The implications are significant in California, where nearly 1 million people live in food deserts. A number of local and state policies aim to combat obesity and promote healthy diets by shaping neighborhood food environments.
Researchers found that living closer to fast food restaurants led to more fast food consumption -- particularly among low-income men. But the availability of supermarkets and grocery stores generally was unrelated to diet quality and fruit and vegetable intake.
The findings, published yesterday in the Archives of Internal Medicine, suggest that reducing food deserts -- neighborhoods with little or no access to healthy foods -- requires more than bringing supermarkets and grocery stores to underserved communities.
"It's not enough to say we will build it (supermarkets) and people will come," lead researcher Penny Gordon-Larson, associate professor of nutrition at the University of North Carolina at Chapel Hill, told HealthDay.
Authors say the study is the first of its kind to follow a large, diverse population over an extended time. Their analysis is based on 15 years of data and interviews, starting in 1985-86, from the Coronary Artery Risk Development in Young Adults study.
The study asked 5,115 black and white men and women, ages 18 to 30 at the start of the study, to detail their diets and how often they ate fast food. Participants lived in Oakland, Chicago, Minneapolis and Birmingham, Ala.
The relationship between fast food availability and consumption was strongest among low-income men. When the availability of fast food less than 3 kilometers from their home increased 1 percent, low-income men ate fast food 0.34 percent more frequently. These men may have limited transportation, increasing their reliance on food options in their neighborhoods, researchers said.
But there was no significant relationship between fast food consumption and availability among low-income women. The connection was weak among middle-income residents and inconsistent among those with high income, the study found.
Across all income levels, the availability of supermarkets and grocery stores generally was unrelated to diet quality and fruit and vegetable intake. Researchers said an array of healthy and unhealthy foods offered at these stores could be part of the reason.
"Overall, classification of food stores and restaurants into 'healthy' or 'unhealthy' according to mode of service (fast food or sit-down) or size (supermarket vs. grocery store) may provide little understanding of how the food environment impacts diet and may overlook innovative policy solutions," researchers wrote.
Still, supermarkets and grocery stores are an important starting point, said John Vigna, spokesman for California Assembly Speaker John A. Pérez, D-Los Angeles, who has written legislation to expand access to healthy foods in underserved neighborhoods and eliminate food deserts within seven years.
"There are a number of areas in urban or rural settings where access to healthy food is virtually nonexistent or extremely limited. That's a major problem," Vigna said. "Most people know eating an apple is better than eating a small order of fries somewhere. So for folks who want to make positive choices for their family, we want to make sure they can do that."
Pérez's bill, AB 581, would use state, federal, philanthropic and private funds to establish the California Healthy Food Financing Initiative and bring grocery stores and healthy food retailers to underserved communities. The bill is pending in the Senate Appropriations Committee.
Health advocates acknowledge that improving diets is a complex challenge.
"Plopping down a full grocery store -- it can't be the only strategy," said Ellen Wu, executive director of the California Pan-Ethnic Health Network, which is supporting Pérez's bill. Still, she said, "when the healthy option is the easy, default, affordable option, that's what people will go with."
Story courtesy of our media partners at California Watch (A Project of the Center for Investigative Reporting)
