results suggest the need to develop culture-specific approaches to characterizing neighborhood contexts when hypotheses are extrapolated across national borders. PMID:21777439

Direct Effects of the Home, School, and Consumer Food Environments on the Association between Food Purchasing Patterns and Dietary Intake among Rural Adolescents in Kentucky and North Carolina, 2017.

PubMed

Gustafson, Alison; Jilcott Pitts, Stephanie; McDonald, Jordan; Ford, Hannah; Connelly, Paige; Gillespie, Rachel; Liu, Emily; Bush, Heather; Brancato, Candace; Babatande, Toyin; Mullins, Janet

2017-10-21

Background : Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake among rural adolescents. Methods : A baseline survey was conducted among adolescents in eight rural high schools (four in Eastern Kentucky, and four in Eastern North Carolina). Participants answered questions about food purchasing patterns, dietary intake, home food availability, and demographics. The school and consumer food environments were assessed using validated measures from the School Meals Cost Study (United States Department of Agriculture-Mathematica) and the Nutrition Environment Measurement Survey for Stores, Restaurants, and Corner Stores. Results : Of 432 adolescents, 55% were normal weight, 24% were overweight, and 21% were obese. There was a direct association between unhealthy food purchasing patterns (shopping frequently at gas stations, fast food, and dollar stores) and consuming more added sugars, when compared to those with a healthy shopping pattern (shopping less frequently at gas stations, fast food, and dollar stores) [Odds Ratio = 2.41 (95% CI (confidence interval) 0.99, 3.82)]. Those who reported always having fruits and vegetables in the home consumed more servings of fruits and vegetables [OR = 0.31 cups (95% CI 0.22, 0.44)] compared to those who reported never having fruits and vegetables in the home. Adolescents attending a school with a low healthy food availability score consumed fewer servings of fruits and vegetables [-0.001 (95% CI -0.001, 0.0001)] compared to those attending a school with a high healthy food availability score. Conclusions : There are direct associations between food purchasing patterns, the home and school food environments, and dietary intake among rural adolescents. These cross-sectional results informed the

Direct Effects of the Home, School, and Consumer Food Environments on the Association between Food Purchasing Patterns and Dietary Intake among Rural Adolescents in Kentucky and North Carolina, 2017

PubMed Central

Gustafson, Alison; Jilcott Pitts, Stephanie; McDonald, Jordan; Ford, Hannah; Connelly, Paige; Gillespie, Rachel; Liu, Emily; Bush, Heather; Brancato, Candace; Babatande, Toyin; Mullins, Janet

2017-01-01

Background: Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake among rural adolescents. Methods: A baseline survey was conducted among adolescents in eight rural high schools (four in Eastern Kentucky, and four in Eastern North Carolina). Participants answered questions about food purchasing patterns, dietary intake, home food availability, and demographics. The school and consumer food environments were assessed using validated measures from the School Meals Cost Study (United States Department of Agriculture-Mathematica) and the Nutrition Environment Measurement Survey for Stores, Restaurants, and Corner Stores. Results: Of 432 adolescents, 55% were normal weight, 24% were overweight, and 21% were obese. There was a direct association between unhealthy food purchasing patterns (shopping frequently at gas stations, fast food, and dollar stores) and consuming more added sugars, when compared to those with a healthy shopping pattern (shopping less frequently at gas stations, fast food, and dollar stores) [Odds Ratio = 2.41 (95% CI (confidence interval) 0.99, 3.82)]. Those who reported always having fruits and vegetables in the home consumed more servings of fruits and vegetables [OR = 0.31 cups (95% CI 0.22, 0.44)] compared to those who reported never having fruits and vegetables in the home. Adolescents attending a school with a low healthy food availability score consumed fewer servings of fruits and vegetables [−0.001 (95% CI −0.001, 0.0001)] compared to those attending a school with a high healthy food availability score. Conclusions: There are direct associations between food purchasing patterns, the home and school food environments, and dietary intake among rural adolescents. These cross-sectional results informed the

Neighborhood socioeconomic characteristics and differences in the availability of healthy food stores and restaurants in Sao Paulo, Brazil.

