Assessing the availability, price, nutritional value and consumer views about foods and beverages from vending machines across university campuses in regional New South Wales, Australia

Assessing the Healthfulness of University Food Environments: A Systematic Review of Methods and Tools

The availability, promotion, and price of healthy foods within the university food environment may impact students' dietary choices. This systematic review summarizes the tools and methods used to assess the healthfulness of university food environments where many students spend a significant portion of their emerging adulthood. Thirty-six global studies published between 2012 and 2022 were sourced from PubMed (NNLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycInfo (EBSCO), CINHAL Complete (EBSCO), ProQuest Nursing, and Allied Health, following PRISMA 2020 guidelines. Of the included studies, 58% were institutional-level audits, 17% examined individual-level perceptions, and 25% combined both. Most institutional-level audits focused on one aspect of the food environment (e.g., eateries, vending machines). For studies examining multiple spaces within the campus environment (38%), comprehensive assessments were limited, and most studies had to employ a combination of assessment tools. Surveys were most often used to gather individual perceptions about the food environment. The Nutrition Environment Measures Survey (NEMS) was the most commonly used tool across all studies. This review highlights the need for a standardized tool, method, or a "healthy" benchmark for specific use at universities to improve methodological rigor and comparability of findings across institutions.

Effect of using the snackability app on snack quality among US college students with overweight and obesity: A randomized controlled trial

OBJECTIVE

To determine if using the Snackability app improves snack intake among college students.

PARTICIPANTS

US college students with overweight/obesity were recruited in June 2020-April 2021.

METHODS

A randomized controlled trial was conducted to test the Snackability app use for 12 wk on snack scores (calculated from the app) compared to controls. We also explored the effect on diet quality (Healthy Eating Index-2015) and weight. Outcomes were compared between the intervention and the control groups at 4, 8, and 12 wk using repeated measures ANOVA.

RESULTS

Participants in the app group significantly increased snack score at week 4 (p < 0.001) and week 8 (p = 0.015) and increased HEI-2020 score (p < 0.001) at week 4 compared to controls. The first 4 wk had the highest app usage. No significant differences were seen in body weight.

CONCLUSIONS

The Snackability app can be used as a tool to help improve snack and diet quality in this group.

Associations between ultraprocessed and minimally processed snacks consumption and overweight/obesity among college students in South Florida

OBJECTIVE

Evaluate the association between ultraprocessed and minimally processed snack consumption and overweight/obesity among college students.

PARTICIPANTS

College students.

METHODS

Cross-sectional study. Participants completed an online survey with questions on socio-demographics, beverages and snacks consumption, and weight status. ANCOVA and logistic regression was used; analyses were adjusted for age, sex, race/ethnicity, physical activity, and sleep duration.

RESULTS

A total of 435 students completed all questions in the survey. Most students were female (73.3%), Hispanics (61.1%), had a mean age of 24.7-year old and 40% had overweight/obesity. Those with overweight/obesity also had higher odds of consuming soft drinks in higher frequency and quantity than those without overweight/obesity (p < .05). Never consuming unsweetened yogurt/cheese and lower frequency and consumption of fruits were associated with higher odds of overweight/obesity (p < .05).

CONCLUSION

Higher frequency and consumption of soft drinks while lower frequency and consumption of unsweetened yogurt/cottage cheese and fruits were associated with overweight/obesity.

Perception about the effectiveness of different vending machine interventions to promote healthier snack selection among college students

OBJECTIVE

Evaluate college students' perception of the effectiveness of different vending machine (VM) interventions for improving snack selection.

PARTICIPANTS

A total of 194 college students with the age of ≥18 years.

METHOD

A cross-sectional survey among a purposive sampling near VM.

RESULTS

Most students use VM frequently or occasionally (63.4%). The intervention perceived as most helpful for choosing healthier snacks was labeling (on or near) which snack is healthy (score 3.83/5) followed by lowering the price of healthy options (score 3.33/5), while the least helpful was having posters nearby explaining which snacks are healthier (2.35/5). Participants suggested including snacks high in protein (58.8%) and low in sugar (56.2%). Most would like to see more healthy options in VM (83.5%) and will purchase them if available (67%).

CONCLUSIONS

Lowering the price for healthy snacks and including labels to indicate which are healthy may be the interventions to test for improving snack intake among college students.

Healthy Food Policies Documented in University Food Service Contracts

In the United States, there is an opportunity to improve the nutritional health of university students through the campus food environment. This project used a content analysis approach to investigate whether healthy food standards and policies were incorporated into the contract agreements between North Carolina (NC) public universities and their food service management companies. Food service contracts were collected from 14 NC public universities using food service management companies on campus. Each contract was evaluated using the 35-item North Carolina Food Service Policy Guidelines Assessment to examine four elements of the campus food environment: Beverages, Packaged Snacks, Prepared Foods, and Other (e.g., strategic placement of healthier food). Five university food service contracts incorporated no North Carolina Food Service Policy Guidelines, three university contracts included one to five guidelines, and six university contracts included six to nine guidelines. Altogether, 13 of the 35 guidelines were incorporated into at least one university food service contract. This project presents a cost and time-effective assessment method for determining if evidence-based nutrition guidelines have been included in university food service contracts. This approach and findings may lead to contract revisions to improve the campus food environment and, subsequently, the nutritional health of college populations.

