Social determinants of household food expenditure in Australia: the role of education, income, geography and time

Status of household dietary diversity and associated factors among rural and urban households of Northern Uganda

BACKGROUND

In Northern Uganda, 21 and 52.4% of children under five are underweight and stunted, respectively while 32.9% of pregnant women are anemic. This demographic situation suggests among other issues, a lack of dietary diversity among households. Good nutrition practices that confer dietary quality such as dietary diversity are known to depend on nutrition knowledge and attitude and are shaped by sociodemographic and cultural factors. However, there is a paucity of empirical evidence to support this assertion for the variably malnourished population of Northern Uganda.

METHODS

A cross-sectional nutrition survey was conducted among 364 household caregivers (182 from two locations in Northern Uganda; Gulu District (the rural) and Gulu City (the urban), selected through a multistage sampling approach. The aim was to determine the status of dietary diversity and its associated factors between rural and urban households of Northern Uganda. The household dietary diversity questionnaire and the food frequency questionnaire on a 7-day reference period were used to collect data on household dietary diversity whereas multiple choice questions and the five points Likert Scale were used to determine knowledge and attitude toward dietary diversity. Consumption of ≤ 5 food groups were regarded as low in dietary diversity, 6-8 food groups as medium and ≥ 9 as high dietary diversity score using the FAO 12 food groups. An Independent two-sample t-test was used to differentiate the status of dietary diversity between the urban and rural areas. The Pearson Chi-square Test was used to determine the status of knowledge and attitude while Poisson regression was used to predict dietary diversity based on caregivers' nutritional knowledge and attitude and their associated factors.

RESULTS

The 7-day dietary recall period revealed that dietary diversity was 22% higher in urban (Gulu City) than in the rural area (Gulu District) with rural and urban households achieving medium (score of 8.76 ± 1.37) and high (score of 9.57 ± 1.44) dietary diversity status, respectively. Diets in both locations were dominated by starchy cereals and tubers while animal-source foods and fruits and vegetables were the least consumed. A higher proportion (51.65%) of urban respondents had good nutrition knowledge toward dietary diversity compared to their rural counterparts (23.08%) and a significantly higher proportion (87.91%) of the former exhibited positive attitude towards dietary diversity than the rural counterparts (72.53%). Application of the Poisson regression shows that nutritional knowledge was a positive predictor of dietary diversity in the rural (β = 0.114; ρ = 0.000) than in the urban areas (β = -0.008; ρ = 0.551). Caregivers attitude had no significant effect across locations. In terms of associated factors, marital status is a positive predictor of dietary diversity in the urban (β = 1.700; ρ = 0.001) than the other location (β = -2.541; ρ = 0.008). Whereas education level of household caregiver and household food expenditure show negative effects across the two locations, the educational level of the household head is an outlier as it positively predicted dietary diversity in the rural (β = 0.003; ρ = 0.002) when compared to urban area (β = -0.002; ρ = -0.011).

CONCLUSION

Rural households in Northern Uganda have medium-level dietary diversity with urban households having high dietary diversity. Diets in both locations are dominated by starchy cereals and roots and tubers. The urban-rural food divide can be harmonized through nutrition education and outreach, specifically focusing on the FAO 12 food groups. Attitude toward consumption of fruits and vegetables which are seasonally abundant would improve dietary diversity and nutritional outcomes in the study area.

The link between unhealthy lifestyle behaviors and emotional and behavioral problems in children and adolescents: a latent class analysis

