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Almoraie NM, Alothmani NM, Alomari WD, Al-Amoudi AH. Addressing nutritional issues and eating behaviours among university students: a narrative review. Nutr Res Rev 2024:1-16. [PMID: 38356364 DOI: 10.1017/s0954422424000088] [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: 02/16/2024]
Abstract
University life is a critical period for establishing healthy eating habits and attitudes. However, university students are at risk of developing poor eating habits due to various factors, including economic conditions, academic stress and lack of information about nutritional concepts. Poor diet quality leads to malnutrition or overnutrition, increasing the risk of preventable diseases. Food environments on university campuses also play a significant role in shaping the dietary habits of students, with the availability of and accessibility to healthy food options being important factors influencing food choices and overall diet quality. Disordered eating habits and body dissatisfaction are prevalent among university students and can lead to eating disorders. Income and living arrangements also influence dietary habits, with low household income and living alone being associated with unhealthy eating habits. This study is a narrative review that aimed to address nutritional issues and eating behaviours, specifically among university students. We investigated the eating behaviours of university students, including their dietary patterns, food choices and food environments. The objective of this review was to provide insights into the nutritional issues and eating behaviours of university students, with the aim of identifying target areas for intervention to improve the overall health and wellbeing among college students. University food environments need to be restructured to promote healthy eating, including the availability, accessibility, affordability and labelling of healthy foods, and policies to limit the availability of unhealthy foods and drinks on campus.
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Affiliation(s)
- Noha M Almoraie
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noor M Alothmani
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wajd D Alomari
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amal H Al-Amoudi
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
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Evans CEL, Worth S, White R, Strachan EK. Evaluation of an experiment to increase availability of healthier snack foods in vending machines situated within English sports facilities. Public Health Nutr 2023; 26:3088-3099. [PMID: 37727877 PMCID: PMC10755406 DOI: 10.1017/s1368980023002069] [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: 07/02/2022] [Revised: 06/14/2023] [Accepted: 09/13/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To evaluate the impact of increased availability of healthier options on purchasing of different types of vending snack products sold in English leisure (sports) centres. DESIGN An evaluation of an intervention using pre-post methods and interrupted time series analysis. Products within the vending machines were altered over three phases to increase the availability of healthier options, using agreed nutrition criteria - Government Buying Standards for Food and Catering Services (GBSF) for England - as a guide, as well as product availability. The primary outcome was the change in mean weekly purchased energy between the first and third phase. Secondary outcomes included changes by phase and by week in weekly number of purchases, fats, sugars and salt for all products combined and by individual product categories. SETTING Fifteen sports centres in the city of Leeds, West Yorkshire, UK. PARTICIPANTS Snack products sold in eighteen vending machines. RESULTS Energy purchased reduced from baseline to phase 2, for all product categories combined, by 47·25 MJ (95 % CI (-61·22, -33·27)) per machine and by 279 kJ, (95 % CI (-325, -266)) per product unit. There were reductions in most nutrients purchased in all individual product categories except chocolate confectionery. Nutrients per product unit decreased for all product categories except saturated fat in chocolate confectionery. Minimal underlying trends in the baseline phase were identified, indicating changes in outcomes were likely to be due to the intervention. CONCLUSIONS Introducing standards to increase availability of healthier snack products in vending machines is feasible without substantially affecting sales.
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Affiliation(s)
- Charlotte EL Evans
- School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | | | - Rachel White
- Health Improvement and Disparities, Department of Health and Social Care, London, UK
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Durán-Agüero S, Valdés-Badilla P, Valladares M, Espinoza V, Mena F, Oñate G, Fernandez M, Godoy-Cumillaf A, Crovetto M. Consumption of ultra-processed food and its association with obesity in Chilean university students: A multi-center study Ultra-processed food and obesity in Chilean university students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2356-2362. [PMID: 34469253 DOI: 10.1080/07448481.2021.1967960] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/07/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To explore the associations between the consumption of three categories of ultra-processed food (sugary beverages, sweet, and salty snacks) and body mass index (BMI) among Chilean university students. METHODS We conducted a multi-center, descriptive study among 2,039 students from 6 Chilean universities. Food consumption was surveyed using a validate food survey. That height and body weight were objectively measured to calculate BMI for determining weight status, and also, tobacco use and physical activity were measured. RESULTS An intake equal to or higher than 1 serving of sugary beverage a day was associated with greater odds of obesity in university students (OR:1.32 [95% CI: 1.00, 1.74]), 2 servings/day (OR: 1.30 [95% CI: 1.04, 1.50]), and 3 servings/day (OR: 1.39 [95% CI: 1.05, 1.80]). Neither consumption of sweet nor salty snacks (≥1 servings/day) related to differential odds of obesity: (OR: 0.83 [95% CI: 0.42, 1.64]) and (OR: 1.79 [95% CI: 0.93, 3.41]), respectively. CONCLUSION In a sample of Chilean university students, consumption of sugary beverages, and not consumption of sweet or salty snacks, was associated with obesity.
