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Mai TMT, Tran QC, Nambiar S, Gallegos D, Van der Pols JC. Dietary patterns and child, parental, and societal factors associated with being overweight and obesity in Vietnamese children living in Ho Chi Minh city. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 2:e13514. [PMID: 37010142 PMCID: PMC10984611 DOI: 10.1111/mcn.13514] [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: 12/01/2022] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 04/04/2023]
Abstract
Childhood overweight and obesity are rapidly increasing in urban Vietnam. Dietary patterns are understudied for their association with obesity risk in these children, and it is unclear which parental and societal factors should be targeted in prevention efforts. The study assessed child characteristics, dietary patterns, parental and societal factors for associations with childhood overweight and obesity status in Ho Chi Minh City, Vietnam. A sample of 221 children aged 9-11 years was randomly selected from four Ho Chi Minh City primary schools. Weight, height and waist circumference were measured using standardized methods. Three 24-h dietary recalls were collected from 124 children, which were used to assess dietary patterns using principal component analysis (PCA). Parents completed a questionnaire about child, parental and societal factors. The overall prevalence of obesity was 31.7% and of combined overweight and obesity 59.3%. Three main dietary patterns from 10 food groups were identified by PCA: traditional (grains, vegetables, meat and meat alternatives), discretionary (snacks and sweetened beverages), and industrialized (fast food and processed meat). Children with higher discretionary diet scores had higher odds of being overweight. Being a boy, screen time over 2 h/day, parental underestimation of child weight status, father's obesity, and household income in the lowest quintile were positively associated with childhood obesity. Future intervention programmes in Vietnam need to consider targeting children's unhealthy diets and parental perceptions of child weight status, as well as focusing on upstream approaches that reduce inequities contributing to childhood obesity and concomitant dietary patterns.
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Affiliation(s)
- Thi My Thien Mai
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Ho Chi Minh City Center for Disease ControlHo Chi Minh CityVietnam
| | - Quoc Cuong Tran
- Department of Nutrition and Food Safety, Faculty of Public HealthPham Ngoc Thach Medical UniversityHo Chi Minh CityVietnam
| | - Smita Nambiar
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
| | - Danielle Gallegos
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Woolworths Centre for Childhood Nutrition ResearchQueensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Jolieke C. Van der Pols
- School of Exercise and Nutrition SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
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Vuong VT, Fiorella KJ, Jones AD, Thi Trinh H, Khoury CK, Huynh TTT, Hoang KT, Nguyen KT. The association between food environment, diet quality and malnutrition in low- and middle-income adult populations across the rural-Urban gradient in Vietnam. J Hum Nutr Diet 2023; 36:2201-2218. [PMID: 37792904 DOI: 10.1111/jhn.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/25/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Economic reforms and trade liberalisation in Vietnam have transformed the food environment, influencing dietary patterns and malnutrition status. The present study focuses on the relationship between food environments (proximity and density of food outlets) and malnutrition (underweight, overweight, obesity) through diet quality in adult populations across urban, periurban and rural areas of Vietnam. METHODS We evaluated food environment by geospatial mapping of food outlets through a transect walk across the "food ecosystem" from rural to urban areas. Diet quality was assessed using the Diet Quality Index - Vietnamese (DQI-V) comprising Variety, Adequacy, Moderation and Balance components. Malnutrition status was determined using body mass index. We performed a mediation analysis utilising mixed effect models to control for neighbourhood clustering effects. Confounders included age, education, income and nutrition knowledge score. RESULTS Analysis of data from 595 adult participants (mean ± SD age: 31.2 ± 6.4 years; 50% female) found that longer distance to the nearest food outlet was associated with higher overall DQI-V (β = 2.0; 95% confidence interval = 0.2-3.8; p = 0.036) and the Moderation component (β = 2.6; 95% confidence interval = 1.2-4.0; p = 0.001). Outlet density shows a negative association with the odds of underweight among women (odds ratio = 0.62; 95% confidence interval = 0.37-0.96). However, we did not observe statistically significant relationships between diet quality and malnutrition. Education and nutrition knowledge scores were positively associated with diet diversity, while income was negatively associated with diet moderation. CONCLUSIONS The findings of the present study have important implications for nutrition and dietetics practice in Vietnam and globally. It emphasises the need to consider various dimensions of sustainable diets, including economic, health and socio-cultural/political factors. Longer distances to food outlets are associated with higher diet quality, whereas lower food outlet density increases the odds of underweight among women. This poses challenges in balancing modernisation and its adverse effects on sustainable food systems. Socio-economic status consistently correlated with diet quality and malnutrition, necessitating further research to promote healthy diets across socio-economic strata.
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Affiliation(s)
- Vy Thao Vuong
- Department of Global Development, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Kathryn J Fiorella
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA
| | | | - Huong Thi Trinh
- Department of Mathematics and Statistics, Thuongmai University, Hanoi, Vietnam
| | | | - Tuyen Thi Thanh Huynh
- The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam
| | - Ky The Hoang
- WorldFish, Penang, Malaysia and The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam
| | - Kien Tri Nguyen
- The Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Hanoi, Vietnam
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Adeosun KP, Oosterveer P, Greene M. Informal ready-to-eat food vending governance in urban Nigeria: Formal and informal lenses guiding the practice. PLoS One 2023; 18:e0288499. [PMID: 37440492 DOI: 10.1371/journal.pone.0288499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Informal ready-to-eat food vending is an important, cheap, convenient, accessible and readily available urban food supply sector that has become an increasingly important part of the diets of people in developing cities in Africa and throughout other contexts in the Global South. Over decades, despite challenges associated with health and hygiene, street foods have been informally accepted as part of the urban food supply system, particularly among the urban poor. Despite the importance of street foods to food security and employment needs in urban Nigeria and elsewhere, very little is known about the governance arrangements (whether formal or informal) revolving around their food provisioning practices. The paper explores governance arrangements that steer and shape food provisioning practices in Ibadan, Nigeria. Taking a social practice approach, the paper analyses the interconnections between governance and ready-to-eat food vending practices. It doing so, it draws on insights generated through a qualitative study incorporating in-depth interviews and participant observation methods to understand different governance arrangements revolving around food vending practices. The findings reveal that formal and informal governance structures are jointly steering and shaping practices of informal ready-to-eat food vending. They furthermore highlight the crucial role informal middlemen fulfill in informal food governance chains. These insights provide new avenues for thinking about food governance of urban food supply systems in terms of co-governance between formal and informal actors. They also provide empirical evidence that can aid policy application and implementation on urban food supply systems going forward. The paper concludes by discussing the potential of a co-governance informal food sector framework that recognizes and encompasses the formal-informal nature of the food sector. Such an approach recognizes and involves informal middlemen in the governance of informal ready-to-eat street food vending embedded in a larger framework of food system governance.