Unhealthy lifestyle behaviors (ULBs) in children and adolescents are relatively common. Previous studies have shown an association between a single ULBs and emotional and behavioral problems (EBPs); however, few studies have explored the connection between multiple behavioral patterns and EBPs in children and adolescents. Hence, we aimed to investigate the link between ULBs clusters and EBPs among Chinese children and adolescents. From April to May 2019, we used cluster sampling to investigate children and adolescents in grades 1-12 from 14 schools located across six streets of Bao'an District in the city of Shenzhen. We measured emotional and behavioral problems using the Strengths and Difficulties Questionnaire (SDQ). ULBs included the consumption of sugar-sweetened beverages, takeaway and fast food consumption, lack of sleep, low outdoor activity, and excessive screen time. We performed clustering of ULBs using the regression hybrid modeling method of latent class analysis (LCA). We analyzed the association between ULBs and EBPs using logistic regression. In total, 30188 children and adolescents remained for analysis, with an average age of 12.44 ± 3.47 years. The LCA revealed four distinct patterns of ULBs: (1) lowest risk; (2) high-risk unhealthy lifestyle behaviors; (3) high-risk dietary unhealthy lifestyle behaviors; and (4) highest risk. Compared to ULBs with the lowest risk, high-risk ULBs, high-risk dietary ULBs, and highest risk ULBs were positively correlated with EBPs, with an adjusted odds ratio (aOR) (95% confidence interval [CI]) of 1.27, 1.34 and 2.05, respectively. Children and adolescents who reported engaging in multiple ULBs were also more likely to have poorer EBPs status. This implies that school administrations should pay more attention to the management of dietary and lifestyle behaviors to prevent EBPs in children and adolescents. Our findings highlight the need to focus on multiple clusters of ULBs among adolescents in a preventive care system and to validate EBP that may occur in children who are exposed to ULBs.

"Maybe it's Not Just the Food?" A Food and Mood Focus Group Study

Epidemiological and intervention studies in nutritional psychiatry suggest that the risk of mood disorders is associated with what we eat. However, few studies use a person-centred approach to explore the food and mood relationship. In this qualitative study of 50 Australian participants, we explored individuals' experiences with food and mood as revealed during focus group discussions. Using a thematic template analysis, we identified three themes in the food and mood relationship: (i) social context: familial and cultural influences of food and mood, (ii) social economics: time, finance, and food security, and (iii) food nostalgia: unlocking memories that impact mood. Participants suggested that nutrients, food components or food patterns may not be the only way that food impacts mood. Rather, they described the social context of who, with, and where food is eaten, and that time, finances, and access to healthy fresh foods and bittersweet memories of foods shared with loved ones all impacted their mood. Findings suggest that quantitative studies examining the links between diet and mood should look beyond nutritional factors and give increased attention to the cultural, social, economic, and identity aspects of diet.

Determinants of the decision to build up excessive food stocks in the COVID-19 crisis

In 2020, the first COVID-19 lockdowns resulted in food panic buying and excessive food stockpiling across many countries around the world. Many governments recommend keeping emergency food stocks for three to ten days for times of potential shortages in food supply. Based on data from an online survey conducted among Swiss inhabitants, we investigated the effect of knowledge level and stockpiling behaviour according to governmental stockpiling recommendations in normal times on the decision to build up more food stocks than usual during the first lockdown in 2020. For this purpose, we applied a combination of latent class analysis and logistic regression. Latent classes were constructed based on knowledge level and stockpiling behaviour according to governmental stockpiling recommendations in normal times. Subsequently, the information on class membership was used as predictor of the decision to excessively stockpile food during the first lockdown. The variable "class membership" revealed that respondents with a low knowledge level and food stocks below governmental recommendations in normal times had a 7.6 percentage points lower probability of excessively stockpiling food during the first lockdown than respondents with a high knowledge level and recommended food stocks in normal times. Excessive stockpiling was additionally driven by the worry that certain food products would disappear from the supermarket shelves entirely or would be in short supply. Moreover, regression results revealed that respondents who reduced their shopping frequency during the first lockdown in 2020 showed a higher probability of building up more food stocks than usual. Our findings are crucial for food suppliers and policymakers to understand the drivers of panic buying and to prevent this phenomenon in future crises.

Poverty, Household Structure and Consumption of Foods Away from Home in Peru in 2019: A Cross-Sectional Study

The aim of this study was to evaluate the probability of buying food away from home according to the type of household using the logit model, as well as the sociodemographic characteristics of the heads of household, and how much income expenditure represents. A cross-sectional study was carried out using the National Household Survey (ENAHO) 2019 database. After joining the database, the household type variables were created. To calculate the probability with the “logit” model of purchase, the variables—family size, income, types of household, and total expenditure—were selected as a measure of the purchasing power of the family. A statistically significant association (p < 0.05) was found between the probability of consumption and the variables: age of household members, predominance, nuclear without children−married, nuclear with children−cohabitant, nuclear with children−widowed, nuclear with children−separated, extended, compounded, poor not extreme, and not poor. The bulk of families was represented by nuclear families (61.97%). The highest expenditure in the CFAH was for families defined as composite with a yearly average of USD 1652.89 (equivalent to PEN 5520.67). Observing the expenditure on food consumed outside the home through the composition of households can allow a better approach to offer educational measures. This information can be helpful to developers of educational issues.

