Food Shopping and Acquisition Behaviors in Relation to BMI among Residents of Low-Income Communities in South Carolina

Abstract

Low-income areas in which residents have poor access to healthy foods have been referred to as “food deserts.” It is thought that improving food access may help curb the obesity epidemic. Little is known about where residents of food deserts shop and if shopping habits are associated with body mass index (BMI). We evaluated the association of food shopping and acquisition (e.g., obtaining food from church, food pantries, etc.) with BMI among 459 residents of low-income communities from two South Carolina counties, 81% of whom lived in United States Department of Agriculture-designated food deserts. Participants were interviewed about food shopping and acquisition and perceptions of their food environment, and weight and height were measured. Distances to food retail outlets were determined. Multivariable linear regression analysis was employed. Our study sample comprising largely African-American women had an average BMI of 32.5 kg/m2. The vast majority of study participants shopped at supermarkets (61%) or supercenters/warehouse clubs (27%). Shopping at a supercenter or warehouse club as one’s primary store was significantly associated with a 2.6 kg/m2 higher BMI compared to shopping at a supermarket, independent of demographics, socioeconomics, physical activity, and all other food shopping/acquisition behaviors. Persons who reported shopping at a small grocery store or a convenience or dollar store as their tertiary store had a 2.6 kg/m2 lower BMI. Respondents who perceived lack of access to adequate food shopping in their neighborhoods as a problem had higher BMI. Living in a food desert census tract was not significantly associated with BMI. Other shopping attributes, including distance to utilized and nearest grocery stores, were not independently associated with BMI. These findings call into question the idea that poor spatial access to grocery stores is a key underlying factor affecting the obesity epidemic. Future research should consider assessing foods purchased and dietary intake within a comprehensive study of food shopping behaviors and health outcomes among persons living in food deserts.

Use of Online Food Delivery Services to Order Food Prepared Away-From-Home and Associated Sociodemographic Characteristics: A Cross-Sectional, Multi-Country Analysis

“…Online food delivery service use could reduce home cooking, which might have implications for the overall diet quality of customers. Whilst it is possible to meet dietary guidelines through consumption of food prepared away-from-home, it may be more difficult and more expensive than through food prepared at home [42,43], and bound by the types of food outlet available [44].…”

Food insecurity in a pre-bariatric surgery sample: prevalence, demographics and food shopping behaviour

“…Based on a literature review of food buying behaviours associated with food insecurity (8,15,39) , we developed five questions that were included in the same survey as the ten US adult food security survey module items. For the full text of all added questions, see Table 4.…”

Growing disparities in an urban food desert: Downtown Albany longitudinal food environment studies

“…B. Morland & Evenson, 2009;Rundle et al, 2009). Others report null, mixed (depending on a subgroup), or contrary associations between supermarket access and health (Aggarwal et al, 2014;Casagrande et al, 2011;Drewnowski, Aggarwal, Hurvitz, Monsivais, & Moudon, 2012;Dubowitz et al, 2015;Gase, DeFosset, Smith, & Kuo, 2014;Hosler, Michaels, & Buckenmeyer, 2016;Lear, Gasevic, & Schuurman, 2013;Liese et al, 2017;Wang, Cubbin, Ahn, & Winkleby, 2007). The null or contrary findings are more common when shopping behavior is incorporated into the analysis.…”

“…Some studies found independent associations between proximity to a supermarket and better dietary behavior and/or lower rates of obesity (Bodor, Rice, Farley, Swalm, & Rose, ; Brown et al, ; Dubowitz et al, ; Laraia, Siega‐Riz, Kaufman, & Jones, ; Moore, Diez Roux, Nettleton, & Jacobs, ; K. B. Morland & Evenson, ; Rundle et al, ). Others report null, mixed (depending on a subgroup), or contrary associations between supermarket access and health (Aggarwal et al, ; Casagrande et al, ; Drewnowski, Aggarwal, Hurvitz, Monsivais, & Moudon, ; Dubowitz et al, ; Gase, DeFosset, Smith, & Kuo, ; Hosler, Michaels, & Buckenmeyer, ; Lear, Gasevic, & Schuurman, ; Liese et al, ; Wang, Cubbin, Ahn, & Winkleby, ). The null or contrary findings are more common when shopping behavior is incorporated into the analysis.…”

“…The null or contrary findings are more common when shopping behavior is incorporated into the analysis. A majority of these studies reported that study participants did not necessarily shop at the nearest store, and that the type of supermarket where they shopped mattered more than the proximity: Specifically, shopping at high‐end supermarkets was associated with better dietary behavior and/or lower weight status/BMI (Aggarwal et al, ; Chaix et al, ; Drewnowski et al, ; Ghosh‐Dastidar et al, ), whereas shopping at low‐end (discount) supermarkets, supercenters (i.e., Walmart), and warehouse clubs was associated with poorer dietary behavior and/or higher obesity measures (Hosler et al, ; Lear et al, ; Liese et al, ).…”