Open Access Open Badges Research article

Association between neighborhood deprivation and fruits and vegetables consumption and leisure-time physical activity: a cross-sectional multilevel analysis

Luís Alves123*, Susana Silva12, Milton Severo12, Diogo Costa12, Maria Fátima Pina124, Henrique Barros12 and Ana Azevedo12

Author Affiliations

1 Institute of Public Health, University of Porto, Rua das Taipas, 135-139, 4050-600 Porto, Portugal

2 Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal

3 St. André de Canidelo Family Health Unit, Rua das Fábricas, 282, 4400-230 Vila Nova de Gaia, Portugal

4 Institute of Biomedical Engineering, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal

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BMC Public Health 2013, 13:1103  doi:10.1186/1471-2458-13-1103

Published: 1 December 2013



Most studies of the association between neighborhood socioeconomic deprivation and individual lifestyles leading to cardiovascular disease focused on a single cardiovascular risk factor. The concomitant assessment of more than one risk factor may provide clues to specific mechanisms linking neighborhood disadvantage to individual lifestyles. We investigated the association of neighborhood deprivation with fruits and vegetables consumption and leisure-time physical activity in adults living in an urban center in Portugal.


In 1999–2003, we assembled a random sample of 2081 adult residents in the city of Porto. Data on sociodemographic characteristics were collected by trained interviewers using structured questionnaires. Fruits and vegetables consumption was estimated using a validated 82-item semiquantitative food frequency questionnaire covering the previous year and expressed in portions per day. Physical activity was evaluated using a questionnaire exploring leisure-time activities over the previous year and expressed in metabolic equivalents (MET).minute/day. Self-reported address was used to place individuals in neighborhoods. Neighborhoods’ socioeconomic characterization was based on aggregated data at the census block level provided by the 2001 National Census. Latent class analysis models were used to identify three discrete socioeconomic classes of neighborhoods. Random effects models with random intercepts at the neighborhood level were used to explore clustering and contextual effects of neighborhood deprivation on each of the outcomes.


We found evidence of neighborhood clustering of fruits and vegetables consumption and leisure-time physical activity that persisted after adjustment for neighborhood deprivation only among women. Women living in the most deprived neighborhoods presented a consumption increase of 0.43 (95% CI: -0.033 to 0.89) portions of fruits and vegetables per day and a decrease in leisure-time physical activity of 47.8 (95% CI: -91.8 to 1.41) MET.minute/day, when compared to those living in the most affluent neighborhoods. Among men, no contextual neighborhood deprivation effects were observed.


Overall, neighborhood deprivation had a small effect on the consumption of fruits and vegetables and leisure-time physical activity. Neighborhood factors other than socioeconomic deprivation may still impact on the studied outcomes among women. This study provides relevant information for the design of interventions directed to neighborhood characteristics in the prevention of cardiovascular diseases.

Neighborhood deprivation; Socioeconomic position; Fruits and vegetables consumption; Leisure-time physical activity