Abstract
Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual’s homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04–1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11–2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04–1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people’s home is an important environmental factor in meeting fruit and vegetable consumption guidelines. “Food swamps” (areas with an abundance of unhealthy foods) rather than “food deserts” (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong’s urban areas. We advanced international literature by providing evidence in a non-western setting.
Highlights
Fruit and vegetable (FV) are important components of a healthy diet, and their sufficient daily consumption could help prevent major, non-communicable diseases, such as cardiovascular diseases, heart disease, stroke, cancer, diabetes, and obesity, according to the World Health Organization [1]
Public Health 2018, 15, x adults (18 years or older), we explored the association of the density of different types of retail food outlets and relative density of fast-food restaurants and convenience stores to grocery stores Retail Food Environment Index (RFEI) within a 1000 m Euclidean buffer around people’s home with infrequent consumption of fruit or vegetable in Hong Kong
We explored whether the density of different types of retail food outlets and the relative density of fast-food restaurants and convenience stores to grocery stores’ RFEI around people’s home was associated with infrequent consumption of fruit or vegetable among adults in Hong Kong
Summary
Fruit and vegetable (FV) are important components of a healthy diet, and their sufficient daily consumption (at least 400 g; ~5 portions per day) could help prevent major, non-communicable diseases, such as cardiovascular diseases, heart disease, stroke, cancer, diabetes, and obesity, according to the World Health Organization [1]. 16.0 million (1.0%) disability adjusted life years (DALYs, a measure of the potential life lost due to premature mortality and the years of productive life lost due to disability) and 1.7 million (2.8%) of deaths worldwide are attributable to low fruit and vegetable consumption. Insufficient intake of fruit and vegetables is estimated to cause. Res. Public Health 2018, 15, 2247; doi:10.3390/ijerph15102247 www.mdpi.com/journal/ijerph
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