The present paper examines dietary intake and body composition in antiretroviral (ARV)-naïve HIV-positive compared with HIV-negative South African women, as well as the impact of disease severity on these variables.

Baseline data from a longitudinal study assessing bone health in HIV-negative and HIV-positive premenopausal South African women over 18 years of age were used. Anthropometry and body composition, measured by dual energy X-ray absorptiometry, were analysed together with dietary intake data assessed using an interviewer-based quantitative FFQ.

Soweto, Johannesburg, South Africa.

Black, urban South African women were divided into three groups: (i) HIV-negative (HIV−; n 98); (ii) HIV-positive with preserved CD4 counts (HIV+ non-ARV; n 74); and (iii) HIV-positive with low CD4 counts and due to start ARV treatment (HIV+ pre-ARV; n 75).

The prevalence of overweight and obesity was high in this population (59 %). The HIV+ pre-ARV group was lighter and had a lower BMI than the other two groups (all P < 0·001). HIV+ pre-ARV women also had lower fat and lean masses and percentage body fat than their HIV− and HIV+ non-ARV counterparts. After adjustment, there were no differences in macronutrient intakes across study groups; however, fat and sugar intakes were high and consumption of predominantly refined food items was common overall.

HIV-associated immunosuppression may be a key determinant of body composition in HIV-positive women. However, in populations with high obesity prevalence, these differences become evident only at advanced stages of infection.

To study the association between the availability of healthy foods and BMI by neighbourhood race and socio-economic status (SES).

Trained staff collected demographic information, height, weight and 24 h dietary recalls between 2004 and 2008. Healthy food availability was determined in thirty-four census tracts of varying racial and SES composition using the Nutrition Environment Measures Survey–Stores in 2007. Multilevel linear regression was used to estimate associations between healthy food availability and BMI.

Baltimore City, Maryland, USA.

Adults aged 30–64 years (n 2616) who participated in the Healthy Aging in Neighborhoods of Diversity across the Life Span study.

Among individuals living in predominantly white neighbourhoods, high availability of healthy foods was associated with significantly higher BMI compared with individuals living in neighbourhoods with low availability of healthy food after adjustment for demographic variables (β = 3·22, P = 0·001). Associations were attenuated but remained significant after controlling for dietary quality (β = 2·81, P = 0·012).

Contrary to expectations, there was a positive association between the availability of healthy food and higher BMI among individuals living in predominantly white neighbourhoods. This result could be due to individuals in neighbourhoods with low healthy food availability travelling outside their neighbourhood to obtain healthy food.

The present study directly compared prices of more and less nutritious foods within given categories in US supermarkets.

Foods selected from six supermarkets in Jackson County were categorized using the five criteria of the Nutrition Detectives™ (ND) programme and an item-to-item cost comparison was made using posted prices. The nutritional quality of foods was distinguished using the clues of the ND nutrition education programme for elementary-school children and validated using the Overall Nutritional Quality Index.

Supermarkets in Jackson County, MO, USA.

Not applicable.

The average price of the item for more nutritious foods did not differ significantly from that of less nutritious foods overall ($US 2·89 (sd $US 0·74) v. $US 2·85 (sd $0·68), P = 0·76). More nutritious breads cost more than less nutritious breads ($US 3·36 (sd $ US 0·28) v. $US 2·56 (sd $US 0·80, P = 0·03), whereas more nutritious cereals ($US 2·46 (sd $US 0·69) v. $US 3·50 (sd $US 0·30), P < 0·01) and cookies ($US 2·76 (sd $US 0·50) v. $US 3·40 (sd $US0·28), P < 0·01) cost less.

Our findings indicate that it is possible to choose more nutritious foods within many common categories without spending more money and suggest that making small improvements in dietary choices does not invariably cost more.

To determine and compare the level of implementation of policies for healthy food environments in Thailand with reference to international best practice by state and non-state actors.

Data on the current level of implementation of food environment policies were assessed independently using the adapted Healthy Food Environment Policy Index (Food-EPI) by two groups of actors. Concrete actions were proposed for Thai Government. A joint meeting between both groups was subsequently held to reach consensus on priority actions.

Thailand.

Thirty state actors and twenty-seven non-state actors.

