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D'Hooghe S, Inaç Y, Vandevijvere S, Deforche B, de Ridder K, Van Dyck D, Van de Weghe N, Dury S. Exploring the multiple dimensions of perceived food access in the local food environment in Flanders: perceptions of adults in socioeconomically disadvantaged situations. Appetite 2024:107609. [PMID: 39094845 DOI: 10.1016/j.appet.2024.107609] [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: 02/05/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
Persons in socioeconomically disadvantaged situations are more susceptible and disproportionally exposed to unhealthy food environments, which results in limited access to healthy foods and poorer dietary outcomes. This qualitative paper examines the various dimensions of perceived food access to healthy and unhealthy foods (i.e., availability, affordability, accessibility, accommodation, desirability, convenience and acceptability) within the local food environment among persons in socioeconomically disadvantaged situations. A total of 23 participants in socioeconomically disadvantaged situations expressed their perceptions of food access within their local food environment and its role in their eating behaviour through participant-driven photo-elicitation in a focus group context (n=7) and researcher-driven photo-elicitation interviews (n=16). Reflexive thematic analysis has been used to analyse our data through an access framework. Four overarching themes were constructed. The first two themes concern barriers to perceived food access in respectively the home and community food environment - including the importance of kitchen infrastructure, household composition and transport options. The third theme encompasses the interaction of perceived food access with the sociocultural environment, highlighting its dual role as facilitator (e.g., through food sharing practices) and barrier (e.g., through social stigma and shame). The fourth theme concerns awareness and the ability to navigate within the information food environment, which has also been proposed as a novel dimension of food access. This study emphasizes the complexity of food access and the need for a multifaceted approach that integrates perceptions to ensure equitable access to healthy foods.
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Affiliation(s)
- Suzannah D'Hooghe
- Sciensano, Department of Epidemiology and public health, Belgium; Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium; Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Yasemin Inaç
- Sciensano, Department of Epidemiology and public health, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium; Ghent University, Faculty of Sciences, Department of Geography, Belgium; Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Benedicte Deforche
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Belgium
| | - Karin de Ridder
- Sciensano, Department of Epidemiology and public health, Belgium
| | - Delfien Van Dyck
- Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Belgium
| | - Nico Van de Weghe
- Ghent University, Faculty of Sciences, Department of Geography, Belgium
| | - Sarah Dury
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium; Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Fernqvist F, Spendrup S, Tellström R. Understanding food choice: A systematic review of reviews. Heliyon 2024; 10:e32492. [PMID: 38952383 PMCID: PMC11215270 DOI: 10.1016/j.heliyon.2024.e32492] [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: 09/11/2023] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 07/03/2024] Open
Abstract
The topic of consumer food choice has received much attention among researchers and stakeholders within the food industry. However, in order to better facilitate food consumption towards a more sustainable direction, we need increased knowledge and understanding of factors that influence consumers' food choice. This study is a systematic review of reviews conducted between 2017 and 2021, summarising and synthesising reviews on food choice. The aim is to provide an update of the current knowledge on consumer food choice, point out what is already known, and identify knowledge gaps to enable a prioritisation for future research. The analysis highlights decisive factors in food choice, i.e. product, available information, price, context, personal and group influences and sensory perceptions. The synthesis of findings follows a socioecological model, integrating four different levels of the social and environmental systems: the physical food environment, the social and community level, interpersonal relations and, finally, individual characteristics such as psychological and behavioural factors. Results show that behavioural patterns, influenced by strong informal institutions, such as culture and norms, can be difficult to break; for example, changing into more sustainable food behaviour. The findings suggest that more interdisciplinary research and studies in real-life settings are needed to grasp the complexity of food choice. This would allow for us to better understand consumers as social beings shaped by, among other things, the physical environment, social interactions, and culture.