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Affiliation(s)
- Samuel Durán-Agüero
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Sede Los Leones, Chile
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences. Faculty of Education Sciences, Universidad Católica del Maule. Talca, Talca, Chile
- Carrera de Entrenador Deportivo. Escuela de Educación, Universidad Viña del Mar, Viña del Mar, Chile
| | - Macarena Valladares
- Centro Integrativo de Biología y Química Aplicada (CIBQA), Universidad Bernardo ÓHiggins, Santiago, Chile
| | - Valentina Espinoza
- Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - Francisco Mena
- Estudiante Doctorado en Nutrición y Alimentos, Universidad de Chile, Santiago, Chile
| | - Gloria Oñate
- Carrera Nutrición y Dietética, Universidad Autónoma de Chile, Santiago, Chile
| | - Macarena Fernandez
- Carrera Nutrición y Dietética, Universidad Autónoma de Chile, Santiago, Chile
| | - Andres Godoy-Cumillaf
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Santiago, Chile
| | - Mirta Crovetto
- Centro de Estudios Avanzados, Facultad de Ciencias de la Salud, Universidad Playa Ancha, Valparaíso, Chile
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Murillo-Figueroa AC, Ramírez-Morales A, López-López FX, Rojo-Trejo ME, Robles-Osorio ML, Sabath E. Comparative Study of Food Quality, Variety and Price Between Vending Machines, Street Vendors, and Cafeterias in Hospitals Located in Central Mexico. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2023. [DOI: 10.1080/19320248.2023.2166801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Ana Carolina Murillo-Figueroa
- Nutrition School, Universidad Autónoma de Querétaro, Queretaro, México
- Nutrition School, Universidad del Valle de Atemajac, Queretaro, México
| | - Ariadna Ramírez-Morales
- Nutrition School, Universidad Autónoma de Querétaro, Queretaro, México
- Nutrition School, Universidad del Valle de Atemajac, Queretaro, México
| | | | - Maria Elena Rojo-Trejo
- Nutrition School, Universidad Autónoma de Querétaro, Queretaro, México
- Renal Division and Metabolic Unit, Hospital General de Querétaro, Querétaro, México
| | | | - Ernesto Sabath
- Nutrition School, Universidad Autónoma de Querétaro, Queretaro, México
- Renal Division and Metabolic Unit, Hospital General de Querétaro, Querétaro, México
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Study on Energy Efficiency of an Off-Grid Vending Machine with Compact Heat Exchangers and Low GWP Refrigerant Powered by Solar Energy. ENERGIES 2022. [DOI: 10.3390/en15124433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this research is to design an energy-efficient off-grid vending machine that has a refrigeration system powered by an environmentally friendly refrigerant. The paper presents details from the equipment’s design phase in terms of the resistance structure, photovoltaic panels area dimensioning, but also in terms of the necessary cooling load to be provided by the refrigeration system. The refrigerant chosen was R290 following a comparative analysis, which showed that it has an efficiency 6.6% higher than R134a. During the monitoring periods, the outdoors temperature varied between −4–28 °C, the relative humidity between 22–100% and yet only a slight indoor temperature variation of ±1.5 °C compared to the set value was recorded. The battery module managed to store enough energy from the photovoltaic panels to keep the vending machine functional through three consecutive days with adverse environmental conditions, as evidenced by the low variation of indoor temperature
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Consumption, Attitudes, and Trends of Vending Machine Foods at a University Campus: A Cross-Sectional Study. Foods 2021; 10:foods10092122. [PMID: 34574231 PMCID: PMC8470557 DOI: 10.3390/foods10092122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/01/2021] [Accepted: 09/05/2021] [Indexed: 01/10/2023] Open
Abstract
Vending machines (VMs) have been identified as an obesogenic factor, offering mainly energy-dense and nutrient-poor foods, with limited healthy options available. This cross-sectional study aimed to assess consumption trends and attitude toward vending machine (VM) foods in a university setting. A web-based survey was conducted among 1250 students and staff. Most participants reported weight gain (43.4%) and poorer food choices (53.4%) since joining the university. Participants described VM foods as expensive (53.7%) and lacking variety (34.3%). Over 81% demanded the availability of healthier options. About 75% of participants were VMs users. The most frequently purchased VM items were water, chocolate, and chips. Males reported consuming nuts, soda, iced tea, and energy drinks more frequently than females (p < 0.005). The main reasons for using the VM were hunger and lack of time. Over 40% nominated fresh fruits, baked chips, sandwiches, and dry roasted nuts to be provided in the VMs as healthier food options. Males and those responsible for buying their own food were more likely to select healthier options (p = 0.001). Findings can be used to inform stakeholders of current vending behaviors and to plan tailored interventions to improve the nutritional quality of vended items and promote healthier food choices.
