Consumer food environment assessment and its association with socioeconomic factors in a midsize city in Brazil
Keywords:
Environment, Food, Socioeconomic factorsAbstract
Objective
To assess the consumer food environment and its associations with socioeconomic factors in a midsize Brazilian city.
Methods
An ecological study that assessed the consumer food environment through audits in a stratified and proportional sample of food stores. The ESAO-S and the ESAO-R instruments were used. Access to healthy food was assessed using the Healthy Food Store Index and the Healthy Meal Restaurant Index. Socioeconomic and demographic characteristics and the Health Vulnerability Index were obtained from the 2010 Demographic Census. Statistical analyses were performed using the IBM®SPSS® software.
Result
A total of 280 food stores were assessed. Only 47.1% of food stores for home consumption had fruits, vegetables, or legumes. High availability of ultra-processed food was identified, such as sugar-sweetened beverages (85.0%) and chocolate sandwich cookies (77.8%). The prices of some unprocessed foods and the availability of snacks were different according to socioeconomic characteristics. In food stores for immediate consumption, low availability of healthy options was identified, and, in most of them, natural juices had higher prices than sugar-sweetened beverages (87.1%). The mean Healthy Food Store Index score was 5.1 (SD=3.6), and the Healthy Meal Restaurant Index was 2.4 (SD=1.2).
Conclusion
These findings allow us to expand the knowledge about the consumer food environment, helping to implement public policies related to food supply.
References
Swinburn B, Sacks G, Vandevijvere S, Kumanyika S, Lobstein T, Neal B, et al. INFORMAS (International Network for Food and Obesity/non-communicable Diseases Research, Monitoring, and Action Support): overview and key principles. Obes Rev. 2013;14(1):1-12.
Global Panel on Agriculture and Food Systems for Nutrition. Improving nutrition through enhanced food environments [Internet]. London: Global Panel on Agriculture and Food Systems for Nutrition; 2017. (Policy Brief; no. 7) [cited 2017 May 7]. Available from: http://glopan.org/sites/default/files/Downloads/FoodEnvironmentsBrief.pdf
Madlala SS, Hill J, Kunneke E, Lopes T, Faber M. Adult food choices in association with the local retail food environment and food access in resource-poor communities: a scoping review. BMC Public Health. 2023;23(1):1083.
Gebremariam MK, Vaqué-Crusellas C, Andersen LF, Stok FM, Stelmach-Mardas M, Brug J, Lien N. Measurement of availability and accessibility of food among youth: a systematic review of methodological studies. Int J Behav Nutr Phys Act. 2017;14(1):22.
Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy nutrition environments: concepts and measures. Am J Health Promot. 2005;19(5):330-3.
Lucan SC, Maroko A, Sanon O, Frias R, Schechter CB. Urban farmers’ markets: accessibility, offerings, and produce variety, quality, and price compared to nearby stores. Appetite. 2015;90:23-30.
Lucan SC. Concerning limitations of food-environment research: a narrative review and commentary framed around obesity and diet-related diseases in youth. J Acad Nutr Diet. 2015;115:205-12.
Williams J, Scarborough P, Matthews A, Cowburn G, Foster C, Roberts N, et al. A systematic review of the influence of the retail food environment around schools on obesity-related outcomes. Obes Rev. 2014;15:359-74.
Larson N, Miller JM, Eisenberg ME, Watts AW, Story M, Neumark-Sztainer D. Multicontextual correlates of energy-dense, nutrient-poor snack food consumption by adolescents. Appetite. 2017;112:23-4.
Powell LM, Chriqui JF, Khan T, Wada R, Chaloupka FJ. Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand and body weight outcomes. Obes Rev. 2013;14(2):110-28.
Thornton LE, Cameron AJ, McNaughton SA, Worsley A, Crawford DA. The availability of snack food displays that may trigger impulse purchases in Melbourne supermarkets. BMC Public Health. 2012;12:194.
Block JP, Subramanian SV. Moving Beyond “Food Deserts”: Reorienting United States Policies to Reduce Disparities in Diet Quality. Plos Med. 2015;12(12):e1001914.
Spires M, Berggreen-Clausen A, Kasujja FX, Delobelle P, Puoane T, Sanders D, et al. Snapshots of Urban and Rural Food Environments: EPOCH-Based Mapping in a High-, Middle-, and Low-Income Country from a Non-Communicable Disease Perspective. Nutrients. 2020;12(2):484.
Pineda E, Barbosa Cunha D, Taghavi Azar Sharabiani M, Millett C. Association of the retail food environment, BMI, dietary patterns, and socioeconomic position in urban areas of Mexico. Plos Glob Public Health. 2023;3(2):e0001069.
Gouri Suresh SS, Schauder SA. Income Segregation and Access to Healthy Food. Am J Prev Med. 2020;59(2):e31-e38.
