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Oldroyd L, Eskandari F, Pratt C, Lake AA. The nutritional quality of food parcels provided by food banks and the effectiveness of food banks at reducing food insecurity in developed countries: a mixed-method systematic review. J Hum Nutr Diet 2022; 35:1202-1229. [PMID: 35112742 PMCID: PMC9790279 DOI: 10.1111/jhn.12994] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/13/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Research indicates that food parcels provided by food banks are nutritionally poor. Food insecurity and the use of food banks are both rising, with detrimental effects on the dietary intake and health of users. This mixed-method systematic review aims to investigate the current nutritional adequacy of pre-packaged food parcels and whether using food banks reduces the food insecurity and improves the dietary intake of their users. METHODS A mixed-method systematic literature review, restricted to articles published from 2015, was conducted using eight electronic databases, four grey literature databases and eight relevant websites. Quantitative findings, investigating the nutritional quality of food parcels and/or their impact on dietary intake or food insecurity, were presented narratively. Qualitative findings reporting the views of food bank users regarding food from food banks underwent thematic synthesis. These independent syntheses were integrated using configurative analysis and presented narratively. RESULTS Of 2189 articles, 11 quantitative and 10 qualitative were included. Food parcels were inconsistent at meeting nutritional requirements and often failed to meet individual needs, including cultural and health preferences. Using food banks improved food security and dietary quality of users, allowing otherwise unachievable access to food. However, food insecurity remained, and is explained by limited food variety, quality and choice. The mixed-method findings support interventions to ensure consistent, adequate nutrition at food banks, including catering for individual needs. CONCLUSIONS Food banks are a lifeline for those severely food insecure. However when used alone, food banks struggle to eliminate the heightened food insecurity of their users. Efforts to improve the nutritional quality of food parcels could improve the experiences and diet-related outcomes of those requiring food banks.
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Affiliation(s)
- Lucy Oldroyd
- Centre for Public Health Research, School of Health & Life SciencesTeesside UniversityMiddlesbroughUK
| | - Fatemeh Eskandari
- Centre for Public Health Research, School of Health & Life SciencesTeesside UniversityMiddlesbroughUK,Fuse, The Centre for Translational Research in Public HealthNewcastleUK
| | - Charlotte Pratt
- Centre for Public Health Research, School of Health & Life SciencesTeesside UniversityMiddlesbroughUK
| | - Amelia A. Lake
- Centre for Public Health Research, School of Health & Life SciencesTeesside UniversityMiddlesbroughUK,Fuse, The Centre for Translational Research in Public HealthNewcastleUK
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Warshawsky DN. Food insecurity and the covid pandemic: uneven impacts for food bank systems in Europe. AGRICULTURE AND HUMAN VALUES 2022; 40:725-743. [PMID: 36340280 PMCID: PMC9628314 DOI: 10.1007/s10460-022-10387-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 06/07/2023]
Abstract
Over the past few decades, large food banks that collect, warehouse, and redistribute food have become institutionalized across Europe. Although food banks gained increased visibility as important food relief mechanisms during the covid pandemic in 2020 and 2021, the crisis also highlighted their structural weaknesses and the fragility of the charity-based emergency food system. In particular, many European food banks faced higher costs, lower food stocks, uneven food donations, and lower numbers of volunteers and personnel as demand for food relief increased sharply. Also, many food banks lacked personal health and safety equipment for front-line staff and volunteers, many of whom were vulnerable or aged, thus forcing the closure of some charities due to health concerns. Yet, the impact of the pandemic was uneven across the continent as the covid pandemic strengthened some food banks while others were weakened. To explore these dynamics in detail, this paper utilizes in-depth interviews and surveys of key food bank operators in the Netherlands, Norway, and Greece to analyze how and why European food bank systems fared so differently from the pandemic. In short, the findings in this paper reveal how the Norwegian food bank system leveraged its position to increase fundraising and visibility, while the Netherlands food bank system suffered from long-term structural weaknesses, and the Greek food bank system was further embroiled in government tensions that threatened its existence. The preexisting structure of food bank systems, broader political economy, and historical context significantly impacted how food relief networks fared during the pandemic.
