Purpose Socioeconomic status and exposure to the neighbourhood food environment is separately associated with fruit and vegetable intake in youth. We investigated whether the association between food outlet concentration and fruit and vegetable intake differed among children from various social backgrounds. Methods Data from the Health Behavior in School Aged Children Study (n = 6,034) were supplemented with geocoded information regarding supermarkets and fast food outlets, 300 meters from each school (n = 80). We used multilevel logistic regression to examine the relationship between infrequent fruit and vegetable intake and supermarket and fast food outlet concentration, stratifying by levels of family social class. Results Examining supermarket exposure alone, children from low social class backgrounds had the greatest odds of infrequent vegetable (OR = 1.50; CI: 1.03-2.20) and fruit (OR = 1.43;CI: 1.06-1.93) intake, attending schools with low concentration of supermarkets. Children from low social class families attending schools with high fast food outlet and low supermarket concentration had the greatest odds of infrequent vegetable (OR = 1.79;CI: 0.99-3.21) and fruit (OR = 1.59; CI: 1.00-2.51) intake compared to referent social classes. Conclusion While social class is an important correlate for infrequent fruit and vegetable intake in youth, it also modifies the effect of food outlet concentration. Children from low family social class backgrounds have the greatest odds of infrequent vegetable and fruit intake with low supermarket concentration. Combined low supermarket and high fast food outlet exposure presents a potential risk for infrequent intake of fruit and vegetables among adolescents.
Schools; Diet; youth; built environment; food outlets