The association between the food environment and adherence to healthy diet quality: the Maastricht Study

Objective:The purpose of this study is to determine if healthier neighbourhood food environments are associated with healthier diet quality. Design:This was a cross-sectional study using linear regression models to analyse data from the Maastricht Study. Diet quality was assessed using data collected with a FFQ to calculate the Dutch Healthy Diet (DHD). A buffer zone encompassing a 1000 m radius was created around each participant home address. The Food Environment Healthiness Index (FEHI) was calculated using a Kernel density analysis within the buffers of available food outlets. The association between the FEHI and the DHD score was analysed and adjusted for socio-economic variables. Setting:The region of Maastricht including the surrounding food retailers in the Netherlands. Participants:7367 subjects aged 40-75 years in the south of the Netherlands. Results:No relationship was identified between either the FEHI (B = 0 & BULL;62; 95 % CI = -2 & BULL;54, 3 & BULL;78) or individual food outlets, such as fast food (B = -0 & BULL;07; 95 % CI = -0 & BULL;20, 0 & BULL;07) and diet quality. Similar null findings using the FEHI were identified at the 500 m (B = 0 & BULL;95; 95 % CI = -0 & BULL;85, 2 & BULL;75) and 1500 m (B = 1 & BULL;57; 95 % CI = -3 & BULL;30, 6 & BULL;44) buffer. There was also no association between the food environment and individual items of the DHD including fruits, vegetables and sugar-sweetened beverages. Conclusion:The food environment in the Maastricht area appeared marginally unhealthy, but the differences in the food environment were not related to the quality of food that participants reported as intake.