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Abstract Objective: To explore store-specific grocery shopping patterns and assess associations with the objective and perceived retail food environment (RFE). Design: This cross-sectional study used principal component analysis and hierarchical cluster analysis to identify grocery shopping patterns and logistic regression models to assess their associations with the RFE, while adjusting for household characteristics. Setting: The Montpellier Metropolitan Area, France. Participants: To be eligible for inclusion, participants had to be 18 years of age or older and reside in the Montpellier Metropolitan Area. Analyses were carried out on 415 households. Results: Households of cluster ‘Supermarket’ (49 % of households) primarily shopped at supermarkets and were less likely to live near a convenience store. Households of cluster ‘Diversified’ (18 %) shopped mostly at organic stores, at markets, at specialised stores, and from producers and were more likely to have a market in their activity space. Households of cluster ‘Discount’ (12 %) primarily shopped at discounters and were less likely to perceive a producer in their activity space. Households of cluster ‘Convenience’ (12 %) mostly shopped online or in convenience stores. Finally, households of cluster ‘Specialized’ (9 %) had high expenditures in greengrocers and in other specialised food stores and were more likely to live near a specialised food store. Conclusions: This study highlighted the importance of considering both perceived and objective RFE indicators, as well as assessments around the home and in activity space. Understanding how people buy food and interact with their RFE is crucial for policymakers seeking to improve urban food policies.

PurposeThe purpose of this study was to assess whether the retail food environment, measured by multiple indicators around the home and in activity space, was associated with the nutritional quality of food purchases.MethodsThis cross-sectional study included 462 households from a quota sampling survey conducted in the south of France (Montpellier Metropolitan Area). The revised Healthy Purchase Index was implemented in order to assess the nutritional quality of food purchases. Food environment indicators (presence, number, relative density and proximity of food outlets) were calculated around the home and in activity space using a geographical information system. Six different types of food outlets were studied: supermarkets, markets, greengrocers, bakeries, other specialized food stores (butcher's, fishmonger's and dairy stores) and small grocery stores. Associations between food environment and the nutritional quality of food purchases were assessed using multilevel models, and geographically weighted regressions to account for spatial non-stationarity. Models were adjusted for households' socioeconomic and demographic characteristics.ResultsThe nutritional quality of food purchases was positively associated with the number of greengrocers around the home (1 vs. 0: β = 0.25, 95%CI = [0.01, 0.49]; >1 vs. 0: β = 0.25, 95%CI = [0.00, 0.50]), but negatively associated with the number of markets around the home (1 vs. 0: β = -0.20, 95%CI = [-0.40, 0.00]; >1 vs. 0: β = -0.37, 95%CI = [-0.69, -0.06]). These associations varied across space in the area studied. For lower income households, the number of greengrocers in activity space was positively associated with the nutritional quality of food purchases (1 vs. 0: β = 0.70, 95%CI = [0.12, 1.3]; >1 vs. 0: β = 0.67, 95%CI = [0.22, 1.1]).ConclusionsGreengrocers might be an effective type of food store for promoting healthier dietary behaviors. Further studies, particularly interventional studies, are needed to confirm these results in order to guide public health policies in actions designed to improve the food environment.