Topical Area: Community and Public Health Nutrition, Obesity
Objectives : Grocery purchases may serve as an objective measure of diet, but it is unclear whether the diet quality of grocery purchases reflect geographic and racial/ethnic disparities observed in existing nationally-representative individual-level data. This study evaluated whether geographic and racial/ethnic disparities exist in the dietary quality of grocery purchases in a nationally-representative sample of US households.
Methods : Grocery purchasing data from 3,961 households from the Food Acquisition and Purchase Study (FoodAPS) were used. Demographic data was self-reported, and 7-day dietary data was recorded with scanners; the Healthy Eating Index (HEI) 2015 was used to assess diet quality. Survey-weighted multivariable-adjusted regression with planned contrasts was used to examine whether HEI-15 scores differed according to geographic region (Northeast, West, South, Midwest) and whether there was effect modification by race/ethnicity (Non-Hispanic White (NHW), Non-Hispanic Black (NHB) and Hispanic).
Results : Primary respondents were, on average, 50.6 years, NHW (70.3%), female (70.2%) and had attended some college (57.8%). The mean HEI-15 score was 54.7, and scores differed by geography (p< 0.05), with the highest scores in the West (57.0±0.8) and lowest scores in the South (53.1±0.8). The influence of region on HEI-15 scores varied by race/ethnicity (p-interaction=0.015). Among NHW, households in the South had scores that were 3.2-points lower than in the West (50.4±0.7 vs. 53.6±0.8, p=0.003). Southern NHB households also had lower diet quality than NHB households in the West (48.6±1.5 vs. 56.7±2.7, p=0.01). Conversely, Hispanic households in the Midwest (47.5±2.0) had lower diet quality than Hispanic households in the South (54.1±0.9, p=0.02). Diet quality only differed across race/ethnicity (versus the NHW referent group) in the South and Midwest where Hispanic households had higher diet quality than NHW (54.1±0.9 vs. 50.4±0.7, p=0.007) in the South, but lower diet quality than NHW households in the Midwest (47.5±2.0 vs 52.2±0.6, p=0.02).
Conclusions : Disparities in grocery purchase quality exist across US geographic regions and are divergent across racial/ethnic groups, which may reflect issues related to acculturation or environmental-level factors that require further study.
Funding Sources : This research was supported by the Rhode Island Foundation.