Accessibility and Affordability of Supermarkets: Associations With the DASH Diet

Abstract

IntroductionIt is unknown whether there is an interplay of affordability (economic accessibility) and proximity (geographic accessibility) of supermarkets in relation to having a Dietary Approaches to Stop Hypertension (DASH)-accordant diet.MethodsData (collected: 2005–2015, analyzed: 2016) were from the cross-sectional, population-based Fenland Study cohort: 9,274 adults aged 29–64 years, living in Cambridgeshire, United Kingdom. Dietary quality was evaluated using an index of DASH dietary accordance, based on recorded consumption of foods and beverages in a validated 130-item, semi-quantitative food frequency questionnaire. DASH accordance was defined as a DASH score in the top quintile. Dietary costs (£/day) were estimated by attributing a food price variable to the foods consumed according to the questionnaire. Individuals were classified as having low-, medium-, or high-cost diets. Supermarket affordability was determined based on the cost of a 101-item market basket. Distances between home address to the nearest supermarket (geographic accessibility) and nearest economically-appropriate supermarket (economic accessibility) were divided into tertiles.ResultsHigher-cost diets were more likely to be DASH-accordant. After adjustment for key demographics and exposure to other food outlets, individuals with lowest economic accessibility to supermarkets had lower odds of being DASH-accordant (OR=0.59, 95% CI=0.52, 0.68) than individuals with greatest economic accessibility. This association was stronger than with geographic accessibility alone (OR=0.85, 95% CI=0.74, 0.98).ConclusionsResults suggest that geographic and economic access to food should be taken into account when considering approaches to promote adherence to healthy diets for the prevention of cardiovascular diseases and other chronic disease.

Consumers’ Response to an On‐Shelf Nutrition Labelling System in Supermarkets: Evidence to Inform Policy and Practice

“…First, the Guiding Stars labels signal consumers to place more weight on nutrition relative to other factors affecting their food‐purchase decisions, such as price. Second, healthier foods offered in supermarkets tend to have relatively higher price points per serving than less healthy foods, and as consumers are encouraged to shift toward choosing healthier foods, the price per product purchased and supermarket revenues increase. This is one of the first studies to report the impact of an on‐shelf nutrition labelling system on supermarket sales, key information that was specifically requested by the US National Academies to determine the impact that FOP and on‐shelf nutrition information has on food‐purchasing patterns and sustainability of the intervention in supermarkets .…”

Ethnicity and Metabolic Syndrome: Implications for Assessment, Management and Prevention

“…While some studies have indicated that the local food environment is associated with diets of nearby residents [99,100], not all studies have [101]. Similarly, the association of the food environment with risk factors is less clear.…”

“…Some studies reported a positive association between fast food restaurants and obesity [95,102], a negative association between supermarkets and obesity [103], while others observed no association between food stores and obesity [104]. However, it appears these associations may depend on socioeconomic strata, which in heterogeneous populations often aligns along race/ethnicity, as the positive relationship between fast food restaurants and obesity was strongest in those with the lowest income [100,105]. Whether interventions to change the local food environment affect risk for the MetS is not known.…”

Adaptação da dieta DASH (Dietary Approaches to Stop Hypertension) para cuidado nutricional no período pós-parto, no âmbito da Atenção Básica

“…The main supermarkets in the region were identified, as well as the small local trades and free markets, where the prices of various foods were surveyed 15 . Due to problems of violence in the territory in question, most of this survey was carried out using internet resources such as Google Maps ® , Google Street View ® and supermarket sites located in the perimeter of the community.…”

“…Due to the result of the criterion "geographical accessibility", the need for individual evaluation of this item to guide the nutritional orientation should be noted 10,11,15 .…”