Food environment and fruit and vegetable intake in a urban population: A multilevel analysis

Abstract

BackgroundEnvironmental, social and individual factors influence eating patterns, which in turn affect the risk of many chronic diseases. This study aimed to estimate associations between environmental factors and the consumption of fruit and vegetables among adults in a Brazilian urban context.MethodsData from the surveillance system for risk factors for chronic diseases (VIGITEL) of Brazilian Ministry of Health were used. A cross-sectional telephone survey (VIGITEL – 2008–2010) was carried out with 5826 adults in the urban area of Belo Horizonte. Individual variables were collected. The frequency of fruit and vegetables consumption was assessed from number of servings, weekly frequency and an intake score was calculated. Georeferenced variables were used to characterize the food environment. The density of healthy food outlets (stores specialized in selling fruit and vegetables), unhealthy food outlets (bars, snack bars and food trucks/trailers) and the neighborhood family income were investigated and associated with fruit and vegetables intake score. Weighted multilevel linear regression was used to evaluate the associations between the environment variables and the fruit and vegetables intake score.ResultsHigher fruit and vegetables intake scores were observed in neighborhoods with higher density of healthy food outlets and higher income. Lower scores were observed in neighborhood with higher density of unhealthy food outlets. These associations were adjusted by individual variables such as gender, age, physical activity, sugar sweetened beverages consumption, education level and smoking.DiscussionThe food environment might explain some of the socioeconomic disparities with respect to healthy food intake and health outcomes. Healthy food stores are less common in socially disadvantaged neighborhoods, and therefore, healthy foods such as fruits and vegetables are less available or are of a lower quality in lower income areas.ConclusionFood environment characteristics and neighborhood socioeconomic level had significant associations with fruit and vegetable intake score. These are initial findings that require further investigation within the middle income world populations and the role of the environment with respect to both healthy and unhealthy food acquisition and intake.

Total and added sugars consumption in Argentina: Their contribution to daily energy intake. Results from Latin American Study of Nutrition and Health (ELANS)

“…It is noteworthy that this trend towards the consumption of higher amounts of sugars in lower‐income populations was observed just for AS but not for TS (21.0%TE, 20.3%TE and 20.1%TE in the population for low, middle and high SEL, respectively). These findings would reflect a higher intake of intrinsic sugars (fruits and vegetables) and/or milk sugars in higher‐income populations . In Argentina, this may be explained by the fact that fruits and vegetables are usually expensive and therefore difficult to obtain in the recommended amounts by people with a lower income.…”

“…These findings would reflect a higher intake of intrinsic sugars (fruits and vegetables) and/or milk sugars in higher-income populations. 19 In Argentina, this may be explained by the fact that fruits and vegetables are usually expensive and therefore difficult to obtain in the recommended amounts by people with a lower income.…”

Tendências temporais do consumo de frutas e hortaliças entre adultos nas capitais brasileiras e Distrito Federal, 2008-2016

“…Nesse sentido, eventualmente o alcance de níveis de consumo superiores aos atuais envolva a adoção de ações que consideram os determinantes do seu baixo consumo. Assim, estratégias de regulamentação do mercado que oportunizem a produção e distribuição de frutas e hortaliças, como o Programa de Aquisição de Alimentos 37 e a inserção de feiras-livres devem ser privilegiadas 38,39 , uma vez que este tipo de ação poderia solucionar questões como a disparidade do acesso físico e financeiro a estes alimentos 36 .…”

Posição socioeconômica no curso de vida e comportamentos de risco relacionados à saúde: ELSA-Brasil

“…Aqueles em desvantagens na posição socioeconômica moram em vizinhanças com menos recursos e oportunidades que estimulariam a adoção de comportamentos saudáveis, como menor disponibilidade de estabelecimentos para a compra de alimentos saudáveis 32 . A restrição no acesso, somada ao fato desses alimentos serem perecíveis e frequentemente caros 33 , pode contribuir para o consumo de alimentos industrializados em populações de baixa posição socioeconômica em detrimento de frutas e hortaliças 34 .…”