Nutrition quality of food purchases varies by household income: The SHoPPER study

Simone A. French, Christy C. Tangney, Melissa M. Crane, Yamin Wang, Bradley M. Appelhans

Research output: Contribution to journalArticlepeer-review

93 Scopus citations


BACKGROUND: Lower household income has been consistently associated with poorer diet quality. Household food purchases may be an important intervention target to improve diet quality among low income populations. Associations between household income and the diet quality of household food purchases were examined.

METHODS: Food purchase receipt data were collected for 14 days from 202 urban households participating in a study about food shopping. Purchase data were analyzed using NDS-R software and scored using the Healthy Eating Index 2010 (HEI 2010). HEI total and subscores, and proportion of grocery dollars spent on food categories (e.g. fruits, vegetables, sugar sweetened beverages) were examined by household income-to-poverty ratio.

RESULTS: Compared to lower income households, after adjusting for education, marital status and race, higher income households had significantly higher HEI total scores (mean [sd] = 68.2 [13.3] versus 51.6 [13.9], respectively, adjusted p = 0.05), higher total vegetable scores (mean [sd] = 3.6 [1.4] versus 2.3 [1.6], respectively, adjusted p < .01), higher dairy scores (mean [sd] = 5.6 [3.0] versus 5.0 [3.3], p = .05) and lower proportion of grocery dollars spent on frozen desserts (1% [.02] versus 3% [.07], respectively, p = .02).

CONCLUSIONS: Lower income households purchase less healthful foods compared with higher income households. Food purchasing patterns may mediate income differences in dietary intake quality.

TRIAL REGISTRATION: identifier: NCT02073643.

Original languageEnglish (US)
Article number231
JournalBMC public health
Issue number1
StatePublished - Feb 26 2019

Bibliographical note

Funding Information:
Funding was provided by the National Institutes of Health NHLBI/NIH award number R01HL117804. The funder did not participate in the study design, data collection, analysis or interpretation, or writing of the publication.

Publisher Copyright:
© 2019 The Author(s).


  • Dietary intake
  • Food purchases
  • Household income
  • Nutritional quality
  • Food Supply
  • Poverty
  • Vegetables
  • Fruit
  • Nutritive Value
  • Humans
  • Middle Aged
  • Income
  • Male
  • Diet, Healthy
  • Young Adult
  • Family Characteristics
  • Consumer Behavior
  • Diet
  • Adolescent
  • Adult
  • Female
  • Aged
  • Beverages

PubMed: MeSH publication types

  • Journal Article


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