A Cross-Sectional Evaluation of the Food Environment at an Australian University Campus

University food environments have a strong influence on the dietary choices of students and staff. The aim of this study was to assess the food environment at a large university in Sydney, Australia. Data were collected between March and July 2022 from 27 fixed food outlets and 24 vending machines. The healthiness of the food environment was evaluated using the Healthy Food and Drink in NSW Health Facilities for Staff and Visitors Framework (‘Framework’), which assesses food environment parameters including the availability, placement, and promotion of ‘Everyday’ (healthy) and ‘Occasional’ (less healthy) products. Each parameter was evaluated overall and across each food outlet type. Across all outlets, Everyday foods and drinks made up 43.9% of all products. Only two outlets met the Framework’s product availability benchmark of ≥75% Everyday foods and drinks. A total of 43 outlets (84.3%) sold sugary drinks as part of their product range. Occasional products made up 68.4%, 53.3%, and 59.9% of all items for sale at checkout areas, countertops, and eye-level shelves, respectively. Finally, 79.7% of meal deals included Occasional products. Our findings highlight the need to improve the availability, placement, and promotion of foods and drinks sold at a major university campus in Sydney, Australia.

Assessment of Nutritional Quality of Products Sold in University Vending Machines According to the Front-of-Pack (FoP) Guide

The aim of this research was to assess the nutritional composition of 654 foods and beverages from vending machines on a University Campus. The guide called “Creating a front of pack nutrition label for pre-packed products sold through retail outlets” from the Department of Health (UK) was used to assess the nutritional composition and to compare values from food and beverage categories. A high proportion of food items had high−moderate content of nutrients related to chronic disease (93, 88, 74 and 49% had high−moderate content of fat, saturated fat, salt and sugar, respectively). On the other hand, a few beverages had high−moderate content of these nutrients, except for sugar (2% high to moderate in fat, 2% in saturated fat, 0% in salt and 39% in sugar). The most frequent food categories were chocolates and bars (10.6%) and breadsticks (8.4%), whereas the most available beverages were water (27.7%) and soft drinks (23.4%). There were no statistically significant differences in the proportion of categories between the health science and humanities faculties, except for energy drinks (p < 0.05) and soft drinks (p < 0.05). Vending machines contribute to an obesogenic environment and do not support healthy snacking. Recommendations in this article should be considered to develop official guidelines to ensure the wider availability of healthy dietary choices in vending machines in university settings.

Undergraduate nursing and medical students’ perceptions of food security and access to healthy food in Qatar: a photovoice study

The present study explored nursing and medical students’ perceptions of food security, their access to healthy food and the circumstances that affect their access to healthy food in Qatar. The photovoice method was adopted in the present study. Students submitted their photos pertaining to food security and their access to healthy food in Qatar. Afterwards, the students completed an online synchronous semi-structured interview. The interviews were transcribed verbatim and thematically analysed. After the data analysis, a focus group discussion was conducted for member checking. The present study is a collaborative project between two universities in Qatar: The University of Calgary in Qatar (UCQ) and Qatar University (QU). Undergraduate students (seven nursing students and nine medical students) were recruited, asked to collect photos and interviewed. Four themes emerged from the data. First, food retail environments promoted unhealthy eating. Second, fast food under stressful circumstances: a sense of comfort. Third, food as a symbol of culture and socialisation. Finally, the paradox of access to affordable and healthy food in Qatar. Undergraduate students highlighted various circumstances that affect their perceptions of food security and their access to healthy food in Qatar. Future research that aims at understanding the facilitators and barriers to access healthy food at the university campus may help to improve nutrition interventions targeting those students. Future initiatives should focus on leveraging various resources to assist universities in tailoring their food initiatives to suit their students’ local needs.

College Students' Perception of Snacks Sold in Vending Machines in the US: A Mixed-Methods Study

Introduction: Food in vending machines in US colleges contain limited nutritious foods available for purchase, which could affect the food choices made by students leading to poor diet quality. Interventions to improve college foodscapes usually follow a top-down approach and fail to affect dietary behavioral changes ultimately. This research aims to uncover what students want and ways to achieve change.

Methods: The mixed-methods approach included peer-led qualitative focus group discussions and a brief quantitative questionnaire on satisfaction from foods available in vending machines. A convenience sample of 20 students (15 females) was recruited from a Hispanic serving institution for this study.

