Perceived Availability of Healthy and Unhealthy Foods in the Community, Work, and Higher Education Settings across Five Countries: Findings from the International Food Policy Study 2018.

BACKGROUND: Food environments play a key role in dietary behavior and vary due to different contexts, regulations, and policies. OBJECTIVES: This study aimed to characterize the perceived availability of healthy and unhealthy foods in 3 different settings in 5 countries. METHODS: We analyzed data from the 2018 International Food Policy Study, a cross-sectional survey of adults (18-100 y, n = 22,824) from Australia, Canada, Mexico, the United Kingdom (UK), and the USA. Perceived availability of unhealthy (junk food and sugary drinks) and healthy foods (fruit or vegetables, healthy snacks, and water) in the community, workplace, and university settings were measured (i.e. not available, available for purchase, or available for free). Differences in perceived availability across countries were tested using adjusted multinomial logistic regression models. RESULTS: Across countries, unhealthy foods were perceived as highly available in all settings; in university and work settings unhealthy foods were perceived as more available than healthy foods. Australia and Canada had the highest perceived availability of unhealthy foods (range 87.5-90.6% between categories), and the UK had the highest perceived availability of fruits and vegetables for purchase (89.3%) in the community. In university and work settings, Mexico had the highest perceived availability for purchase of unhealthy foods (range 69.9-84.9%). The USA and the UK had the highest perceived availability of fruits and vegetables for purchase (65.3-66.3%) or for free (21.2-22.8%) in the university. In the workplace, the UK had high perceived availability of fruits and vegetables for purchase (40.2%) or for free (18.5%), and the USA had the highest perceived availability of junk food for free (17.3%). CONCLUSIONS: Across countries, unhealthy foods were perceived as highly available in all settings. Variability between countries may reflect differences in policies and regulations. Results underscore the need for the continuation and improvement of policy efforts to generate healthier food environments.

Keywords

community, food environment, food policy, perceived availability, university, work environment, Adult, Cross-Sectional Studies, Fruit, Humans, Nutrition Policy, Snacks, Vegetables

Journal Title

J Nutr

Journal ISSN

0022-3166
1541-6100

Publisher

Elsevier BV

Publisher DOI

https://doi.org/10.1093/jn/nxac070

Rights

Sponsorship

MRC (MC_UU_00006/7)

Sources of support Funding for this project was provided by a Canadian Institutes of Health Research (CIHR) Project Grant, with additional support from an International Health Grant, the Public Health Agency of Canada (PHAC), and a CIHR – PHAC Applied Public Health Chair (Hammond). Funders had no role in designing the study, collecting, analyzing, and interpreting the data, drafting the manuscript nor the decision to publish findings. The supporting sources had no involvement or restrictions regarding publication. Conflict of Interest and Funding Disclosure – Alejandra Contreras-Manzano works in a civil society organization funded by Bloomberg Philanthropies, Claudia Nieto was awarded with the healthy food policy fellowship from Vital Strategies. Jean Adams is supported by the Medical Research Council (grant number MC_UU_00006/7). David Hammond has served as a paid expert witness on behalf of public health authorities in the legal challenge to San Francisco’s health warning ordinance for sugar-sweetened beverages. No other financial disclosures were reported by the authors of this paper.

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