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Affiliation(s)
- Daniel N. Warshawsky
- School of Social Sciences and International Studies, Wright State University, 311 Millett Hall, 3640 Colonel Glenn Highway, Dayton, OH 45435 USA
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Rao M, Bast A, de Boer A. How COVID-19 impacted surplus food redistribution in the Netherlands: An explorative study. Food Secur 2022; 14:1377-1385. [PMID: 35634258 PMCID: PMC9123920 DOI: 10.1007/s12571-022-01291-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 04/17/2022] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic has been detrimental to food security globally. The Netherlands, despite its advanced stage of development, saw a surge in food insecurity among its most vulnerable citizens. Dutch food aid is managed by private charities and social organisations that often aim to address the problems of food insecurity and food waste by redistributing surplus food that is safe to consume. This paper investigates how the pandemic impacted surplus food redistribution in the country by employing an Exploratory-Descriptive-Qualitative approach. This is done by analysing data from interviews with relevant stakeholders involved in redistributing surplus food in the Netherlands as well as media reports on the topic. Our findings indicate that the interviewed organisations experienced drastic fluctuations in supply and demand. To cope with these changes, rapid organisational and supply chain innovation was observed. Next to this, there seems to have been disproportionate negative impact on smaller charities in comparison to bigger, better established organisations. Based on our findings, we discuss what the future of surplus food distribution in the Netherlands might look like and why changes made during the pandemic must be well documented and carefully analysed.
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Affiliation(s)
- Madhura Rao
- Food Claims Centre Venlo, Maastricht University, Campus Venlo, Maastricht, the Netherlands
| | - Aalt Bast
- University College Venlo, Maastricht University, Campus Venlo, Maastricht, the Netherlands
- Department of Pharmacology & Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Alie de Boer
- Food Claims Centre Venlo, Maastricht University, Campus Venlo, Maastricht, the Netherlands
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Wang X, Wang S, Zhang C, Zhong L, Lerman L, Lerman A, Guo Y, Wu Y, Lopez-Jimenez F. Internet-based platform for a low-calorie dietary intervention involving prepackaged food for weight loss in overweight and obese individuals in China: protocol for a randomised controlled trial. BMJ Open 2022; 12:e048106. [PMID: 35063952 PMCID: PMC8785159 DOI: 10.1136/bmjopen-2020-048106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Obesity is a global health issue that impacts quality of life. A calorie-restricted diet with high-intensity consultation provided via the internet may be an effective way to lose weight. The objective of this study was to assess the effectiveness of a practitioner-guided, mobile internet-based low-energy dietary intervention in overweight and obese populations in China. METHODS AND ANALYSIS This open-label randomised controlled trial enrolled 220 overweight and obese adults aged 18-70 years who met the inclusion criteria. Participants were assigned to the control group (n=110) or trial group (n=110). The trial group will be enrolled in the MetaWell programme, a weight loss programme using diet replacement products, wireless scales and a mobile phone app. Participants in the control group will receive paper material containing a sample diet for weight loss. The follow-up period will be 1 year, and measurements will occur at 3, 6 and 12 months. Dual-emission X-ray absorptiometry and abdominal quantitative CT will be performed to estimate the percentage of overall body fat and areas of visceral and subcutaneous fat, alongside several cardiometabolic measurements. The primary outcome of this study is the change in body mas index (BMI) at 6 months after enrolment. A mixed-effects model will be used to compare BMI and body fat changes between the two groups. ETHICS AND DISSEMINATION This study was approved by the ethics committee of the Hospital of Chengdu Office of the People's Government of the Tibetan Autonomous Region. Advertisements for recruitment will be sent via official accounts using WeChat. The results will be disseminated via publications in academic journals and our clinic. Our study group will maintain contact with the participants to inform them of the study findings. TRIAL REGISTRATION NUMBER ChiCTR1900021630.
