The importance of availability of, proximity to, and use of food retailers in relation to snack consumption – a cross-sectional mediation analysis in the Eet & Leef study

Food access can have a substantial impact on food consumption and health. International literature suggests that density metrics are best used to measure access to food retailer, with the exception of supermarkets for which distance metrics can also be used. However, whether to use distance or density-based metrics in the Netherlands, which is a densely populated country with short distances to food retailers, is unknown. Using a cross-sectional sample of Dutch adults aged 18–65 years living in cities (N = 1589), we examined correlations between distance to the nearest and distance to the actually visited food retailer. In addition, we examined whether the perceived availability and use of food retailers explains any association between distance from home to the nearest food retailer and snack food consumption. We examined fast food restaurants, regular supermarkets and discount supermarkets. We found that the correlations between the nearest and actual visited food retailer were moderate, ranging from r =.73 (discount supermarkets) to r =.43 (fast food restaurants). For none of the food retailers we found a direct association with snack food consumption, and neither was there evidence for mediation through perceived availability and use of food retailers. In Dutch cities, distance-based metrics may not be a good indicator of food retailer access.