Level of policy implementation varied across different domains and actor groups. State actors rated implementation levels higher than non-state actors. Both state and non-state actors rated level of implementation of monitoring of BMI highest. Level of implementation of policies promoting in-store availability of healthy foods and policies increasing tax on unhealthy foods were rated lowest by state and non-state actors, respectively. Both groups reached consensus on eleven priority actions for implementation, focusing on food provision in public-sector settings, food composition, food promotion, leadership, monitoring and intelligence, and food trade.

Although the implementation gaps identified and priority actions proposed varied between state and non-state actors, both groups achieved consensus on a comprehensive food policy package to be implemented by the Thai Government to improve the healthiness of food environments. This consensus is a platform for continued policy dialogue towards cross-sectoral policy coherence and effective actions to address the growing burden of non-communicable diseases and obesity in Thailand.

To determine the vitamin D status of women of South Asian origin living in Auckland, New Zealand, and to investigate their attitudes and behaviours with regard to sun exposure.

Cross-sectional study.

Auckland, New Zealand.

Women of South Asian origin (n 235) aged 20 years and older were tested for serum 25(OH)D, and 228 were included in these analyses. Of these, 140 completed a questionnaire about attitudes and behaviours to sun exposure, and health motivation. Exclusion criteria included high dose (>1000 IU/d) supplementation with 25(OH)D3, or any supplementation with 1,25(OH)2D3.

As serum vitamin D concentrations were not normally distributed, data are reported as median (25th, 75th percentile). Median serum 25(OH)D3 was 27·5 (18·0, 41·0) nmol/l. Adequate concentrations (>50 nmol/l) were observed in only 16 % of the subjects. Concern about skin cancer and the strength of the New Zealand sun were the most prevalent reasons given for sun avoidance, with 65 % saying they did avoid the sun. However, a seasonal variation was observed, with concentrations reducing significantly (P < 0·001) from summer through to early spring by 19·5 nmol/l.

The results of the present study suggest that South Asian women are at high risk of hypovitaminosis D, due, in part, to deliberate sun avoidance and an indoor lifestyle, and that they are especially vulnerable in winter and spring.

To quantify marine food product consumption and EPA + DHA intake among Quebecers, and to compare the results with the most recent recommendations.

Data were obtained from a representative cross-sectional telephone survey (June 2006). Intakes of marine food product species and EPA + DHA were estimated from a validated FFQ on the consumption of marine food products during the previous month. Prevalence of fish oil consumption in the last 6 months was also assessed.

Province of Quebec (Canada).

A representative sample (n 1001) of adults in the province of Quebec. Of these, eight were excluded from the present analysis (n 993).

Mean and median EPA + DHA intakes for all participants were estimated to be 291 mg/d (sem 11) and 207 mg/d, respectively. 85·0 % (95 % CI 82·7, 87·3) of Quebecers had an EPA + DHA intake lower than 500 mg/d, which is the amount internationally recommended for the prevention of CVD. Mean and median DHA intakes among women of childbearing age (n 128, 18–34 years) were estimated to be 169 mg/d (sem 17) and 126 mg/d, respectively. Of these women, 27·7 % had a daily intake >200 mg DHA and 15·9 % had an intake >300 mg DHA. We noted that 13 % of Quebecers take ≥1 capsule of fish oil/d.

Consumption of marine food products and EPA + DHA among Quebecers clearly appears to be lower than international recommendations. Since EPA + DHA confer health benefits and may reduce health costs, strategies to increase their consumption should be implemented to improve public health in Quebec.

We examined whether drinking water per se is associated with drinking less of other beverages and whether changes in BMI are associated with the intake of water and other beverages.

Secondary analysis of a randomized trial of fourth graders followed over 1 year.

Public schools in the metropolitan area of Rio de Janeiro, Brazil.

Participants were 1134 students aged 10–11 years.

At baseline, a higher frequency of water consumption was associated with a greater daily intake of fruit juice (P = 0·02) and a higher daily frequency of milk (P = 0·005). In the intervention group, the baseline frequency of water consumption was negatively associated with weight change over 1 year but without statistical significance (coefficient = −0·08 kg/m2; 95 % CI −0·37, 0·24 kg/m2), whereas fruit juice intake frequency was positively associated with weight change: each increase in fruit juice intake of 1 glass/d was associated with a BMI increase of 0·16 (95 % CI 0·02, 0·30) kg/m2.

