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Cade JE, Warthon-Medina M, Albar S, Alwan NA, Ness A, Roe M, Wark PA, Greathead K, Burley VJ, Finglas P, Johnson L, Page P, Roberts K, Steer T, Hooson J, Greenwood DC, Robinson S. DIET@NET: Best Practice Guidelines for dietary assessment in health research. BMC Med 2017; 15:202. [PMID: 29137630 PMCID: PMC5686956 DOI: 10.1186/s12916-017-0962-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 10/19/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Dietary assessment is complex, and strategies to select the most appropriate dietary assessment tool (DAT) in epidemiological research are needed. The DIETary Assessment Tool NETwork (DIET@NET) aimed to establish expert consensus on Best Practice Guidelines (BPGs) for dietary assessment using self-report. METHODS The BPGs were developed using the Delphi technique. Two Delphi rounds were conducted. A total of 131 experts were invited, and of these 65 accepted, with 48 completing Delphi round I and 51 completing Delphi round II. In all, a total of 57 experts from North America, Europe, Asia and Australia commented on the 47 suggested guidelines. RESULTS Forty-three guidelines were generated, grouped into the following four stages: Stage I. Define what is to be measured in terms of dietary intake (what? who? and when?); Stage II. Investigate different types of DATs; Stage III. Evaluate existing tools to select the most appropriate DAT by evaluating published validation studies; Stage IV. Think through the implementation of the chosen DAT and consider sources of potential biases. CONCLUSIONS The Delphi technique consolidated expert views on best practice in assessing dietary intake. The BPGs provide a valuable guide for health researchers to choose the most appropriate dietary assessment method for their studies. These guidelines will be accessible through the Nutritools website, www.nutritools.org .
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Affiliation(s)
- Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK.
| | - Marisol Warthon-Medina
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Salwa Albar
- Department of Food Science and Nutrition, King Abdulaziz University, PO Box 42807, 21551, Jeddah, Saudi Arabia
| | - Nisreen A Alwan
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Andrew Ness
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, BS8 1TH, UK
| | - Mark Roe
- Quadram Institute Bioscience, Norwich, NR4 7UA, UK
| | - Petra A Wark
- Centre for Innovative Research Across the Life Course (CIRAL), Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, UK.,Global eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Katharine Greathead
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Victoria J Burley
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Paul Finglas
- Quadram Institute Bioscience, Norwich, NR4 7UA, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, BS8 1TH, UK
| | - Polly Page
- MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK
| | - Katharine Roberts
- Public Health Section, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, S10 2TN, UK.,Public Health England, London, SE1 8UG, UK
| | - Toni Steer
- MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK
| | - Jozef Hooson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Darren C Greenwood
- Faculty of Medicine and Health, Division of Biostatistics, University of Leeds, Leeds, LS2 9JT, UK
| | - Sian Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
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Examination of the Relationship between In-Store Environmental Factors and Fruit and Vegetable Purchasing among Hispanics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111305. [PMID: 29077075 PMCID: PMC5707944 DOI: 10.3390/ijerph14111305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/03/2017] [Accepted: 10/21/2017] [Indexed: 12/17/2022]
Abstract
Retail food environments have received attention for their influence on dietary behaviors and for their nutrition intervention potential. To improve diet-related behaviors, such as fruit and vegetable (FV) purchasing, it is important to examine its relationship with in-store environmental characteristics. This study used baseline data from the “El Valor de Nuestra Salud” study to examine how in-store environmental characteristics, such as product availability, placement and promotion, were associated with FV purchasing among Hispanic customers in San Diego County. Mixed linear regression models indicated that greater availability of fresh FVs was associated with a $0.36 increase in FV purchasing (p = 0.01). Placement variables, specifically each additional square foot of display space dedicated to FVs (p = 0.01) and each additional fresh FV display (p = 0.01), were associated with a $0.02 increase and $0.29 decrease, respectively, in FV purchasing. Introducing FV promotions in the final model was not related to FV purchasing. Exploratory analyses indicated that men reported spending $3.69 fewer dollars on FVs compared to women, controlling for covariates (p = 0.02). These results can help inform interventions targeting in-store environmental characteristics to encourage FV purchasing among Hispanics.
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53
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Is there a link between availability of food and beverage establishments and BMI in Mexican adults? Public Health Nutr 2017; 20:3326-3332. [DOI: 10.1017/s1368980017002373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveTo study the association between density of stores (food and beverage stores, stores selling only fruits and vegetables, and supermarkets) and the BMI of adults aged ≥20 years in Mexico.DesignA cross-sectional study was performed. Individual data came from the 2012 National Health and Nutrition Survey, while information on stores was taken from the National Institute of Geography and Statistics’ National Statistics Directory of Economic Units. A weighted least-squares model was estimated to test the association between density of stores and BMI of adults adjusting for sex, age, education, presence of hypertension, diabetes or both, household assets index and marginality index at the municipality level.SettingMexico.ResultsAn additional 1 sd in the density of fruit and vegetable stores was associated with a reduction of 0·24 (95 % CI −0·37, −0·12) kg/m2 in BMI when the densities of the other stores were at their mean values. For food and beverage store density, a difference of 1 sd was associated with an increase of 0·50 (95 % CI 0·33, 0·67) kg/m2 in BMI, while for supermarkets the corresponding association was a reduction of 0·48 (95 % CI −1·52, 0·56) kg/m2 in BMI.ConclusionsIn places with a higher density of stores that offer unhealthy foods, the BMI of adults tends to be higher.
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Who is behind the stocking of energy-dense foods and beverages in small stores? The importance of food and beverage distributors. Public Health Nutr 2017; 20:3333-3342. [PMID: 28969723 DOI: 10.1017/s1368980016003621] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study examined food and beverage distributors' sourcing, placement and promotion of obesogenic (energy-dense, nutrient-poor) product categories from the perspective of small food store owners/managers. The obesogenic product categories of interest were savoury snacks, sugary beverages, sweet snacks, confectionery and frozen treats. Specifically, we examined how frequently distributors sourced these products, and the types of agreements and expectations they had for their placement and promotion. Differences were explored by store size and ethnicity. Fresh produce was used as a comparison when examining differences in frequency of sourcing only, with implications for healthy food access. DESIGN Survey research involving in-person interviews. SETTING Four urban areas in the USA: Baltimore, MD; Durham, NC; Minneapolis/St. Paul, MN; and San Diego, CA. SUBJECTS Seventy-two small food store owners/managers, 65 % consent rate. RESULTS Most distributors sourced obesogenic products weekly. Agreements to place products were predominantly informal (e.g. handshake) with sweet snack, confectionery and frozen treat distributors, and formal (e.g. contract) with savoury snack and sugary beverage distributors. Free-standing displays were the most common incentive provided by distributors and they expected some control over their placement and pricing. Free/discounted products and signage were also common incentives but slotting fees were not. Smaller stores and ethnic stores were less likely to receive various incentives, but among sweet snack distributors, they were more likely to control the price in ethnic v. non-ethnic stores. CONCLUSIONS Obesogenic products are ubiquitous. Influencing what is made available to consumers in the retail food environment needs to consider the distributor.
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Rummo PE, Guilkey DK, Ng SW, Meyer KA, Popkin BM, Reis JP, Shikany JM, Gordon-Larsen P. Does unmeasured confounding influence associations between the retail food environment and body mass index over time? The Coronary Artery Risk Development in Young Adults (CARDIA) study. Int J Epidemiol 2017; 46:1456-1464. [PMID: 28586464 PMCID: PMC5837451 DOI: 10.1093/ije/dyx070] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/06/2017] [Accepted: 04/12/2017] [Indexed: 11/14/2022] Open
Abstract
Background Findings in the observational retail food environment and obesity literature are inconsistent, potentially due to a lack of adjustment for residual confounding. Methods Using data from the CARDIA study (n = 12 174 person-observations; 6 examinations; 1985-2011) across four US cities (Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA), we used instrumental-variables (IV) regression to obtain causal estimates of the longitudinal associations between the percentage of neighbourhood food stores or restaurants (per total food outlets within 1 km network distance of respondent residence) with body mass index (BMI), adjusting for individual-level socio-demographics, health behaviours, city, year, total food outlets and market-level prices. To determine the presence and extent of bias, we compared the magnitude and direction of results with ordinary least squares (OLS) and random effects (RE) regression, which do not control for residual confounding, and with fixed effects (FE) regression, which does not control for time-varying residual confounding. Results Relative to neighbourhood supermarkets (which tend to be larger and have healthier options than grocery stores), a higher percentage of grocery stores [mean = 53.4%; standard deviation (SD) = 31.8%] was positively associated with BMI [β = 0.05; 95% confidence interval (CI) = 0.01, 0.10] using IV regression. However, associations were negligible or null using OLS (β = -0.001; 95% CI = -0.01, 0.01), RE (β = -0.003; 95% CI = -0.01, 0.0001) and FE (β = -0.003; 95% CI = -0.01, 0.0002) regression. Neighbourhood convenience stores and fast-food restaurants were not associated with BMI in any model. Conclusions Longitudinal associations between neighbourhood food outlets and BMI were greater in magnitude using a causal model, suggesting that weak findings in the literature may be due to residual confounding.
