title: Individual, Social, and Environmental Correlates of Healthy and Unhealthy Eating.
abstract: BACKGROUND
  Few studies use comprehensive ecological approaches considering multilevel factors to understand correlates of healthy (and unhealthy) dietary intake. The aim of this study was to examine the association between individual, social, and environmental factors on composite measures of healthy and unhealthy dietary intake in adults.
  
  
  METHODS
  Participants (n = 565) of the Australian RESIDential Environments (RESIDE) project self-reported dietary intake, home food availability, and behavioral and perceived social and physical environmental inﬂuences on food choices. A geographic information system measured proximity of supermarkets from each participant's home. "Healthy" and "unhealthy" eating scores were computed based on adherence to dietary guidelines. Univariate and multivariate models were constructed using linear regression.
  
  
  RESULTS
  After full adjustment, "healthy" eating (mean = 6.25, standard deviation [SD] = 1.95) was significantly associated with having confidence to prepare healthy meals (β = 0.34; 95% confidence interval [CI] = [0.13, 0.55]); having more healthy (β = 0.13; 95% CI = [0.09-0.16]) and fewer unhealthy (β = -0.04; 95% CI = [-0.06, -0.02]) foods available at home; and having a supermarket within 800 meters of home (β = 1.39; 95% CI = [0.37, 2.404]). "Unhealthy" eating (mean = 3.53, SD = 2.06) was associated with being male (β = 0.39; 95% CI = [0.02, 0.75]), frequently eating takeaway (β = 0.33; 95% CI = [0.21, 0.46]) and cafe or restaurant meals (β = 0.20; 95% CI = [0.06, 0.33]) and having fewer healthy (β = -0.07; 95% CI = [-0.10, -0.03]) and more unhealthy (β = 0.09; 95% CI = [0.07, 0.10]) foods available within the home.
  
  
  CONCLUSIONS
  Initiatives to improve adherence to dietary guidelines and reduce the consumption of unhealthy foods needs to be multifaceted; addressing individual factors and access to healthy food choices in both the home and neighborhood food environment. Ensuring proximity to local supermarkets, particularly in new suburban developments, appears to be an important strategy for facilitating healthy eating.
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Australia Centre for the Built Environment and Health, The University of Western Australia, Australia School of Population Health, The University of Western Australia, Australia gina.trapp@telethonkids.org.au.
authors.forename: Georgina S A
authors.initials: GS
authors.lastname: Trapp
authors.affiliation: School of Population Health, The University of Western Australia, Australia.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Hickling
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Australia Centre for the Built Environment and Health, The University of Western Australia, Australia School of Population Health, The University of Western Australia, Australia.
authors.forename: Hayley E
authors.initials: HE
authors.lastname: Christian
authors.affiliation: Centre for the Built Environment and Health, The University of Western Australia, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Bull
authors.affiliation: Centre for Physical Activity and Nutrition Research, Deakin University, Australia.
authors.forename: Anna F
authors.initials: AF
authors.lastname: Timperio
authors.affiliation: School of Earth and Environment, The University of Western Australia.
authors.forename: Bryan
authors.initials: B
authors.lastname: Boruff
authors.affiliation: Centre for the Built Environment and Health, The University of Western Australia, Australia.
authors.forename: Damber
authors.initials: D
authors.lastname: Shrestha
authors.affiliation: McCaughey VicHealth Centre for Community Wellbeing, Melbourne School of Population Health, University of Melbourne, Australia.
authors.forename: Billie
authors.initials: B
authors.lastname: Giles-Corti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D004777:Environment; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005518:Food Preferences; D005638:Fruit; D040362:Geographic Information Systems; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D012959:Socioeconomic Factors; D014675:Vegetables
keywords: diet; eating behavior; food environment; geographic information system (GIS); supermarkets