Limited research has focused on the availability of more healthful food alternatives in traditional food stores (supermarkets and grocery stores) in rural areas. Current market trends suggest that food items may be available for purchase in stores other than traditional food stores. An observational survey was developed and used on-site to document the availability and variety of fruit and vegetables (fresh, canned, and frozen), meats (meat, poultry, fish, and eggs), dairy (milk, yogurt, and cheese), and grains (whole grains and refined grains) in all traditional food stores, convenience stores, and nontraditional food stores (dollar stores and mass merchandisers) in two rural Texas counties. Descriptive statistics and t tests identified that although the widest selection of more healthful food items was available in supermarkets, not all supermarkets carried all items. Grocery stores carried less variety of fresh fruits (8+/-0.7 vs 4.7+/-0.3; P<0.01) and vegetables (10.7+/-0.2 vs 6+/-0; P<0.001) than supermarkets. Fresh fruits and vegetables were not readily available in convenience or nontraditional food stores. Among convenience and nontraditional food stores, "dollar" stores offered the best variety of more healthful canned fruits and vegetables, whole-wheat bread, and whole-grain cereal. Mass merchandisers and dollar stores offered a greater variety of more healthful types of canned tuna and poultry, reduced-fat and skim milk, and low-fat tortillas. In these rural counties, traditional food stores offered greater availability of more healthful food choices across food groups. More healthful food choices in canned fruits and vegetables, canned meat and fish, milk, and grains were also available in dollar stores, mass merchandisers, and convenience stores. Results suggest that a complete understanding of the food environment, especially in rural areas, requires knowledge of the availability and variety of healthful food in all types of stores that are accessible to families.
