Abstract

Because supermarkets are a critical part of the community food environment, the purpose of this paper is to examine the association between accessibility to the supermarket where participants were surveyed, frequency of shopping at the supermarket, and self-reported and objectively-assessed fruit and vegetable consumption. Accessibility was assessed using Geographic Information Systems (GIS) measured distance and multiple versions of the modified Retail Food Environment Index (mRFEI), including a localized road network buffer version. Frequency of shopping was assessed using self-report. The National Cancer Institute Fruit and Vegetable screener was used to calculate daily servings of fruits and vegetables. Skin carotenoids were assessed using the “Veggie Meter™” which utilizes reflection spectroscopy to non-invasively assess skin carotenoids as an objective measure of fruit and vegetable consumption. Bivariate and multivariable statistics were used to examine the associations in RStudio. There was a positive association between skin carotenoids and the Special Supplemental Nutrition Program for Women Infants and Children (WIC) and mRFEI scores, suggesting that WIC participation and a healthier food environment were associated with objectively-assessed fruit and vegetable consumption (skin carotenoids). Future research should examine these associations using longitudinal study designs and larger sample sizes.

Highlights

  • Fruit and vegetable consumption is important for a healthy and balanced diet [1]

  • The Veggie MeterTM was found to be a valid measure of fruit and vegetable consumption among a racially diverse sample in eastern North Carolina [60], with a correlation coefficient of 0.71 (p < 0.0001) between plasma carotenoids assessed via High Performance Liquid Chromatography and skin carotenoids assessed via the Veggie MeterTM

  • We examined bivariate associations between objectively-measured fruit and vegetable consumption (Veggie MeterTM) and spatial access variables: road network distance and time to supermarket where surveyed; modified Retail Food Environment Index (mRFEI), number of mRFEI-defined healthy outlets, number of mRFEI-defined less healthy outlets, density of supermarkets around residence at 1, 3, and 5 mile localized Service Areas [53], and distance to the closest supermarket and supercenter, using Spearman’s correlation coefficient

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Summary

Introduction

Frequent consumption of a variety of fruits and vegetables reduces the risk of diet-related diseases such as heart disease, diabetes, and cancer [2,3,4,5,6]. Despite these benefits, Americans consume less than the recommended amounts of fruits and vegetables [7,8,9,10], with lower consumption levels among rural and disadvantaged populations [11,12]. It is imperative to develop and evaluate supermarket-based initiatives to increase healthy food purchase and consumption.

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