Review of the nutritional implications of farmers' markets and community gardens: a call for evaluation and research efforts

Investigating consumers' experiences with community supported agriculture: Convergent parallel design methods

Community-supported agriculture (CSA) represents a collaborative model where local farms and community members form partnerships to facilitate the direct delivery of fresh produce from farms to consumers. This study primarily investigates the experiences of current CSA members, focusing on the key factors influencing their retention intentions. Employing a convergent parallel mixed methods approach, this study gathers and analyzes both quantitative data (such as factors affecting members' retention intentions) and qualitative data (derived from interviews reflecting members' perceptions of their CSA experiences). The integration of these datasets provides a comprehensive understanding of the factors that shape CSA membership dynamics. The research findings underscore that Convenience, Product Quality, and Positive Interactions are pivotal factors that contribute to members' Intentions to continue their CSA memberships. These insights are crucial for enhancing the services provided to CSA members and hold significant implications for the broader scope of CSA membership research. This study not only fills a critical gap in understanding the Chinese CSA context but also contributes to the global discourse on sustainable agriculture practices and community engagement.

Food Environment Quality and Cardiovascular Disease Mortality in the United States: a County-Level Analysis from 2017 to 2019

BACKGROUND

Upstream socioeconomic circumstances including food insecurity and food desert are important drivers of community-level health disparities in cardiovascular mortality let alone traditional risk factors. The study assessed the association between differences in food environment quality and cardiovascular mortality in US adults.

DESIGN

Retrospective analysis of the association between cardiovascular mortality among US adults aged 45 and above and food environment quality, measured as the food environment index (FEI), in 2615 US counties. FEI was measured by equal weights of food insecurity (limited access to a reliable food source) and food desert (limited access to healthy food), ranging from 0 (worst) to 10 (best). Age-adjusted cardiovascular mortality rates per 100,000 adults aged 45 and above in the calendar year 2017-2019. County-level association between CVD mortality rate and FEI was modeled using generalized linear regression. Data were weighted using county population.

RESULT

Median CVD deaths per 100,000 population were 645.4 (IQR 561.5, 747.0) among adults aged 45 years and above across US counties in 2017-2019. About 12.8% (IQR 10.7%, 15.1%) of residents were food insecure and 6.3% (IQR 3.6%, 9.9%) were living in food desert areas. Comparing counties by FEI quartiles, the CVD mortality rate was higher in the least healthy FE counties (704.3 vs 598.6 deaths per 100,000 population) compared to the healthiest FE counties. One unit increase in FEI was associated with - 12.95 CVD deaths/100,000 population. In the subgroup analysis of counties with higher income inequality, the healthiest food environment was associated with 46.4 lower CVD deaths/100,000 population than the least healthy food environment. One unit increase in FEI in counties with higher income inequality was associated with a fivefold decrease in CVD mortality difference in African American counties (- 18.4 deaths/100,000 population) when compared to non-African American counties (- 3.63 deaths/100,000 population).

CONCLUSION

In this retrospective multi-county study in the USA, a higher food environment index was significantly associated with lower cardiovascular mortality.

SNAP Participation Moderates Fruit and Vegetable Intake Among Minority Families With Low Income

OBJECTIVE

To examine the moderation effect of Supplemental Nutrition Assistance Program (SNAP) participation on the baseline fruit and vegetable (FV) intake of Hispanic/Latino and African American children and parents participating in the Brighter Bites program.

DESIGN

Cross-sectional.

SETTING

Houston, Austin, and Dallas, TX; Washington, DC; and Southwest Florida.

PARTICIPANTS

Self-reported surveys (n = 6,037) of Hispanic/Latino and African American adult-child dyads enrolled in Brighter Bites in Fall 2018.

VARIABLES MEASURED

Dependent variable, child FV intake; Independent variable, parent FV intake, and FV shopping behavior; Effect Measure Modifier, SNAP participation.

ANALYSIS

Quantitatively used mixed effects linear regression models to test if the effect of parental baseline FV intake and shopping behavior on a child's baseline FV intake differed by SNAP participation. Analyses were performed using STATA with significance set at P < 0.05 and 95% confidence intervals (CIs).

RESULTS

For parents that consumed FV ≥ 2 times/d at baseline, there was a 0.1 times increase in child FV intake at baseline among those who participated in SNAP as compared with those who did not participate in SNAP (ß = 0.1; 95% CI, 0.1-0.2; P = 0.001), and for parents who shopped at convenience stores ≥ 2 times/wk for FV, there was 0.6 times increase in child FV intake at baseline for those who participated in SNAP as compared with those that did not participate in SNAP (ß = 0.6; 95% CI, 0.3-0.9; P < 0.001).

CONCLUSIONS AND IMPLICATIONS

Supplemental Nutrition Assistance Program participation moderated the associations between FV intake among African American and Hispanic/Latino parents and children and FV shopping at convenience stores and child FV intake. Findings indicate a need for future interventions to promote SNAP participation among those eligible and improve access to FV.

Participation in Intergenerational Food and Agriculture Education Programs Effectively Promotes Place Attachment

This study adopted an empirical approach to examine the effectiveness of integrating intergenerational education with food and agricultural education to increase students' affection for their learning environment. The intergenerational food and agricultural education program in this study consisted of various courses promoting educational dialogue between students and their parents and grandparents at home. The bidirectional learning process allowed the three generations to better understand each other's dietary and life experiences and pass on the relevant knowledge and culture. The 51 participants in this quantitative study were rural elementary schoolchildren who were divided into an experimental group and a control group. Place attachment was evaluated through the two sub-dimensions of place identity and place dependence. The results revealed that food and agricultural education implemented as intergenerational education strengthens learners' affective attachment to their school environment.

An Evaluation of the Implementation of the Women, Infants, and Children (WIC) Farmers Market Nutrition Program at Four Chicago WIC Sites

The Farmers Market Nutrition Program (FMNP), a program of the U.S. Department of Agriculture (USDA), provides coupons to individuals/families enrolled in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC) to purchase fresh produce from approved farmers markets. While some studies suggest FMNP may improve nutrition for WIC clients, there is limited research on program implementation in practice. A mixed-methods equitable evaluation framework was utilized to: (1) better understand the FMNP in practice at four WIC clinics on Chicago's west and southwest sides that serve predominately Black and Latinx families; (2) detail facilitators and barriers to participation in the FMNP; and (3) describe the potential impact on nutrition. In this manuscript, we present qualitative findings from Aim 1. We identified six steps for how the FMNP has been implemented in our study setting and opportunities to improve the implementation of the program. Findings suggest that well-defined and consistent guidelines on: (1) how to seek state approval for farmers markets; and (2) coupon distribution and redemption, are necessary to optimize utilization. Future research should explore the impact of newly offered electronic coupons on redemption rates and fresh fruit and vegetable purchasing behaviors.

