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Slusser W, Schmidt L, Imbery C, Watson T, Moin T, Chobdee J, Alas S, Ezenwugo S, Sheean-Remotto G. Anchor universities as leaders in the well-being movement: lessons learned from the University of California Healthy Campus Network & pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-5. [PMID: 38848274 DOI: 10.1080/07448481.2024.2351407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/19/2024] [Indexed: 06/09/2024]
Abstract
The University of California (UC) Healthy Campus Network (HCN) is a robust network of diverse coalitions across 10 UC campuses, 5 UC teaching hospitals, and UC Agriculture & Natural Resources working to promote individual campus and systemwide changes toward a culture of health and equity. The success of this work has been evident in the HCN's ability to quickly pivot to meet emergent needs during the COVID-19 pandemic, including social support through the UC Diabetes Prevention Program, tap water access for essential workers through the UC Healthy Beverage Initiative, and food security efforts through the UC Global Food Initiative. Building a culture of health and equity across a large public university system generated valuable lessons learned which enhanced the UC's preparedness and resilience in the face of the pandemic, and other institutions may benefit from these best practices to respond effectively to emergencies and thrive in states of relative normalcy.
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Affiliation(s)
- Wendelin Slusser
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
- Jonathan and Karin Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California, USA
| | - L Schmidt
- Philip R Lee Institute for Health Policy Studies and Department of Humanities and Social Sciences, University of California at San Francisco, San Francisco, California, USA
| | - C Imbery
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
| | - T Watson
- Jonathan and Karin Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California, USA
| | - T Moin
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
- HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - J Chobdee
- Workplace Health & Wellness/Human Resources, University of California at Riverside, Riverside, California, USA
| | - S Alas
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
| | - S Ezenwugo
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
| | - G Sheean-Remotto
- Strategy and Program Management, University of California Office of the President, Oakland, California, USA
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Gligorić K, Zbinden R, Chiolero A, Kıcıman E, White RW, Horvitz E, West R. Measuring and shaping the nutritional environment via food sales logs: case studies of campus-wide food choice and a call to action. Front Nutr 2024; 11:1231070. [PMID: 38899323 PMCID: PMC11186467 DOI: 10.3389/fnut.2024.1231070] [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: 05/30/2023] [Accepted: 05/14/2024] [Indexed: 06/21/2024] Open
Abstract
Although diets influence health and the environment, measuring and changing nutrition is challenging. Traditional measurement methods face challenges, and designing and conducting behavior-changing interventions is conceptually and logistically complicated. Situated local communities such as university campuses offer unique opportunities to shape the nutritional environment and promote health and sustainability. The present study investigates how passively sensed food purchase logs typically collected as part of regular business operations can be used to monitor and measure on-campus food consumption and understand food choice determinants. First, based on 38 million sales logs collected on a large university campus over eight years, we perform statistical analyses to quantify spatio-temporal determinants of food choice and characterize harmful patterns in dietary behaviors, in a case study of food purchasing at EPFL campus. We identify spatial proximity, food item pairing, and academic schedules (yearly and daily) as important determinants driving the on-campus food choice. The case studies demonstrate the potential of food sales logs for measuring nutrition and highlight the breadth and depth of future possibilities to study individual food-choice determinants. We describe how these insights provide an opportunity for stakeholders, such as campus offices responsible for managing food services, to shape the nutritional environment and improve health and sustainability by designing policies and behavioral interventions. Finally, based on the insights derived through the case study of food purchases at EPFL campus, we identify five future opportunities and offer a call to action for the nutrition research community to contribute to ensuring the health and sustainability of on-campus populations-the very communities to which many researchers belong.
