Abstract
BACKGROUND: With the significant changes in dietary patterns, nutrition-related health issues such as overweight and obesity have become great challenges for public health in emerging economies. However, whether and how food availability could affect nutrition-related health is still unclear. METHODS: The data set comprises 14,505 observations for 8,299 individuals from the 2009-2015 China Health and Nutrition Survey (CHNS) of rural China. Panel regression models with Mundlak (MK) estimators are employed to evaluate the nutritional effect of food availability from five food outlets. RESULTS: Our findings indicate that the presence, quantity, and density of food outlets have a significant impact on body mass index (BMI) and the likelihood of being overweight. Notably, approximately 39.9% of the probability of being overweight can be attributed to food outlet density, with supermarkets exerting the most substantial influence. Additionally, the food outlet density of free markets and grocery stores has a significantly negative effect on the likelihood of being overweight. To further elucidate the mechanisms through which food availability influences nutritional outcomes, we assess diet quality and dietary knowledge. Our study reveals that food outlet density has a significant effect on the Diet Quality Distance of Dietary Balance Index (DBI-DQD), the Chinese Healthy Eating Index (CHEI), and dietary knowledge. CONCLUSION: This study reinforces the significant impact of food availability on nutrition-related health. Therefore, policies aimed at effectively improving nutrition-related health in rural China should focus on dynamically adjusting food outlet distribution, particularly supermarkets and grocery stores, enhancing diet quality and nutritional knowledge, and increasing overall food availability in these areas.