The residential food environment, financial constraints, and dietary behavior in Dutch adults with low socioeconomic position: a test of the EnRG framework.

Socioeconomic disparities in dietary behavior are often partially attributed to differences in the residential food environment, yet evidence linking food outlet availability to diet quality remains inconsistent. The Environmental Research framework for weight Gain prevention (EnRG) proposes that environmental influences operate through both a cognitive pathway, mediated by Theory of Planned Behavior (TPB) constructs, and a direct, automatic pathway. In this secondary analysis of cross-sectional data from 1,033 adults with oversampling of low socioeconomic position, we tested both pathways while additionally examining the role of food insecurity and financial scarcity. Outlet density and distance to nearest fast-food and fruit and vegetable outlet were measured at the postal code level. Dietary behavior, TPB constructs, food insecurity, and financial scarcity were assessed by self-report. Path analyses tested cognitive mediation; subgroup and moderation analyses examined whether food insecurity altered food environment effects. The residential food environment showed minimal associations with dietary consumption: only one of eight direct associations reached significance (fast-food distance and fast-food consumption), and was attenuated in path analyses. All paths from food environment characteristics to TPB constructs were non-significant, indicating no support for cognitive mediation. Food insecurity did not moderate food environment effects. In contrast, food insecurity and financial scarcity were consistently associated with lower fruit and vegetable consumption and poorer diet quality, but not with fast-food consumption. These findings do not support the hypothesis that the residential food environment plays a large role in shaping dietary behavior in low-SEP populations, while financial constraints were more consistently associated with dietary outcomes supporting evaluation of policies aimed at affordability alongside environmental interventions.