The role of the local retail food environment in fruit, vegetable and sugar-sweetened beverage consumption in Brazil

Abstract

Objective: To examine the relationship between the local retail food environment and consumption of fruits and vegetables (FV) and sugar-sweetened beverages (SSB) in São Paulo, Brazil, as well as the moderation effects of income in the studied relationships. Design: Cross-sectional study design that drew upon neighbourhood-and individual-level data. For each participant, community (density and proximity) and community food environment (availability, variety, quality and price) measures of FV and SSB were assessed in retail food stores and specialized fresh produce markets within 1·6 km of their homes. Poisson generalized estimating equations (GEE) were used to model the associations of food consumption with food environment measures, adjusted by individual-level characteristics. Setting: São Paulo, Brazil. Subjects: Adults (n 1842) residing in the same census tracts (n 52) in São Paulo, Brazil as those where the neighbourhood-level measures were taken. Results: FV availability in neighbourhoods was associated with regular FV consumption (≥5 times/week; prevalence ratio = 1·41; 95 % CI 1·19, 1·67). Regular FV consumption prevalence was significantly lower among lower-income individuals living in neighbourhoods with fewer supermarkets and fresh produce markets (P-interaction <0·05). A greater variety of SSB was associated with a 15 % increase in regular SSB consumption (≥5 times/week) prevalence, after adjustment for confounding variables. Conclusions: Our findings suggest that the local retail food environment is associated with FV and SSB consumption in a Brazilian urban sample.

A influência dos locais de refeição e de aquisição de alimentos no consumo de frutas e hortaliças por adultos no município de São Paulo

“…Since the intake of these foods, presented by the studied population, was higher than that found in previous analyses 7 , maybe the intake in this population is not influenced by the consumption or not of meals at fast-food restaurants; that is, the individuals who consume fruits and vegetables are not affected by the regular intake of meals at fast-food restaurants. However, it is still necessary to understand how the presence of this type of restaurant can affect and change the dietary behavior and the health of the population, for the implementation of effective strategies to stimulate healthy diets, even if outside the household 12 .…”

“…In São Paulo, the highest density of supermarkets and fruit stores is associated with the regular intake of fruits and vegetables, especially in the lower income categories 12 .…”

“…The dietary behavior is highly complex. The reasons that lead a person to consume a specific food come from the interaction of multiple influences, in different contexts and conditions, being influenced by socioeconomic and demographic characteristics [9][10][11][12][13][14][15] . The choice of locations to purchase food is also influenced by the environment and by individual characteristics 16,17 .…”

“…Adulto. at more accessible prices, when compared to convenience stores and corner stores 12,19 . Studies in the United States and in the United Kingdom present diverse results when assessing the presence of purchasing sites for fruits and vegetables, and the effect on the consumption of these foods by the population 20 .…”

Consumo de frutas e hortaliças em adultos no município de São Paulo: a influência dos locais de aquisição e consumo de alimentos

“…O comportamento alimentar vem sofrendo constantes mudanças. Os motivos que levam uma pessoa a consumir determinado alimento são complexos e estão associados a diversos fatores ambientais, pessoais e sociais 9,10,11,12 .…”