Consumer Food Environment Research Articles

The community and consumer food environment and children's diet: a systematic review.

BackgroundWhile there is a growing body of research on food environments for children, there has not been a published comprehensive review to date evaluating food environments outside the home and school and their relationship with diet in children. The purpose of this paper is to review evidence on the influence of the community and consumer nutrition environments on the diet of children under the age of 18 years.MethodsOur search strategy included a combination of both subject heading searching as well as natural language, free-text searching. We searched nine databases (MEDLINE, Web of Science, CINAHL, Embase, Scopus, ProQuest Public Health, PsycINFO, Sociological s, and GEOBASE) for papers published between 1995 and July 2013. Study designs were included if they were empirically-based, published scholarly research articles, were focused on children as the population of interest, fit within the previously mentioned date range, included at least one diet outcome, and exposures within the community nutrition environment (e.g., location and accessibility of food outlets), and consumer nutrition environment (e.g., price, promotion, and placement of food choices).ResultsAfter applying exclusion and inclusion criteria, a total of 26 articles were included in our review. The vast majority of the studies were cross-sectional in design, except for two articles reporting on longitudinal studies. The food environment exposure(s) included aspects of the community nutrition environments, except for three that focused on the consumer nutrition environment. The community nutrition environment characterization most often used Geographic Information Systems to geolocate participants’ homes (and/or schools) and then one or more types of food outlets in relation to these. The children included were all of school age. Twenty-two out of 26 studies showed at least one positive association between the food environment exposure and diet outcome. Four studies reported only null associations.ConclusionsThis review found moderate evidence of the relationship between the community and consumer nutrition environments and dietary intake in children up to 18 years of age. There is wide variation in measures used to characterize both the community and consumer nutrition environments and diet, and future research should work to decrease this heterogeneity.

Assessing the Food Environment of a Rural Community: Baseline Findings From the Heart of New Ulm Project, Minnesota, 2010–2011

IntroductionChanges in the food environment in the United States during the past few decades have contributed to increased rates of obesity, diabetes, and heart disease. Improving the food environment may be an effective primary prevention strategy to address these rising disease rates. The purpose of this study was to assess the consumer food environment of a rural community with high rates of obesity and low levels of fruit and vegetable consumption. Findings were used to identify food environment intervention strategies to be implemented as part of a larger community-based heart disease prevention program.MethodsWe used the Nutrition Environment Measures Survey for Restaurants (NEMS-R) and Stores (NEMS-S) to assess 34 restaurants, 3 grocery stores, and 5 convenience stores in New Ulm, Minnesota.ResultsAt least half of the restaurants offered nonfried vegetables and 100% fruit juice. Only 32% had at least 1 entrée or 1 main dish salad that met standards for “healthy.” Fewer than half (41%) had fruit available and under one-third offered reduced-size portions (29%) or whole-grain bread (26%). Grocery stores had more healthful items available, but findings were mixed on whether these items were made available at a lower price than less healthful items. Convenience stores were less likely to have fruits and vegetables and less likely to carry more healthful products (except milk) than grocery stores.ConclusionBaseline findings indicated opportunities to improve availability, quality, and price of foods to support more healthful eating. A community-wide food environment assessment can be used to strategically plan targeted interventions.

Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally

E-mail: c.nimhurchu@nihi.auckland.ac.nz Summary Retail food environments are increasingly considered influential in determining dietary behaviours and health outcomes. We reviewed the available evidence on associations between community (type, availability and accessibility of food outlets) and consumer (product availability, prices, promotions and nutritional quality within stores) food environments and dietary outcomes in order to develop an evidence-based framework for monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in retail food environments. Current evidence is suggestive of an association between community and consumer food environments and dietary outcomes; however, substantial heterogeneity in study designs, methods and measurement tools makes it difficult to draw firm conclusions. The use of standardized tools to monitor local food environments within and across countries may help to validate this relationship. We propose a stepwise framework to monitor and benchmark community and consumer retail food environments that can be used to assess density of healthy and unhealthy food outlets; measure proximity of healthy and unhealthy food outlets to homes/ schools; evaluate availability of healthy and unhealthy foods in-store; compare food environments over time and between regions and countries; evaluate compliance with local policies, guidelines or voluntary codes of practice; and determine the impact of changes to retail food environments on health outcomes, such as obesity.

Monitoring the availability of healthy and unhealthy foods and non‐alcoholic beverages in community and consumer retail food environments globally

Retail food environments are increasingly considered influential in determining dietary behaviours and health outcomes. We reviewed the available evidence on associations between community (type, availability and accessibility of food outlets) and consumer (product availability, prices, promotions and nutritional quality within stores) food environments and dietary outcomes in order to develop an evidence-based framework for monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in retail food environments. Current evidence is suggestive of an association between community and consumer food environments and dietary outcomes; however, substantial heterogeneity in study designs, methods and measurement tools makes it difficult to draw firm conclusions. The use of standardized tools to monitor local food environments within and across countries may help to validate this relationship. We propose a step-wise framework to monitor and benchmark community and consumer retail food environments that can be used to assess density of healthy and unhealthy food outlets; measure proximity of healthy and unhealthy food outlets to homes/schools; evaluate availability of healthy and unhealthy foods in-store; compare food environments over time and between regions and countries; evaluate compliance with local policies, guidelines or voluntary codes of practice; and determine the impact of changes to retail food environments on health outcomes, such as obesity.

Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Assessing the Rural Food Environment, Part 1

IntroductionObesity prevalence in the rural United States is higher than in urban or suburban areas, perhaps as a result of the food environment. Because rural residents live farther from supermarkets than their urban- and suburban-dwelling counterparts, they may be more reliant on smaller corner stores that offer fewer healthful food items.MethodsAs part of a Communities Putting Prevention to Work (CPPW) healthy corner store initiative, we reviewed audit tools in the fall of 2010 to measure the consumer food environment in eastern North Carolina and chose the NEMS-S-Rev (Nutrition Environment Measures Survey-Stores-Revised) to assess 42 food stores. During the spring and summer of 2011, 2 trained graduate assistants audited stores, achieving interrater reliability of at least 80%. NEMS-S-Rev scores of stores in rural versus urban areas were compared.ResultsOverall, healthful foods were less available and of lower quality in rural areas than in urban areas. NEMS-S-Rev scores indicated that healthful foods were more likely to be available and had similar pricing and quality in rural corner stores than in urban corner stores.ConclusionFood store audit data provided a baseline to implement and evaluate a CPPW healthy corner store initiative in Pitt County. This work serves as a case study, providing lessons learned for engaging community partners when conducting rural food store audits.

Neighbourhood and consumer food environment is associated with dietary intake among Supplemental Nutrition Assistance Program (SNAP) participants in Fayette County, Kentucky.

The aim of the study was to determine the association between dietary outcomes and the neighbourhood food environment (street network distance from home to stores) and consumer food environment (Nutrition Environment Measurement Survey-Stores (NEMS-S) audit). The neighbourhood food environment was captured by creating 0?5-mile and 1-mile network distance (street distance) around each participant’s home and the nearest food venue (convenience store, grocery store, supermarket, farmers’ market and produce stand). The consumer food environment was captured by conducting NEMS-S in all grocery stores/supermarkets within 0?5 and 1 mile of participants’ homes. Fayette County, KY, USA. Supplemental Nutrition Assessment Program (SNAP) participants, n 147. SNAP participants who lived within 0?5 mile of at least one farmers’ market/produce stand had higher odds of consuming one serving or more of vegetables (OR56?92; 95% CI 4?09, 11?69), five servings or more of grains (OR51?76; 95% CI 1?01, 3?05) and one serving or more of milk (OR53?79; 95% CI 2?14, 6?71) on a daily basis. SNAP participants who lived within 0?5 mile of stores receiving a high score on the NEMS-S audit reported higher odds of consuming at least one serving of vegetables daily (OR53?07; 95% CI 1?78, 5?31). Taken together, both the neighbourhood food environment and the consumer food environment are associated with a healthy dietary intake among SNAP participants.

Food venue choice, consumer food environment, but not food venue availability within daily travel patterns are associated with dietary intake among adults, Lexington Kentucky 2011

ObjectiveThe retail food environment may be one important determinant of dietary intake. However, limited research focuses on individuals’ food shopping behavior and activity within the retail food environment. This study’s aims were to determine the association between six various dietary indicators and 1) food venue availability; 2) food venue choice and frequency; and 3) availability of healthy food within food venue.MethodsIn Fall, 2011, a cross-sectional survey was conducted among adults (n=121) age 18 years and over in Lexington, Kentucky. Participants wore a global position system (GPS) data logger for 3-days (2 weekdays and 1 weekend day) to track their daily activity space, which was used to assess food activity space. They completed a survey to assess demographics, food shopping behaviors, and dietary outcomes. Food store audits were conducted using the Nutrition Environment Measurement Survey-Store Rudd (NEMS-S) in stores where respondents reported purchasing food (n=22). Multivariate logistic regression was used to examine associations between six dietary variables with food venue availability within activity space; food venue choice; frequency of shopping; and availability of food within food venue.Results1) Food venue availability within activity space – no significant associations. 2) Food Venue Choice – Shopping at farmers’ markets or specialty grocery stores reported higher odds of consuming fruits and vegetables (OR 1.60 95% CI [1.21, 2.79]). Frequency of shopping - Shopping at a farmers’ markets and specialty stores at least once a week reported higher odds of consumption of fruits and vegetables (OR 1.55 95% CI [1.08, 2.23]). Yet, shopping frequently at a super market had higher odds of consuming sugar-sweetened beverages (OR 1.39 95% CI [1.03, 1.86]). 3) Availability of food within store – those who shop in supermarkets with high availability of healthy food has lower odds of consuming sugar-sweetened beverages (OR 0.65 95% CI [0.14, 0.83]).ConclusionInterventions aimed at improving fruit and vegetable intake need to consider where individuals’ purchase food and the availability within stores as a behavioral and environmental strategy.

Meeting the Whole Grain Dietary Guidelines - Are they sustainable given the food supply and current consumer food environment?

