Food environments can influence dietary behaviours. Promotion of foods high in fats, salt and sugars is a barrier to healthy eating. We explore advertising by deprivation in an English city.

Using a cross-sectional design, we describe the prevalence of outdoor advertising, the types of products advertised and the UK Nutrient Profile Modelling scores for advertised foods and non-alcoholic beverages. Differences in outdoor advertising prevalence by area deprivation were assessed using χ2 tests.

Six areas in each of five deprivation strata were randomly selected from all 482 Leeds neighbourhoods (England) (n 30 neighbourhoods).

Eligible outdoor advertisement assets (intentionally placed permanent/semi-permanent advertisements visible from the street) were photographed in May–June 2023.

A total of 295 outdoor advertising assets were recorded. The most deprived quintile had the highest number of advertising assets (n 74). Bus shelters were the most prevalent asset (n 68). The number of food adverts differed significantly by deprivation level. The two most deprived areas had higher than expected exposure, while the two least deprived areas had lower than expected exposure (P < 0·01). Data were insufficient to compare compliance against a hypothetical Healthier Food Advertising Policy; however, bus shelters were most likely to display high in fats, salt and sugars food adverts.

Food advertising in Leeds is unequally distributed, with more food adverts in more deprived areas. Similar inequalities may exist in other cities, but data are scarce. Unhealthy adverts are most prevalent on bus shelters, highlighting an important asset for policy focus.

Current indices of diet quality generally include intakes of specific foods or nutrients. We sought to develop an index that discriminates healthy and unhealthy eating choices for use in large surveys as a short questionnaire and as a measure in existing studies with adequate dietary data.

The Eating Choices Index (ECI) score included four components: (i) consumption of breakfast, (ii) consumption of two portions of fruit per day, (iii) type of milk consumed and (iv) type of bread consumed, each providing a score from 1 to 5. In analysis of 5 d food records, the ECI score was examined in relation to macronutrients, fibre, vitamin C, Fe, Ca and folate using Pearson correlations. Variation with sex, BMI, socio-economic status, marital status, smoking status and physical activity were also investigated.

Medical Research Council National Survey of Health and Development.

Individuals (n 2256) aged 43 years.

The ECI score (mean 12·3 (sd 3·5)) was significantly positively associated with protein, carbohydrate, fibre, vitamin C, Fe, Ca and folate (r = 0·2–0·5; P < 0·001) and significantly negatively associated with fat intake (r = –0·2; P < 0·001); ECI scores were not correlated with total energy intake. Individuals with a lower ECI score were more likely to be men (P < 0·001), overweight or obese (P < 0·001), have lower socio-economic status (P < 0·001), smoke more (P < 0·001) and be less physically active (P < 0·001).

ECI scores correlated with nutrient profiles consistent with a healthy diet. It provides a simple method to rank diet healthiness in large observational studies.