Skip to main content Accessibility help

Associations between frequency of food shopping at different food sources and fruit and vegetable intake among rural residents in upstate New York, USA

  • Brian K Lo (a1), Sarah Megiel (a1), Evelyn Liu (a1), Sara C Folta (a2), Meredith L Graham (a1) and Rebecca A Seguin (a1)...



To examine the frequency of shopping at different food sources and the associations between shopping at different food sources and fruit and vegetable (FV) intake among upstate New York rural residents.


Cross-sectional study. Descriptive statistics and linear mixed models were used.


Eighty-two rural communities in upstate New York, USA.


Adults (n 465; 82·3 % female, mean age 51·5 years, mean BMI 31·7 kg/m2).


Within one’s community, the majority of participants reported often going to supermarkets (73·1 %). Many participants sometimes or occasionally shopped at superstores (48·0 %), convenience stores (57·9 %), small grocery stores or local markets (57·2 %), farmers’ markets or FV stores (66·6 %), dollar stores (51·5 %), pharmacies (46·0 %), or farm stands or community-supported agriculture (56·8 %). Most participants had never utilized food banks or food pantries (94·0 %), community gardens (92·7 %) or home food delivery (91·9 %). While frequent visits to farmers’ markets or farm stands were associated with higher fruit intake (P < 0·001), frequent visits to food co-ops or food hubs were associated with lower fruit intake (P = 0·004). Frequent visits to convenience stores (P = 0·002) and dollar stores (P = 0·004) were associated with lower vegetable intake. When FV intakes were combined, frequent visits to farmers’ markets or farm stands (P < 0·001) were associated with higher FV intake, and frequent visits to convenience stores (P = 0·005) were associated with lower FV intake.


Findings from the present study provide important insight for informing future food environment interventions related to helping rural residents consume adequate FV.


