Consumer food environment and overweight.

Objectives: The aim of this study was to investigate the association between aspects of the consumer food environment in food stores selling fruit and vegetables (FVs) and the incidence of overweight among users of a Brazilian primary health care service.

Methods: This cross-sectional study assessed individual-level and food environment variables, within the context of a representative sample of a primary health care service in a Brazilian city (the Health Academy Program [HAP]) in 2013. Users of HAP units and multiple aspects of the consumer food environment (availability, diversity, variety, quality, advertising, and price) related to FVs and ultraprocessed foods (UPFs) were examined. Multilevel logistic models were used to examine the relationships among overweight and consumer environment characteristics. We analyzed 2810 participants and audited 336 food stores.

Results: More than 70% of stores had adequate diversity and variety of FVs; Regarding quality, only 24.5% of stores presented inadequate quality of fruits and 39.6% inadequate quality of vegetables. UPFs were present in 60.6% of FV stores. The results indicated a high prevalence of overweight (62.6%) in participants of the health promotion service and the multilevel models revealed an association with variety of vegetables in stores (0.99; 95% confidence interval, 0.97-0.99; P < 0.05).

Conclusions: Given the importance of food environment in food choice at the time of purchase, it is important to consider consumer food environment in determining consumption. The results suggest that increased exposure to healthy foods should be included as guidelines for weight management.