Employment status,residential and workplace food environments: Associations with women's eating behaviours

There remains a lack of consistent evidence linking food environments with eating behaviours. Studies to date have largely ignored the way different individuals interact with their local food environment and have primarily focussed on exposures within the residential neighbourhood without consideration of exposures around the workplace, for example. In this study we firstly examine whether associations between the residential food environment and eating behaviours differ by employment status and, secondly, whether food environments near employed women's workplaces are more strongly associated with dietary behaviours than food environments near home. Employment status did not modify the associations between residential food environments and eating behaviours, however results showed that having access to healthy foods near the workplace was associated with healthier food consumption. Policies focused on supportive environments should consider commercial areas as well as residential neighbourhoods.     

Measuring local food environments: an overview of available methods and measures

Reliable and valid measures of local food environments are needed to more fully understand the relationship between these environments and health and identify potential intervention points to improve access to, and the availability of, healthy foods. These measures also inform policy making, including the zoning of food outlets and food labelling/information requirements. A literature review was undertaken using health, behavioural and social sciences, nutrition and public health databases and grey literature, to determine available information on the measurement of local food environments. Included articles were those measuring aspects of food environments published from 2000 to 2010. A range of tools and methods are available to measure different components of food environments. Those focusing on community nutrition environments record the number, type and location of food outlets. The tools that focus on the consumer nutrition environment incorporate other factors, such as available food and beverage products, their price and quality, and any promotions or information to prompt consumers to make purchasing decisions. A summary and critique of these measures are provided.     

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

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.     

Integrating coordination of food purchasing into activity space-based food environment research: Toward a household perspective

Despite the advances in person-based approaches to studying food environments, most studies using these approaches have relied on individual-centered activity space measures and largely ignored cohabiting household members who play crucial roles in shaping an individual's food access, food behaviors, and diet. This can be problematic for completely capturing food environments relevant to an individual and add uncertainties to explorations of how individuals' food environments relate to their food behaviors. This viewpoint discusses the need for, and implications of, considering household members when measuring food access and disentangling the behavioral pathways connecting the food environment to diet. Ultimately, a conceptual framework and potential questions are proposed to integrate household members into food environment research.     

Urban physical food environments drive dietary behaviours in Ghana and Kenya: A photovoice study

We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home gardening supplemented household nutritional needs, particularly in Nairobi. Policies to enhance food safety in neighbourhood environments are required. Home gardening, food pricing policies and social protection schemes could reduce financial barriers to safe and healthy diets.     

Use of nutrition facts panels among adults who make household food purchasing decisions

OBJECTIVE: To identify sociodemographic variables and beliefs about the causes of obesity associated with reported use of Nutrition Facts panel (NFP) information. DESIGN/SETTING: Nationally representative, cross-sectional survey of 1139 adults. Data collection employed a single-stage, equal-probability sampling design with random-digit dialing across 50 states and the District of Columbia. Analysis sample consisted of 390 adults living with one or more children who reported making food purchasing decisions. MAIN OUTCOME MEASURE: Respondents provided self-reported information on their use of NFP information when making food purchasing decisions for their household. ANALYSIS: Chi-square and analysis of variance (ANOVA) tests compared the analysis sample to the broader population. Logistic regression analyses identified the sociodemographic and beliefs about obesity variables related to NFP use. RESULTS: Fifty-three percent of the sample reported using NFP information on a consistent basis. Females, those with more education, and those currently married were more likely to use NFP labels. The importance of knowledge in order to maintain healthy body weight was the only belief variable associated with use of NFP information. IMPLICATIONS FOR RESEARCH AND PRACTICE: Nutrition educators interested in changing dietary behaviors should begin by identifying levels of nutritional literacy and beliefs about the importance of nutrition to motivate use of NFP labels.     

Who uses what food retailers? A cluster analysis of food retail usage in the Netherlands

The aim of this study is to describe how individuals use different food retailers and how food retail usage varies according to socio-demographic and diet-related characteristics. A cross-sectional survey among Dutch adults (N = 1784) was used. Results from the Two-step cluster analysis indicated that there were five clusters of food retail users. Use of discount supermarkets, organic supermarkets, fast-food outlets, and restaurants contributed to clustering, but use of regular supermarkets, local food shops and whether food retailers were close to home or further from home did not. The clusters included mixed food outlet users, discount supermarket and restaurant users, fast-food and restaurant users, predominant discount supermarket users and supermarkets, fast-food and restaurant users. Participants in each cluster had their own characteristics especially in terms of socio-economic position and diet quality. Future studies need to consider further how food retail selection links physical exposure to the food environment and diet.     

