Digital food environments, food literacy, and sustainable eating among children in China: evidence from National Panel Data on supermarket availability and nutritional status

Abstract

Children’s dietary behavior in China is increasingly shaped by digital food environments, yet how digital exposure interacts with physical food access and food literacy in relation to child nutrition remains unclear at a national scale. This study utilized a longitudinal province-year panel covering 31 mainland Chinese provinces from 2006 to 2025 (N = 620). Core variables—specifically the health-promoting and risk-enhancing digital food environments, food literacy, supermarket availability, and sustainable eating—were operationalized as macro-level indices using the entropy weighting method based on regional statistical and household consumption data. To evaluate these constructs against child nutritional outcomes, we estimated two-way fixed-effects models, mediation and moderation pathways, and geographically weighted regressions. Health-promoting digital food environments were positively associated with sustainable eating (β = 0.115), with food literacy mediating 21.8% of the total association. Supermarket availability strengthened this beneficial association (β = 0.073), while food literacy buffered the risk-enhancing digital pathway toward unhealthy eating tendencies (β = −0.087). In lagged models, sustainable eating was associated with lower child nutritional risk (β = −0.124). Regional heterogeneity indicated that digital pathways were stronger in more developed provinces, whereas physical food retail availability mattered more in western regions. These findings support integrated, region-sensitive strategies that combine digital health access, food literacy promotion, and physical retail development.