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Affiliation(s)
| | | | - Arnaud Chiolero
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- School of Population and Global Health, McGill University, Montreal, QC, Canada
- Swiss School of Public Health (SSPH+), Zurich, Switzerland
| | | | | | - Eric Horvitz
- Office of the Chief Scientific Officer, Microsoft, Redmond, WA, United States
| | - Robert West
- Data Science Lab, EPFL, Lausanne, Switzerland
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Dahl AA, Fandetti SM, Ademu LO, Harris R, Racine EF. Assessing the Healthfulness of University Food Environments: A Systematic Review of Methods and Tools. Nutrients 2024; 16:1426. [PMID: 38794664 PMCID: PMC11123862 DOI: 10.3390/nu16101426] [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: 04/16/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The availability, promotion, and price of healthy foods within the university food environment may impact students' dietary choices. This systematic review summarizes the tools and methods used to assess the healthfulness of university food environments where many students spend a significant portion of their emerging adulthood. Thirty-six global studies published between 2012 and 2022 were sourced from PubMed (NNLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycInfo (EBSCO), CINHAL Complete (EBSCO), ProQuest Nursing, and Allied Health, following PRISMA 2020 guidelines. Of the included studies, 58% were institutional-level audits, 17% examined individual-level perceptions, and 25% combined both. Most institutional-level audits focused on one aspect of the food environment (e.g., eateries, vending machines). For studies examining multiple spaces within the campus environment (38%), comprehensive assessments were limited, and most studies had to employ a combination of assessment tools. Surveys were most often used to gather individual perceptions about the food environment. The Nutrition Environment Measures Survey (NEMS) was the most commonly used tool across all studies. This review highlights the need for a standardized tool, method, or a "healthy" benchmark for specific use at universities to improve methodological rigor and comparability of findings across institutions.
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Affiliation(s)
- Alicia Anne Dahl
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Stacy M. Fandetti
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Lilian O. Ademu
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Research Center at El Paso, Texas A&M University, El Paso, TX 79927, USA
| | - Ryan Harris
- J. Murrey Atkins Library, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Elizabeth F. Racine
- Texas A&M AgriLife Research Center at El Paso, Texas A&M University, El Paso, TX 79927, USA;
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Prapkree L, Deringer R, Coccia C, Huffman F, Palacios C. Effect of using the snackability app on snack quality among US college students with overweight and obesity: A randomized controlled trial. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-10. [PMID: 38652645 DOI: 10.1080/07448481.2024.2337008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To determine if using the Snackability app improves snack intake among college students. PARTICIPANTS US college students with overweight/obesity were recruited in June 2020-April 2021. METHODS A randomized controlled trial was conducted to test the Snackability app use for 12 wk on snack scores (calculated from the app) compared to controls. We also explored the effect on diet quality (Healthy Eating Index-2015) and weight. Outcomes were compared between the intervention and the control groups at 4, 8, and 12 wk using repeated measures ANOVA. RESULTS Participants in the app group significantly increased snack score at week 4 (p < 0.001) and week 8 (p = 0.015) and increased HEI-2020 score (p < 0.001) at week 4 compared to controls. The first 4 wk had the highest app usage. No significant differences were seen in body weight. CONCLUSIONS The Snackability app can be used as a tool to help improve snack and diet quality in this group.
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Affiliation(s)
- Lukkamol Prapkree
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Rianna Deringer
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Catherine Coccia
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Fatma Huffman
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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Calabro R, Kemps E, Prichard I, Tiggemann M. Effects of traffic light labelling and increased healthy range on beverage choices from vending machines. Public Health Nutr 2024; 27:e113. [PMID: 38587000 PMCID: PMC11036432 DOI: 10.1017/s1368980024000843] [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: 08/31/2023] [Revised: 01/28/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To test whether traffic light labels and an increased range of healthy beverages, individually and in combination, can increase healthy beverage choices from vending machines. DESIGN Two studies (n 558, 420) tested whether the provision of traffic light labels (green, amber and red) and an increased range of healthy beverages (from 20 % to 50 % green options), individually and in combination, could increase healthy beverage choices from a digital vending machine display. The studies used a between-subjects experimental design, and a hypothetical beverage choice, a limitation when considering real-world applicability. SETTING Both studies utilised an online Qualtrics survey that featured a digital vending machine display. PARTICIPANTS Both studies (n 558, 420) consisted of university students from Flinders University and individuals from a survey recruitment service. RESULTS Featuring traffic lights did not significantly influence beverage choices (P = 0·074), while increasing the healthy range (P = 0·003, OR = 3·27), and the combination of both, did significantly increase healthier beverage choices (P < 0·001, OR = 4·83). CONCLUSIONS The results suggest that the traffic light system and increased healthy range are not maximally effective when used on their own, and benefit greatly when combined, to increase healthy beverage choices. It was suggested that the provision of traffic light labels supplied the necessary nutritional information, and the increased healthy range offered greater opportunity to act in accordance with that information. In so doing, the present findings offer a promising pathway for reducing unhealthy beverage consumption.