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Rozman U, Mis NF, Kupirovič UP, Pravst I, Kocbek P, Strauss M, Turk SŠ. Nutritional quality of beverages available in vending machines in health and social care institutions: do we really want such offers? JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:29. [PMID: 34215329 PMCID: PMC8252244 DOI: 10.1186/s41043-021-00250-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/27/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Vending machines represent one way of offering food, but they are overlooked in the efforts to improve people's eating habits. The aim of our study was to analyse the variety and nutritional values of beverages offered in vending machines in social and health care institution in Slovenia. METHODS The available beverages were quantitatively assessed using traffic light profiling and the model for nutrient profiling used by Food Standards Australia New Zealand. Vending machines in 188 institutions were surveyed, resulting in 3046 different beverages consisting of 162 unique product labels. RESULTS Between 51 and 54% of beverages were categorised as unhealthy with regard to sugar content. Water accounted for only 13.7% of all beverages in vending machines. About 82% of beverages in vending machines were devoted to sugar-sweetened beverages, the majority (58.9%) presented in 500-ml bottles. The average sugar content and average calories in beverages sold in vending machines are slightly lower than in beverages sold in food stores. CONCLUSIONS We suggest that regulatory guidelines should be included in the tender conditions for vending machines in health and social care institutions, to ensure healthy food and beverage choices.
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Affiliation(s)
- Urška Rozman
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia
| | - Nataša Fidler Mis
- Department of Gastroenterology, Hepatology and Nutrition, University Children’s Hospital, University Medical Centre Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia
| | | | - Igor Pravst
- Nutrition Institute, Tržaška cesta 40, 1000 Ljubljana, Slovenia
| | - Primož Kocbek
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia
| | - Maja Strauss
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia
| | - Sonja Šostar Turk
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia
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Availability, Nutritional Profile and Processing Level of Food Products Sold in Vending Machines in a Spanish Public University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136842. [PMID: 34202231 PMCID: PMC8297357 DOI: 10.3390/ijerph18136842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Given the lack of data about the nutritional value and other determinants of the consumption of foods and drinks sold in vending machines in European universities and the relevance of this sector in Spain, it is necessary to obtain scientific data on this topic. The present study aimed to assess the availability, nutritional profile and processing level of food products from vending machines at a Spanish public university and to investigate differences in nutritional profile according to the cost and promotion. METHODS Cross-sectional descriptive study. Data from all products available (3894) were collected and analysed using the criteria of the Spanish Agency for Consumption, Food Safety and Nutrition and the United Kingdom nutrient profiling model. The items were also classified according to the degree of industrial processing through the NOVA system. Promotion was assessed, taking into account where products were displayed in vending machines. RESULTS The most common products were sweets (23.4% of the total options), coffee (20.3%) and salty snacks (11.7%). According to the combination of the two criteria used to assess nutritional profile, 48.6% of the products were classified as with low nutritional quality (LNQ). In addition, 73.8% of the items were categorised as "ultra-processed". Foods (β = 0.31, 95% CI 0.24, 0.39, p < 0.001) and hot drinks (β = 0.46, 95% CI 0.39, 0.52, p < 0.001) with high nutritional quality (HNQ) were more likely to have higher prices than alternatives with LNQ. Both foods and cold drinks that support healthy dietary recommendations were promoted to a lesser extent than those with LNQ (p < 0.001). CONCLUSION Almost half of the products were of LNQ and three-quarters had a high level of processing. Moreover, foods and cold drinks with LNQ were less expensive and more often promoted than alternatives with HNQ.
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Whatnall MC, Patterson AJ, Hutchesson MJ. Effectiveness of Nutrition Interventions in Vending Machines to Encourage the Purchase and Consumption of Healthier Food and Drinks in the University Setting: A Systematic Review. Nutrients 2020; 12:nu12030876. [PMID: 32213973 PMCID: PMC7146342 DOI: 10.3390/nu12030876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/18/2020] [Accepted: 03/22/2020] [Indexed: 11/16/2022] Open
Abstract
University food environments typically offer an abundance of unhealthy foods, including through vending machines. This review evaluated the effectiveness of nutrition interventions in vending machines in the university setting. Ten databases were searched for experimental studies published up to July 2019, evaluating nutrition interventions that aimed to encourage the purchase or consumption of healthier foods and drinks in vending machines in the university setting. In total, 401 articles were identified, and 13 studies were included. Studies were pre-post test (n = 7, 54%), randomized controlled trials (RCTs) (n = 5, 38%), and non-randomized controlled trial (n = 1, 8%). Most studies were from the USA (n = 10, 77%) and were published between 2014 and 2018 (n = 9, 69%). Eight interventions (62%) reported positive change in outcomes, including increased number/proportion of sales or revenue from healthier items (n = 6), improved adherence to guidelines for the ratio of healthy/unhealthy products available (n = 1), and improved consumer perception of items available (n = 1). Effective interventions involved the promotion, reduced pricing, increased availability, and/or optimized product placement of healthier items within vending machines. Strategies to improve the nutritional quality of food and drinks in vending machines are warranted. This may be achieved by making healthier options more available and promoting them; however, more robust intervention studies are needed to determine effectiveness.