Consumer demand for healthy beverages in the hospitality industry: Examining willingness to pay a premium, and barriers to purchase

This study empirically examines consumer demand for healthy beverages within the hospitality industry. The research investigates sociodemographic and motivational factors that influence consumers’ ‘willingness to pay a premium’ (WTPP) price for healthy beverages using survey data from 1021 consumers in Australia and New Zealand (NZ). Water and juice are rated as representing ‘healthy’ beverages sold by hospitality businesses. Under 2% of respondents consider sugar free drinks as being healthy. Consumers rate a ‘healthy’ beverage as having low/no sugar, natural/no additives, or containing vitamins and minerals. Less than 1% of respondents identify ‘probiotics’ or ‘organic’ as a healthy beverage. Censored Poisson finds consumers who frequently eat out or are younger have higher WTPP. Healthy eating goals increase WTPP, whereas food economizing goals decreases WTPP. Food hedonism goals reduces consumers’ WTPP, and gender differences moderates this relationship. The findings present new insights on consumer behavior and healthy consumption in hospitality.

Involvement Theory with Market Segmentation: Effect of False Functional Food Advertising on Purchase Intention

In certain cases, people’s health can be compromised or medical treatment delayed as a result of their misplaced belief in false advertisements and purchasing of functional foods. These advertisements can be divided into three distinct types of claims: nutrition, health, and reduction in disease risk. This study analysed how, after consumers realise advertising violations, their intention to purchase functional foods with different claims are affected by the degree of consumer involvement (product, advertising, and situational involvement) and region of residence. A total of 1046 survey responses were collected for analysis. The results reveal that both product and advertising involvement influence purchase intention through the mediation of situational involvement. Residents in nonnorthern regions of Taiwan exhibited a greater effect of overall involvement on purchase intention than did those in the north. In addition, products and advertisements with health claims had a stronger effect on purchase intention than did those with nutrition and disease risk reduction claims. The results indicate that, for functional foods and advertisements with nutrition and health claims, the effects of overall involvement on nonnorthern residents’ purchase intentions were greater than those on the northern residents, but for functional foods with disease risk reduction claims, the effects were greater on the northern residents’ purchase intentions.

Health Star Ratings and Beverage Purchase Intentions: A Study of Australian and New Zealand Hospitality Consumers

This study examines the effects of a health star rating system on the attitudes of consumers and their purchase intentions towards beverage products sold in hospitality venues. Previous studies linking health ratings to the food and beverages of consumers mainly focus on fast-moving consumer goods and retail purchasing. However, purchasing patterns in hospitality and foodservice environments are distinct as consumers may be less concerned about health and more interested in the dining experience. Thus, this research focuses on: (1) whether the presence of health star ratings on beverage products influences the willingness of consumers to purchase in the context of the hospitality industry, and (2) identifying the demographic and psychographic factors influencing these behavioural intentions. Using Ordinary Least Squares regression to analyse data from an e-survey of 1021 consumers in Australia and New Zealand, the study found that health star ratings do have an impact on the willingness of consumers to purchase healthy beverages. Specifically, psychographic segmentation around ‘health goals’ is far more pertinent to understanding purchase behaviour in a hospitality setting than age, gender, income, or country. The findings present new insights into the importance of health star labelling on beverages and the purchase intentions of consumers.

Small increments in diet cost can improve compliance with the Dietary Guidelines for Americans

Adherence to the Dietary Guidelines for Americans (DGA) may involve higher diet costs. This study assessed the relation between two measures of food spending and diet quality among adult participants (N = 768) in the Seattle Obesity Study (SOS III). All participants completed socio-demographic and food expenditure surveys and the Fred Hutch food frequency questionnaire. Dietary intakes were joined with local supermarket prices to estimate individual-level diet costs. Healthy Eating Index (HEI- 2015) scores measured compliance with DGA. Multiple linear regressions using Generalized Estimating Equations with robust standard errors showed that lower food spending was associated with younger age, Hispanic ethnicity, and lower socioeconomic status. Even though higher HEI-2015 scores were associated with higher diet costs per 2000 kcal, much individual variability was observed. A positive curvilinear relationship was observed in adjusted models. At lower cost diets, a $100/month increase in cost (from $150 to $250) was associated with a 20.6% increase in HEI-2015. For higher levels of diet cost (from $350 to $450) there were diminishing returns (2.8% increase in HEI- 2015). These findings indicate that increases in food spending at the lower end of the range have the most potential to improve diet quality.

