Fruit and Vegetable Availability, Quality, & Consumption in Detroit's Food Desert among African American Adolescents with Obesity

Introduction: Literature suggests that “food deserts” have been a contributing factor to obesity. The prevalence of obesity in a “food desert” is assumed to represent the absence of healthy foods, specifically fruits and vegetables (FV). However, no studies have evaluated whether obesity promoting behaviors, such as low FV consumption, have been influenced by availability in the food environment. The purpose of this study is to address this gap in understanding behavioral patterns within the built environment.

Methods: The availability, price, and quality of FV in Detroit grocery stores (n=76) were evaluated using the Nutrition Environment Measures Survey (NEMS-S). Surveys were repeated for 10% of store locations to account for test-retest reliability and each independent surveyor (n=8) was evaluated on inter-rater reliability for FV quality acceptability. The Block Food Frequency Questionnaire and questions related to store walkability were collected from 126 African American Adolescents with obesity (AAAO).

Results: Inter-rater and test-retest reliabilities were within acceptable ranges (0.81-0.95 and 0.62-0.95). Acceptability of all FV was 68-100%, with only 4 stores <80%. FV access was not correlated with AAAO FV consumption (r's<0.08). Mean daily fruit (including juice) and vegetable consumption was 1.15+/-1.25 and 1.22+/-1.49, respectively. Overall, 87% of AAAO were found to live within the 1 mile radius of a grocery store with at least 15 varieties of FV and 72% of families “strongly agreed” that it was easy to walk to the store. 

Discussion: Availability of FV for AAAO in Detroit presents a contradiction to the “food desert” label. Proximity cannot be used as either an indicator or a proxy for healthy habits. Changes to the built environment must be paired with significant community outreach or intervention. A host of social, economic, and cultural factors need to be examined to understand what drives consumption of fruits and vegetables.