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Affiliation(s)
- Megan C. Whatnall
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (M.C.W.); (A.J.P.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
| | - Amanda J. Patterson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (M.C.W.); (A.J.P.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
| | - Melinda J. Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; (M.C.W.); (A.J.P.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia
- Correspondence: ; Tel.: +61-2-49-215405
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Martin Payo R, Sánchez Díaz C, Suarez Colunga M, García García R, Blanco Díaz M, Fernández Álvarez MDM. [Nutritional composition of vending foods of public university and hospital buildings in Asturias]. Aten Primaria 2020; 52:22-28. [PMID: 30770153 PMCID: PMC6938996 DOI: 10.1016/j.aprim.2018.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/25/2018] [Accepted: 04/26/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To evaluate the nutritional composition of food vending machines (VM) located in university public buildings and hospitals in Asturias. DESIGN Descriptive cross-sectional study. LOCATION The analysis was made of the contents of VMs located in public buildings, hospitals, and university teaching centres in the Principality of Asturias. MAIN MEASUREMENTS After the public buildings were mapped, each of them was visited to check for the presence of the VMs. A a photograph was then taken of the food contained in them. The variables analysed were the type of products and their nutritional composition. RESULTS The VMs of 19 buildings (12 university and 7 hospital), contained 215 foods that were grouped into 11 categories. The most frequent were "chocolates and chocolate bars" (30,2%), "cookies" (11.6%) and "chips" (11.6%). The Kcal average was 216 (SD=133.1). The mean fat, in grams was 12.52 (SD=11.21), saturated fat 4.48 (SD=3,83), sugars 11.88 (SD=31.13), fibre 1.9 (SD=2.47), proteins 3.38 (SD=3.62), and salt 0.3 (SD=0.62). A high excess of fat, saturated fat, and salt was observed, as well as a medium excess of sugars. CONCLUSIONS The nutritional quality of VM in hospitals and public university centres of the Principality of Asturias cannot be defined as healthy. Therefore, health promotion strategies could be developed with the aim of improving their nutritional composition or guiding the population/users towards the selection and consumption of healthier foods.
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Affiliation(s)
- Rubén Martin Payo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Campus del Cristo, Oviedo, España.
| | | | | | | | - María Blanco Díaz
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Campus del Cristo, Oviedo, España
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Prowse RJL, Tomlin DL, Naylor PJ, Raine KD. Exploring Nutrition Labelling of Food and Beverages in Vending Machines in Canadian Recreational Sport Settings. CAN J DIET PRACT RES 2019; 80:55-62. [PMID: 30430860 DOI: 10.3148/cjdpr-2018-039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To evaluate whether interpretive "health" labels placed in vending machines in recreation centres represented products' nutrient content when compared with provincial nutrition guidelines. Methods: A cross-sectional audit (November 2015 - April 2016) of 139 vending machines in recreation facilities found 525 foods and beverages in 17 machines labelled by vendors according to healthfulness. Product nutrient content was compared with provincial nutrition guideline criteria. Cross-tabulation and weighted Cohen's kappa evaluated agreement between vendor interpretive labels and guideline ranks. Descriptive statistics evaluated how mislabelled products deviated from recommended nutrient content. Mann-Whitney tests compared nutrient content of "healthy" and "unhealthy" labelled products. Results: Almost one-third of all products were mislabelled by vendors with 72% of those labelled healthier than their actual guideline rank. Energy, total fat, sugar, and sodium contents exceeded recommended levels in one-third to one-half of mislabelled products. Overall, products labelled healthy by vendors were significantly lower in energy, sodium, and fat compared with those labelled unhealthy; however, not for all food types (e.g., bars, fruit snacks, nuts). Conclusions: For certain product categories, vendor interpretive nutrition labels poorly represented products' nutrient content according to provincial nutrition guidelines. Dietitians may be a valuable resource to help implement nutrition guidelines to create credible interpretive product labelling systems.