Our findings do not support a protective effect of water consumption on BMI, but confirm consumption of juice drinks as a risk factor for BMI gain. Students who reported high water consumption also reported high intake of other beverages; therefore, the promotion of water consumption per se would not prevent excessive weight gain.

To examine knowledge of and adherence to the Mediterranean dietary pattern (MDP) among Greek adolescents, assess associations between MDP knowledge and adherence with BMI, and determine socio-cultural factors predicting MDP compliance.

Cross-sectional.

Greek adolescents aged 15–17 years.

Two hundred adolescents (103 females, ninety-seven males) from six schools on the Greek island of Chios. The sampling procedure was similar for all schools; schools were randomly selected from different geographic areas and all municipalities. BMI was calculated from measured height and weight; participants completed four questionnaires assessing parents’ socio-economic status and education, adolescents’ perceived and actual MDP knowledge, past-week dietary habits, and MDP adherence.

Participants’ BMI indicated 64·5 % were normal weight and 35·5 % were overweight/obese (mean BMI 23·7 (sd 3·8) kg/m2). Over half had very poor MDP knowledge (58·5 %) and adherence (59·5 %); both perceived (F = 3·35, P = 0·037) and actual MDP knowledge (F = 3·45, P = 0·034) were significantly different across MDP adherence. Perceived MDP knowledge was positively correlated with vegetable consumption (r = 0·185, P = 0·009); actual knowledge was negatively correlated with meat consumption (r = −0·191, P = 0·007). BMI was negatively correlated with family income (r = −0·202, P = 0·004), indicating higher BMI in less affluent households. Actual MDP knowledge was the only significant predictor of MDP adherence (standardized β = 0·162, P = 0·030) in a model accounting for 7·3 % of overall variance.

Greek adolescents reported consuming a more Westernized diet detached from the traditional MDP. Actual MDP knowledge and family income were important factors affecting MDP adherence and BMI, respectively. Promoting the traditional MDP among Greek adolescents and their families appears warranted.

The present work aimed at cross-cultural adaptation and validation of the health literacy assessment tool Newest Vital Sign (NVS) in general population (GP) and highly educated (HE) samples of Brazilian adults.

An expert committee reviewed the translation and back-translation processes and the cultural adaptation. The construct validity was analysed with confirmatory factor analysis and via associations with features of the study population.

The final validation test was performed in two different populations from Londrina, a large town in southern Brazil.

Brazilian adults: GP (adult clients of community pharmacies; n 189) and HE (public school teachers; n 301).

The tool under validation showed good cross-cultural adaptation and internal consistency, with Cronbach’s α of 0·75 for GP and 0·74 for HE. Confirmatory factor analysis showed acceptable models and identified two independent factors according to the relationship between components and numeracy for both GP and HE data. According to the Brazilian Portuguese version of the NVS instrument (NVS-BR), 48·7 % of GP and 33·5 % of HE presented adequate health literacy; this condition was inversely associated with age for both populations and directly correlated with educational level for GP.

The NVS-BR showed good validity in two different populations of Brazilian adults and can be considered an alternative in screening for inadequate health literacy.

To investigate differences between dietary habits in Glasgow and those in the rest of Scotland and the role that socio-economic factors have in explaining these.

Data on age, sex, area deprivation, social class, educational qualifications, economic activity, health board region, postcode sector area and informants’ usual intake of foods covering sugary foods, snacks, fibre, starch, meat, fish, spreading fats, dairy products, salt, dietary supplements, fruit and vegetables were available from the 1995, 1998 and 2003 Scottish Health Surveys. Multilevel logistic regression was used to model the relationship between diet and living in Greater Glasgow compared with elsewhere in Scotland, unadjusted and adjusted for age, survey year and socio-economic factors, accounting for the clustering within postcode sector area.

Scotland.

Subjects comprised 11 075 male and 14 052 female respondents.

Lower consumption of high-fibre bread and potatoes/pasta/rice (among men and women), of cakes (men) and of cereals, meat, skimmed/semi-skimmed milk and green vegetables (women) in Glasgow was explained by socio-economic factors, as was higher consumption of non-diet soft drinks among women; lower consumption of ice cream, bread, cereals, meat and green vegetables (men) and high butter and salt consumption (women) in Greater Glasgow were not.