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Affiliation(s)
- Fredrik Fernqvist
- Department of People and Society, Swedish University of Agricultural Sciences, PO Box 190, 234 22, Lomma, Sweden
| | - Sara Spendrup
- Department of People and Society, Swedish University of Agricultural Sciences, PO Box 190, 234 22, Lomma, Sweden
| | - Richard Tellström
- SLU Future Food, Swedish University of Agricultural Sciences, PO Box 7082, 750 07, Uppsala, Sweden
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Maredia MK, Nakasone E, Porter M, Nordhagen S, Caputo V, Djimeu EW, Jones AD, Mbuya MNN, Ortega DL, Toure D, Tschirley D. Using Novel Multimethod Evaluation Approaches to Understand Complex Food System Interventions: Insights from a Supply Chain Intervention Intended to Improve Nutrition. Curr Dev Nutr 2024; 8:103776. [PMID: 38979104 PMCID: PMC11228647 DOI: 10.1016/j.cdnut.2024.103776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 04/18/2024] [Accepted: 05/09/2024] [Indexed: 07/10/2024] Open
Abstract
Background A "food system" approach to improve diet quality by intervening within areas such as food supply chains is gaining prominence. However, evidence of such interventions' impact, and understanding of appropriate methods to evaluate them, is lacking. Objectives We present an impact evaluation of an intervention that aimed to increase consumption of nutritious foods by supporting food-producing firms in Kenya. In doing so, we demonstrate how multiple methods, including those from other disciplines, can be used to evaluate a complex food systems intervention. Methods Four methods focused on food-producing firms and their management, including a survey of intervention participants (n = 83 individuals), a "laboratory-in-the-field" experiment (n = 83 individuals), baseline/endline data on firm performance (n = 71 firms), and semistructured interviews (n = 19 firms). Three methods focused on consumers in neighborhoods targeted by a supported firm: a randomized field experiment tested effects of making a supported product exhaustively available on consumers' purchases and consumption (n = 1295 consumers); 3 discrete choice experiments (n = 1295 consumers) tested factors influencing consumers' willingness to pay for foods with relevant characteristics. Results Among firms, we saw suggestive evidence of increased networking and business relationships, while laboratory-in-the-field experiments indicated the intervention might foster cooperation among participants. Qualitative interviews suggested that the intervention enabled firms to increase production, improve management, increase revenues, and lower costs. Baseline/endline data confirmed a positive effect only on the launch of new products and hiring workers. In the field experiment, consumption of the supported product increased in areas where it was made available relative to a control group, but this did not increase overall consumption of the food type or dietary diversity. Conclusions Results showed positive signs of the intervention improving firm-level outcomes but limited impact on consumers' diet quality. The evaluation also demonstrates how diverse methods can be used to evaluate complex interventions.
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Affiliation(s)
- Mywish K Maredia
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Eduardo Nakasone
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Maria Porter
- Department of Political Economy and Moral Science, University of Arizona, Tucson, AZ, United States
| | - Stella Nordhagen
- Knowledge Leadership Team, Global Alliance for Improved Nutrition, Geneva, Switzerland
| | - Vincenzina Caputo
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Eric W Djimeu
- Results for Development, Washington, DC, United States
| | - Andrew D Jones
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Mduduzi NN Mbuya
- Knowledge Leadership Team, Global Alliance for Improved Nutrition, Washington, DC, United States
| | - David L Ortega
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Djeinam Toure
- Africa Regional Office, Helen Keller International, Dakar, Senegal
| | - David Tschirley
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
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Tharrey M, Bohn T, Klein O, Bulaev D, Van Beek J, Nazare JA, Franco M, Malisoux L, Perchoux C. Local retail food environment exposure and diet quality in rural and urban adults: A longitudinal analysis of the ORISCAV-LUX cohort study. Health Place 2024; 87:103240. [PMID: 38593577 DOI: 10.1016/j.healthplace.2024.103240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Despite growing interest in understanding how food environments shape dietary behaviors, European longitudinal evidence is scarce. We aimed to investigate the associations of 9-year average and change in exposure to local retail food environments with the diet quality of residents in Luxembourg. We used data from 566 adults enrolled in both waves of the nationwide ORISCAV-LUX study (2007-2017). Dietary quality was assessed by the Diet Quality Index-International (DQI-I). Exposure to "healthy" and "less healthy" food outlets was assessed by both absolute and relative GIS-based measurements. The results showed a 56.3% increase in less healthy food outlets over the period. In adjusted linear mixed models, high (vs. low) 9-year average exposure to less healthy food outlets was associated with lower DQI-I, when examining spatial access (β = -1.25, 95% CI: -2.29, -0.22) and proportions (β = -1.24, 95% CI: -2.15, -0.33). Stratified analyses showed these associations to be significant only among urban residents. There was no association between change in exposure to less healthy food outlets and DQI-I. Increased exposure to healthy outlets in rural areas, using absolute measurements, was associated with worsened DQI-I. Neighborhood socioeconomic status did not moderate the above associations. Findings suggest that the proliferation of less healthy food outlets may have contributed to the deterioration of the diet quality of urban residents, and support the use of relative measurements to fully capture the healthiness of food environments.