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Affiliation(s)
- Pasquale E Rummo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
- Carolina Population Center, Chapel Hill, North Carolina
| | - David K Guilkey
- Carolina Population Center, Chapel Hill, North Carolina
- Department of Economics, University of North Carolina at Chapel Hill, NC, USA
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
- Carolina Population Center, Chapel Hill, North Carolina
| | - Katie A Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
- Carolina Population Center, Chapel Hill, North Carolina
| | - Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
- Carolina Population Center, Chapel Hill, North Carolina
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, AL, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
- Carolina Population Center, Chapel Hill, North Carolina
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Is Living near Healthier Food Stores Associated with Better Food Intake in Regional Australia? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080884. [PMID: 28783099 PMCID: PMC5580588 DOI: 10.3390/ijerph14080884] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 08/04/2017] [Accepted: 08/05/2017] [Indexed: 11/16/2022]
Abstract
High prevalence of obesity and non-communicable diseases is a global public health problem, in which the quality of food environments is thought to play an important role. Current scientific evidence is not consistent regarding the impact of food environments on diet. The relationship between local food environments and diet quality was assessed across 10 Australian suburbs, using Australian-based indices devised to measure the two parameters. Data of dietary habits from the participants was gathered using a short questionnaire. The suburbs' Food Environment Score (higher being healthier) was associated with higher consumption of fruit (χ² (40, 230) = 58.8, p = 0.04), and vegetables (χ² (40, 230) = 81.3, p = 0.03). The Food Environment Score identified a significant positive correlation with four of the diet scores: individual total diet score (rs = 0.30, p < 0.01), fruit and vegetable score (rs = 0.43, p < 0.01), sugary drink score (rs = 0.13, p < 0.05), and discretionary food score (rs = 0.15, p < 0.05). Moreover, the suburbs' RFEI (Retail Food Environment Index, higher being unhealthier) showed a significant association with higher consumption of salty snacks (χ² (24, 230) = 43.9, p = 0.04). Food environments dominated by food outlets considered as 'healthier' were associated with healthier population food intakes, as indicated by a higher consumption of fruit, vegetables, and water, as well as a lower consumption of junk food, salty snacks, and sugary drinks. This association suggests that healthier diet quality is associated with healthier food environments in regional Australia.
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Olstad DL, Ancilotto R, Teychenne M, Minaker LM, Taber DR, Raine KD, Nykiforuk CIJ, Ball K. Can targeted policies reduce obesity and improve obesity-related behaviours in socioeconomically disadvantaged populations? A systematic review. Obes Rev 2017; 18:791-807. [PMID: 28434185 DOI: 10.1111/obr.12546] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/05/2017] [Accepted: 03/07/2017] [Indexed: 12/19/2022]
Abstract
This review synthesized evidence from controlled studies pertaining to the impact of targeted policies on anthropometric, dietary and physical activity outcomes amongst socioeconomically disadvantaged children and adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity guidelines were followed. Eligible studies were published from 2004 to August 2015 and examined the impact of targeted policies on anthropometric, dietary and physical activity outcomes amongst socioeconomically disadvantaged populations. Twenty articles (18 studies) were included. Eight studies examined organizational policies within multi-component interventions in schools. Common elements of successful policy-containing interventions included nutritional standards, enhancements to physical education, additional physical activity opportunities, school self-assessments, and nutrition and physical activity education. Of the 10 studies of government policies, policies providing information/education and fruit and vegetable subsidies had positive impacts amongst children, but no impact amongst adults. Policies involving changes to built environments yielded nearly uniformly null findings in children and adults. Overall, the largest quantity of high-quality evidence of effectiveness was for comprehensive interventions that included school policies, and government policies targeting disadvantaged children in schools. None of the government policies targeting disadvantaged adults proved effective. Interventions during childhood may ameliorate negative obesity-related manifestations of socioeconomic disadvantage. Gaps in knowledge remain surrounding effective policies in adults, adolescents and very young children.
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Affiliation(s)
- D L Olstad
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - R Ancilotto
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - M Teychenne
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - L M Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, Ontario, Canada
| | - D R Taber
- Healthy Food America, Seattle, Washington, USA
| | - K D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - C I J Nykiforuk
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - K Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Charting Availability of Processed and Unprocessed Foods in School Neighbourhood Nutrition Environments in an Urban Australian Setting. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2017; 2017:8397469. [PMID: 28553361 PMCID: PMC5434266 DOI: 10.1155/2017/8397469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/20/2017] [Indexed: 11/17/2022]
Abstract
School Neighbourhood Nutrition Environments (SNNEs) can facilitate or impede healthy eating. This study describes the SNNEs surrounding 6 Good Start Program (GSP) schools in 5 suburbs in Logan, Queensland. Relative density of healthy and unhealthy food outlets was calculated for SNNEs surrounding GSP (6) and non-GSP (10) schools within the 5 suburbs. Relative accessibility of minimally processed and highly processed food and drink in SNNEs of the 6 GSP schools was determined using shelf measurements of snack foods. Unhealthy outlets greatly outnumber healthy outlets (mean relative density 15.6%, median 19.1%). The majority of outlets stock predominantly highly processed food and drink. Study areas are dominated by unhealthy food outlets and highly processed food.
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59
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Vandevijvere S, Mackenzie T, Mhurchu CN. Indicators of the relative availability of healthy versus unhealthy foods in supermarkets: a validation study. Int J Behav Nutr Phys Act 2017; 14:53. [PMID: 28441947 PMCID: PMC5405544 DOI: 10.1186/s12966-017-0512-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/12/2017] [Indexed: 11/24/2022] Open
Abstract
Background In-store availability of healthy and unhealthy foods may influence consumer purchases. Methods used to measure food availability, however, vary widely. A simple, valid, and reliable indicator to collect comparable data on in-store food availability is needed. Methods Cumulative linear shelf length of and variety within 22 healthy and 28 unhealthy food groups, determined based on a comparison of three nutrient profiling systems, were measured in 15 New Zealand supermarkets. Inter-rater reliability was tested in one supermarket by a second researcher. The construct validity of five simple indicators of relative availability of healthy versus unhealthy foods was assessed against this ‘gold standard’. Results Cumulative linear shelf length was a more sensitive and feasible measure of food availability than variety. Four out of five shelf length ratio indicators were significantly associated with the gold standard (ρ = 0.70–0.75). Based on a non-significant difference from the ‘gold standard’ (d = 0.053 ± 0.040) and feasibility, the ratio of cumulative linear shelf length of fresh and frozen fruits and vegetables versus soft and energy drinks, crisps and snacks, sweet biscuits and confectionery performed best for use in New Zealand supermarkets. Conclusions Four out of the five shelf length ratio indicators of the relative availability of healthy versus unhealthy foods in-store tested could be used for future research and monitoring, but additional validation studies in other settings and countries are recommended. Consistent use of those shelf length ratio indicators could enhance comparability of supermarket food availability between studies, and help inform policies to create healthy consumer food retail environments. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0512-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stefanie Vandevijvere
- School of Population Health, The University of Auckland, Private bag 92019, Glen Innes, New Zealand.
| | - Tara Mackenzie
- School of Population Health, The University of Auckland, Private bag 92019, Glen Innes, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
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Corrêa EN, Rossi CE, das Neves J, Silva DAS, de Vasconcelos FDAG. Utilization and environmental availability of food outlets and overweight/obesity among schoolchildren in a city in the south of Brazil. J Public Health (Oxf) 2017; 40:106-113. [DOI: 10.1093/pubmed/fdx017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/31/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Elizabeth Nappi Corrêa
- Departamento de Nutrição – Programa de Pós-Graduação em Nutrição (PPGN), Universidade Federal de Santa Catarina, Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n – Centro de Ciências da Saúde, Bloco A, 208, Trindade, Florianópolis – SC, Brazil
| | - Camila Elizandra Rossi
- Departamento de Nutrição – Programa de Pós-Graduação em Nutrição (PPGN), Universidade Federal de Santa Catarina, Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n – Centro de Ciências da Saúde, Bloco A, 208, Trindade, Florianópolis – SC, Brazil
| | - Janaina das Neves
- Departamento de Nutrição – Programa de Pós-Graduação em Nutrição (PPGN), Universidade Federal de Santa Catarina, Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n – Centro de Ciências da Saúde, Bloco A, 208, Trindade, Florianópolis – SC, Brazil
| | - Diego Augusto Santos Silva
- Departamento de Educação Física – Programa de Pós-Graduação em Educação Física (PPGEF), Universidade Federal de Santa Catarina, Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n – Centro de Desportos, Trindade, Florianópolis – SC, Brazil
| | - Francisco de Assis Guedes de Vasconcelos
- Departamento de Nutrição – Programa de Pós-Graduação em Nutrição (PPGN), Universidade Federal de Santa Catarina, Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n – Centro de Ciências da Saúde, Bloco A, 208, Trindade, Florianópolis – SC, Brazil
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Using Geographic Information Systems to measure retail food environments: Discussion of methodological considerations and a proposed reporting checklist (Geo-FERN). Health Place 2017; 44:110-117. [DOI: 10.1016/j.healthplace.2017.01.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 01/03/2017] [Accepted: 01/09/2017] [Indexed: 12/18/2022]
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Personal characteristics, cooking at home and shopping frequency influence consumption. Prev Med Rep 2017; 6:104-110. [PMID: 28280684 PMCID: PMC5342997 DOI: 10.1016/j.pmedr.2017.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 02/02/2017] [Accepted: 02/13/2017] [Indexed: 02/07/2023] Open
Abstract
This study examines how the consumption of fruits and vegetables is affected by home cooking habits and shopping patterns, including distance to patronized stores and frequency of shopping, in two low-income predominantly African American urban neighborhoods in New Orleans, Louisiana. In-person interviews were conducted in 2013 with 901 adult residents who identified themselves as the primary household shopper. Respondents were asked where and how often they shopped and answered a food frequency questionnaire. Addresses were geocoded and distances to the stores where respondents shopped were calculated. Multivariable logistic regression was used to examine the relationship between food consumption and personal factors, neighborhood factors and shopping habits. Consumption of daily servings of fresh produce increased by 3% for each additional trip to a grocery store, by 76% for shopping at a farmer's market, and by 38% for preparing food at home. Each additional trip to a convenience store increased the frequency of consumption of chips, candy and pastries by 3%. The distance from residence to the type of store patronized was not associated with consumption of produce or chips, candy or pastries. Shopping at full-service grocery stores, farmer's markets and cooking at home were positively associated with the consumption of fresh produce while shopping at convenience stores was associated with increased consumption of chips, candy and pastries. These findings are useful for designing programmatic interventions to increase fresh fruit and vegetable consumption among residents in low-income urban communities. Shopping frequency and store type influence consumption of food. Distance to patronized store was not associated with consumption. Food prepared at home is associated with increased consumption of produce.
