FIGURE 5-1 Model of community nutrition environments.

FIGURE 5-1 Model of community nutrition environments.

SOURCE: Glanz et al., 2005. Reprinted with permission from the American Journal of Health Promotion.

combine to affect eating patterns on an individual and collective basis (see Figure 5-1).

Given this caveat, changing the food environment has many potential benefits. Among these benefits, such changes can limit or expand the range of choices available to consumers, increase access to healthy foods, complement individual behavioral change programs, reach large numbers of people, and provide long-term sustainability if efforts are institutionalized. It is a practical way, perhaps the only practical way, to address the obesity epidemic. In addition to altering access, the food environment can also be changed within stores, within neighborhoods, and in other settings through provision of information and promotions to consumers. In all cases, the link between supply and demand is key to determining whether changes in the environment will be linked with healthier eating. As Gittelsohn termed it, the “trifecta” is to increase availability, reduce price, and promote healthier choices.

Availability in Large and Small Stores

Seymour et al. (2004) reviewed 11 supermarket intervention studies, 8 of which provided information about healthy foods to consumers and 3 of which combined information with changes in access, availability, and incentives. Six of the studies (four with information only) showed increases in sales of healthier foods, while five did not show a change. Of

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