title: Associations between the purchase of healthy and fast foods and restrictions to food access: a cross-sectional study in Melbourne, Australia.
abstract: OBJECTIVE
  To examine the associations between financial, physical and transport conditions that may restrict food access (which we define as food security indicators) and the purchase of fast foods and nutritious staples such as bread and milk.
  
  
  METHODS
  Multilevel logistic and multinomial regression analysis of cross-sectional survey data to assess associations between the three indicators of food insecurity and household food shopping adjusted for sociodemographic and socio-economic variables.
  
  
  METHODS
  Random selection of households (n 3995) from fifty Census Collector Districts in Melbourne, Australia, in 2003.
  
  
  METHODS
  The main food shoppers in each household (n 2564).
  
  
  RESULTS
  After adjustment for confounders, analysis showed that a greater likelihood of purchasing chain-brand fast food on a weekly basis compared with never was associated with running out of money to buy food (OR = 1·59; 95 % CI 1·08, 2·34) and reporting difficulties lifting groceries (OR = 1·77; 95 % CI 1·23, 2·54). Respondents without regular access to a car to do food shopping were less likely to purchase bread types considered more nutritious than white bread (OR = 0·75; 95 % CI 0·59, 0·95) and milk types considered more nutritious than full-cream milk (OR = 0·62; 95 % CI 0·47, 0·81). The food insecurity indicators were not associated with the purchasing of fruits, vegetables or non-chain fast food.
  
  
  CONCLUSIONS
  Householders experiencing financial and physical barriers were more likely to frequently purchase chain fast foods while limited access to a car resulted in a lower likelihood that the nutritious options were purchased for two core food items (bread and milk). Policies and interventions that improve financial access to food and lessen the effect of physical limitations to carrying groceries may reduce the purchasing of fast foods. Further research is required on food sourcing and dietary quality among those with food access restrictions.
authors.affiliation: 1WHO Collaborating Centre for Obesity Prevention,Deakin University,221 Burwood Highway,Burwood,VIC 3125,Australia.
authors.forename: Cate
authors.initials: C
authors.lastname: Burns
authors.affiliation: 2Centre for Women's Health,Gender and Society,Melbourne School of Population Health,University of Melbourne,Melbourne,Victoria,Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Bentley
authors.affiliation: 3Centre for Physical Activity and Nutrition Research,Deakin University,Melbourne,Victoria,Australia.
authors.forename: Lukar
authors.initials: L
authors.lastname: Thornton
authors.affiliation: 2Centre for Women's Health,Gender and Society,Melbourne School of Population Health,University of Melbourne,Melbourne,Victoria,Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Kavanagh
mesh_terms: D000818:Animals; D001939:Bread / Q000032:analysis / Q000191:economics; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000191:economics / Q000208:ethnology / Q000523:psychology; D005191:Family Characteristics / Q000208:ethnology; D057140:Fast Foods / Q000009:adverse effects* / Q000191:economics; D005523:Food Supply / Q000191:economics; D005638:Fruit / Q000737:chemistry / Q000191:economics; D006801:Humans; D016015:Logistic Models; D008892:Milk / Q000737:chemistry / Q000191:economics; D018673:Nutrition Policy; D009749:Nutrition Surveys; D010349:Patient Compliance / Q000208:ethnology; D012044:Regression Analysis; D012111:Residence Characteristics; D014186:Transportation / Q000191:economics; D014504:Urban Health / Q000191:economics / Q000208:ethnology; D014675:Vegetables / Q000737:chemistry / Q000191:economics; D014739:Victoria
keywords: Fast-food purchase; Food access; Food security indicators; Fruit and vegetable purchase; Grocery shopping