Impact of a farmers' market healthy food subsidy on the diet quality of adults with low incomes in British Columbia, Canada: a pragmatic randomized controlled trial

BACKGROUND

Adults with low incomes have lower diet quality than their higher income counterparts. In Canada, the British Columbia Farmers' Market Nutrition Coupon Program (FMNCP) provides coupons to low-income households to purchase healthy foods in farmers' markets.

OBJECTIVE

The objective of this study was to examine the impact of the FMNCP on the diet quality of adults with low incomes.

METHOD

In a pragmatic randomized controlled trial conducted in 2019, adults with low incomes (≥18 y) were randomly assigned either to an FMNCP intervention (n = 143) or a no-intervention control group (n = 142). The FMNCP group received 16 coupon sheets valued at $21 per sheet over 10-15 wk to purchase healthy foods from farmers' markets. Participants completed a questionnaire and 2 24-h dietary recalls at baseline (0 wk), immediately post-intervention (10-15 wk), and 16-wk post-intervention (26-31 wk). Diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015). Linear mixed-effects regression assessed differences in HEI-2015 total (primary outcome) and component scores (secondary outcomes) between the FMNCP and control groups at post-intervention and 16-wk post-intervention. Subgroup analyses examined program impacts by sex and age group (18-59 y, ≥60 y).

RESULTS

There were no significant differences in HEI-2015 total scores between the FMNCP and control groups at post-intervention (-0.07; 95% CI: -4.07, 3.93) or 16-wk post-intervention (1.22; 95% CI: -3.00, 5.44) overall or between subgroups. There were no significant between-group differences in HEI-2015 component scores at post-intervention, although there were significant differences in component scores for dairy and fatty acids at 16-wk post-intervention.

CONCLUSION

The FMNCP did not significantly improve diet quality among adults with low incomes over the study period. Further research is needed to explore whether higher subsidy amounts or a longer intervention period is needed to meaningfully improve diet quality among adults with low incomes. This trial was registered at [clinicaltrials.gov] as [NCT03952338].

Community solutions to food apartheid: A spatial analysis of community food-growing spaces and neighborhood demographics in Philadelphia

Black and low-income neighborhoods tend to have higher concentrations of fast-food restaurants and low produce supply stores. Limited access to and consumption of nutrient-rich foods is associated with poor health outcomes. Given the realities of food access, many members within the Black communities grow food as a strategy of resistance to food apartheid, and for the healing and self-determination that agriculture offers. In this paper, we unpack the history of Black people, agriculture, and land in the United States. In addition to our brief historical review, we conduct a descriptive epidemiologic study of community food-growing spaces, food access, and neighborhood racial composition in present day Philadelphia. We leverage one of the few existing datasets that systematically documents community food-growing locations throughout a major US city. By applying spatial regression techniques, we use conditional autoregressive models to determine if there are spatial associations between Black neighborhoods, poverty, food access, and urban agriculture in Philadelphia. Fully adjusted spatial models showed significant associations between Black neighborhoods and urban agriculture (RR: 1.28, 95% CI = 1.03, 1.59) and poverty and urban agriculture (RR: 1.27, 95% CI = 1.1, 1.46). The association between low food access and the presence of urban agriculture was generally increased across neighborhoods with a higher proportion of Black residents. These results show that Philadelphia neighborhoods with higher populations of Black people and neighborhoods with lower incomes, on average, tend to have more community gardens and urban farms. While the garden data is non-temporal and non-causal, one possible explanation for these findings, in alignment with what Philadelphia growers have claimed, is that urban agriculture may be a manifestation of collective agency and community resistance in Black and low-income communities, particularly in neighborhoods with low food access.

Relationships between Food Production Experience and the Behavior, Attitude, and Knowledge of Dietary Recommendations among Japanese Adults: A Cross-Sectional Study

The Japanese Ministry of Agriculture, Forestry, and Fisheries proposed to educate more people in food production as one of the objectives of the Basic Plan for Food and Nutrition Education Promotion. This cross-sectional study aims to elucidate the relationship between food production experience (agricultural, forestry, and fishery experiences) and the behavior, attitude, and knowledge of dietary recommendations among Japanese adults. This study was conducted using data obtained from the “Survey on Dietary Habits and Agriculture, Forestry, and Fishery Experiences (2019)”. This survey was conducted by mailing paper questionnaires to respondents aged 20–69 years living in 17 regions across Japan. The independent variable was food production experience. The dependent variables were each of the 13 goals of the dietary guidelines in Japan, the total score for adherence to the 13 items (low scores indicate good adherence), adherence to a Japanese-style diet, and four items on the attitude and knowledge of dietary recommendations. I also examined the association between the point in life the food production experience occurred and the above outcomes. The data obtained from 3461 participants aged 20 to 69 years were used for multivariate logistic and linear regression analyses. Food production experience was positively associated with an improved behavior, attitude, and knowledge of dietary recommendations among adults in Japan. The study found a strong relationship with food production experiences in adulthood.

Relationships among Local Agricultural Product Purchases, Self-Cooked Meal Consumption, and Healthy Eating Habits: A Cross-Sectional Study in a Town in Gunma, Japan

This study examined whether the frequency of purchasing local agricultural products and the intake frequency of self-cooked meals were related to healthy eating habits. A cross-sectional study was conducted using anonymized data from the “Survey on health promotion and food-and-nutritional education” conducted in 2021 in Tamamura, Gunma, Japan, targeting residents aged 20–65. Logistic regression analyses were conducted using the purchasing frequency of local agricultural products (often/sometimes/rarely) and the intake frequency of self-cooked meals (almost every day/not every day) as independent variables. The dependent variables were the frequencies of breakfast (every day/not every day), balanced meal (two times/day or more/fewer than two times/day), and vegetable intake (two times/day or more/fewer than two times/day). The purchasing frequency of local agricultural products was positively related to the frequency of balanced meal and vegetable intake. Additionally, the intake frequency of self-cooked meals was positively related to the frequencies of breakfast, balanced meal, and vegetable intake. In conclusion, significant positive relationships of the purchasing frequency of local agricultural products and the intake frequency of self-cooked meals with healthy eating habits were confirmed.

