Abstract
BACKGROUND: Few studies have characterised community food environments and their influence on dietary behaviours in Latin America. In particular, community food environment data do not exist for Chilean contexts. This study aims to characterise the community food environment across neighbourhoods in three major Chilean cities and explore associations between these food environments and fruit and vegetable consumption among adult residents. METHODS: We used a geospatial query tool to identify, georeference, and classify food establishments (FE, n = 46,950) across 3 large Chilean cities (Santiago, Valparaíso, Concepción). Neighbourhood characteristics were derived from the 2017 Census (n = 2,442 neighbourhoods) while individual-level data came from the 2017 National Health Survey (Encuesta Nacional de Salud, n = 1,275 adults). Lower dietary quality was proxied by non-daily consumption of fruits or vegetables (ND-FV, prevalence 17.3%). We used random intercept logistic regression models adjusting for survey participants age, gender, educational attainment, neighbourhood population density and social environment. RESULTS: The median density of FE was 41.36 per km(2), increasing with neighbourhood population density and more favourable social environments. Ready-for-consumption FE and small food retail were the most prevalent types (68% and 11%, respectively). The adjusted odds of ND-FV consumption was approximately 20% higher with increases in the z-score of those FE types. No associations were found between other types of FE and ND-FV consumption. CONCLUSION: Food establishments were unequally distributed across urban Chilean neighbourhoods. Overall, unhealthy outlets are predominant. Higher densities of small and ready-to-consume FE were associated with lower fruit and vegetable consumption. These findings underscore the need for targeted public policies aimed at promoting healthier food environments, reducing social inequalities in food access within Chilean cities, and improving dietary quality.