The ubiquity of energy-dense snack foods: a national multicity study.

OBJECTIVES We assessed the availability and accessibility of energy-dense snacks in retail stores whose primary merchandise was not food and whether these varied by store type, region, or socioeconomic factors. METHODS We conducted systematic observations of 1082 retail stores in 19 US cities and determined the availability and accessibility of 6 categories of energy-dense snack foods. RESULTS Snack food was available in 41% of the stores; the most common forms were candy (33%), sweetened beverages (20%), and salty snacks (17%). These foods were often within arm's reach of the cash register queue. We observed snack foods in 96% of pharmacies, 94% of gasoline stations, 22% of furniture stores, 16% of apparel stores, and 29% to 65% of other types of stores. Availability varied somewhat by region but not by the racial or socioeconomic characteristics of nearby census tracts. CONCLUSIONS Energy-dense snack foods and beverages, implicated as contributors to the obesity epidemic, are widely available in retail stores whose primary business is not food. The ubiquity of these products may contribute to excess energy consumption in the United States.