The Effects of Increasing Fruit and Vegetable Intake in Children with Asthma on the Modulation of Innate Immune Responses

Children with asthma are at risk of acute exacerbations triggered mainly by viral infections. A diet high in fruit and vegetables (F&V), a rich source of carotenoids, may improve innate immune responses in children with asthma. Children with asthma (3−11 years) with a history of exacerbations and low F&V intake (≤3 serves/d) were randomly assigned to a high F&V diet or control (usual diet) for 6 months. Outcomes included respiratory-related adverse events and in-vitro cytokine production in peripheral blood mononuclear cells (PBMCs), treated with rhinovirus-1B (RV1B), house dust mite (HDM) and lipopolysaccharide (LPS). During the trial, there were fewer subjects with ≥2 asthma exacerbations in the high F&V diet group (n = 22) compared to the control group (n = 25) (63.6% vs. 88.0%, p = 0.049). Duration and severity of exacerbations were similar between groups. LPS-induced interferon (IFN)-γ and IFN-λ production showed a small but significant increase in the high F&V group after 3 months compared to baseline (p < 0.05). Additionally, RV1B-induced IFN-λ production in PBMCs was positively associated with the change in plasma lycopene at 6 months (rs = 0.35, p = 0.015). A high F&V diet reduced asthma-related illness and modulated in vitro PBMC cytokine production in young children with asthma. Improving diet quality by increasing F&V intake could be an effective non-pharmacological strategy for preventing asthma-related illness by enhancing children’s innate immune responses.

Influence of Prefecture-Level Yield of Not-for-Sale Vegetables on Vegetable Intake in Japan: A Natural Experiment

Increased vegetable intake contributes to better health for people. The distribution of not-for-sale vegetables is an important source of vegetable intake in Japan. This study examined the impact of prefecture-level yield of not-for-sale vegetables on vegetable intake in Japan. This study regarded the increase in yield of not-for-sale Chinese cabbage in Nagano Prefecture in 2012 as a natural experiment. The years 2012 and 2016 were the large-scale survey years of the Japanese National Health and Nutrition Survey. Therefore, the effect of the change in prefecture-level yield of not-for-sale vegetables on vegetable intake was evaluated by comparing the changes in Chinese cabbage intake in Nagano between 2012 and 2016 with those of other prefectures classified in the same regional block as Nagano. Statistical analysis was performed using general linear models to examine the interaction of year and prefecture with Chinese cabbage intake. Consequently, the regression coefficient for the interaction term was −3.38 (95% CI, −9.59–2.83), that of the model adjusted for basic characteristics and energy intake was −2.99 (95% CI, −9.22–3.24), and that of the model adding health-related variables was −5.03 (95% CI, −12.40–2.34). The prefecture-level yield of not-for-sale vegetables typically had a minor effect on vegetable intake.

Community gardens and their effects on diet, health, psychosocial and community outcomes: a systematic review

Background

We systematically reviewed the effects of community gardens on physical and psychosocial health, health behaviors and community outcomes.

Methods

Quantitative studies that examined associations of health, psychosocial or community outcomes with community gardens were included in the review. Studies up to December 2020 were captured from searches of Medline, Web of Science, PsycInfo, EBSCOHost and CAB Abstracts. Data were extracted and study quality including risk of bias was examined.

Results

There were 53 studies that met the inclusion criteria. Studies examining associations between community gardens and nutrition or food security were most frequently reported (k = 23). Other factors examined for associations with community gardens were health (k = 16), psychosocial (k = 16) and community outcomes (k = 7). Effects appeared positive for fruit and vegetable intake, some psychosocial and community outcomes, but mixed for physical health outcomes. Evidence quality overall was low.

Conclusions

Community gardening was associated with higher fruit and vegetable intake, positive psychosocial and community outcomes, but poor evidence quality suggests the effects of community gardening may be overestimated.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13591-1.

Validation of the FRESH Austin food frequency questionnaire using multiple 24-h dietary recalls

OBJECTIVE

The purpose of the current study was to examine the validity of an FFQ utilised in the Food Retail: Evaluating Strategies for a Healthy Austin (FRESH Austin) study, designed to evaluate changes in the consumption of fruits and vegetables (FV) in diverse low-income communities in Austin, TX.

DESIGN

The FRESH Austin FFQ was validated against three 24-h dietary recalls (24hDR). All dietary assessments were administered (in-person or by telephone) by trained investigators.

SETTING

Recruitment was conducted at sites within the geographic areas targeted in the FRESH Austin recruitment. People at a community health clinic, a local health centre and a YMCA within the intervention area were approached by trained and certified data collectors, and invited to participate.

PARTICIPANTS

Among fifty-six participants, 83 % were female, 46 % were non-White, 24 % had income < $25 K/year and 30 % spoke only/mostly Spanish at home.

RESULTS

The FFQ and average of three 24hDR produce similar estimates of average total servings/d across FV (6·68 and 6·40 servings/d, respectively). Correlations produced measures from 0·01 for 'Potatoes' and 0·59 for 'Other Vegetables'. Mean absolute percentage errors values were small for all FV, suggesting the variance of the error estimates was also small. Bland-Altman plots indicate acceptable levels of agreement between the two methods.

CONCLUSION

These outcomes indicate that the FRESH FFQ is a valid instrument for assessing FV consumption. The validation of the FRESH Austin FFQ provides important insights for evaluating community-based efforts to increase FV consumption in diverse populations.

A Comprehensive Review of Hass Avocado Clinical Trials, Observational Studies, and Biological Mechanisms

This first comprehensive review of fresh Hass avocados includes 19 clinical trials, five observational studies, and biological mechanisms. We identified four primary avocado health effects: (1) reducing cardiovascular disease risk in healthy overweight or obese adults with dyslipidemia by lowering non-HDL-C profiles, triglycerides, LDL oxidation, small atherogenic LDL particles and promoting postprandial vascular endothelial health for better peripheral blood flow; (2) lowering the risk of being overweight or obese, supporting weight loss, and reducing visceral fat tissue in overweight or obese women; (3) improving cognitive function in older normal-weight adults and in young to middle age overweight or obese adults especially in frontal cortex executive function; and (4) stimulating improved colonic microbiota health in overweight or obese adults by promoting healthier microflora and fecal metabolites. We also identified a unique combination of four Hass avocado nutritional features that appear to be primarily responsible for these health effects: (1) a 6 to 1 unsaturated (rich in oleic acid) to saturated fat ratio similar to olive oil; (2) a source of multifunctional prebiotic and viscous fiber; (3) a relatively low energy density of 1.6 kcal/g (79% of edible Hass avocado weight consists of water and fiber with a creamy, smooth texture); and (4) its oleic acid and water emulsion increases carotenoid absorption from low-fat fruits and vegetables (e.g., salsa or salad) when consumed with avocados. They are also a good source of micronutrients and polyphenols, and are very low in sodium and available carbohydrates supporting secondary health and wellness benefits. Hass avocado health effects are best demonstrated when consumed in a healthy dietary plan such as the Mediterranean diet. More extensive and longer clinical trials are needed to further enhance our understanding of the Hass avocado’s health effects.