Duran AC. Development of a Healthy Meal-Restaurant Index and a Healthy Retail Food Store Index: Obesogenic Environment Brazilian Study (ESAO). São Paulo; 2012.
Neff Warner L, Pinero Walkinshaw L, Oddo VM, Knox MA, Hurvitz PM, Rocha A, et al. The Availability and Price of Healthy Food in Seattle by Neighborhood Sociodemographic Characteristics. Prev Chronic Dis. 2022;19:e77.
Kern DM, Auchincloss AH, Stehr MF, Roux AVD, Moore LV, Kanter GP, et al. Neighborhood Prices of healthier and unhealthier foods and associations with diet quality: evidence from the multi-ethnic study of atherosclerosis. Int J Environ Res Public Health. 2017;14(11):1394.
Costa B, Oliveira CD, Lopes A. Ambiente alimentar de frutas e hortaliças no território do Programa Academia da Saúde. Cad Saude Publica. 2015;31(1):159-69.
Peng K, Kaza N. Association between neighborhood food access, household income, and purchase of snacks and beverages in the United States. Int J Environ Res Public Health. 2020;17(20):7517.
Duran AC, Lock K, Latorre MR. Evaluating the use of in-store measures in retail food stores and restaurants in Brazil. Rev Saude Publica. 2015;49.
Duran AC, Diez Roux AV, Latorre MR, JAIME PC. Neighborhood socioeconomic characteristics and differences in the availability of healthy food stores and restaurants in Sao Paulo, Brazil. Health Place. 2013;23:39-47.
Azeredo CM, De Rezende LF, Canella DS, Claro RM, Peres MF, C. Luiz OC, et al. Food environments in schools and in the immediate vicinity are associated with unhealthy food consumption among Brazilian adolescents. Prev Med. 2016;88:73-9.
Duran AC, De Almeida SL, Latorre MDO, Jaime PC. The role of the local retail food environment in fruit, vegetable, and sugar-sweetened beverage consumption in Brazil. Public Health Nutr. 2016;19:1093-1102 .
Menezes MC, Diez-Roux AV, Costa BVL, Lopes ACS. Individual and food environmental factors: association with diet. Public Health Nutr. 2018;21(15):2782-92.
Kirkpatrick SI, Reedy J, Butler EN, Dodd KW, Subar AF, Thompson FE, et al. Dietary Assessment in Food Environment Research. Am J Prev Med. 2014;46(1):94-102.
Bower KM, Thorpe RJ Jr, Rohde C, Gaskin DJ. The intersection of neighborhood racial segregation, poverty, and urbanicity and its impact on food store availability in the United States. Prev Med. 2014;58:33-9.
Souza BB, Quialheiro A, Correa EN, Rech CR, Giehl MWC, d’Orsi E. Association between healthy food environment and metabolic syndrome, waist circumference, and systolic blood pressure in older adults in Southern Brazil. Front Aging. 2022;3:922687.
Gustafson A, Hankins S, Jilcott S. Measures of the consumer food store environment: a systematic review of the evidence 2000-2011. J Community Health. 2012;37(4):897-911.
Instituto Brasileiro de Geografia e Estatística. Cidades e Estados, População estimada em 2019 [Internet]. Rio de Janeiro: Instituto; 2019 [cited 2020 July 10]. Avaiable from: https://www.ibge.gov.br/cidades-e-estados/mg/juiz-de-fora.html
Instituto Brasileiro de Geografia e Estatística. Censo 2010. [Internet]. Rio de Janeiro: Instituto; 2010[cited 2020 June 5]. Avaiable from: http://www.censo2010.ibge.gov.br/.
Stamm C, Staduto JAR, Lima JF, Wadi YM. A população urbana e a difusão das cidades de porte médio no Brasil. Interações. 2013;14(2):251-65.
Belo Horizonte. Secretaria Municipal de Saúde. Gerência de Epidemiologia e Informação. Índice de Vulnerabilidade à Saúde 2013 [Internet]. Belo Horizonte: Secretaria Municipal de Saúde; 2013 [cited 2022 Oct 10]. Available in: https://prefeitura.pbh.gov.br/sites/default/files/estrutura-de-governo/saude/2018/publicacaoes-da-vigilancia-em-aude/indice_vulnerabilidade2012.pdf
Hirsch JA, Zhao Y, Melly S, Moore KA, Berger N, Quinn J, et al. National trends and disparities in retail food environments in the USA between 1990 and 2014. Public Health Nutr. 2023;26(5):1052-62.
Robinson PL, Dominguez F, Teklehaimanot S, Lee M, Brown A, Goodchild M. Does distance decay modeling of supermarket accessibility predict fruit and vegetable intake by individuals in a large metropolitan area? J Health Care Poor Underserved. 2013;24(1Suppl):172-85.