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Affiliation(s)
- Ryan Calabro
- Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, SA5001, Australia
| | - Eva Kemps
- Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, SA5001, Australia
| | - Ivanka Prichard
- Health & Exercise Sciences, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Marika Tiggemann
- Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, SA5001, Australia
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Kirchoff C, Abadia K, Palacios C. Perception about the effectiveness of different vending machine interventions to promote healthier snack selection among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:94-100. [PMID: 35025718 DOI: 10.1080/07448481.2021.2024207] [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: 02/11/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Evaluate college students' perception of the effectiveness of different vending machine (VM) interventions for improving snack selection. PARTICIPANTS A total of 194 college students with the age of ≥18 years. METHOD A cross-sectional survey among a purposive sampling near VM. RESULTS Most students use VM frequently or occasionally (63.4%). The intervention perceived as most helpful for choosing healthier snacks was labeling (on or near) which snack is healthy (score 3.83/5) followed by lowering the price of healthy options (score 3.33/5), while the least helpful was having posters nearby explaining which snacks are healthier (2.35/5). Participants suggested including snacks high in protein (58.8%) and low in sugar (56.2%). Most would like to see more healthy options in VM (83.5%) and will purchase them if available (67%). CONCLUSIONS Lowering the price for healthy snacks and including labels to indicate which are healthy may be the interventions to test for improving snack intake among college students.
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Affiliation(s)
- Christie Kirchoff
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Karina Abadia
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
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Fandetti SM, Dahl AA, Webster C, Bably MB, Coffman MJ, Racine EF. Healthy Food Policies Documented in University Food Service Contracts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6617. [PMID: 37623200 PMCID: PMC10454280 DOI: 10.3390/ijerph20166617] [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] [Received: 06/08/2023] [Revised: 08/07/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023]
Abstract
In the United States, there is an opportunity to improve the nutritional health of university students through the campus food environment. This project used a content analysis approach to investigate whether healthy food standards and policies were incorporated into the contract agreements between North Carolina (NC) public universities and their food service management companies. Food service contracts were collected from 14 NC public universities using food service management companies on campus. Each contract was evaluated using the 35-item North Carolina Food Service Policy Guidelines Assessment to examine four elements of the campus food environment: Beverages, Packaged Snacks, Prepared Foods, and Other (e.g., strategic placement of healthier food). Five university food service contracts incorporated no North Carolina Food Service Policy Guidelines, three university contracts included one to five guidelines, and six university contracts included six to nine guidelines. Altogether, 13 of the 35 guidelines were incorporated into at least one university food service contract. This project presents a cost and time-effective assessment method for determining if evidence-based nutrition guidelines have been included in university food service contracts. This approach and findings may lead to contract revisions to improve the campus food environment and, subsequently, the nutritional health of college populations.
