Research report Degree of food processing of household acquisition patterns in a Brazilian urban area is related to food buying preferences and perceived food environment ☆ G.M. Vedovato a , A.C.B. Trude b , A.Y. Kharmats b , P.A. Martins a, * a Federal University of Sao Paulo, Department of Human Movement Science Nutritional Epidemiology Laboratory, 95 Ana Costa Avenue, Santos, SP CEP 11060001, Brazil b Johns Hopkins Bloomberg School of Public Health, Global Center for Obesity Prevention, 615 N. Wolfe Street, Room W3507, Baltimore, MD 21205, USA ARTICLE INFO Article history: Received 19 May 2014 Received in revised form 21 December 2014 Accepted 30 December 2014 Available online 6 January 2015 Keywords: Food environment Food stores Food habits Food-processing Urban health A B ST R AC T Objective: This cross-sectional study examined the association between local food environment and con- sumers’ acquisition of ultra-processed food. Methods: Households were randomly selected from 36 census tracts in Santos City, Brazil. Mothers, of varying economic status, who had children ages 10 or younger (n = 538) were interviewed concerning: their household food acquisition of 31 groups of food and bev- erages, perceptions of local food environment, food sources destinations, means of transportation used, and socioeconomic status. Food acquisition patterns were classified based on the degree of industrial food processing. Logistic regression models were fitted to assess the association between consumer be- haviors and acquisition patterns. Results: The large variety of fresh produce available in supermarkets was significantly related to lower odds of ultra-processed food purchases. After adjusting for sociode- mographic characteristics, higher odds for minimally-processed food acquisition were associated with: frequent use of specialized markets to purchase fruits and vegetables (OR 1.89, 95% CI 1.01–2.34), the habit of walking to buy food (OR 1.58, 95% CI 1.08–2.30), and perceived availability of fresh produce in participants’ neighborhood (OR 1.58, 95% CI 1.08–2.30). Acquisition of ultra-processed food was posi- tively associated with the use of taxis as principal means of transportation to food sources (OR 2.35, 95% CI 1.08–5.13), and negatively associated with perceived availability of a variety of fruits and vegetables in the neighborhood (OR 0.57, 95% CI 0.37–0.88). Conclusion: The results suggest that interventions aiming to promote acquisition of less processed food in settings similar to Santos, may be most effective if they focus on increasing the number of specialized fresh food markets in local neighborhood areas, improve residents’ awareness of these markets’ availability, and provide appropriate transportation. © 2014 Elsevier Ltd. All rights reserved. Introduction Obesity and diet-related chronic diseases have emerged as global challenges of the 21th century, fueled by rapid and intense urbaniza- tion, and subsequent changes in food environments and food choices (Huang, Drewnowski, Kumanyika, & Glass, 2009; Larson & Story, 2009; Ludwig, 2011; Townshend & Lake, 2009). Globalization, free trade, economic growth and urbanization are macro-level factors that increased utilization of new food production technologies, and influ- enced the types of foods available in neighborhoods worldwide (Monteiro, Levy, Claro, de Castro, & Cannon, 2011; Monteiro, Moubarac, Cannon, Ng, & Popkin, 2013; Pérez-Cueto et al., 2010; Townshend & Lake, 2009). Although the availability of healthy foods is a significant influ- ence on food choice (Hawkes, 2009; Larson & Story, 2009; Murakami, Sasaki, Takahashi, & Uenishi, 2009; Walker, Block, & Kawachi, 2012), the consumer decisions are also motivated by other factors, includ- ing: perceived barriers to obtaining healthy food (such as distance to food sources), quality of food sold, prices, and store attributes such as store size, food safety, cleanliness, customer service, and brands sold (Blitstein, Snider, & Evans, 2012; Gittelsohn & Sharma, 2009; Krukowski, McSweeney, Sparks, & West, 2012; Larson & Story, 2009; Macdonald, Ellaway, Ball, & Macintyre, 2011; Morland & Evenson, 2009; Thornton, Pearce, Macdonald, Lamb, & Ellaway, 2012; Walker et al., 2012). These factors may interact with community ☆ Acknowledgements: The authors wish to thank all the families who partici- pated in the study and the interviewers for their cooperation in collecting the data. This research was supported by Sao Paulo State Foundation (FAPESP, no. 2009/ 01361-0). * Corresponding author. E-mail address: paula.andrea.martins@gmail.com (P.A. Martins). http://dx.doi.org/10.1016/j.appet.2014.12.229 0195-6663/© 2014 Elsevier Ltd. All rights reserved. Appetite 87 (2015) 296–302 Contents lists available at ScienceDirect Appetite journal homepage: www.elsevier.com/locate/appet