Fast food and deprivation in Nova Scotia

Unraveling Elusive Boundaries: A Comprehensive Framework for Assessing Local Food Consumption Patterns in Nova Scotia, Canada

Promoting local food consumption for economic growth is a priority; however, defining "local" remains challenging. In Nova Scotia, Canada, this pioneering research establishes a comprehensive framework for assessing local food consumption. Employing three data collection methods, our study reveals that, on average, Nova Scotians allocate 31.2% of their food expenditures to locally sourced products, excluding restaurant and take-out spending, as per the provincial guidelines. The participants estimated that, in the previous year, 37.6% of their spending was on local food; this figure was derived from the most effective method among the three. However, the figure was potentially influenced by participant perspective and was prone to overestimation. To enhance accuracy, we propose methodological enhancements. Despite the limitations, the 31.2% baseline offers a substantial foundation for understanding local food patterns in Nova Scotia. It serves as a replicable benchmark for future investigations and guides researchers with similar objectives, thereby establishing a robust research platform.

Spatial inequalities of retail food stores may determine availability of healthful food choices in a Brazilian metropolis

OBJECTIVE

To examine the association between economic residential segregation and food environment.

DESIGN

Ecological: Food stores categorised according to the NOVA classification were geocoded, and absolute availability was calculated for each neighbourhood. Segregation was measured using local Gi* statistic, a measure of the sd between the economic composition of a neighbourhood (the proportion of heads of households in neighbourhoods earn monthly income of 0 to 3 minimum wages) and larger metropolitan area, weighted by the economic composition of surrounding neighbourhoods. Segregation was categorised as high (most segregated), medium (integrated) and low (less segregated or integrated). A proportional odds models were used to model the association between segregation and food environment.

SETTING

Belo Horizonte, Brazil.

PARTICIPANTS

Food stores.

RESULTS

After adjustment for covariates, neighbourhoods characterised by high economic segregation had fewer food stores overall compared with neighbourhoods characterised by low segregation (OR = 0·56; 95 % CI (0·45, 0·69)). In addition, high segregated neighbourhoods were 49 % (OR = 0·51; 95 % CI (0·42, 0·61)) and 45 % (OR = 0·55; 95 % CI (0·45, 0·67)) less likely to have a high number of food stores that predominantly marketed ultra-processed foods and mixed food stores, respectively, as compared with their counterparts.

CONCLUSIONS

Economic segregation is associated with differences in the distribution of food stores. Both low and high segregation territories should be prioritised by public policies to ensure healthy and adequate nutrition as a right for all communities. The former must continue to be protected from access to unhealthy commercial food outlets, while the latter must be the locus of actions that limit the availability of unhealthy commercial food store.

Diet Quality and Neighborhood Environment in the Atlantic Partnership for Tomorrow's Health Project

An understanding of relationships between different constructs of the neighbourhood environment and diet quality is needed to inform public health interventions. This study investigated associations between material deprivation, social deprivation and population density with diet quality in a cohort of 19,973 Canadian adults aged 35 to 69 years within the Atlantic PATH cohort study. Diet quality, a metric of how well diet conforms to recommendations was determined from a 24-item food frequency questionnaire. Neighbourhood environment data were derived from dissemination area level Census data. Two deprivation indices were evaluated: material and social deprivation, which reflect access to goods and amenities and social relationships. Multi-level models were used to estimate relationships (mean differences and 95% CI) between neighbourhood environment and diet quality, adjusting for covariates. Mean diet quality was lower in the most socially deprived neighbourhoods compared to the least socially deprived: −0.56, 95% CI (−0.88, −0.25). Relationships between diet quality and population density differed between urban and rural areas (p-interaction < 0.0001). In rural areas, diet quality was higher in intermediate-density neighbourhoods: 0.54, 95% CI (0.05, 1.03). In urban areas, diet quality was lower in intermediate-density and the most-dense neighbourhoods: −0.84, 95% CI (−1.28, −0.40) and −0.72, 95% CI (−1.20, −0.25). Our findings suggest socially deprived and high-density neighbourhoods are associated with lower diet quality and possible urban-rural differences in neighbourhood environment-diet quality relationships. Additional studies are needed to determine the temporal nature of relationships and whether differences in diet quality are meaningful.

Spatial variation in risk for physician diagnosed environmental sensitivity

Multiple chemical sensitivity (MCS) is a chronic condition characterized by recurring and severe symptoms triggered by exposures to low levels of toxicants or anthropogenic pollution. This study investigated the spatial structure of MCS incidence and estimated the contribution of socio-economic deprivation to variations in rates of MCS at the community level in Nova Scotia, Canada. Patient data were used to calculate cumulative incidence rate ratios for treated multiple chemical sensitivities. Poisson regression with a spatially autoregressive random effect was employed to assess spatial variation in MCS. Odds of MSC incidence are greatest among patients from the highest socioeconomic category using the most socioeconomically deprived category as reference (OR: 1.94, CI [2.5-95%] 1.45-2.56). No discernable spatial pattern for MCS risk was evident after controlling for known risk factors. This is the first study to investigate spatial variations in cumulative incidence of multiple chemical sensitivities. The socioeconomic status of the community in which patients live has a significant influence on the geographic patterns of MCS. Future research will include a smartphone application to assess positional and temporal information on environmental exposures to further explain MCS prevalence.

