Comparing food environment and food purchase in areas with low and high prevalence of obesity: data from a mapping, in-store audit, and population-based survey

Abstract

Our study aimed to compare key aspects of the food environment in two low-income areas in the city of Campinas, São Paulo State, Brazil: one with low and the other with high prevalence of obesity. We compared the availability of retail food establishments, the types of food sold, and the residents’ eating habits. Demographic and socioeconomic data and eating habits were obtained from a population-based health survey. We also analyzed local food environment data collected from remote mapping of the retail food establishments and audit of the foods sold. For comparison purposes, the areas were selected according to obesity prevalence (body mass index - BMI ≥ 30kg/m²), defined as low prevalence (< 25%) and high prevalence (> 45%). Only 18 out of the 150 points of sale for food products sold fruits and vegetables across the areas. Areas with high obesity prevalence had more grocery stores and shops specialized in fruits and vegetables, as well as more supermarkets that sold fruits and vegetables. With less schooling, residents in the areas with high obesity prevalence reported purchasing food more often in supermarket chains and specialized shops with fruits and vegetables, although they consumed more sodas when compared with residents of areas with low obesity prevalence. Our results suggest interventions in low-income areas should consider the diverse environmental contexts and the interaction between schooling and food purchase behaviors in settings less prone to healthy eating.

The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review

“…48 49 Further, 10 good studies found a significant association between an availability characteristic and a health outcome [50][51][52][53][54][55][56][57][58][59] as did 2 fair studies 60 61 and 1 further poor study. 62 Additionally, one poor study reported that prevalence of overweight and mean body mass index (BMI) trended in the same direction as the number of 'westernstyle' restaurants and convenience stores, however, no statistics were presented. 63 Two further good studies suggested that availability characteristics were important for childhood obesity prevalence.…”

Sociodemographic Differences in the Dietary Quality of Food-at-Home Acquisitions and Purchases among Participants in the U.S. Nationally Representative Food Acquisition and Purchase Survey (FoodAPS)

“…While grocery purchases—particularly at the household-level—do not perfectly reflect individual-level intake, grocery purchase sales data are strongly associated with self-reported, individual-level nutrient intake [ 9 , 10 ], and the dietary quality of foods purchased and the dietary quality of foods consumed are correlated [ 11 ]. Furthermore, as an alternative source of dietary data, grocery acquisition data may circumvent well-documented limitations of self-reported intake data while providing a lens into often unmeasured characteristics of local food environments (e.g., types of retailers, cost of living, access to transportation), which influence food availability in different communities [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

Acting against obesity: a cross-cultural analysis of prevention models in Spain, Argentina and Brazil

“…Some very recent initiatives can be taken as examples in this direction. Such is the case with the studies carried out in Brazil on the food environment from the point of view of access to healthy and sustainable food, which are mapping places and relating them to income levels in order to influence public policy (Backes et al, 2019;Camargo et al, 2019), or the research currently being carried out in Argentina with Health Ministry funding on obesogenic environments in socially vulnerable…”