Use of concept mapping to explore the influence of food security on food buying practices

Paradoxically, individuals with food insecurity have been observed to have higher rates of obesity compared with their counterparts with food security. The factors influencing food purchasing behaviors in households with food security vs food insecurity are poorly understood. Using the mixed methods approach of concept mapping, we examined the perceptions and preferences driving the food purchasing behaviors of households with food security vs food insecurity. Twenty-six men and women with food security and 41 men and women with food insecurity from four neighborhoods in Boston, MA, completed the concept mapping process during 2010. Prevalence of overweight and obesity was greater among participants with food insecurity (80.5%) compared with those with food security (61.5%). Participants identified 163 unique factors that influenced their food purchasing behavior. Using multivariate analyses, these factors were grouped into eight unique concepts or clusters that reflected their perceptions of factors hindering healthy eating. Average cluster ratings were similar between participants with food security and food insecurity, suggesting that similar food purchasing behaviors are employed and are perceived similarly in how they hinder or promote healthy eating. The use of emergency food assistance programs may play a role in minimizing the burden of food insecurity while providing access to foods with varying degrees of nutritional quality that may be associated with increased risk of overweight and obesity observed in individuals and households with food insecurity.     

Perceptions of the food marketing environment among African American teen girls and adults

Obesity disproportionately affects African American adolescents, particularly girls. While ethnically targeted marketing of unhealthful food products contributes to this disparity, it is not known how African Americans perceive the food marketing environment in their communities. Qualitative methods, specifically photovoice and group discussions, were used to understand perceptions of African American adults and teen girls regarding targeted food marketing to adolescent girls. An advisory committee of four students, two faculty, and two parents was formed, who recruited peers to photograph their environments and participate in group discussions to answer “what influences teen girls to eat what they do.” Seven adults and nine teens (all female) participated in the study. Discussions were transcribed, coded, and analyzed with ATLAS.ti to identify common and disparate themes among participants. Results indicated that adults and teens perceived the type of food products, availability of foods, and price to influence the girls’ choices. The girls spoke about products that were highly convenient and tasty as being particularly attractive. The adults reported that advertisements and insufficient nutrition education were also influencers. The teens discussed that the places in which food products were available influenced their choices. Results suggest that the marketing of highly available, convenient food at low prices sell products to teen girls. Future work is needed to better understand the consumer’s perspective on the food and beverage marketing strategies used.     

A relational approach to evaluate food environments finds that the proximate food environment matters for those who use it

Using a relational approach, this study investigates whether shopping close to home moderates the relationship between the proximate food environment and diet. To address this question, we develop the proximate food retail quality (PFRQ) score, an inverse-distance weighted measure of all food retailers within a resident's neighborhood that incorporates audit data of each food retailer. This study relies on data collected through 24-h dietary recalls and psychosocial surveys administered to 449 adults in two socioeconomically matched neighborhoods. Food retailer audits collected data on the availability, price, and quality of healthful foods. Seventy-one percent of study participants report conducting at least 50% of their food shopping within approximately one mile of their home. Household income and education are associated with likelihood to shop close to home, while access to a personal vehicle is not. Finally, results suggest that, for residents who shop primarily close to home, a one unit increase in proximate food retail environment score is associated with a 17.2-point increase in HEI-2010 score, a measure of overall diet quality that ranges from zero to 100. This study suggests that the food environment matters for those who use it and that a low-quality proximate food environment can amplify individual disadvantage.     

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

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.     