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Affiliation(s)
- Marion Tharrey
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg; Department of Precision Health, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg.
| | - Torsten Bohn
- Department of Precision Health, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Olivier Klein
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg
| | - Dmitry Bulaev
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Juliette Van Beek
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg; Department of Geography and Spatial Planning, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch/Alzette, Luxembourg
| | - Julie-Anne Nazare
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Univ-Lyon, INSERM, INRAe, Claude Bernard Lyon 1 University, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Manuel Franco
- Surgery and Medical and Social Sciences Department, Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Laurent Malisoux
- Department of Precision Health, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Camille Perchoux
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg
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Pineda E, Stockton J, Scholes S, Lassale C, Mindell JS. Food environment and obesity: a systematic review and meta-analysis. BMJ Nutr Prev Health 2024; 7:204-211. [PMID: 38966119 PMCID: PMC11221287 DOI: 10.1136/bmjnph-2023-000663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 03/21/2024] [Indexed: 07/06/2024] Open
Abstract
Background Obesity is influenced by a complex, multifaceted system of determinants, including the food environment. Governments need evidence to act on improving the food environment. The aim of this study was to review the evidence from spatial environmental analyses and to conduct the first series of meta-analyses to assess the impact of the retail food environment on obesity. Methods We performed a systematic review and random-effects meta-analyses, focusing on geographical-statistical methods to assess the associations between food outlet availability and obesity. We searched OvidSP-Medline, Scielo, Scopus and Google Scholar databases up to January 2022. The search terms included spatial analysis, obesity and the retail food environment. Effect sizes were pooled by random-effects meta-analyses separately according to food outlet type and geographical and statistical measures. Findings Of the 4118 retrieved papers, we included 103 studies. Density (n=52, 50%) and linear and logistic regressions (n=68, 66%) were the main measures used to assess the association of the food environment with obesity. Multilevel or autocorrelation analyses were used in 35 (34%) studies. Fast-food outlet proximity was positively and significantly associated with obesity (OR: 1.15, 95% CI: 1.02 to 1.30, p=0.02). Fresh fruit and vegetable outlet density and supermarket proximity were inversely associated with obesity (OR: 0.93, 95% CI: 0.90 to 0.96, p<0.001; OR: 0.90, 95% CI: 0.82 to 0.98, p=0.02). No significant associations were found for restaurants, convenience stores or any of the body mass index measures. Conclusions Food outlets which sell mostly unhealthy and ultra-processed foods were associated with higher levels of obesity, while fruit and vegetable availability and supermarket accessibility, which enable healthier food access, were related to lower levels of obesity. The regulation of food outlets through zoning laws may not be enough to tackle the burden of obesity. Regulations that focus on increasing the availability of healthy food within stores and ensure overall healthy food environments require further attention. PROSPERO registration number CRD42018111652.
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Affiliation(s)
- Elisa Pineda
- The George Institute for Global Health UK, Imperial College London, London, UK
- School of Public Health, Imperial College London, London, UK
| | - Jemima Stockton
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Camille Lassale
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Jennifer S Mindell
- Research Department of Epidemiology and Public Health, University College London, London, UK
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Rajagopalan S, Ramaswami A, Bhatnagar A, Brook RD, Fenton M, Gardner C, Neff R, Russell AG, Seto KC, Whitsel LP. Toward Heart-Healthy and Sustainable Cities: A Policy Statement From the American Heart Association. Circulation 2024; 149:e1067-e1089. [PMID: 38436070 DOI: 10.1161/cir.0000000000001217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Nearly 56% of the global population lives in cities, with this number expected to increase to 6.6 billion or >70% of the world's population by 2050. Given that cardiometabolic diseases are the leading causes of morbidity and mortality in people living in urban areas, transforming cities and urban provisioning systems (or urban systems) toward health, equity, and economic productivity can enable the dual attainment of climate and health goals. Seven urban provisioning systems that provide food, energy, mobility-connectivity, housing, green infrastructure, water management, and waste management lie at the core of human health, well-being, and sustainability. These provisioning systems transcend city boundaries (eg, demand for food, water, or energy is met by transboundary supply); thus, transforming the entire system is a larger construct than local urban environments. Poorly designed urban provisioning systems are starkly evident worldwide, resulting in unprecedented exposures to adverse cardiometabolic risk factors, including limited physical activity, lack of access to heart-healthy diets, and reduced access to greenery and beneficial social interactions. Transforming urban systems with a cardiometabolic health-first approach could be accomplished through integrated spatial planning, along with addressing current gaps in key urban provisioning systems. Such an approach will help mitigate undesirable environmental exposures and improve cardiovascular and metabolic health while improving planetary health. The purposes of this American Heart Association policy statement are to present a conceptual framework, summarize the evidence base, and outline policy principles for transforming key urban provisioning systems to heart-health and sustainability outcomes.
