Prepared Food Availability in U.S. Food Stores: A National Study.
BACKGROUND
Prepared, ready-to-eat foods comprise a significant part of Americans' diets and are increasingly obtained from food stores. Yet, little is known about the availability and healthfulness of prepared, ready-to-eat food offerings at stores. This study examines associations among community characteristics (racial/ethnic composition, poverty level, urbanicity) and availability of both healthier and less-healthy prepared foods in U.S. supermarkets, grocery stores, and convenience stores.


METHODS
Observational data were collected from 4,361 stores in 317 communities spanning 42 states in 2011 and 2012. Prepared food availability was assessed via one healthier food (salads or salad bar), three less-healthy items (pizza, hot dog/hamburger, taco/burrito/taquito), and one cold sandwich item. In 2014, multivariable generalized linear models were used to test associations with community characteristics.


RESULTS
Overall, 63.6% of stores sold prepared foods, with 20.0% offering prepared salads and 36.4% offering at least one less-healthy item. Rural stores were 26% less likely to carry prepared salads (prevalence ratio [PR]=0.74, 95% CI=0.62, 0.88) and 14% more likely to carry at least one less-healthy prepared food item (PR=1.14, 95% CI=1.00, 1.30). Convenience stores in high-poverty communities were less likely to carry prepared salads than those in low-poverty communities (PR=0.64, 95% CI=0.47, 0.87). Among supermarkets, prepared salads were more likely to be carried in majority-white, low-poverty communities than in non-white, high-poverty communities.


CONCLUSIONS
Increasing the healthfulness of prepared foods within stores may offer an important opportunity to improve the food environment.
College of Nursing, University of Illinois at Chicago, Chicago, Illinois. Electronic address: szenk@uic.edu.
Shannon N
SN
Zenk
School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
Lisa M
LM
Powell
Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
Zeynep
Z
Isgor
Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
Leah
L
Rimkus
Barker Bi-Coastal Health Consultants Inc., Calabasas, California.
Dianne C
DC
Barker
Department of Economics, University of Illinois at Chicago, Chicago, Illinois.
Frank J
FJ
Chaloupka
D003430:Cross-Sectional Studies; D005502:Food / Q000706:statistics & numerical data*; D005523:Food Supply / Q000706:statistics & numerical data*; D014481:United States