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Affiliation(s)
- Kehinde Paul Adeosun
- Environmental Policy Group, Wageningen University and Research Centre, Wageningen, The Netherlands
- Department of Agricultural Economics, University of Nigeria, Nsukka, Nigeria
| | - Peter Oosterveer
- Environmental Policy Group, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Mary Greene
- Environmental Policy Group, Wageningen University and Research Centre, Wageningen, The Netherlands
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Rousham E, Clark M, Latham M, Oo SP, Read S, Griffiths P, Blankenship J, Goudet S. Resilience and vulnerabilities of urban food environments in the Asia-Pacific region. MATERNAL & CHILD NUTRITION 2023:e13513. [PMID: 37097115 DOI: 10.1111/mcn.13513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/26/2023]
Abstract
Rapid urbanisation in the Asia-Pacific region is associated with complex changes to urban food environments. The impact of changing food environments on food purchasing and consumption and the diets and nutritional status of vulnerable groups, especially women and young children, is not well researched in low- and middle-income country cities. This paper aimed to examine: the risks and opportunities for healthy diets for low income populations offered by modernising urban centres; the concept of food deserts in relation to urban food environments in the Asia-Pacific region and how these could be mitigated; and measures to strengthen the resilience of food environments in the region using a case study of the impact of COVID-19 on informal food vendors. Our findings indicate that the dynamic changes in urban food environments in the Asia- Pacific region need to be understood by examining not only modern retail food outlets but also wet markets and informal food outlets, including street foods. Efforts should be made to ensure both modern and traditional outlets provide complementary platforms for convenient, affordable and accessible nutritious foods for urban populations. The resilience of urban food environments to environmental, physical and socio-economic shocks can be strengthened by shortening food supply chains and maximising food production in cities. Support mechanisms targeting urban informal food outlets and street vendors can also strengthen resilience and improve food security. Further research is needed on the impact of urbanising food environments on consumer choices, preferences, diets and health outcomes.
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Affiliation(s)
- Emily Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | | | | | | | - Paula Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jessica Blankenship
- Nutrition Section, UNICEF East Asia and the Pacific Regional Office, Bangkok, Thailand
| | - Sophie Goudet
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Nutrition Research, Dikoda, London, UK
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The diverse and complementary components of urban food systems in the global South: Characterization and policy implications. GLOBAL FOOD SECURITY 2023. [DOI: 10.1016/j.gfs.2022.100663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Isanovic S, Constantinides SV, Frongillo EA, Bhandari S, Samin S, Kenney E, Wertheim-Heck S, Nordhagen S, Holdsworth M, Dominguez-Salas P, Ambikapathi R, Laar A, Patil CL, Kulkarni B, Bukachi SA, Ngutu M, Blake CE. How Perspectives on Food Safety of Vendors and Consumers Translate into Food-Choice Behaviors in 6 African and Asian Countries. Curr Dev Nutr 2023; 7:100015. [PMID: 37181131 PMCID: PMC10100931 DOI: 10.1016/j.cdnut.2022.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/30/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middle-income countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supply-side risk management, lessening the degree to which consumer perspectives of food safety are considered. Objectives This study aimed to provide an in-depth understanding, from vendor and consumer perspectives, of how food-safety concerns of consumers translate into their subsequent food-choice behaviors in 6 diverse low- and middle-income countries. Methods Six Drivers of Food Choice projects (2016-2022) provided transcripts from 17 focus group discussions and 343 interviews conducted in Ghana, Guinea, India, Kenya, Tanzania, and Vietnam. Qualitative thematic analysis was used to identify emerging themes important to food safety. Results The analysis suggests that consumers constructed meaning about food safety through personal lived experience and social influences. Community and family members contributed knowledge about food safety. Concerns about food safety were influenced by reputations of and relationships with food vendors. Consumers' mistrust of food vendors was amplified by purposeful adulteration or unsafe selling practices and new methods used to produce food. Moreover, consumers were reassured of food safety by positive relationships with vendors; meals cooked at home; implementation of policies and following regulations; vendor adherence to environmental sanitation and food-hygiene practices; cleanliness of vendors' appearance; and vendors' or producers' agency to use risk mitigation strategies in production, processing, and distribution of food. Conclusions Consumers integrated their meanings, knowledge, and concerns about food safety to achieve assurance about the safety of their foods when making food-choice decisions. The success of food-safety policies hinges on consideration of consumers' food-safety concerns in their design and implementation, alongside actions to reduce risk in food supply.