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de Freitas PP, Lopes MS, Costa BVDL, Sales DM, de Menezes MC, Jaime PC, Lopes ACS. A longitudinal analysis of the fluctuation of food stores in Belo Horizonte, Minas Gerais, Brazil. BMC Public Health 2023; 23:2454. [PMID: 38062435 PMCID: PMC10704749 DOI: 10.1186/s12889-023-17350-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Changes in food environments have the potential to affect consumption, nutritional status, and health, and understanding these changes is of utmost importance. This study, therefore, aimed to examine the fluctuation of food stores that sell fruits and vegetables over five years in the health promotion service area of Primary Health Care (PHC) in Belo Horizonte, Minas Gerais, Brazil. METHODS This was an ecological study that used data from a food environment audit conducted in the realm of Brazilian PHC. Buffers of 1 mile (equivalent to 1600 m) were created around health promotion services to define food environments. All food stores and open-air food markets that sold fruits and vegetables (FV) within this buffer area were considered eligible. The data collection was performed during two periods: the baseline, in 2013, and after five years, in 2018. This study compares the fluctuation by the type of stores and according to the health vulnerability index (HVI). RESULTS After 5 years, 35.2% of the stores were stable; 154 stores were closed, and 155 were opened. The stability was greater in low-vulnerability areas, and the fluctuation differed by type of store only for areas with high vulnerability. The number of supermarket decreased in high HVI territories; and local stores, showed greater stability when compared to specialized FV markets. CONCLUSIONS The differences in store fluctuations according to the vulnerability of areas demonstrate the importance of food supply policies considering the local characteristics to reduce inequities of access to healthy foods.
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Affiliation(s)
- Patrícia Pinheiro de Freitas
- Research Group on Nutrition Interventions, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, room 316, Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Mariana Souza Lopes
- Department of Nutrition, Universidade Federal da Paraíba, Campos I, Cidade Universitária, Castelo Branco, João Pessoa, 58051-900, Brazil
| | - Bruna Vieira de Lima Costa
- Nutrition Department, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, room 314, Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Denise Marques Sales
- Institute of Geosciences in Geography (IGC), Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6.627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Mariana Carvalho de Menezes
- School of Nutrition, Research Group on Nutrition and Collective Health, Universidade Federal de Ouro Preto, St Dois, 607, room 64, Ouro Preto, MG, 35400-000, Brazil
| | - Patrícia Constante Jaime
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil
| | - Aline Cristine Souza Lopes
- Research Group on Nutrition Interventions, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, room 316, Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil.
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Lofton S, Martin A, Kersten M, Lubimbi N, Vilme H, Avorgbedor F, Odoms-Young A. Understanding Barriers and Strategies to Accessing Healthy Food in Urban Agriculture for Community Residents in Predominantly Black Communities. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023:2752535X231214844. [PMID: 37948604 DOI: 10.1177/2752535x231214844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Some residents in predominantly Black communities face significant challenges in accessing healthy food. However, urban agriculture is a growing sector that aims to increase overall food production, access to affordable and nutritious produce, and potentially improve community food security. PURPOSE This study aimed to provide insight into barriers and strategies that urban agriculture growers and advocates identified for accessing urban agriculture markets in their communities. RESEARCH DESIGN AND STUDY SAMPLE We interviewed and conducted focus groups with 17 urban growers and local food advocates that work in predominantly Black communities in Chicago. DATA COLLECTION AND/OR ANALYSIS Understanding the complexities of access to healthy food can be challenging; therefore, we used the concept of access - accessibility, availability, affordability, accommodation, and acceptability - to better understand these barriers. RESULTS Key barriers were the lack of accessibility to traditional food retailers, high availability of processed foods, and cultural acceptability of urban-produced foods. CONCLUSION Building urban agriculture networks to support growers, connect with consumers, and emphasize political engagement can help to diversify and grow urban agriculture.
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Affiliation(s)
- Saria Lofton
- College of Nursing, Population Health Science Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Marjorie Kersten
- College of Nursing, Population Health Science Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Nanyombi Lubimbi
- College of Nursing, Population Health Science Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Hong J, Yang N, Kim K. Development and Validation of a Perceived Community Food Accessibility Measurement Questionnaire for Korean Older Adults. Nutrients 2023; 15:4301. [PMID: 37836585 PMCID: PMC10574782 DOI: 10.3390/nu15194301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
As the community food environment is known to be an important factor in healthy food choices, it needs to be measured, to increase awareness and improve healthy eating. The objective of this study was to develop a perceived community food accessibility measurement (P-CFAM) questionnaire applicable to older adults in Korea and evaluate its reliability and validity. The questionnaire was developed based on community food environment factors that were found to affect food choices in previous studies. We evaluated the internal consistency reliability, construct validity, and criterion-related validity. The subjects were 188 older adults for validity. The Cronbach's alpha value for the reliability measure was 0.9. The confirmatory factor analysis to evaluate the construct validity of the questionnaire showed values close to those of the optimal model (GFI = 0.983, AGFI = 0.948, RMR = 0.004, NFI = 0.987, CFI = 0.996). Regarding the criterion-related validity, the P-CFAM questionnaire results were significantly related to objective measurement indicators such as the number of grocery stores, the travel time to a grocery store, and the intake of vegetables and fruit. In conclusion, the developed P-CFAM questionnaire was shown to be reliable and valid, and useful for assessing older adults' perceptions of community food accessibility in Korea.