Results: Vending machines were perceived as convenient, plentiful, and unhealthy. Students expressed dissatisfaction with both the variety and nutritional quality of snacks in vending machines. Suggestions for improvement included more fresh items (fruits and vegetables) and refrigerated items with higher protein content (low-fat yogurt, hummus, and peanut butter). To implement these improvements, participants discussed the cost and feasibility of perishable items. Increasing awareness and partnering strategies were proposed to mediate potential cost and buy-in obstacles as was elevating the appeal of healthy vending machines with technological enhancements that draw customers in and educate.

Conclusion and Implication for Practice: This group of college students was eager for positive changes in foods sold in vending machines and understand the major difficulties. The suggested changes may help this and other colleges develop policies to regulate the foods in vending machines to promote overall health and help prevent chronic diseases in the future.

Nutritional quality of beverages available in vending machines in health and social care institutions: do we really want such offers?

BACKGROUND

Vending machines represent one way of offering food, but they are overlooked in the efforts to improve people's eating habits. The aim of our study was to analyse the variety and nutritional values of beverages offered in vending machines in social and health care institution in Slovenia.

METHODS

The available beverages were quantitatively assessed using traffic light profiling and the model for nutrient profiling used by Food Standards Australia New Zealand. Vending machines in 188 institutions were surveyed, resulting in 3046 different beverages consisting of 162 unique product labels.

RESULTS

Between 51 and 54% of beverages were categorised as unhealthy with regard to sugar content. Water accounted for only 13.7% of all beverages in vending machines. About 82% of beverages in vending machines were devoted to sugar-sweetened beverages, the majority (58.9%) presented in 500-ml bottles. The average sugar content and average calories in beverages sold in vending machines are slightly lower than in beverages sold in food stores.

CONCLUSIONS

We suggest that regulatory guidelines should be included in the tender conditions for vending machines in health and social care institutions, to ensure healthy food and beverage choices.

Availability, Nutritional Profile and Processing Level of Food Products Sold in Vending Machines in a Spanish Public University

BACKGROUND

Given the lack of data about the nutritional value and other determinants of the consumption of foods and drinks sold in vending machines in European universities and the relevance of this sector in Spain, it is necessary to obtain scientific data on this topic. The present study aimed to assess the availability, nutritional profile and processing level of food products from vending machines at a Spanish public university and to investigate differences in nutritional profile according to the cost and promotion.

METHODS

Cross-sectional descriptive study. Data from all products available (3894) were collected and analysed using the criteria of the Spanish Agency for Consumption, Food Safety and Nutrition and the United Kingdom nutrient profiling model. The items were also classified according to the degree of industrial processing through the NOVA system. Promotion was assessed, taking into account where products were displayed in vending machines.

RESULTS

The most common products were sweets (23.4% of the total options), coffee (20.3%) and salty snacks (11.7%). According to the combination of the two criteria used to assess nutritional profile, 48.6% of the products were classified as with low nutritional quality (LNQ). In addition, 73.8% of the items were categorised as "ultra-processed". Foods (β = 0.31, 95% CI 0.24, 0.39, p < 0.001) and hot drinks (β = 0.46, 95% CI 0.39, 0.52, p < 0.001) with high nutritional quality (HNQ) were more likely to have higher prices than alternatives with LNQ. Both foods and cold drinks that support healthy dietary recommendations were promoted to a lesser extent than those with LNQ (p < 0.001).

CONCLUSION

Almost half of the products were of LNQ and three-quarters had a high level of processing. Moreover, foods and cold drinks with LNQ were less expensive and more often promoted than alternatives with HNQ.

[Nutritional composition of vending foods of public university and hospital buildings in Asturias]

OBJECTIVE

To evaluate the nutritional composition of food vending machines (VM) located in university public buildings and hospitals in Asturias.

DESIGN

Descriptive cross-sectional study.

LOCATION

The analysis was made of the contents of VMs located in public buildings, hospitals, and university teaching centres in the Principality of Asturias.

MAIN MEASUREMENTS

After the public buildings were mapped, each of them was visited to check for the presence of the VMs. A a photograph was then taken of the food contained in them. The variables analysed were the type of products and their nutritional composition.

RESULTS

The VMs of 19 buildings (12 university and 7 hospital), contained 215 foods that were grouped into 11 categories. The most frequent were "chocolates and chocolate bars" (30,2%), "cookies" (11.6%) and "chips" (11.6%). The Kcal average was 216 (SD=133.1). The mean fat, in grams was 12.52 (SD=11.21), saturated fat 4.48 (SD=3,83), sugars 11.88 (SD=31.13), fibre 1.9 (SD=2.47), proteins 3.38 (SD=3.62), and salt 0.3 (SD=0.62). A high excess of fat, saturated fat, and salt was observed, as well as a medium excess of sugars.

CONCLUSIONS

The nutritional quality of VM in hospitals and public university centres of the Principality of Asturias cannot be defined as healthy. Therefore, health promotion strategies could be developed with the aim of improving their nutritional composition or guiding the population/users towards the selection and consumption of healthier foods.