Kalbus Alexandra Irene, Cornelsen Laura, Ballatore Andrea, Cummins Steven
Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Department of Digital Humanities, King's College London, London, United Kingdom.
PLoS One. 2024 Jul 17;19(7):e0305295. doi: 10.1371/journal.pone.0305295. eCollection 2024.
Evidence for the effect of neighbourhood food environment (NFE) exposures on diet in the UK is mixed, potentially due to exposure misclassification. This study used the first national COVID-19 lockdown in England as an opportunity to isolate the independent effects of the NFE exposure on food and drink purchasing, and assessed whether these varied by region.
Transaction-level purchasing data for food and drink items for at-home (1,221 households) and out-of-home consumption (171 individuals) were available from the GB Kantar Fast Moving Consumer Goods Panel for London and the North of England. The study period included 23rd March to 10th May 2020 ('lockdown'), and the same period in 2019 for comparison. NFE exposures included food outlet density and proximity, and NFE composition within a 1 km network buffer around the home. Associations were estimated for both years separately, adjusted for individual and household characteristics, population density and area deprivation. Interaction terms between region and exposures were explored.
There were no consistent patterns of association between NFE exposures and food and drink purchasing in either time period. In 2019, there was some evidence for a 1.4% decrease in energy purchased from ultra-processed foods for each additional 500 m in the distance to the nearest OOH outlet (IR 0.986, 95% CI 0.977 to 0.995, p = 0.020). In 2020, there was some evidence for a 1.8% reduction in total take-home energy for each additional chain supermarket per km2 in the neighbourhood (IR 0.982, 95% CI 0.969, 0.995, p = 0.045). Region-specific effects were observed in 2019 only.
Findings suggest that the differences in exposure to the NFE may not explain differences in the patterns or healthiness of grocery purchasing. Observed pre-pandemic region-specific effects allude to the importance of geographical context when designing research and policy. Future research may assess associations for those who relied on their NFE during lockdown.
英国邻里食物环境（NFE）暴露对饮食影响的证据并不一致，这可能是由于暴露误分类所致。本研究利用英格兰首次全国性新冠疫情封锁的机会，来分离NFE暴露对食品和饮料购买的独立影响，并评估这些影响是否因地区而异。
可从英国凯度快速消费品面板获取伦敦和英格兰北部家庭（1221户）在家消费以及外出消费（171人）的食品和饮料项目交易层面的购买数据。研究期包括2020年3月23日至5月10日（“封锁期”），以及2019年同期用于比较。NFE暴露包括食品店密度和距离，以及家周围1公里网络缓冲区内的NFE构成。分别对两年的数据进行关联估计，并对个人和家庭特征、人口密度和地区贫困程度进行调整。探讨了地区与暴露之间的交互项。
在两个时间段内，NFE暴露与食品和饮料购买之间均未呈现出一致的关联模式。2019年，有证据表明，与最近的户外食品店距离每增加500米，从超加工食品购买的能量减少1.4%（发病率比0.986，95%置信区间0.977至0.995，p = 0.020）。2020年，有证据表明，邻里每平方公里连锁超市数量每增加一家，带回家的总能量减少1.8%（发病率比0.982，95%置信区间0.969，0.995，p = 0.045）。仅在2019年观察到了地区特异性效应。
研究结果表明，NFE暴露的差异可能无法解释食品杂货购买模式或健康程度的差异。疫情前观察到的地区特异性效应表明，在设计研究和政策时考虑地理背景的重要性。未来的研究可以评估在封锁期间依赖其NFE的人群的关联情况。