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Affiliation(s)
- Xi Wang
- Endocrinology department, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | - Suyuan Wang
- Endocrinology department, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | - Chenghui Zhang
- Endocrinology department, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | - Lingyu Zhong
- .Clinical nutrition department, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | - Lilach Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Yanhong Guo
- Endocrinology department, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | - Yunhong Wu
- Endocrinology department, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
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The Nutritional Content of Rescued Food Conveyed by a Food Aid Organization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212212. [PMID: 34831968 PMCID: PMC8624580 DOI: 10.3390/ijerph182212212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022]
Abstract
Background: The number of food-insecure families in the European Union has increased, resulting in an increasing number of households depending on food assistance programs. The aim in this study was to evaluate the nutrient content of food rescued by a food aid organization that rescues and redistributes fresh or freshly cooked food to low-income households. Methods: To determine the nutritional content of food hampers provided by our case study organization, we weighed all items of food hampers in three weighing rounds over a period of four months. The Food Insecurity Experience Scale (FIES) was applied to measure households’ food insecurity. Results: Our results show that, at our case study food aid organization, food donations substantially contribute to energy, macro, and micronutrient dietary recommendation intake (DRI). Conclusions: When evaluating how these nutrients contribute to alleviating food insecurity of the beneficiary households, we found that the perception of food insecurity is independent of the amount of nutrients served. To the best of our knowledge, this is the first study measuring the nutritional content of fresh or freshly cooked rescued food conveyed by a food aid organization.
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Rao M, Bilić L, Duwel J, Herentrey C, Lehtinen E, Lee M, Díaz Calixto MA, Bast A, de Boer A. Let Them Eat Fish!-Exploring the Possibility of Utilising Unwanted Catch in Food Bank Parcels in The Netherlands. Foods 2021; 10:foods10112775. [PMID: 34829053 PMCID: PMC8620036 DOI: 10.3390/foods10112775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
The Common Fisheries Policy of the European Union was reformed in 2013 with the aim of improving the sustainability of the fishing sector. The Landing Obligation, a cornerstone of this reform, requires fishers to land their unwanted catch instead of discarding it at sea. Existing literature pays little attention to what becomes of this unwanted catch once it is landed. To further the discourse on the sustainable valorisation of unwanted catch, this study explores whether unwanted catch that is safe for human consumption could be used for improving food security. The paper focuses on Dutch food banks, which deliver critical food aid to over 160,000 individuals yearly but struggle to provide all dependant recipients with nutritionally balanced food parcels. The research question is addressed in two ways. The food bank recipients’ willingness to consume UWC is evaluated quantitatively through a survey. Next to this, data from interviews with relevant stakeholders are analysed qualitatively. Results indicate that the Food Bank Foundation and its recipients are willing to receive this fish if it is safe to consume and accessible. However, various factors such as existing infrastructure, lack of economic incentive to donate, competition from non-food and black markets, and the fishing industry’s conflict with the landing obligation might pose barriers to this kind of valorisation. The dissonance between fisheries, food, and sustainability policies is discussed and identified as a key limiting factor. To bridge the differences between these policy areas, we propose public-private partnerships and voluntary agreements among involved stakeholders.
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Affiliation(s)
- Madhura Rao
- Campus Venlo, Food Claims Centre Venlo, Faculty of Science and Engineering, Maastricht University, 5900 AA Venlo, The Netherlands;
- Correspondence: ; Tel.: +31-433883666
| | - Lea Bilić
- Campus Venlo, University College Venlo, Maastricht University, 5900 AA Venlo, The Netherlands; (L.B.); (J.D.); (C.H.); (E.L.); (M.L.); (M.A.D.C.); (A.B.)
| | - Joanna Duwel
- Campus Venlo, University College Venlo, Maastricht University, 5900 AA Venlo, The Netherlands; (L.B.); (J.D.); (C.H.); (E.L.); (M.L.); (M.A.D.C.); (A.B.)