Gustafson A, Christian JW, Lewis S, Moore K, Jilcott S. Food venue choice, consumer food environment, but not food venue availability within daily travel patterns are associated with dietary intake among adults, Lexington Kentucky 2011. Nutr J. 2013;12(1):1-11.
Yamaguchi M, Praditsorn P, Purnamasari SD, Sranacharoenpong K, Arai Y, Sundermeir SM, et al. Measures of perceived neighborhood food environments and dietary habits: a systematic review of methods and associations. Nutrients. 2022;14(9):1788.
Louzada MLC, Ricardo CZ, Steele EM, Levy RB, Cannon G, Monteiro CA. The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil. Public Health Nutr. 2018;21(1):94-102.
Martins APB, Levy RB, Claro RM, Moubarac JC, Monteiro CA, Martins APB, et al. Participação crescente de produtos ultraprocessados na dieta brasileira (1987-2009). Rev Saude Publica. 2013;47(4):656-65.
Louzada MLC, Martins APB, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Ultra-processed foods and the nutritional dietary profile in Brazil. Rev Saude Publica. 2015;49.
Leite M, Assis M, Carmo A, Costa B, Claro R, Castro I., et al. Is neighborhood social deprivation in a Brazilian city associated with the availability, variety, quality, and price of food in supermarkets? Public Health Nutr. 2019;22(18):3395-404.
Lee RE, Heinrich KM, Medina AV, Regan GR, Reese-Smith JY, Jokura Y, et al. A picture of the healthful food environment in two diverse urban cities. Environ Health Insights. 2010;4:49-60.
Thelen J, Sant Fruchtman C, Bilal M, Gabaake K, Iqbal S, Keakabetse T, et al. Development of the Systems Thinking for Health Actions framework: a literature review and a case study. BMJ Glob Health. 2023;8(3):e010191.
Filomena S, Scanlin K, Morland KB. Brooklyn, New York foodscape 2007-2011: a five-year analysis of stability in food retail environments. Int J Behav Nutr Phys Act. 2013;10(1):1-7.
Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K. Creating healthy food and eating environments: policy and environmental approaches. Rev Public Health. 2008;29:253-72.
Lee A, Mhurchu CN, Sacks G, Swinburn B, Snowdon W, Vandevijvere S, et al. Monitoring the price and affordability of foods and diets globally. Obes Rev. 2013;14:82-95.
Costa BVL, Menezes MC, Oliveira CDL, Mingoti, SA, Jaime PC, Caiaffa WT, et al. Does access to healthy food vary according to socioeconomic status and to food store type? An ecologic study. BMC Public Health. 2019;19(1):1-7.
Darmon N, Drewnowski A. Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis. Nutr Rev. 2015;73(10):643-60.
Instituto Brasileiro de Geografia e Estatística. Pesquisa de orçamentos familiares, 2017-2018: primeiros resultados. Rio de Janeiro: Instituto; 2019.
Claro RM, Monteiro CA. Renda familiar, preço de alimentos e aquisição domiciliar de frutas e hortaliças no Brasil. Rev Saude Publica. 2010;44(6):1014-20.
Herforth A, Ahmed S. The food environment, its effects on dietary consumption, and potential for measurement within agriculture-nutrition interventions. Food Sec. 2015;7(3):505-20.
Engler-Stringer R, Fuller D, Abeykoon AMH, Olauson C, Muhajarine N. An Examination of Failed Grocery Store Interventions in Former Food Deserts. Health Educ Behav. 2019;46(5):749-54.
Kern DM, Auchincloss AH, Robinson LF, Stehr MF, Pham-Kanter G. Healthy and unhealthy food prices across neighborhoods and their association with neighborhood socioeconomic status and proportion black/Hispanic. J Urban Health. 2017;94(4):494-505.
Moubarac JC, Claro RM, Baraldi LG, Levy RB, Martins APB, Cannon G, et al. International differences in cost and consumption of ready-to-consume food and drink products: United Kingdom and Brazil, 2008–2009. Plos Glob Public Health. 2013;8(7):845-56.
Crepaldi BVC, Okada LM, Claro RM, Louzada MLDC, Rezende LFM, Levy RB, et al. Educational inequality in consumption of natural or minimally processed foods and ultra-processed foods: the intersection between sex and race/skin color in Brazil. Front Nutr. 2022;9:1055532.
Maia EG, dos Passos CM, Levy RB, Martins APB, Mais LA, Claro RM. What to expect from the price of healthy and unhealthy foods over time? The case is from Brazil. Public Health Nutr. 2020;23(4):579-88.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Priscila Moreira de Lima PEREIRA, Felipe Silva NEVES, Mário Círio NOGUEIRA, Ana Paula Carlos CÂNDIDO
This work is licensed under a Creative Commons Attribution 4.0 International License.
