title: Assessing the food environment of a rural community: baseline findings from the heart of New Ulm project, Minnesota, 2010-2011.
abstract: BACKGROUND
  Changes in the food environment in the United States during the past few decades have contributed to increased rates of obesity, diabetes, and heart disease. Improving the food environment may be an effective primary prevention strategy to address these rising disease rates. The purpose of this study was to assess the consumer food environment of a rural community with high rates of obesity and low levels of fruit and vegetable consumption. Findings were used to identify food environment intervention strategies to be implemented as part of a larger community-based heart disease prevention program.
  
  
  METHODS
  We used the Nutrition Environment Measures Survey for Restaurants (NEMS-R) and Stores (NEMS-S) to assess 34 restaurants, 3 grocery stores, and 5 convenience stores in New Ulm, Minnesota.
  
  
  RESULTS
  At least half of the restaurants offered nonfried vegetables and 100% fruit juice. Only 32% had at least 1 entrée or 1 main dish salad that met standards for "healthy." Fewer than half (41%) had fruit available and under one-third offered reduced-size portions (29%) or whole-grain bread (26%). Grocery stores had more healthful items available, but findings were mixed on whether these items were made available at a lower price than less healthful items. Convenience stores were less likely to have fruits and vegetables and less likely to carry more healthful products (except milk) than grocery stores.
  
  
  CONCLUSIONS
  Baseline findings indicated opportunities to improve availability, quality, and price of foods to support more healthful eating. A community-wide food environment assessment can be used to strategically plan targeted interventions.
authors.affiliation: Raquel F. Pereira, MS, RD, Community Project Manager, Heart of New Ulm Project, Department of Education, Minneapolis Heart Institute Foundation, 920 E 28th St, Suite 100, Minneapolis, MN, 55407. E-mail: rpereira@mhif.org.
authors.forename: Raquel F
authors.initials: RF
authors.lastname: Pereira
authors.affiliation: Allina Health, Minneapolis, Minnesota.
authors.forename: Abbey C
authors.initials: AC
authors.lastname: Sidebottom
authors.affiliation: Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Boucher
authors.affiliation: Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lindberg
authors.affiliation: New Ulm Medical Center, New Ulm, Minnesota.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Werner
mesh_terms: D001939:Bread; D003132:Commerce; D003296:Cooking; D005523:Food Supply / Q000145:classification* / Q000191:economics / Q000592:standards; D005638:Fruit; D006801:Humans; D008910:Minnesota; D012147:Restaurants; D012424:Rural Population; D014675:Vegetables