Local Value Chain Models of Healthy Food Access: A Qualitative Study of Two Approaches

Food value chains are increasingly recognized as more equitable alternatives to traditional supply chains and may represent a novel mechanism to achieve health equity at the local level. Country Fresh Stops (CFS) and Donation Station (DS) are two complementary programs that are part of a more robust value chain designed to support local agriculture in Appalachia Ohio. As the first study of these programs in the peer-reviewed literature, the objectives were to identify factors that facilitate or hinder the implementation of these two local value chain models of healthy food access and to identify the perceived impacts from the perspective of the sites implementing them. In-depth, semi-structured interviews were conducted with CFS (n = 7) and DS (n = 10) site representatives in January 2020. Template analysis was used to identify themes through a priori and inductive codes. Participants identified two primary facilitators: support from partner organizations and on-site program stewardship. Produce (and program) seasonality and mitigating food waste were the most cited challenges. Despite challenges, both CFS and DS sites perceive the models to be successful efforts for supporting the local economy, achieving organizational missions, and providing consumers with greater access to locally grown produce. These innovative programs demonstrate good feasibility, but long-term sustainability and impacts on other key stakeholders merit further investigation.

Accelerating Evaluation of Financial Incentives for Fruits and Vegetables: A Case for Shared Measures

Food insecurity, or lack of consistent access to enough food, is associated with low intakes of fruits and vegetables (FVs) and higher risk of chronic diseases and disproportionately affects populations with low income. Financial incentives for FVs are supported by the 2018 Farm Bill and United States (U.S.) Department of Agriculture’s Gus Schumacher Nutrition Incentive Program (GusNIP) and aim to increase dietary quality and food security among households participating in the Supplemental Nutrition Assistance Program (SNAP) and with low income. Currently, there is no shared evaluation model for the hundreds of financial incentive projects across the U.S. Despite the fact that a majority of these projects are federally funded and united as a cohort of grantees through GusNIP, it is unclear which models and attributes have the greatest public health impact. We explore the evaluation of financial incentives in the U.S. to demonstrate the need for shared measurement in the future. We describe the process of the GusNIP NTAE, a federally supported initiative, to identify and develop shared measurement to be able to determine the potential impact of financial incentives in the U.S. This commentary discusses the rationale, considerations, and next steps for establishing shared evaluation measures for financial incentives for FVs, to accelerate our understanding of impact, and support evidence-based policymaking.

Garden Access, Race and Vegetable Acquisition among U.S. Adults: Findings from a National Survey

With the majority of U.S. adults not meeting recommended vegetable intakes and well-documented racial and ethnic disparities in fruit and vegetable consumption, various approaches to increase vegetable consumption have been implemented. Gardening is one approach that has been associated with increased vegetable consumption in various subpopulations; however, limited national data exist examining this relationship. Since vegetable acquisition is a necessary antecedent to increased vegetable consumption, this study examines if garden access is associated with vegetable acquisition among adults in a nationally representative sample of U.S. households. Data come from the National Food Acquisition and Purchasing Survey (FAPS), a survey of 4826 US households. Descriptive analysis and modified Poisson regressions were performed to examine associations between household garden access and vegetable acquisition amongst the total population and by race. Results indicate that for foods for at-home consumption, respondents with their own garden had a 30% greater prevalence (PR: 1.30, 95% CI: 1.01, 1.64) of acquiring enough vegetables to meet USDA recommendations compared to respondents in households without access to any gardens. Among Black respondents, those with access to their own garden had over two times increased prevalence (PR: 2.35, 95% CI: 1.10, 5.01) of acquiring enough vegetables to meet recommended consumption amounts, compared to Black respondents without any access to a garden. No relationships between garden access and vegetable acquisition were observed for White or Asian respondents. This information may contribute to the body of evidence on strategies for increasing vegetable consumption among U.S. adults.

Relationship between Prefecture-Level Yield of Not-for-Sale Fruits and Vegetables and Individual-Level Fruit and Vegetable Intake in Japan: A Cross-Sectional Study

This study investigated the relationship between prefecture-level yield of not-for-sale fruits and vegetables and individual-level fruit and vegetable intake in Japan. Data were drawn from the Japanese National Health and Nutrition Survey and National Crop Survey of 2016. Random intercept models were used for the analyses. Individual-level fruit and vegetable intake was used for the dependent variable, and prefecture-level yield of not-for-sale fruits and vegetables was used for the independent variable as a fixed effect. In addition, participants’ characteristics and health-related factors at the individual level were also put into independent variables as fixed effects. The prefectures were used as random intercepts. It was found that prefecture-level yield of not-for-sale fruits and vegetables was significantly related to individual-level fruit and vegetable intake (vegetable: B = 0.390, p < 0.001; fruit: B = 0.268, p = 0.003; fruits and vegetables: B = 0.357, p < 0.001). These relationships were also significant in the gender-specific analysis. Thus, the yield of not-for-sale fruits and vegetables might contribute to the intake of fruits and vegetables in Japan.

A Rapid Review of Territorialized Food Systems and Their Impacts on Human Health, Food Security, and the Environment

The global food system is facing multiple problems, including rising food insecurity, degrading environments, and an increased incidence of diet-related chronic diseases. International organizations are thus calling for a transition toward territorialized food systems to alleviate some of these challenges. Yet, limited evidence supporting the benefits of territorialized food systems is available. Our objective was to summarize the current body of literature on territorialized food systems and their impacts on human health, food security, and the environment using a rapid review methodology. Articles were retrieved from three databases and analyzed using keywords and inclusion criteria corresponding to territorialized food systems, environment, human health, and food security. Six relevant publications were identified. While this limited evidence suggests that territorialized food systems may have positive effects on all three dimensions, data are not consistent across publications. For example, territorialized food systems may contribute to improved diet quality, provide agroecosystem services, and contribute to food security. However, food produced within these food systems may have a higher carbon footprint and be less available than industrially produced food. This rapid review also highlights the siloed nature of the current research on territorialized food systems and emphasizes the need for more holistic and interdisciplinary research.

Evidence on the contribution of community gardens to promote physical and mental health and well-being of non-institutionalized individuals: A systematic review

INTRODUCTION

There has been growing interest in community gardens as an effective and affordable health promotion strategy. However, most available evidence is derived from qualitative studies, whereas quantitative research on this subject is limited.

OBJECTIVES

To synthetize the literature about physical and mental health outcomes associated with community gardening. Two main questions were addressed: a) is there evidence, from quantitative studies, that community gardening is associated to physical and mental health and well-being of non-institutionalized individuals? b) Does community gardening provokes any discomfort in terms of physical health, i.e., bodily pain, to their beneficiaries?

METHODS

A systematic review of the literature was carried out following PRISMA guidelines by searching relevant electronic databases (PubMed, Scopus, and Web of Science). Empirical, quantitative studies published in English with no restrictions concerning the date of publication were considered eligible. The quality of the evidence was appraised using the tool developed by the National Heart, Lung, and Blood Institute of the National Institutes of Health for Observational Cohort and Cross-Sectional Studies.