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Affiliation(s)
- Stacy M. Fandetti
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Alicia Anne Dahl
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Caitlan Webster
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Morium Barakat Bably
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA; (A.A.D.); (C.W.); (M.B.B.)
| | - Maren J. Coffman
- School of Nursing, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA;
| | - Elizabeth F. Racine
- Texas A&M AgriLife Research, Texas A&M University, 1380 A and M Circle, El Paso, TX 79927, USA;
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Samuel L, Odoom-Darko E, del Rosario SJ, Blake C. Nutritional quality of snacks and beverages sold through vending machines in a large Hispanic-serving urban college campus in the United States: A cross-sectional study. J Public Health Res 2023; 12:22799036231170842. [PMID: 37152114 PMCID: PMC10161316 DOI: 10.1177/22799036231170842] [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: 08/14/2022] [Accepted: 04/01/2023] [Indexed: 05/09/2023] Open
Abstract
Students from nutritionally-vulnerable neighborhoods face dietary challenges through built environment of college vending machines. In this cross-sectional study, snacks and beverages sold in vending machines for a 4-week period in a Bronx-based Hispanic-serving college were recorded. Nutritional information was recorded from nutrition labels. Proportion of low- and high-sodium foods, "smart snacks" with a limit of 200 kcal and 200 mg of sodium, and foods with added sugar were recorded. Snacks had significantly higher calories and sodium per serving (227 kcal, 208 mg) than beverages (132 kcal, 90 mg) (t-test, p < 0.001). Almost a third of the snacks (32%) qualified as "smart snacks" for calories and 62% qualified as "smart snacks" for sodium. Beverages contained less than half the number of ingredients as snacks. About 53% of beverages and almost 60% of snacks listed sugar among the first five ingredients. Results underscore the need for colleges to promote less-processed entities with less added sugar.
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Affiliation(s)
- Lalitha Samuel
- Lalitha Samuel, Department of Health Promotion and Nutrition Sciences, Lehman College, The City University of New York, Bronx, NY 10468, USA.
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Kirchoff CL, Agarwal R, Sanchez M, Palacios C. Factors That "Nudge People towards the Healthier" Snacks-A Qualitative Study with Student, Faculty, and Staff Leaders and Decision Makers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15922. [PMID: 36497996 PMCID: PMC9737412 DOI: 10.3390/ijerph192315922] [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] [Received: 10/10/2022] [Revised: 11/26/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
(1) College campuses pose numerous public health challenges for students, faculty and staff. The healthfulness of the snacks available on campuses is lacking, and there is a desire for change among the students and staff. The objective of this study is to understand the perspectives of the students, staff, and decision makers regarding the college campus food environment and the perceived facilitators and barriers to improving it. (2) In-depth interviews were conducted (n = 15) with decision makers in food, policy development, wellness, and nutrition at a large Hispanic-Serving University in South Florida. (3) The key stakeholders shared that educational campaigns, student buy-in, raising awareness around obesity and chronic disease, and the university's position within the community would all help to facilitate improvements to the snack food environment. However, the participants noted that the complex nature of what is considered to be healthy and what divergent consumers want are significant barriers to improving the snack food environment along with concerns over lost revenue and the corporate structure. (4) These results inform potential focal points for multi-level interventions and inform policy discussions focused on improving the snack food environment at minority-serving universities. Taking strategic actions to improve the snack food environment may aid the students and staff of the university to enhance their diet quality.
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Affiliation(s)
| | - Rumi Agarwal
- FIU Embrace, Florida International University, Miami, FL 33199, USA
| | - Mariana Sanchez
- Health Promotion and Disease Prevention, Florida International University, Miami, FL 33199, USA
| | - Cristina Palacios
- Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA
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Mengarelli CA, Kirchoff C, Palacios C. College Students' Perception of Snacks Sold in Vending Machines in the US: A Mixed-Methods Study. Front Nutr 2021; 8:742121. [PMID: 34778337 PMCID: PMC8578334 DOI: 10.3389/fnut.2021.742121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Food in vending machines in US colleges contain limited nutritious foods available for purchase, which could affect the food choices made by students leading to poor diet quality. Interventions to improve college foodscapes usually follow a top-down approach and fail to affect dietary behavioral changes ultimately. This research aims to uncover what students want and ways to achieve change. Methods: The mixed-methods approach included peer-led qualitative focus group discussions and a brief quantitative questionnaire on satisfaction from foods available in vending machines. A convenience sample of 20 students (15 females) was recruited from a Hispanic serving institution for this study. Results: Vending machines were perceived as convenient, plentiful, and unhealthy. Students expressed dissatisfaction with both the variety and nutritional quality of snacks in vending machines. Suggestions for improvement included more fresh items (fruits and vegetables) and refrigerated items with higher protein content (low-fat yogurt, hummus, and peanut butter). To implement these improvements, participants discussed the cost and feasibility of perishable items. Increasing awareness and partnering strategies were proposed to mediate potential cost and buy-in obstacles as was elevating the appeal of healthy vending machines with technological enhancements that draw customers in and educate. Conclusion and Implication for Practice: This group of college students was eager for positive changes in foods sold in vending machines and understand the major difficulties. The suggested changes may help this and other colleges develop policies to regulate the foods in vending machines to promote overall health and help prevent chronic diseases in the future.