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Affiliation(s)
- Sejla Isanovic
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shilpa V. Constantinides
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shiva Bhandari
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sharraf Samin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sigrid Wertheim-Heck
- Environmental Policy Group, Department of Social Sciences, Wageningen University, Wageningen, the Netherlands
| | | | - Michelle Holdsworth
- Montpellier Interdisciplinary Center on Sustainable Agri-food Systems, University of Montpellier, French Agricultural Research Centre for International Development, International Center for Advanced Mediterranean Agronomic Studies, Mediterranean Agronomic Institute of Montpellier, French National Institute for Agricultural Research, Institut Agro, French National Research Institute for Sustainable Development, Montpellier, France
| | - Paula Dominguez-Salas
- Natural Resources Institute, University of Greenwich, London, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, USA
- Department of Global Development, Cornell University, Ithaca, NY, USA
| | - Amos Laar
- University of Ghana, Department of Population, Family and Reproductive Health, School of Public Health, Accra, Ghana
| | - Crystal L. Patil
- Department of Human Development Nursing Science, University of Illinois–Chicago, Chicago, IL, USA
| | - Bharati Kulkarni
- Division of Reproductive Biology, Maternal and Child Health and Nutrition, Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Mariah Ngutu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Christine E. Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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de Menezes RCE, Oliveira JS, Almendra R, de Lira PIC, Costa EC, Leal VS, Santana P. Influence of food environment on ultra-processed drinks consumption among an economically vulnerable population in a metropolitan area in Brazil: A multilevel analysis. Health Place 2022; 77:102869. [PMID: 35932598 DOI: 10.1016/j.healthplace.2022.102869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 05/26/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
Ultra-processed drinks (UPDs) consumption is increasing, and this intake has been associated with the risk of illness and death. Data on individuals (n = 430) and food stores (n = 231) were collected in an economically vulnerable area in Recife-Brazil, and multilevel regression models were applied to assess the association between UPDs consumption with food environment characteristics. The results show 29.5% of individuals consume UPDs, higher UPD consumption was significantly associated with age (OR: 0.96), lower educational levels (OR:2.06), high density of stores predominantly selling UPFs (OR:2.34) and lower availability of FV in stores (OR:0.49). The applied methodology can inform food environment interventions to reduce UPDs consumption.
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Affiliation(s)
| | | | - Ricardo Almendra
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Portugal; Department of Geography and Turism, University of Coimbra, Portugal.
| | | | - Emília Chagas Costa
- Physical Education and Sports Science Unit, Vitória Academic Center, Federal University of Pernambuco, Brazil.
| | - Vanessa Sá Leal
- Nutrition Unit, Vitória Academic Center, Federal University of Pernambuco, Brazil.
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Portugal; Department of Geography and Turism, University of Coimbra, Portugal.
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Gaupholm J, Papadopoulos A, Asif A, Dodd W, Little M. The influence of food environments on dietary behaviour and nutrition in Southeast Asia: A systematic scoping review. Nutr Health 2022; 29:231-253. [PMID: 35850565 PMCID: PMC10114263 DOI: 10.1177/02601060221112810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Food environments are crucial spaces within the food system for understanding and addressing many of the shared drivers of malnutrition. In recent years, food environment research has grown rapidly, however, definitions, measures, and methods remain highly inconsistent, leading to a body of literature that is notably heterogeneous and poorly understood, particularly within regions of the Asia-Pacific. Aim: This scoping review aims to synthesize the nature, extent, and range of published literature surrounding the role of the food environment on influencing dietary behaviour and nutrition in Southeast Asia. Methods: A systematic search of 5 databases was conducted following PRISMA guidelines for scoping reviews. Eligible studies included peer-reviewed research with adult participants living in Southeast Asia that examined the food environment as a determinant of dietary behaviour or nutrition. Results: A total of 45 articles were included. Overall, studies indicated that dietary behaviours in Southeast Asia were primarily driven by social, cultural, and economic factors rather than physical (e.g. geographical) features of food environments. Food price and affordability were most consistently identified as key barriers to achieving healthy diets. Conclusion: This work contributes to the establishment of more robust conceptualizations of food environments within diverse settings which may aid future policymakers and researchers identify and address the barriers or obstacles impacting nutrition and food security in their communities. Further research is needed to strengthen this knowledge, particularly research that explicitly explores the macro-level mechanisms and pathways that influence diet and nutrition outcomes.
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Affiliation(s)
- Josephine Gaupholm
- Department of Population Medicine, 3653University of Guelph, Guelph, ON, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, 3653University of Guelph, Guelph, ON, Canada
| | - Aiza Asif
- Department of Population Medicine, 3653University of Guelph, Guelph, ON, Canada
| | - Warren Dodd
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Matthew Little
- School of Public Health and Social Policy, 574711University of Victoria, Victoria, BC, Canada
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Parikh P, Aparo NO, Nordhagen S, De Steur H. Food safety-related perspectives and practices of consumers and vendors in Ethiopia: A scoping review. Food Res Int 2022; 157:111376. [PMID: 35761632 DOI: 10.1016/j.foodres.2022.111376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 11/04/2022]
Abstract
Despite being one of the first African countries to prioritize food safety, foodborne diseases are of acute concern in Ethiopia. This review aims to understand food safety-related perspectives and practices among consumers and food vendors in Ethiopia to identify motivations, beliefs, and values that shape and/or drive their practices. A well-defined search and review identified 116 relevant articles. These spanned eight of the ten regional states and two chartered cities, with most work focusing on urban areas and on a sample within one state or chartered city. Ninety-four studies focused on vendors or food handlers; fifteen articles examined both consumers and vendors, but only four assessed interactions between the groups. Meat, dairy products, and ready-to-eat (street) foods were the most studied food groups. Food service establishments were the most examined outlets. Forty-six studies examined generic food safety issues or concerns. Overall, 102 studies assessed food safety practices; 53 studies examined knowledge, and 19 studies assessed attitudes. A gap in vendors' observed practices versus knowledge and attitudes was noted. Consumer deductions of food safety were based on vendor practices. Both groups used physical attributes based on senses to assess quality and safety of animal-source foods, had their own 'coping' strategies to address food safety-related concerns, and had similar views on consumer choice motives. Analysis of food and the food handling environment revealed a high level of contamination. An additional study, included after the original search, identified training to be effective in influencing knowledge, attitudes, and practices - though results for attitudes and practices were not sustained in the long term. Future research should address consumers and consumer-vendor interactions and include the full triad of knowledge-attitudes-practices. It is also recommended to focus on nutrient-rich foods as well as on traditional markets and local eateries. Improving the quality of research will be critical to improve food safety in Ethiopia.
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Affiliation(s)
- Panam Parikh
- Nutrition for Impact, Papiermolenstraat 51, 1160 Oudergem, Belgium.
| | - Nathaline Onek Aparo
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; Department of Rural Development and Agribusiness, Gulu University, PO Box 166, Laroo Division, Gulu City, Uganda.
| | - Stella Nordhagen
- Global Alliance for Improved Nutrition, Rue de Varembe 7, CH-1202 Geneva, Switzerland.
| | - Hans De Steur
- Department of Agricultural Economics, Ghent University, Coupure Links 653, 9000 Ghent, Belgium.