RESULTS

Overall, 8 studies were considered eligible, of which seven studies were rated as having good methodological quality (one scored as fair). Community gardeners had significantly better health outcomes than their neighbours not engaged in gardening activities in terms of life satisfaction, happiness, general health, mental health, and social cohesion.

CONCLUSION

Community gardens are associated to health gains for their users, irrespective of age, being an affordable and efficient way of promoting physical and mental health and well-being. To encourage the design, maintenance, and prospective evaluation of supportive urban environments promoting healthy and, at the same time, sustainable lifestyles, is essential to achieve public health gains and environmental sustainability.

Exploring the Potential Risk of Heavy Metal Pollution of Edible Cultivated Plants in Urban Gardening Contexts Using a Citizen Science Approach in the Project “Heavy Metal City-Zen”

Urban gardening has become increasingly popular, creating green oases in cities; however, many of these activities are undertaken in areas of high traffic density or on ex-brown field sites. As a consequence, there are still some barriers to the adoption of these urban gardening practices for food production. One of the public concerns is the transfer of urban pollutants such as heavy metals into the consumer’s food chain, however, city-wide data is often difficult and expensive to collect. In the citizen science project described herein, we conducted simple citizen-led common collaborative experiments in urban community gardens. These data provided information on the potential risk of heavy metal contaminants and ways in which to mitigate those risks in an urban gardening context. Generally, values were below guideline thresholds, however, at a few garden sites, soil trace metal concentrations (Pb, Cd, Zn) exceeded Austrian recommended limits. Moreover, only at two sites were plant trace metal concentrations shown to be above European food standards limits. Given the citizen’s positive response to the project, we suggest expanding this study to the whole of Vienna, giving newly established gardens a chance to predetermine the risks posed by their local soils.

Urban collective garden participation and health: a systematic literature review of potential benefits for free-living adults

CONTEXT

Collective gardens are increasingly considered a tool to promote health and well-being.

OBJECTIVE

In this systematic review, we critically appraise quantitative studies exploring the potential health benefits of urban collective garden participation.

DATA SOURCES

Articles published between January 2000 and August 2020 were used.

DATA EXTRACTION

All original research studies reporting at least 1 health outcomes associated with urban collective gardening in free-living adults from Western and other high-income countries were included. Of 1261 articles identified, 15 were included in the systematic review. Methodological quality was assessed by applying the criteria of the Quantitative Study Quality Assessment Tool.

ANALYSIS

A wide range of health indicators was used. Collective gardening was associated with higher fruit and vegetable consumption than was nongardening. Mixed results were found for physical activity and physiological health. A positive association was found in most studies with mental health and social health. However, the vast majority of included studies were cross-sectional and presented selection bias (n = 13 of 15 for both) and very few used objective measurement methods (n = 3 of 15).

CONCLUSIONS

Longitudinal studies allowing the exploration of causal relationships are needed before the health benefits of collective garden participation suggested by existing studies can be confirmed.

Uncovering the relationship between food-related discussion on Twitter and neighborhood characteristics

Objective

Initiatives to reduce neighborhood-based health disparities require access to meaningful, timely, and local information regarding health behavior and its determinants. We examined the validity of Twitter as a source of information for neighborhood-level analysis of dietary choices and attitudes.

Materials and Methods

We analyzed the “healthiness” quotient and sentiment in food-related tweets at the census tract level, and associated them with neighborhood characteristics and health outcomes. We analyzed keywords driving the differences in food healthiness between the most and least-affluent tracts, and qualitatively analyzed contents of a random sample of tweets.

Results

Significant, albeit weak, correlations existed between healthiness and sentiment in food-related tweets and tract-level measures of affluence, disadvantage, race, age, U.S. density, and mortality from conditions associated with obesity. Analyses of keywords driving the differences in food healthiness revealed foods high in saturated fat (eg, pizza, bacon, fries) were mentioned more frequently in less-affluent tracts. Food-related discussion referred to activities (eating, drinking, cooking), locations where food was consumed, and positive (affection, cravings, enjoyment) and negative attitudes (dislike, personal struggles, complaints).

Discussion

Tweet-based healthiness scores largely correlated with offline phenomena in the expected directions. Social media offer less resource-intensive data collection methods than traditional surveys do. Twitter may assist in informing local health programs that focus on drivers of food consumption and could inform interventions focused on attitudes and the food environment.

Conclusions

Twitter provided weak but significant signals concerning food-related behavior and attitudes at the neighborhood level, suggesting its potential usefulness for informing local health disparity reduction efforts.

Home gardening and associations with fruit and vegetable intake and BMI

OBJECTIVE

To understand who engages in home gardening and whether gardening is associated with fruit and vegetable intake and weight status.

DESIGN

A national cross-sectional survey.

SETTING

Online survey panel in the USA.

PARTICIPANTS

Adults aged 18-75 years representing the US population with respect to gender, age, race/ethnicity, income and geographic region (n 3889).

RESULTS

Approximately 30 % of survey respondents reported growing edible plants in a home garden. Gardeners were more likely to be White or Asian, employed, have higher income, be married, have children in the household and live in rural areas. Gardeners were less likely to be obese and more likely to meet US dietary recommendations for fruit and vegetable consumption. In multivariable analyses, home gardens remained associated with fruit and vegetable intake and BMI when controlling for a range of socio-demographic characteristics and level of rurality.

CONCLUSIONS

The current study identifies who is gardening in the USA and provides useful information for public health efforts to increase gardening as a nutrition intervention. Future research should examine the benefits of home gardening and interventions to increase home gardening using more rigorous designs.

A dietary assessment tool to estimate arsenic and cadmium exposures from locally grown foods

Certain food products have been shown to accumulate arsenic (As) and cadmium (Cd) making it critical to monitor individual's intake, particularly when they live near sources of environmental contamination. After a literature review, a novel dietary assessment was conducted to estimate a child's potential exposure to these metal(loid)s via consumption of locally grown foods in communities impacted by active or legacy resource extraction activities. Mean ingestion rates of As- and Cd-translocating crops belonging to the Asteraceae, Brassicaceae, Caricaceae, Amaranthaceae, Cucurbitaceae, Liliaceae, Solanaceae, Apiaceae, and Fabaceae plant families were calculated for children: 1 to < 2 years, 2 to < 3 years, and 3 to < 6 years of age. These calculated ingestion rates ranged from 0 to 143,571 mg day^-1. Farmer-consumer relationship was the leading motivation for buying locally grown foods, while lack of experience/unfamiliarity was the most frequently reported reason for not buying locally. The median percentages of child's yearly consumption of fruits and vegetables originating from stores (conventionally grown) and from local sources (farmer's market) were 48% and 38%, respectively. Tomato was the crop with the highest intake rate among children 1 to < 2 years and 2 to < 3 years of age and broccoli for children 3 to < 6 years of age. It was concluded that families who are reliant on locally grown food products may be disproportionately exposed to As and Cd, which could cause detrimental health effects.