Association between Diet Quality and Adiposity in the Atlantic PATH Cohort

The aim of this study was to examine diet quality among participants in the Atlantic Partnership for Tomorrow’s Health (PATH) cohort and to assess the association with adiposity. Data were collected from participants (n = 23,768) aged 35–69 years that were residents of the Atlantic Canadian provinces. Both measured and self-reported data were used to examine adiposity (including body mass index (BMI), abdominal obesity, waist-to-hip ratio and fat mass) and food frequency questionnaires were used to assess diet quality. Overall, diet quality was statistically different among provinces. Of concern, participants across all the provinces reported consuming only 1–2 servings of vegetables and 1–2 servings fruit per day. However, participants also reported some healthy dietary choices such as consuming more servings of whole grains than refined grains, and eating at fast food restaurants ≤1 per month. Significant differences in BMI, body weight, percentage body fat, and fat mass index were also observed among provinces. Adiposity measures were positively associated with consumption of meat/poultry, fish, snack food, sweeteners, diet soft drinks, and frequenting fast food restaurants, and inversely associated with consumption of whole grains and green tea. Although all four provinces are in the Atlantic region, diet quality vary greatly among provinces and are associated with adiposity.

Measures of the food environment: A systematic review of the field, 2007-2015

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.

Assessing the Consumer Food Environment in Restaurants by Neighbourhood Distress Level across Saskatoon, Saskatchewan

PURPOSE

To assess the consumer food environment in restaurants in Saskatoon, using the Nutrition Environment Measures Survey for Restaurants (NEMS-R), to examine differences by neighbourhood distress level and to reflect on the need for further refinement of the assessment of restaurant consumer food environments.

METHODS

Neighbourhoods were classified as low, middle, or high distress level based on the socioeconomic indicators (income, employment, and education) in the Material Deprivation Index. Differences in restaurant consumer food environments, indicated by mean NEMS-R total and sub-scores, were examined by various restaurant categories and by varying neighbourhood distress levels.

RESULTS

Chain coffee shops and pita and sandwich restaurants had higher NEMS-R totals and "Healthy Entrées" sub-scores; however, burger and chicken restaurants and pizza restaurants had more barriers to healthful eating. Although restaurants in lower distress level neighbourhoods generally rated healthier (higher NEMS-R scores), only a few measures (such as "Facilitators" and "Barriers") significantly differed by neighbourhood distress level.

CONCLUSIONS

The findings highlight the importance of developing interventions to improve restaurant consumer food environments, especially in neighbourhoods with higher distress levels. The results suggest that reliable measures of the consumer food environment could be developed beginning with what can be measured by NEMS-R.

Health Implications of Adults' Eating at and Living near Fast Food or Quick Service Restaurants

Background:

This paper examined whether the reported health impacts of frequent eating at a fast food or quick service restaurant on health were related to having such a restaurant near home.

Methods:

Logistic regressions estimated associations between frequent fast food or quick service restaurant use and health status, being overweight or obese, having a cardiovascular disease or diabetes, as binary health outcomes. In all, 2001 participants in the 2008–2009 Seattle Obesity Study survey were included in the analyses.

Results:

Results showed eating ⩾2 times a week at a fast food or quick service restaurant was associated with perceived poor health status, overweight and obese. However, living close to such restaurants was not related to negative health outcomes.

Conclusions:

Frequent eating at a fast food or quick service restaurant was associated with perceived poor health status and higher body mass index, but living close to such facilities was not.

Food Retailers and Obesity

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.

The ethnoepidemiology of obesity

The prevalence of overweight and obesity varies significantly across ethnic groups and among aboriginal people in Canada and appears to be increasing overall in children and youth, which will have significant health consequences in the future. Individual health behaviours, genetic predisposition, and community-level factors all contribute to the high burden of overweight and obesity across communities in Canada. Preliminary studies indicate that individuals who live in neighbourhoods in Canada with increased walkability, fewer fast food outlets, and higher socioeconomic status have lower rates of overweight/obesity when compared with other neighbourhoods. However, more research is required to understand the impact of community level factors on overweight/obesity trends in Canadian ethnic groups, including children and youth, and aboriginal people.

Neighborhood disparities in access to healthy foods and their effects on environmental justice

Environmental justice is concerned with an equitable distribution of environmental burdens. These burdens comprise immediate health hazards as well as subtle inequities, such as limited access to healthy foods. We reviewed the literature on neighborhood disparities in access to fast-food outlets and convenience stores. Low-income neighborhoods offered greater access to food sources that promote unhealthy eating. The distribution of fast-food outlets and convenience stores differed by the racial/ethnic characteristics of the neighborhood. Further research is needed to address the limitations of current studies, identify effective policy actions to achieve environmental justice, and evaluate intervention strategies to promote lifelong healthy eating habits, optimum health, and vibrant communities.

Urban youths go 3000 miles: engaging and supporting young residents to conduct neighborhood asset mapping

In 2009, CARE (Community Alliance for Research and Engagement at Yale University) launched a multisectoral chronic disease prevention initiative that conducts baseline data collection, interventions, and follow-up data collection to measure change. Data collection includes asset mapping to assess environmental determinants of chronic disease risk factors in neighborhoods and around schools. CARE hired 7 local high school students to conduct asset mapping; they walked more than 3000 miles and collected 492 data points. Employing youths as community health workers to collect data greatly enriched the community research process and offered many advantages. We were able to efficiently and effectively conduct scientifically rigorous mapping while gaining entry into some of New Haven's most research-wary and skeptical neighborhoods.