Characteristics of the retail food environment and acceptability of policies promoting healthier restaurant food environments: to what extent are these concepts associated?

Objective: This study explores associations between clusters characterising urban Canadians' retail food environments and their acceptability levels of three policies aimed at promoting healthier restaurant food environments (RFE).

Design: The three examined policies related to (1) proposing healthier menu default options, (2) restricting the establishment of fast-food restaurants near schools and (3) eliminating unhealthy foods from municipal buildings' food outlets. Retail food environment clusters were available for 1- and 3-km buffer zones from the centroid of participants' residential dissemination area. Retail food environment data were extracted from Can-FED, whereas acceptability data were provided by the THEPA dataset.

Setting: Retail food environments present across Canada's seventeen most populated census metropolitan areas.

Participants: Urban-dwelling Canadians (n 27 162).

Results: Results from multivariate multilevel logistic regression analyses showed that those who were surrounded by the greatest relative density of both healthy food outlets (HFO) and fast-food outlets (FFO) within a 3-km buffer zone were less likely to be in complete agreement with the fast-food zoning policy than the reference category. Findings also indicated that, within a 1-km buffer zone, those whose retail food environment was categorised as being the least healthy (no HFO and highest relative density of FFO) were less likely to be in complete agreement with the unhealthy food elimination policy than the reference category.

Conclusions: This study provides new evidence of associations between retail food environments and RFE policy acceptability, which may help orient the implementation of these policies.