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Affiliation(s)
| | - Dona L Tomlin
- b School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC
| | - Patti-Jean Naylor
- b School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC
| | - Kim D Raine
- a School of Public Health, University of Alberta, Edmonton, AB
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Sowers MF, Colby S, Kavanagh K, Zhou W. Testing product, pricing, and promotional strategies for vending machine interventions with a college population. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/15378020.2019.1592653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Morgan F. Sowers
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Sarah Colby
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Katie Kavanagh
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Wenjun Zhou
- Department of Business Analytics and Statistics, University of Tennessee, Knoxville, TN, USA
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Horacek TM, Yildirim ED, Matthews Schreiber M, Byrd-Bredbenner C, Colby S, White AA, Shelnutt KP, Olfert MD, Mathews AE, Riggsbee K, Franzen-Castle L, Morrell JS, Kattelmann K. Development and Validation of the Vending Evaluation for Nutrient-Density (VEND)ing Audit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E514. [PMID: 30759796 PMCID: PMC6388218 DOI: 10.3390/ijerph16030514] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/08/2019] [Accepted: 02/08/2019] [Indexed: 12/13/2022]
Abstract
Background: This paper describes the development and validation of the Vending Evaluation for Nutrient-Density (VEND)ing audit to comprehensively evaluate vended products based upon healthfulness, price and promotion, and machine accessibility. Methods: A novel vending nutrient-density score was created to determine the healthfulness of vended snack/beverage products. Field tested in United States colleges, VENDing audit (∑nutrient-density + 10 × % healthy products) and Support sub-scores (price + promotion + accessibility) were calculated for snack/beverage machines. Higher scores indicate more healthful vending options and supports for choosing healthfully. Nutrition Environment Measures Survey-Vending (NEMS-V) was used to validate the nutrient-density score for a sub-sample of machines. Sensitivity and specificity were computed by comparing the number of healthy snacks/beverages determined by NEMS-V and the VENDing nutrient-density scores. Results: Researchers conducted the VENDing audit on 228 snack/beverage vending machines at 9 universities within the United States and used both VENDing and NEMS-V on 33 snack and 52 beverage vending machines. Mean VENDing audit scores were 4.5 ± 2.0 (2.6, 3.4) and 2.6 ± 2.0 (0, 12) for snack/beverage machines, respectively. The number of products considered healthy assessed with both the VENDing nutrient-density scores and the NEMS-V were positively correlated for beverages (r = 0.687, p < 0.001) and snacks (r = 0.366, p < 0.05). The sensitivity was excellent for beverages (0.83) and moderate for snacks (0.69); while the specificity was moderate for both beverages (0.66) and snacks (0.50). Conclusions: The VENDing audit uses unique, valid, and reliable nutrient-density scoring to evaluate snacks/beverages along a continuum of healthful criteria and comprehensively evaluates the full vending environment.
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Affiliation(s)
- Tanya M Horacek
- Department of Public Health Food Studies and Nutrition, Syracuse University, Syracuse, NY 13244, USA.
| | - Elif Dede Yildirim
- Human Development and Family Studies, Auburn University, Auburn, AL 36849, USA.
| | | | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08901, USA.
| | - Sarah Colby
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA.
| | - Adrienne A White
- School of Food and Agriculture, University of Maine, Orono, ME 04469-5735, USA.
| | - Karla P Shelnutt
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL 32611, USA.
| | - Melissa D Olfert
- Division of Animal & Nutritional Sciences, School of Agriculture, West Virginia University, Morgantown, WV 26506, USA.
| | - Anne E Mathews
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA.
| | - Kristin Riggsbee
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA.
| | - Lisa Franzen-Castle
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588, USA.
| | - Jesse Stabile Morrell
- Department of Molecular, Cellular & Biomedical Sciences, University of New Hampshire, Durham, NH 03824, USA.
| | - Kendra Kattelmann
- Health and Nutritional Sciences Department, South Dakota State University, Brookings, SD 57007, USA.
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Shi Y, Grech AL, Allman-Farinelli M. Changes in the nutritional quality of products sold in university vending machines since implementation of the health star rating in 2014; an environmental audit. BMC Public Health 2018; 18:1255. [PMID: 30428873 PMCID: PMC6234540 DOI: 10.1186/s12889-018-6177-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 11/01/2018] [Indexed: 01/01/2023] Open
Abstract
Background Snacking is a prevalent dietary behaviour among young adults, which could independently contribute to weight gain. Vending machines provide easy access to unhealthy snacks and beverages for young adults in universities. A voluntary front-of-pack labelling, named the Health Star Rating (HSR) system, has been implemented nationally by the Australian government as one strategy to address obesity since 2014. The primary aim of this study was to detect changes in the availability, pricing and advertising of healthy and unhealthy snacks and beverages in university vending machines after introduction of the HSR. Methods The study design was two cross-sectional audits of university vending machines one before (in 2014) and another after (in 2017) the implementation of the HSR. Data collections were conducted in a large urban university (> 60,000 students). Every machine was assessed; the product’s name, price, portion sizes and advertisements were recorded. Products were assigned an HSR to classify as healthy (≥3.5 stars) or unhealthy (< 3.5 stars). To compare the differences of product availability between 2014 and 2017, the Chi-square test was used. Results A total of 1836 and 2458 slots were audited in 2014 and 2017, respectively. The proportion of healthy snacks and beverages increased from 7 to 14% (p < 0.001) and 38 to 44% (p < 0.05) since 2014, respectively. The mean costs of unhealthy snacks and healthy beverages increased after three years. Healthy food and drink options were more expensive than unhealthy choices in 2017. Advertisements on vending machines for unhealthy foods and drinks remained prevalent. Conclusion Only small changes have been observed in the availability of healthy snacks and beverages in vending machines since implementation of the HSR system. Policy directives are indicated to encourage further improvements.