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Zenk SN, Mentz G, Schulz AJ, Johnson-Lawrence V, Gaines CR. Longitudinal Associations Between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample. HEALTH EDUCATION & BEHAVIOR 2017; 44:41-51. [PMID: 27230271 PMCID: PMC5777147 DOI: 10.1177/1090198116644150] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Blacks, Hispanics, and women of lower socioeconomic status tend to have a higher risk of obesity. Numerous studies over the past decade examined the role of the neighborhood food environment in body weight. However, few were longitudinal. PURPOSE This longitudinal study examined whether multiple measures of neighborhood food availability were associated with body mass index (BMI) in a predominately Black and Hispanic adult sample living in low- to moderate-income urban neighborhoods. METHOD This longitudinal study used two waves of data (2002, 2008), including interviewer-measured height and weight, from a community survey of adults ( n = 219). In both 2002 and 2008, multiple measures characterized neighborhood food availability: GIS-derived availability of retail food outlets (large grocery store, small grocery store, convenience store, liquor stores), observed fruit and vegetable availability (count of stores selling 10 or more fresh fruit or vegetable varieties), and perceived fruit and vegetable access. Random intercept models estimated multivariable associations, controlling for individual-level demographics and neighborhood median household income. RESULTS Small grocery store availability was associated with 1.22-unit increase in BMI ( p = .047), while each unit increase in perceived fruit and vegetable access was associated with a 0.69-unit decrease in BMI ( p = .055). BMI was not associated with large grocery store, convenience store, or liquor store availability, or with observed fruit and vegetable availability. CONCLUSIONS Findings suggest that improving the neighborhood food environment, particularly at small grocery stores, may help urban residents living in low- to moderate-income neighborhoods achieve healthier body weights over time.
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Lytle LA, Sokol RL. Measures of the food environment: A systematic review of the field, 2007-2015. Health Place 2017; 44:18-34. [PMID: 28135633 DOI: 10.1016/j.healthplace.2016.12.007] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Many studies have examined the relationship between the food environment and health-related outcomes, but fewer consider the integrity of measures used to assess the food environment. The present review builds on and makes comparisons with a previous review examining food environment measures and expands the previous review to include a more in depth examination of reliability and validity of measures and study designs employed. METHODS We conducted a systematic review of studies measuring the food environment published between 2007 and 2015. We identified these articles through: PubMed, Embase, Web of Science, PsycINFO, and Global Health databases; tables of contents of relevant journals; and the National Cancer Institute's Measures of the Food Environment website. This search yielded 11,928 citations. We retained and abstracted data from 432 studies. RESULTS The most common methodology used to study the food environment was geographic analysis (65% of articles) and the domination of this methodology has persisted since the last review. Only 25.9% of studies in this review reported the reliability of measures and 28.2% reported validity, but this was an improvement as compared to the earlier review. Very few of the studies reported construct validity. Studies reporting measures of the school or worksite environment have decreased since the previous review. Only 13.9% of the studies used a longitudinal design. CONCLUSIONS To strengthen research examining the relationship between the food environment and population health, there is a need for robust and psychometrically-sound measures and more sophisticated study designs.
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Affiliation(s)
- Leslie A Lytle
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States.
| | - Rebeccah L Sokol
- Department of Health Behavior, Campus Box 7440, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, United States
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Research Article: Food Availability and the Food Desert Frame in Detroit: An Overview of the City's Food System. ACTA ACUST UNITED AC 2017. [DOI: 10.1017/s1466046614000544] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Choice architecture to promote fruit and vegetable purchases by families participating in the Special Supplemental Program for Women, Infants, and Children (WIC): randomized corner store pilot study. Public Health Nutr 2016; 20:1297-1305. [PMID: 27890020 DOI: 10.1017/s1368980016003074] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To conduct a pilot study to determine if improving the visibility and quality of fresh produce (choice architecture) in corner stores would increase fruit/vegetable purchases by families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Six stores were randomly assigned to choice architecture intervention or control. Store-level WIC sales data were provided by the state. Primary outcomes were WIC fruit/vegetable voucher and non-fruit/vegetable voucher sales, comparing trends from baseline (December 2012-October 2013) with the five-month intervention period (December 2013-April 2014). Secondary outcomes were differences in customer self-reported fruit/vegetable purchases between baseline and end of the intervention. SETTING Chelsea, MA, USA, a low-income urban community. SUBJECTS Adult customers (n 575) completing store exit interviews. RESULTS During baseline, WIC fruit/vegetable and non-fruit/vegetable sales decreased in both intervention and control stores by $US 16/month. During the intervention period, WIC fruit/vegetable sales increased in intervention stores by $US 40/month but decreased in control stores by $US 23/month (difference in trends: $US 63/month; 95 % CI 4, 121 $US/month; P=0·036); WIC non-fruit/vegetable sales were not different (P=0·45). Comparing baseline and intervention-period exit interview responses by customers participating in WIC (n 134), intervention store customers reported increased fruit/vegetable purchases compared with control store customers (18 v. -2 %), but this did not achieve statistical significance (P=0·11). CONCLUSIONS Placement of fruits/vegetables near the front of corner stores increased purchase of produce by customers using WIC. New policies that incentivize stores to stock and prominently display good-quality produce could promote healthier food choices of low-income families.
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Winkler LL, Christensen U, Glümer C, Bloch P, Mikkelsen BE, Wansink B, Toft U. Substituting sugar confectionery with fruit and healthy snacks at checkout - a win-win strategy for consumers and food stores? a study on consumer attitudes and sales effects of a healthy supermarket intervention. BMC Public Health 2016; 16:1184. [PMID: 27876025 PMCID: PMC5120526 DOI: 10.1186/s12889-016-3849-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 11/16/2016] [Indexed: 11/29/2022] Open
Abstract
Background The widespread use of in-store marketing strategies to induce unhealthy impulsive purchases has implications for shopping experience, food choice and possibly adverse health outcomes. The aim of this study was to examine consumer attitudes and evaluate sales effects of a healthy checkout supermarket intervention. The study was part of Project Sundhed & Lokalsamfund (Project SoL); a Danish participatory community-based health promotion intervention. Methods Consumer attitudes towards unhealthy snack exposure in supermarkets were examined in a qualitative pre-intervention study (29 short in-store interviews, 11 semi-structured interviews and three focus group interviews). Findings were presented to food retailers and informed the decision to test a healthy checkout intervention. Sugar confectionery at one checkout counter was substituted with fruit and healthy snacking items in four stores for 4 weeks. The intervention was evaluated by 48 short exit interviews on consumer perceptions of the intervention and by linear mixed model analyses of supermarket sales data from the intervention area and a matched control area. Results The qualitative pre-intervention study identified consumer concern and annoyance with placement and promotion of unhealthy snacks in local stores. Store managers were willing to respond to local consumer concern and a healthy checkout intervention was therefore implemented. Exit interviews found positive attitudes towards the intervention, while intervention awareness was modest. Most participants believed that the intervention could help other consumers make healthier choices, while fewer expected to be influenced by the intervention themselves. Statistical analyses suggested an intervention effect on sales of carrot snack packs when compared with sales before the intervention in Bornholm control stores (P < 0.05). No significant intervention effect on sales of other intervention items or sugar confectionery was found. Conclusions The present study finds that the healthy checkout intervention was positively evaluated by consumers and provided a ‘responsible’ branding opportunity for supermarkets, thus representing a win-win strategy for store managers and consumers in the short term. However, the intervention was too modest to draw conclusions on long-term sales and health implications of this initiative. More research is needed to assess whether retailer-researcher collaborations on health promotion can be a winning strategy for public health.
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Affiliation(s)
- Lise L Winkler
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark.
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark
| | - Paul Bloch
- Steno Health Promotion Research, Steno Diabetes Center, Niels Steensens Vej 8, 2820, Gentofte, Denmark
| | - Bent E Mikkelsen
- Department of Clinical Medicine, Aalborg University, Frederikskaj 10, Building B, B2,, 2450, Copenhagen, SV, Denmark
| | - Brian Wansink
- Marketing in the Department of Applied Economics, Management at Cornell University, 114 Warren Hall, Ithaca, NY, 14853, USA
| | - Ulla Toft
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark
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Prescott SL, Logan AC. Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111075. [PMID: 27827896 PMCID: PMC5129285 DOI: 10.3390/ijerph13111075] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/21/2016] [Accepted: 10/28/2016] [Indexed: 12/20/2022]
Abstract
The influential scientist Rene J. Dubos (1901–1982) conducted groundbreaking studies concerning early-life environmental exposures (e.g., diet, social interactions, commensal microbiota, housing conditions) and adult disease. However, Dubos looked beyond the scientific focus on disease, arguing that “mere survival is not enough”. He defined mental health as fulfilling human potential, and expressed concerns about urbanization occurring in tandem with disappearing access to natural environments (and elements found within them); thus modernity could interfere with health via “missing exposures”. With the advantage of emerging research involving green space, the microbiome, biodiversity and positive psychology, we discuss ecological justice in the dysbiosphere and the forces—financial inequity, voids in public policy, marketing and otherwise—that interfere with the fundamental rights of children to thrive in a healthy urban ecosystem and learn respect for the natural environment. We emphasize health within the developmental origins of health and disease (DOHaD) rubric and suggest that greater focus on positive exposures might uncover mechanisms of resiliency that contribute to maximizing human potential. We will entrain our perspective to socioeconomic disadvantage in developed nations and what we have described as “grey space”; this is a mental as much as a physical environment, a space that serves to insidiously reinforce unhealthy behavior, compromise positive psychological outlook and, ultimately, trans-generational health. It is a dwelling place that cannot be fixed with encephalobiotics or the drug-class known as psychobiotics.