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de Medeiros MFA, Silva SGB, Teixeira CD, Lima SCVC, Marchioni DM, Jacob MCM. Assessment of Biodiversity in Food Consumption Studies: A Systematic Review. Front Nutr 2022; 9:832288. [PMID: 35774537 PMCID: PMC9237621 DOI: 10.3389/fnut.2022.832288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
The assessment of food biodiversity has gained importance in nutrition due to the positive association between the diversity of foods consumed and the quality of diets. To date, however, we do not know systematically how food consumption studies address food biodiversity. Our objective with this paper was to characterize how food consumption studies address biodiverse foods, both in terms of (i) new methods capable of overcoming the limitations of existing methods, and (ii) indicators capable of measuring the contribution of biodiversity to nutrition. We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), using four databases: Web of Science, Medline/PubMed (via National Library of Medicine), Scopus, and Google Scholar. We selected papers focused on the consumption of biodiverse foods without time constraints. In addition, we assessed the methodological quality of the studies we selected. We reviewed a total of 22 studies, and summarized the methods and indicators most used. We found that some researchers used biodiversity mapping strategies based on ethnographic approaches before the dietary assessment. Regarding dietary assessment tools, retrospective direct methods were the most used by researchers. We list 23 indicators used by the authors, among them the Dietary Species Richness (DSR), used in 18% of the studies. Studies that used biodiversity mapping strategies based on ethnographic approaches before the dietary assessment portrayed the local availability of biodiverse foods more consistently, i.e., presented lists with local edible species satisfactorily identified. We believe researchers in the future can avoid many of the limitations of current methods by ensuring that teams are interprofessional. We emphasize that most of the indicators we summarized are not sensitive enough to biodiversity since they do not measure edible resources at the species level. In this sense, the DSR is promising, because it fills information gaps, especially in the case of wild or neglected species.
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Affiliation(s)
| | | | - Carla Djaine Teixeira
- Graduate Program in Social Sciences, Center for Human Sciences, Letters and Arts, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Dirce Maria Marchioni
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
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Kumar GS, Kulkarni M, Rathi N. Evolving Food Choices Among the Urban Indian Middle-Class: A Qualitative Study. Front Nutr 2022; 9:844413. [PMID: 35425799 PMCID: PMC9001910 DOI: 10.3389/fnut.2022.844413] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/03/2022] [Indexed: 12/02/2022] Open
Abstract
One of the leading risk factors for an escalating obesity burden in India is non-nutritious choices. Underpinned by the nutrition transition theory, this qualitative inquiry was designed to understand the urban middle-class Indian consumers’ views about processed foods and rapidly changing food choices. The study consisted of two phases, the first phase consisted of focus group discussions pertaining to the definition and conception of processed foods and the second phase consisted of interviews regarding the changing food environment. A convenience sample of Indian consumers aged 40–65 years were recruited from Mumbai and Kochi to participate in focus group discussions (FGD1 – nine participants and FGD2 – seven participants) and semi-structured face-to-face interviews (N = 22). Both discussions and interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyze the transcribed data. Features of processed foods mentioned were chemical and physical processing, prolonged shelf life and poor nutritional quality. Factors influencing food choices and consumption of processed foods reported by participants could be categorized into changes in the socio-cultural environment and changes in the food environment. Changes in the socio-cultural environment included globalization and urbanization, long work days and sedentary living, rise in income levels and decrease in household cooking. Changes in the food environment included increased availability and accessibility of processed foods, replacement of traditional Indian diet with Western food, food as indicators of status, food advertisements and convenience. These results are consistent with nutrition transition theory and provide useful direction for public health policies aimed at promoting healthy diets.
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Affiliation(s)
- Gargi S. Kumar
- Department of Humanities and Social Sciences, Indian Institute of Technology Bombay, Mumbai, India
| | - Mrinmoyi Kulkarni
- Department of Humanities and Social Sciences, Indian Institute of Technology Bombay, Mumbai, India
| | - Neha Rathi
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
- *Correspondence: Neha Rathi, , ,
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Hanley-Cook GT, Daly AJ, Remans R, Jones AD, Murray KA, Huybrechts I, De Baets B, Lachat C. Food biodiversity: Quantifying the unquantifiable in human diets. Crit Rev Food Sci Nutr 2022; 63:7837-7851. [PMID: 35297716 DOI: 10.1080/10408398.2022.2051163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Dietary diversity is an established public health principle, and its measurement is essential for studies of diet quality and food security. However, conventional between food group scores fail to capture the nutritional variability and ecosystem services delivered by dietary richness and dissimilarity within food groups, or the relative distribution (i.e., evenness or moderation) of e.g., species or varieties across whole diets. Summarizing food biodiversity in an all-encompassing index is problematic. Therefore, various diversity indices have been proposed in ecology, yet these require methodological adaption for integration in dietary assessments. In this narrative review, we summarize the key conceptual issues underlying the measurement of food biodiversity at an edible species level, assess the ecological diversity indices previously applied to food consumption and food supply data, discuss their relative suitability, and potential amendments for use in (quantitative) dietary intake studies. Ecological diversity indices are often used without justification through the lens of nutrition. To illustrate: (i) dietary species richness fails to account for the distribution of foods across the diet or their functional traits; (ii) evenness indices, such as the Gini-Simpson index, require widely accepted relative abundance units (e.g., kcal, g, cups) and evidence-based moderation weighting factors; and (iii) functional dissimilarity indices are constructed based on an arbitrary selection of distance measures, cutoff criteria, and number of phylogenetic, nutritional, and morphological traits. Disregard for these limitations can lead to counterintuitive results and ambiguous or incorrect conclusions about the food biodiversity within diets or food systems. To ensure comparability and robustness of future research, we advocate food biodiversity indices that: (i) satisfy key axioms; (ii) can be extended to account for disparity between edible species; and (iii) are used in combination, rather than in isolation.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2051163 .