Use of vendedores (mobile food vendors), pulgas (flea markets), and vecinos o amigos (neighbors or friends) as alternative sources of food for purchase among Mexican-origin households in Texas border colonias

There is a paucity of studies acknowledging the existence of alternative food sources, and factors associated with food purchasing from three common alternative sources: vendedores (mobile food vendors), pulgas (flea markets), and vecinos/amigos (neighbors/friends). This analysis aims to examine the use of alternative food sources by Mexican-origin women from Texas-border colonias and determine factors associated with their use. The design was cross-sectional. Promotora-researchers (promotoras de salud trained in research methods) recruited 610 Mexican-origin women from 44 colonias and conducted in-person surveys. Surveys included participant characteristics and measures of food environment use and household food security. Statistical analyses included separate logistic regressions, modeled for food purchase from mobile food vendors, pulgas, or neighbors/friends. Child food insecurity was associated with purchasing food from mobile food vendors, while household food security was associated with using pulgas or neighbors/friends. School nutrition program participants were more likely to live in households that depend on alternative food sources. Efforts to increase healthful food consumption such as fruits and vegetables should acknowledge all potential food sources (traditional, convenience, nontraditional, and alternative), especially those preferred by colonia residents. Current findings support the conceptual broadening of the retail food environment, and the importance of linking use with spatial access (proximity) to more accurately depict access to food sources.     

Examining the interaction between food outlets and outdoor food advertisements with primary school food environments

Schools are commonly seen as a site of intervention to improve children's nutrition, and prevent excess weight gain. Schools may have limited influence over children's diets; however, with home and community environments also exerting an influence within schools. This study considered the environment of food outlets and outdoor food advertisements surrounding four case study primary schools in New Zealand, and the impact of that external environment on within-school food environments. The shortest travel route between school and home addresses, and the number of food outlets and advertisements passed on that route, was calculated for each student. Interviews with school management were conducted. The schools with a higher percentage of students passing food outlets and advertisements considered that their presence impacted on efforts within schools to improve the food environment. Limiting students’ exposure to food outlets and outdoor food adverts through travel route planning, reducing advertising, or limiting the location of food outlets surrounding schools could be explored as intervention options to support schools in promoting nutrition.     

Australian consumers' food-related environmental beliefs and behaviours

The aim of this study was to examine Australians' food-related environmental beliefs and behaviours. Questionnaires were posted to 500 randomly selected adults, with 223 questionnaires completed (58% response rate). Decreased use of packaging by food manufacturers was viewed as being the most important item to help the environment, while lower meat consumption was seen as least likely to help. Composting food scraps and purchase or consumption of locally produced foods were the most commonly performed food-related environmental behaviours, while use of organic products was the least commonly performed. Moderate consistency (rs=0.54) was found between reported beliefs and behaviours. Older people were more likely to perform certain food-related environmental behaviours, such as composting. Awareness of the impact on the environment of meat production, organic compared to conventional farming, and food packaging was low even among those who were found to already believe that food-related actions are important to help the environment, suggesting widespread consciousness raising is needed.     

Eating green. Consumers' willingness to adopt ecological food consumption behaviors

Food consumption is associated with various environmental impacts, and consumers’ food choices therefore represent important environmental decisions. In a large-scale survey, we examined consumers’ beliefs about ecological food consumption and their willingness to adopt such behaviors. Additionally, we investigated in more detail how different motives and food-related attitudes influenced consumers’ willingness to reduce meat consumption and to buy seasonal fruits and vegetables. We found consumers believed avoiding excessive packaging had the strongest impact on the environment, whereas they rated purchasing organic food and reducing meat consumption as least environmentally beneficial. Similarly, respondents appeared to be most unwilling to reduce meat consumption and purchase organic food. Taste and environmental motives influenced consumers’ willingness to eat seasonal fruits and vegetables, whereas preparedness to reduce meat consumption was influenced by health and ethical motives. Women and respondents who preferred natural foods were more willing to adopt ecological food consumption patterns.     

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

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.     

Historical redlining and food environments: A study of 102 urban areas in the United States