The role of dwelling type on food expenditure: a cross-sectional analysis of the 2015-2016 Australian Household Expenditure Survey

OBJECTIVE

To explore differences in proportion of food budget and total food expenditure by dwelling type.

DESIGN

A cross-sectional study using data from the Australian Bureau of Statistics 2015-2016 Household Expenditure Survey. Food expenditure was examined on multiple categories: fresh fruits, fresh vegetables, pre-prepared meals, meals in restaurants, hotels and clubs, and fast food and takeaway meals, using two-part models and zero-one inflated beta regression models. Dwelling types were categorised as separate house, semi-detached house, low-rise apartment and high-rise apartment.

SETTING

Australia, 2015-2016.

PARTICIPANTS

Seven thousand three hundred and fifty-eight households from greater capital city areas.

RESULTS

Households living in high-rise apartments were estimated to allocate a greater proportion of their food budget to meals in restaurants, hotels and clubs, and to spend more (actual dollars) on that category, compared with other dwelling types. No substantial differences were estimated in the proportion of food budget allocated to the other food categories across dwelling types.

CONCLUSIONS

The dwelling type households live in may play a role in their food budget. Households living in a high-rise apartment may potentially spend more on meals in restaurants, hotels and clubs than those living in other dwelling types. Given the growth in urban population and the changes in living arrangements, findings point to the critical need for a better understanding of the influence of dwelling types on food expenditure and call for research investigating the relationship between the two.

Pengembangan Indeks Ketahanan Pangan Rumah Tangga dan Kaitannya dengan Tingkat Kecukupan Zat Gizi dan Status Gizi Anak Balita

 Background: Household food insecurity is a underlaying causes on undernutrition problems in children under five years. Household food security especially from food acces dimention is reflected from many indicators that are complex and easier to understand in a composite index. Objectives: The purpose of this study was to develop a index of household food security and its relationship to nutrient intake level and nutritional status in children under five years. Method: This cross-sectional study was conducted in four villages in West Bangka Regency in December 2018 until April 2019. The study involved 219 subjects consisting of mothers and children aged 12-59 months. Data were analyzed using Rank Spearman relationship test. Results: The validation results showed that the index score has a negatively correlation (p<0.01) with the proportion of food expenditure and it has a significant correlation with dietary diversity (HDDS Score). In addition, the index score was a significant correlation (p<0.01) with the level of adequacy of energy, protein, fat, calcium, iron, zinc and dietary diversity in children. The index score was a significant associated (p<0.01) with the nutritional status of children based on height for age, weight gor age, and height for wight. Conclusions: The index was developed from this study can be an alternative to evaluate the status of household food security level and stronger marker of food consumption and nutritional status of under five children.ABSTRAKLatar Belakang: Kondisi rawan pangan pada rumah tangga merupakan salah satu penyebab masalah kekurangan gizi pada anak berusia di bawah lima tahun. Ketahanan pangan rumah tangga tercermin dari banyak indikator yang kompleks dan lebih mudah dipahami dalam indeks komposit.Tujuan: Penelitian ini bertujuan mengembangkan indeks ketahanan pangan rumah tangga serta hubungannya dengan tingkat asupan gizi dan status gizi pada anak balita.Metode: Penelitian cross-sectional ini dilakukan di empat desa di Kabupaten Bangka Barat. Penelitian ini melibatkan 219 subjek yang terdiri dari anak berusia 12-59 bulan dan ibu dari anak. Data dianalis menggunakan uji beda Kruskal Wallis dan uji hubungan Rank Spearman.Hasil: Hasil validasi menunjukkan bahwa skor indeks memiliki perbedaan yang nyata (p<0,05) berdasarkan tingkat kerentanan pangan wilayah dan terdapat hubungan negatif yang kuat (p<0,05) dengan proporsi pengeluaran pangan. Selain itu, skor indeks memiliki keterkaitan yang kuat (p<0,05) dengan tingkat kecukupan energi, protein, lemak, kalsium, besi, seng serta keragaman diet pada balita. Skor indeks juga memiliki hubungan yang nyata (p<0,05) dengan nilai z-score status gizi balita berdasarkan indeks antropometri tinggi badan menurut usia, berat badan menurut umur, dan tinggi badan menurut berat badan.Kesimpulan: Indeks yang dikembangkan dari penelitian ini dapat menjadi alternatif dalam menilai status ketahanan pangan rumah tangga serta prediktor yang kuat dalam melihat gambaran konsumsi pangan dan status gizi balita. 

