Five-a-Day, Fruit and Vegetables Portions, and the Food Environment: The Italian Case

Italy has one of the largest per-capita consumption rates of fruits and vegetables (FV) among European Union countries. However, the number of adult Italians consuming the recommended daily amounts of FV is declining, especially in regions where the food retail industry's expansion is lagging. In this article we investigate the effect of the food environment on the likelihood of adult Italians consuming five or more daily portions of FV, and on the probability of consuming more portions of FV. We combine individual-level data on adult Italians' lifestyle with regional food retail structure measures. To correct for the endogeneity of the food environment, we use an identification strategy based on aggregate drivers of food stores' location, and on the regional political climate affecting retail liberalization reforms. The results show that increased access affects positively the probability of consuming the daily-recommended amounts of FV, as well as the probability of consuming more portions of FV. However, the role of the food environment is less marked for individuals declaring it to experience a hardship to access supermarkets.