White, Martin James Reeve (2010)
M.D. thesis, University of Birmingham.
This cross-sectional study aimed to determine whether dietary intake is associated with food retailing. 5044 adults aged 16-97 years completed a 134-item food frequency questionnaire (FFQ), from which three dietary indices were derived. Data on 33 retailed foods were obtained from 560 food stores in Newcastle upon Tyne, UK.
Poorer people lived closer to stores selling a wider range of foods. Fresh fruits and vegetables were more costly in more affluent areas. Higher fat and lower fruit and vegetable intake, poorer dietary knowledge, more frequently shopping at discount and convenience stores, and travel by foot or public transport, were all more common among less affluent households. In multilevel regression analyses, no area level variables were associated with variation in dietary indices, which was most strongly associated with lifestyle variables and dietary knowledge.
Retail access to healthy foods is important for a healthy diet. However, where such access is uniformly good, dietary quality is most importantly associated with lifestyle choices, which are driven by dietary knowledge and socio-economic factors. Interventions to improve diet need to focus on the knowledge and behaviours needed to acquire, prepare and consume a healthy diet, as well as the economic means to do so.
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