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Affiliation(s)
| | | | - Kirang Kim
- Department of Food Science and Nutrition, College of Science and Technology, Dankook University, Cheonan 31116, Republic of Korea
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Algur Y, Rummo PE, McAlexander TP, De Silva SSA, Lovasi GS, Judd SE, Ryan V, Malla G, Koyama AK, Lee DC, Thorpe LE, McClure LA. Assessing the association between food environment and dietary inflammation by community type: a cross-sectional REGARDS study. Int J Health Geogr 2023; 22:24. [PMID: 37730612 PMCID: PMC10510199 DOI: 10.1186/s12942-023-00345-4] [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: 03/29/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Communities in the United States (US) exist on a continuum of urbanicity, which may inform how individuals interact with their food environment, and thus modify the relationship between food access and dietary behaviors. OBJECTIVE This cross-sectional study aims to examine the modifying effect of community type in the association between the relative availability of food outlets and dietary inflammation across the US. METHODS Using baseline data from the REasons for Geographic and Racial Differences in Stroke study (2003-2007), we calculated participants' dietary inflammation score (DIS). Higher DIS indicates greater pro-inflammatory exposure. We defined our exposures as the relative availability of supermarkets and fast-food restaurants (percentage of food outlet type out of all food stores or restaurants, respectively) using street-network buffers around the population-weighted centroid of each participant's census tract. We used 1-, 2-, 6-, and 10-mile (~ 2-, 3-, 10-, and 16 km) buffer sizes for higher density urban, lower density urban, suburban/small town, and rural community types, respectively. Using generalized estimating equations, we estimated the association between relative food outlet availability and DIS, controlling for individual and neighborhood socio-demographics and total food outlets. The percentage of supermarkets and fast-food restaurants were modeled together. RESULTS Participants (n = 20,322) were distributed across all community types: higher density urban (16.7%), lower density urban (39.8%), suburban/small town (19.3%), and rural (24.2%). Across all community types, mean DIS was - 0.004 (SD = 2.5; min = - 14.2, max = 9.9). DIS was associated with relative availability of fast-food restaurants, but not supermarkets. Association between fast-food restaurants and DIS varied by community type (P for interaction = 0.02). Increases in the relative availability of fast-food restaurants were associated with higher DIS in suburban/small towns and lower density urban areas (p-values < 0.01); no significant associations were present in higher density urban or rural areas. CONCLUSIONS The relative availability of fast-food restaurants was associated with higher DIS among participants residing in suburban/small town and lower density urban community types, suggesting that these communities might benefit most from interventions and policies that either promote restaurant diversity or expand healthier food options.
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Affiliation(s)
- Yasemin Algur
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA.
| | - Pasquale E Rummo
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Tara P McAlexander
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - S Shanika A De Silva
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Suzanne E Judd
- Department of Biostatistics, The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Victoria Ryan
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Gargya Malla
- Department of Epidemiology, The University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Alain K Koyama
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David C Lee
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA, 19104, USA
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11
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Avelino DC, Duffy VB, Puglisi M, Ray S, Lituma-Solis B, Nosal BM, Madore M, Chun OK. Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments? Nutrients 2023; 15:nu15040862. [PMID: 36839221 PMCID: PMC9964317 DOI: 10.3390/nu15040862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in Northeastern Connecticut during the pandemic. Via online survey, adults (n = 276) reported their perceived home and store food environments, food assistance participation, whether they ordered groceries online, and consumption frequency and liking of foods/beverages to calculate diet quality indices. Those who ordered groceries online (44.6%) were more likely to participate in food assistance programs and report greater diet quality. Perceived healthiness of store and home food environments was variable, with the ease of obtaining and selecting unhealthy foods in the neighborhood significantly greater than healthy foods. Healthier perceived home food environments were associated with significantly higher diet qualities, especially among individuals who participated in multiple food assistance programs. Ordering groceries online interacted with multiple measures of the food environment to influence diet quality. Generally, the poorest diet quality was observed among individuals who perceived their store and home food environments as least healthy and who did not order groceries online. Thus, ordering groceries online may support higher diet quality among adults who can use their food assistance for purchasing groceries online and who live in low-income, low-access food environments.
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Affiliation(s)
- Daniela C. Avelino
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
- Correspondence: (V.B.D.); (O.K.C.); Tel.: +860-486-1997 (V.B.D.); +860-486-6275 (O.K.C.)