PubMed

Duran, Ana Clara; Diez Roux, Ana V; Latorre, Maria do Rosario D O; Jaime, Patricia Constante

2013-09-01

Differential access to healthy foods has been hypothesized to contribute to health disparities, but evidence from low and middle-income countries is still scarce. This study examines whether the access of healthy foods varies across store types and neighborhoods of different socioeconomic statuses (SES) in a large Brazilian city. A cross-sectional study was conducted in 2010-2011 across 52 census tracts. Healthy food access was measured by a comprehensive in-store data collection, summarized into two indexes developed for retail food stores (HFSI) and restaurants (HMRI). Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood SES with healthy food access. Fast food restaurants were more likely to be located in low SES neighborhoods whereas supermarkets and full service restaurants were more likely to be found in higher SES neighborhoods. Multilevel analyses showed that both store type and neighborhood SES were independently associated with in-store food measures. We found differences in the availability of healthy food stores and restaurants in Sao Paulo city favoring middle and high SES neighborhoods. © 2013 Elsevier Ltd. All rights reserved.

Neighborhood socioeconomic characteristics and differences in the availability of healthy food stores and restaurants in Sao Paulo, Brazil

PubMed Central

Duran, Ana Clara; Diez Roux, Ana V; do Rosario DO Latorre, Maria; Jaime, Patricia C

2013-01-01

Differential access to healthy foods has been hypothesized to contribute to health disparities, but evidence from low and middle-income countries is still scarce. This study examines whether the access of healthy foods varies across store types and neighborhoods of different socioeconomic statuses (SES) in a large Brazilian city. A cross-sectional study was conducted in 2010–2011 across 52 census tracts. Healthy food access was measured by a comprehensive in-store data collection, summarized into two indexes developed for retail food stores (HFSI) and restaurants (HMRI). Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood SES with healthy food access. Fast food restaurants were more likely to be located in low SES neighborhoods whereas supermarkets and full service restaurants were more likely to be found in higher SES neighborhoods. Multilevel analyses showed that both store type and neighborhood SES were independently associated with in-store food measures. We found differences in the availability of healthy food stores and restaurants in Sao Paulo city favoring middle and high SES neighborhoods. PMID:23747923

Examining community and consumer food environments for children: An urban-suburban-rural comparison in Southwestern Ontario.

PubMed

DuBreck, Catherine M; Sadler, Richard C; Arku, Godwin; Gilliland, Jason A

2018-07-01

The aim of this study is to evaluate how retail food environments for children in the City of London and Middlesex County, Ontario, Canada, vary according to level of urbanicity and level of socioeconomic distress. Urbanicity in this study is defined as a neighbourhood's designation as urban, suburban, or rural. We assessed community food environments (e.g., the type, location, and accessibility of food outlets) using 800m and 1600m network buffers (school zones) around all public and private elementary schools, and we calculated and compared density of junk food opportunities (JFO) (e.g., fast food and full-service restaurants, grocery stores, and convenience stores) within each school zone in urban, suburban and rural settings. The study also assessed consumer food environments (e.g., the price, promotion, placement, and availability of healthy options and nutrition information) through restaurant children's menu audits using the Children's Menu Assessment tool. Results suggest JFO density is greater around elementary schools in areas with higher levels of socioeconomic distress and urbanicity, while urbanicity is also associated with greater use of branded marketing and inclusion of an unhealthy dessert on children's menus. Copyright © 2018 Elsevier Ltd. All rights reserved.

Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study.

PubMed

Boone-Heinonen, Janne; Gordon-Larsen, Penny; Kiefe, Catarina I; Shikany, James M; Lewis, Cora E; Popkin, Barry M

2011-07-11

A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts--neighborhoods with little or no access to healthy foods--by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of US young adults (aged 18-30 years at baseline) (n = 5115), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from 4 examination periods (n = 15,854 person-examination observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and adherence to fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within less than 1.00 km, 1.00 to 2.99 km, 3.00 to 4.99 km, and 5.00 to 8.05 km of respondents' homes. Models were sex stratified, controlled for individual sociodemographic characteristics and neighborhood poverty, and tested for interaction by individual-level income. Fast food consumption was related to fast food availability among low-income respondents, particularly within 1.00 to 2.99 km of home among men (coefficient, 0.34; 95% confidence interval, 0.16-0.51). Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed. Our findings provide some evidence for zoning restrictions on fast food restaurants within 3 km of low-income residents but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change.