Food Co-Operatives: A Potential Community-Based Strategy to Improve Fruit and Vegetable Intake in Australia

Only 5% of Australian children and adults eat enough fruit and vegetables. Two common barriers are high cost and limited access. Food co-operatives (‘co-ops’) may have the potential to reduce these barriers. We conducted a scoping analysis of food co-ops in the Sydney region to describe their characteristics and objectives. We also conducted a survey of members and non-members of co-ops to assess their fruit and vegetable intake using validated questions. Fifteen food co-ops were identified in the Sydney region and the most common objective was to provide cheap affordable produce. Most co-ops (61%) were in areas of high socio-economic status (SES). Members of food co-ops had a higher vegetable intake than non-members [mean difference (MD) = 0.54 serves/daily; 95% confidence interval (CI) of 0.15 to 0.93] and were also more likely to meet the recommendations for fruit and vegetable intake [odds ratio (OR) = 4.77 (95% CI = 1.15, 19.86)]. Implications of this study are that if food co-ops can be implemented on a wider scale, they hold potential for improving fruit and vegetable intakes.

Dietary policies and programs in the United States: A narrative review

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School-based and youth targeted programs and policies were most frequently studied.

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Research has rather neglected older adult, Asian, Native Hawaiian and American Indian populations.

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Despite existing research indicating effectiveness, faith-based were understudied.

Prior reviews describing approach, methodological quality and effectiveness of dietary policies and programs may be limited in use for practitioners seeking to introduce innovative programming, or academic researchers hoping to understand and address gaps in the current literature. This review is novel, assessing the “where, who, and in whom” of dietary policies and programs research in the United States over the past decade – with results intended to serve as a practical guide and foundation for innovation. This study was conducted from October 2018 to March 2019. Papers were selected through a tailored search strategy on PubMed as well as citation searches, to identify grey literature. A total of 489 papers were relevant to our research objective. The largest proportion of papers described school-based strategies (31%) or included economic incentives (19%). In papers that specified demographics, the study populations most often included children, adults and adolescents (54%, 46%, and 42% respectively); and White, Black and Hispanic populations (77%, 76% and 70%, respectively). Results highlight opportunities for future research within workplace and faith-based settings, among racial/ethnic minorities, and older adults.

The Motivation of Urban Gardens in Mountain Areas. The Case of South Tyrol

Urban gardens have attracted considerable academic attention in recent years. Several studies have, in fact, emphasized their positive contribution in terms of social integration, community health, urban regeneration, and food security, and explored individual gardeners´ motivations behind these practices. While these topics are well-documented with reference to metropolitan urban areas, few studies have been carried out in relation to other contexts such as mountain areas. This limited interest is probably due to the reduced urbanization of these areas, a preference for other forms of horticulture (essentially those practiced in people’s own homes) or the use of different solutions to mitigate the negative effects of social problems. The recent proliferation of urban gardens in South Tyrol (IT) makes this mountain province an interesting laboratory for practices and narratives associated with socially innovative urban gardening experiences. This paper presents a characterization of all urban gardening initiatives in South Tyrol through cartographical representation. It explains gardeners´ and public institutions´ motivations, as well as non-gardeners’ perceptions of urban gardening. Semi-structured interviews were conducted in the various South Tyrolean municipalities where urban gardening projects have been undertaken. The results suggest the great importance of the social and environmental aspect of urban gardens, and an interest in reconnecting with food practices even when food access is not a priority.

Impact of a farmers' market nutrition coupon programme on diet quality and psychosocial well-being among low-income adults: protocol for a randomised controlled trial and a longitudinal qualitative investigation

INTRODUCTION

Low-income populations have poorer diet quality and lower psychosocial well-being than their higher-income counterparts. These inequities increase the burden of chronic disease in low-income populations. Farmers' market subsidies may improve diet quality and psychosocial well-being among low-income populations. In Canada, the British Columbia (BC) Farmers' Market Nutrition Coupon Programme (FMNCP) aims to improve dietary patterns and health among low-income participants by providing coupons to purchase healthy foods from farmers' markets. This study will assess the impact of the BC FMNCP on the diet quality and psychosocial well-being of low-income adults and explore mechanisms of programme impacts.

METHODS AND ANALYSIS

In a parallel group randomised controlled trial, low-income adults will be randomised to an FMNCP intervention (n=132) or a no-intervention control group (n=132). The FMNCP group will receive 16 coupon sheets valued at CAD$21/sheet over 10-15 weeks to purchase fruits, vegetables, dairy, meat/poultry/fish, eggs, nuts and herbs at farmers' markets and will be invited to participate in nutrition skill-building activities. Overall diet quality (primary outcome), diet quality subscores, mental well-being, sense of community, food insecurity and malnutrition risk (secondary outcomes) will be assessed at baseline, immediately post-intervention and 16 weeks post-intervention. Dietary intake will be assessed using the Automated Self-Administered 24-hour Dietary Recall. Diet quality will be calculated using the Healthy Eating Index-2015. Repeated measures mixed-effect regression will assess differences in outcomes between groups from baseline to 16 weeks post-intervention. Furthermore, 25-30 participants will partake in semi-structured interviews during and 5 weeks after programme completion to explore participants' experiences with and perceived outcomes from the programme.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of Calgary Conjoint Health Research Ethics Board, Rutgers University Ethics and Compliance, and University of Waterloo Office of Research Ethics. Findings will be disseminated through policy briefs, conference presentations and peer-reviewed publications.

TRIAL REGISTRATION NUMBER

NCT03952338.

Atlanta Residents' Knowledge Regarding Heavy Metal Exposures and Remediation in Urban Agriculture

Urban agriculture and gardening provide many health benefits, but the soil is sometimes at risk of heavy metal and metalloid (HMM) contamination. HMM, such as lead and arsenic, can result in adverse health effects for humans. Gardeners may face exposure to these contaminants because of their regular contact with soil and consumption of produce grown in urban areas. However, there is a lack of research regarding whether differential exposure to HMM may be attributed to differential knowledge of exposure sources. In 2018, industrial slag and hazardous levels of soil contamination were detected in West Atlanta. We conducted community-engaged research through surveys and follow-up interviews to understand awareness of slag, HMM in soil, and potential remediation options. Home gardeners were more likely to recognize HMM health effects and to cite health as a significant benefit of gardening than community gardeners. In terms of knowledge, participants were concerned about the potential health effects of contaminants in soil yet unconcerned with produce in their gardens. Gardeners’ knowledge on sources of HMM exposure and methods for remediation were low and varied based on racial group.

