How are grocery shopping patterns related to individual diet quality, overall health and mental health? Evidence from four Canadian metropolises

Grocery shopping is a modifiable factor influencing diet and health, yet most studies only considered single or independent attributes of shopping trips, neglecting their interrelated nature. Recent research has identified grocery shopping patterns based on a series of transportation-related characteristics, but their links to diet and health outcomes remain underexplored. This study aims to examine the associations of grocery shopping patterns identified using multidimensional measures of shopping trips with self-rated diet quality, overall health, and mental health, and moreover, tests if the associations between shopping patterns and health are mediated by diet quality. Data are from the 2021 Time Use & Food Habits Survey of Canadian adults living with children under 18 years in four Canadian census metropolitan areas, including Edmonton, Halifax, Vancouver, and Toronto. Structural equation modeling was applied to estimate the associations between shopping patterns, diet quality, and health. Compared to respondents classified as large store shoppers, respondents identified as accompanied shoppers and as frequent shoppers were directly associated with better self-rated diet quality and overall health, but their direct associations with mental health were not significant. They were also indirectly related to better overall and mental health, mediated via better diet quality, while the effect size of accompanied shoppers on mental health is relatively small. Regarding the total associations between shopping patterns and health, frequent shoppers were associated with better overall and mental health, while accompanied shoppers were only related to better overall health. The results imply that grocery shopping patterns with combinations of certain attributes, including relatively high frequency, shopping less at large stores, non-driving travel, and organization in trip chaining, may be beneficial to diet quality and health among households with children. Therefore, interventions should focus on encouraging the combination of certain shopping attributes rather than independent attributes of shopping trips. • Diet and health outcomes of multidimensional grocery shopping attributes were examined. • Grocery shopping patterns were employed to integrate multiple attributes. • The patterns of accompanied and frequent shoppers were related to better diet and health. • They were indirectly associated with better overall and mental health via diet quality.