ObjectiveUnhealthy food environments are disproportionally concentrated in neighborhoods with clustering of racial/ethnic minorities and poverty. This disparity has been blamed, in part, on market self-regulation. This explanation risks overlooking past and current practices of racial segregation that have created and reinforced the obstacles blocking investments from food retailers in marginalized neighborhoods. We fill this gap by investigating how the long-term ramifications of redlining, discriminatory housing practices enacted by federal Home Owner Lending Corporation (HOLC) in the 1930s, has evolved generations later to disproportionally exposing neighborhoods to unhealthy food environments.MethodsWe overlaid historical redlining maps over 2010 food environment observations at the census tract level to identify areas with less healthy food environments and to assess the historical context of those areas. For 11,651 census tracts within 102 U.S. urban areas, we described the healthiness of food environments as measured by the modified retail food environment index (mRFEI). Using hurdle models with random effects, we further examined the association between redlining housing practice and food environments.ResultsThe results indicate that historically redlined neighborhoods show a higher likelihood for unhealthy retail food environments even for census tracts with present-day economic and racial privilege.ConclusionThe current evidence shows how structural discrimination manifested by unjust housing practices and racial residential segregation fueled an uneven food environment where minority neighborhoods disproportionally bore the brunt of restrictive food access. It highlights an urgent need to ameliorate patterns of housing inequality as a fix to unequal food environments.     

Assessing exposure to food and beverage advertisements surrounding schools in Vancouver,BC

Recent policy initiatives call for restricting food marketing to children, yet little is known about children's current exposure to outdoor advertisements. This paper describes the prevalence and characteristics of food- or beverage-related advertisements surrounding 25 public elementary and secondary schools in Vancouver, Canada and assesses whether the informational food environment differs by neighbourhood or school characteristics. All but four schools had at least one food- or beverage-related advertisement within 400 m (median: 18, range: 0–96) and approximately 90% of food or beverage advertisements were for items not recommended for frequent consumption by provincial school food guidelines. After controlling for commercial density, secondary schools were associated with more outdoor food and beverage advertisements overall in comparison with elementary schools. The presence of an additional limited-service food outlet within 400 m was associated with a 7% increase in the number of overall advertisements (p < 0.001) while an additional grocery store was associated with fewer advertisements (IRR: 0.69, p < 0.001), controlling for commercial density. Findings suggest the need to consider the informational food environment as part of broader assessments of the school and retail food environments.     

Autonomy and control: the co-construction of adolescent food choice

We explored how adolescents and parents negotiate adolescents' increasing food choice autonomy in European Canadian, Punjabi Canadian and African Canadian families. Data were collected through semi-structured interviews with 47 adolescents and their parents, participant observation at a family meal and a grocery shopping trip with the family shopper(s). Thematic and constant comparative analyses were used. Adolescents exercised considerable autonomy over much of their food choice and their parents monitored and controlled the environment within which adolescents were given independence and responsibility. Parents used strategies of coaxing, coaching and coercing, while teens responded by complaining, ignoring and refusing their parents' advice. At the same time, teens took responsibility and reflected on their behaviours while keeping in mind their parents' advice, even if in some cases they were as yet unable to act upon it. Food choice autonomy is not simply a negative act of teenage defiance. Instead, it is actively co-constructed by both teens and their parents as each resists and responds to the others. Studies of adolescent autonomy related to food choices, and interventions based on nutritional autonomy as a risk factor for poor nutrition would do well to take account of the co-constructive parent-adolescent process of teen autonomy.     

Socio-demographic influences on food purchasing among Canadian households

OBJECTIVE: To characterize the relationships between selected socio-demographic factors and food selection among Canadian households. DESIGN: A secondary analysis of data from the 1996 Family Food Expenditure survey was conducted (n=10,924). Household food purchases were classified into one of the five food groups from Canada's Food Guide to Healthy Eating. Parametric and non-parametric modelling techniques were employed to analyse the effects of household size, composition, income and education on the proportion of income spent on each food group and the quantity purchased from each food group. RESULTS: Household size, composition, income and education together explained 21-29% of the variation in food purchasing. Households with older adults spent a greater share of their income on vegetables and fruit (P<0.0001), whereas households with children purchased greater quantities of milk products (P<0.0001). Higher income was associated with purchasing more of all food groups (P<0.0001), but the associations were nonlinear, with the strongest effects at lower income levels. Households where the reference person had a university degree purchased significantly more vegetables and fruit, and less meat and alternatives and 'other' foods (P<0.0001), relative to households with the lowest education level. CONCLUSIONS: Household socio-demographic characteristics have a strong influence on food purchasing, with the purchase of vegetables and fruit being particularly sensitive. Results reinforce concerns about constraints on food purchasing among lower income households. Furthermore, the differential effects of income and education on food choice need to be considered in the design of public health interventions aimed at altering dietary behaviour.