title: Where people shop is not associated with the nutrient quality of packaged foods for any racial-ethnic group in the United States.
abstract: BACKGROUND
  In the literature, it has been suggested that there are race-ethnic disparities in what Americans eat. In addition, some studies have shown that residents of African American and low-income neighborhoods have less access to grocery stores and supermarkets, which tend to stock healthier foods. However, it is unclear whether differences in food shopping patterns contribute to the poorer nutrient profile of food purchases made by racial-ethnic minorities.
  
  
  OBJECTIVE
  We examined whether the mix of food stores where people shop (i.e., food-shopping patterns) was associated with the nutrient profile of packaged food purchases (PFPs) and the types of foods and beverages purchased, and we determined whether these associations differ across racial-ethnic groups.
  
  
  METHODS
  We used PFPs by US households (Nielsen National Consumer Panel) from 2007 to 2012 and implemented a cluster analysis to categorize households according to their food-shopping patterns. Longitudinal random-effects linear regression models were used to examine the association between food shopping patterns and the nutrient qualities and types of packaged foods and beverages purchased by race-ethnicity in US households.
  
  
  RESULTS
  Shopping primarily at grocery chains was not associated with a better nutrient profile of household PFPs or the food and beverages that households purchased than was shopping primarily at mass merchandisers (value-oriented stores that sell merchandise lines in multiple departments) or at a combination of large and small stores. These results were consistent across racial-ethnic groups. Regardless of where households shopped, non-Hispanic African American households purchased foods with higher energy, total sugar, and sodium densities than did non-Hispanic white and Hispanic households.
  
  
  CONCLUSIONS
  Policy initiatives that focus on increasing physical access to stores or helping stores sell healthier products to encourage healthier purchases may be ineffective because other factors may be more important determinants of food and beverage purchases than where people shop or what is available in the store.
authors.affiliation: Departments of Nutrition and.
authors.forename: Dalia
authors.initials: D
authors.lastname: Stern
authors.affiliation: Departments of Nutrition and.
authors.forename: Jennifer M
authors.identifier: http://orcid.org/0000-0002-7651-3625
authors.initials: JM
authors.lastname: Poti
authors.affiliation: Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and USDA Duke-University of North Carolina Collaborative Center for Behavioral Economics and Healthier Food Choice Research (BECR), Durham-Chapel Hill, NC.
authors.forename: Shu Wen
authors.identifier: http://orcid.org/0000-0003-0582-110X
authors.initials: SW
authors.lastname: Ng
authors.affiliation: Epidemiology, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and.
authors.forename: Whitney R
authors.initials: WR
authors.lastname: Robinson
authors.affiliation: Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and.
authors.forename: Penny
authors.identifier: http://orcid.org/0000-0001-5322-4188
authors.initials: P
authors.lastname: Gordon-Larsen
authors.affiliation: Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and popkin@unc.edu.
authors.forename: Barry M
authors.initials: BM
authors.lastname: Popkin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001628:Beverages; D002648:Child; D002675:Child, Preschool; D004040:Dietary Carbohydrates / Q000032:analysis; D002149:Energy Intake; D005006:Ethnicity; D005191:Family Characteristics; D005227:Fatty Acids / Q000032:analysis; D005260:Female; D005515:Food Labeling; D018857:Food Packaging; D005518:Food Preferences; D063427:Food Quality; D005523:Food Supply; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D012982:Sodium, Dietary / Q000032:analysis; D014481:United States; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D005227:Fatty Acids; D012982:Sodium, Dietary
keywords: US; disparities; food environment; food purchases; store type