Meeting the Whole Grain Dietary Guidelines - Are they sustainable given the food supply and current consumer food environment?

"Big food," the consumer food environment, health, and the policy response in South Africa.

In an article that forms part of the PLoS Medicine series on Big Food, Corinna Hawkes and colleagues provide a perspective from South Africa on the rise of multinational and domestic food companies, and argue that government should act urgently through education about the health risks of unhealthy diets, regulation of Big Food, and support for healthy foods.

Exporting obesity: US farm and trade policy and the transformation of the Mexican consumer food environment

Obesity has reached epidemic proportions, in the United States as well as among its trade partners such as Mexico. It has been established that an "obesogenic" (obesity-causing) food environment is one influence on obesity prevalence. To isolate the particular role of NAFTA, the North American Free Trade Agreement, in changing Mexico's food environment, we plotted the flow of several key products between the United States and Mexico over the 14-year NAFTA period (1994-2008) and situated them in a broader historical context. Key sources of USDA data include the Foreign Agricultural Service's Global Agricultural Trade System, its official repository for current and historical data on imports, exports and re-exports, and its Production, Supply, and Distribution online database. US export data were queried for agricultural products linked to shifting diet patterns including: corn, soybeans, sugar and sweeteners, consumer-oriented products, and livestock products. The Bureau of Economic Analysis' Balance of Payments and Direct Investment Position Data in their web-based International Economic Accounts system also helped determine changes in US direct investment abroad from 1982 to 2009. Directly and indirectly, the United States has exported increasing amounts of corn, soybeans, sugar, snack foods, and meat products into Mexico over the last two decades. Facilitated by NAFTA, these exports are one important way in which US agriculture and trade policy influences Mexico's food system. Because of significant US agribusiness investment in Mexico across the full spectrum of the latter's food supply chain, from production and processing to distribution and retail, the Mexican food system increasingly looks like the industrialized food system of the United States.

Measuring the food environment in three rural towns in New South Wales, Australia

Food availability affects eating habits, and in the Australian context, refers to the numbers and locations of food retail and food service outlets and the types and range of foods in those outlets. The aim of this study was to assess the community and consumer food environment in three small rural towns in New South Wales, Australia. Geographical analyses were used to measure the diversity, variety and locations of food outlets (community food environment); and checklists were used to assess the availability of selected indicator foods within food outlets (consumer food environment). Supermarkets provided access to the full range of healthy indicator foods, with convenience stores selling a more limited set of healthy food items. There were high numbers of take-away food outlets in each town that had no, or a limited number of, healthy food items. Energy-dense, nutrient-poor foods such as soft drinks and potato crisps were readily available across all food retail outlets in all towns. This study illustrates a valid, reliable and practical way of systematically describing food availability at a local level. The findings emphasise the ubiquity of energy-dense, nutrient-poor foods, and suggest that interventions to promote the availability of healthier food items in take-away food outlets are required. Further research is required to assess other factors which may affect residents' food access, such as cost and transport.

Measures of the Consumer Food Store Environment: A Systematic Review of the Evidence 2000–2011

Description of the consumer food environment has proliferated in publication. However, there has been a lack of systematic reviews focusing on how the consumer food environment is associated with the following: (1) neighborhood characteristics; (2) food prices; (3) dietary patterns; and (4) weight status. We conducted a systematic review of primary, quantitative, observational studies, published in English that conducted an audit of the consumer food environment. The literature search included electronic, hand searches, and peer-reviewed from 2000 to 2011. Fifty six papers met the inclusion criteria. Six studies reported stores in low income neighborhoods or high minority neighborhoods had less availability of healthy food. While, four studies found there was no difference in availability between neighborhoods. The results were also inconsistent for differences in food prices, dietary patterns, and weight status. This systematic review uncovered several key findings. (1) Systematic measurement of determining availability of food within stores and store types is needed; (2) Context is relevant for understanding the complexities of the consumer food environment; (3) Interventions and longitudinal studies addressing purchasing habits, diet, and obesity outcomes are needed; and (4) Influences of price and marketing that may be linked with why people purchase certain items.

Obesity and the community food environment: a systematic review

To examine the relationship between obesity and the community and/or consumer food environment. A comprehensive literature search of multiple databases was conducted and seven studies were identified for review. Studies were selected if they measured BMI and environmental variables related to food outlets. Environmental variables included the geographic arrangement of food stores or restaurants in communities and consumer conditions such as food price and availability within each outlet. The study designs, methods, limitations and results related to obesity and the food environment were reviewed, and implications for future research were synthesized. The reviewed studies used cross-sectional designs to examine the community food environment defined as the number per capita, proximity or density of food outlets. Most studies indirectly identified food outlets through large databases. The studies varied substantially in sample populations, outcome variables, units of measurement and data analysis. Two studies did not find any significant association between obesity rates and community food environment variables. Five studies found significant results. Many of the studies were subject to limitations that may have mitigated the validity of the results. Research examining obesity and the community or consumer food environment is at an early stage. The most pertinent gaps include primary data at the individual level, direct measures of the environment, studies examining the consumer environment and study designs involving a time sequence. Future research should directly measure multiple levels of the food environment and key confounders at the individual level.