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Affiliation(s)
- Giles T Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Aisling J Daly
- Department of Data Analysis and Mathematical Modelling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Roseline Remans
- The Alliance of Bioversity International and International Centre for Tropical Agriculture, Geneva, Switzerland
| | - Andrew D Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- School of Hygiene & Tropical Medicine, MRC Unit The Gambia at London, Banjul, The Gambia
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Bernard De Baets
- Department of Data Analysis and Mathematical Modelling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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Reyes LI, Constantinides SV, Bhandari S, Frongillo EA, Schreinemachers P, Wertheim-Heck S, Walls H, Holdsworth M, Laar A, Nguyen T, Turner C, Wellard K, Blake CE. Actions in global nutrition initiatives to promote sustainable healthy diets. GLOBAL FOOD SECURITY 2021. [DOI: 10.1016/j.gfs.2021.100585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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15
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Westbury S, Ghosh I, Jones HM, Mensah D, Samuel F, Irache A, Azhar N, Al-Khudairy L, Iqbal R, Oyebode O. The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review. BMJ Glob Health 2021; 6:bmjgh-2021-006358. [PMID: 34635553 PMCID: PMC8506857 DOI: 10.1136/bmjgh-2021-006358] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions. Methods We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively. Results 74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap. Conclusion ‘Zoning’ or ‘healthy food cart’ interventions to alter food availability may be appropriate in urban LMIC. PROSPERO registration number CRD42020207475.
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Affiliation(s)
- Susannah Westbury
- School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Daniel Mensah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Folake Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Nida Azhar
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Romaina Iqbal
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
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16
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Downs SM, Fox EL, Zivkovic A, Mavros T, Sabbahi M, Merchant EV, Mutuku V, Okumu-Camerra K, Kimenju S. Drivers of food choice among women living in informal settlements in Nairobi, Kenya. Appetite 2021; 168:105748. [PMID: 34637773 DOI: 10.1016/j.appet.2021.105748] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022]
Abstract
Suboptimal diets drive the multiple burdens of malnutrition among women living in informal settlements. Women's food choices have important implications for their health, as well as that of their families. The purpose of this study was to examine how food choice decisions might differ across different age groups of women living in informal settlements in Nairobi, Kenya. Using in-depth interviews which incorporated a free-listing task, we determined the factors influencing food choice decisions in women in two informal settlements, Kibera and Mukuru. Among women in all age groups, we found income and food price to be the most salient factors influencing food choice decisions. Differences across age groups regarding food choice considerations included individual preference and quality being more salient factors amongst younger women while household preferences were more salient among older women. Women also reported making trade-offs between food affordability and other factors including time and nutrition, which led to sub-optimal diets. Our findings suggest that interventions in these settings may need to be tailored to specific age groups. Additionally, interventions may need to target both individual factors and the external food environment to help women overcome the trade-offs they often find themselves making in food choice decisions.
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Affiliation(s)
- Shauna M Downs
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, NJ, USA; Center for Agricultural Food Ecosystems, The New Jersey Institute for Food, Nutrition, and Health, Rutgers University, NJ, USA.
| | - Elizabeth L Fox
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Alexandra Zivkovic
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, NJ, USA
| | - Theodora Mavros
- School of Environmental and Biological Sciences, Rutgers University, NJ, USA
| | - Minna Sabbahi
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, NJ, USA
| | - Emily V Merchant
- Center for Agricultural Food Ecosystems, The New Jersey Institute for Food, Nutrition, and Health, Rutgers University, NJ, USA; School of Environmental and Biological Sciences, Rutgers University, NJ, USA
| | | | - Kedeen Okumu-Camerra
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, NJ, USA
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17
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Truong VA, Lang B, Conroy DM. When food governance matters to consumer food choice: Consumer perception of and preference for food quality certifications. Appetite 2021; 168:105688. [PMID: 34509543 DOI: 10.1016/j.appet.2021.105688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/31/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Food quality certifications have been widely promoted for sustainable goals and addressing consumers' increasing concern for food safety. However, these mechanisms have achieved varied success in practice. Prior research notes the importance of certification and certifying agencies in making tangible an invisible process to build consumer trust in certified food. What we have yet to understand is if and how perceived trustworthiness of food actors, such as growers and retailers in that process, influences consumers' trust in food certification and their food choices. To extend the literature on food certification in a complex network environment, we examined consumer trust in three food certification schemes which represent two types (community-based versus third-party), two certification origins (international versus domestic), and two certification standards (organic versus Good Agricultural Practice or GAP). Data were collected via in-depth interviews with 27 participants in Vietnam. These participants have similar awareness of, access to and capability to afford organic food but differ in their food choice. This is the first study exploring consumers' perceptions of community-based certification in comparison with other third-party certifications in the same market. Our study shows that the variation in consumer trust in certifications depends on their perceived trustworthiness of the food system and its actors to deliver certified food. Findings reveal that the higher the level of trust in the certification, the lower the need for trust in food actors. Conversely, the lower the level of trust in the system, the higher the need for trust in food actors. Importantly, food chain governance, the mechanisms linking growers to retailers, increase consumers' trust in certified food. The study proposes two food governance frameworks to improve consumer trust in certification schemes in developing countries.
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Affiliation(s)
- Van Anh Truong
- University of Auckland Business School, Auckland, New Zealand.
| | - Bodo Lang
- University of Auckland Business School, Auckland, New Zealand.
| | - Denise M Conroy
- The New Zealand Institute for Plant and Food Research Limited, New Zealand.