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Snehaa Ray
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Brenda Lituma-Solis
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Briana M. Nosal
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Matthew Madore
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
- Correspondence: (V.B.D.); (O.K.C.); Tel.: +860-486-1997 (V.B.D.); +860-486-6275 (O.K.C.)
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12
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Feasibility and Acceptability of Policies and Environmental Strategies for Improving Physical Activity and Healthy Eating in Japanese Small and Medium Corporations. J Occup Environ Med 2023; 65:39-47. [PMID: 35941735 PMCID: PMC9835672 DOI: 10.1097/jom.0000000000002661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We assessed the implementation status of policies and environmental strategies for increasing physical activity (PA) and healthy eating (HE) in small and medium corporations to identify feasible and acceptable interventions. METHODS An anonymous self-administered questionnaire was administered to 655 small and medium corporations to determine whether they implemented PA (18 items) and HE (17 items) policies and environmental strategies and, if not, their intention to do so in the future. We compared differences in the implementation and intention to implement rate by corporation size. RESULTS The implementation and intention rates of costly items for PA and HE were low, regardless of corporation size, but were significantly lower in small corporations than in medium corporations. CONCLUSIONS To overcome cost barriers, employee participation must be encouraged, and employee knowledge of PA and HE must be improved.
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13
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Cardozo NDO, Crisp AH, Pinheiro Fernandes AC, Trude ACB, Araneda-Flores J, Oliveira MRMD. Ambiente alimentar e excesso de peso em escolares: uma revisão sistemática sul-americana. Rev Panam Salud Publica 2022; 46:e164. [PMID: 36320205 PMCID: PMC9595220 DOI: 10.26633/rpsp.2022.164] [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: 12/01/2021] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Objetivo. Identificar e compilar os achados de estudos observacionais que analisaram a relação de fatores do ambiente alimentar escolar e individuais de consumo na escola com excesso de peso em escolares da América do Sul no período de 2011 a 2021. Métodos. A pesquisa foi realizada em cinco bases de dados (PubMed, Web of Science, SciELO, Scopus e LILACS) e no Google Scholar, além de consulta a especialistas. Foram selecionados estudos observacionais com escolares de 5 a 19 anos, realizados na América do Sul, que usaram medidas objetivas para avaliar excesso de peso, como o índice de massa corporal (Organização Mundial da Saúde e/ou International Obesity Task Force), em associação a fatores do ambiente alimentar escolar e individuais de consumo na escola. O protocolo foi registrado na plataforma PROSPERO (CRD42020212383). Resultados. Dos 906 registros identificados, 13 estudos transversais (um da Argentina, um do Equador e 11 do Brasil) foram incluídos na revisão. As prevalências variaram de 7,5% a 32,5% para sobrepeso e 1,7% a 28,0% para obesidade. Fatores do ambiente alimentar escolar, dos domínios político e físico (como educação alimentar e nutricional insatisfatória e indisponibilidade de refeições preparadas na escola) se associaram com maiores prevalências de excesso de peso. Fatores individuais relacionados à adesão ao programa de alimentação escolar (como consumo da alimentação oferecida pela escola ao invés de lanche trazido de casa) se associaram a menores prevalências de excesso de peso. Conclusões. São escassos os estudos sul-americanos enfocando a associação entre fatores do ambiente alimentar escolar e/ou individuais e excesso de peso em escolares. As evidências restritas a contextos locais ou regionais incentivam novos estudos de abrangência nacional.
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Affiliation(s)
- Najla de Oliveira Cardozo
- Universidade Estadual Paulista, Faculdade de Ciências Farmacêuticas, Programa de Pós-Graduação de Alimentos e Nutrição, Araraquara (SP), Brasil
| | - Alex Harley Crisp
- Universidade Metodista de Piracicaba, Programa de Pós-Graduação em Ciências do Movimento Humano, Piracicaba (SP), Brasil
| | | | | | | | - Maria Rita Marques de Oliveira
- Universidade Estadual Paulista, Faculdade de Ciências Farmacêuticas, Programa de Pós-Graduação de Alimentos e Nutrição, Araraquara (SP), Brasil
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14
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Isaacs A, Halligan J, Neve K, Hawkes C. From healthy food environments to healthy wellbeing environments: Policy insights from a focused ethnography with low-income parents' in England. Health Place 2022; 77:102862. [PMID: 35926370 DOI: 10.1016/j.healthplace.2022.102862] [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: 08/23/2021] [Revised: 05/31/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022]
Abstract
Overweight and obesity continue to increase globally. In England, as in many other countries, this disproportionately affects people who experience socioeconomic deprivation. One factor blamed for inequalities in obesity is unhealthy food provisioning environments (FPEs), leading to a focus on policies and interventions to change FPEs. This paper aims to provide insights into how FPE policies could more effectively tackle inequalities in obesity by addressing a key research gap: how the structural contexts in which people live their lives influence their interaction with their FPEs. It aims to understand how low-income families engage with FPEs through in-depth focused ethnographic research with 60 parents across three locations in England: Great Yarmouth, Stoke-on-Trent, and the London Borough of Lewisham. Analysis was guided by sociological perspectives. FPEs simultaneously push low-income families towards unhealthy products while supporting multiple other family needs, such as social wellbeing. FPE policies and interventions to address obesity must acknowledge this challenge and consider not just the makeup of FPEs themselves but how various structural contexts shape how people come to use them.