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Affiliation(s)
- Susan L Prescott
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- School of Paediatrics and Child Health Research, University of Western Australia, P.O. Box D184, Princess Margaret Hospital, Perth 6001, Australia.
| | - Alan C Logan
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- PathLight Synergy, 23679 Calabassas Road, Suite 542, Calabassas, CA 91302, USA.
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Lo BK, Minaker LM, Mah CL, Cook B. Development and Testing of the Toronto Nutrition Environment Measures Survey-Store (ToNEMS-S). JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:723-729.e1. [PMID: 27575848 DOI: 10.1016/j.jneb.2016.07.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/24/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe the adaptation and inter-rater reliability assessment of the Toronto Nutrition Environment Measures Survey-Store. METHODS A total of 55 food stores (2 bakeries, 2 dollar stores, 19 gas/convenience stores, 18 grocery stores, 4 pharmacies, 8 specialty stores, and 2 superstores) were assessed in 2014. Cohen's kappa and intra-class correlation coefficients (ICC) were assessed for inter-rater reliability for product availability, price, quality, ethno-cultural accessibility scores, and overall store scores. RESULTS Inter-rater reliability was high for availability (average kappa = 0.91), price (average ICC = 0.964), ethno-cultural accessibility score (ICC = 0.981), and overall store scores (ICC = 0.991). CONCLUSIONS AND IMPLICATIONS Measures in the Toronto Nutrition Environment Measures Survey-Store demonstrated excellent inter-rater agreement. Limited access to fruits and vegetables and ethno-cultural foods are related to diet-related chronic diseases, particularly among immigrants. Findings of the study may be useful in guiding public health programming.
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Affiliation(s)
- Brian K Lo
- Division of Nutritional Sciences, Cornell University, Ithaca, NY.
| | - Leia M Minaker
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, Canada
| | - Catherine L Mah
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brian Cook
- Toronto Food Strategy, Toronto Public Health, Toronto, Ontario, Canada
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Futrell Dunaway L, Mundorf AR, Rose D. Fresh Fruit and Vegetable Profitability: Insights From a Corner Store Intervention in New Orleans, Louisiana. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2016.1227746] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lauren Futrell Dunaway
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Adrienne R. Mundorf
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Donald Rose
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
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Moayyed H, Kelly B, Feng X, Flood V. Evaluation of a 'healthiness' rating system for food outlet types in Australian residential communities. Nutr Diet 2016; 74:29-35. [PMID: 28731554 DOI: 10.1111/1747-0080.12286] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 03/09/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022]
Abstract
AIM To obtain expert consensus to develop and evaluate a rating system on the relative healthiness of Australian suburbs' food outlet types. METHODS Twenty-four food outlet types and 10 local suburbs were identified from previous mapping studies and based on a scan of suburbs across one large Australian geographical region. Initial food outlet 'scores' for relative healthiness were proposed based on available literature, classified into five categories, from 'most' to 'least' healthy. In round 1 of a modified Delphi survey, participants, Australian public health and nutrition experts, were given each outlet type's definition and the proposed scores and invited to modify the scores based on their perceived 'healthiness'. In round 2, participants were able to revise or adjust their scores. RESULTS Median scores for food outlet types from both rounds highly correlated with the originally proposed scores (two-tailed Pearson's correlation coefficient 0.97 and 0.96, respectively, P = 0.01), and scores from round 1 highly correlated with those from round 2 (Pearson's coefficient 0.998, P = 0.01). Round 2 scores were used to calculate suburbs' overall food environment score, healthiness score, unhealthiness score and a ratio of unhealthiness to healthiness scores. There was strong positive correlation between suburbs' ratio of unhealthiness to healthiness scores and a previously recognised scoring ratio, Retail Food Environment Index (Spearman's rho 0.847, P < 0.01). CONCLUSIONS The study generated experts' consensus about relative healthiness of food outlet types found in Australian neighbourhoods. Proposed scores can be used to assess and compare healthiness of community food environments and to explore their associations with area characteristics, population's diet and health outcomes.
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Affiliation(s)
- Hamid Moayyed
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Bridget Kelly
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Xiaoqi Feng
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
| | - Victoria Flood
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,St Vincent's Hospital Research Committee, Sydney, New South Wales, Australia
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Shier V, Nicosia N, Datar A. Neighborhood and home food environment and children's diet and obesity: Evidence from military personnel's installation assignment. Soc Sci Med 2016; 158:122-31. [PMID: 27135542 PMCID: PMC5042141 DOI: 10.1016/j.socscimed.2016.03.043] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/24/2016] [Accepted: 03/29/2016] [Indexed: 01/08/2023]
Abstract
Research and policy initiatives are increasingly focused on the role of neighborhood food environment in children's diet and obesity. However, existing evidence relies on observational data that is limited by neighborhood selection bias. The Military Teenagers' Environments, Exercise, and Nutrition Study (M-TEENS) leverages the quasi-random variation in neighborhood environment generated by military personnel's assignment to installations to examine whether neighborhood food environments are associated with children's dietary behaviors and BMI. Our results suggest that neither the actual nor the perceived availability of particular food outlets in the neighborhood is associated with children's diet or BMI. The availability of supermarkets and convenience stores in the neighborhood was not associated with where families shop for food or children's dietary behaviors. Further, the type of store that families shop at was not associated with the healthiness of food available at home. Similarly, availability of fast food and restaurants was unrelated to children's dietary behaviors or how often children eat fast food or restaurant meals. However, the healthiness of food available at home was associated with healthy dietary behaviors while eating at fast food outlets and restaurants were associated with unhealthy dietary behaviors in children. Further, parental supervision, including limits on snack foods and meals eaten as a family, was associated with dietary behaviors. These findings suggest that focusing only on the neighborhood food environment may ignore important factors that influence children's outcomes. Future research should also consider how families make decisions about what foods to purchase, where to shop for foods and eating out, how closely to monitor their children's food intake, and, ultimately how these decisions collectively impact children's outcomes.
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Affiliation(s)
- Victoria Shier
- Pardee RAND Graduate School, 1776 Main St, Santa Monica CA 90401, USA.
| | - Nancy Nicosia
- RAND Corporation, 20 Park Plaza #920, Boston, MA 02116, USA.
| | - Ashlesha Datar
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089, USA.
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Anggraini R, Februhartanty J, Bardosono S, Khusun H, Worsley A. Food Store Choice Among Urban Slum Women Is Associated With Consumption of Energy-Dense Food. Asia Pac J Public Health 2016; 28:458-68. [PMID: 27208014 DOI: 10.1177/1010539516646849] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The aim of this study was to examine the associations of food store choice with food consumption among urban slum women. A cross-sectional survey was carried out among 188 urban slum women (19-50 years old) in Jakarta, Indonesia. A semiquantitative food frequency questionnaire was used to assess food consumption. Associations between food consumption and food store choice were tested by linear regression. This study found that frequencies of buying food from small shops (warung), street food vendors, and modern food stores were significantly associated with consumption of snacks, mixed dishes, and fruit respectively. In addition, buying food from traditional markets and small cafes (warung makan) was not significantly associated with particular types of food consumption. As modern food stores are rarely utilized by these women, small shops (warung) and street food vendors are likely to be important channels to improve slum dwellers' diet.
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Affiliation(s)
- Roselynne Anggraini
- SEAMEO RECFON (Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition), Central Jakarta, Indonesia
| | - Judhiastuty Februhartanty
- SEAMEO RECFON (Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition), Central Jakarta, Indonesia
| | | | - Helda Khusun
- SEAMEO RECFON (Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition), Central Jakarta, Indonesia
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Price promotions for food and beverage products in a nationwide sample of food stores. Prev Med 2016; 86:106-13. [PMID: 26827618 DOI: 10.1016/j.ypmed.2016.01.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 01/13/2016] [Accepted: 01/18/2016] [Indexed: 11/23/2022]
Abstract
Food and beverage price promotions may be potential targets for public health initiatives but have not been well documented. We assessed prevalence and patterns of price promotions for food and beverage products in a nationwide sample of food stores by store type, product package size, and product healthfulness. We also assessed associations of price promotions with community characteristics and product prices. In-store data collected in 2010-2012 from 8959 food stores in 468 communities spanning 46 U.S. states were used. Differences in the prevalence of price promotions were tested across stores types, product varieties, and product package sizes. Multivariable regression analyses examined associations of presence of price promotions with community racial/ethnic and socioeconomic characteristics and with product prices. The prevalence of price promotions across all 44 products sampled was, on average, 13.4% in supermarkets (ranging from 9.1% for fresh fruits and vegetables to 18.2% for sugar-sweetened beverages), 4.5% in grocery stores (ranging from 2.5% for milk to 6.6% for breads and cereals), and 2.6% in limited service stores (ranging from 1.2% for fresh fruits and vegetables to 4.1% for breads and cereals). No differences were observed by community characteristics. Less-healthy versus more-healthy product varieties and larger versus smaller product package sizes generally had a higher prevalence of price promotion, particularly in supermarkets. On average, in supermarkets, price promotions were associated with 15.2% lower prices. The observed patterns of price promotions warrant more attention in public health food environment research and intervention.