| | - Charlotte Herentrey
- Campus Venlo, University College Venlo, Maastricht University, 5900 AA Venlo, The Netherlands; (L.B.); (J.D.); (C.H.); (E.L.); (M.L.); (M.A.D.C.); (A.B.)
| | - Essi Lehtinen
- Campus Venlo, University College Venlo, Maastricht University, 5900 AA Venlo, The Netherlands; (L.B.); (J.D.); (C.H.); (E.L.); (M.L.); (M.A.D.C.); (A.B.)
| | - Malin Lee
- Campus Venlo, University College Venlo, Maastricht University, 5900 AA Venlo, The Netherlands; (L.B.); (J.D.); (C.H.); (E.L.); (M.L.); (M.A.D.C.); (A.B.)
| | - María Alejandra Díaz Calixto
- Campus Venlo, University College Venlo, Maastricht University, 5900 AA Venlo, The Netherlands; (L.B.); (J.D.); (C.H.); (E.L.); (M.L.); (M.A.D.C.); (A.B.)
| | - Aalt Bast
- Campus Venlo, University College Venlo, Maastricht University, 5900 AA Venlo, The Netherlands; (L.B.); (J.D.); (C.H.); (E.L.); (M.L.); (M.A.D.C.); (A.B.)
- Department of Pharmacology & Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Alie de Boer
- Campus Venlo, Food Claims Centre Venlo, Faculty of Science and Engineering, Maastricht University, 5900 AA Venlo, The Netherlands;
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Hardcastle SJ, Caraher M. The role of foodbanks in the context of food insecurity: Experiences and eating behaviours amongst users. Appetite 2021; 163:105208. [PMID: 33774137 DOI: 10.1016/j.appet.2021.105208] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/24/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
The study aim was to investigate the role of foodbanks in the context of food insecurity and explore food choices and eating behaviours amongst users. Food insecurity is associated with poor diet quality and obesity; however, the dimensions that influence food choices and eating behaviour remain unclear. Face-to-face interviews were conducted with individuals who had visited a faith-based foodbank in Perth, Western Australia. Participants were thirty-three service users who had collected a food hamper from the foodbank. Interview transcripts were analyzed using thematic analysis. Four main themes emerged: Ties you over until pay day; Food hamper supporting meals and fruit and vegetable consumption; Food choices supplementing hamper; Household gatekeeping and food control. Participants were complimentary about the content of the food hamper received which included a variety of fresh produce. A key new finding was the frequent purchase and consumption of meat and processed meat to supplement the food hamper provision. Future work and interventions to improve eating behaviour and reduce food-related financial pressure for those vulnerable to food insecurity include further exploration of the dimensions influencing food choices (i.e., cultural norms, habits, symbols); exposure to healthy and tasty plant-based meals, (i.e., tasting low-cost and tasty vegetable-based meals); parenting training focused on handling child/partner food choice influences, and, enforcing household rules governing food.
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Affiliation(s)
- Sarah J Hardcastle
- Dublin City University, Glasnevin, Dublin, Ireland; Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.
| | - Martin Caraher
- Centre for Food Policy, City, University of London, London, UK
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8
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The role of food parcel use on dietary intake: perception of Dutch food bank recipients - a focus group study. Public Health Nutr 2020; 23:1647-1656. [PMID: 32066521 DOI: 10.1017/s1368980019003823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To gain insight in Dutch food bank recipients' perception on the content of the food parcels, their dietary intake and how the parcels contribute to their overall dietary intake. DESIGN Eleven semi-structured focus group discussions were conducted. Focus group topics were based on Andersons food insecurity definition: the lack of availability of nutritionally adequate foods and the assured ability to acquire foods in socially acceptable ways. Data were coded and analysed with Atlas.ti 7.0 software, using the framework approach. SETTING Seven food banks throughout the Netherlands. PARTICIPANTS A total of 44 Dutch food bank recipients. RESULTS Food bank recipients were not always satisfied with the amount, quality, variation and type of foods in the food parcel. For the participants who could afford to, supplementing the food parcel was reported as main reason for buying foods, and price was the most important aspect in selecting these foods. Participants were not satisfied with their dietary intake; they mainly reported not having enough to eat. The content of the food parcel importantly influenced participants' overall dietary intake. Finally, participants reported struggling with their feelings of dissatisfaction, while also being grateful for the foods they receive. CONCLUSIONS This study suggests that, despite their best efforts, food banks are not meeting food bank recipients' needs. Our results provide valuable directions for improving the content of the food parcels by increasing the quantity, quality and variation in the foods supplied. Whether this also improves the dietary intake of recipients needs to be determined.
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Improving the dietary quality of food parcels leads to improved dietary intake in Dutch food bank recipients-effects of a randomized controlled trial. Eur J Nutr 2020; 59:3491-3501. [PMID: 31996978 PMCID: PMC7669798 DOI: 10.1007/s00394-020-02182-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 01/08/2020] [Indexed: 11/29/2022]
Abstract
Purpose Since food banks have a strong influence on recipients’ diets, and seem to have difficulties in supporting healthy diets, improving the dietary quality of food parcels is important. The aim of our study was to assess whether improving the dietary quality of food parcels, using different strategies, can positively impact the actual dietary intake of Dutch food bank recipients. Methods This randomized cross-over controlled trial (Trial ID: ISRCTN40554133) with four intervention conditions [(1) Control (standard food parcel), (2) snacks– (standard food parcel with replacement of unhealthy snacks by staple foods), (3) FV+ (standard food parcel plus the recommended daily amount of fruit and vegetables), (4) snacks– + FV+ (standard food parcel with replacement of unhealthy snacks by staple foods plus the recommended daily amount of fruit and vegetables)] included 163 food bank recipients, from three food banks. At baseline, participants filled in a questionnaire. Dietary intake data were collected through 24-h recalls after both intervention conditions at 4 and 8 weeks follow-up. Primary outcome was daily fruit and vegetable intake, secondary outcomes were daily dietary intakes of food groups and nutrients. Results Multi-level linear regression analysis, using a two-level model, showed a higher mean daily fruit intake in participants in the FV+ condition than in participants in the Control condition (delta (δ): 74 [40.3;107.6] g). Both mean daily fruit and vegetable intake were higher in participants in the Snacks– + FV+ condition than in participants in the Control condition (fruit δ: 81.3 [56.5;106.2] g; vegetables δ: 46.2 [17.5;74.9] g), as well as in the Snacks– condition (fruit δ: 70.0 [38.8;101.1] g; vegetables δ: 62.2 [26.2; 98.2] g). Conclusions This study shows that improving the dietary quality of food parcels can positively impact the dietary intake of Dutch food bank recipients. With this information we can further develop effective strategies that can be easily applied by food banks, to improve dietary intake of food bank recipients.
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van der Velde LA, Schuilenburg LA, Thrivikraman JK, Numans ME, Kiefte-de Jong JC. Needs and perceptions regarding healthy eating among people at risk of food insecurity: a qualitative analysis. Int J Equity Health 2019; 18:184. [PMID: 31775770 PMCID: PMC6880580 DOI: 10.1186/s12939-019-1077-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/21/2019] [Indexed: 12/24/2022] Open
Abstract
Background Healthy eating behaviour is an essential determinant of overall health. This behaviour is generally poor among people at risk of experiencing food insecurity, which may be caused by many factors including perceived higher costs of healthy foods, financial stress, inadequate nutritional knowledge, and inadequate skills required for healthy food preparation. Few studies have examined how these factors influence eating behaviour among people at risk of experiencing food insecurity. We therefore aimed to gain a better understanding of the needs and perceptions regarding healthy eating in this target group. Methods We conducted a qualitative exploration grounded in data using inductive analyses with 10 participants at risk of experiencing food insecurity. The analysis using an inductive approach identified four core factors influencing eating behaviour: Health related topics; Social and cultural influences; Influences by the physical environment; and Financial influences. Results Overall, participants showed adequate nutrition knowledge. However, eating behaviour was strongly influenced by both social factors (e.g. child food preferences and cultural food habits), and physical environmental factors (e.g. temptations in the local food environment). Perceived barriers for healthy eating behaviour included poor mental health, financial stress, and high food prices. Participants had a generally conscious attitude towards their financial situation, reflected in their strategies to cope with a limited budget. Food insecurity was mostly mentioned in reference to the past or to others and not to participants’ own current experiences. Participants were familiar with several existing resources to reduce food-related financial strain (e.g. debt assistance) and generally had a positive attitude towards these resources. An exception was the Food Bank, of which the food parcel content was not well appreciated. Proposed interventions to reduce food-related financial strain included distributing free meals, facilitating social contacts, increasing healthy food supply in the neighbourhood, and lowering prices of healthy foods. Conclusion The insights from this study increase understanding of factors influencing eating behaviour of people at risk of food insecurity. Therefore, this study could inform future development of potential interventions aiming at helping people at risk of experiencing food insecurity to improve healthy eating, thereby decreasing the risk of diet-related diseases.
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Affiliation(s)
- Laura A van der Velde
- Department of Public Health and Primary Care/ LUMC-Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
| | - Linde A Schuilenburg
- Department of Public Health and Primary Care/ LUMC-Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
| | - Jyothi K Thrivikraman
- Faculty of Governance and Global Affairs, Leiden University College, The Hague, The Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care/ LUMC-Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care/ LUMC-Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands. .,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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11
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Efrati Philip D, Baransi G, Shahar DR, Troen AM. Food-Aid Quality Correlates Positively With Diet Quality of Food Pantry Users in the Leket Israel Food Bank Collaborative. Front Nutr 2018; 5:123. [PMID: 30619869 PMCID: PMC6305620 DOI: 10.3389/fnut.2018.00123] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/22/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction: In many affluent countries, including Israel, networks of food banks and pantries have increasing responsibility to alleviate endemic poverty and food insecurity. While they may relieve acute hunger, their long-term influence on health and well-being is poorly understood. Methods: An exploratory cross-sectional telephone survey assessed both adequacy and quality of food aid provided via food pantries in the Leket Israel food bank network, in relation to recipients' dietary needs and health. The quality of food baskets and recipient diets were given a Healthy Portions Score (HPS) to measure compliance with Government guidelines for a “Basic Healthy Food Basket,” and a Nutrient Density Score (NDS) to capture how well the food achieved the recommended dietary allowance (RDA) for vital macro and micronutrients. A total of 105 pantry users were surveyed from 16 pantries around the country. Results: The basket HPS correlated positively and highly significantly with dietary quality (individual NDS) after adjusting for gender, marital status and country of birth (standardized β = 0.22, p = 0.03). Nearly half (46%) reported food insecurity with hunger. Two thirds were overweight or obese, and anemia, cardiovascular and metabolic disease were prevalent. The average food basket provides 30% of energy, 55% of protein, 50% of fiber, but only 33% or less of the household requirement for most minerals and vitamins. Only 60% of participants met their estimated energy requirements, and the intake of many essential micronutrients was well below the RDA. Fruits and vegetable portions contributed by Leket Israel correlated positively with the dietary quality (individual NDS) after adjustment for the same covariates (Standardized β = 0.20, p = 0.04). Discussion: A structured telephone survey proved a feasible method to study the impact of food-aid quality on the nutrition and health of food pantry users in an affluent country. Food baskets with fruits, vegetables and higher quality nutrition were correlated with healthier diets among the recipients. Data correlating food-aid quality and recipient diet and health is essential to effective policy making.
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Affiliation(s)
- Dana Efrati Philip
- The Nutrition and Brain Health Laboratory, The Institute of Biochemistry Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ghada Baransi
- The Nutrition and Brain Health Laboratory, The Institute of Biochemistry Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Danit R Shahar
- Department of Public Health, Faculty of Health Sciences, The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Aron M Troen
- The Nutrition and Brain Health Laboratory, The Institute of Biochemistry Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Graça P, Gregório MJ, de Sousa SM, Brás S, Penedo T, Carvalho T, Bandarra NM, Lima RM, Simão AP, Goiana-da-Silva F, Freitas MG, Araújo FF. A new interministerial strategy for the promotion of healthy eating in Portugal: implementation and initial results. Health Res Policy Syst 2018; 16:102. [PMID: 30376876 PMCID: PMC6208124 DOI: 10.1186/s12961-018-0380-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To describe the implementation, main intervention areas and initial results of the Integrated Strategy for the Promotion of Healthy Eating (EIPAS) in Portugal. METHODS EIPAS was published as a Law, in December of 2017, as a result of a collaboration between several ministries, including the Finance, Internal Affairs, Education, Health, Economy, Agriculture, and Sea Ministries, aiming at improving the dietary habits of the Portuguese population. The working group, led by the Ministry of Health, developed this strategy for over a year. The framework produced was based on WHO and European Commission recommendations as well as on relevant data from the last Portuguese dietary intake survey (2015/2016). EIPAS also reflects the results of a public hearing, including the food industry, among others, and the experience gathered, since 2012, through the National Programme for the Promotion of Healthy Eating. It considers the 'health in all policies' challenge set by WHO and has four different strategic areas, namely (1) creation of healthier food environments, (2) improvement of the quality and accessibility of healthy food choices for consumers, (3) promotion and development of literacy, in order to encourage healthy food choices, and (4) promotion of innovation and entrepreneurship. In order to achieve these goals, a set of 51 actions was established and assigned to the seven ministries involved. RESULTS Under the scope of this strategy, Portugal has already implemented several actions, including (1) definition of standards for food availability at all public healthcare institutions; (2) implementation of a sugar tax on sweetened beverages; (3) implementation of a voluntary agreement with the food industry sector for food reformulation (work in progress); (4) design of a proposal for an interpretative model of front-of-pack food labelling; (5) improvement of the nutritional quality of food aid programmes for low-income groups; and (6) regulation of marketing of unhealthy foods to children. CONCLUSIONS For the first time, Portugal has a nutrition policy based on the WHO concept of 'health in all policies' and on the national data on food intake. The implementing process of all 51 actions and the inherent complexities and difficulties found so far have made this process be an authentic political and social laboratory that deserves to be followed.
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Affiliation(s)
- Pedro Graça
- National Programme for the Promotion of Healthy Eating, Directorate-General of Health, Lisbon, Portugal.,Faculty of Nutrition and Food Sciences of University of Porto, Porto, Portugal
| | - Maria João Gregório
- National Programme for the Promotion of Healthy Eating, Directorate-General of Health, Lisbon, Portugal. .,Faculty of Nutrition and Food Sciences of University of Porto, Porto, Portugal. .,EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisbon, Portugal.
| | - Sofia Mendes de Sousa
- National Programme for the Promotion of Healthy Eating, Directorate-General of Health, Lisbon, Portugal
| | - Sónia Brás
- Technical Experts of the Cabinet of the Secretary of State for local Administration, Lisbon, Portugal
| | - Tatiana Penedo
- Technical Experts of the Cabinet of the Secretary of State for local Administration, Lisbon, Portugal
| | - Telmo Carvalho
- Department of Sea and Marine Resources, Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho, 1495-006, Lisbon, Portugal.,Ministry of Sea, Lisbon, Portugal
| | - Narcisa M Bandarra
- Department of Sea and Marine Resources, Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho, 1495-006, Lisbon, Portugal
| | | | - Ana Paula Simão
- Legal Advisor to the Secretary of State of Industry, Lisbon, Portugal
| | - Francisco Goiana-da-Silva
- Department of Surgery and Cancer, Imperial College Medical School, London, United Kingdom.,Invited Assistant of Management and Leadership on Health, Health Sciences Faculty of Beira Interior University, Covilhã, Portugal
| | | | - Fernando Ferreira Araújo
- Secretário de Estado Adjunto e da Saúde, XXI Governo Constitucional, Lisbon, Portugal.,Invited Professor of Faculty of Medicine of University of Porto, Porto, Portugal
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Gregório MJ, Rodrigues AM, Graça P, de Sousa RD, Dias SS, Branco JC, Canhão H. Food Insecurity Is Associated with Low Adherence to the Mediterranean Diet and Adverse Health Conditions in Portuguese Adults. Front Public Health 2018. [PMID: 29515992 PMCID: PMC5826370 DOI: 10.3389/fpubh.2018.00038] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Food insecurity is a limited or uncertain access to the adequate food and is a significant public health problem. We aimed to assess determinants of food insecurity and the corresponding health impact in Portugal, a southern European country that faced a severe economic crisis. Methods Data were derived from the Epidemiology of Chronic Diseases Cohort Study (EpiDoC), a population-based cohort of 10,661 individuals that were representative of the Portuguese adult population and followed since 2011. A cross-sectional analysis of the third wave of evaluation (EpiDoC 3) was performed between 2015 and 2016. Food insecurity was assessed with the household food insecurity psychometric scale. Socioeconomic, demographic, lifestyle, adherence to Mediterranean diet (MD), self-reported non-communicable disease, health-related quality of life (HRQoL) (EQ-5D-3L), physical function (HAQ score), and health resource consumption information was also collected. Results The estimated proportion of food insecurity was 19.3% among a total of 5,653 participants. Food insecure households had low adherence to the MD (OR = 0.44; 95% IC 0.31–0.62). In addition, diabetes (OR = 1.69; 95% IC 1.20–2.40), rheumatic disease (OR = 1.67; 95% IC 1.07–2.60), and depression symptoms (OR = 1.50; 95% IC 1.09–2.06) were independently associated with food insecurity. On average, food insecure households had a lower HRQoL (OR = 0.18; 95% IC 0.11–0.31) and a higher disability (OR = 2.59; 95% IC 2.04–3.29). A significantly higher proportion of food insecure households reported being hospitalized (OR = 1.57; 95% IC 1.18–2.07) and had more public hospital medical appointments (OR = 1.48; 95% IC 1.12–1.94) in the previous 12 months. Conclusion We found that food insecurity is highly prevalent in Portugal. Food insecurity was associated with low adherence to the MD, non-communicable chronic diseases, lower quality of life, and higher health resource consumption. Therefore, this study provides valuable insight into the relationship between food security and the diet and health of the population during an economic crisis.
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Affiliation(s)
- Maria João Gregório
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal.,Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Lisboa, Portugal.,EpiSaúde Scientific Association, Évora, Portugal
| | - Ana M Rodrigues
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.,EpiSaúde Scientific Association, Évora, Portugal.,Sociedade Portuguesa de Reumatologia, Lisboa, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal
| | - Pedro Graça
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal.,Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Lisboa, Portugal
| | - Rute Dinis de Sousa
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.,EpiSaúde Scientific Association, Évora, Portugal
| | - Sara S Dias
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.,EpiSaúde Scientific Association, Évora, Portugal.,Unidade de Investigação em Saúde (UI), Escola Superior de Saúde do Instituto Politécnico de Leiria, Leiria, Portugal
| | - Jaime C Branco
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.,EpiSaúde Scientific Association, Évora, Portugal.,Sociedade Portuguesa de Reumatologia, Lisboa, Portugal.,Serviço de Reumatologia do Hospital Egas Moniz - Centro Hospitalar Lisboa Ocidental (CHLO-E.P.E.), Lisboa, Portugal
| | - Helena Canhão
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.,EpiSaúde Scientific Association, Évora, Portugal.,Sociedade Portuguesa de Reumatologia, Lisboa, Portugal.,Escola Nacional de Saúde Pública da Universidade Nova de Lisboa, Lisboa, Portugal.,Serviço Reumatologia, Centro Hospitalar Lisboa Central-HSM, Lisboa, Portugal
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