OBJECTIVE: To examine the associations of individual and food environmental factors with fruit and vegetable (F&V) intake in a city in a low-to-middle-income country (LMIC). DESIGN: Cross-sectional. SETTING: Representative sample of the Brazilian Primary Care service known as the Health Academy Program (HAP) in Belo Horizonte, a Brazilian city. SUBJECTS: Using a conceptual model as a guide, individual and food environment data were obtained through: (i) face-to-face interviews with participants aged 20 years or older; and (ii) F&V food store audits. A broad set of individual, household, and community and consumer nutrition environment variables was investigated. Multilevel linear regression was used to quantify area-level variations in F&V intake and to estimate associations with the factors. RESULTS: Eighteen HAP centres were selected and 2944 participants and 336 food stores were included. F&V intake varied between contexts, being higher in areas with better socio-economic conditions and food store quality, such as specialised F&V markets. Individual-level factors, including age, income, food insecurity, stage of change, self-efficacy and decisional balance, were significantly associated with F&V intake. After controlling for individual-level characteristics, greater F&V intake was also associated with higher quality of food stores. CONCLUSIONS: In one of the first studies to comprehensively assess the food environment in an LMIC, individual-level factors accounted for the largest variation in F&V intake; however, the food environment was also important, because area-level variables explained 10·5 % of the F&V intake variation. The consumer nutrition environment was more predictive of healthy eating than was the community nutrition environment. The findings suggest new possibilities for interventions.
OBJECTIVE: To examine the associations of individual and food environmental factors with fruit and vegetable (F&V) intake in a city in a low-to-middle-income country (LMIC). DESIGN: Cross-sectional. SETTING: Representative sample of the Brazilian Primary Care service known as the Health Academy Program (HAP) in Belo Horizonte, a Brazilian city. SUBJECTS: Using a conceptual model as a guide, individual and food environment data were obtained through: (i) face-to-face interviews with participants aged 20 years or older; and (ii) F&V food store audits. A broad set of individual, household, and community and consumer nutrition environment variables was investigated. Multilevel linear regression was used to quantify area-level variations in F&V intake and to estimate associations with the factors. RESULTS: Eighteen HAP centres were selected and 2944 participants and 336 food stores were included. F&V intake varied between contexts, being higher in areas with better socio-economic conditions and food store quality, such as specialised F&V markets. Individual-level factors, including age, income, food insecurity, stage of change, self-efficacy and decisional balance, were significantly associated with F&V intake. After controlling for individual-level characteristics, greater F&V intake was also associated with higher quality of food stores. CONCLUSIONS: In one of the first studies to comprehensively assess the food environment in an LMIC, individual-level factors accounted for the largest variation in F&V intake; however, the food environment was also important, because area-level variables explained 10·5 % of the F&V intake variation. The consumer nutrition environment was more predictive of healthy eating than was the community nutrition environment. The findings suggest new possibilities for interventions.
Entities:
Keywords:
Epidemiological factors; Food environment; Fruit and vegetables; Health behaviour; Multilevel analysis
Authors: Yang Liu; Shenzhi Song; Joel Gittelsohn; Nan Jiang; Jiajin Hu; Yanan Ma; Deliang Wen Journal: Int J Environ Res Public Health Date: 2019-03-04 Impact factor: 3.390
Authors: Susannah Westbury; Iman Ghosh; Helen Margaret Jones; Daniel Mensah; Folake Samuel; Ana Irache; Nida Azhar; Lena Al-Khudairy; Romaina Iqbal; Oyinlola Oyebode Journal: BMJ Glob Health Date: 2021-10