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Compernolle S, Oppert JM, Mackenbach JD, Lakerveld J, Charreire H, Glonti K, Bardos H, Rutter H, De Cocker K, Cardon G, De Bourdeaudhuij I. Mediating role of energy-balance related behaviors in the association of neighborhood socio-economic status and residential area density with BMI: The SPOTLIGHT study. Prev Med 2016; 86:84-91. [PMID: 26794046 DOI: 10.1016/j.ypmed.2016.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 12/25/2015] [Accepted: 01/03/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to examine the mediating effects of energy-balance related behaviors on the association of neighborhood socio-economic status (SES) and neighborhood residential area density (RAD) with body mass index (BMI). METHODS In total, 6037 adults from four neighborhood types (high SES/high RAD, high SES/low RAD, low SES/high RAD, and low SES/low RAD) in five Mid-European urban regions completed an online survey asking about their energy-balance related behaviors (physical activity [PA], sedentary behavior, and dietary behavior), determinants of these behaviors and their body weight and height. MacKinnon's product-of-coefficients test was used to assess mediating effects. RESULTS Transport-related PA, leisure-time PA and vegetable intake seemed to mediate the association between neighborhood type and BMI. Residents from low SES/low RAD neighborhoods reported less transport-related PA, less leisure-time PA and less vegetable intake than high SES/high RAD residents, and these behaviors (i.e. transport-related PA, leisure-time PA and vegetable intake) were related to having a higher BMI. CONCLUSION The association between neighborhood type and BMI can be explained, at least in part, by energy-balance related behaviors.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Michel Oppert
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie, Nutritionnelle), U1153 INSERM, INRA, CNAM, Centre de Recherche en Epidémiologie et, Biostatistiques, CRNH IdF, Bobigny, France; Université Pierre et Marie Curie, Institut cardiométabolisme et nutrition, service de nutrition, hôpital Piitie-Salpêtrière (AP-HP), France
| | - Joreintje D Mackenbach
- Department of Epidemiology & Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology & Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Helene Charreire
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie, Nutritionnelle), U1153 INSERM, INRA, CNAM, Centre de Recherche en Epidémiologie et, Biostatistiques, CRNH IdF, Bobigny, France; Université Pierre et Marie Curie, Institut cardiométabolisme et nutrition, service de nutrition, hôpital Piitie-Salpêtrière (AP-HP), France; Paris Est University, Lab-Urba Urban Institute of Paris, UPEC, Créteil, France
| | - Ketevan Glonti
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - Helga Bardos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary
| | - Harry Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Research Foundation Flanders (FWO), Brussels, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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Abstract
AbstractObesity in young adults is an increasing health problem in Australia and many other countries. Evidence-based information is needed to guide interventions that reduce the obesity-promoting elements in tertiary-education environments. In a food environmental audit survey, 252 outlets were audited across seven institutions: three universities and four technical and further education institutions campuses. A scoring instrument called the food environment-quality index was developed and used to assess all food outlets on these campuses. Information was collated on the availability, accessibility and promotion of foods and beverages and a composite score (maximum score=148; higher score indicates healthier outlets) was calculated. Each outlet and the overall campus were ranked into tertiles based on their ‘healthiness’. Differences in median scores for each outcome measure were compared between institutions and outlet types using one-way ANOVA with post hoc Scheffe’s testing, χ2 tests, Kruskal–Wallis H test and the Mann–Whitney U test. Binomial logistic regressions were used to compare the proportion of healthy v. unhealthy food categories across different types of outlets. Overall, the most frequently available items were sugar-sweetened beverages (20 % of all food/drink items) followed by chocolates (12 %), high-energy (>600 kJ/serve) foods (10 %), chips (10 %) and confectionery (10 %). Healthy food and beverages were observed to be less available, accessible and promoted than unhealthy options. The median score across all outlets was 72 (interquartile range=7). Tertiary-education food environments are dominated by high-energy, nutrient-poor foods and beverages. Interventions to decrease availability, accessibility and promotion of unhealthy foods are needed.
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Reitzel LR, Okamoto H, Hernandez DC, Regan SD, McNeill LH, Obasi EM. The Built Food Environment and Dietary Intake among African-American Adults. Am J Health Behav 2016; 40:3-11. [PMID: 26685808 DOI: 10.5993/ajhb.40.1.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The built food environment surrounding people's homes may influence their dietary intake. This exploratory study examined how the density of different sources of food in the residential environment was associated with dietary consumption among 77 African-American adults in Houston, Texas. METHODS The number of fast-food-type restaurants, large grocery stores, and convenience-type stores within 2- and 5-mile residential buffers were divided by the respective areas to obtain food environment density variables. Intake of fruit and vegetables [FV], fiber [FI], and percent energy from fat [PEF] was assessed using National Health Interview Survey items. Covariate-adjusted regressions were used to assess relations of interest. RESULTS Greater density of fast-food-type restaurants within 2 miles was associated with greater FV, FI, and PEF (ps ≤ .012); and for FV and FI within 5 miles (ps ≤ .004). Density of large grocery stores was unrelated to intake. Greater density of convenience-type stores within 2 miles was negatively associated with FV and FI (ps ≤ .03); results became marginal at 5 miles for FV (p = .10) but not FI (p = .03). CONCLUSION Maximizing healthy offerings in venue-rich metropolitan areas might provide direction for policies to reduce obesity.
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Affiliation(s)
- Lorraine R Reitzel
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
| | - Hiroe Okamoto
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
| | - Daphne C Hernandez
- The University of Houston, Department of Health and Human Performance, Houston, TX, USA
| | | | - Lorna H McNeill
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX, USA
| | - Ezemenari M Obasi
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, USA
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Block JP, Subramanian SV. Moving Beyond "Food Deserts": Reorienting United States Policies to Reduce Disparities in Diet Quality. PLoS Med 2015; 12:e1001914. [PMID: 26645285 PMCID: PMC4672916 DOI: 10.1371/journal.pmed.1001914] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Jason Block and S. V. Subramanian explore avenues for improving the health of Americans through reducing dietary inequalities and look at whether concern over "food deserts" has been taken too far.
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Affiliation(s)
- Jason P Block
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
- Harvard Center for Population and Development Studies, Harvard T H Chain School of Public Health, Cambridge, Massachusetts, United States of America
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Harvard T H Chain School of Public Health, Cambridge, Massachusetts, United States of America
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health Boston, Massachusetts, United States of America
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79
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Zenk SN, Powell LM, Isgor Z, Rimkus L, Barker DC, Chaloupka FJ. Prepared Food Availability in U.S. Food Stores: A National Study. Am J Prev Med 2015; 49:553-62. [PMID: 25913149 DOI: 10.1016/j.amepre.2015.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Prepared, ready-to-eat foods comprise a significant part of Americans' diets and are increasingly obtained from food stores. Yet, little is known about the availability and healthfulness of prepared, ready-to-eat food offerings at stores. This study examines associations among community characteristics (racial/ethnic composition, poverty level, urbanicity) and availability of both healthier and less-healthy prepared foods in U.S. supermarkets, grocery stores, and convenience stores. METHODS Observational data were collected from 4,361 stores in 317 communities spanning 42 states in 2011 and 2012. Prepared food availability was assessed via one healthier food (salads or salad bar), three less-healthy items (pizza, hot dog/hamburger, taco/burrito/taquito), and one cold sandwich item. In 2014, multivariable generalized linear models were used to test associations with community characteristics. RESULTS Overall, 63.6% of stores sold prepared foods, with 20.0% offering prepared salads and 36.4% offering at least one less-healthy item. Rural stores were 26% less likely to carry prepared salads (prevalence ratio [PR]=0.74, 95% CI=0.62, 0.88) and 14% more likely to carry at least one less-healthy prepared food item (PR=1.14, 95% CI=1.00, 1.30). Convenience stores in high-poverty communities were less likely to carry prepared salads than those in low-poverty communities (PR=0.64, 95% CI=0.47, 0.87). Among supermarkets, prepared salads were more likely to be carried in majority-white, low-poverty communities than in non-white, high-poverty communities. CONCLUSIONS Increasing the healthfulness of prepared foods within stores may offer an important opportunity to improve the food environment.
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Affiliation(s)
- Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
| | - Lisa M Powell
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Zeynep Isgor
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Leah Rimkus
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Dianne C Barker
- Barker Bi-Coastal Health Consultants Inc., Calabasas, California
| | - Frank J Chaloupka
- Department of Economics, University of Illinois at Chicago, Chicago, Illinois
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80
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Logan AC. Dysbiotic drift: mental health, environmental grey space, and microbiota. J Physiol Anthropol 2015; 34:23. [PMID: 25947328 PMCID: PMC4438628 DOI: 10.1186/s40101-015-0061-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/23/2015] [Indexed: 02/07/2023] Open
Abstract
Advances in research concerning the mental health implications of dietary patterns and select nutrients have been remarkable. At the same time, there have been rapid increases in the understanding of the ways in which non-pathogenic microbes can potentially influence many aspects of human health, including those in the mental realm. Discussions of nutrition and microbiota are often overlapping. A separate, yet equally connected, avenue of research is that related to natural (for example, green space) and built environments, and in particular, how they are connected to human cognition and behaviors. It is argued here that in Western industrial nations a ‘disparity of microbiota’ might be expected among the socioeconomically disadvantaged, those whom face more profound environmental forces. Many of the environmental forces pushing against the vulnerable are at the neighborhood level. Matching the developing microbiome research with existing environmental justice research suggests that grey space may promote dysbiosis by default. In addition, the influence of Westernized lifestyle patterns, and the marketing forces that drive unhealthy behaviors in deprived communities, might allow dysbiosis to be the norm rather than the exception in those already at high risk of depression, subthreshold (subsyndromal) conditions, and subpar mental health. If microbiota are indeed at the intersection of nutrition, environmental health, and lifestyle medicine (as these avenues pertain to mental health), then perhaps the rapidly evolving gut-brain-microbiota conversation needs to operate through a wider lens. In contrast to the more narrowly defined psychobiotic, the term eco-psychotropic is introduced.
