The Importance of a Multi-Dimensional Approach for Studying the Links between Food Access and Consumption

Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112-2699, USA.
Journal of Nutrition (Impact Factor: 3.88). 06/2010; 140(6):1170-4. DOI: 10.3945/jn.109.113159
Source: PubMed


Research on neighborhood food access has focused on documenting disparities in the food environment and on assessing the links between the environment and consumption. Relatively few studies have combined in-store food availability measures with geographic mapping of stores. We review research that has used these multi-dimensional measures of access to explore the links between the neighborhood food environment and consumption or weight status. Early research in California found correlations between red meat, reduced-fat milk, and whole-grain bread consumption and shelf space availability of these products in area stores. Subsequent research in New York confirmed the low-fat milk findings. Recent research in Baltimore has used more sophisticated diet assessment tools and store-based instruments, along with controls for individual characteristics, to show that low availability of healthy food in area stores is associated with low-quality diets of area residents. Our research in southeastern Louisiana has shown that shelf space availability of energy-dense snack foods is positively associated with BMI after controlling for individual socioeconomic characteristics. Most of this research is based on cross-sectional studies. To assess the direction of causality, future research testing the effects of interventions is needed. We suggest that multi-dimensional measures of the neighborhood food environment are important to understanding these links between access and consumption. They provide a more nuanced assessment of the food environment. Moreover, given the typical duration of research project cycles, changes to in-store environments may be more feasible than changes to the overall mix of retail outlets in communities.

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    • "If such processes are not feasible, all POP items chosen and developed by intervention program staff should be preapproved by managers and employees so that they are accepted and are practical to their stores. The various dimensions of a consumer food environment (physical, social, and dual) are important to consider in terms of the perspectives of store managers and employees for the development of in-store interventions (Gittelsohn et al. 2007; Rose et al. 2010). Doing so will help to identify which dimensions are most relevant to specific consumer food environments and grocery shoppers, which in turn will help to identify potential avenues for intervention. "
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    ABSTRACT: To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers' grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and sociocultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers.
    No preview · Article · Jan 2016 · Ecology of Food and Nutrition
    • " e . g . , candy and snacks ] ( Economic Research Service - USDA , 2013 ) , which could allow consumers to purchase a fast food - style diet from supermarkets , particularly given that supermarkets and convenience stores sell a mix of unhealthy and healthy food options ( Bodor et al . , 2010 ; Gustafson et al . , 2013 ; Hutchinson et al . , 2012 ; Rose et al . , 2010 ) . We found very few direct pathways from food environments to BMI . After accounting for indirect pathways from neighborhood restaurants and food stores to BMI through diet , direct pathways from neighborhood food environments to BMI did not contribute consistently to BMI . Findings from our model suggest that asso - ciations in previ"
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    ABSTRACT: Objectives: To examine longitudinal pathways from multiple types of neighborhood restaurants and food stores to BMI, through dietary behaviors. Methods: We used data from participants (n=5114) in the United States-based Coronary Artery Risk Development in Young Adults study and a structural equation model to estimate longitudinal (1985-86 to 2005-06) pathways simultaneously from neighborhood fast food restaurants, sit-down restaurants, supermarkets, and convenience stores to BMI through dietary behaviors, controlling for socioeconomic status (SES) and physical activity. Results: Higher numbers of neighborhood fast food restaurants and lower numbers of sit-down restaurants were associated with higher consumption of an obesogenic fast food-type diet. The pathways from food stores to BMI through diet were inconsistent in magnitude and statistical significance. Conclusions: Efforts to decrease the numbers of neighborhood fast food restaurants and to increase the numbers of sit-down restaurant options could influence diet behaviors. Availability of neighborhood fast food and sit-down restaurants may play comparatively stronger roles than food stores in shaping dietary behaviors and BMI.
    No preview · Article · Oct 2015 · Health & Place
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    • "While most recent studies of food deserts have focused on geomapping the food environment by analyzing the density, location, and proximity of store types, earlier research took a marketbasket approach that examined within-store characteristics by analyzing the variety, quantity, quality, pricing, promotion, and placement of different foods (Beaulac et al., 2009). Few studies have taken a multidimensional approach, combining both geographic and within-store measures (Gustafson et al., 2013; Hermstad et al., 2010; Rose et al., 2010). Fewer still have combined multidimensional objective measures of food access with qualitative research that analyzes consumers' subjective perceptions of their food environments and interactions within them (Cannuscio et al., 2014). "
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    ABSTRACT: Differential access to healthy foods has been hypothesized to contribute to disparities in eating behaviors and health outcomes. While food deserts have been researched extensively in developed Anglophone countries, evidence from low- and middle-income countries is still scarce. In Mexico, prevalence of obesity is among the highest worldwide. As obesity has increased nationally and become a widespread public health issue, it is becoming concentrated in the low-income population. This mixed-methods study uses a multidimensional approach to analyze food environments in a low-, middle-, and high-income community in a Mexican city. The study advances understanding of the role that food environments may play in shaping eating patterns by analyzing the density and proximity of food outlet types as well as the variety, quantity, quality, pricing, and promotion of different foods. These measures are combined with in-depth qualitative research with families in the communities, including photo elicitation, to assess perceptions of food access. The central aims of the research were to evaluate physical and economic access and exposure to healthy and unhealthy foods in communities of differing socioeconomic status as well as participants' subjective perceptions of such access and exposure. The findings suggest a need to reach beyond a narrow focus on food store types and the distance from residence to grocery stores when analyzing food access. Results show that excessive access and exposure to unhealthy foods and drinks, or "food swamps," may be a greater concern than food deserts for obesity-prevention policy in Mexico. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Aug 2015 · Social Science [?] Medicine
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