Objectives The purpose of this study was to assess whether the retail food environment, measured by multiple indicators around home and in activity space, was associated with nutritional quality of food purchases. Methods This cross-sectional study included 462 households from a quota sampling survey conducted in the south of France (Montpellier Metropolitan Area). The revised Healthy Purchase Index was implemented in order to assess nutritional quality of food purchases. Food environment indicators (presence, number, relative density and proximity of food outlets) were calculated around home and in activity space (around home, work, other places of activity and along commuting journeys) using a geographical information system. Six different types of food outlets were studied: supermarkets, markets, greengrocers, bakeries, other specialized food stores (butcher's, fishmonger's and dairy stores) and small grocery stores. Associations between food environment and nutritional quality of food purchases were assessed using multilevel models, and geographically weighted regressions to account for spatial non-stationarity. Models were adjusted for households’ socioeconomic and demographic characteristics. Results Nutritional quality of food purchases was positively associated with the number of greengrocers around home (1 vs 0: β = 0.25, 95%CI = [0.01, 0.49]; >1 vs 0: β = 0.25, 95%CI = [0.00, 0.50]), but negatively associated with the number of markets around home (1 vs 0: β = −0.20, 95%CI = [−0.40, 0.00]; >1 vs 0: β = −0.37, 95%CI = [−0.69, −0.06]). These associations varied across space in the studied area. For households with lower income, number of greengrocers in activity space was positively associated with nutritional quality of food purchases (1 vs 0: β = 0.70, 95%CI = [0.12, 1.3]; >1 vs 0: β = 0.67, 95%CI = [0.22, 1.1]). Conclusions Greengrocers might be an efficient food store type to promote healthier dietary behaviors. Further studies, particularly interventional studies, are needed to confirm these results in order to guide public health policies in actions designed to improve the food environment. Funding Sources Région Occitanie; Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE); ANR (the French National Research Agency).

Objectives This study aimed to explore changes in food purchasing practices (FPP) of French households during the first COVID-19 lockdown and associations with individual and environmental factors. Methods In April of 2020 households from the Mont'Panier cross-sectional study (n = 306), a quota sampling survey conducted in the south of France, were asked to complete an online questionnaire about their FPP during lockdown and related factors, including perceived food environment (FE) (distance to closest food store, perception of increased food prices etc.). Objective FE (presence, number, proximity and density of food outlets) was assessed around participant's home using a geographical information system. Multiple correspondence analysis based on changes in frequency of use and quantity of food purchased by food outlet, followed by a hierarchical cluster analysis resulted in the identification of clusters. Logistic regression models were performed to assess associations between identified clusters and household's sociodemographic characteristics, perceived and objective FE. Results Five clusters were identified. Cluster “Supermarket” (38% of the total sample), in which households reduced frequency of trips, but increased quantity bought in supermarkets during lockdown, was associated with lower incomes. Cluster “E-supermarket” (12%), in which households increased online food shopping, was associated with higher incomes. Cluster “Diversified” (22%), made up of households who reduced frequency of trips to diverse food outlet types, was associated with the perception of increased food prices. Cluster “Organic Food Store” (20%), in which households did not change frequency of trips, nor quantity purchased in organic food stores, was associated with being older (35–50 y vs < 35 y). Finally, cluster “Producer” (8%), including households who regularly purchased food from producers, but mostly reduced these purchases during lockdown, was associated with the presence of an organic food store within a 1-km walking distance around home. Conclusions This study highlighted diverse changes in FPP during lockdown and overall more significant associations with perceived than with objective FE indicators. Funding Sources ANR, INRAE, Région Occitanie.