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Affiliation(s)
- Yumeng Shi
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, the Charles Perkins Centre, The University of Sydney, Level 4 East, Building D17, John Hopkins Drive, Camperdown, NSW, 2006, Australia.
| | - Amanda Lee Grech
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, the Charles Perkins Centre, The University of Sydney, Level 4 East, Building D17, John Hopkins Drive, Camperdown, NSW, 2006, Australia
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, the Charles Perkins Centre, The University of Sydney, Level 4 East, Building D17, John Hopkins Drive, Camperdown, NSW, 2006, Australia
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15
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Evenhuis IJ, Wezenbeek NLWJ, Vyth EL, Veldhuis L, Poelman MP, Wolvers D, Seidell JC, Renders CM. Development of the 'Canteen Scan': an online tool to monitor implementation of healthy canteen guidelines. BMC Public Health 2018; 18:1109. [PMID: 30200919 PMCID: PMC6131796 DOI: 10.1186/s12889-018-5974-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/16/2018] [Indexed: 11/23/2022] Open
Abstract
Background To improve the availability and accessibility of healthier food and drinks in schools, sports and worksites canteens, national Guidelines for Healthier Canteens were developed by the Netherlands Nutrition Centre. Until now, no tool was available to monitor implementation of these guidelines. This study developed and assessed the content validity and usability of an online tool (the ‘Canteen Scan’) that provides insight into and directions for improvement of healthier food products in canteens. Methods The Canteen Scan was developed using a three-step iterative process. First, preliminary measures and items to evaluate adherence to the guidelines were developed based on literature, and on discussions and pre-tests with end-users and experts from science, policy and practice. Second, content validity of a paper version of the Canteen Scan was assessed among five end-users. Third, the online Canteen Scan was pilot tested among end-users representing school canteens. Usability was measured by comprehensibility, user-friendliness, feasibility, time investment, and satisfaction. Results The content validity of the Canteen Scan was ensured by reaching agreement between stakeholders representing science, policy and practice. The scan consists of five elements: 1) basic conditions (e.g. encouragement to drink water and availability of policy regarding the guidelines), 2) product availability offered on displays (counter, shelf) and 3) in vending machines, 4) product accessibility (e.g. promotion and placement of products), and 5) an overall score based on the former elements and tailored feedback for creating a healthier canteen. The scan automatically classifies products into healthier or less healthy products. Pilot tests indicated good usability of the tool, with mean scores of 4.0–4.6 (5-point Likert scale) on the concepts comprehensibility, user-friendliness and feasibility. Conclusion The Canteen Scan provides insight into the extent to which canteens meet the Dutch Guidelines for Healthier Canteens. It also provides tailored feedback to support adjustments towards a healthier canteen and with the scan changes over time can be monitored. Pilot tests show this tool to be usable in practice.
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Affiliation(s)
- I J Evenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands.
