ObjectiveThe present study aimed to: (i) examine associations between food store patronage and diet and weight-related outcomes; and (ii) explore consumer motivations for visiting different types of food store.DesignA stratified probability sample of residents completed household and individual-level surveys in 2009/2010 on food purchasing patterns and motivations, dietary intake, waist circumference (WC), weight and height. Diet quality was calculated using the Healthy Eating Index for Canada from a subset of participants (n 1362). Generalized estimating equations were created in 2015 to examine how frequency of patronizing different types of food store was associated with diet quality, intake of fruits and vegetable, mean intake of energy (kcal) sodium and saturated fat, WC and BMI.SettingThree mid-sized urban municipalities in Ontario, Canada.SubjectsA representative sample of residents (n 4574).ResultsParticipants who shopped frequently at food co-ops had significantly better diet quality (β=5·3; 99 % CI 0·3, 10·2) than those who did not. BMI and WC were significantly lower among those who frequently shopped at specialty shops (BMI, β=−2·1; 99 % CI −3·0, −1·1; WC, β=−4·8; 99 % CI −7·0, −2·5) and farmers’ markets (BMI, β=−1·4; 99 % CI −2·3, −0·5; WC, β=−3·8; 99 % CI −6·0, −1·6) compared with those who did not. Relative importance of reasons for food outlet selection differed by large (price, food quality) v. small (proximity, convenient hours) shopping trip and by outlet type.ConclusionsFindings contribute to our understanding of food store selection and have implications for potentially relevant retail food intervention settings.

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Understanding neighborhood preferences remains a key focus for planners. While many studies document the effects of either neighborhood design or neighborhood preference on health and travel behavior, few have explored their combined effect in smaller regions. Using a sample of 2,597 adults in the Region of Waterloo, Ontario, we found an unmet demand for walkable neighborhoods. Results suggest that walkable neighborhoods are independently associated with less vehicle travel after adjusting for sociodemographic and residential preferences. Our study highlights the importance of combining the effects of walkable neighborhoods and preferences for them when addressing health and sustainability goals in suburban communities.

Objective The Neighbourhood Environments in Waterloo: Patterns of Active Transportation and Health (NEWPATH) study examined built environment influences on travel, physical activity, food consumption, and health. This collaboration between researchers and practitioners in health and transportation planning is the first, to our knowledge, to integrate food purchasing, diet, travel, and objectively measured physical activity into a trip‐destination protocol. This study simultaneously examines diet and physical activity relationships with BMI and waist circumference (WC). Methods Individual diet and travel diary data were linked to objective built‐environment measures of walkability and retail food environments. BMI and WC were self‐reported (n = 1,160). Some respondents wore accelerometers to objectively measure physical activity (n = 549). Pathways from the built environment through behavior (walking and eating) to BMI and WC were assessed using path analysis. Results Walkability was associated with lower BMI and WC through physical activity and active travel. Healthy retail food environments were associated with healthy eating and lower BMI and WC, whereas walkability and healthy retail food environments were insignificant (p < 0.05). Walkable neighborhoods had less healthy food environments, but active travel was not associated with healthy eating or caloric intake. Conclusions Findings highlight the importance of neighborhood walkability and food environments in shaping physical activity, diet, and obesity.

The retail food environment is becoming an increasingly important consideration in land use planning decisions. Although many municipal official (or comprehensive) plans call for improved food environments, there are no standard methods by which to assess the implementation of policies reflecting these priorities. Methods developed to assess policy enforcement should be feasible to implement by urban planners and developers, should show some correlation between food environments and residents' health or diet outcomes, and should consider a more nuanced view of food environments than solely focusing on food access. In this paper we review food environment characteristics, theories and conceptual models, and assessment methods with goal of presenting theoretical bases for the selection of food environment assessment tools by public health planners and other practitioners. We examine methods to assess food environments and discuss potential adaptations of the methods to suit the needs of urban planners. A case study of the region of Waterloo is presented to illuminate the potential of food environment assessments for healthy public policy enforcement. Finally we describe implications for public health and urban planning.