Measures of the food environment: a compilation of the literature, 1990-2007.

PubMed

McKinnon, Robin A; Reedy, Jill; Morrissette, Meredith A; Lytle, Leslie A; Yaroch, Amy L

2009-04-01

Valid and reliable measures are required to assess any effect of the food environment on individual dietary behavior, and form the foundation of research that may inform obesity-related policy. Although many methods of measuring the food environment exist, this area of research is still relatively new and there has been no systematic attempt to gather these measures, to compare and contrast them, or to report on their psychometric properties. A structured literature search was conducted to identify peer-reviewed articles published between January 1990 and August 2007 that measured the community-level food environment. These articles were categorized into the following environments: food stores, restaurants, schools, and worksites. The measurement strategies in these studies were categorized as instruments (checklists, market baskets, inventories, or interviews/questionnaires) or methodologies (geographic, sales, menu, or nutrient analyses). A total of 137 articles were identified that included measures of the food environment. Researchers focused on assessing the accessibility, availability, affordability, and quality of the food environment. The most frequently used measure overall was some form of geographic analysis. Eighteen of the 137 articles (13.1%) tested for any psychometric properties, including inter-rater reliability, test-retest reliability, and/or validity. A greater focus on testing for reliability and validity of measures of the food environment may increase rigor in research in this area. Robust measures of the food environment may strengthen research on the effects of the community-level food environment on individual dietary behavior, assist in the development and evaluation of interventions, and inform policymaking targeted at reducing the prevalence of obesity and improving diet.

Is Living near Healthier Food Stores Associated with Better Food Intake in Regional Australia?

PubMed

Moayyed, Hamid; Kelly, Bridget; Feng, Xiaoqi; Flood, Victoria

2017-08-07

High prevalence of obesity and non-communicable diseases is a global public health problem, in which the quality of food environments is thought to play an important role. Current scientific evidence is not consistent regarding the impact of food environments on diet. The relationship between local food environments and diet quality was assessed across 10 Australian suburbs, using Australian-based indices devised to measure the two parameters. Data of dietary habits from the participants was gathered using a short questionnaire. The suburbs' Food Environment Score (higher being healthier) was associated with higher consumption of fruit (χ² (40, 230) = 58.8, p = 0.04), and vegetables (χ² (40, 230) = 81.3, p = 0.03). The Food Environment Score identified a significant positive correlation with four of the diet scores: individual total diet score (r s = 0.30, p < 0.01), fruit and vegetable score (r s = 0.43, p < 0.01), sugary drink score (r s = 0.13, p < 0.05), and discretionary food score (r s = 0.15, p < 0.05). Moreover, the suburbs' RFEI (Retail Food Environment Index, higher being unhealthier) showed a significant association with higher consumption of salty snacks (χ² (24, 230) = 43.9, p = 0.04). Food environments dominated by food outlets considered as 'healthier' were associated with healthier population food intakes, as indicated by a higher consumption of fruit, vegetables, and water, as well as a lower consumption of junk food, salty snacks, and sugary drinks. This association suggests that healthier diet quality is associated with healthier food environments in regional Australia.

Is Living near Healthier Food Stores Associated with Better Food Intake in Regional Australia?