| | - N L W J Wezenbeek
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
| | - E L Vyth
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
| | - L Veldhuis
- Netherlands Nutrition Centre, PO Box 85700, 2508, CK, The Hague, the Netherlands
| | - M P Poelman
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Heidelberglaan 2, 3584, CS, Utrecht, the Netherlands
| | - D Wolvers
- Netherlands Nutrition Centre, PO Box 85700, 2508, CK, The Hague, the Netherlands
| | - J C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
| | - C M Renders
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
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16
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Appelhans BM, French SA, Olinger T, Bogucki M, Janssen I, Avery-Mamer EF, Powell LM. Leveraging delay discounting for health: Can time delays influence food choice? Appetite 2018; 126:16-25. [PMID: 29551401 DOI: 10.1016/j.appet.2018.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 03/05/2018] [Accepted: 03/14/2018] [Indexed: 11/28/2022]
Abstract
Delay discounting, the tendency to choose smaller immediate rewards over larger delayed rewards, is theorized to promote consumption of immediately rewarding but unhealthy foods at the expense of long-term weight maintenance and nutritional health. An untested implication of delay discounting models of decision-making is that selectively delaying access to less healthy foods may promote selection of healthier (immediately available) alternatives, even if they may be less desirable. The current study tested this hypothesis by measuring healthy versus regular vending machine snack purchasing before and during the implementation of a 25-s time delay on the delivery of regular snacks. Purchasing was also examined under a $0.25 discount on healthy snacks, a $0.25 tax on regular snacks, and the combination of both pricing interventions with the 25-s time delay. Across 32,019 vending sales from three separate vending locations, the 25-s time delay increased healthy snack purchasing from 40.1% to 42.5%, which was comparable to the impact of a $0.25 discount (43.0%). Combining the delay and the discount had a roughly additive effect (46.0%). However, the strongest effects were seen under the $0.25 tax on regular snacks (53.7%) and the combination of the delay and the tax (50.2%). Intervention effects varied substantially between vending locations. Importantly, time delays did not harm overall vending sales or revenue, which is relevant to the real-world feasibility of this intervention. More investigation is needed to better understand how the impact of time delays on food choice varies across populations, evaluate the effects of time delays on beverage vending choices, and extend this approach to food choices in contexts other than vending machines. TRIAL REGISTRATION ClinicalTrials.gov, NCT02359916.
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Affiliation(s)
- Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA; Department of Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 400, Chicago, IL, 60612, USA.
| | - Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN, 55454, USA
| | - Tamara Olinger
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | | | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Elizabeth F Avery-Mamer
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Lisa M Powell
- Health Policy and Administration, School of Public Health, University of Illinois at Chicago, MC 923, 1603 W Taylor St, Chicago, IL, 60612, USA
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17
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Rosi A, Zerbini C, Pellegrini N, Scazzina F, Brighenti F, Lugli G. How to improve food choices through vending machines: The importance of healthy food availability and consumers’ awareness. Food Qual Prefer 2017. [DOI: 10.1016/j.foodqual.2017.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Viana J, Leonard SA, Kitay B, Ansel D, Angelis P, Slusser W. Healthier vending machines in a university setting: Effective and financially sustainable. Appetite 2017; 121:263-267. [PMID: 29137969 DOI: 10.1016/j.appet.2017.11.094] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/03/2017] [Accepted: 11/10/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Joseph Viana
- UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles Young Dr. S., 31-269 CHS, Box 951772, Los Angeles, CA 90095, USA.
| | - Stephanie A Leonard
- UCLA Fielding School of Public Health, Department of Epidemiology, 650 Charles Young Dr. S., 71-254 CHS, Box 951772, Los Angeles, CA 90095, USA.
| | - Bob Kitay
- UCLA Housing & Hospitality Services, 360 De Neve Drive, Suite 182, Los Angeles, CA 90095, USA.
| | - Daryl Ansel
- UCLA Housing & Hospitality Services, 360 De Neve Drive, Suite 182, Los Angeles, CA 90095, USA.
| | - Peter Angelis
- UCLA Housing & Hospitality Services, 360 De Neve Drive, Suite 182, Los Angeles, CA 90095, USA.
| | - Wendelin Slusser
- UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles Young Dr. S., 31-269 CHS, Box 951772, Los Angeles, CA 90095, USA; UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA.
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19
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Orava T, Manske S, Hanning R. Beverages and snacks available in vending machines from a subset of Ontario secondary schools: Do offerings align with provincial nutrition standards? Canadian Journal of Public Health 2016; 107:e417-e423. [PMID: 28026708 DOI: 10.17269/cjph.107.5326] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 09/12/2016] [Accepted: 06/18/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES As part of an evaluation of Ontario's School Food and Beverage Policy (P/PM 150) in a populous Ontario region, this research aimed to: 1) identify, describe and categorize beverages and snacks available for purchase in secondary school vending machines according to P/PM 150 standards; and 2) compare the number and percentage of beverages and snacks within P/PM 150 categories (Sell Most, Sell Less, Not Permitted) from Time I (2012/2013) to Time II (2014). METHODS Representatives from consenting secondary schools assisted researchers in completing a Food Environmental Scan checklist in Times I and II. Sourced nutritional content information (calories, fats, sodium, sugars, ingredients and % daily values) was used to categorize products. The number and percentage of products in P/PM 150 categories were compared between Times by paired t-tests. RESULTS Of 26 secondary schools participating in total, 19 participated in both Time periods and were included in the study. There were 75 beverages identified (59 Time I, 45 Time II), mostly water, juices and milk-based beverages; and 132 types of snacks (87 Time I, 103 Time II), mostly grain-based snacks, vegetable/fruit chips, and baked goods. A majority of schools offered one or more Not Permitted beverages (47% Time I, 58% Time II) or snacks (74% Time I, 53% Time II). Significantly more schools met P/PM 150 standards for snacks (p = 0.02) but not beverages in Time II. CONCLUSION Full P/PM 150 compliance was achieved by few schools, indicating that schools, school boards, public health, and food services need to continue to collaborate to ensure nutrient-poor products are not sold to students in school settings.