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Affiliation(s)
- Cristiana Assumpção Mengarelli
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Christie Kirchoff
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
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Rickrode-Fernandez Z, Kao J, Lesser MNR, Guess K. Implementation of a Healthy Food and Beverage Policy at a Public University. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:891-899. [PMID: 34373195 DOI: 10.1016/j.jneb.2021.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
University nutrition policies are a useful step toward improving the food environment for students, faculty, and staff, leading to improved health outcomes for the campus community. As 1 of the first universities to adopt and implement a campus-wide nutrition policy, the objective of this report is to share the university's experience with policy development, implementation, monitoring and evaluation, challenges, facilitators, and recommendations to inform these processes for future university nutrition policies.
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Affiliation(s)
- Zachary Rickrode-Fernandez
- Center for Environmental Health, Oakland, CA; School of Public Health, University of California Berkeley, Berkeley, CA
| | - Janice Kao
- University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute, Oakland, CA
| | - Mary N R Lesser
- Department of Nutritional Sciences and Toxicology, University of California Berkeley, Berkeley, CA; University of California San Francisco Benioff Children's Hospital Oakland, Oakland, CA; Children's Hospital Oakland Research Institute, Oakland, CA
| | - Kim Guess
- University Health Services, University of California Berkeley, Berkeley, CA.
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12
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Lee KM, Dias GM, Boluk K, Scott S, Chang YS, Williams TE, Kirkpatrick SI. Toward a Healthy and Environmentally Sustainable Campus Food Environment: A Scoping Review of Postsecondary Food Interventions. Adv Nutr 2021; 12:1996-2022. [PMID: 33836531 PMCID: PMC8483956 DOI: 10.1093/advances/nmab026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 12/31/2022] Open
Abstract
Interventions are urgently needed to transform the food system and shift population eating patterns toward those consistent with human health and environmental sustainability. Postsecondary campuses offer a naturalistic setting to trial interventions to improve the health of students and provide insight into interventions that could be scaled up in other settings. However, the current state of the evidence on interventions to support healthy and environmentally sustainable eating within postsecondary settings is not well understood. A scoping review of food- and nutrition-related interventions implemented and evaluated on postsecondary campuses was conducted to determine the extent to which they integrate considerations related to human health and/or environmental sustainability, as well as to synthesize the nature and effectiveness of interventions and to identify knowledge gaps in the literature. MEDLINE (via PubMed), CINAHL, Scopus, and ERIC were searched to identify articles describing naturalistic campus food interventions published in English from January 2015 to December 2019. Data were extracted from 38 peer-reviewed articles, representing 37 unique interventions, and synthesized according to policy domains within the World Cancer Research Foundation's NOURISHING framework. Most interventions were focused on supporting human health, whereas considerations related to environmental sustainability were minimal. Interventions to support human health primarily sought to increase nutrition knowledge or to make complementary shifts in food environments, such as through nutrition labeling at point of purchase. Interventions to support environmental sustainability often focused on reducing food waste and few emphasized consumption patterns with lower environmental impacts. The implementation of integrated approaches considering the complexity and interconnectivity of human and planetary health is needed. Such approaches must go beyond the individual to alter the structural determinants that shape our food system and eating patterns.