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18
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Laar A, Kelly B, Holdsworth M, Quarpong W, Aryeetey R, Amevinya GS, Tandoh A, Agyemang C, Zotor F, Laar ME, Mensah K, Laryea D, Asiki G, Pradeilles R, Sellen D, L'Abbe MR, Vandevijvere S. Providing Measurement, Evaluation, Accountability, and Leadership Support (MEALS) for Non-communicable Diseases Prevention in Ghana: Project Implementation Protocol. Front Nutr 2021; 8:644320. [PMID: 34485355 PMCID: PMC8416277 DOI: 10.3389/fnut.2021.644320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 07/12/2021] [Indexed: 01/22/2023] Open
Abstract
Background: This study describes the rationale, adaptation, and final protocol of a project developed to address the increase in obesity and nutrition-related non-communicable diseases (NR-NCDs) in Ghana. Code-named the Measurement, Evaluation, Accountability, and Leadership Support for NCDs (MEALS4NCDs) project, it aims to measure and support public sector actions that create healthy food marketing, retail, and provisioning environments for Ghanaian children using adapted methods from the International Network for Food and Obesity/NCDs Research Monitoring and Action Support (INFORMAS). Methods: The protocol for this observational study draws substantially from the INFORMAS' Food Promotion and Food Provision Modules. However, to appraise the readiness of local communities to implement interventions with strong potential to improve food environments of Ghanaian children, the MEALS4NCDs protocol has innovatively integrated a local community participatory approach based on the community readiness model (CRM) into the INFORMAS approaches. The setting is Ghana, and the participants include health and nutrition policy-makers, nutrition and food service providers, consumers, school authorities, and pupils of Ghanaian basic schools. Results: The study establishes a standardized approach to providing implementation science evidence for the prevention of non-communicable diseases (NCDs) in Ghana. It demonstrates feasibility and the innovative application of the INFORMAS expanded food promotion and food provision modules, together with the integration of the CRM in a lower-middle income setting. Conclusion: The research will facilitate the understanding of the processes through which the INFORMAS approach is contextualized to a lower-middle income African context. The protocol could be adapted for similar country settings to monitor relevant aspects of food environments of children.
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Affiliation(s)
- Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Wilhemina Quarpong
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Gideon Senyo Amevinya
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Francis Zotor
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Matilda E Laar
- Department Family and Consumer Sciences, School of Agriculture, University of Ghana, Accra, Ghana
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, University of Ghana, Accra, Ghana
| | - Dennis Laryea
- Non-communicable Disease Programme, Ghana Health Service, Accra, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Daniel Sellen
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Mary R L'Abbe
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
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19
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Constantinides SV, Turner C, Frongillo EA, Bhandari S, Reyes LI, Blake CE. Using a global food environment framework to understand relationships with food choice in diverse low- and middle-income countries. GLOBAL FOOD SECURITY 2021. [DOI: 10.1016/j.gfs.2021.100511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Trübswasser U, Verstraeten R, Salm L, Holdsworth M, Baye K, Booth A, Feskens EJM, Gillespie S, Talsma EF. Factors influencing obesogenic behaviours of adolescent girls and women in low- and middle-income countries: A qualitative evidence synthesis. Obes Rev 2021; 22:e13163. [PMID: 33283419 PMCID: PMC7988604 DOI: 10.1111/obr.13163] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/20/2020] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
This systematic review synthesized the qualitative evidence on factors influencing obesogenic behaviours in adolescent girls and women of reproductive age in low- and middle-income countries (LMICs). This qualitative evidence synthesis followed the framework synthesis approach to extract, analyse and synthesize data. Electronic searches were conducted in the Web of Science, SCOPUS, CABI Abstracts, MEDLINE, PsycINFO and Google Scholar. Studies were eligible if they were conducted in LMICs, of qualitative nature, and reported obesogenic behaviours of female adolescents (10-19 years of age) or women of reproductive age (15-49 years of age). The review resulted in 71 included studies from 27 different countries. Thirty-two studies focused on dietary behaviours, 17 on physical activity and 22 on both behaviours. Gender norms and failures to recognize the importance of healthy behaviours across the life cycle were important factors. The abundance and promotion of affordable but unhealthy food, food safety concerns, taste preferences and social desirability of foods drive consumption of unhealthy foods. Busy lives and limited exercise spaces keep girls and women from being physically active. Obesogenic behaviours of adolescent girls and women of reproductive age are influenced by factors at individual, social, physical and environmental levels and require diverse solutions to address these factors in LMICs.
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Affiliation(s)
- Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Roos Verstraeten
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute (IFPRI), Dakar, Senegal
| | - Leah Salm
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute (IFPRI), Dakar, Senegal.,Institute for Development Studies (IDS), Brighton, UK
| | - Michelle Holdsworth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.,Food and Nutrition in the Global South Research Unit (NUTRIPASS), Institut de Recherche pour le Développement (IRD), Montpellier, France
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Stuart Gillespie
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute (IFPRI), Brighton, UK
| | - Elise F Talsma
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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21
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Hernández-F M, Figueroa JL, Colchero MA. Association between density of stores and purchases of ultra-processed food and sugar-sweetened beverages in Mexico. Health Place 2021; 68:102528. [PMID: 33662788 DOI: 10.1016/j.healthplace.2021.102528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
In Mexico, purchases of ultra-processed food and sugar-sweetened beverages (SSB) and the number of large supermarkets, discount and convenience stores are growing. The objective of this study was to analyze the association between the density of different types of food stores and ultra-processed food and SSB (taxed beverages) purchases in a representative sample of Mexican households. Results show that the density of convenience stores (national and in urban areas) was significantly associated with higher purchases of ultra-processed food and that supermarkets were marginally associated. Our findings are stronger for beverages where we found that convenience stores, discount stores, small grocery stores and stores speciliazed in selling candies, popsicles, soft drinks and other food were associated with higher purchases of taxed beverages. Mexico should implement or strengthen current policies to reduce purchases of ultra-processed food and sugar-sweetened beverages and to regulate the location and density of stores.
