The logic seems simple enough: the consumption of healthy foods is low, and obesity is high, in neighborhoods where supermarkets are notably absent; so, opening supermarkets in those neighborhoods should boost consumption of healthier foods and drive down obesity. Right?
Not so fast, says the first American study gauging the success of a popular initiative aimed at combatting obesity: improving access to fresh produce and healthy food in the nation's "food deserts."
Six months after the grand opening of a new supermarket in Philadelphia, the study found, residents of the surrounding low-income neighborhood were not eating more fresh fruits and vegetables, nor were they less likely to be obese than were low-income Philadelphians across town whose neighborhood continued to be a food desert.
But compared with those trapped in food deserts, the residents of the newly served neighborhood did perceive their access to fruits and vegetables to be greater, and the cost of that produce to have declined, the study said. And among the roughly half of residents who said they were shopping at the new store, the trends in fruit-and-vegetable consumption were positive.
And that, said authors, is a start.
The latest research, published in the journal Health Affairs, underscores what many on the front lines of the war on obesity have begun to surmise: that reversing obesity will be far more complicated than simply turning back the clock on developments that may demonstrably have led us to a place where roughly two-thirds of Americans are overweight or obese.
Just as building new playgrounds will not automatically make couch potatoes spring from their chairs and jog, replanting "food deserts" with farmers markets and supermarkets will not automatically prompt working parents to race home and make delicious, healthful meals for their children; it will not blunt the continuing allure of fast foods and sugar-sweetened drinks that are easy and cheap to buy on every corner; and it will not immediately inspire an increase in demand for foods that are low in fat, added sugar and salt, that need to be chopped and cooked, that are not necessarily cheap, and that are not heavily advertised on TV.
The new study echoes the findings of two earlier studies conducted in food deserts in Britain. One, in Leeds, found that the appearance of a new nearby supermarket boosted fruit and vegetable consumption, but only among those who ate the least to begin with. The other, in Glasgow, Scotland, found that overall consumption patterns of the store's would-be customers did not change.
"Simply building new food retail stores may not be sufficient," wrote the authors, who included Penn State sociologist Stephen A. Matthews. Supermarkets and community groups may have to work together to "help consumers bridge the gap between improvements in perception and action leading to behavior change," the coauthors wrote.
That means that community groups and supermarkets may need to teach shopping and cooking skills to consumers who might not know how to choose a ripe tomato and may never have learned to cook at home. The retailers that open those stores may need to develop pricing and credit policies that make sense in the neighborhoods they serve. And the store shelves themselves may need to help educate new customers about what a healthy diet looks like.
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