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A Census of Midsize to Large Supermarkets in Toronto: A Cross-Sectional Analysis of the Consumer Nutrition
Andi Camden1, Jennifer Levy1, Kate Bassil2
1Healthy Public Policy, Toronto Public Health, Toronto, Ontario, Canada.
Objective:
Assess the consumer nutrition environment in midsize to large supermarkets by supermarket type and area-level socioeconomic variables.
Design:
Cross-sectional census of 257 supermarkets using the Toronto Nutrition Environment Measures Survey in Stores.
Setting:
Toronto, Canada.
Variables Measured:
Availability; price and linear shelf space of fruits and vegetables vs energy-dense snack foods by supermarket type; after-tax, low-income measure; and neighborhood improvement area.
Analysis:
Multivariate linear regression.
Results:
There was a high availability of fruits (7.7 of 8) and vegetables (9.5 of 11). There was similar linear shelf space for fruits and vegetables vs energy-dense snack foods (ratio, 1.1 m). Adjusted fruit prices were lowest in quintiles 1 (β = -$1.30; P = .008), 2 (β = -$1.41; P = .005), and 3 (β = -$1.89; P < .001) vs quintile 5 (lowest percentage of people living with low income) and in ethnic (β = -$3.47; P < .001) and discount stores (β = -$5.64; P < .001) vs conventional. Adjusted vegetable prices were lowest in quintiles 2 (β = -$1.87; P = .04), 3 (β = -$1.78; P = .03), and 4 (β = -$2.65; P = .001) vs quintile 5 and in ethnic (β = -$7.10; P < .001) and discount (β = -$5.49; P < .001) stores. They were highest in other (β = + $3.08; P = .003) vs conventional stores. Adjusted soda and chips prices were lower in discount (β = -$1.16; P < .001) and higher in other stores (β = + $0.67; P < .001) vs conventional.
Conclusions And Implications:
Findings do not indicate inequities in shelf space, availability, or price across diverse neighborhoods. Practitioners can use findings to help consumers navigate supermarkets to make healthy choices.
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