PubMed Central

Moayyed, Hamid; Kelly, Bridget; Feng, Xiaoqi; Flood, Victoria

2017-01-01

High prevalence of obesity and non-communicable diseases is a global public health problem, in which the quality of food environments is thought to play an important role. Current scientific evidence is not consistent regarding the impact of food environments on diet. The relationship between local food environments and diet quality was assessed across 10 Australian suburbs, using Australian-based indices devised to measure the two parameters. Data of dietary habits from the participants was gathered using a short questionnaire. The suburbs’ Food Environment Score (higher being healthier) was associated with higher consumption of fruit (χ2 (40, 230) = 58.8, p = 0.04), and vegetables (χ2 (40, 230) = 81.3, p = 0.03). The Food Environment Score identified a significant positive correlation with four of the diet scores: individual total diet score (rs = 0.30, p < 0.01), fruit and vegetable score (rs = 0.43, p < 0.01), sugary drink score (rs = 0.13, p < 0.05), and discretionary food score (rs = 0.15, p < 0.05). Moreover, the suburbs’ RFEI (Retail Food Environment Index, higher being unhealthier) showed a significant association with higher consumption of salty snacks (χ2 (24, 230) = 43.9, p = 0.04). Food environments dominated by food outlets considered as ‘healthier’ were associated with healthier population food intakes, as indicated by a higher consumption of fruit, vegetables, and water, as well as a lower consumption of junk food, salty snacks, and sugary drinks. This association suggests that healthier diet quality is associated with healthier food environments in regional Australia. PMID:28783099

Pulga (flea market) contributions to the retail food environment of colonias in the South Texas border region.

PubMed

Dean, Wesley R; Sharkey, Joseph R; St John, Julie

2011-05-01

Accounts of the retail food environment have been limited by research that focused on supermarkets, grocery stores, and restaurants as the principal food sources for consumers. Little is known about alternative retail food sources, especially in rural and underserved areas such as the colonias along the South Texas border with Mexico. Many colonias are located near pulgas (flea markets). This is the first study to examine this alternative food source for colonia residents. This study's purpose is to provide preliminary data on food availability in this unstudied element of the retail food environment. Five pulgas were identified for study by local informants. Two separate teams of two promotores (indigenous community health workers) conducted observations, wrote field notes, and surveyed vendors in each pulga. Traditional foods, prepared foods, and fresh fruits and vegetables were available in the observed pulgas. Traditional foods included staples, meal items, and snacks and sweets. Prepared foods were available in small stands run by independent operators, and each pulga had permanent restaurants that served prepared foods. A large variety of fresh fruits and vegetables were also available. An emphasis on supermarkets and grocery stores will provide an incomplete account of the retail food environment. Further studies should attempt to provide a more complete account by identifying alternative retail sources used by local residents. One such alternative retail food source, the pulga, provides a range of traditional food stuffs, prepared food items, and fruits and vegetables that complement conventionally studied aspects of the retail food environment. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Food environment and fruit and vegetable intake in a urban population: a multilevel analysis.

PubMed

Pessoa, Milene Cristine; Mendes, Larissa Loures; Gomes, Crizian Saar; Martins, Paula Andréa; Velasquez-Melendez, Gustavo

2015-10-05

Environmental, social and individual factors influence eating patterns, which in turn affect the risk of many chronic diseases. This study aimed to estimate associations between environmental factors and the consumption of fruit and vegetables among adults in a Brazilian urban context. Data from the surveillance system for risk factors for chronic diseases (VIGITEL) of Brazilian Ministry of Health were used. A cross-sectional telephone survey (VIGITEL - 2008-2010) was carried out with 5826 adults in the urban area of Belo Horizonte. Individual variables were collected. The frequency of fruit and vegetables consumption was assessed from number of servings, weekly frequency and an intake score was calculated. Georeferenced variables were used to characterize the food environment. The density of healthy food outlets (stores specialized in selling fruit and vegetables), unhealthy food outlets (bars, snack bars and food trucks/trailers) and the neighborhood family income were investigated and associated with fruit and vegetables intake score. Weighted multilevel linear regression was used to evaluate the associations between the environment variables and the fruit and vegetables intake score. Higher fruit and vegetables intake scores were observed in neighborhoods with higher density of healthy food outlets and higher income. Lower scores were observed in neighborhood with higher density of unhealthy food outlets. These associations were adjusted by individual variables such as gender, age, physical activity, sugar sweetened beverages consumption, education level and smoking. The food environment might explain some of the socioeconomic disparities with respect to healthy food intake and health outcomes. Healthy food stores are less common in socially disadvantaged neighborhoods, and therefore, healthy foods such as fruits and vegetables are less available or are of a lower quality in lower income areas. Food environment characteristics and neighborhood socioeconomic