Estimating food production in an urban landscape

There is increasing interest in urban food production for reasons of food security, environmental sustainability, social and health benefits. In developed nations urban food growing is largely informal and localised, in gardens, allotments and public spaces, but we know little about the magnitude of this production. Here we couple own-grown crop yield data with garden and allotment areal surveys and urban fruit tree occurrence to provide one of the first estimates for current and potential food production in a UK urban setting. Current production is estimated to be sufficient to supply the urban population with fruit and vegetables for about 30 days per year, while the most optimistic model results suggest that existing land cultivated for food could supply over half of the annual demand. Our findings provide a baseline for current production whilst highlighting the potential for change under the scaling up of cultivation on existing land.

The Influence of Food Production Experience on Dietary Knowledge, Awareness, Behaviors, and Health among Japanese: A Systematic Review

This study aimed to reveal the influence of food production experience on dietary knowledge, dietary awareness, dietary behaviors, and health among Japanese populations. We conducted a systematic review of articles published between January 2000 and September 2018 (PROSPERO registration number: CRD42019117163) using the following four databases: PubMed, Web of Science, CiNii, and ICHUSHI. The search formulas were created by combining search terms “agricultural experience,” “garden,” “diet,” “food,” “physical activity,” “health,” and “well-being.” The articles were identified by titles, abstracts, and whole texts. We evaluated the content of the articles that met the adoption criteria. We included original articles from peer-reviewed scientific journals, articles written in Japanese or English, observational or interventional studies with statistical analyses, and articles targeting general Japanese people (except for those targeting patients or disabled) to examine the relationship according to the purpose of this review. Nineteen articles met the study criteria, including 10 cross-sectional studies, one retrospective study, seven pre–post studies, and three non-randomized controlled trials. Two studies combined multiple research designs. Thus, food production experiences were suggested to have a positive influence on dietary knowledge, dietary awareness, food preference, dietary behaviors, and mental health among the Japanese. However, the overall quality of the included studies was low. Further verification with randomized controlled trials and prospective cohort studies is required.

Social movement involvement and healthy diet and activity behaviors among US adults

Unhealthy lifestyle behaviors, namely poor diet and inadequate physical activity, significantly contribute to poor health and obesity risk, which in turn impact chronic illness outcomes. A possible approach to improving these health behaviors and subsequent outcomes is to capitalize on the theorized link between social movement involvement and overlapping health behaviors. Social movement involvement may be a viable stealth intervention for health, utilizing intrinsic motivators to improve health without an explicit focus on changing health behavior. Thus, the current study explored the links between social movement involvement and diet and physical activity. Two samples from a college population (N = 196) and the general population (N = 195) participated in an online survey, which included measures of social movement involvement, social movement-related health behaviors and dietary intake and physical activity. After controlling for known covariates, social movement-related health behaviors mediated the relationship between level of social movement involvement and fruit and vegetable consumption, whole grain intake and average daily physical activity in both samples. These findings suggest that health behaviors associated with social movement involvement may be an important mechanism in promoting health among social movement members and that the model holds across adult populations. This research adds to existing literature on stealth interventions as a viable means of improving important behavioral health components linked with obesity and chronic disease and supports social movement involvement as a potential form of stealth intervention.

Quantifying soil contamination and identifying interventions to limit health risks

Numerous toxicants contaminate soil and negatively affect the environments that children explore. Accurately measuring these toxicants and characterizing the level of soil contamination may be difficult and must include measurements of both the environmental concentrations and the exposure responses of human populations. This article reviews the current methods and technologies available for quantifying soil contamination. Several intervention strategies exist for limiting human exposure to contaminated soils and the strengths and weaknesses of these methods are discussed. Lastly, current policies on soil contamination and the importance of protecting vulnerable populations by developing means to improve health conditions for children are reviewed.

Best Practices Among Food-Based Community Organizations: A Qualitative Analysis

Food-based community organizations (FBCO) have positive impacts on community health, yet little is known about best practices that facilitate organization sustainability. To identify strategies among FBCOs used to facilitate member engagement/retention, reach future members/participants, and support organizational growth, key informants from four FBCOs in Texas participated in in-depth interviews. Semi-structured interviews were informed by grounded theory, voice recorded, and transcribed. Results from eight interviews, representing four organizations, indicated five themes for organization sustainability: commitment to a mission, supportive leadership, physical meeting space, clear communication, and community partnerships. Implementation of these strategies may benefit other FBCOs by helping them create sustainable organizations.

Monitoring and mitigation of toxic heavy metals and arsenic accumulation in food crops: A case study of an urban community garden

Urban community gardens have increased in prevalence as a means to generate fresh fruits and vegetables, including in areas lacking access to healthy food options. However, urban soils may have high levels of toxic heavy metals, including lead and cadmium and the metalloid arsenic, which can lead to severe health risks. In this study, fruit and vegetable samples grown at an urban community garden in southeastern San Diego, the Ocean View Growing Grounds, were sampled repeatedly over a four-year time period in order to measure potential contamination of toxic heavy metals and metalloids and to develop solutions for this problem. Metal nutrient, heavy metal, and metalloid concentrations were monitored in the leaf and fruit tissues of fruit trees over the sampling period. Several of the fruit trees showed uptake of lead in the leaf samples, with Black Mission fig measuring 0.843-1.531 mg/kg dry weight and Mexican Lime measuring 1.103-1.522 mg/kg dry weight over the sampling period. Vegetables that were grown directly in the ground at this community garden and surrounding areas showed arsenic, 0.80 + 0.073 mg/kg dry weight for Swiss chard, and lead, 0.84 ± 0.404 mg/kg dry weight for strawberries, in their edible tissues. The subsequent introduction of raised beds with uncontaminated soil is described, which eliminated any detectable heavy metal or metalloid contamination in these crops during the monitoring period. Recommendations for facilitating the monitoring of edible tissues and for reducing risk are discussed, including introduction of raised beds and collaborations with local universities and research groups.

Fruit and Vegetable Purchases in Farmer's Market Stands: Analysing Survey and Sales Data

Farmers' market implementation holds promise for increasing access to healthy foods. Although rarely measured, purchase data constitute an intermediate outcome between food environment and actual consumption. In a study conducted with two seasonal Fruits and Vegetables (FV) stands in a disadvantaged area of Montréal (Canada), we analysed how accessibility, perception, and mobility-related factors were associated with FV purchase. This analysis uses a novel measure of FV purchasing practices based on sales data obtained from a mobile application. A 2016 survey collected information on markets' physical access, perceived access to FV in the neighbourhood, usual FV consumption and purchases. Multivariate models were used to analyse three purchasing practice indicators: number of FV portions, FV variety and expenditures. Average shoppers purchased 12 FV portions of three distinct varieties and spent 5$. Shoppers stopping at the market on their usual travel route spent less (p = 0.11), bought fewer portions (p = 0.03) and a lesser FV variety (p < 0.01). FV stands may complement FV dietary intake. Individuals for whom the market is on their usual travel route might make more frequent visits and, therefore, smaller purchases. The novel data collection method allowed analysis of multiple purchase variables, is precise and easy to apply at unconventional points of sales and could be transposed elsewhere.