Associations between unhealthy eating and deprivation accounted for much of the tendency of people in Glasgow to have poor diets. Policies are needed to encourage improvements in diet in Glasgow and more effort is required to reduce social inequalities in eating habits. Glasgow’s poor diet will remain unless problems associated with poverty are tackled.

To examine the association between food insecurity and child sleep outcomes and to investigate whether parent psychosocial factors mediate such associations.

Cross-sectional study. Usual wake time and bedtime, bedtime routine and sleep quality were reported by parents using the adapted Brief Infant Sleep Questionnaire. Food insecurity was assessed using the eighteen-item US Department of Agriculture Household Food Security Module. Parent psychosocial factors, including perceived stress, parenting self-efficacy and depressive symptomology, were assessed using validated scales. Multivariable logistic regression models were performed to determine the association between food insecurity and sleep outcomes controlling for potential confounders. Mediation analyses and Sobel tests were applied to test the mediating effect of psychosocial factors.

Head Start pre-school classrooms in four regions across central Pennsylvania, USA.

Low-income children of pre-school age (n 362) and their caregivers.

Prevalence of household, adult and child food insecurity was 37·3, 31·8 and 17·7 %, respectively. Food security status at any level was not associated with child sleep duration or bedtime routine. Child food insecurity, but not household or adult food insecurity, was associated with 2·25 times increased odds (95 % CI 1·11, 4·55) of poor child sleep quality in the adjusted model. Perceived stress, self-efficacy and depressive symptomology mediated less than 2 % of the observed effect (all Sobel test P > 0·6).

Food insecurity, particularly at the child level, is a potential modifiable risk factor for reducing sleep-related health disparities in early childhood. Future studies are needed to explore the plausible mechanisms underlying the associations between food insecurity and adverse child sleep outcomes.

To (i) describe the proportion of foods and beverages available on school canteen menus classified as having high (‘green’), moderate (‘amber’) or low (‘red’) nutritional value; (ii) describe the proportion of these items purchased by students; and (iii) examine the association between food and beverage availability on school canteen menus and food and beverage purchasing by students.

A cross-sectional study was conducted as part of a larger randomised controlled trial (RCT).

A nested sample of fifty randomly selected government schools from the Hunter New England region of New South Wales, Australia, who had participated in an RCT of an intervention to improve the availability of healthy foods sold from school canteens, was approached to participate.

School principals, canteen managers and students.

The average proportion of green, amber and red items available on menus was 47·9, 47·4 and 4·7 %, respectively. The average proportion of green, amber and red items purchased by students was 30·1, 61·8 and 8·1 %, respectively. There was a significant positive relationship between the availability and purchasing of green (R2=0·66), amber (R2=0·57) and red menu items (R2=0·61). In each case, a 1 % increase in the availability of items in these categories was associated with a 1·21, 1·35 and 1·67 % increase in purchasing of items of high, moderate and low nutritional value, respectively.

The findings provide support for school-based policies to improve the relative availability of healthy foods for sale in these settings.

To explore how some of the largest food companies involved in producing alternative proteins (AP) use health and nutrition claims to market their products.

We identified the largest food manufacturers, meat processors and AP companies selling plant-based AP products in the USA. Using publicly available data, we analysed the voluntary health and nutrition claims made on front-of-pack labels (FOPL) and company webpages. We also analysed company websites for further nutrition and health-related statements about their products or AP more generally. Claim classification was guided by the INFORMAS (International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring, and Action Support) taxonomy for health-related food labelling.

USA.

Not applicable.

1394 health and nutrition-related FOPL claims were identified on 216 products, including 685 nutrition claims and 709 ‘other health-related’ claims. No FOPL health claims were identified. Most nutrient claims were for nutrients associated with meat, with 94 % of products carrying a protein claim and 30 % carrying a cholesterol claim. 74 % of products carried a GMO-free claim, and 63 % carried a plant-based claim. On their websites, some companies expanded on these claims or discussed the health benefits of specific ingredients.

Companies involved in this category appear to be using nutritional marketing primarily to position their products in relation to meat. There is a focus on nutrient and ingredient claims, with discussion of processing largely avoided. The findings highlight the challenges companies face in positioning AP products as healthy against the backdrop of debates about ultra-processed foods.

