Local food environment and fruit and vegetable consumption: An ecological study

Abstract

Ecological studies are essential for understanding the environment-diet relationship. The purpose of this study was to describe environmental conditions and their relationship with fruit and vegetable (FV) consumption among Brazilian public health service users in the city of Belo Horizonte. We evaluated food stores contained within 1600 m buffer zones at 18 Health Academy Programme sites, from 2013 to 2014. Variables at the community (density, proximity and type) and the consumer (sectional location of FV; availability, quality, variety, price and advertising of FV and ultra-processed foods) nutrition environment were measured by direct observation, while aggregate data from users (income and FV consumption) were obtained by interview. Data were analysed using the Kernel intensity estimator, average nearest neighbour value and Local Moran's Index for local spatial autocorrelation. We interviewed 3414 users and analysed 336 food stores. Major geographical variations in the FV consumption were identified. Average consumption was higher (site 2A: 410.5 ± 185.7 g vs. site 4B: 311.2 ± 159.9 g) in neighbourhoods with higher income and concentration of food stores, and better index of access to healthy foods. Sites with poor FV consumption had the most stores with poor access to healthy foods (index in the first tertile, ≤ 10). In conclusion, negative characteristics of the food environment, as seen in the present study, may contribute to low FV consumption, suggesting the need for the development and consolidation of public policies aimed at creating healthy environments through built environment interventions that increase access to and consumption of healthy foods like FV.

Ambiente alimentar: validação de método de mensuração e caracterização em território com o Programa Academia da Saúde

“…Também não foram avaliados os estabelecimentos de comercialização de alimentos para consumo imediato. Entretanto, o estudo de Bezerra et al (2013, apud Menezes et al 37 ) verificou que 40% da população brasileira consomem alimentos fora do domicílio, sendo este consumo menor em idosos (18,9%), mulheres (39,5%) e indivíduos com menor renda (36%). Neste trabalho, a unidade de análise foi o território com PAS, de Belo Horizonte, no qual os usuários são, em sua maioria, mulheres (88,1%), com idade média de 56,7 ± 11,8 anos (56,6% eram adultos mais velhos e 43,4% eram idosos), com baixo nível educacional (7,2 ± 4,1 anos) e renda mensal per capita [R$ 678,0; P 25 -P 75 :423,8-1000,0] 37 .…”

Perception versus intake of fruit and vegetables

“…Based on simple conglomerate sampling, stratified by the nine administrative regions of the municipality, two units of the PAS of each region were randomly selected, totaling 18 units. Further details on sampling can be found in Menezes et al [20].…”

Food environment, income and obesity: a multilevel analysis of a reality of women in Southern Brazil

“…Neighborhood social disadvantage is another contextual characteristic related to obesity. Socially disadvantaged neighborhoods tend to have a lower availability of healthy foods when compared to more advantaged neighborhoods 29,30,31,32,33,34,35,36,37 . Menezes et al 35 , when evaluated Brazilian adults found that average consumption of fruits and vegetables was higher in neighbourhoods with higher income and concentration of food stores.…”

“…Socially disadvantaged neighborhoods tend to have a lower availability of healthy foods when compared to more advantaged neighborhoods 29,30,31,32,33,34,35,36,37 . Menezes et al 35 , when evaluated Brazilian adults found that average consumption of fruits and vegetables was higher in neighbourhoods with higher income and concentration of food stores. Furthermore, studies exploring the relationship between the food environment and obesity suggest that higher access to healthy food is associated with better diet quality and lower rates of obesity 26,29,38,39,40 .…”