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Affiliation(s)
- Anna Isaacs
- Centre for Food Policy, City University of London, UK.
| | - Joel Halligan
- Centre for Food Policy, City University of London, UK
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15
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Oladele CR, Colón-Ramos U, Galusha D, Tran E, Adams OP, Maharaj RG, Nazario CM, Nunez M, Pérez-Escamilla R, Nunez-Smith M. Perceptions of the local food environment and fruit and vegetable intake in the Eastern Caribbean Health Outcomes research Network (ECHORN) Cohort study. Prev Med Rep 2022; 26:101694. [PMID: 35242499 PMCID: PMC8861285 DOI: 10.1016/j.pmedr.2022.101694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 12/26/2021] [Accepted: 01/15/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Studies conducted in the US and other high-income countries show that the local food environment influences dietary intakes that are protective for cardiovascular health.However, few studies have examined this relationship in the Caribbean. This study aimed to determine whether perceptions of the local food environment were associated with fruit and vegetable (FV) intake in the Eastern Caribbean, where daily FV intake remains below recommended levels. METHODS Cross-sectional analysis of Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) baseline data (2013-2016) from Barbados, Puerto Rico, Trinidad and Tobago, and US Virgin Islands was conducted in 2020. The National Cancer Institute Dietary Screener Questionnaire was adapted to measure daily servings of FV. Existing scales were used to assess participant perceptions of the food environment (availability, affordability, and quality). Chi-square tests and Poisson regression were used for analyses. RESULTS Participants reported eating one mean daily serving of FV. Mean daily intake was higher among those who perceived FV as usually/always affordable, available, and high quality. Multivariate results showed statistically significant associations between FV and affordability. Persons who perceived FV as affordable had 0.10 more daily servings of FV compared to those who reported FV as not always affordable (p = 0.02). Food insecurity modified the association between affordability and FV intake. CONCLUSIONS This study highlights the importance of affordability in consumption of FV in the Eastern Caribbean, and how this relationship may be modified by food insecurity.
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Affiliation(s)
- Carol R Oladele
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
| | - Uriyoán Colón-Ramos
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC 20052, USA
| | - Deron Galusha
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
| | - Emma Tran
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
| | - Oswald P Adams
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Rohan G Maharaj
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
| | - Cruz M Nazario
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Maxine Nunez
- University of the Virgin Islands, School of Nursing, St. Thomas, US VI, USA
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, 135 College Street, Suite 216, New Haven, CT 06520, USA
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Yale School of Medicine, 100 Church Street South, Suite A200, New Haven, CT 06510, USA
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16
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Gomes CS, Silveira EA, Velasquez-Melendez G. Neighborhood environment is associated with unhealthy food intake in a Brazilian urban area. Appetite 2022; 172:105972. [PMID: 35176434 DOI: 10.1016/j.appet.2022.105972] [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: 11/16/2021] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 11/20/2022]
Abstract
Unhealthy food intake is one of the main risk factors for morbidity and mortality for non-communicable diseases (NCDs), and is associated with multiple factors, including the neighborhood environment. The present study aimed to examine the association between the neighborhood context and unhealthy food intake in adults. This is a cross-sectional study, carried out in Belo Horizonte, Brazil. This study used the database of Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel), which was georeferenced and linked to a database with information on the physical and social realities of a neighborhood context. The administrative boundary of the basic health units (ABBHU) was used as a neighborhood unit. Unhealthy food intake was assessed by the regular consumption of meat with excess fat, soft drinks, and red meat, as well as the irregular consumption of fruits and vegetables. To characterize the physical and social realities of a neighborhood, this study used georeferenced data of establishments selling foods, population density, homicide rates, health vulnerability Index, and total income. For data analysis, multilevel logistic regression was used. The sample consisted of 5783 adults. It was observed that younger, males, people with a lower-level education, who were inactive during leisure time, who had abusive alcohol consumption, and who were current smokers, were associated with a greater chance of having an unhealthy food intake. After adjusting for individual characteristics, it was observed that living in ABBHU, with a low mean income and an extremely high vulnerability, increases the individual's chances of having an unhealthy food intake. An unhealthy food intake is partially explained by demographic characteristics and socioeconomic conditions in the neighborhood. The present study can contribute to improving the understanding of the importance of the urban environment in food choices.