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Affiliation(s)
- Mauricio Hernández-F
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Av. Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | - José Luis Figueroa
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Av. Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | - M Arantxa Colchero
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Av. Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
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22
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Ambikapathi R, Shively G, Leyna G, Mosha D, Mangara A, Patil CL, Boncyk M, Froese SL, Verissimo CK, Kazonda P, Mwanyika-Sando M, Killewo J, Gunaratna NS. Informal food environment is associated with household vegetable purchase patterns and dietary intake in the DECIDE study: Empirical evidence from food vendor mapping in peri-urban Dar es Salaam, Tanzania. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2021; 28:100474. [PMID: 33738186 PMCID: PMC7938223 DOI: 10.1016/j.gfs.2020.100474] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 12/02/2022]
Abstract
We study the relationship between the food environment (FE) and the food purchase patterns, dietary intakes, and nutritional status of individuals in peri-urban Tanzania. In Africa, the prevailing high density of informal vendors creates challenges to characterizing the FE. We present a protocol and tool developed as part of the Diet, Environment, and Choices of positive living (DECIDE) study to measure characteristics of the FE. We mapped 6627 food vendors in a peri-urban settlement of Dar es Salaam, of which over 60% were semi-formal and informal (mobile) vendors. We compute and compare four FE metrics inspired by landscape ecology—density, dispersion, diversity, and dominance—to better understand how the informal food environment relates to food purchase patterns, diets, and nutritional status among households with persons living with human immunodeficiency virus (PLHIV). In Tanzania, a high density of informal vendors within this transitioning food system creates challenges to characterizing the food environment. We develop four metrics inspired by landscape ecology to characterize formal, semi-formal, and informal food environments. We use these metrics to evaluate associations to household food purchase patterns, energy intake, and nutritional status. Vegetables, especially green leafy vegetables, were primarily sold by informal mobile food vendors, most of whom were women. A greater density of vegetable vendors or informal vendors within 500 meters of a household is associated with a higher likelihood of vegetable purchases and lower energy intake. The role of informal and semi-formal food vendors in supporting consumption of nutritious diets should not be discounted, and gender sensitive actions to promote their livelihoods is needed.
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Affiliation(s)
| | - Gerald Shively
- Department of Agricultural Economics & International Programs in Agriculture, Purdue University, USA
| | | | | | - Ally Mangara
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Crystal L Patil
- Department of Women, Children & Family Health Science, University of Illinois at Chicago, USA
| | | | - Savannah L Froese
- Department of Public Health, Purdue University, USA.,Department of Nutrition Science, Purdue University, USA
| | | | - Patrick Kazonda
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Tanzania
| | | | - Japhet Killewo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Tanzania
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23
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Shahril MR, Amirfaiz S, Lua PL, Nurnazahiah A, Zakarai NS, Kow VL, Ahmad A, Sulaiman S. Prevalence of metabolic syndrome among breast cancer survivors in East Coast of Peninsular Malaysia. BMC Public Health 2021; 21:238. [PMID: 33509143 PMCID: PMC7844947 DOI: 10.1186/s12889-021-10288-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 01/20/2021] [Indexed: 11/27/2022] Open
Abstract
Background To date, limited data are available on metabolic syndrome prevalence among breast cancer survivors in Malaysia. Therefore, this study was conducted to determine the prevalence of metabolic syndrome and abnormal metabolic syndrome components among breast cancer survivors in East Coast of Peninsular Malaysia. Methods This cross-sectional study included 95 breast cancer survivors (age 53.7 ± 7.6 years) who have completed main cancer treatments for ≥6 months. Cancer survivors were recruited from two main government hospitals in Kelantan and Terengganu using a purposive sampling method. Results According to the Harmonized criteria, the metabolic syndrome prevalence was 50.5%. Among those with metabolic syndrome, the most prevalent abnormal metabolic components were triglycerides (91.2%), fasting blood glucose (79.6%) and HDL-c level (78.4%). Except for total cholesterol and LDL-c, all other metabolic syndrome components were significantly different (p < 0.05) between those with and without metabolic syndrome. Significant differences between metabolic syndrome and non-metabolic syndrome groups were found for weight, BMI, waist circumference, body fat percentage and cancer stages (p < 0.05). However, no significant relationship was reported between sociodemographic, clinical parameters and metabolic syndrome among breast cancer survivors in this study. Conclusions Metabolic syndrome was highly prevalent among breast cancer survivors. It is recommended for health care professionals to closely monitor and improve the triglycerides, blood glucose and HDL-c level of the breast cancer survivors under their care to control the detrimental effect of metabolic syndrome. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10288-9.
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Affiliation(s)
- Mohd Razif Shahril
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia. .,Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, 21300, Kuala Terengganu, Terengganu, Malaysia.
| | - Syed Amirfaiz
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, 21300, Kuala Terengganu, Terengganu, Malaysia
| | - Pei Lin Lua
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Besut Campus, Besut, 22200, Kuala Terengganu, Terengganu, Malaysia
| | - Ali Nurnazahiah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, 21300, Kuala Terengganu, Terengganu, Malaysia
| | - Nor Syamimi Zakarai
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, 21300, Kuala Terengganu, Terengganu, Malaysia
| | - Ving Lok Kow
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, 21300, Kuala Terengganu, Terengganu, Malaysia
| | - Aryati Ahmad
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, 21300, Kuala Terengganu, Terengganu, Malaysia
| | - Suhaina Sulaiman
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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24
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Sánchez Urbano RE, Paredes A, Vargas Chambi FR, Guedes Ruela P, Olivares DEV, Souza Pereira BT, Pacheco SOS, Pacheco FJ. Reception of Dietary and Other Health-Related Lifestyle Advice to Address Non-communicable Diseases in a Primary Care Context: A Mixed-Method Study in Central Argentina. Front Nutr 2021; 8:622543. [PMID: 33585541 PMCID: PMC7873357 DOI: 10.3389/fnut.2021.622543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/04/2021] [Indexed: 11/13/2022] Open
Abstract
An effective way to address risk factors for non-communicable chronic diseases (NCD) and reduce healthcare costs is by using sound health-related advice (HRA) to promote healthy lifestyle habits. In Argentina, however, few studies have examined the context in which HRA is communicated and undertaken by patients at the primary care level. In this study, we assessed the reception of HRA using a mixed-method approach in a central area of Argentina. A total of 1,044 participants from the community were contacted and sociodemographic characteristics, health-related lifestyle factors, and medical history were collected. A calendar with health messages was provided to participants and its usage was assessed after 1 year. Additionally, semi-structured interviews were conducted with 34 patients attending a local primary healthcare center. The results show that HRA was given more frequently to individuals with higher mean age, lower educational level, and to females. Participants with a chronic health condition are at a higher chance of receiving advice to reduce salt intake and maintain a healthy weight. Dietary advice is offered along with other lifestyle recommendations. The use of alcohol and tobacco is usually addressed together. HRA was primarily received in the context of an NCD diagnosis and advice was directed, especially, to risky behaviors. The HRA to increase the intake of fruits and vegetables was mentioned less frequently. Patients at the healthcare center greatly appreciated receiving an HRA, especially when given in a tailored, written, and detailed form, and acknowledged its importance to prevent or control a chronic health condition as part of the medical treatment but showed concern regarding the ability to fully incorporate the advice. Lifestyle recommendations are highly appreciated by patients but are still underutilized since they are offered mostly in the context of illness. The health calendar was shown to be useful to complement health intervention programs at the community level. The findings of our study underscore the acknowledged value of HRA by participants to tackle the risk factors of chronic diseases. If properly used HRA constitutes a simple and highly valued tool to help address patient's needs to prevent and control NCD in Argentina.