Corresponding author

*Corresponding author: Email


Hide All
1.Dean, WR & Sharkey, JR (2011) Rural and urban differences in the associations between characteristics of the community food environment and fruit and vegetable intake. J Nutr Educ Behav 43, 426433.
2.Lutfiyya, MN, Chang, LF & Lipsky, MS (2012) A cross-sectional study of US rural adults’ consumption of fruits and vegetables: do they consume at least five servings daily? BMC Public Health 12, 280.
3.Jackson, JE, Doescher, MP, Jerant, AF et al. (2005) A national study of obesity prevalence and trends by type of rural county. J Rural Health 21, 140148.
4.Befort, CA, Klemp, JR, Austin, HL et al. (2012) Outcomes of a weight loss intervention among rural breast cancer survivors. Breast Cancer Res Treat 132, 631639.
5.Matthews, KA, Croft, JB, Liu, Y et al. (2017) Health-related behaviors by urban–rural county classification – United States, 2013. MMWR Surveill Summ 66, 18.
6.Sharkey, JR, Johnson, CM & Dean, WR (2010) Food access and perceptions of the community and household food environment as correlates of fruit and vegetable intake among rural seniors. BMC Geriatr 10, 32.
7.Campbell, EA, Shapiro, MJ, Welsh, C et al. (2017) Healthy food availability among food sources in rural Maryland counties. J Hunger Environ Nutr 12, 328341.
8.Bailey, JM (2010) Rural grocery stores: importance and challenges. (accessed August 2018).
9.Dean, WR, Sharkey, JR & Johnson, CM (2011) Food insecurity is associated with social capital, perceived personal disparity, and partnership status among older and senior adults in a largely rural area of central Texas. J Nutr Gerontol Geriatr 30, 169186.
10.Pinard, CA, Fricke, HE, Smith, TM et al. (2016) The future of the small rural grocery store: a qualitative exploration. Am J Health Behav 40, 749760.
11.Morton, L & Blanchard, T (2007) Starved for access: life in rural America’s food deserts. Rural Realities 1, issue 4, 110.
12.Blanchard, T & Lyson, T (2010) Retail concentration, food deserts, and food disadvantaged communities. Food Cult Soc 13, 460.
13.Sharkey, JR, Dean, WR & Johnson, CM (2012) Use of vendedores (mobile food vendors), pulgas (flea markets), and vecinos o amigos (neighbors or friends) as alternative sources of food for purchase among Mexican-origin households in Texas border colonias. J Acad Nutr Diet 112, 705710.
14.Valdez, Z, Dean, WR & Sharkey, JR (2012) Mobile and home-based vendors’ contributions to the retail food environment in rural South Texas Mexican-origin settlements. Appetite 59, 212227.
15.Van Hoesen, J, Bunkley, B & Currier, C (2013) A GIS-based methodology toward refining the concept of rural food deserts: a case study from Rutland County, Vermont. J Agric Food Syst Community Dev 3, issue 2, 6176.
16.Wegener, J & Hanning, RM (2010) Concepts and measures of ‘alternative’ retail food outlets: considerations for facilitating access to healthy, local food. J Hunger Environ Nutr 5, 158173.
17.Yousefian, A, Leighton, A, Fox, K et al. (2011) Understanding the rural food environment – perspectives of low-income parents. Rural Remote Health 11, 1631.
18.Seguin, RA, Eldridge, G, Graham, ML et al. (2016) Strong Hearts, Healthy Communities: a rural community-based cardiovascular disease prevention program. BMC Public Health 16, 86.
19.Ratcliffe, M, Burd, C, Holder, K et al. (2016) Defining Rural at the US Census Bureau (ACSGEO-1). Washington, DC: US Census Bureau.
20.Minaker, LM, Olstad, DL, Thompson, ME et al. (2016) Associations between frequency of food shopping at different store types and diet and weight outcomes: findings from the NEWPATH study. Public Health Nutr 19, 22682277.
21.American Heart Association (2017) My Life Check – Life’s Simple 7. (accessed July 2018).
22.Pitts, SBJ, Gustafson, A, Wu, Q et al. (2014) Farmers’ market use is associated with fruit and vegetable consumption in diverse southern rural communities. Nutr J 13, 1.
23.Jilcott Pitts, SB, Wu, Q, McGuirt, JT et al. (2013) Associations between access to farmers’ markets and supermarkets, shopping patterns, fruit and vegetable consumption and health indicators among women of reproductive age in eastern North Carolina, USA. Public Health Nutr 16, 19441952.
24.Freedman, DA, Choi, SK, Hurley, T et al. (2013) A farmers’ market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics. Prev Med 56, 288292.
25.Feagan, R (2008) Direct marketing: towards sustainable local food systems? Local Environ 13, 161167.
26.Brown, A (2002) Farmers’ market research 1940–2000: an inventory and review. Am J Altern Agric 17, 167176.
27.DeWitt, E, McGladrey, M, Liu, E et al. (2017) Social marketing campaign at farmers’ markets to encourage fruit and vegetable purchases in rural obese counties. J Nutr Educ Behav 49, S109.
28.Stewart, H (2018) Shopping at farmers’ markets and roadside stands increases fruit and vegetable demand. (accessed July 2018).
29.Ruff, RR, Akhund, A & Adjoian, T (2016) Small convenience stores and the local food environment: an analysis of resident shopping behavior using multilevel modeling. Am J Health Promot 30, 172180.
30.Zenk, SN, Schulz, AJ, Hollis-Neely, T et al. (2005) Fruit and vegetable intake in African Americans: income and store characteristics. Am J Prev Med 29, 19.
31.Alaimo, K, Packnett, E, Miles, RA et al. (2008) Fruit and vegetable intake among urban community gardeners. J Nutr Educ Behav 40, 94101.
32.Shim, JS, Oh, K, & Kim, HC (2014) Dietary assessment methods in epidemiologic studies. Epidemiol Health 36, e2014009.
33.Subar, AF, Laurence, SF, Janet, A et al. (2015) Addressing current criticism regarding the value of self-report dietary data. J Nutr 145, 26392645.
34.Ledoux, TF & Vojnovic, I (2013) Going outside the neighborhood: the shopping patterns and adaptations of disadvantaged consumers living in the lower eastside neighborhoods of Detroit, Michigan. Health Place 19, 114.
35.Stern, D, Robinson, WR, Ng, SW et al. (2015) US household food shopping patterns: dynamic shifts since 2000 and socioeconomic predictors. Health Aff (Millwood) 34, 18401848.


Type Description Title
Supplementary materials

Lo et al. supplementary material
Lo et al. supplementary material 1

 Word (16 KB)
16 KB

Associations between frequency of food shopping at different food sources and fruit and vegetable intake among rural residents in upstate New York, USA

  • Brian K Lo (a1), Sarah Megiel (a1), Evelyn Liu (a1), Sara C Folta (a2), Meredith L Graham (a1) and Rebecca A Seguin (a1)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed