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Antonacci CC, Kegler MC, Bigger L, Hermstad A, Ebey-Tessendorf K, Haardörfer R. Individual- and environmental-level determinants of fruit and vegetable intakes in rural Georgia. J Rural Health 2024. [PMID: 39344063 DOI: 10.1111/jrh.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/29/2024] [Accepted: 09/09/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVE To investigate the ways in which food insecurity, food acquisition behaviors, and perceived and objective food access influence fruit and vegetable intakes among rural Georgians. DESIGN A population-based survey was merged with USDA's Food Access Research Atlas, and multilevel modeling was used to determine individual-level (eg, food insecurity, food acquisition behaviors, perceived access) and environmental-level (eg, census tract food access) predictors of fruit and vegetable intakes. SETTING Twenty-four rural census tracts in 6 counties in Georgia, USA. PARTICIPANTS One thousand four hundred and seventy-four adults. RESULTS Residing in a low food access census tract was not associated with fruit or vegetable intake. Food insecurity had negative effects on both fruit and vegetable intakes. Perceived access to fresh fruits and vegetables was positively associated with fruit intake, and obtaining fresh fruits and vegetables from community or home gardens was positively associated with both fruit and vegetable intakes. CONCLUSIONS Findings are unique from previous research on census tract-level fruit and vegetable determinants, underscoring the need for a better understanding of influences on fruit and vegetable intakes among rural populations. Interventions to increase fruit and vegetable consumption in rural areas should prioritize food security.
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Affiliation(s)
- Cerra C Antonacci
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Michelle C Kegler
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lauren Bigger
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - April Hermstad
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Karen Ebey-Tessendorf
- Georgia Department of Public Health North Central Health District, Macon, Georgia, USA
| | - Regine Haardörfer
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Gálvez Espinoza P, Rodríguez Osiac L, Franch Maggiolo C, Egaña Rojas D. Rethinking the Social Determination of Food in Chile Through Practices and Interactions of Actors in Food Environments: Nonexperimental, Cross-Sectional Study. JMIR Res Protoc 2024; 13:e62765. [PMID: 39270213 PMCID: PMC11437218 DOI: 10.2196/62765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Food environments are crucial for promoting healthy and sustainable eating and preventing obesity. However, existing food environment frameworks assume an already installed causality and do not explain how associations in food environments are established or articulated, especially from an integrative and transdisciplinary approach. This research attempts to bridge these gaps through the use of Actor-Network Theory, which traces the relationship network between human (and nonhuman) actors in order to describe how these interact and what agencies (direct or remote) are involved. OBJECTIVE This study aims to explain the practices and interactions of actors in food environments in order to approach the problem of unhealthy eating with a transdisciplinary approach. METHODS This is a nonexperimental, cross-sectional study. Due to the complexity of the study phenomena, a mixed methods approach with 4 consecutive phases will be developed in Chile. Phase 1 involves a systematic literature review of food environment evidence since 2015, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol; phase 2 involves the application of a shortened version of the Nutrition Environment Measure Scale-Perceptions adapted to Chile (NEMS-P-Ch) in 2 neighborhoods with different socioeconomic levels; in phase 3, six focus groups in each neighborhood will be conducted to address social determinants such as gender, employment status, and migration; and in phase 4, participant observation and in-depth interviews will be used to analyze the direct and empirical exploration of the actors in their daily interaction with food environments. The triangulation and complementarity of the data will allow us to create a practical model about the practices and interactions of actors in their food environments, which reflects the complexity and transdisciplinary nature of the study. RESULTS We have advanced in phases 1-3 of the study. In phase 1, a total of 109 manuscripts are being revised for data extraction. In phase 2, we applied the NEMS-P-Ch to 785 people, 49.4% (388/785) of whom belong to a low socioeconomic neighborhood. Participants from phase 2 are being contacted to participate in the focus groups (phase 3). By the end of July, we have conducted 6 focus groups with 5-11 participants. CONCLUSIONS This study will provide a comprehensive understanding of how individuals interact with their food environments, offering deep insights into the factors influencing their food-related decisions. In addition, the study aims to develop a model that more accurately reflects reality by examining not only the food environments themselves but also the interactions among various stakeholders within these environments and their daily practices. The findings of this study will offer evidence-based insights to inform public policies tailored to the specific territories and communities under investigation or those with similar characteristics. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/62765.
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Affiliation(s)
| | | | | | - Daniel Egaña Rojas
- Department of Primary Care and Family Health, Universidad de Chile, Santiago, Chile
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Abrams EJ, Jao J, Madlala HP, Zerbe A, Catalano P, Gerschenson M, Goedecke JH, Gomba Y, Josefson J, Kurland IJ, Legbedze J, McComsey GA, Matyesini S, Mukonda E, Robinson D, Myer L. An observational cohort study to investigate the impact of dolutegravir in pregnancy and its obesogenic effects on the metabolic health of women living with HIV and their children: Study protocol. PLoS One 2024; 19:e0307296. [PMID: 39159183 PMCID: PMC11332920 DOI: 10.1371/journal.pone.0307296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Dolutegravir (DTG)-based antiretroviral therapy is the World Health Organization's preferred first-line regimen for all persons with HIV, including pregnant women. While DTG has been implicated as an obesogen associated with greater weight gain compared to other antiretrovirals, there is a paucity of data in pregnant women and their children. The Obesogenic oRigins of maternal and Child metabolic health Involving Dolutegravir (ORCHID) study is investigating associations between DTG, weight gain, and metabolic outcomes in the context of HIV. MATERIALS & METHODS ORCHID is a prospective observational study taking place in Cape Town, South Africa (NCT04991402). A total of 1920 pregnant women with and without HIV infection are being followed from ≤18 weeks gestational age to 24 months postpartum with their children. Participants attend eleven study visits: 3 antenatal, delivery, and 7 postnatal visits. Several embedded sub-studies address specific scientific aims. Primary outcome measurements in mothers include anthropometry, blood pressure, body composition, dysglycemia, insulin resistance (IR), and dyslipidemia. Other maternal measures include demographics, resting energy expenditure, viral load, physical activity, dietary intake, hepatic steatosis, and repository specimens. Sub-study measurements include markers of adipose inflammation, gut integrity, and satiety/hunger, subcutaneous adipose tissue morphology and mitochondrial function, and metabolomics. Primary outcome measurements in children include anthropometry, adipose tissue mass, dysglycemia, IR, and dyslipidemia. Other variables include fetal growth, birth outcomes, medical/breastfeeding history, caloric intake, neurodevelopment, and repository specimens. Sub-study measurements include metabolites/lipid subspecies in umbilical cord blood, as well as breast milk composition and DTG exposure. DISCUSSION ORCHID will play a pivotal role in defining obesogenic mechanisms and clinical consequences of DTG use in pregnancy in women with HIV and their children. It will provide insights into metabolic disease risk reduction in the context of HIV/DTG, identify intervention targets, and inform public health approaches to diminish chronic metabolic co-morbidities for women and children.
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Affiliation(s)
- Elaine J. Abrams
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, United States of America
| | - Jennifer Jao
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Hlengiwe P. Madlala
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Western Cape, Cape Town, South Africa
| | - Allison Zerbe
- ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Patrick Catalano
- Maternal Infant Research Institute, Obstetrics and Gynecology Research, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Tufts University, Boston, MA, United States of America
| | - Mariana Gerschenson
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States of America
| | - Julia H. Goedecke
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Division of Physiological Sciences, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Yolanda Gomba
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Western Cape, Cape Town, South Africa
| | - Jami Josefson
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Irwin J. Kurland
- Department of Medicine, Stable Isotope and Metabolomics Core Facility, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Justine Legbedze
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Grace A. McComsey
- University Hospitals Health System, Cleveland, OH, United States of America
- Department of Medicine and Pediatrics of Case Western Reserve University, Cleveland, OH, United States of America
| | - Sandisiwe Matyesini
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Western Cape, Cape Town, South Africa
| | - Elton Mukonda
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Western Cape, Cape Town, South Africa
| | - Daniel Robinson
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Western Cape, Cape Town, South Africa
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Inaç Y, D'Hooghe S, De Ridder K, Dury S, Van de Weghe N, De Clercq EM, Van Dyck D, Deforche B, Vandevijvere S. Determinants of food insecurity among adults residing in peri-urban municipal settings in Flanders, Belgium. BMC Public Health 2024; 24:2034. [PMID: 39075409 PMCID: PMC11287922 DOI: 10.1186/s12889-024-19389-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/05/2024] [Indexed: 07/31/2024] Open
Abstract
Food insecurity is a global public health issue associated with noncommunicable diseases. Individual factors are strongly associated with food insecurity, but there is limited literature on the broader impact of both the social and food environments on food insecurity in non-English speaking European countries, given that the research was predominantly conducted in Anglophone settings. In addition, these studies have mostly been conducted in urban areas. Therefore, this study aimed to identify the main determinants of food insecurity among adults living in peri-urban areas in Flanders, Belgium. Data on socio-demographics, neighborhood social cohesion, social isolation, and perceived food environments were collected from 567 adults through a self-administered questionnaire, and objective data on the food environment were obtained through (commercial) databases on food outlets. Food insecurity was measured using the USDA Household Food Security Survey Module. Multivariable logistic regression models revealed that lower socioeconomic status (OR14.11,95%CI:4.72;61.11), reasonable (OR4.16,95%CI: 2.11;8.47) to poor and very poor (OR6.54,95%CI: 2.11;8.47) subjective health status, and living in private (OR7.01, 95% CI:3.0;17.0) or government-assisted (OR6.32,95%CI: 3.13;13.26) rental housing significantly increased the odds of food insecurity. Additionally, residing in a neighborhood with low (OR2.64, 95% CI:1.13;6.26) to medium (OR2.45,95% CI:1.21;5.11) social cohesion, having a neutral opinion (OR4.12,95%CI:1.51;11.54) about the availability of fruit and vegetables in one's neighborhood, and having an opinion that fruit and vegetable prices are too expensive (OR5.43,95% CI 2.26;14.4) significantly increased the odds of experiencing food insecurity. This study underscores the need for policies that consider factors related to social and food environments, in addition to individual factors, to effectively address food insecurity.
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Affiliation(s)
- Yasemin Inaç
- Sciensano, Department of Epidemiology and Public Health, Brussels, Belgium.
- Sciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium.
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Adult Educational Sciences, Brussels, Belgium.
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
| | - Suzannah D'Hooghe
- Sciensano, Department of Epidemiology and Public Health, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Adult Educational Sciences, Brussels, Belgium
| | - Karin De Ridder
- Sciensano, Department of Epidemiology and Public Health, Brussels, Belgium
| | - Sarah Dury
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Adult Educational Sciences, Brussels, Belgium
| | - Nico Van de Weghe
- Faculty of Sciences, Department of Geography, Ghent University, Ghent, Belgium
| | - Eva M De Clercq
- Sciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium
| | - Delfien Van Dyck
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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Kennedy L, Holt T, Hunter A, Golshan S, Cadenhead K, Mirzakhanian H. Development of an anti-inflammatory diet for first-episode psychosis (FEP): a feasibility study protocol. Front Nutr 2024; 11:1397544. [PMID: 39131737 PMCID: PMC11310932 DOI: 10.3389/fnut.2024.1397544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/17/2024] [Indexed: 08/13/2024] Open
Abstract
Background Evidence suggests inflammation plays a role in the pathophysiology of psychosis even in early illness, indicating a potential avenue for anti-inflammatory interventions that simultaneously address high rates of metabolic disease in this population. The aim of this study is to design a novel anti-inflammatory diet intervention (DI) that is feasible to implement in a first-episode psychosis (FEP) population. Methods Eligible FEP Participants are aged 15-30. The DI is currently being refined through a multi-phase process that includes the recruitment of focus groups that provide insight into feasibility of measures and nutritional education, as well as the implementation of the DI. The phases in the study are the Development Phase, Formative Phase, and the Feasibility Phase. Results The Development phase has resulted in the creation of a flexible DI for FEP based on existing research on nutritional health and informed by providers. This study has just completed the Formative phase, recruiting eligible participants to join focus groups that gleaned information about dietary habits, preferences, and food environments to further refine the DI. Conclusion Findings from earlier phases have advised the current Feasibility Phase in which this novel DI is being administered to a small cohort of FEP participants (N = 12) to determine acceptability of the DI from a lived experience perspective. Naturalistic changes in inflammatory biomarkers, metabolic health, and symptoms will also be measured.
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Affiliation(s)
- Leda Kennedy
- Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Tiffany Holt
- Center for Integrative Medicine, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Anna Hunter
- Center for Integrative Medicine, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Shahrokh Golshan
- Center for Integrative Medicine, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, United States
| | - Heline Mirzakhanian
- Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, United States
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Glick AA, Winham DM, Heer MM, Shelley MC, Hutchins AM. Health Belief Model Predicts Likelihood of Eating Nutrient-Rich Foods among U.S. Adults. Nutrients 2024; 16:2335. [PMID: 39064780 PMCID: PMC11279385 DOI: 10.3390/nu16142335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/06/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Despite decades of messaging, most Americans still consume excess fats and sugars, but inadequate fiber, potassium, and calcium. Nutrient-rich foods (NRFs) have a high density of favorable nutrients related to calories. Choosing NRFs could lower risk of nutrition-related chronic diseases and aid in their control. We hypothesized that having greater knowledge of NRFs, the presence of a nutrition-related chronic disease or risk factor, and positive Health Belief Model (HBM) views would be predictive of the likelihood of eating NRFs. Through a national online survey panel, 976 adults aged 18-80 completed demographic, health, NRF knowledge, attitudes, and HBM construct questions. Participants were 77% White, 52% women, and 55% had a nutrition-related disease or risk factor. Multivariable HBM scales were generated by theory, principal components, and reliability analysis. NRF knowledge was significantly higher for women, Whites, households without children, and persons without a nutrition-related disease (all p ≤ 0.015). 'Likelihood of eating NRFs' was significantly higher for persons with a nutrition-related disease, Whites, married participants, main food shoppers, and households with children (all p ≤ 0.022). Regressing demographic and HBM constructs on the 'likelihood of eating NRFs' resulted in R2 of 0.435. Nutrition-related disease and HBM constructs of self-efficacy, perceived benefits, and cues to action were predictive of the likelihood of eating NRFs, but higher NRF knowledge was negatively associated.
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Affiliation(s)
- Abigail A. Glick
- Department of Food Science & Human Nutrition, Iowa State University, Ames, IA 50011, USA; (A.A.G.); (M.M.H.)
| | - Donna M. Winham
- Department of Food Science & Human Nutrition, Iowa State University, Ames, IA 50011, USA; (A.A.G.); (M.M.H.)
| | - Michelle M. Heer
- Department of Food Science & Human Nutrition, Iowa State University, Ames, IA 50011, USA; (A.A.G.); (M.M.H.)
| | - Mack C. Shelley
- Departments of Political Science and Statistics, Iowa State University, Ames, IA 50011, USA;
| | - Andrea M. Hutchins
- Department of Human Physiology & Nutrition, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA;
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Bellows AL, Ganpule A, Raza A, Kapoor D, Musicus A, Spiker ML, Jaacks LM. Environmental Sustainability of Food Environments: Development and Application of a Framework in 4 cities in South Asia. Curr Dev Nutr 2024; 8:103791. [PMID: 39045144 PMCID: PMC11263746 DOI: 10.1016/j.cdnut.2024.103791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/21/2024] [Accepted: 05/25/2024] [Indexed: 07/25/2024] Open
Abstract
Background Food environments, where people directly engage with broader food systems, may be an important contributor to the environmental sustainability of food systems. Objectives The primary objectives of this study were to establish a new food environment framework that considers environmental indicators and to assess data availability and gaps using data previously collected as part of a food systems survey in 4 South Asian cities. Methods The framework was developed by conducting a structured literature review of previous food environment frameworks and in-depth interviews with content experts (n = 6). The framework and indicators were then mapped to data collected by consumer and vendor surveys using the Urban Food Systems Assessment Tool (UFSAT) in Ahmedabad (India), Pune (India), Kathmandu (Nepal), and Pokhara (Nepal). Results We have expanded the sustainability domain within food environments to include consumer travel to food vendors, the presence of food delivery services, policies related to sustainability, vendor food waste, vendor plastic use, vendor utility usage, vendor recycling and waste management practices, and food packaging. Mapping the framework to existing data from 4 cities in South Asia, we found variations in food environment sustainability indicators, particularly regarding consumer transportation to food vendors, the presence of delivery services, and food waste. Conclusions Although the majority of food environment research focuses on the availability and affordability of healthy foods, there is an urgent need to understand better how aspects of food environments contribute to environmental goals. When mapping the framework to existing food systems data, we found gaps in data on environmental sustainability in food environments and variation in indicators across settings.
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Affiliation(s)
- Alexandra L Bellows
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, United Kingdom
| | | | - Ahmed Raza
- Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Deksha Kapoor
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, United Kingdom
| | - Aviva Musicus
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Marie L Spiker
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, United States
- Food Systems, Nutrition, and Health Program, University of Washington School of Public Health, Seattle, WA, United States
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, United Kingdom
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Inaç Y, D'Hooghe S, Van Dyck D, Dury S, Vandevijvere S, Deforche B, De Clercq EM, Van de Weghe N, De Ridder K. Associations between the objective and perceived food environment and eating behavior in relation to socioeconomic status among adults in peri-urban settings: results from the CIVISANO study in Flanders, Belgium. Int J Health Geogr 2024; 23:10. [PMID: 38724949 PMCID: PMC11080110 DOI: 10.1186/s12942-024-00369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/10/2024] [Indexed: 05/13/2024] Open
Abstract
Obesity, a significant public health concern, disproportionately affects people with lower socioeconomic status (SES). Food environments have been identified as part of the causal chain of this disparity. This study investigated variations in the food environment across groups with different SES profiles residing in peri-urban municipal settings. In addition, it examined the association of the perceived and objective food environments with eating behaviour and assessed if these associations were moderated by SES. Utilizing GIS and survey data (n = 497, aged 25-65), results showed differences in the objective and perceived food environments based on SES. Respondents with higher SES perceived their food environments as better but resided farther from all food outlets compared to respondents with lower SES. However, there was no difference in outlet density or mRFEI between SES groups. SES moderated associations between the objective and perceived food environments and most eating behavior outcomes except fast food consumption frequency. For fruits and vegetables, SES moderated the association between neighborhood availability and consumption frequency (β0.23,CI0.03;0.49). Stratified analysis revealed a positive association for both lower (β0.15, CI0.03;0.27) and higher (β0.37, CI 0.12;0.63) SES groups. For snack foods, SES moderated the association between healthy outlet density and consumption frequency (β-0.60, CI-0.94; -0.23), showing statistical significance only for respondents with higher SES (β0.36,CI 0.18;0.55). Similarly, for sugar-sweetened beverages, a statistically significant interaction was observed between unhealthy outlet density in the 1000m buffer and consumption frequency (β 0.06, CI 0.02; 0.11). However, this association was only statistically significant for respondents with higher SES (β-0.02,CI -0.05;-0.0002). These results emphasize the significance of SES as a crucial element in comprehending the connection between the food environment and eating behaviour. Indicating the need for policymakers to take SES into account when implementing food environment interventions, particularly when focusing on the neighborhood food environment without considering residents' SES and their perceptions.
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Affiliation(s)
- Yasemin Inaç
- Sciensano, Department of Epidemiology and Public Health, Brussels, Belgium.
- Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
| | - Suzannah D'Hooghe
- Sciensano, Department of Epidemiology and Public Health, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Delfien Van Dyck
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Sarah Dury
- Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Benedicte Deforche
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva M De Clercq
- Sciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium
| | - Nico Van de Weghe
- Faculty of Sciences, Department of Geography, Ghent University, Ghent, Belgium
| | - Karin De Ridder
- Sciensano, Department of Epidemiology and Public Health, Brussels, Belgium
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Ganasegeran K, Abdul Manaf MR, Safian N, Waller LA, Abdul Maulud KN, Mustapha FI. GIS-Based Assessments of Neighborhood Food Environments and Chronic Conditions: An Overview of Methodologies. Annu Rev Public Health 2024; 45:109-132. [PMID: 38061019 DOI: 10.1146/annurev-publhealth-101322-031206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The industrial revolution and urbanization fundamentally restructured populations' living circumstances, often with poor impacts on health. As an example, unhealthy food establishments may concentrate in some neighborhoods and, mediated by social and commercial drivers, increase local health risks. To understand the connections between neighborhood food environments and public health, researchers often use geographic information systems (GIS) and spatial statistics to analyze place-based evidence, but such tools require careful application and interpretation. In this article, we summarize the factors shaping neighborhood health in relation to local food environments and outline the use of GIS methodologies to assess associations between the two. We provide an overview of available data sources, analytical approaches, and their strengths and weaknesses. We postulate next steps in GIS integration with forecasting, prediction, and simulation measures to frame implications for local health policies.
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Affiliation(s)
- Kurubaran Ganasegeran
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
- Clinical Research Center, Seberang Jaya Hospital, Ministry of Health Malaysia, Penang, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
| | - Nazarudin Safian
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Khairul Nizam Abdul Maulud
- Earth Observation Centre (EOC), Institute of Climate Change, Universiti Kebangsaan Malaysia, Selangor Darul Ehsan, Malaysia
- Department of Civil Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia, Selangor Darul Ehsan, Malaysia
| | - Feisul Idzwan Mustapha
- Public Health Division, Perak State Health Department, Ministry of Health Malaysia, Perak, Malaysia
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Geboers L, de Vet E, Rongen FC, Poelman MP. More than the worksite cafeteria: the workplace food environment of small and medium-sized enterprises in the Netherlands. Public Health Nutr 2024; 27:e137. [PMID: 38679460 PMCID: PMC11374566 DOI: 10.1017/s1368980024000946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To characterise the food environment of Dutch small and medium-sized enterprises (SMEs), encompassing physical, sociocultural, economic and policy features and to explore variations within SMEs according to company characteristics (number of employees, location of work and presence of worksite cafeteria). DESIGN Online cross-sectional survey study of a representative Dutch SME sample by a panel agency. SETTING Dutch SMEs. PARTICIPANTS Three hundred and fifteen employees of Dutch SMEs responsible for food and drink in their company. RESULTS Most SMEs did not have a worksite cafeteria, no provision of fruits or vegetables, and did not offer discounts on food or drinks. The food environment of these SMEs varied significantly based on company characteristics. For example, SMEs with a worksite cafeteria were significantly more likely to have fruits (OR = 8·76, 95 % CI (4·50, 17·06)), vegetables (OR = 10·29, 95 % CI (5·49, 19·31)) and company food policies (OR = 5·04, 95 % CI (2·08, 12·20)) than SMEs without. Additionally, SMEs with ≥ 50 employees were more likely to have fruits (OR = 2·39, 95 % CI (1·42, 4·03)), vegetables (OR = 1·89, 95 % CI (1·04, 3·46)) and company food policies (OR = 2·82, 95 % CI (1·09, 7·29) than SMEs with < 50 employees. Moreover, having a worksite cafeteria (B = 0·23, 95 % CI (0·08, 0·38)) and employees working mostly on-site (B = 0·14, 95 % CI (0·01, 0·28)) were associated with stronger social norms of healthy and sustainable eating at work compared to SMEs without a worksite cafeteria and working mostly off-site. CONCLUSIONS In SMEs, an overall comprehensive picture of the food environment points to its limited active encouragement of healthy food choices, particularly so in small SMEs without a worksite cafeteria. Company characteristics strongly influence SME food environments and should be considered when developing interventions improving SME workplace food environments.
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Affiliation(s)
- Lisanne Geboers
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
| | - Emely de Vet
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
| | - Frédérique C Rongen
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
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Martin S, McCormack L. Eating behaviors and the perceived nutrition environment among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:685-689. [PMID: 35549833 DOI: 10.1080/07448481.2022.2068019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Objectives: To assess eating behaviors and identify whether there is an association between eating behaviors and the perceived nutrition environment among college students. Participants: College students (n = 180) actively living on campus during the 2019-2020 academic school year. Methods: Cross- sectional study utilizing the validated NEMS-P survey tool to collect all data. A multivariate logistics regression was used to assess the association between eating behaviors and the perceived nutrition environment. Results: Statistically significant association noted between perceived higher cost of healthy eating and decreased consumption of fruit (p = .027), availability of nutrition information (healthy eating signs) and increased vegetable and fruit consumption (p = .018, p = 0.010) and increased ease of purchasing fruits and vegetables and increased consumption (p = 0.037). Conclusion: The campus nutrition environment can provide students the opportunity to learn about and practice healthy eating through available foods and beverages, nutrition education and signs that encourage healthy eating throughout the campus.
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Affiliation(s)
- Shadai Martin
- Department of Family & Consumer Sciences, New Mexico State University, Las Cruces, New Mexico, USA
| | - Lacey McCormack
- Division of Health and Consumer Sciences, South Dakota State University, Brookings, South Dakota, USA
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12
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Avelar BA, Hino AAF, Santos AP, Mendes LL, Cardoso Carraro JC, Mendonça RDD, de Menezes MC. Validity and reliability of the Perceived Nutrition Environment Measures Survey (NEMS-P) for use in Brazil. Public Health Nutr 2023; 27:e11. [PMID: 38072396 PMCID: PMC10830366 DOI: 10.1017/s1368980023002653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE The aim of this study is to evaluate the validity and reliability of the Perceived Nutrition Environment Measures Survey (NEMS-P) translated and adapted for use in Brazil. DESIGN Validation of the NEMS-P questionnaire. The questionnaires were applied to assess validity and reliability, based on exploratory factor analysis, Cronbach's α coefficient and intra-class correlation, with a significance level of 95 %. SETTING Brazil. PARTICIPANTS Adults over 20 years of age diagnosed with hypertension were included in the internal validity and reliability test (n 176) and intra-rater reliability (subsample n 35). RESULTS Factor analysis obtained satisfactory results. Internal consistency was acceptable for most items, with Cronbach's α ranging from 0·6 to 0·9. The intra-rater reliability of the subsample was also valid, with intra-class correlation coefficient values ranging from 0·5 to 0·9. CONCLUSION This work reveals the usefulness of the instrument to assess the perceived food environment in the Brazilian context, being able to measure what is proposed according to its theoretical model, and reproduces the values when applied to a sample different from its original validation. However, refinement of some questions is suggested. Finally, it demonstrates the possibility of using the entire instrument or each section independently, according to the food environments to be investigated.
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Affiliation(s)
- Bruna Aparecida Avelar
- School of Nutrition, Federal University of Ouro Preto, Rua Dois, Campus Morro do Cruzeiro, CEP, Ouro Preto, Minas Gerais, 35400-000, Brazil
| | - Adriano Akira Ferreira Hino
- Life Science School, Pontíficia Universidade Católica do Paraná, Rua Imaculada Conceição, Escola de Medicina, Curitiba, Paraná, 80215901, Brazil
| | - Anabele Pires Santos
- School of Nutrition, Federal University of Ouro Preto, Rua Dois, Campus Morro do Cruzeiro, CEP, Ouro Preto, Minas Gerais, 35400-000, Brazil
| | - Larissa Loures Mendes
- Department of Nutrition, Federal University of Minas Gerais, Avenida Professor Alfredo Balena, CEP, Belo Horizonte, Minas Gerais, 30130100, Brazil
| | - Júlia Cristina Cardoso Carraro
- School of Nutrition, Federal University of Ouro Preto, Rua Dois, Campus Morro do Cruzeiro, CEP, Ouro Preto, Minas Gerais, 35400-000, Brazil
| | - Raquel de Deus Mendonça
- School of Nutrition, Federal University of Ouro Preto, Rua Dois, Campus Morro do Cruzeiro, CEP, Ouro Preto, Minas Gerais, 35400-000, Brazil
| | - Mariana Carvalho de Menezes
- School of Nutrition, Federal University of Ouro Preto, Rua Dois, Campus Morro do Cruzeiro, CEP, Ouro Preto, Minas Gerais, 35400-000, Brazil
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13
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Han Y, Fan Z, Li T. Oil/Salt Use Assessment of Chinese-Style Canteens Based on Consumers' Perception of the Nutrition Environment. Nutrients 2023; 15:4321. [PMID: 37892397 PMCID: PMC10609421 DOI: 10.3390/nu15204321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/22/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Excess cooking oil and salt use in catering services contributes to obesity and cardiovascular disease, but the assessment of oil/salt use has been a challenge in nutrition environment measurement. We conducted a knowledge, attitude, and practice survey on 250 respondents in five university canteens at China Agricultural University, Beijing, China. Using on-site tools including a newly developed Likert scale and the previously tested Oil-Salt Visual Analogue Scale (OS-VAS), the respondents were asked to evaluate their personal taste, their impression of the oil/salt status of canteen dishes, and their attitude toward oil/salt reduction. Data analysis showed that gender and self-image of body shape had a significant impact on KAP scores and the impression of the oil/salt environment. The respondents' taste preferences correlated with their perception of oil and salt, but knowledge and attitude were not directly related to scores on oil and salt, while weight status was related to oil and salt scores. The Likert scale-based assessment could work but was not as effective as the OS-VAS in distinguishing the differences among the selected canteens. These results indicate that the quality of the nutrition environment in catering services needs to be comprehensively evaluated with an objective evaluation of raters and a subjective evaluation of consumers.
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Affiliation(s)
| | - Zhihong Fan
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (Y.H.); (T.L.)
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14
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Hong J, Yang N, Kim K. Development and Validation of a Perceived Community Food Accessibility Measurement Questionnaire for Korean Older Adults. Nutrients 2023; 15:4301. [PMID: 37836585 PMCID: PMC10574782 DOI: 10.3390/nu15194301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
As the community food environment is known to be an important factor in healthy food choices, it needs to be measured, to increase awareness and improve healthy eating. The objective of this study was to develop a perceived community food accessibility measurement (P-CFAM) questionnaire applicable to older adults in Korea and evaluate its reliability and validity. The questionnaire was developed based on community food environment factors that were found to affect food choices in previous studies. We evaluated the internal consistency reliability, construct validity, and criterion-related validity. The subjects were 188 older adults for validity. The Cronbach's alpha value for the reliability measure was 0.9. The confirmatory factor analysis to evaluate the construct validity of the questionnaire showed values close to those of the optimal model (GFI = 0.983, AGFI = 0.948, RMR = 0.004, NFI = 0.987, CFI = 0.996). Regarding the criterion-related validity, the P-CFAM questionnaire results were significantly related to objective measurement indicators such as the number of grocery stores, the travel time to a grocery store, and the intake of vegetables and fruit. In conclusion, the developed P-CFAM questionnaire was shown to be reliable and valid, and useful for assessing older adults' perceptions of community food accessibility in Korea.
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Affiliation(s)
| | | | - Kirang Kim
- Department of Food Science and Nutrition, College of Science and Technology, Dankook University, Cheonan 31116, Republic of Korea
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15
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Lyu W, Seok N, Chen X, Xu R. Using Crowdsourced Food Image Data for Assessing Restaurant Nutrition Environment: A Validation Study. Nutrients 2023; 15:4287. [PMID: 37836570 PMCID: PMC10574450 DOI: 10.3390/nu15194287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/18/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
Crowdsourced online food images, when combined with food image recognition technologies, have the potential to offer a cost-effective and scalable solution for the assessment of the restaurant nutrition environment. While previous research has explored this approach and validated the accuracy of food image recognition technologies, much remains unknown about the validity of crowdsourced food images as the primary data source for large-scale assessments. In this paper, we collect data from multiple sources and comprehensively examine the validity of using crowdsourced food images for assessing the restaurant nutrition environment in the Greater Hartford region. Our results indicate that while crowdsourced food images are useful in terms of the initial assessment of restaurant nutrition quality and the identification of popular food items, they are subject to selection bias on multiple levels and do not fully represent the restaurant nutrition quality or customers' dietary behaviors. If employed, the food image data must be supplemented with alternative data sources, such as field surveys, store audits, and commercial data, to offer a more representative assessment of the restaurant nutrition environment.
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Affiliation(s)
- Weixuan Lyu
- Department of Geography, University of Connecticut, Storrs, CT 06269, USA; (W.L.); (X.C.)
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Nina Seok
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Xiang Chen
- Department of Geography, University of Connecticut, Storrs, CT 06269, USA; (W.L.); (X.C.)
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
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16
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Hossfeld C, Rennert L, Baxter SLK, Griffin SF, Parisi M. The Association between Food Security Status and the Home Food Environment among a Sample of Rural South Carolina Residents. Nutrients 2023; 15:3918. [PMID: 37764701 PMCID: PMC10534860 DOI: 10.3390/nu15183918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Prior research suggests that food security status may have an effect on the home food environment. Further, the literature suggests that food access factors may function to influence said relationship. The purpose of this research is to fill a gap in the literature on this relationship, as well as to identify potential food access effect modifiers. This research employs linear mixed effects modeling with a random intercept variable (zip codes). Eleven food access variables are included in regression analyses and are tested as potential effect modifiers in the association between food security status and the home food environment. Food security status is significantly associated with the home food environment (95% CI = 0.1-1.38) in the unadjusted model. In the adjusted model, food pantry usage is found to be a significant effect modifier on the association between food security status and the home food environment. This research concludes that food security status has a significant but disparate effect on the home food environment depending on participant food pantry usage. Practical implications from this research would be for relevant stakeholders to potentially improve rural food pantry access in order to increase the home food environment among rural and food insecure populations.
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Affiliation(s)
- Cassius Hossfeld
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; (L.R.); (S.L.K.B.); (S.F.G.)
| | - Lior Rennert
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; (L.R.); (S.L.K.B.); (S.F.G.)
| | - Samuel L. K. Baxter
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; (L.R.); (S.L.K.B.); (S.F.G.)
| | - Sarah F. Griffin
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA; (L.R.); (S.L.K.B.); (S.F.G.)
| | - Michelle Parisi
- Cooperative Extension Service, Clemson University, Clemson, SC 29634, USA;
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Nedzingahe V, Tambe BA, Zuma MK, Mbhenyane XG. Associations among Food Systems, Food Environments, Food Choices, Food Security, and Nutrition Transition in Limpopo Province, South Africa: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6557. [PMID: 37623143 PMCID: PMC10454841 DOI: 10.3390/ijerph20166557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Abstract
A cross-sectional study was applied to investigate the influence of food systems and food environments on food choices and nutrition transition of households in Limpopo province, South Africa. A sample of 429 households was systematically selected using a paper selection draw from three districts. This paper determines the association among food systems, food environments, food choices, and nutritional measurements of the respondents. A validated questionnaire was used. Most of the respondents responsible for food procurement were females (80.4%). There was a significant association (p < 0.001) between proximity to food stores and dietary diversity of the households. Staple foods such as bread, maize, rice, samp, and mealie rice were available in almost all surveyed households (95.6%). More than half of the households (59.8%) had home gardens in their yards. Almost half of the households (48.4%) had a low Dietary Diversity Score. The study further revealed that 46.0% of households were food secure. Over a third (36.2%) of the respondents were obese, and 32.5% were diabetic. The mean total blood cholesterol was 3.69 ± 0.74 mmol/L. A high percentage of both females (89.6%) and males (91.5%) had normal hemoglobin levels. Almost half of the respondents had normal systolic blood pressure levels (45.6%), and nearly a quarter had high diastolic levels (21.4%). The 25 coping strategies were applied during food shortage periods. Even though the food environments provided both obesogenic and protective foods, the consumption of unhealthy foods was high.
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Affiliation(s)
- Vhushavhelo Nedzingahe
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, Western Cape, South Africa; (V.N.); (B.A.T.); (M.K.Z.)
| | - Betrand Ayuk Tambe
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, Western Cape, South Africa; (V.N.); (B.A.T.); (M.K.Z.)
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea P.O. Box 63, Cameroon
| | - Mthokozisi Kwazi Zuma
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, Western Cape, South Africa; (V.N.); (B.A.T.); (M.K.Z.)
- Impact and Partnerships Division, Agricultural Research Council, P.O. Box 8783, Pretoria 0084, Gauteng, South Africa
| | - Xikombiso Gertrude Mbhenyane
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, Western Cape, South Africa; (V.N.); (B.A.T.); (M.K.Z.)
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18
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Calloway EE, Carpenter LR, Gargano T, Sharp JL, Yaroch AL. New measures to assess the "Other" three pillars of food security-availability, utilization, and stability. Int J Behav Nutr Phys Act 2023; 20:51. [PMID: 37101157 PMCID: PMC10134599 DOI: 10.1186/s12966-023-01451-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND In recent reviews of available measures, no existing measures assessed all four pillars of food security and most only assessed one or two pillars-predominantly the access pillar. The purpose of this study was to preliminarily develop novel measures of availability, utilization, and stability that are complementary to the USDA's household food security survey measure (HFSSM). METHODS A formative phase included an expert advisory group, literature scans, and interviews with individuals experiencing food insecurity. From April-June 2021, the new measures were piloted in five states (California, Florida, Maryland, North Carolina, and Washington). The cross-sectional pilot survey included the new measures (perceived limited availability, utilization barriers, and food insecurity stability), scales and items for validation (e.g., food security, and self-reported dietary and health outcomes), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal consistency was assessed using Kuder-Richardson formula 21 (KR21), and convergent and discriminant validity were assessed using Spearman's correlation coefficients. Also, a brief screener version was created for the utilization barriers measure that may be necessary for certain applications (e.g., clinical intake screening to inform referrals to assistance programs). RESULTS The analytic samples (perceived limited availability (n = 334); utilization barriers (n = 428); food insecurity stability (n = 445)) were around 45 years old on average, most households had children, over two-thirds were food insecure, over three-fourths were women, and the samples were racially/ethnically diverse. All items loaded highly and unambiguously to a factor (factor loadings range 0.525-0.903). Food insecurity stability showed a four-factor structure, utilization barriers showed a two-factor structure, and perceived limited availability showed a two-factor structure. KR21 metrics ranged from 0.72 to 0.84. Higher scores for the new measures were generally associated with increased food insecurity (rhos = 0.248-0.497), except for one of the food insecurity stability scores. Also, several of the measures were associated with statistically significantly worse health and dietary outcomes. CONCLUSIONS The findings support the reliability and construct validity of these new measures within a largely low-income and food insecure sample of households in the United States. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may be used in various applications to promote a more comprehensive understanding of the food insecurity experience. Such work can help inform novel intervention approaches to address food insecurity more fully.
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Affiliation(s)
- Eric E Calloway
- The Gretchen Swanson Center for Nutrition, 14301 FNB Parkway, Suite 100, Omaha, NE, 68154, USA.
| | - Leah R Carpenter
- The Gretchen Swanson Center for Nutrition, 14301 FNB Parkway, Suite 100, Omaha, NE, 68154, USA
| | - Tony Gargano
- The Gretchen Swanson Center for Nutrition, 14301 FNB Parkway, Suite 100, Omaha, NE, 68154, USA
| | | | - Amy L Yaroch
- The Gretchen Swanson Center for Nutrition, 14301 FNB Parkway, Suite 100, Omaha, NE, 68154, USA
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Glanz K, Fultz AK, Sallis JF, Clawson M, McLaughlin KC, Green S, Saelens BE. Use of the Nutrition Environment Measures Survey: A Systematic Review. Am J Prev Med 2023:S0749-3797(23)00068-5. [PMID: 36990939 DOI: 10.1016/j.amepre.2023.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION The Nutrition Environment Measurement Survey (NEMS) measures were developed to assess the consumer food environment in stores and restaurants. NEMS tools have been widely used in research and adapted for diverse settings and populations in the 15 years since they were created. This systematic review examines the use and adaptations of these measures and what can be learned from published studies using NEMS tools. METHODS A comprehensive search of bibliographic databases was conducted from 2007 to September 2021, supplemented by backward searches and communications with authors, to identify research articles using NEMS tools. Data on purpose, key findings, sample characteristics, NEMS characteristics, and modifications were abstracted. Articles were categorized on the basis of study goals, NEMS tool(s) used, variables measured, and common themes. RESULTS A total of 190 articles from 18 countries were identified. Most studies (69.5%, n=123) used a modified version of NEMS tools. There were 23 intervention studies that used measures from NEMS tools or adaptations as outcomes, moderators, or process assessments. A total of 41% (n=78) of the articles evaluated inter-rater reliability, and 17% (n=33) evaluated test-retest reliability. DISCUSSION NEMS measures have played an important role in the growth of research on food environments and have helped researchers to explore the relationships among healthy food availability, demographic variables, eating behaviors, health outcomes, and intervention-driven changes in food environments. The food environment is constantly changing, so NEMS measures should continue to evolve. Researchers should document data quality of modifications and use in new settings.
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Affiliation(s)
- Karen Glanz
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Amanda K Fultz
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, California
| | - Margaret Clawson
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C McLaughlin
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Sarah Green
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle, Washington; Seattle Children's Research Institute, Seattle, Washington
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20
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Avelino DC, Duffy VB, Puglisi M, Ray S, Lituma-Solis B, Nosal BM, Madore M, Chun OK. Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments? Nutrients 2023; 15:862. [PMID: 36839221 PMCID: PMC9964317 DOI: 10.3390/nu15040862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in Northeastern Connecticut during the pandemic. Via online survey, adults (n = 276) reported their perceived home and store food environments, food assistance participation, whether they ordered groceries online, and consumption frequency and liking of foods/beverages to calculate diet quality indices. Those who ordered groceries online (44.6%) were more likely to participate in food assistance programs and report greater diet quality. Perceived healthiness of store and home food environments was variable, with the ease of obtaining and selecting unhealthy foods in the neighborhood significantly greater than healthy foods. Healthier perceived home food environments were associated with significantly higher diet qualities, especially among individuals who participated in multiple food assistance programs. Ordering groceries online interacted with multiple measures of the food environment to influence diet quality. Generally, the poorest diet quality was observed among individuals who perceived their store and home food environments as least healthy and who did not order groceries online. Thus, ordering groceries online may support higher diet quality among adults who can use their food assistance for purchasing groceries online and who live in low-income, low-access food environments.
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Affiliation(s)
- Daniela C. Avelino
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Snehaa Ray
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Brenda Lituma-Solis
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Briana M. Nosal
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Matthew Madore
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
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Tay JEF, Tung SEH, Kaur S, Gan WY, Che’Ya NN, Tan CH. Seasonal variation in food security, lifestyle, nutritional status and its associated factors of the urban poor adolescents in Kuala Lumpur, Malaysia: research protocol of a prospective cohort study. BMC Nutr 2023; 9:24. [PMID: 36732839 PMCID: PMC9893186 DOI: 10.1186/s40795-023-00680-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Climate change, obesity and undernutrition have now become a worldwide syndemic that threatens most people's health and natural systems in the twenty-first century. Adolescent malnutrition appears to be a matter of concern in Malaysia, and this is particularly relevant among the urban poor population. Mounting evidence points to the fact that underlying factors of malnutrition are subject to climate variability and profoundly affect nutritional outcomes. Hence, it is interesting to examine seasonal variation in nutritional status and its associated factors of urban poor adolescents in Malaysia. METHODS This is a prospective cohort study following urban poor adolescents aged 10-17 years living in low-cost high-rise flats in Kuala Lumpur, Malaysia, across two monsoon seasons. The baseline assessment will be conducted during the onset of the Northeast Monsoon and followed up during Southwest Monsoon. Climate data will be collected by obtaining the climatological data (rainfall, temperature, and relative humidity) from Malaysia Meteorological Department. Geospatial data for food accessibility and availability, and also built (recreational facilities) environments, will be analyzed using the QGIS 3.4 Madeira software. Information on socio-demographic data, food security, lifestyle (diet and physical activity), and neighbourhood environment (food and built environment) will be collected using a self-administrative questionnaire. Anthropometric measurements, including weight, height, and waist circumference, will be conducted following WHO standardized protocol. WHO Anthro Plus was used to determine the height-for-age (HAZ) and BMI-for-age (BAZ). Anaemic status through biochemical analyses will be taken using HemoCue 201+® haemoglobinometer. DISCUSSION The study will provide insights into the seasonal effects in nutritional status and its associated factors of urban poor adolescents. These findings can be useful for relevant stakeholders, including policymakers and the government sector, in seizing context-specific strategies and policy opportunities that are seasonally sensitive, effective, and sustainable in addressing multiple challenges to combat all forms of malnutrition, especially among urban poor communities. TRIAL REGISTRATION The protocol for this review has not been registered.
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Affiliation(s)
- Janice Ee Fang Tay
- grid.444472.50000 0004 1756 3061Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Serene En Hui Tung
- grid.411729.80000 0000 8946 5787Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Satvinder Kaur
- grid.444472.50000 0004 1756 3061Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Wan Ying Gan
- grid.11142.370000 0001 2231 800XDepartment of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Nik Norasma Che’Ya
- grid.11142.370000 0001 2231 800XDepartment of Agriculture Technology, Faculty of Agriculture, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Choon Hui Tan
- grid.444472.50000 0004 1756 3061Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Cheras, 56000 Kuala Lumpur, Malaysia
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Seguin-Fowler RA, Eldridge GD, Graham M, Folta SC, Hanson KL, Maddock JE. COVID-19 Related Protocol Considerations and Modifications within a Rural, Community-Engaged Health Promotion Randomized Trial. Methods Protoc 2023; 6:mps6010005. [PMID: 36648954 PMCID: PMC9844482 DOI: 10.3390/mps6010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 01/06/2023] Open
Abstract
Rural communities are at higher risk for physical inactivity, poor dietary behaviors, and related chronic diseases and obesity. These disparities are largely driven by built environment, socioeconomic, and social factors. A community-based cluster randomized controlled trial of an intervention, the Change Club, aims to address some of these disparities via civic engagement for built environment change. Baseline data collection began in February 2020, only to be paused by the COVID-19 pandemic. In this context, the investigators evaluated multiple approaches for collecting data when the study resumed, focusing on Life’s Simple 7, and additional anthropometric, physiologic, and behavioral outcomes in rural and micropolitan (<50,000 population) communities in Texas and New York. Life’s Simple 7 includes fasting blood glucose, total cholesterol, blood pressure, weight, physical activity, diet, and smoking. Rigor and feasibility were considered across a variety of in-person versus at-home measurement options. After a comprehensive input from participants, partners, staff, researchers, and the funding liaison, the study team chose self-measurement and use of validated questionnaires/surveys to measure the Life’s Simple 7 components. This case provides an example of how a study team might adjust data collection protocol during unexpected and acute events while giving consideration to rigor, feasibility, stakeholder views, and participants’ health and safety.
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Affiliation(s)
- Rebecca A. Seguin-Fowler
- Institute for Advancing Health through Agriculture, Texas A&M AgriLife, College Station, TX 77845, USA
- Correspondence: ; Tel.:+1-979-314-3398
| | - Galen D. Eldridge
- Texas A&M AgriLife Research and Extension Center, Dallas, TX 75252, USA
| | - Meredith Graham
- Texas A&M AgriLife Research and Extension Center, Dallas, TX 75252, USA
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Medford, MA 02155, USA
| | - Karla L. Hanson
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA
| | - Jay E. Maddock
- School of Public Health, Texas A&M University, College Station, TX 77843, USA
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23
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Seals K, Stroope J, Freightman J, Ainsworth L, Moles A, Holston D. Empty Houses, Loose Dogs, and Engaged Citizens: Lessons Learned From Community Participatory Data Collection in Rural Areas. Health Promot Pract 2022; 23:140S-148S. [DOI: 10.1177/15248399221111181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rural surveys tend to oversample easy to reach populations, which can misrepresent community health needs. To achieve baseline data reflective of the communities served by the high obesity program (HOP), an innovative evaluation plan was created to prioritize equity and reflect the whole community. Principles of Community-Based Participatory Research (CBPR) were used to guide instrument development, research protocols, and data collection. A random sample of addresses created with United States Postal Service records provided a representative list of addresses in three HOP counties in Louisiana. Local data collectors were recruited to go door to door at the selected addresses to collect in-person surveys (N = 682; response rate of 84%). Over a quarter of participants reported using the charitable food system and walking for transportation at least weekly. Collecting door to door data in rural communities presents unique challenges, including abandoned properties, inaccurate address records, loose dogs, and at times, racial tensions and houses far removed from public roads. Lessons learned include the importance of local knowledge, adapting protocols to fit local conditions, and community awareness of the survey. Health practitioners need confidence when they are making data-based decisions about interventions, and one way to provide this confidence is to collect data from a true cross-section of the community. With a plan and in partnership with community members, a probability sample is feasible to collect in rural communities.
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Affiliation(s)
| | | | | | | | - Aimee Moles
- Louisiana State University, Baton Rouge, LA, USA
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24
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Brytek-Matera A, Ziółkowska B, Ocalewski J. Symptoms of Avoidant/Restrictive Food Intake Disorder among 2-10-Year-Old Children: The Significance of Maternal Feeding Style and Maternal Eating Disorders. Nutrients 2022; 14:4527. [PMID: 36364790 PMCID: PMC9653907 DOI: 10.3390/nu14214527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 09/08/2024] Open
Abstract
The aim of the present study was to investigate whether the feeding style and core behavioral features of eating disorders of mothers are related to the symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID) among their children. This study involved 207 mothers of children aged 2 to 10 years (Mage = 5.82 ± 2.59 years), of which 19.32% were children with neurodevelopmental disorders and 22.71% were children with chronic diseases (e.g., allergy, asthma, diabetes). The mothers were asked to complete the ARFID Parents Questionnaire-Parents Report (ARFID-Q-PR), the Parental Feeding Style Questionnaire (PFSQ) and the Eating Disorder Examination Questionnaire (EDE-Q). Our findings revealed that both the maternal feeding style and core behavioral features of eating disorders were associated with ARFID symptoms among their 2-10-year-old children. While biological factors increase the risk of feeding/nutrition difficulties, the maternal attitude towards feeding and eating behavior may play a relevant role in children's eating behavior.
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Affiliation(s)
| | - Beata Ziółkowska
- Faculty of Psychology, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland
| | - Jarosław Ocalewski
- Faculty of Psychology, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland
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25
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D’Hooghe S, Inaç Y, De Clercq E, Deforche B, Dury S, Vandevijvere S, Van de Weghe N, Van Dyck D, De Ridder K. The CIVISANO protocol: a mixed-method study about the role of objective and perceived environmental factors on physical activity and eating behavior among socioeconomically disadvantaged adults. Arch Public Health 2022; 80:219. [PMID: 36199109 PMCID: PMC9533259 DOI: 10.1186/s13690-022-00956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity have a strong socioeconomic profile. Unhealthy behaviors like insufficient physical activity and an unbalanced diet, which are causal factors of overweight and obesity, tend to be more pronounced in socioeconomically disadvantaged groups in high income countries. The CIVISANO project aims to identify objective and perceived environmental factors among different socioeconomic population groups that impede or facilitate physical activity and healthy eating behavior in the local context of two peri-urban Flemish municipalities in Belgium. We also aim to identify and discuss possible local interventions and evaluate the participatory processes of the project. METHODS This study (2020-2023) will use community-based participatory tools, involving collaborative partnerships with civic and stakeholder members of the community and regular exchanges among all partners to bridge knowledge development and health promotion for socioeconomically disadvantaged citizens. Furthermore, a mixed-methods approach will be used. A population survey and geographic analysis will explore potential associations between the physical activity and eating behaviors of socioeconomically disadvantaged adults (25-65 years old) and both their perceived and objective physical, food and social environments. Profound perceptive context information will be gathered from socioeconomically disadvantaged adults by using participatory methods like photovoice, walk-along, individual map creation and group model building. An evaluation of the participatory process will be conducted simultaneously. DISCUSSION The CIVISANO project will identify factors in the local environment that might provoke inequities in adopting a healthy lifestyle. The combination of perceived and objective measures using validated strategies will provide a robust assessment of the municipality environment. Through this analysis, the project will investigate to what extent community engagement can be a useful strategy to reduce health inequities. The strong knowledge exchange and capacity-building in a local setting is expected to contribute to our understanding of how to maximize research impact in this field and generate evidence about potential linkages between a health enhancing lifestyle among socioeconomically disadvantaged groups and their physical, food and social environments.
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Affiliation(s)
- Suzannah D’Hooghe
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Yasemin Inaç
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Eva De Clercq
- grid.508031.fSciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium
| | - Benedicte Deforche
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Brussels, Belgium
| | - Sarah Dury
- grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Stefanie Vandevijvere
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
| | - Nico Van de Weghe
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Delfien Van Dyck
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Brussels, Belgium
| | - Karin De Ridder
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
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26
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Kegler MC, Raskind IG, Bundy ŁT, Owolabi S, Veluswamy JK, Hernandez C, Hodge T, Haardörfer R. Barriers to Creating Healthier Home Food Environments: Process Evaluation Results From 2 Home Food Environment Intervention Studies. FAMILY & COMMUNITY HEALTH 2022; 45:247-256. [PMID: 35536715 PMCID: PMC9391264 DOI: 10.1097/fch.0000000000000335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Few studies have identified barriers to creating a home environment more supportive of healthy eating. We examined barriers faced by participants in a randomized controlled trial and an adaptation study of the Healthy Homes/Healthy Families intervention, which uses health coaches to support low-income families in creating healthier home food environments. Coaches maintained logs of participant interactions as part of a process evaluation. We thematically analyzed logs from interactions with participants, mostly lower-income African American women (n = 114), to identify barriers for each of 8 healthy actions that serve as core elements of the intervention. Difficulty of changing current habits was a barrier for 5 of the healthy actions. No time/convenience and limited family support each influenced 2 of the healthy actions, with interpersonal barriers also stemming from social situations and visitors, including grandchildren. Cost and economic challenges were barriers for 3 of the actions. Hunger, cravings, and limited access to resources (eg, transportation, fresh fruits and vegetables) were each noted as barriers for 1 healthy action. Overall, these findings provide insight for how to better support families who are trying to improve their home food environments and highlight the need for multilevel interventions.
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Affiliation(s)
- Michelle C Kegler
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia (Drs Kegler and Haardörfer and Mss Bundy, Owolabi, and Hernandez); Stanford Prevention Research Center, Stanford University, Stanford, California (Dr Raskind); and Horizons Community Solutions, Albany, Georgia (Mss Veluswamy and Hodge)
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27
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Chaparro MP, Lopez MA, Hernandez J, Brewer JD, Santos MP, Paz-Soldan VA. The association between the observed and perceived neighbourhood food environment and household food insecurity in a low-income district in Lima, Peru. J Nutr Sci 2022; 11:e86. [PMID: 36304828 PMCID: PMC9554428 DOI: 10.1017/jns.2022.88] [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] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 12/14/2022] Open
Abstract
The objective of the present study was to assess the association between the observed and perceived food environment and food insecurity among households with children <18 years in Lima, Peru. This was a cross-sectional study including an income-stratified random sample of households (n 329) in Villa el Salvador, a low-income district in Lima, Peru. Data were collected with a household questionnaire - including the Household Food Insecurity Access Scale (HFIAS) and the University of Pennsylvania's Perceived Nutrition Environment Survey (NEMS-P) - and a neighbourhood food outlet census, including recording of food outlets' GPS coordinates. Three-quarters of the households interviewed were food insecure. Compared with food secure households and adjusting for socio-demographic covariates, food insecure households were more likely to disagree to having easy access (OR 5⋅4; 95 % CI 2⋅1, 13⋅4), high quality (OR 3⋅1; 95 % CI 1⋅7, 5⋅5) and variety (OR 2⋅5; 95 % CI 1⋅4, 4⋅6) of fresh fruits and vegetables in their neighbourhood. About 60 % (513 out of 861) of the food outlets identified in participants' neighbourhoods were classified as fresh, including markets, bodegas, and fruit and vegetable vendors. There was no difference in distance to fresh food outlets by household food insecurity; all households were on average within 52-62 m from a fresh food outlet (~2-min walk). Despite negative perceptions of their neighbourhood food environment, food insecure households had similar physical access to fresh food sources than their food secure counterparts. Thus, changes to the food environment may not alleviate food insecurity in urban poor areas of Peru.
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Affiliation(s)
- M. Pia Chaparro
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210-16, mail code #8319, New Orleans, LA 70112, USA
| | - Miguel A. Lopez
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210-16, mail code #8319, New Orleans, LA 70112, USA
| | - Julie Hernandez
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210, New Orleans, LA 70112, USA
| | - Jessica D. Brewer
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210-16, mail code #8319, New Orleans, LA 70112, USA
| | - Maria P. Santos
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2000, New Orleans, LA 70112, USA
| | - Valerie A. Paz-Soldan
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210, New Orleans, LA 70112, USA
- Asociación Benéfica PRISMA, Av. Santo Toribio 115, 5to piso, San Isidro, Lima, Peru
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Seguin-Fowler RA, Hanson KL, Villarreal D, Rethorst CD, Ayine P, Folta SC, Maddock JE, Patterson MS, Marshall GA, Volpe LC, Eldridge GD, Kershaw M, Luong V, Wang H, Kenkel D. Evaluation of a civic engagement approach to catalyze built environment change and promote healthy eating and physical activity among rural residents: a cluster (community) randomized controlled trial. BMC Public Health 2022; 22:1674. [PMID: 36058913 PMCID: PMC9441047 DOI: 10.1186/s12889-022-13653-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prior studies demonstrate associations between risk factors for obesity and related chronic diseases (e.g., cardiovascular disease) and features of the built environment. This is particularly true for rural populations, who have higher rates of obesity, cancer, and other chronic diseases than urban residents. There is also evidence linking health behaviors and outcomes to social factors such as social support, opposition, and norms. Thus, overlapping social networks that have a high degree of social capital and community cohesion, such as those found in rural communities, may be effective targets for introducing and maintaining healthy behaviors. METHODS This study will evaluate the effectiveness of the Change Club (CC) intervention, a civic engagement intervention for built environment change to improve health behaviors and outcomes for residents of rural communities. The CC intervention provides small groups of community residents (approximately 10-14 people) with nutrition and physical activity lessons and stepwise built environment change planning workshops delivered by trained extension educators via in-person, virtual, or hybrid methods. We will conduct process, multilevel outcome, and cost evaluations of implementation of the CC intervention in a cluster randomized controlled trial in 10 communities across two states using a two-arm parallel design. Change in the primary outcome, American Heart Association's Life's Simple 7 composite cardiovascular health score, will be evaluated among CC members, their friends and family members, and other community residents and compared to comparable samples in control communities. We will also evaluate changes at the social/collective level (e.g., social cohesion, social trust) and examine costs as well as barriers and facilitators to implementation. DISCUSSION Our central hypothesis is the CC intervention will improve health behaviors and outcomes among engaged citizens and their family and friends within 24 months. Furthermore, we hypothesize that positive changes will catalyze critical steps in the pathway to improving longer-term health among community residents through improved healthy eating and physical activity opportunities. This study also represents a unique opportunity to evaluate process and cost-related data, which will provide key insights into the viability of this approach for widespread dissemination. TRIAL REGISTRATION ClinicalTrials.gov: NCT05002660 , Registered 12 August 2021.
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Affiliation(s)
- Rebecca A. Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife, College Station, TX 77843 USA
| | - Karla L. Hanson
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Deyaun Villarreal
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Chad D. Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Priscilla Ayine
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Sara C. Folta
- grid.429997.80000 0004 1936 7531Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02155 USA
| | - Jay E. Maddock
- grid.264756.40000 0004 4687 2082School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Megan S. Patterson
- grid.264756.40000 0004 4687 2082School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Grace A. Marshall
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Leah C. Volpe
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Galen D. Eldridge
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Meghan Kershaw
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Vi Luong
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Hua Wang
- grid.5386.8000000041936877XJeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY 14853 USA
| | - Don Kenkel
- grid.5386.8000000041936877XJeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY 14853 USA
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Wetherill MS, Bakhsh C, Caywood L, Williams MB, Hartwell ML, Wheeler DL, Hubach RD, Teague TK, Köhler G, Hebert JR, Weiser SD. Unpacking determinants and consequences of food insecurity for insulin resistance among people living with HIV: Conceptual framework and protocol for the NOURISH-OK study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3. [PMID: 36225538 PMCID: PMC9552993 DOI: 10.3389/fcdhc.2022.947552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Over the past four decades, advances in HIV treatment have contributed to a longer life expectancy for people living with HIV (PLWH). With these gains, the prevention and management of chronic co-morbidities, such as diabetes, are now central medical care goals for this population. In the United States, food insecurity disproportionately impacts PLWH and may play a role in the development of insulin resistance through direct and indirect pathways. The Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in HIV for Oklahoma (NOURISH-OK) will use a novel, multi-level, integrated framework to explore how food insecurity contributes to insulin resistance among PLWH. Specifically, it will explore how food insecurity may operate as an intermediary risk factor for insulin resistance, including potential linkages between upstream determinants of health and downstream consequences of poor diet, other behavioral risk factors, and chronic inflammation. Methods/design: This paper summarizes the protocol for the first aim of the NOURISH-OK study, which involves purposeful cross-sectional sampling of PLWH (n=500) across four levels of food insecurity to test our conceptual framework. Developed in collaboration with community stakeholders, this initial phase involves the collection of anthropometrics, fasting blood samples, non-blood biomarkers, 24-hour food recall to estimate the Dietary Inflammatory Index (DII®) score, and survey data. A 1-month, prospective observational sub-study (total n=100; n=25 for each food security group) involves weekly 24-hour food recalls and stool samples to identify temporal associations between food insecurity, diet, and gut microbiome composition. Using structural equation modeling, we will explore how upstream risk factors, including early life events, current discrimination, and community food access, may influence food insecurity and its potential downstream impacts, including diet, other lifestyle risk behaviors, and chronic inflammation, with insulin resistance as the ultimate outcome variable. Findings from these analyses of observational data will inform the subsequent study aims, which involve qualitative exploration of significant pathways, followed by development and testing of a low-DII® food as medicine intervention to reverse insulin resistance among PLWH (ClinicalTrials.gov Identifier: NCT05208671). Discussion: The NOURISH-OK study will address important research gaps to inform the development of food as medicine interventions to support healthy aging for PLWH.
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Affiliation(s)
- Marianna S. Wetherill
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK, United States
- Department of Family and Community Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- *Correspondence: Marianna S. Wetherill,
| | | | - Lacey Caywood
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK, United States
| | - Mary B. Williams
- Department of Family and Community Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK, United States
| | - Micah L. Hartwell
- Department of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Denna L. Wheeler
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Randolph D. Hubach
- Department of Public Health, Purdue University, West Lafayette, IN, United States
| | - T. Kent Teague
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, OK, United States
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Gerwald Köhler
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - James R. Hebert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, United States
| | - Sheri D. Weiser
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States
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30
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Socioeconomic, intrapersonal and food environmental correlates of unhealthy snack consumption in school-going adolescents in Mumbai. BMC Public Health 2022; 22:1129. [PMID: 35668419 PMCID: PMC9171983 DOI: 10.1186/s12889-022-13449-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions. Methods A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factors of unhealthy snack consumption in adolescents attending private and public schools. Results The mean age of adolescents was 10.9 (1.1) years, 48.2% were girls and 53.9% attended private schools. The most frequently consumed unhealthy snacks were biscuits/ cookies (5.2d/wk) followed by wafers (3.4d/wk) and Indian fried snacks- samosa/ vada pav (2.8 d/wk). Among the public-school adolescents, the odds of unhealthy snack consumption were 0.89 times lower when meals were had frequently at the dinner table and 4.97 times higher when the perceived barriers related to the affordability of healthy snacks were greater. Maternal education (OR 0.78, 95% CI 0.66–0.82, p < 0.001), family income (OR 2.15, 95% CI 1.98–2.32, p < 0.001), availability of unhealthy snacks (OR 2.98, 95% CI 1.36–3.46, p < 0.001) and fruits (OR 0.57, 95% CI 0.49–0.69, p < 0.001) at home, having evening meals together (OR 0.71, 95% CI 0.63–0.81, p 0.031), and perceived parental control during mealtimes (OR 0.67, 95% CI 0.62–0.72, p < 0.001) were associated with unhealthy snack consumption in adolescents attending private schools. Conclusions The results highlighted a pervasiveness of unhealthy snacks in adolescents’ food environments. Improving provisions and affordability of fruits and healthy snacks at schools, encouraging family mealtimes, and limiting the availability of unhealthy snacks at home whilst addressing the perceived barriers within food environments, and inculcating self-efficacy skills can improve snacking habits in Indian adolescents, irrespective of socioeconomic backgrounds. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13449-6.
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Becker TB, Contreras D, Porth O. Differences in Eating and Physical Activity Behaviors, and Perceived Accessibility and Availability Barriers between Midwestern Rural and Urban Adults. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2021.1930318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tyler Brian Becker
- Department of Food Science and Human Nutrition, Michigan State University(MSU), East Lansing, Michigan, USA
- Health and Nutrition Institute, Michigan State University(MSU), East Lansing, Michigan, USA
| | - Dawn Contreras
- Health and Nutrition Institute, Michigan State University(MSU), East Lansing, Michigan, USA
| | - Olivia Porth
- Department of Food Science and Human Nutrition, Michigan State University(MSU), East Lansing, Michigan, USA
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Cyrkot S, Gidrewicz D, Anders S, Marcon M, Turner JM, Mager DR. Food Environment and Youth Intake May Influence Uptake of Gluten-Free Food Guide Recommendations in Celiac Disease. CAN J DIET PRACT RES 2022; 83:186-192. [PMID: 35503896 DOI: 10.3148/cjdpr-2022-011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A gluten-free (GF) food guide for children and youth (4-18 years) living with celiac disease (CD) has been developed and extensively evaluated by stakeholders, including registered dietitians. A case study analysis was conducted on data from 16 households of youth with CD to examine how factors related to parental food literacy, the home food environment, and food purchasing patterns may influence food guide uptake by Canadian youth with CD and their families. Households were of higher socioeconomic status, parents had good food literacy, and the home food availability of fruits, vegetables and GF grains was diverse. However, households also had a diverse supply of convenience foods and snack options. Youth reported consuming a larger proportion of these foods (>35% dietary intake) and had suboptimal diet quality. Dietary intake of fruits and vegetables were below GF plate model recommendations by over 30%. Despite limited economical barriers, good parental food literacy, and diverse food availability, meeting fruit and vegetable recommendations based on the pediatric GF food guide remains a major challenge. Findings inform that effective strategies and healthy public policies to support the uptake of GF food guide recommendations are needed to improve the health outcomes of youth with CD.
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Affiliation(s)
- Samantha Cyrkot
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
| | - Dominica Gidrewicz
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB.,Section of Pediatric Gastroenterology, Hepatology and Nutrition, South Health Campus, Calgary, AB
| | - Sven Anders
- Department of Resource Economics and Environmental Sociology, University of Alberta, Edmonton, AB
| | - Margaret Marcon
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON
| | - Justine M Turner
- Department of Pediatrics, University of Alberta, Edmonton, AB.,Division of Pediatric Gastroenterology and Nutrition, Stollery Children's Hospital, Edmonton, AB
| | - Diana R Mager
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB.,Department of Pediatrics, University of Alberta, Edmonton, AB
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Yamaguchi M, Praditsorn P, Purnamasari SD, Sranacharoenpong K, Arai Y, Sundermeir SM, Gittelsohn J, Hadi H, Nishi N. Measures of Perceived Neighborhood Food Environments and Dietary Habits: A Systematic Review of Methods and Associations. Nutrients 2022; 14:1788. [PMID: 35565756 PMCID: PMC9099956 DOI: 10.3390/nu14091788] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.
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Affiliation(s)
- Miwa Yamaguchi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
| | - Panrawee Praditsorn
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Sintha Dewi Purnamasari
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Kitti Sranacharoenpong
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, 2-10-1 Wakaba, Mihama-ku, Chiba-shi 261-0014, Japan;
| | - Samantha M. Sundermeir
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Hamam Hadi
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
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Trübswasser U, Talsma EF, Ekubay S, Poelman MP, Holdsworth M, Feskens EJM, Baye K. Factors Influencing Adolescents' Dietary Behaviors in the School and Home Environment in Addis Ababa, Ethiopia. Front Public Health 2022; 10:861463. [PMID: 35462798 PMCID: PMC9024113 DOI: 10.3389/fpubh.2022.861463] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Malnutrition affects many adolescents in Ethiopia. Over one-third of adolescent girls and two-thirds of boys are thin. Overweight and obesity in Ethiopia is mostly a concern in urban populations of higher wealth quintiles. Urbanization and globalization of diets is shifting food environments. The objective of this study was to assess whether food environments in and around schools in urban Ethiopia influence dietary diversity, quality, BMI status or perceptions of adolescents. Methods Twelve high schools were selected in Addis Ababa (private/government). From each school, 20 pupils aged 15–19 years were randomly selected (n = 217) and interviewed about assets in their households, their diets (categorized into 10 food groups of the Minimum Dietary Diversity, the Global Dietary Recommendations scores and four categories of the NOVA classification based on level of processing) and their use of pocket money. In addition, food environment audits were conducted within the school compound and a 0.5 km radius around each school and types of food outlets. Results On average there were 436 food outlets and 246 food or drink advertisements around each school. The majority of the advertisements (89.9%) were of ultra-processed foods, mostly sugar-sweetened beverages (SSBs). Most were positioned on food outlets (89.1%). SSBs or sweets were visibly on display in 26.3% of the outlets and fresh fruits and vegetables in 17.9% of outlets. Dietary diversity of adolescents was poor with an average of 3.6 food groups out of 10 consumed in the last 24 h. Ultra-processed foods and beverages were consumed by 23.5% of adolescents. The majority of adolescents spent their pocket money on SSBs, sweets or fried foods. Our analysis found that higher assets in adolescents' households were associated with higher dietary diversity and consumption of healthy food groups. We found no association between the food environment and dietary indicators or the BMI-z-score. Conclusion While the school food environments investigated were not conducive with promoting healthy dietary behaviors, we cannot conclude that these environmental factors directly influence adolescents' diets. The pervasive advertising and availability of unhealthy foods and beverages requires policy action for healthy school food environments.
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Affiliation(s)
- Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- *Correspondence: Ursula Trübswasser
| | - Elise F. Talsma
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Selamawit Ekubay
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Maartje P. Poelman
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University, Wageningen, Netherlands
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
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35
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Mayne SL, Hannan C, DiFiore G, Virudachalam S, Glanz K, Fiks AG. Associations of Neighborhood Safety and Collective Efficacy with Dietary Intake among Preschool-Aged Children and Mothers. Child Obes 2022; 18:120-131. [PMID: 34613834 DOI: 10.1089/chi.2021.0144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Positive neighborhood environments may promote healthier behaviors, yet few studies have examined associations between neighborhood social environment and diet. We examined associations of neighborhood perceived safety, collective efficacy, and violent crime with dietary intake among preschool-aged children and their mothers. Methods: We administered a cross-sectional survey to 300 mothers/female caregivers of Medicaid-enrolled 2- to 4-year-old children in Philadelphia. Mothers reported their own and their child's dietary intake using the validated Dietary Screener Questionnaire. Mixed-effects linear regression models assessed associations of perceived neighborhood safety, collective efficacy, and census tract-level violent crime with parent and child dietary intake, adjusted for individual, family, and neighborhood covariates. Results: Among mothers, higher perceived neighborhood safety and collective efficacy were associated with higher daily intake of fruits/vegetables (β = 0.35 cups, 95% CI: 0.12-0.58 and β = 0.30 cups, 95% CI: 0.08-0.52, comparing the highest with lowest tertile). Higher neighborhood-perceived safety was also associated with higher whole-grain intake among mothers (β = 0.14 ounces, 95% CI: 0.02-0.27) and children (β = 0.07 ounces, 95% CI: 0.01-0.13, comparing the highest with lowest tertile). Neighborhood social exposures were not associated with intake of added sugars or sugar-sweetened beverages for mothers or children, nor were lower levels of violent crime associated with any outcome. Conclusions: More favorable perceptions of neighborhood safety and collective efficacy were associated with a slightly higher consumption of some healthy foods among mothers and their young children. Future prospective research is needed to confirm these findings, explore potential mechanisms, and determine whether intervening on the social environment improves diet.
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Affiliation(s)
- Stephanie L Mayne
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA
| | - Chloe Hannan
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA
| | - Gabrielle DiFiore
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA
| | - Senbagam Virudachalam
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA
| | - Karen Glanz
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA.,Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Alexander G Fiks
- Center for Pediatric Clinical Effectiveness, Possibilities Project and PolicyLab, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute for Health Economics, University of Pennsylvania, Colonial Penn Center, Philadelphia, PA, USA
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36
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Edney SM, Park SH, Tan L, Chua XH, Dickens BSL, Rebello SA, Petrunoff N, Müller AM, Tan CS, Müller-Riemenschneider F, van Dam RM. Advancing understanding of dietary and movement behaviours in an Asian population through real-time monitoring: Protocol of the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA). Digit Health 2022; 8:20552076221110534. [PMID: 35795338 PMCID: PMC9251970 DOI: 10.1177/20552076221110534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Modifiable risk factors for non-communicable diseases, including eating an unhealthy diet and being physically inactive, are influenced by complex and dynamic interactions between people and their social and physical environment. Therefore, understanding patterns and determinants of these risk factors as they occur in real life is essential to enable the design of precision public health interventions. Objective This paper describes the protocol for the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA). The study uses real-time data capture methods to gain a comprehensive understanding of eating and movement behaviours, including how these differ by socio-demographic characteristics and are shaped by people's interaction with their social and physical environment. Methods COBRA is an observational study in free-living conditions. We will recruit 1500 adults aged 21-69 years from a large prospective cohort study. Real-time data capture methods will be used for nine consecutive days: an ecological momentary assessment app with a global positioning system enabled to collect location data, accelerometers to measure movement, and wearable sensors to monitor blood glucose levels. Participants receive six EMA surveys per day between 8 a.m. and 9.30 p.m. to capture information on behavioural risk factors including eating behaviours and diet composition movement behaviours (physical activity, sedentary behaviour, sleep), and related contextual factors. The second wave of ecological momentary assessment surveys with a global positioning system enabled will be sent 6 months later. Data will be analysed using generalised linear models to examine associations between behavioural risk factors and contextual determinants. Discussion Findings from this study will advance our understanding of dietary and movement behaviours as they occur in real-life and inform the development of personalised interventions to prevent chronic diseases.
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Affiliation(s)
- Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Su Hyun Park
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Linda Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Xin Hui Chua
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Nick Petrunoff
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheun Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute of Public Health, The George Washington University, Washington, DC, USA
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Roberts SB, Das SK, Sayer RD, Caldwell AE, Wyatt HR, Mehta TS, Gorczyca AM, Oslund JL, Peters JC, Friedman JE, Chiu CY, Greenway FL, Donnelly JE, Dao MC, Cuevas AG, Affuso O, Wilkinson LL, Thomas D, Al-Ozairi E, Yannakoulia M, Khazrai YM, Manalac RJ, Bachiashvili V, Hill JO. Technical report: an online international weight control registry to inform precision approaches to healthy weight management. Int J Obes (Lond) 2022; 46:1728-1733. [PMID: 35710944 PMCID: PMC9201790 DOI: 10.1038/s41366-022-01158-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Personalizing approaches to prevention and treatment of obesity will be a crucial aspect of precision health initiatives. However, in considering individual susceptibility to obesity, much remains to be learned about how to support healthy weight management in different population subgroups, environments and geographical locations. SUBJECTS/METHODS The International Weight Control Registry (IWCR) has been launched to facilitate a deeper and broader understanding of the spectrum of factors contributing to success and challenges in weight loss and weight loss maintenance in individuals and across population groups. The IWCR registry aims to recruit, enroll and follow a diverse cohort of adults with varying rates of success in weight management. Data collection methods include questionnaires of demographic variables, weight history, and behavioral, cultural, economic, psychological, and environmental domains. A subset of participants will provide objective measures of physical activity, weight, and body composition along with detailed reports of dietary intake. Lastly, participants will be able to provide qualitative information in an unstructured format on additional topics they feel are relevant, and environmental data will be obtained from public sources based on participant zip code. CONCLUSIONS The IWCR will be a resource for researchers to inform improvements in interventions for weight loss and weight loss maintenance in different countries, and to examine environmental and policy-level factors that affect weight management in different population groups. This large scale, multi-level approach aims to inform efforts to reduce the prevalence of obesity worldwide and its associated comorbidities and economic impacts. TRIAL REGISTRATION NCT04907396 (clinicaltrials.gov) sponsor SB Roberts; Tufts University IRB #13075.
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Affiliation(s)
- Susan B. Roberts
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - Sai Krupa Das
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - R. Drew Sayer
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Ann E. Caldwell
- grid.430503.10000 0001 0703 675XDivision of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, CO 80045 USA
| | - Holly R. Wyatt
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Tapan S. Mehta
- grid.265892.20000000106344187Department of Family and Community Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - Anna M. Gorczyca
- grid.412016.00000 0001 2177 6375Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160 USA
| | - Jennifer L. Oslund
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - John C. Peters
- grid.430503.10000 0001 0703 675XDivision of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, CO 80045 USA
| | - James E. Friedman
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Chia-Ying Chiu
- grid.265892.20000000106344187Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - Frank L. Greenway
- grid.410428.b0000 0001 0665 5823Clinical Trials Unit, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808 USA
| | - Joseph E. Donnelly
- grid.412016.00000 0001 2177 6375Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160 USA
| | - Maria Carlota Dao
- grid.167436.10000 0001 2192 7145Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH 03824 USA
| | - Adolfo G. Cuevas
- grid.429997.80000 0004 1936 7531Department of Community Health, Tufts University, Medford, MA 02155 USA
| | - Olivia Affuso
- grid.265892.20000000106344187Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Larrell L. Wilkinson
- grid.265892.20000000106344187Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Diana Thomas
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Ebaa Al-Ozairi
- grid.452356.30000 0004 0518 1285Clinical Research Unit, Dasman Diabetes Institute, 15462 Kuwait City, Kuwait
| | - Mary Yannakoulia
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 176 71 Kallithea, Greece
| | - Yeganeh M. Khazrai
- grid.9657.d0000 0004 1757 5329Department of Food Science and Human Nutrition, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, RM Italy
| | - Raoul J. Manalac
- grid.64337.350000 0001 0662 7451Bariatric & Metabolic Institute, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA USA
| | - Vasil Bachiashvili
- grid.265892.20000000106344187Department of Family and Community Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - James O. Hill
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
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Ahmed S, Kennedy G, Crum J, Vogliano C, McClung S, Anderson C. Suitability of Data-Collection Methods, Tools, and Metrics for Evaluating Market Food Environments in Low- and Middle-Income Countries. Foods 2021; 10:foods10112728. [PMID: 34829009 PMCID: PMC8621112 DOI: 10.3390/foods10112728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/24/2022] Open
Abstract
Globalization is transforming food environments in low- and middle-income countries (LMICs) with implications for diets and nutrition. However, most food-environment assessments were developed for use in high-income countries. We evaluated the suitability of 113 data-collection assessments (i.e., methods, tools, and metrics) for eight dimensions of informal and formal market food environments for diverse contexts of LMICs. We used a scoring exercise and a survey of experts (n = 27). According to the scoring exercise, 10 assessments (8 methods, 1 tool, and 1 metric) were suitable without modification for informal markets. Suitability for formal markets was markedly higher, with 41 assessments (21 methods, 14 tools, and 6 metrics) found suitable without modification. Experts considered availability, accessibility, price, and affordability the most important dimensions of market food environments to evaluate in LMICs. Market-basket analysis and vendor audits (which include inventories) were ranked as the most suitable methods to assess multiple dimensions of market food environments, including availability, price, affordability, vendor and product characteristics, marketing, and regulation. Gaps in relevant assessments were found for convenience and desirability. Results demonstrate the need for the development, adaptation, and validation of assessments relevant for informal markets in a diverse range of LMIC contexts to support diets, nutrition, and health globally.
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Affiliation(s)
- Selena Ahmed
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA
- Correspondence:
| | - Gina Kennedy
- USAID Advancing Nutrition, Arlington, VA 22202, USA; (G.K.); (J.C.); (C.V.); (S.M.); (C.A.)
| | - Jennifer Crum
- USAID Advancing Nutrition, Arlington, VA 22202, USA; (G.K.); (J.C.); (C.V.); (S.M.); (C.A.)
| | - Chris Vogliano
- USAID Advancing Nutrition, Arlington, VA 22202, USA; (G.K.); (J.C.); (C.V.); (S.M.); (C.A.)
| | - Sarah McClung
- USAID Advancing Nutrition, Arlington, VA 22202, USA; (G.K.); (J.C.); (C.V.); (S.M.); (C.A.)
| | - Collin Anderson
- USAID Advancing Nutrition, Arlington, VA 22202, USA; (G.K.); (J.C.); (C.V.); (S.M.); (C.A.)
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Stearns JA, Ren H, Spence JC, Avedzi H, Lee KK. Protocol for an evaluation of the Designing Communities to Support Healthy Living in Aging Residents Study. ACTA ACUST UNITED AC 2021; 79:172. [PMID: 34620222 PMCID: PMC8496141 DOI: 10.1186/s13690-021-00691-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/12/2021] [Indexed: 10/29/2022]
Abstract
BACKGROUND In collaboration with building developers, the Housing for Health team is contributing to the design of community-based congregate living facilities to support healthy living in older adults. There may also be opportunities to improve the surrounding neighbourhoods by collaborating with the municipalities where the developments are located. We will evaluate whether one or more of these comprehensive interventions lead to changes in the perceived, microscale, and macroscale neighbourhood-built environment (BE) and amenities, and impacts on the physical activity (PA), healthy eating, and social connections of residents. In parallel, we will gather qualitative data to provide a more in-depth understanding of how the BE may facilitate or hinder resident's healthy living outcomes. METHODS This project employs a quasi-experimental pre-post design with at least one or more intervention and control sites. The quantitative BE evaluation will include pre- and post-intervention assessments of neighbourhood macroscale (e.g., layout of communities) and microscale (e.g., street details and characteristics) changes using Geographical Information Systems (GIS) and Microscale Audit Pedestrian Streetscapes (MAPS) audits, respectively. The quantitative resident evaluation will include self-report (i.e., surveys) and objective assessments (i.e., accelerometers, Global Positioning System [GPS]) of residents at baseline (3-6-months pre-move-in) and follow-up (3-6-months and 9-12-months post-move-in if possible). The qualitative resident-environment component will involve in-depth semi-structured interviews post-intervention with building residents, family members, and stakeholders involved in the design/development and/or operation of the intervention site(s). Participant observations will be completed in the building and neighbourhood environments of the intervention site(s). DISCUSSION Findings will provide evidence on whether and how comprehensive changes to the BE and amenities of at least one congregate living facility and the surrounding neighbourhood can impact PA, healthy eating, and social connections of older adults. Successful intervention elements will be scaled up in future work. We will disseminate findings to a broad audience including the scientific community via peer-reviewed publications, conference presentations, and discussion panels; and the private, public, and not-for-profit sectors via reports, public presentations, and/or communications via our partners and their networks. TRIAL REGISTRATION Protocol ID: 1819-HQ-000051. ClinicalTrials.gov ID: NCT05031273. Registered 29 June 2021 with ClinicalTrials.gov.
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Affiliation(s)
- Jodie A Stearns
- Division of Preventive Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Hui Ren
- Division of Preventive Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Hayford Avedzi
- Division of Preventive Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Karen K Lee
- Division of Preventive Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. .,Housing for Health, Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, 1902 College Plaza, 8215 112 St NW, AB, T6G 2C8, Edmonton, Canada.
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Laar A, Kelly B, Holdsworth M, Quarpong W, Aryeetey R, Amevinya GS, Tandoh A, Agyemang C, Zotor F, Laar ME, Mensah K, Laryea D, Asiki G, Pradeilles R, Sellen D, L'Abbe MR, Vandevijvere S. Providing Measurement, Evaluation, Accountability, and Leadership Support (MEALS) for Non-communicable Diseases Prevention in Ghana: Project Implementation Protocol. Front Nutr 2021; 8:644320. [PMID: 34485355 PMCID: PMC8416277 DOI: 10.3389/fnut.2021.644320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 07/12/2021] [Indexed: 01/22/2023] Open
Abstract
Background: This study describes the rationale, adaptation, and final protocol of a project developed to address the increase in obesity and nutrition-related non-communicable diseases (NR-NCDs) in Ghana. Code-named the Measurement, Evaluation, Accountability, and Leadership Support for NCDs (MEALS4NCDs) project, it aims to measure and support public sector actions that create healthy food marketing, retail, and provisioning environments for Ghanaian children using adapted methods from the International Network for Food and Obesity/NCDs Research Monitoring and Action Support (INFORMAS). Methods: The protocol for this observational study draws substantially from the INFORMAS' Food Promotion and Food Provision Modules. However, to appraise the readiness of local communities to implement interventions with strong potential to improve food environments of Ghanaian children, the MEALS4NCDs protocol has innovatively integrated a local community participatory approach based on the community readiness model (CRM) into the INFORMAS approaches. The setting is Ghana, and the participants include health and nutrition policy-makers, nutrition and food service providers, consumers, school authorities, and pupils of Ghanaian basic schools. Results: The study establishes a standardized approach to providing implementation science evidence for the prevention of non-communicable diseases (NCDs) in Ghana. It demonstrates feasibility and the innovative application of the INFORMAS expanded food promotion and food provision modules, together with the integration of the CRM in a lower-middle income setting. Conclusion: The research will facilitate the understanding of the processes through which the INFORMAS approach is contextualized to a lower-middle income African context. The protocol could be adapted for similar country settings to monitor relevant aspects of food environments of children.
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Affiliation(s)
- Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Wilhemina Quarpong
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Gideon Senyo Amevinya
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Francis Zotor
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Matilda E Laar
- Department Family and Consumer Sciences, School of Agriculture, University of Ghana, Accra, Ghana
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Dennis Laryea
- Non-communicable Disease Programme, Ghana Health Service, Accra, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Daniel Sellen
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Mary R L'Abbe
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
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Home food environment and associations with weight and diet among U.S. adults: a cross-sectional study. BMC Public Health 2021; 21:1032. [PMID: 34074262 PMCID: PMC8169424 DOI: 10.1186/s12889-021-11102-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The home provides the physical and social context for the majority of eating behaviors for U.S. adults. This study describes eleven dimensions of the home food environment among a national sample of U.S. adults and identifies which are associated with diet quality and overweight/obesity. METHODS A national sample of U.S. adults ages 18 to 75 was recruited from an online survey panel. Respondents (n = 4942) reported on foods available in the home, including 1) fruit and vegetables, 2) salty snacks/sweets, 3) less healthy beverages, as well as 4) food placement, 5) shopping practices for fruits and vegetables, 6) food preparation, 7) portion control methods, 8) family meals from restaurants, 9) family household practices around TV and eating, 10) presence of a TV in the dining area, and 11) ownership of a scale. Self-reported height and weight, fruit and vegetable intake, and percent calories from fat were also assessed. RESULTS Mean household size was 2.6, 32.7% had children in the home, and 23.1% lived alone. The majority were White (67.7%), with 12.3% Black and 14.3% Hispanic. Mean age was 44.4 and 48.3% were men. In multivariable models, seven features of the home food environment were associated with meeting the recommended fruit and vegetable intake guidelines, with food placement, meal preparation, frequency of shopping for fruit, and a greater variety of fruits and vegetables available in the home most strongly associated. Eight of 11 features were associated with percent energy from fat, including restaurant food for family meals, salty snacks and sweets availability, less healthy beverages availability, food placement, meal preparation, frequency of shopping for fruit, family eating with the TV on, and having a TV in the dining area. More diverse fruit and vegetable availability was associated with lower odds of overweight/obesity, and more frequent family eating while watching TV was associated with increased odds of overweight/obesity. CONCLUSION Targeting these dimensions of the home food environment may be a promising approach for future intervention research.
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Toure D, Herforth A, Pelto GH, Neufeld LM, Mbuya MNN. An Emergent Framework of the Market Food Environment in Low- and Middle-Income Countries. Curr Dev Nutr 2021; 5:nzab023. [PMID: 33948531 PMCID: PMC8075774 DOI: 10.1093/cdn/nzab023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/28/2021] [Accepted: 03/09/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Food systems are increasingly recognized as critical for advancing nutrition, and the food environment is viewed as the nexus between those systems and dietary consumption. Developing a measurement framework of the market food environment is a research priority, particularly for low- and middle-income countries (LMICs), which face rapid shifts in markets, dietary patterns, and nutrition outcomes. OBJECTIVES In this study, we sought to assess current conceptions and measures of the market food environment that could be adapted for use in LMICs. METHODS We conducted a narrative review of the literature to identify measures of the market food environment in recent use. First, we identified and reviewed frameworks of the food environment for LMICs with a specific focus on the market food environment. Second, we compiled 141 unique measures of the market food environment from 20 articles into a list that was pile-sorted by 5 nutrition experts into domains. We then categorized the measures based on percentage agreement across all sorts. Finally, we compared measured and conceptual domains of the market food environment to identify measurement gaps and needed adaptations. RESULTS Conceptual frameworks provide differing definitions of the market food environment but conform in their definitions of food availability, price, marketing, and product characteristics. Greater clarity is needed in defining relevant vendor and product characteristics. Eight measured domains of the market food environment emerged from the literature review, with significant overlap among conceptual domains. Measurement gaps exist for food quality, safety, packaging, desirability, and convenience. Personal characteristics also emerged as measured domains, although these are not part of the food environment per se. CONCLUSIONS These results are a step toward elucidating how, why, and where we measure the market food environment in LMICs. Future research should focus on prioritizing the most meaningful methods and metrics and on developing new measures where gaps exist.
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Affiliation(s)
- Djeinam Toure
- Global Alliance for Improved Nutrition, Washington, DC, USA
- Helen Keller International, Dakar, Senegal
| | - Anna Herforth
- Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Gretel H Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Litton MM, Beavers AW. The Relationship between Food Security Status and Fruit and Vegetable Intake during the COVID-19 Pandemic. Nutrients 2021; 13:nu13030712. [PMID: 33668207 PMCID: PMC7995961 DOI: 10.3390/nu13030712] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/31/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has drastically altered food shopping behaviors, and the resulting economic recession has caused a spike in food insecurity. Since food insecurity is associated with poor diet, especially low intake of fruits and vegetables, food-insecure individuals may disproportionately experience negative health impacts related to poor diet during the pandemic. To assess the relationship between food security status and fruit and vegetable intake during the COVID-19 pandemic, we conducted an online survey of adult residents of the US state of Michigan in June of 2020. Among the 484 survey respondents, 36.2% were classified as food-insecure. Food-insecure respondents consumed fruits and vegetables fewer times per day than food-secure respondents and were more likely to report decreasing their consumption of any type of fruits and vegetables (total, fresh, frozen, and canned) since the pandemic started. For those who reduced their purchase of fresh fruit and vegetable, reasons included poor quality, poor availability, high price, reduced store trips, and concerns of contamination. These findings highlight the need for adequate food assistance during the COVID-19 pandemic and in future pandemics, as well as public health messages that promote healthy eating.
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Martínez-García A, Trescastro-López EM, Galiana-Sánchez ME, Llorens-Ivorra C, Pereyra-Zamora P. Cultural Adaptation and Evaluation of the Perceived Nutrition Environment Measures Survey to the Mediterranean Spanish Context (NEMS-P-MED). Nutrients 2020; 12:nu12113257. [PMID: 33114384 PMCID: PMC7693738 DOI: 10.3390/nu12113257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 12/04/2022] Open
Abstract
Individuals’ perceptions of their food environments are a mediator between exposure to the environment and people’s interaction with it. The Nutrition Environment Measures Surveys (NEMS) are valid and reliable measures to assess food environments. In Spain, there is no adapted instrument to measure the perceived obesogenic environment. This article aims to adapt and evaluate the Perceived Nutrition Environment Measures Survey for a Spanish context (NEMS-P-MED). The Spanish version has 32 questions to measure the perception about availability, accessibility and marketing of 3 types of environment: home, shops and restaurants. We assess feasibility, construct validity and internal consistency reliability through a sample of 95 individuals. The internal consistency was acceptable for most items (Cronbach’s alpha coefficients range from 0.6 to 0.9), similar to that of the original scale. The NEMS-P-MED has been shown to be valid and, on certain items reliable, and was useful to assess the population’s perceptions of the food environment in the home, restaurants and food stores in a Spanish context. Adapting standardized measurement tools to specific contexts to assess the perceived and observed characteristics of food environments may facilitate the development of effective policy interventions to reduce excess weight.
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Affiliation(s)
- Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
| | - Eva María Trescastro-López
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
- Correspondence: ; Tel.: +34-96-590-34-00 (ext. 3834)
| | - María Eugenia Galiana-Sánchez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
| | - Cristóbal Llorens-Ivorra
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
- Public Health Center of Dénia (Alicante), Valencian Community, 03700 Alicante, Spain
| | - Pamela Pereyra-Zamora
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
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Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197143. [PMID: 33003573 PMCID: PMC7579470 DOI: 10.3390/ijerph17197143] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 01/24/2023]
Abstract
Both food swamps and food deserts have been associated with racial, ethnic, and socioeconomic disparities in obesity rates. Little is known about how the distribution of food deserts and food swamps relate to disparities in self-reported dietary habits, and health status, particularly for historically marginalized groups. In a national U.S. sample of 4305 online survey participants (age 18+), multinomial logistic regression analyses were used to assess by race and ethnicity the likelihood of living in a food swamp or food desert area. Predicted probabilities of self-reported dietary habits, health status, and weight status were calculated using the fitted values from ordinal or multinomial logistic regression models adjusted for relevant covariates. Results showed that non-Hispanic, Black participants (N = 954) were most likely to report living in a food swamp. In the full and White subsamples (N = 2912), the perception of residing in a food swamp/desert was associated with less-healthful self-reported dietary habits overall. For non-Hispanic Blacks, regression results also showed that residents of perceived food swamp areas (OR = 0.66, p < 0.01, 95% CI (0.51, 0.86)) had a lower diet quality than those not living in a food swamp/food desert area. Black communities in particular may be at risk for environment-linked diet-related health inequities. These findings suggest that an individual's perceptions of food swamp and food desert exposure may be related to diet habits among adults.
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Correlates of Healthy Eating in Urban Food Desert Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176305. [PMID: 32872539 PMCID: PMC7504505 DOI: 10.3390/ijerph17176305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 11/17/2022]
Abstract
The food environment is well documented as an important emphasis for public health intervention. While theoretical models of the relationship between the food environment and dietary outcomes have been proposed, empirical testing of conceptual models has been limited. The purpose of this study was to explore which factors in nutrition environments are significantly associated with dietary outcomes in two urban, low-income, and minority food desert communities. This study analyzed cross-sectional data based on 796 participants from the Food in Our Neighborhood Study. Participants were recruited based on a random sample of addresses in neighborhood study areas, Philadelphia, PA (n = 393) and Trenton, NJ (n = 403). Main dietary outcomes were Healthy Eating Index (HEI) scores and fruit and vegetable consumption subscores computed from ASA24® assessments. Exploratory factor analysis was conducted and yielded a model of four factors with 22 items. Among four factors that emerged, three factors (Perceptions of Neighborhood Food Availability; and Household Food Challenges) were significantly correlated with dietary outcomes. My Store's Quality and Perceptions of Neighborhood Food Availability were positively correlated with vegetable consumption subscore. The Household Food Challenges factor was negatively correlated with both vegetable subscore and overall HEI score (i.e., more household challenges were associated with lower dietary scores). These findings confirmed the importance of perceived nutrition environments and household food challenges in predicting dietary outcomes among residents of two urban, low-income, and minority food desert communities.
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Abstract
OBJECTIVE To examine cross-sectional associations of four aspects of the consumer food environment - price, availability, marketing and product placement - with BMI and fruit and vegetable intake. DESIGN This cross-sectional study measured the consumer food environment using grocery store audits and surveys. Outcomes were measured through surveys and physical exams. Multivariable linear regression models were run; models were all adjusted for age, neighbourhood, education, race/ethnicity and financial burden. SETTING Non-proportional quota sample of four socio-economically and racial/ethnically diverse neighbourhoods in Chicago, IL. PARTICIPANTS Women (n 228) aged 18-44 years. RESULTS Participants who reported seeing healthy food marketing had a higher vegetable intake (β = 0·24, 95 % CI 0·06, 0·42). There was some suggestive evidence that participants who shopped at stores that were more expensive (β = -0·90, 95 % CI -1·94, 0·14) had lower BMI, but this association was not statistically significant. Multivariable regression models did not indicate any significant association between any measure of the consumer food environment and fruit intake. CONCLUSIONS Our findings add to the growing interest in the role of the consumer food environment in health behaviours. Further research is needed to better understand the role of price and marketing characteristics on eating behaviours and BMI.
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Katare B, Lynch K, Savaiano D. Perceived neighbourhood food environment and overweight and obesity among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) participants in the Midwest US. Public Health Nutr 2020; 24:1-9. [PMID: 32744206 DOI: 10.1017/s136898002000155x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the relationship between neighbourhood food environment perceptions and obesity among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) or Expanded Food and Nutrition Education Program (EFNEP) participants. DESIGN A cross-sectional study conducted during SNAP-Ed or EFNEP programme participation in six states in the Midwest US between May 2016 and November 2017. SETTING Community centres, food pantries and other SNAP-Ed or EFNEP recruitment locations. PARTICIPANTS Convenience sample of 1743 low-income, adult nutrition education programme participants. RESULTS Controlling for participant location and other demographic variables, those who perceived that a large selection of fruits and vegetables were available to them were 22 % less likely to be obese (adjusted odds ratio 0·78, 95 % CI 0·63, 0·97). In addition, participants who perceived the distance to the grocery store where they purchased most of their groceries to be greater than 5 miles were 1·36 times more likely to be overweight or obese than those who travelled shorter distances for their groceries. CONCLUSIONS SNAP-Ed or EFNEP participants' weight status may be associated with their perceptions of their neighbourhood food environments. Programmes incorporating nutrition education and food access initiatives should attempt to better understand participant perceptions in order to address barriers in their efforts and to ensure that healthy food is accessible to low-income residents.
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Affiliation(s)
- Bhagyashree Katare
- Department of Agricultural Economics, Purdue University, West Lafayette, IN, USA
| | - Krystal Lynch
- Nutrition and Dietetics, College of Health and Human Services, Eastern Illinois University, Charleston, IL, USA
- Purdue Extension Nutrition Education Program, West Lafayette, IN, USA
| | - Dennis Savaiano
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
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Latent Class Analysis Offers Insight into the Complex Food Environments of Native American Communities: Findings from the Randomly Selected OPREVENT2 Trial Baseline Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041237. [PMID: 32075090 PMCID: PMC7068597 DOI: 10.3390/ijerph17041237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/18/2019] [Accepted: 11/25/2019] [Indexed: 11/22/2022]
Abstract
Native Americans (NAs) experience a high burden of obesity and diabetes, yet previous research has not holistically described the unique food environments of NA communities. The objective of this paper is to describe the subgroups and demographic characteristics related to NA household food environments. Surveys collected food getting, food assistance, and sociodemographic variables from randomly selected adults from three NA communities (n = 300) in the Midwest and Southwest. Exploratory latent class analysis (LCA) identified the appropriate number of subgroups based on indicator responses. After assigning participants to classes, demographic differences were examined using bivariate analyses. NA household food environments could be described using two subgroups (“lower” and “higher access household food environments”). The “lower access” group had significantly higher age, smaller household size, and fewer children per household than the “higher access” group, while body mass index (BMI) did not significantly vary. This is the first LCA of NA household food environments and highlights the need for approaches that characterize the complexity of these environments. Findings demonstrate that NA household food environments can be described by developing subgroups based on patterns of market and traditional food getting, and food assistance utilization. Understanding NA household food environments could identify tailored individual and community-level approaches to promoting healthy eating for NA Nations.
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Vlot-van Anrooij K, Hilgenkamp TI, Leusink GL, van der Cruijsen A, Jansen H, Naaldenberg J, van der Velden K. Improving Environmental Capacities for Health Promotion in Support Settings for People with Intellectual Disabilities: Inclusive Design of the DIHASID Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E794. [PMID: 32012833 PMCID: PMC7037294 DOI: 10.3390/ijerph17030794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 01/17/2023]
Abstract
People with intellectual disabilities (ID) have unhealthier lifestyles than the general population. To sustainably improve their lifestyle and health status, a whole-system approach to creating healthy environments is crucial. To gain insight into how support for physical activity and healthy nutrition can be embedded in a setting, asset mapping can be helpful. Asset mapping involves creating a bottom-up overview of promoting and protective factors for health. However, there is no asset mapping tool available for ID support settings. This study aims to develop an asset mapping tool in collaboration with people with ID to gain insight into assets for healthy nutrition and physical activity in such settings. The tool is based on previous research and development continued in an iterative and inclusive process in order to create a clear, comprehensive, and usable tool. Expert interviews (n = 7), interviews with end-users (n = 7), and pilot testing (n = 16) were conducted to refine the tool. Pilot participants perceived the tool as helpful in pinpointing perceived assets and in prompting ideas on how to create inclusive environments with support for physical activity and healthy nutrition. This overview of assets can be helpful for mobilizing assets and building the health-promoting capacities of ID support settings.
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Affiliation(s)
- Kristel Vlot-van Anrooij
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Thessa I.M. Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas, NV 89154-3029, USA;
- Department of General Practice, Intellectual Disability Medicine, Erasmus University Medical Center, Rotterdam, P.O box 2040, 3000 CA Rotterdam, The Netherlands
| | - Geraline L. Leusink
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Anneke van der Cruijsen
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Henk Jansen
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands;
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