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Affiliation(s)
- Alan C Logan
- CAMNR, 23679 Calabasas Road Suite 542, Calabasas, CA, 91302, USA.
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81
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Shulman ST. Junk food thoughts. Pediatr Ann 2015; 44:172-3. [PMID: 26023850 DOI: 10.3928/00904481-20150512-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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83
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Rummo PE, Meyer KA, Boone-Heinonen J, Jacobs DR, Kiefe CI, Lewis CE, Steffen LM, Gordon-Larsen P. Neighborhood availability of convenience stores and diet quality: findings from 20 years of follow-up in the coronary artery risk development in young adults study. Am J Public Health 2015; 105:e65-73. [PMID: 25790410 PMCID: PMC4386512 DOI: 10.2105/ajph.2014.302435] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association between neighborhood convenience stores and diet outcomes for 20 years of the Coronary Artery Risk Development in Young Adults study. METHODS We used dietary data from the Coronary Artery Risk Development in Young Adults study years 1985-1986, 1992-1993, and 2005-2006 (n = 3299; Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA) and geographically and temporally matched neighborhood-level food resource and US Census data. We used random effects repeated measures regression to estimate associations between availability of neighborhood convenience stores with diet outcomes and whether these associations differed by individual-level income. RESULTS In multivariable-adjusted analyses, greater availability of neighborhood convenience stores was associated with lower diet quality (mean score = 66.3; SD = 13.0) for participants with lower individual-level income (b = -2.40; 95% CI = -3.30, -1.51); associations at higher individual-level income were weaker. We observed similar associations with whole grain consumption across time but no statistically significant associations with consumption of sugar-sweetened beverages, artificially sweetened beverages, snacks, processed meats, fruits, or vegetables. CONCLUSIONS The presence of neighborhood convenience stores may be associated with lower quality diets. Low-income individuals may be most sensitive to convenience store availability.
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Affiliation(s)
- Pasquale E Rummo
- Pasquale E. Rummo, Katie A. Meyer, and Penny Gordon-Larsen are with the Department of Nutrition, University of North Carolina, Chapel Hill. Janne Boone-Heinonen is with the Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland. David R. Jacobs Jr and Lyn M. Steffen are with the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis. Catarina I. Kiefe is with the Department of Quantitative Health Sciences, University of Massachusetts Medical School, Boston. Cora E. Lewis is with the Division of Preventive Medicine, University of Alabama, Birmingham
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84
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Abstract
We live in an 'obesogenic environment' where we are constantly bombarded with choices that encourage us to move less and eat more. Many factors influence our dietary choices, including the expert marketers who advise manufacturers on ways to encourage the population to buy more, especially profitable, palatable 'ultra-processed' foods. Supermarkets themselves have become skilled in manipulating buying behaviour, using their layout and specific product placement as well as advertising to maximise purchases of particular foods. Increasingly, supermarkets push their own 'house' brands. Those marketing fast foods also use persuasive tactics to attract customers, especially children who they entice with non-food items such as promotional or collectable toys. There is no mystery to the increase in obesity: our energy intake from foods and drinks has increased over the same period that energy output has decreased. Obesity has a range of relevant factors, but there is little doubt that marketing from supermarkets and fast food retailers has played a role.
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Affiliation(s)
- Rosemary A Stanton
- School of Medical Sciences, Department of Medicine, University of New South Wales, 2866 Moss Vale Road, Barrengarry, 2577, Australia.
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85
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Gustat J, O'Malley K, Luckett BG, Johnson CC. Fresh produce consumption and the association between frequency of food shopping, car access, and distance to supermarkets. Prev Med Rep 2015; 2:47-52. [PMID: 26844049 PMCID: PMC4721283 DOI: 10.1016/j.pmedr.2014.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Fresh fruit and vegetables are important components of a healthy diet. Distance to a supermarket has been associated with the ability to access fresh produce. METHODS A randomly sampled telephone survey was conducted with the main shopper for 3000 households in New Orleans, Louisiana in 2011. Individuals were asked where and how often they shopped for groceries, frequency of consumption of a variety of foods, and whether they had access to a car. Bivariate models assessed the relationship between four outcomes: car access, distance to the store patronized by the respondent, number of monthly shopping trips, and daily servings of produce. Structural equation modeling (SEM) was used to distinguish direct and indirect effects. RESULTS In bivariate models, car access was positively associated with number of shopping trips and produce consumption while distance was inversely associated with shopping trips. In SEM models, produce consumption was not associated with car access or distance, but to the number of monthly shopping trips. CONCLUSION The frequency of shopping is associated with car access but a further distance deters it. Access to stores closer to the shopper may promote more frequent shopping and consumption of produce.
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Affiliation(s)
- Jeanette Gustat
- Tulane Prevention Research Center, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, United States
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA 70112, United States
| | - Keelia O'Malley
- Tulane Prevention Research Center, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, United States
- Department of Global Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2300, New Orleans, LA 70112, United States
| | - Brian G. Luckett
- Tulane Prevention Research Center, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, United States
- Department of Global Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2300, New Orleans, LA 70112, United States
| | - Carolyn C. Johnson
- Tulane Prevention Research Center, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, United States
- Department of Global Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2300, New Orleans, LA 70112, United States
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Abstract
Obesity is a national public health concern linked to numerous chronic health conditions among Americans of all age groups. Evidence suggests that discretionary calories from sugary drink consumption have been a significant contributor to excess caloric intake among both children and adults. Research has established strong links between retail food environments and purchasing habits of consumers, but little information exists on the sugary drink retail environment in urban neighborhoods. The objective of this assessment was to compare various aspects of the sugary drink retail environment across New York City (NYC) neighborhoods with disparate self-reported sugary drink consumption patterns. In-store retail audits were conducted at 883 corner stores, chain pharmacies, and grocery stores in 12 zip codes throughout NYC. Results showed that among all beverage types assessed, sugary drinks had the most prominent presence in the retail environment overall, which was even more pronounced in higher-consumption neighborhoods. In higher- versus lower-consumption neighborhoods, the mean number of sugary drink varieties available at stores was higher (11.4 vs. 10.4 varieties), stores were more likely to feature sugary drink advertising (97 vs. 89 %) and advertising at multiple places throughout the store (78 vs. 57 %), and several sugary drinks, including 20-oz Coke® or Pepsi®, were less expensive ($1.38 vs. $1.60). These results, all statistically significant, indicate that neighborhoods characterized by higher levels of sugary drink consumption expose shoppers to sugary drinks to a greater extent than lower-consumption neighborhoods. This builds upon evidence documenting the association between the environment and individual behavior.
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87
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Zenk SN, Powell LM, Rimkus L, Isgor Z, Barker DC, Ohri-Vachaspati P, Chaloupka F. Relative and absolute availability of healthier food and beverage alternatives across communities in the United States. Am J Public Health 2014; 104:2170-8. [PMID: 25211721 DOI: 10.2105/ajph.2014.302113] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined associations between the relative and absolute availability of healthier food and beverage alternatives at food stores and community racial/ethnic, socioeconomic, and urban-rural characteristics. METHODS We analyzed pooled, annual cross-sectional data collected in 2010 to 2012 from 8462 food stores in 468 communities spanning 46 US states. Relative availability was the ratio of 7 healthier products (e.g., whole-wheat bread) to less healthy counterparts (e.g., white bread); we based absolute availability on the 7 healthier products. RESULTS The mean healthier food and beverage ratio was 0.71, indicating that stores averaged 29% fewer healthier than less healthy products. Lower relative availability of healthier alternatives was associated with low-income, Black, and Hispanic communities. Small stores had the largest differences: relative availability of healthier alternatives was 0.61 and 0.60, respectively, for very low-income Black and very low-income Hispanic communities, and 0.74 for very high-income White communities. We found fewer associations between absolute availability of healthier products and community characteristics. CONCLUSIONS Policies to improve the relative availability of healthier alternatives may be needed to improve population health and reduce disparities.
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Affiliation(s)
- Shannon N Zenk
- Shannon N. Zenk is with the College of Nursing, Lisa M. Powell is with the School of Public Health, Leah Rimkus and Zeynep Isgor are with the Institute for Health Research and Policy, and Frank Chaloupka is with the Department of Economics, University of Illinois at Chicago. Dianne C. Barker is with Barker Bi-Coastal Health Consultants Inc, Calabasas, CA. Punam Ohri-Vachaspati is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix
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88
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Changes in food and beverage environments after an urban corner store intervention. Prev Med 2014; 65:7-12. [PMID: 24732720 DOI: 10.1016/j.ypmed.2014.04.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 03/08/2014] [Accepted: 04/03/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In response to the obesity epidemic, interventions to improve the food environment in corner stores have gained attention. This study evaluated the availability, quality, and price of foods in Philadelphia corner stores before and after a healthy corner store intervention with two levels of intervention intensity ("basic" and "conversion"). METHODS Observational measures of the food environment were completed in 2011 and again in 2012 in corner stores participating in the intervention, using the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS). Main analyses included the 211 stores evaluated at both time-points. A time-by-treatment interaction analysis was used to evaluate the changes in NEMS-CS scores by intervention level over time. RESULTS Availability of fresh fruit increased significantly in conversion stores over time. Specifically, there were significant increases in the availability of apples, oranges, grapes, and broccoli in conversion stores over time. Conversion stores showed a trend toward a significantly larger increase in the availability score compared to basic stores over time. CONCLUSION Interventions aimed at increasing healthy food availability are associated with improvements in the availability of low-fat milk, fruits, and some vegetables, especially when infrastructure changes, such as refrigeration and shelving enhancements, are offered.
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89
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Chaparro MP, Whaley SE, Crespi CM, Koleilat M, Nobari TZ, Seto E, Wang MC. Influences of the neighbourhood food environment on adiposity of low-income preschool-aged children in Los Angeles County: a longitudinal study. J Epidemiol Community Health 2014; 68:1027-33. [PMID: 25012991 DOI: 10.1136/jech-2014-204034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Few studies have examined the association between the food environment and adiposity in early childhood, a critical time for obesity prevention. The objective of this study was to examine the longitudinal association between neighbourhood food environment and adiposity among low-income preschool-aged children in a major metropolitan region in the USA. METHODS The study sample was 32 172 low-income preschool-aged children in Los Angeles County who had repeated weight and height measurements collected between ages 2 and 5 years through a federal nutrition assistance programme. We conducted multilevel longitudinal analyses to examine how spatial densities of healthy and unhealthy retail food outlets in the children's neighbourhoods were related to adiposity, as measured by weight-for-height z-score (WHZ), while controlling for neighbourhood-level income and education, family income, maternal education, and child's gender and race/ethnicity. RESULTS Density of healthy food outlets was associated with mean WHZ at age 3 in a non-linear fashion, with mean WHZ being lowest for those exposed to approximately 0.7 healthy food outlets per square mile and higher for lesser and greater densities. Density of unhealthy food outlets was not associated with child WHZ. CONCLUSIONS We found a non-linear relationship between WHZ and density of healthy food outlets. Research aiming to understand the sociobehavioural mechanisms by which the retail food environment influences early childhood obesity development is complex and must consider contextual settings.
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Affiliation(s)
- M Pia Chaparro
- Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institute, Stockholm, Sweden Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Shannon E Whaley
- Public Health Foundation Enterprises-Special Supplemental Nutrition Program for Women, Infants and Children (PHFE-WIC), Irwindale, California, USA
| | - Catherine M Crespi
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Maria Koleilat
- Department of Health Science, California State Fullerton, Fullerton, California, USA
| | - Tabashir Z Nobari
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Edmund Seto
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
| | - May C Wang
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
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90
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Rose D, O'Malley K, Dunaway LF, Bodor JN. The influence of the WIC food package changes on the retail food environment in New Orleans. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:S38-S44. [PMID: 24809995 DOI: 10.1016/j.jneb.2014.01.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/20/2014] [Accepted: 01/28/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To examine the effect of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package changes on availability of healthy foods in small stores. DESIGN Pre-post comparison group design with repeat in-store observations. SETTING New Orleans. PARTICIPANTS Small stores (n = 102; 77% of total) were visited in 2009. Of these, 91% were observed again in 2010, including both WIC (n = 27) and non-WIC (n = 66) stores. INTERVENTION The 2009 WIC food package changes to include healthier foods. MAIN OUTCOME MEASURES Change in store availability of fruits, vegetables, lower-fat milks, whole wheat bread, and brown rice. Change in number of varieties and shelf length of fruits and vegetables. ANALYSIS Difference-in-differences analysis using logit models for change in availability and regression models for change in number of varieties or shelf length. RESULTS The WIC stores were more likely to improve availability of lower-fat milks than non-WIC stores (adjusted odds ratio, 5.0, 95% confidence interval, 1.2-21.0). An even greater relative improvement was seen with whole grains. The WIC stores showed a relative increase in number of varieties of fresh fruits (0.9 ± 0.3; P < .01) and shelf length of vegetables (1.2 ± 0.4 meters; P < .01). CONCLUSIONS AND IMPLICATIONS Results suggest that WIC changes improved the availability of healthy foods in small stores in New Orleans. Similar changes throughout the country could have a significant impact on neighborhood food environments.
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Affiliation(s)
- Donald Rose
- Department of Global Community Health, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA.
| | - Keelia O'Malley
- Department of Global Community Health, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Lauren Futrell Dunaway
- Department of Global Community Health, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - J Nicholas Bodor
- Department of Global Community Health, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
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91
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Greer S, Schieb L, Schwartz G, Onufrak S, Park S. Association of the neighborhood retail food environment with sodium and potassium intake among US adults. Prev Chronic Dis 2014; 11:E70. [PMID: 24784906 PMCID: PMC4008950 DOI: 10.5888/pcd11.130340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION High sodium intake and low potassium intake, which can contribute to hypertension and risk of cardiovascular disease, may be related to the availability of healthful food in neighborhood stores. Despite evidence linking food environment with diet quality, this relationship has not been evaluated in the United States. The modified retail food environment index (mRFEI) provides a composite measure of the retail food environment and represents the percentage of healthful-food vendors within a 0.5 mile buffer of a census tract. METHODS We analyzed data from 8,779 participants in the National Health and Nutrition Examination Survey, 2005-2008. By using linear regression, we assessed the relationship between mRFEI and sodium intake, potassium intake, and the sodium-potassium ratio. Models were stratified by region (South and non-South) and included participant and neighborhood characteristics. RESULTS In the non-South region, higher mRFEI scores (indicating a more healthful food environment) were not associated with sodium intake, were positively associated with potassium intake (P [trend] = .005), and were negatively associated with the sodium-potassium ratio (P [trend] = .02); these associations diminished when neighborhood characteristics were included, but remained close to statistical significance for potassium intake (P [trend] = .05) and sodium-potassium ratio (P [trend] = .07). In the South, mRFEI scores were not associated with sodium intake, were negatively associated with potassium intake (P [trend] = < .001), and were positively associated with sodium-potassium ratio (P [trend] = .01). These associations also diminished after controlling for neighborhood characteristics for both potassium intake (P [trend] = .03) and sodium-potassium ratio (P [trend] = .40). CONCLUSION We found no association between mRFEI and sodium intake. The association between mRFEI and potassium intake and the sodium-potassium ratio varied by region. National strategies to reduce sodium in the food supply may be most effective to reduce sodium intake. Strategies aimed at the local level should consider regional context and neighborhood characteristics.
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Affiliation(s)
- Sophia Greer
- Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS F-72, Atlanta, GA 30341. E-mail:
| | - Linda Schieb
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Greg Schwartz
- Veteran's Health Administration, Seattle, Washington
| | - Stephen Onufrak
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sohyun Park
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Use of a new availability index to evaluate the effect of policy changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the food environment in New Orleans. Public Health Nutr 2014; 18:25-32. [PMID: 24762525 DOI: 10.1017/s1368980014000524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) occurred in 2009 when supplemental foods offered through the programme were updated to align with current dietary recommendations. The present study reports on a new index developed to monitor the retail environment's adoption of these new food supply requirements in New Orleans. DESIGN A 100-point WIC Availability Index (WIC-AI) was derived from new minimum state stocking requirements for WIC vendors. A sample of supermarkets, medium and small food stores was assessed in 2009 before changes were implemented and in 2010 after revisions had gone into effect. WIC-AI scores were utilized to compare differences in meeting requirements by store type, WIC vendor status and year of measurement. SETTING Supermarkets, medium and small WIC and non-WIC food stores in New Orleans, Louisiana, USA. RESULTS At baseline supermarkets had the highest median WIC-AI score (93·3) followed by medium (69·8) and small food stores (48·0). Small WIC stores had a higher median WIC-AI score at baseline than small non-WIC stores (66·9 v. 38·0). Both medium and small WIC stores significantly increased their median WIC-AI scores between 2009 and 2010 (P<0·01). The increased median WIC-AI score in small food stores was largely attributed to increased availability of cereals and grains, juices and fruit, and infant fruit and vegetables. CONCLUSIONS The WIC-AI is a simple tool useful in summarizing complex food store environment data and may be adapted for use in other states or a national level to inform food policy decisions and direction.
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93
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Abstract
The feasibility of working with neighborhood corner stores to increase the availability of fresh fruit and vegetables in low-income neighborhoods in New Orleans was assessed. Household interviews and 24-hour dietary recalls (n = 97), corner store customer intercept interviews (n = 60) and interviews with corner store operators (owners/managers) (n = 12) were conducted in three neighborhoods without supermarkets. Regional produce wholesalers were contacted by phone. Results indicated that the majority of neighborhood residents use supermarkets or super stores as their primary food source. Those who did shop at corner stores typically purchased prepared foods and/or beverages making up nearly one third of their daily energy intake. Most individuals would be likely to purchase fresh fruit and vegetables from the corner stores if these foods were offered. Store operators identified cost, infrastructure and lack of customer demand as major barriers to stocking more fresh produce. Produce wholesalers did not see much business opportunity in supplying fresh produce to neighborhood corner stores on a small scale. Increasing availability of fresh fruit and vegetables in corner stores may be more feasible with the addition of systems changes that provide incentives and make it easier for neighborhood corner stores to stock and sell fresh produce.
