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

Objective: We examined associations between access to food venues (farmers' markets and supermarkets), shopping patterns, fruit and vegetable consumption and health indicators among women of reproductive age in eastern North Carolina, USA. Design: Access to food venues was measured using a Geographic Information System incorporating distance, seasonality and business hours, to quantify access to farmers' markets. Produce consumption was assessed by self-report of eating five or more fruits and vegetables daily. BMI and blood pressure were assessed by clinical measurements. Poisson regression with robust variance was used for dichotomous outcomes and multiple linear regression was used for continuous outcomes. As the study occurred in a university town and university students are likely to have different shopping patterns from non-students, we stratified analyses by student status. Setting: Eastern North Carolina. Subjects: Low-income women of reproductive age (18-44 years) with valid address information accessing family planning services at a local health department (n 400). Results: Over a quarter reported ever shopping at farmers' markets (114/400). A larger percentage of women who shopped at farmers' markets consumed five or more fruits and vegetables daily (42.1%) than those who did not (24.0%; P<0.001). The mean objectively measured distance to the farmers' markets where women reported shopping was 11.4 (SD 9.0) km (7.1 (SD 5.6) miles), while the mean distance to the farmers' market closest to the residence was 4.0 (SD 3.7) km (2.5 (SD 2.3) miles). Conclusions: Among non-students, those who shopped at farmers' markets were more likely to consume five or more servings of fruits and vegetables daily. Future research should further explore potential health benefits of farmers' markets.