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Affiliation(s)
- Kirsten M Lee
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Goretty M Dias
- School of Environment, Enterprise and Development, University of Waterloo, Waterloo, Ontario, Canada
| | - Karla Boluk
- Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Steffanie Scott
- Geography and Environmental Management, University of Waterloo, Waterloo, Ontario, Canada
| | - Yi-Shin Chang
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Tabitha E Williams
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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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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Utter J, McCray S. Vending Machines in Australian Hospitals: Are They Meeting the Needs of the Consumer? JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:183-186. [PMID: 33573768 DOI: 10.1016/j.jneb.2020.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/18/2020] [Accepted: 11/22/2020] [Indexed: 06/12/2023]
Abstract
The current report explores how well vending machines are meeting the needs of health care organizations and their staff and visitors in Australia. Hospital vending machines often provide the only source of food through the night to staff and visitors and traditionally offer less-healthy options. Findings presented in this report suggest that vending machines are not meeting current statewide policies and guidelines for healthier food environments in health care. This is despite widespread support for healthier refreshments in hospitals by staff, visitors, and patients. Alternatives to traditional vending and opportunities for nutrition educators and researchers are discussed.
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Affiliation(s)
- Jennifer Utter
- Department of Dietetics and Foodservices, Mater Health, South Brisbane, Queensland, Australia.
| | - Sally McCray
- Department of Dietetics and Foodservices, Mater Health, South Brisbane, Queensland, Australia
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Mann G, Lambert LG, Gupta K, Partacz M. Smart snacks in universities: possibilities for university vending. Health Promot Perspect 2020; 10:393-400. [PMID: 33312935 PMCID: PMC7722994 DOI: 10.34172/hpp.2020.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/20/2020] [Indexed: 11/15/2022] Open
Abstract
Background: The study goal was to evaluate the nutritional impact of a healthy snack intervention on a southern university campus. Methods: This quasi-experimental study was conducted during the fall 2017 semester weekly for 14 weeks in a large southern U.S. university. For the intervention, half of vending snacks in four campus residential halls (housing from 216 to 361 students) were substituted with snacks complying with federal Smart Snacks in School nutrition standards for K-12 schools. For analysis, data from the Nutrition Facts labels of 14 vending machines or from manufacturer’s websites was collected by trained graduate and undergraduate researchers. Results: On average, for each Smart Snack sold, there was a statistically significant reduction of 99.38 calories (CI=42.32, 156.43), 4 g saturated fat (CI = 2.23, 5.75), and 10.06 g of sugar(CI=2.92, 17.20). An average reduction of 41.88 mg in sodium and an increase of 0.81g in fiber was also found, but was not statistically significant. There was a significant difference (t(16)=3.02, P < 0.025, 95% CI = 10.77, 55.79) between the Quality Score of Smart Snacks (M=59.13,SD= ± 36.50) and that of non-compliant snacks (M=25.85, SD= ± 24.72). Conclusion: The nutritional impact with even a 50% Smart Snack replacement is promising. Many available comparable snacks mimic the mouthfeel, taste, and appearance of their original full-fat, full-sodium, and full-sugar counterparts. Including healthier snack choices in vending machines may be a viable option for universities to transform the campus eating environment.
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Affiliation(s)
- Georgianna Mann
- Department Nutrition and Hospitality Management, 220 Lenoir Hall, P.O. Box 1848, University of Mississippi, University, MS 38677, United States
| | - Laurel Greenway Lambert
- Department Nutrition and Hospitality Management, 220 Lenoir Hall, P.O. Box 1848, University of Mississippi, University, MS 38677, United States
| | - Kritika Gupta
- Department Nutrition and Hospitality Management, 220 Lenoir Hall, P.O. Box 1848, University of Mississippi, University, MS 38677, United States
| | - Megan Partacz
- University of Memphis Dining, University of Memphis, TN, 38152, United States
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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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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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