Longitudinal changes in the retail food environment in Mexico and their association with diabetes

Abstract

The retail food environment is a potential population-level determinant of diet and nutrition-related chronic diseases, yet little is known about its composition and association with diabetes in low- and middle-income countries. Our objectives were: (1) to describe changes in the composition of the retail food environment in Mexican neighborhoods from 2010 to 2016 and (2) to examine the association between these changes and diabetes cases diagnosed over the same period. Individual level data came from the 2016 Mexican Health and Nutrition Survey (N = 2808 adults). Neighborhood level retail food environment data for 2010 and 2016 came from the National Directory of Economic Units of Mexico. Multilevel logistic regression was used to examine the adjusted association between changes in the neighborhood density per km 2 of fruit and vegetable stores, chain convenience stores and supermarkets with diabetes. Small store formats still predominate in Mexico's food environment, however there is evidence of fast increase in chain convenience stores and supermarkets. Adults living in neighborhoods that saw a decline in fruit and vegetable store density and a simultaneous increase in chain convenience store density experienced higher odds of diabetes, compared to adults who lived in neighborhoods where fruit and vegetable and convenience stores did not change (OR 3.90, 95% CI 1.61, 9.48). Considering the complex interplay between store types, understanding the mechanisms and confirming the causal implications of these findings could inform policies that improve the quality of food environments in cities.

Is store density associated with sugar‐sweetened beverages consumption and overweight or obesity in Mexican adolescents?

“…22 Another common way to define store density or availability is by using geographic area or census tract as a denominator. 39,57 We decided not to employ this definition since geographic area does not necessarily imply urbanization or even habitation, considering that in Mexico there are municipalities with large unpopulated areas. Nonetheless, we recognize that the density of stores within municipalities can vary, i.e., small areas with the presence of many stores that we cannot account for.…”

From agricultural supply chains to food system transformation : Tracing the impact of private sector activities on food systems in developing countries

“…For example, Curioni et al (2020) show that distance and store density are strongly related with consumption of fruit and leafy vegetable in Brazil. Pérez-Ferrer et al, (2020) relates changes in diets and increase in obesity in Mexican neighbourhoods to a decline in fruit and vegetable store density and a simultaneous increase in chain convenience store density. Machado et al (2018) analyse the association between food store type and the consumption of ultraprocessed products in Brazil confirming an intimate relationship between the food purchase pattern and the consumption of ultra-processed products.…”

“…• Key innovations in retail focus on investments in upgrading of informal trade outlets (Davies et al, 2021;Wertheim-Heck et al, 2014) to enhance access to affordable and safe food. Curioni et al (2020) show that investment in neighbourhoods store density and diversity can improve the consumption of fruit and leafy vegetable in Brazil, while Pérez-Ferrer et al (2020) relate obesity in Mexican neighbourhoods to the decline in fruit and vegetable store density and a simultaneous increase in chain convenience store density. Toiba et al (2015) and Reardon et al (2014) consider resource-providing procurement contracts of smallholder farmers with modern retailers as an incentive for food system integration.…”

“…discuss differential access to foods across store types and neighbourhoods of different socioeconomic statuses in Sao Paulo, whilePérez-Ferrer et al (2020) identify store density as a key determinant for health outcomes Reddy et al (2020). outline that organisation of street vendors can be a feasible strategy to enforce better food safety standards.These insights enable us to understand that coordinated policy initiatives are required to mitigate distributional effects of the food retail landscape and to reduce the associated health risks.…”

Development and Application of Healthiness Indicators for Commercial Establishments that Sell Foods for Immediate Consumption

“…Different conceptual models for characterizing the food environment have been proposed in recent decades [ 2 , 3 , 4 , 5 , 6 ]. Among them, the model proposed by Glanz et al (2005) [ 3 ] has been widely adopted in studies that seek to characterize food environments in different settings [ 7 , 8 ] and examine their association with health outcomes [ 9 , 10 , 11 ]. One of the types included in this model is the “consumer food environment”, demarcated by what is found within and around establishments that sell (or supply) foods, beverages, preparations, and convenience items.…”