Community Food Store Types Availability is Associated with Fruit and Vegetable Consumption in North Carolina

Despite the nutritional guidelines promoting consumption of fruits and vegetables, the level of fruits and vegetable consumption is drastically below the recommended levels nationally, as well as at the state levels. Among factors that may influence consumption of fruits and vegetables, it is held that factors within the food environment such as the availability of retail types that are conducive for easy access to fruits and vegetables within communities may be presenting barriers to purchase. We employ multilevel modeling approaches to investigate the determinants of fruit and vegetable intake in North Carolina, accounting for food environment factors. Results of the study indicate that availability of supermarkets and full service restaurants is associated positively with fruits and vegetable consumption while fast food outlets are associated negatively. Other smaller store types were not statistically significant. Individual factors including age, being female, employed, income and education all were positively associated with fruits and vegetable consumption. The significant positive association of area level food environmental factors with the consumption of fruits and vegetables indicates a complementary role for intervention directed at improving the availability of supermarket type stores so as to impact healthy food purchases and consumption.