title: Availability of healthy foods and dietary patterns: the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Inadequate availability of healthy foods may be a barrier to achieving recommended diets.
  
  
  OBJECTIVE
  The objective was to study the association between the directly measured availability of healthy foods and diet quality.
  
  
  METHODS
  We conducted a cross-sectional study of 759 participants from the Baltimore site of the Multi-Ethnic Study of Atherosclerosis. Diet was characterized by using a food-frequency questionnaire and summarized by using 2 empirically derived dietary patterns reflecting low- and high-quality diets. For each participant, the availability of healthy foods was directly assessed by using 3 measures: in all food stores within their census tract, in their closest food store, and in all food stores within 1 mile (1.6 km) of their residence.
  
  
  RESULTS
  Twenty-four percent of the black participants lived in neighborhoods with a low availability of healthy food compared with 5% of white participants (P < 0.01). After adjustment for age, sex, income, and education, a lower availability of healthy foods in the tract of residence or in the closest store was associated with higher scores on the low-quality dietary pattern (P < 0.05). Less consistent associations were observed for the high-quality dietary pattern.
  
  
  CONCLUSIONS
  Healthy foods were less available for black participants. Low availability of healthy foods was associated with a lower-quality diet. The extent to which improvements in the availability of healthy foods results in higher-quality diets deserves further investigation.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. mfranco@cnic.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Franco
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Nettleton
authors.forename: Mariana
authors.initials: M
authors.lastname: Lazo
authors.forename: Frederick
authors.initials: F
authors.lastname: Brancati
authors.forename: Benjamin
authors.initials: B
authors.lastname: Caballero
authors.forename: Thom
authors.initials: T
authors.lastname: Glass
authors.forename: Latetia V
authors.initials: LV
authors.lastname: Moore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000208:ethnology / Q000517:prevention & control*; D015142:Baltimore; D044383:Black People; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D005523:Food Supply / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D044465:White People; D001741:Black or African American