One-Year Follow-Up Examination of the Impact of the North Carolina Healthy Food Small Retailer Program on Healthy Food Availability, Purchases, and Consumption

We examined the short-term impact of the North Carolina Healthy Food Small Retailer Program (HFSRP), a legislatively appropriated bill providing funding up to $25,000 to small food retailers for equipment to stock and promote healthier foods, on store-level availability and purchase of healthy foods and beverages, as well as customer dietary patterns, one year post-policy implementation. We evaluated healthy food availability using a validated audit tool, purchases using customer bag-checks, and diet using self-reported questionnaires and skin carotenoid levels, assessed via Veggie Meter™, a non-invasive tool to objectively measure fruit and vegetable consumption. Difference-in-difference analyses were used to examine changes in HFSRP stores versus control stores after 1 year. There were statistically significant improvements in healthy food supply scores (availability), with the Healthy Food Supply HFS score being −0.44 points lower in control stores and 3.13 points higher in HFSRP stores pre/post HFSRP (p = 0.04). However, there were no statistically significant changes in purchases or self-reported consumption or skin carotenoids among customers in HFSRP versus control stores. Additional time or other supports for retailers (e.g., marketing and promotional materials) may be needed for HFSRP implementation to influence purchase and consumption

Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina

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Disparities in Healthy Food Zoning, Farmers\u27 Market Availability, and Fruit and Vegetable Consumption Among North Carolina Residents

Background: Context and purpose of the study. To examine (1) associations between county-level zoning to support farmers\u27 market placement and county-level farmers\u27 market availability, rural/urban designation, percent African American residents, and percent of residents living below poverty and (2) individual-level associations between zoning to support farmers\u27 markets; fruit and vegetable consumption and body mass index (BMI) among a random sample of residents of six North Carolina (NC) counties. Methods: Zoning ordinances were scored to indicate supportiveness for healthy food outlets. Number of farmers\u27 markets (per capita) was obtained from the NC-Community Transformation Grant Project Fruit and Vegetable Outlet Inventory (2013). County-level census data on rural/urban status, percent African American, and percent poverty were obtained. For data on farmers\u27 market shopping, fruit and vegetable consumption, and BMI, trained interviewers conducted a random digit dial telephone survey of residents of six NC counties (3 urban and 3 rural). Pearson correlation coefficients and multilevel linear regression models were used to examine county-level and individual-level associations between zoning supportiveness, farmers\u27 market availability, and fruit and vegetable consumption and BMI. Results: At the county-level, healthier food zoning was greater in more urban areas and areas with less poverty. At the individual-level, self-reported fruit and vegetable consumption was associated with healthier food zoning. Conclusions: Disparities in zoning to promote healthy eating should be further examined, and future studies should assess whether amending zoning ordinances will lead to greater availability of healthy foods and changes in dietary behavior and health outcomes

A Non-Invasive Assessment of Skin Carotenoid Status Through Reflection Spectroscopy is a Feasible, Reliable and Potentially Valid Measure of Fruit and Vegetable Consumption in a Diverse Community Sample

Objective To assess the feasibility, reliability and validity of reflection spectroscopy (RS) to assess skin carotenoids in a racially diverse sample. Design Study 1 was a cross-sectional study of corner store customers (n 479) who completed the National Cancer Institute Fruit and Vegetable Screener as well as RS measures. Feasibility was assessed by examining the time it took to complete three RS measures, reliability was assessed by examining the variation between three RS measures, and validity was examined by correlation with self-reported fruit and vegetable consumption. In Study 2, validity was assessed in a smaller sample (n 30) by examining associations between RS measures and dietary carotenoids, fruits and vegetables as calculated from a validated FFQ and plasma carotenoids. Setting Eastern North Carolina, USA. Results It took on average 94·0 s to complete three RS readings per person. The average variation between three readings for each participant was 6·8 %. In Study 2, in models adjusted for age, race and sex, there were statistically significant associations between RS measures and (i) FFQ-estimated carotenoid intake (P<0·0001); (ii) FFQ-estimated fruit and vegetable consumption (P<0·010); and (iii) plasma carotenoids (P<0·0001).Conclusions RS is a potentially improved method to approximate fruit and vegetable consumption among diverse participants. RS is portable and easy to use in field-based public health nutrition settings. More research is needed to investigate validity and sensitivity in diverse populations

Disparities in healthy food zoning, farmers' market availability, and fruit and vegetable consumption among North Carolina residents

Background: Context and purpose of the study. To examine (1) associations between county-level zoning to supportfarmers" market placement and county-level farmers" market availability, rural/urban designation, percent AfricanAmerican residents, and percent of residents living below poverty and (2) individual-level associations between zoningto support farmers" markets; fruit and vegetable consumption and body mass index (BMI) among a random sample ofresidents of six North Carolina (NC) counties.Methods: Zoning ordinances were scored to indicate supportiveness for healthy food outlets. Number of farmers"markets (per capita) was obtained from the NC-Community Transformation Grant Project Fruit and Vegetable OutletInventory (2013). County-level census data on rural/urban status, percent African American, and percent poverty wereobtained. For data on farmers" market shopping, fruit and vegetable consumption, and BMI, trained interviewersconducted a random digit dial telephone survey of residents of six NC counties (3 urban and 3 rural). Pearsoncorrelation coefficients and multilevel linear regression models were used to examine county-level and individual-levelassociations between zoning supportiveness, farmers" market availability, and fruit and vegetable consumptionand BMI.Results: At the county-level, healthier food zoning was greater in more urban areas and areas with less poverty.At the individual-level, self-reported fruit and vegetable consumption was associated with healthier food zoning.Conclusions: Disparities in zoning to promote healthy eating should be further examined, and future studiesshould assess whether amending zoning ordinances will lead to greater availability of healthy foods and changesin dietary behavior and health outcomes