Variation in supermarket exposure to energy-dense snack foods by socio-economic position

Abstract

Objective The present study aimed to examine the availability of energy-dense, nutrient-poor snack foods (and fruits and vegetables) in supermarkets located in socio-economically advantaged and disadvantaged neighbourhoods. Design Cross-sectional supermarket audit. Setting Melbourne, Australia. Measures included product shelf space and number of varieties for soft drinks, crisps, chocolate, confectionery and fruits and vegetables, as well as store size. Subjects Thirty-five supermarkets (response 83%) from neighbourhoods in the lowest and highest quintile of socio-economic disadvantage. Results Shelf space allocated to soft drinks (23·6 m v. 17·7 m, P = 0·006), crisps (16·5 m v. 13·0 m, P = 0·016), chocolate (12·2 m v. 10·1 m, P = 0·022) and confectionery (6·7 m v. 5·1 m, P = 0·003) was greater in stores from socio-economically disadvantaged neighbourhoods. After adjustment for store size (stores in disadvantaged areas being larger), shelf space for confectionery (6·3 m v. 5·6 m, P = 0·024) and combined shelf space for all energy-dense foods and drinks (55·0 m v. 48·9 m, P = 0·017) remained greater in stores from socio-economically disadvantaged neighbourhoods. The ratio of shelf space allocated to fruits and vegetables to that for energy-dense snack foods also varied by socio-economic disadvantage after adjustment for store size (most disadvantaged v. least disadvantaged: 1·7 v. 2·1, P = 0·025). Varieties of fruits and vegetables and chocolate bars were more numerous in less disadvantaged areas (P < 0·05). Conclusions Exposure to energy-dense snack foods and soft drinks in supermarkets was greater in socio-economically disadvantaged neighbourhoods. This may impact purchasing, consumption and cultural norms related to eating behaviours and may therefore work against elimination of the known socio-economic gradient in obesity levels. Reform of supermarket stocking practices may represent an effective means of obesity prevention. © 2012 The Authors.