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Affiliation(s)
- Crizian Saar Gomes
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Federal Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Erika Aparecida Silveira
- Health Science Post-graduate Program, Medicine Faculty, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Federal Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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17
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Kebede A, Jirström M, Worku A, Alemu K, Berhane HY, Turner C, Ekström EC, Berhane Y. Residential Food Environment, Household Wealth and Maternal Education Association to Preschoolers' Consumption of Plant-Based Vitamin A-Rich Foods: The EAT Addis Survey in Addis Ababa. Nutrients 2022; 14:296. [PMID: 35057477 PMCID: PMC8778225 DOI: 10.3390/nu14020296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 11/29/2022] Open
Abstract
Vitamin A deficiency is common among preschoolers in low-income settings and a serious public health concern due to its association to increased morbidity and mortality. The limited consumption of vitamin A-rich food is contributing to the problem. Many factors may influence children's diet, including residential food environment, household wealth, and maternal education. However, very few studies in low-income settings have examined the relationship of these factors to children's diet together. This study aimed to assess the importance of residential food availability of three plant-based groups of vitamin A-rich foods, household wealth, and maternal education for preschoolers' consumption of plant-based vitamin A-rich foods in Addis Ababa. A multistage sampling procedure was used to enroll 5467 households with under-five children and 233 residential food environments with 2568 vendors. Data were analyzed using a multilevel binary logistic regression model. Overall, 36% (95% CI: 34.26, 36.95) of the study children reportedly consumed at least one plant-based vitamin A-rich food group in the 24-h dietary recall period. The odds of consuming any plant-based vitamin A-rich food were significantly higher among children whose mothers had a higher education level (AOR: 2.55; 95% CI: 2.01, 3.25), those living in the highest wealth quintile households (AOR: 2.37; 95% CI: 1.92, 2.93), and in residentials where vitamin A-rich fruits were available (AOR: 1.20; 95% CI: 1.02, 1.41). Further research in residential food environment is necessary to understand the purchasing habits, affordability, and desirability of plant-based vitamin A-rich foods to widen strategic options to improve its consumption among preschoolers in low-income and low-education communities.
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Affiliation(s)
- Adane Kebede
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Magnus Jirström
- Department of Human Geography, Lund University, 223 62 Lund, Sweden;
| | - Alemayehu Worku
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa 1176, Ethiopia;
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Hanna Y. Berhane
- Department of Nutrition and Behavioral Sciences, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia;
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Christopher Turner
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Eva-Charlotte Ekström
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Yemane Berhane
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia
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18
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Gu Y, Zhou G, Zhou F, Wu Q, Ma C, Zhang Y, Ding J, Hua K. Life Modifications and PCOS: Old Story But New Tales. Front Endocrinol (Lausanne) 2022; 13:808898. [PMID: 35498415 PMCID: PMC9045543 DOI: 10.3389/fendo.2022.808898] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is defined as a kind of endocrine and metabolic disorder that affects female individuals of reproductive age. Lifestyle modifications, including diet modifications, exercise, and behavioral modification, appear to alleviate the metabolic dysfunction and improve the reproductive disorders of PCOS patients (particularly in obese women). Therefore, lifestyle modifications have been gradually acknowledged as the first-line management for PCOS, especially in obese patients with PCOS. However, the mechanism of lifestyle modifications in PCOS, the appropriate composition of diet modifications, and the applicable type of exercise modifications for specific female populations are rarely reported. We conducted a systematic review and enrolled 10 randomized controlled trials for inclusion in a certain selection. In this review, we summarized the existing research on lifestyle modifications in PCOS. We aimed to illustrate the relationship between lifestyle modifications and PCOS (referring to hyperandrogenism, insulin resistance as well as obesity) and also considered the priorities for future research. These results might be an invaluable tool to serve as a guide in lifestyle modifications as the intervention for PCOS and other related endocrine disorders.
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Affiliation(s)
- Yuanyuan Gu
- Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
- Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Guannan Zhou
- Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Gynecology, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Fangyue Zhou
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiongwei Wu
- Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Chengbin Ma
- Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Yi Zhang
- Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
- *Correspondence: Yi Zhang, ; Jingxin Ding, ; Keqin Hua,
| | - Jingxin Ding
- Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Gynecology, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
- *Correspondence: Yi Zhang, ; Jingxin Ding, ; Keqin Hua,
| | - Keqin Hua
- Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Department of Gynecology, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
- *Correspondence: Yi Zhang, ; Jingxin Ding, ; Keqin Hua,
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