Associations between the external and personal food environment and eating behavior in relation to socioeconomic status in peri-urban settings: Results from the CIVISANO study in Flanders, Belgium

Abstract

The prevalence of obesity has increased dramatically over the last decades, with a clear social gradient, affecting more people with lower socioeconomic status (SES). Food environments have been identified as part of the causal chain of this increase. It is hypothesized that people in distinct socioeconomic positions are differently affected by the food environment, with people with lower SES being more susceptible to an unhealthy food environment. Therefore, this study aimed to assess the external (objective) and personal (perceived) domains of the food environment of people with distinct SES and determine which indicators of these domains were associated with eating behavior (i.e. frequency of consumption of fruit and vegetables, fast food, snack and sugar-sweetened beverages). We used both existing GIS data and survey data on socio-demographic characteristics, eating behavior and perceptions on the food environment (25–65 y/o) (n = 497). Both domains of the food environment differed between the respondents with lower and higher SES. However, these differences were not observed for all indicators of the food environment. Additionally, SES moderated the associations of the food environment with all dietary-outcomes under study, except fast food consumption frequency, resulting in non-statistically significant associations among respondents with lower SES and associations in a negative direction for respondents with higher SES.