MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France.
INNOVATION, Univ Montpellier, CIRAD, INRAE, Institut Agro, Montpellier, France.
PLoS One. 2022 Apr 27;17(4):e0267639. doi: 10.1371/journal.pone.0267639. eCollection 2022.
The purpose of this study was to assess whether the retail food environment, measured by multiple indicators around the home and in activity space, was associated with the nutritional quality of food purchases.
This cross-sectional study included 462 households from a quota sampling survey conducted in the south of France (Montpellier Metropolitan Area). The revised Healthy Purchase Index was implemented in order to assess the nutritional quality of food purchases. Food environment indicators (presence, number, relative density and proximity of food outlets) were calculated around the home and in activity space using a geographical information system. Six different types of food outlets were studied: supermarkets, markets, greengrocers, bakeries, other specialized food stores (butcher's, fishmonger's and dairy stores) and small grocery stores. Associations between food environment and the nutritional quality of food purchases were assessed using multilevel models, and geographically weighted regressions to account for spatial non-stationarity. Models were adjusted for households' socioeconomic and demographic characteristics.
The nutritional quality of food purchases was positively associated with the number of greengrocers around the home (1 vs. 0: β = 0.25, 95%CI = [0.01, 0.49]; >1 vs. 0: β = 0.25, 95%CI = [0.00, 0.50]), but negatively associated with the number of markets around the home (1 vs. 0: β = -0.20, 95%CI = [-0.40, 0.00]; >1 vs. 0: β = -0.37, 95%CI = [-0.69, -0.06]). These associations varied across space in the area studied. For lower income households, the number of greengrocers in activity space was positively associated with the nutritional quality of food purchases (1 vs. 0: β = 0.70, 95%CI = [0.12, 1.3]; >1 vs. 0: β = 0.67, 95%CI = [0.22, 1.1]).
Greengrocers might be an effective type of food store for promoting healthier dietary behaviors. Further studies, particularly interventional studies, are needed to confirm these results in order to guide public health policies in actions designed to improve the food environment.
本研究旨在评估家庭周边和活动空间中的多种食品零售环境指标与食品购买的营养质量是否存在关联。
本横断面研究纳入了来自法国南部（蒙彼利埃大都市区）配额抽样调查的 462 户家庭。实施修订后的健康购买指数以评估食品购买的营养质量。使用地理信息系统在家中和活动空间中计算食品环境指标（存在情况、数量、相对密度和接近度）。研究了 6 种不同类型的食品店：超市、市场、蔬菜水果店、面包店、其他专业食品店（肉店、鱼店和奶制品店）和小杂货店。使用多水平模型和地理加权回归来评估食品环境与食品购买营养质量之间的关联，以考虑空间非平稳性。模型根据家庭的社会经济和人口统计学特征进行了调整。
食品购买的营养质量与家庭周边的蔬菜水果店数量呈正相关（1 家与 0 家相比：β=0.25，95%CI=[0.01，0.49]；＞1 家与 0 家相比：β=0.25，95%CI=[0.00，0.50]），但与家庭周边的市场数量呈负相关（1 家与 0 家相比：β=-0.20，95%CI=[-0.40，0.00]；＞1 家与 0 家相比：β=-0.37，95%CI=[-0.69，-0.06]）。这些关联在研究区域内存在空间差异。对于收入较低的家庭，活动空间中的蔬菜水果店数量与食品购买的营养质量呈正相关（1 家与 0 家相比：β=0.70，95%CI=[0.12，1.3]；＞1 家与 0 家相比：β=0.67，95%CI=[0.22，1.1]）。
蔬菜水果店可能是促进更健康饮食行为的有效食品店类型。需要进一步的研究，特别是干预研究，以确认这些结果，从而为改善食品环境的公共卫生政策提供指导。
