Is Food Outlet Accessibility a Significant Factor of Fruit and Vegetable Intake? Evidence from a Cross-Sectional Province-Wide Study in Quebec, Canada

Unhealthy eating habits can compromise one’s health and generate significant individual, social, and health services costs. The adoption of healthy eating habits depends on individual and environmental determinants related to the characteristics of the physical, economic, political, and socio-cultural environments. The objective of this cross-sectional study was to assess the effect of the physical environment, more precisely the effect of food outlet accessibility, on diet. A subsample of the CARTaGENE survey, composed of 7783 adults aged 40 to 70 years old residing in four cities in Quebec (Canada), was used. Measures of proximity as well as absolute and relative measures of the density of retail food outlets, fast-food outlets, and convenience stores near participants’ residences were used to analyze fruit and vegetable (F&V) intake. Univariate logistic regression showed that the minimal recommended portions of F&V intake (5 or more portions) were significantly associated with all seven measures of the retail food environment (OR between 0.76 and 1.27). However, these relations were mostly non-significant when confounding variables were considered in the analysis except and counterintuitively for proximity to the nearest convenience store and density of convenience stores. Variables most significantly correlated to F&V intake were individual-level confounding variables of sex, income, and education. These results show that more research is needed to understand factors explaining F&V intake in this population