Supermarket environment and nutrition outcomes: Evidence from rural China.

Globally, the supermarket environment is playing an increasingly important role in dietary and public health transformation. This study highlights the nutrition effect of the supermarket environment and sheds light on the potential mechanisms through which this environment impacts nutrition outcomes. The data used in this study are longitudinal data from the China Health and Nutrition Survey (CHNS) for the period from 2004 to 2011 considering rural China. To account for individual heterogeneity and the endogeneity of the supermarket environment in panel estimation, a pseudo-fixed-effects estimator combined with a control function is applied within a multinomial logit model. Our panel estimations suggest that there are no significant effects of supermarket availability and accessibility on nutrition outcomes, while food variety (fruits and vegetables) indicates a significantly negative effect on being underweight, overweight, and obese. The results are largely consistent when the control function is used to address the endogeneity of the supermarket environment. To further clarify the mechanisms through which food variety influences nutrition outcomes, calorie intakes and the Chinese Healthy Eating Index (CHEI) are used to measure nutritional intakes and dietary quality, respectively. Our findings demonstrate that food variety in supermarkets shows a significantly negative effect on calorie intakes but a significantly positive effect on the CHEI. Policies targeted at efficiently improving nutrition-related health in rural China might, thus, focus on improving consumers' food choices, through more food variety in supermarkets. • We analyse the nutrition impact of the supermarket environment for rural residents in China. • We shed light on the potential mechanisms through which supermarket environment impacts nutrition outcomes. • We find that supermarket availability and accessibility have no significant effect on nutrition outcomes. • We reveal that food variety in supermarkets negatively affects the probability of being underweight, overweight, and obese. • We demonstrate that food variety in supermarkets tends to decrease calorie intakes but improves dietary quality. [ABSTRACT FROM AUTHOR]