title: Degree of food processing of household acquisition patterns in a Brazilian urban area is related to food buying preferences and perceived food environment.
abstract: OBJECTIVE
  This cross-sectional study examined the association between local food environment and consumers' acquisition of ultra-processed food.
  
  
  METHODS
  Households were randomly selected from 36 census tracts in Santos City, Brazil. Mothers, of varying economic status, who had children ages 10 or younger (n = 538) were interviewed concerning: their household food acquisition of 31 groups of food and beverages, perceptions of local food environment, food sources destinations, means of transportation used, and socioeconomic status. Food acquisition patterns were classified based on the degree of industrial food processing. Logistic regression models were fitted to assess the association between consumer behaviors and acquisition patterns.
  
  
  RESULTS
  The large variety of fresh produce available in supermarkets was significantly related to lower odds of ultra-processed food purchases. After adjusting for sociodemographic characteristics, higher odds for minimally-processed food acquisition were associated with: frequent use of specialized markets to purchase fruits and vegetables (OR 1.89, 95% CI 1.01-2.34), the habit of walking to buy food (OR 1.58, 95% CI 1.08-2.30), and perceived availability of fresh produce in participants' neighborhood (OR 1.58, 95% CI 1.08-2.30). Acquisition of ultra-processed food was positively associated with the use of taxis as principal means of transportation to food sources (OR 2.35, 95% CI 1.08-5.13), and negatively associated with perceived availability of a variety of fruits and vegetables in the neighborhood (OR 0.57, 95% CI 0.37-0.88).
  
  
  CONCLUSIONS
  The results suggest that interventions aiming to promote acquisition of less processed food in settings similar to Santos, may be most effective if they focus on increasing the number of specialized fresh food markets in local neighborhood areas, improve residents' awareness of these markets' availability, and provide appropriate transportation.
authors.affiliation: Federal University of Sao Paulo, Department of Human Movement Science Nutritional Epidemiology Laboratory, 95 Ana Costa Avenue, Santos, SP CEP 11060001, Brazil.
authors.forename: G M
authors.initials: GM
authors.lastname: Vedovato
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Global Center for Obesity Prevention, 615 N. Wolfe Street, Room W3507, Baltimore, MD 21205, USA.
authors.forename: A C B
authors.initials: AC
authors.lastname: Trude
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Global Center for Obesity Prevention, 615 N. Wolfe Street, Room W3507, Baltimore, MD 21205, USA.
authors.forename: A Y
authors.initials: AY
authors.lastname: Kharmats
authors.affiliation: Federal University of Sao Paulo, Department of Human Movement Science Nutritional Epidemiology Laboratory, 95 Ana Costa Avenue, Santos, SP CEP 11060001, Brazil. Electronic address: paula.andrea.martins@gmail.com.
authors.forename: P A
authors.initials: PA
authors.lastname: Martins
mesh_terms: D000328:Adult; D001938:Brazil; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005511:Food Handling; D005518:Food Preferences; D005523:Food Supply / Q000191:economics; D005638:Fruit; D006801:Humans; D016015:Logistic Models; D010465:Perception; D012959:Socioeconomic Factors; D014505:Urban Population; D014675:Vegetables
keywords: Food environment; Food habits; Food stores; Food-processing; Urban health