Abstract
OBJECTIVE: To examine the associations between financial, physical and transport conditions that may restrict food access (which we define as food security indicators) and the purchase of fast foods and nutritious staples such as bread and milk. DESIGN: Multilevel logistic and multinomial regression analysis of cross-sectional survey data to assess associations between the three indicators of food insecurity and household food shopping adjusted for sociodemographic and socio-economic variables. SETTING: Random selection of households (n 3995) from fifty Census Collector Districts in Melbourne, Australia, in 2003. SUBJECTS: The main food shoppers in each household (n 2564). RESULTS: After adjustment for confounders, analysis showed that a greater likelihood of purchasing chain-brand fast food on a weekly basis compared with never was associated with running out of money to buy food (OR = 1·59; 95 % CI 1·08, 2·34) and reporting difficulties lifting groceries (OR = 1·77; 95 % CI 1·23, 2·54). Respondents without regular access to a car to do food shopping were less likely to purchase bread types considered more nutritious than white bread (OR = 0·75; 95 % CI 0·59, 0·95) and milk types considered more nutritious than full-cream milk (OR = 0·62; 95 % CI 0·47, 0·81). The food insecurity indicators were not associated with the purchasing of fruits, vegetables or non-chain fast food. CONCLUSIONS: Householders experiencing financial and physical barriers were more likely to frequently purchase chain fast foods while limited access to a car resulted in a lower likelihood that the nutritious options were purchased for two core food items (bread and milk). Policies and interventions that improve financial access to food and lessen the effect of physical limitations to carrying groceries may reduce the purchasing of fast foods. Further research is required on food sourcing and dietary quality among those with food access restrictions.