Built environment and fruit and vegetable consumption: an ecological study

Background: Ecological studies have been essential to understand the relationship between environmental conditions and food consumption. The purpose of this study was to describe the environmental conditions and their relation... [ view full abstract ]

Background: Ecological studies have been essential to understand the relationship between environmental conditions and food consumption. The purpose of this study was to describe the environmental conditions and their relation with the consumption of fruits and vegetables (FV) among users of Brazilian's public health services.

Methods: This is an ecological study that evaluated food stores contained in buffers with rays of 1,600 meters from 18 sites of the Health Academy Program (HAP). We measured by direct observation variables from the macro-level (density, proximity and type) and the micro-level (section location of FV; availability, quality, variety, price and advertising of FV and ultra-processed foods). Aggregate data from users (monthly income and FV consumption) were obtained by interview. The analysis included Kernel intensity estimator, average nearest neighbor and function LISA of local spatial autocorrelation.

Results: 3,414 users were interviewed and 336 food stores were analyzed. Major geographical variations were identified in the FV consumption. The average consumption was higher in neighborhoods with higher income and concentration of food stores, and better index of access to healthy foods. The sites with poor FV consumption had most stores with poor access to healthy foods.

Conclusion: We found negative characteristics of the food environment that may contribute to the low FV consumption found, suggesting the need for the development and consolidation of public policies aimed at creating healthy environments through interventions in the built environment that increases access and the consumption of healthy foods, such as FV.