The relationship between food deserts, farmers' markets, Nutrition Benefits, and health in Delaware census tracts; 2017

Food desert residents struggle to maintain a well-balanced, nutritious diet, increasing their risk of obesity and diabetes. Farmers' markets are a community-level intervention, bringing healthy food to food deserts. This study explores the relationship between food deserts, farmers' market location, the prevalence of obesity and diabetes, and the availability of Nutrition Benefit Programs (NBPs) in Delaware. Data are from the 2017 USDA Food Access Research Atlas and the Farmers' Market Directory. Descriptive statistics and spatial visualization were used to explore census tract-level relationships. Twenty percent of Delaware census tracts are food deserts. Of these, 7.2% have a farmers' market within their boundary, compared to 5.7% of non-food desert tracts. Of these markets, 3.2% accept Farmers' Market Nutrition Program coupons, 9.6% accept WIC Fruit and Vegetable Checks, and 21.6% accept Supplemental Nutrition Assistance Program. Sussex County has the highest obesity and diabetes rates, and the least number of markets that accept NBPs. Fresh food remains inaccessible to low-income residents, which is associated with diet-related chronic diseases. To reduce food insecurity, farmers' markets could expand acceptance of NBPs. Additional farmers' markets could be established in food deserts to increase the availability of healthy food, reducing the risk of developing obesity and diabetes.

Caregiver Experiences With an Innovative Farmers' Market Incentive Program for Children in Flint, Michigan

An innovative farmers’ market incentive program designed specifically for children was implemented to address persistent challenges with accessing fresh, nutrient-rich foods in a food desert community. The current study sought to qualitatively examine caregiver perceptions of the incentive program. Following distribution of farmers’ market incentives to all children (ages 0 to 15 years) at 43 Flint-area early childcare facilities and elementary schools, researchers conducted semistructured interviews with 37 caregivers (mean age = 39.59 ± 11.73 years). The majority were female (87%) and African American (53%). Through these interviews, researchers explored family experiences with the farmers’ market incentive program, as well as changes in environmental factors that may have resulted from program participation. Interviews were audio recorded and transcribed verbatim for textual analysis. Thematic analysis was used to identify patterns across transcripts and formulate emerging themes. Four recurrent themes emerged during interviews: (1) fruit and vegetable access, (2) child influence, (3) autonomous grocery shopping, and (4) program expansion. Interview participants indicated that the farmers’ market incentive program was an effective tool to both encourage families to visit the farmers’ market and purchase fresh foods there. Program design, particularly distribution to children, was credited with introducing families to the local farmers’ market. The current study suggests that a farmers’ market incentive program targeting children who reside in a food desert community may have meaningful impacts on access to fresh, nutrient-rich foods.

Knowledge, Attitudes, Beliefs and Behaviors regarding Fruits and Vegetables among Cost-offset Community-Supported Agriculture (CSA) Applicants, Purchasers, and a Comparison Sample

Community-supported agriculture (CSA) participation has been associated with high fruit and vegetable (FV) consumption, which may be due to better access to FV for CSA purchasers, or to positive knowledge, attitudes, and beliefs (KAB) regarding healthy eating among CSA applicants. The objective of this study was to examine KAB and consumption, in association with application to a cost-offset CSA (CO-CSA) program, and with CO-CSA purchase among applicants. We conducted a cross-sectional survey of CO-CSA applicants and a comparison sample in August 2017. All respondents were English-reading adults with a child 2–12 years old and household income of ≤185% of the federal poverty level. Among CO-CSA applicants, some were CO-CSA purchasers (n = 46) and some were not (n = 18). An online comparison sample met equivalent eligibility criteria, but had not participated in CSA for three years (n = 105). We compared CO-CSA applicants to the comparison sample, and compared purchasers and non-purchaser sub-groups, using Mann-Whitney U tests and chi-square analysis. CO-CSA applicants reported better knowledge, self-efficacy, home habits, and diet than the comparison sample. Among applicants, CO-CSA purchasers and non-purchasers had equivalent KAB, but children in purchaser households had higher FV consumption than in non-purchaser households (4.14 vs. 1.83 cups, p = 0.001). Future research should explore associations between CO-CSA participation and diet using experimental methods.

Does participating in community gardens promote sustainable lifestyles in urban settings? Design and protocol of the JArDinS study

Background

Despite growing evidence for the multiple health benefits of community gardening, longitudinal studies based on quantitative data are needed. Here we describe the protocol of JArDinS, a quasi-experimental study, aimed at assessing the impact of community garden participation (a natural experiment) in the adoption of more sustainable lifestyles.

Methods

Gardeners (n = 80) starting gardening in a community garden in Montpellier (France) will be recruited. Volunteers with no experience in community gardening and matched for age range, gender, household income and household composition will be recruited in a control group (n = 80). The sustainability of lifestyles in its social/health, environmental and economic dimensions will be assessed from a food supply diary (recording type, quantity and price of foods acquired in a 1-month period and the carbon impact of relevant food trips), a triaxial accelerometer (measuring physical activity) and online questionnaires on mental and social health, sensitivity to food waste, and connection with nature. Change of outcomes after 1 year will be compared between the natural experiment and the control groups.

Discussion

This study will provide information on the impact of participation in a community garden on the different dimensions of sustainability, based on a robust quasi-experimental design allowing causality evaluation.

Trial registration

The JArDinS study was registered at clinicaltrials.gov as NCT03694782. Date of registration: 3rd October 2018, retrospectively registered.

A Framework for Integrating Agriculture in Urban Sustainability in Australia

Rapid urbanisation all over the world poses a serious question about urban sustainability in relation to food. Urban agriculture can contribute to feeding city dwellers as well as improving metropolitan environments by providing more green space. Australia is recognised as one of the most urbanised countries in the world, and achieving urban sustainability should be high on the policy and planning agenda. A strong consensus exists among policymakers and academics that urban agriculture could be a tenable way of enhancing urban sustainability, and therefore, it should be a vital part of planning processes and urban design as administered by local and state governments. However, in recent decades, planning has overlooked and failed to realise this opportunity. The most significant constraints to urban agriculture are its regulatory and legal frameworks, including access to suitable land. Without direct public policy support and institutional recognition, it would be difficult to make urban agriculture an integral part of the development and planning goals of Australian cities. Developing and implementing clear planning policies, laws and programs that support urban agriculture can assist in decreasing competing land demands. This study analyses the policy and planning practices that can support integrating urban agriculture into city land-use planning. It examines current practices and identifies existing opportunities and constraints. An integration framework for urban agriculture for Australian cities is presented. If implemented, such a conceptual framework would allow improved sustainability of cities by bringing together the advantages of growing food within a greener urban environment.