Public Health Nutrition | VOL. 24

Food security moderates relationship between perceived food environment and diet quality among adults in communities with low access to healthy food retail

Publication Date Jul 2, 2020


AbstractObjective:To examine the relationship between food security status, diet quality measured using Healthy Eating Index-2010 (HEI-2010) scores, demographics and the following factors: perceptions of healthy food availability, healthy eating identity and perceived control of healthy eating.Design:A cross-sectional study in 2016–2017 using three 24-h dietary recalls and one psychosocial survey.Setting:Two urban communities in Cleveland and Columbus, Ohio, USA, with low access to healthy food retailers.Participants:Primary food shoppers living in the targeted geographic areas (N 450).Results:Our results indicated that high school graduates had lower HEI-2010 scores compared with participants who had some college education or more (β = –2·77, P = 0·02). Participants receiving Supplemental Nutrition Assistance Program (SNAP) benefits had lower HEI-2010 scores (β = –2·69, P = 0·03). Healthy eating identity was associated with higher HEI-2010 scores (β = 1·85, P = 0·004). Food security status moderated the relationship between perception of healthy food availability and HEI-2010 scores. Among participants with very low food security (VLFS), greater perceptions of healthy food availability were associated with higher HEI-2010 scores (β = 3·25, P = 0·03), compared with food secure participants. Only 14 % of VLFS participants used a personal vehicle as transportation to their primary food shopping store.Conclusions:Findings offer targets for future intervention development and evaluation to promote community nutrition. These targ...


Healthy Eating Index-2010 Scores Higher Healthy Eating Index-2010 Scores Very Low Food Security Supplemental Nutrition Assistance Program Benefits Food Secure Healthy Food Supplemental Nutrition Assistance Program Perceived Food Environment Food Secure Participants Healthy Eating Index-2010

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