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Minaker LM, Raine KD, Wild TC, Nykiforuk CIJ, Thompson ME, Frank LD. Construct validation of 4 food-environment assessment methods: adapting a multitrait-multimethod matrix approach for environmental measures. Am J Epidemiol 2014; 179:519-28. [PMID: 24264292 DOI: 10.1093/aje/kwt272] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Few studies have assessed the construct validity of measures of neighborhood food environment, which remains a major challenge in accurately assessing food access. In this study, we adapted a psychometric tool to examine the construct validity of 4 such measures for 3 constructs. We used 4 food-environment measures to collect objective data from 422 Ontario, Canada, food stores in 2010. Residents' perceptions of their neighborhood food environment were collected from 2,397 households between 2009 and 2010. Objective and perceptual data were aggregated within buffer zones around respondents' homes (at 250 m, 500 m, 1,000 m, and 1,500 m). We constructed multitrait-multimethod matrices for each scale to examine construct validity for the constructs of food availability, food quality, and food affordability. Convergent validity between objective measures decreased with increasing geographic scale. Convergent validity between objective and subjective measures increased with increasing geographic scale. High discriminant validity coefficients existed between food availability and food quality, indicating that these two constructs may not be distinct in this setting. We conclude that the construct validity of food environment measures varies over geographic scales, which has implications for research, policy, and practice.
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95
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Bodor JN, Hutchinson PL, Rose D. Car ownership and the association between fruit and vegetable availability and diet. Prev Med 2013; 57:903-5. [PMID: 24145203 PMCID: PMC3871886 DOI: 10.1016/j.ypmed.2013.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/04/2013] [Accepted: 10/04/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Nearly all research on the food environment and diet has not accounted for car ownership - a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake. METHODS Data on respondents' (n=760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n=114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car. RESULTS Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners. CONCLUSIONS Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.
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Affiliation(s)
- J Nicholas Bodor
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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96
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Ni Mhurchu C, Vandevijvere S, Waterlander W, Thornton LE, Kelly B, Cameron AJ, Snowdon W, Swinburn B. Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally. Obes Rev 2013; 14 Suppl 1:108-19. [PMID: 24074215 DOI: 10.1111/obr.12080] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Retail food environments are increasingly considered influential in determining dietary behaviours and health outcomes. We reviewed the available evidence on associations between community (type, availability and accessibility of food outlets) and consumer (product availability, prices, promotions and nutritional quality within stores) food environments and dietary outcomes in order to develop an evidence-based framework for monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in retail food environments. Current evidence is suggestive of an association between community and consumer food environments and dietary outcomes; however, substantial heterogeneity in study designs, methods and measurement tools makes it difficult to draw firm conclusions. The use of standardized tools to monitor local food environments within and across countries may help to validate this relationship. We propose a step-wise framework to monitor and benchmark community and consumer retail food environments that can be used to assess density of healthy and unhealthy food outlets; measure proximity of healthy and unhealthy food outlets to homes/schools; evaluate availability of healthy and unhealthy foods in-store; compare food environments over time and between regions and countries; evaluate compliance with local policies, guidelines or voluntary codes of practice; and determine the impact of changes to retail food environments on health outcomes, such as obesity.
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Affiliation(s)
- C Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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97
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Minaker LM, Raine KD, Wild TC, Nykiforuk CIJ, Thompson ME, Frank LD. Objective food environments and health outcomes. Am J Prev Med 2013; 45:289-96. [PMID: 23953355 DOI: 10.1016/j.amepre.2013.05.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 01/31/2013] [Accepted: 05/21/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pathways by which food environments affect residents' diet-related outcomes are still unclear. Understanding pathways may help decision makers identify food environment strategies to promote healthy diets. PURPOSE To examine the hypothesis that residents' perceptions mediate the relationship between objective food environment and residents' diet quality and weight status. METHODS In the Waterloo Region, Ontario, objective food environment data were collected from 422 food stores and 912 restaurants using the Nutrition Environment Measure Survey in Stores and Restaurants, a shelf-space measure of fruits and vegetables, and the Retail Food Environment Index. Waterloo Region households (n=2223) completed a subjective food environment perception survey; household members (n=4102) self-reported weight, height, and waist circumference. A subsample (1170 individuals within 690 households) completed diet records. Food environment data were collected in 2010; respondent data were collected from 2009-2010; and data were analyzed in 2012. A series of gender-specific models were conducted to test mediation, adjusting for household income, car ownership, age, and education level. RESULTS Residents' perceptions did not mediate the relationship between objective measures and diet-related outcomes; instead, results revealed the direct effect of several objectively measured factors of the food environment (notably food access and relative food affordability) on outcomes. Perceptions generally were not associated with diet-related outcomes. CONCLUSIONS These results reveal that in this setting, strategies aimed at improving residents' perceptions may be less effective than those acting directly on food environments to improve food access and relative food affordability.
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Affiliation(s)
- Leia M Minaker
- School of Public Health, University of Alberta, Edmonton, Alberta
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98
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Lucan SC, Maroko AR, Bumol J, Torrens L, Varona M, Berke EM. Business list vs ground observation for measuring a food environment: saving time or waste of time (or worse)? J Acad Nutr Diet 2013; 113:1332-9. [PMID: 23871107 DOI: 10.1016/j.jand.2013.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 05/06/2013] [Indexed: 12/21/2022]
Abstract
In food-environment research, an alternative to resource-intensive direct observation on the ground has been the use of commercial business lists. We sought to determine how well a frequently used commercial business list measures a dense urban food environment like the Bronx, NY. On 155 Bronx street segments, investigators compared two different levels for matches between the business list and direct ground observation: lenient (by business type) and strict (by business name). For each level of matching, researchers calculated sensitivities and positive predictive values (PPVs) for the business list overall and by broad business categories: General Grocers (eg, supermarkets), Specialty Food Stores (eg, produce markets), Restaurants, and Businesses Not Primarily Selling Food (eg, newsstands). Even after cleaning the business list (eg, for cases of multiple listings at a single location), and allowing for inexactness in listed street addresses and spellings of business names, the overall performance of the business list was poor. For strict matches, the business list had an overall sensitivity of 39.3% and PPV of 45.5%. Sensitivities and PPVs by broad business categories were not meaningfully different from overall values, although sensitivity for General Grocers and PPV for Specialty Food Stores were particularly low: 26.2% and 32%, respectively. For lenient matches, sensitivities and PPVs were somewhat higher but still poor: 52.4% to 60% and 60% to 75%, respectively. The business list is inadequate to measure the actual food environment in the Bronx. If results represent performance in other settings, findings from prior studies linking food environments to diet and diet-related health outcomes using such business lists are in question, and future studies of this type should avoid relying solely on such business lists.
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99
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Gustafson A, Lewis S, Perkins S, Damewood M, Buckner E, Vail A, Mullins J, Jilcott-Pitts SB. Association Between the Retail Food Environment, Neighborhood Deprivation, and County-Level Dietary Outcomes Among Supplemental Nutrition Assistance Program–Education (SNAP-Ed) Recipients in Kentucky, 2010–2011. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2013. [DOI: 10.1080/19320248.2013.816993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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100
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Smith ML, Sunil TS, Salazar CI, Rafique S, Ory MG. Disparities of food availability and affordability within convenience stores in Bexar County, Texas. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:782756. [PMID: 23935645 PMCID: PMC3713310 DOI: 10.1155/2013/782756] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/15/2013] [Accepted: 06/17/2013] [Indexed: 11/18/2022]
Abstract
The American Diabetes Association (ADA) recommends healthful food choices; however, some geographic areas are limited in the types of foods they offer. Little is known about the role of convenience stores as viable channels to provide healthier foods in our "grab and go" society. The purposes of this study were to (1) identify foods offered within convenience stores located in two Bexar County, Texas, ZIP Codes and (2) compare the availability and cost of ADA-recommended foods including beverages, produce, grains, and oils/fats. Data were analyzed from 28 convenience store audits performed in two sociodemographically diverse ZIP Codes in Bexar County, Texas. Chi-squared tests were used to compare food availability, and t-tests were used to compare food cost in convenience stores between ZIP Codes. A significantly larger proportion of convenience stores in more affluent areas offered bananas (χ (2) = 4.17, P = 0.003), whole grain bread (χ (2) = 8.33, P = 0.004), and baked potato chips (χ (2) = 13.68, P < 0.001). On average, the price of diet cola (t = -2.12, P = 0.044) and certain produce items (e.g., bananas, oranges, tomatoes, broccoli, and cucumber) was significantly higher within convenience stores in more affluent areas. Convenience stores can play an important role to positively shape a community's food environment by stocking healthier foods at affordable prices.
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Affiliation(s)
- Matthew Lee Smith
- Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, 330 River Road, 315 Ramsey Center, Athens, GA 30602, USA
- Department of Health Promotion and Community Health Sciences, School of Rural Public Health, Texas A&M Health Science Center, TAMU 1266, College Station, TX 77843, USA
| | - T. S. Sunil
- Department of Sociology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
| | - Camerino I. Salazar
- Department of Quality and Outcomes, University Health System-Ambulatory Services, 701 S. Zarzamora, MS 41-5, San Antonio, TX 78207, USA
| | - Sadaf Rafique
- Department of Quality and Outcomes, University Health System-Ambulatory Services, 701 S. Zarzamora, MS 41-5, San Antonio, TX 78207, USA
| | - Marcia G. Ory
- Department of Health Promotion and Community Health Sciences, School of Rural Public Health, Texas A&M Health Science Center, TAMU 1266, College Station, TX 77843, USA
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