The aim of this umbrella review was to summarise the evidence from existing systematic reviews on the association between different dietary patterns (DP) and overweight or obesity outcomes in adults.

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched the MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science for systematic reviews reporting on DP and weight gain or overweight/obesity outcomes.

We identified 16 systematic reviews with 143 unique studies published between 2001 and 2019. Overall quality scores ranged from 4 to 10. Six reviews in 2/11 cohort and 6/19 cross-sectional studies reported (statistically significant) decreased OR for obesity (range: 0·53 to 0·73 and 0·35 to 0·88, respectively) associated with the Mediterranean diet. Five reviews in 5/15 cohort and 10/45 cross-sectional studies reported an inverse association between diet quality and weight gain or BMI (β range: –1·3 to –0·09). Two reviews in 1/3 cohort and 1/2 cross-sectional studies reported a decreased risk of obesity (OR = 0·76) and weight gain (OR = 0·26), respectively, with fruit and vegetable intake. Five reviews of mixed DP in 3/40 cross-sectional studies reported an increased prevalence of obesity (OR = 1·19) or abdominal obesity (OR range: 1·07 to 1·27) with the Korean diet pattern.

Our umbrella review confirms the hypothesis that Mediterranean-type DP reduce the risk of obesity in adults. Although population-specific evidence of effective interventions is needed, characteristics of Mediterranean-type DP are important considerations for national obesity prevention strategies.

The current study prospectively examines the intra-uterine hypothesis by comparing maternal, paternal and grandparental lineage influences on children's diet and also maternal–child aggregation patterns during pregnancy and early childhood.

Prenatal dietary information was available for expectant mothers, fathers and up to four grandparents through a detailed validated semi-quantitative FFQ. At 6-year follow-up, when children averaged 5 years of age, dietary information was re-collected for mothers and a subset of maternal grandmothers using the same FFQ. Child's FFQ version was used for children. Anthropometric and sociodemographic variables were also collected.

Three-generation familial cohort representative of the contemporary Irish national population.

Children aged 5 years (n 567) and their parents and grandparents.

Associations for energy, macronutrient and fibre intakes were compared using Pearson's correlations, intra-class correlations (ICC) and linear regression models, adjusted for energy and potential confounders. Significant, moderate-strength positive correlations were observed for nutrient intakes in children's nuclear families (ICC (range) = 0·22–0·28). The father–child associations (r (range) = 0·13–0·20) were weaker than the mother–child associations (r (range) = 0·14–0·33). In general, associations were stronger for maternal postnatal intake–child intake than for maternal prenatal intake–child intake, except for percentage of energy from fat (adjusted β = 0·16, 95 % CI 0·05, 0·26; P = 0·004), which was stronger for maternal prenatal intake, specifically in non-breast-fed children (adjusted β = 0·28, 95 % CI 0·12, 0·44; P = 0·001). Among all grandparents, correlations were significant only for maternal grandmother–mother pairs (r (range) = 0·10–0·36). Significant positive ICC were observed for nutrient intakes of maternal grandmother–mother–child triads (ICC (range) = 0·12–0·27), not found in paternal lines.

These findings suggest that maternal-environment programming influences dietary intake.

To evaluate the nutritional quality of products advertised on television (TV) during children's viewing time in Spain, applying the UK nutrient profile model (UKNPM).

We recorded 80 h of four general TV station broadcasts during children's viewing time in May and June 2008, and identified all advertisements for foods and beverages. Nutritional information was obtained from the product labels or websites and from food composition tables. Each product was classified as healthy (e.g. gazpacho, a vegetable juice) or less healthy (e.g. potato crisp snacks) according to the UKNPM criteria.

Four free-of-charge TV channels in Spain: two national channels and two regional ones.

TV commercials of food and beverages.

A total of 486 commercials were broadcast for ninety-six different products, with a mean frequency of 5·1 advertisements per product. Some 61·5 % of the ninety-six products were less healthy, and the percentage was higher for foods (74·1 %). All (100 %) of the breakfast cereals and 80 % of the non-alcoholic drinks and soft drinks were less healthy. Of the total sample of commercials, 59·7 % were for less healthy products, a percentage that rose to 71·2 % during children's reinforced protection viewing time.

