Associations Between Retail Food Environment and Nutritional Quality of Food Purchases in French Households: The Mont’Panier Cross-Sectional Study

Abstract

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).

Associations between the objective and perceived food environment and eating behavior in relation to socioeconomic status among adults in peri-urban settings: results from the CIVISANO study in Flanders, Belgium

“…Suggesting that the overall link between the food environment, especially the objective domain and eating behavior, might be more complex than initially thought and that the concept of objective indicators of the food environment representing the type and location of food outlets on people’s eating behavior is not enough to provide a holistic view of the food environment, to which an individual is exposed. This might be because the food environment is a vastly complex system and that focusing on a single setting, such as the neighborhood setting of this study, narrows the food environment to an ´artificial environment´ and deviates from the complexity of real-life food acquisition and eating behavior, resulting in statistically insignificant observations [ 35 ].…”

“…Taking the specific nature of peri-urban areas into account could improve our understanding of context-specific influences of the environment on eating behavior. To the best of our knowledge, only a limited number of studies in Europe (such as the Mont’Panier study by Recchia et al (2022)) have examined the food environments of populations with distinct socioeconomic profiles in peri-urban settings and investigated variations between these groups [ 35 ]. In Belgium, the majority of research on nutritional inequities has focused on urban settings such as Brussels, Ghent, and Antwerp.…”