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Affiliation(s)
- Raúl E Sánchez Urbano
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Ariel Paredes
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Frank R Vargas Chambi
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Pedro Guedes Ruela
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - David E V Olivares
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Benicio T Souza Pereira
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Sandaly O S Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Fabio J Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Argentina
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Assessing factors influencing adolescents' dietary behaviours in urban Ethiopia using participatory photography. Public Health Nutr 2020; 24:3615-3623. [PMID: 32792020 PMCID: PMC8369459 DOI: 10.1017/s1368980020002487] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: To assess factors influencing dietary behaviours of adolescents in Addis Ababa, Ethiopia. Design: Using the qualitative participatory method Photovoice, participants received training on the basics of Photovoice and took photographs related to (un)healthy eating in their environment. Transcripts of individual interviews, focus group discussions and photographs were coded for thematic analysis. Setting: One private and one public school located in the same, central neighbourhood in Addis Ababa, Ethiopia to explore how school populations of different socio-economic status experience the same neighbourhood environment. Participants: Twenty-six adolescents aged 14–19 years old, of which there were seventeen girls and nine boys. Results: Findings from the current study indicate that food safety concerns appear to be the major influencing factors for adolescents’ dietary choices. Unhealthy and unsafe foods appear to be widely available and/or affordable in adolescents’ neighbourhoods and almost half of the photographs taken by adolescents depicted poor hygiene conditions related to food vendors. Participants considered foods available in their environments as generally unsafe, calling for more packaged food. Conclusions: Concerns for food safety, hygiene and affordability are the dominating factors for adolescents’ food choices. These concerns, together with limited nutrition knowledge and preference for packaged foods, could make cheap, ultra-processed packaged foods more desirable.
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Understanding food westernisation and other contemporary drivers of adult, adolescent and child nutrition quality in urban Vietnam. Public Health Nutr 2020; 23:2571-2583. [PMID: 32665051 DOI: 10.1017/s1368980020001354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the association between consumption of western foods purchased and consumed away from home and measures of nutrition quality: average daily caloric intake and macronutrient (carbohydrates, fat and protein) shares, for urban consumers in Vietnam, a country undergoing economic transition. DESIGN Cross-sectional observational data were collected using household surveys and 24-h food diaries. Outcome variables were individual average daily caloric intake and shares of calories from macronutrients: carbohydrates, fat and protein. The key explanatory variable was individual daily share of calories from western food purchased and consumed away from home. Ordinary least squares and multivariate regression analyses were used to examine the association between the outcome variables: caloric intake and macronutrient shares and the share of calories from western food consumed away from home. SETTING Hanoi and Ho Chi Minh City in Vietnam. PARTICIPANTS In total, 1685 households and 4997 individuals, including adults (aged $$ \ge $$ 18 years), adolescents (aged 10-17 years) and children (aged 0-9 years). RESULTS The share of calories from western food away from home was significantly associated with higher caloric intake among male and female adults (P < 0·01), adolescents (P < 0·01) and male children (P < 0·10) and was associated with higher shares of fat for male and female adults (P < 0·01), adolescents (P < 0·01) and male children (P < 0·01). CONCLUSIONS Policymakers must be conscious of the numerous factors associated with poor nutrition quality, especially in younger Vietnamese individuals. Relevant interventions targeting at risk groups are required if nutrition improvement is a long-term goal.
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Sato PDM, Couto MT, Wells J, Cardoso MA, Devakumar D, Scagliusi FB. Mothers' food choices and consumption of ultra-processed foods in the Brazilian Amazon: A grounded theory study. Appetite 2020; 148:104602. [PMID: 31953143 DOI: 10.1016/j.appet.2020.104602] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
In recent decades, an increase in consumption of ultra-processed foods (UPF), a type of product frequently associated with diet-related obesity, chronic diseases, decrease of eating traditions and loss of culinary diversity, has been observed in middle-income countries. However, there is lack of information on factors related to choosing UPF. In this study, we aimed to understand the factors promoting UPF choices and consumption among mothers living in an urban context in the Brazilian Amazon, and to present a conceptual model grounded on their experiences that illustrates the dynamics between the observed factors. For this qualitative study, we used a constructive grounded theory approach, with a theoretical sampling of 40 women, to choose mothers with high and low consumption of ultra-processed foods. Data production and the first steps of analysis were performed concomitantly, followed by four steps of coding focused on creating conceptual categories and explaining the interactions between them. Our findings highlighted the importance of context in promoting UPF choice and consumption, particularly the "food environment", physical and virtual, and the "sociocultural environment". These contextual aspects interacted with the two main personal aspects influencing participants' UPF consumption, one concerning practices, "cooking behaviors", and the other concerning preferences, "food tastes". Factors such as economic and time constraints were also important and competed to shape eating practices through interactions with participants' health valorization. Findings are discussed in relation to food choice theories, social roles and the food environment. Implications for public health initiatives include the importance of considering environmental changes, sociocultural and economic influences, the reliance on UPF, and the role of women in the home, when promoting healthy diets.
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Affiliation(s)
- Priscila de Morais Sato
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
| | - Marcia Thereza Couto
- Department of Preventive Medicine, Medical School, University of São Paulo, Avenida Doutor Arnaldo 455, 01246-903, São Paulo, Brazil.
| | - Jonathan Wells
- Pop, Policy & Practice Program, UCL Great Ormond Street Institute of Child Health, London, WC1N1EH, United Kingdom.
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
| | - Delanjathan Devakumar
- Institute for Global Health, University College of London, London, WC1N1EH, United Kingdom.
| | - Fernanda Baeza Scagliusi
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, 01246-904, São Paulo, Brazil.
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