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Affiliation(s)
- Taryn Orava
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON.
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20
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Grech A, Hebden L, Roy R, Allman-Farinelli M. Are products sold in university vending machines nutritionally poor? A food environment audit. Nutr Diet 2016; 74:185-190. [PMID: 28731640 DOI: 10.1111/1747-0080.12332] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/25/2016] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
AIM (i) To audit the nutritional composition, promotion and cost of products available from vending machines available to young adults; and (ii) to examine the relationship between product availability and sales. METHODS A cross-sectional analysis of snacks and beverages available and purchased at a large urban university was conducted between March and September 2014. Sales were electronically tracked for nine months. RESULTS A total of 61 vending machines were identified; 95% (n = 864) of the available snacks and 49% of beverages (n = 455) were less-healthy items. The mean (SD) nutrient value of snacks sold was: energy 1173 kJ (437.5), saturated fat 5.36 g (3.6), sodium 251 mg (219), fibre 1.56 g (1.29) and energy density 20.16 kJ/g (2.34) per portion vended. There was a strong correlation between the availability of food and beverages and purchases (R2 = 0.98, P < 0.001). CONCLUSIONS Vending machines market and sell less-healthy food and beverages to university students. Efforts to improve the nutritional quality are indicated and afford an opportunity to improve the diet quality of young adults, a group at risk of obesity.
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Affiliation(s)
- Amanda Grech
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Lana Hebden
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rajshri Roy
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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21
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Hua SV, Ickovics JR. Vending Machines: A Narrative Review of Factors Influencing Items Purchased. J Acad Nutr Diet 2016; 116:1578-1588. [PMID: 27546077 DOI: 10.1016/j.jand.2016.06.378] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 06/24/2016] [Indexed: 11/18/2022]
Abstract
Vending machines are a ubiquitous part of our food environments. Unfortunately, items found in vending machines tend to be processed foods and beverages high in salt, sugar, and/or fat. The purpose of this review is to describe intervention and case studies designed to promote healthier vending purchases by consumers and identify which manipulations are most effective. All studies analyzed were intervention or case studies that manipulated vending machines and analyzed sales or revenue data. This literature review is limited to studies conducted in the United States within the past 2 decades (ie, 1994 to 2015), regardless of study population or setting. Ten articles met these criteria based on a search conducted using PubMed. Study manipulations included price changes, increase in healthier items, changes to the advertisements wrapped around vending machines, and promotional signs such as a stoplight system to indicate healthfulness of items and to remind consumers to make healthy choices. Overall, seven studies had manipulations that resulted in statistically significant positive changes in purchasing behavior. Two studies used manipulations that did not influence consumer behavior, and one study was equivocal. Although there was no intervention pattern that ensured changes in purchasing, price reductions were most effective overall. Revenue from vending sales did not change substantially regardless of intervention, which will be important to foster initiation and sustainability of healthier vending. Future research should identify price changes that would balance healthier choices and revenue as well as better marketing to promote purchase of healthier items.
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Abstract
AbstractObesity in young adults is an increasing health problem in Australia and many other countries. Evidence-based information is needed to guide interventions that reduce the obesity-promoting elements in tertiary-education environments. In a food environmental audit survey, 252 outlets were audited across seven institutions: three universities and four technical and further education institutions campuses. A scoring instrument called the food environment-quality index was developed and used to assess all food outlets on these campuses. Information was collated on the availability, accessibility and promotion of foods and beverages and a composite score (maximum score=148; higher score indicates healthier outlets) was calculated. Each outlet and the overall campus were ranked into tertiles based on their ‘healthiness’. Differences in median scores for each outcome measure were compared between institutions and outlet types using one-way ANOVA with post hoc Scheffe’s testing, χ2 tests, Kruskal–Wallis H test and the Mann–Whitney U test. Binomial logistic regressions were used to compare the proportion of healthy v. unhealthy food categories across different types of outlets. Overall, the most frequently available items were sugar-sweetened beverages (20 % of all food/drink items) followed by chocolates (12 %), high-energy (>600 kJ/serve) foods (10 %), chips (10 %) and confectionery (10 %). Healthy food and beverages were observed to be less available, accessible and promoted than unhealthy options. The median score across all outlets was 72 (interquartile range=7). Tertiary-education food environments are dominated by high-energy, nutrient-poor foods and beverages. Interventions to decrease availability, accessibility and promotion of unhealthy foods are needed.
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