Flexible employment policies, temporal control and health promoting practices: A qualitative study in two Australian worksites

For four decades, theories of job demand-control have proposed that higher occupational status groups have lower health risks due to the stress accompanying jobs featuring high demands but high control. This research examines whether Flexible Work Arrangements (FWAs) can improve the health prospects of a range of workers by giving greater control over work time arrangements. Our setting is Australia, where FWAs were introduced in 2009. In line with these early studies alongside studies of work-life balance, we expected to observe that workers with access to control over daily work times could better control the activities outside of work that influence chronic disease. Using a practice sociology approach, we compared the accounts of twenty-eight workers in blue and white collar industries with differing degrees of work time flexibility. The findings do not contradict early theories describing occupational differences of job demand-control dynamics and their relationship to health risks. However, this study suggests that a) time demands and strains have increased for a broad sweep of workers since the 1980s, b) the greater control of higher occupational status groups has been eroded by the high performance movement, which has attracted less scrutiny than FWAs, and c) more workers are forced to adapt their daily lives, including their approach to health, to accommodate their job demands. Job insecurity further impedes preventative health practices adoption. What might appear to be worker-controlled flexibility can-under the pressures of job insecurity and performance expectations without time limits-transform into health-eroding unpredictability. The answer however is not greater flexibility in the absence of limits on the well-documented precursors of work stress: long hours, job insecurity and intensity-related exhaustion. While there have been welcome developments in job demand-control-health conceptualizations, they typically ignore the out-of-work temporal demands that workers face and which compound on-the-job demands. Redesign of the temporalities of working life within worksites need to be accompanied by society-level policies which address caring responsibilities, gender equality as well as broad labour market conditions.

Local level estimates of food, drink and tobacco expenditure for Great Britain

We present expenditure estimates for 106 product categories across Great Britain for the years 2008-2016. Estimates are at the Local Authority District level (n = 380) and the categories cover all food, drink and tobacco commodities. Reliable, local level expenditure estimates are crucial for understanding broader market trends, assessing economic stability and for projections. This is especially important for commodities such as alcohol, tobacco and unhealthy foods due to their role in the prevalence of non-communicable diseases. There has been relatively little research into local area spatial patterns of expenditure, with existing estimates often of insufficient resolution for informing planning decisions. We use spatial microsimulation to create an archive of expenditure datasets. This was achieved by linking socio-demographic foundations with detailed datasets on individual expenditure. Whilst initially developed to aid investigations into sociodemographic trends in the meat industry, the data have reuse potential in a number of disciplines, including public health, economics, retail geography and environmental management. The framework could be applied to other regions with appropriate data.

'Buying Salad Is a Lot More Expensive than Going to McDonalds': Young Adults' Views about What Influences Their Food Choices

Young adults (18⁻30 years of age) are an 'at-risk' group for poor dietary behaviours and less healthy food choices. Previous research with young adults has looked at the barriers and enablers driving their food choices, focusing primarily on university and college students. However, there is less research using qualitative methods with young adults as a broader population group. This study aimed to explore the experiences of young adults in two different yet similar settings: Sydney, Australia and Glasgow, Scotland. Eight focus groups of young adult participants, ranging in size from 2⁻6 participants, were held in Sydney, Australia (n = 14) and Glasgow, Scotland (n = 16) to discuss, explore and compare the determinants and influences of their food choices. Focus group transcripts were coded thematically based on a process of narrative analysis. Three major narratives were identified across both locations: value of food; appeal of food; and emotional connections with food. These narratives were underpinned by a broader narrative of 'performing adulthood.' This narrative reflected a belief amongst participants that they should make rational, informed choices about food despite this conflicting with their broader food environment. Future research could examine which environment-level or policy-based interventions are most acceptable to young adults in terms of influencing their food choices and dietary behaviours.