Over half the commercials were for less healthy products, a proportion that rose to over two-thirds during the hours of special protection for children. This suggests that applying the UKNPM to regulate food advertising during this slot would entail the withdrawal of most food commercials in Spain. TV advertising of products with low nutritional quality should be restricted.

To explore why there is a lack of acceptance among Western Australian (WA) adults of the Go for 2&5®fruit and vegetable social marketing message to consume at least five servings of vegetables per day.

A series of focus group discussions comprised of homogeneous groups varied by sex and age, until saturation of themes was achieved, followed by thematic analysis.

Part of qualitative research for the Go for 2&5® fruit and vegetable social marketing campaign in WA (2009 population: 2·2 million).

WA adults stratified by sex and age groups (18–29 and 30–55 years) drawn from the second and third quartiles of socio-economic disadvantage.

Familiarity with the Go for 2&5® message was excellent. Understanding of what constitutes ‘two servings of fruit’ was excellent and regarded by participants as highly achievable. Understanding of what constitutes ‘five servings of vegetables’ was suboptimal with widespread overestimation contributing to the belief that it is unrealistic. Participants did not know how the 2&5 recommendation was formulated and believed that daily consumption of two servings of fruit and five of vegetables would confer no greater health benefit than one of fruit and three of vegetables. Participants assumed that the 2&5 recommendation was ‘aspirational’ in the sense that it was purposely exaggerated to simply encourage greater overall consumption.

A convincing case needs to be presented to WA adults as to why they should consume five servings of vegetables per day. Continuing efforts to educate incorporating what constitutes a serving will assist perceptions that the recommendation is realistic.

Although the fatty acid fractions provide similar metabolizable energy, the type of dietary fat consumed could be relevant to the development of obesity.

To investigate the relationship between body mass index (BMI), obesity and the consumption of different types of fat and olive oil in a Mediterranean country with high prevalence of obesity, and high intake of monounsaturated fatty acids (MUFA) and olive oil.

The study was carried out in Spain among 23 289 women and 14 374 men, aged 29–69 years, who were participants of a large European prospective cohort.

Information on usual food intake was collected by interviewers by means of a dietary history questionnaire. The association between obesity (BMI ≥ 30 kg m2), dietary fat, other dietary patterns and other non-dietary factors were tested using multilinear regression analysis. The ratio of reported energy intake to energy requirement was used as an estimation of dietary underreporting.

The association between fatty acid fractions intake (saturated fatty acids (SFA) in women, and MUFA and polyunsaturated fatty acids (PUFA) in both sexes) and BMI was very weak, accounting for less than 1% of variance. All dietary and non-dietary variables accounted for 21% of variance in the measurement of BMI in women and only 6.7% of variance in men. Estimated underreporting of energy intake was 17.5% in obese women and 5.5% in obese men.

The association between consumption of specific types of dietary fat, olive oil and obesity in Spain is not very important. However, because of the cross-sectional design and some level of underreporting of energy intake observed in overweight subjects and overreporting in underweight subjects, systematic bias cannot be completely discarded.

To explore whether area-level socio-economic position or the form of retail stream (conventional v. farmers’ market) is associated with differences in the price, availability, variety and quality of a range of fresh fruit and vegetables.

A multi-site cross-sectional pilot study of farmers’ markets, supermarkets and independent fruit and vegetable retailers. Each was surveyed to assess the price, availability, variety and quality of fifteen fruit and eighteen vegetable items.

Retail outlets were located in south-east Queensland.

Fifteen retail outlets were surveyed (five of each retail stream).

Average basket prices were not significantly different across the socio-economic spectrum, but prices in low socio-economic areas were cheapest. Availability, variety and quality did not differ significantly across levels of socio-economic position; however, the areas with the most socio-economic disadvantage scored poorest for quality and variety. Supermarkets had significantly better fruit and vegetable availability than farmers’ markets, although price, variety and quality scores were not different across retail streams. Results demonstrate a trend to fruit and vegetable prices being more expensive at farmers’ markets, with the price of the fruit basket being significantly greater at the organic farmers’ market compared with the non-organic farmers’ markets.

Neither area-level socio-economic position nor the form of retail stream was significantly associated with differences in the availability, price, variety and quality of fruit and vegetables, except for availability which was higher in supermarkets than farmers’ markets. Further research is needed to determine what role farmers’ markets can play in affecting fruit and vegetable intake.