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Behavioral and Metabolic Risk Factors for Noncommunicable Diseases among Population in the Republic of Srpska (Bosnia and Herzegovina). Healthcare (Basel) 2023; 11:healthcare11040483. [PMID: 36833017 PMCID: PMC9957477 DOI: 10.3390/healthcare11040483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Noncommunicable diseases (NCDs) are the major cause of death worldwide, and they are attributable to genetic and physiological determinants, behavioral risk factors and environmental impacts. The aim of this study is to assess behavioral risk factors for metabolic disease using demographic and social-economic aspects of the population characterized by risk factors, and to investigate relations among lifestyle risk factors (alcohol consumption, tobacco use, physical inactivity, intake of vitamins, fruits and vegetables) that are responsible for the majority of NCD deaths in the Republic of Srpska's (RS's) population. This is a cross-sectional study based on the analysis of a survey conducted among 2311 adult (≥18 years) persons (54.0% women, and 46.0% men). The statistical analysis was carried out by using Cramer's V values, clustering, logistic regression (binomial, multinomial and ordinal), a chi-square test and odds ratios. In the case of logistic regression, we provide the prediction accuracy in percentages. A significant statistical correlation between demographic characteristics (gender and age) and risk factors was observed. The highest difference according to gender was observed in alcohol consumption (odds ratio (OR) = 2.705, confidence interval (95% CI) = 2.206-3.317), particularly in frequent consumption (OR = 3.164, 95% CI = 2.664-3.758). The highest prevalence of high blood pressure was registered in the elderly (66.5%); the same holds for hypertension (44.3%). Additionally, physical inactivity was one of the most common risk factors (33.4% physically inactive respondents). A significant presence of risk factors was confirmed among the RS population, with higher involvement of metabolic risk factors among the older population, while the prevalence of behavioral factors was related to younger age groups, particularly in the case of alcohol consumption and smoking. A low level of preventive awareness was observed among the younger population. Therefore, prevention is one of the most important instruments related to decreasing NCD risk factors in the RS population.
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Foinant D, Lafraire J, Thibaut JP. Tears for pears: Influence of children’s neophobia on categorization performance and strategy in the food domain. Front Nutr 2022; 9:951890. [PMID: 36211481 PMCID: PMC9533737 DOI: 10.3389/fnut.2022.951890] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022] Open
Abstract
Preschoolers’ neophobic dispositions mainly target fruits and vegetables. They received a great deal of attention in the past decades as these dispositions represent the main psychological barrier to dietary variety. Recently, children’s food neophobia has been found to be negatively correlated with their categorization performance (i.e., the accuracy to discriminate between food categories). We investigated categorization strategies among neophobic children, tendencies to favor one type of error over the other (misses over false alarms), in order to compensate for their poor categorization performance. To capture children’s categorization strategies, we used the Signal Detection Theory framework. A first experiment assessed 120 3-to-6-years old children’ sensitivity to discriminate between foods and nonfoods as well as their decision criterion (i.e., response strategy). In a second experiment, we manipulated the influence of food processing. The hypothesis was that food processing acts as a sign of human interventions that decreases uncertainty about edibility and thus promotes feelings of safety in the food domain. 137 children were tested on a food versus nonfood categorization task contrasting whole and sliced stimuli. In both experiments, increased levels of food neophobia were significantly associated with poorer categorization sensitivity and with a more conservative decision criterion (i.e., favoring “it is inedible” errors). Additionally, results from Experiment 2 revealed that food processing did not influence neophobic children, whereas their neophilic counterparts adopted a more liberal decision criterion for sliced stimuli than for whole stimuli. These findings are the first demonstration of a relationship between a decision criterion and food neophobia in young children. These results have strong implications for theories of food neophobia and laid the groundwork for designing novel types of food education interventions.
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Affiliation(s)
- Damien Foinant
- LEAD – CNRS UMR-5022, Université Bourgogne Franche-Comté, Dijon, France
- Institut Paul Bocuse Research Center, Écully, France
- *Correspondence: Damien Foinant,
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Craveiro D, Marques S, Bell R, Khan M, Godinho C, Peixeiro F. Behavioural change box? Applying the COM-B model to understand behavioural triggers that support consumption of fruits and vegetable among subscribers of a fruit and vegetable box scheme. Public Health Nutr 2021; 24:6488-6498. [PMID: 34482856 PMCID: PMC11374553 DOI: 10.1017/s1368980021003839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To understand the key mechanisms that support healthy dietary habits promoted by fruit and vegetable (F&V) box schemes, testing relevant behaviour change triggers identified under the COM-B model in an evaluation research study of a Portuguese F&V box scheme (PROVE). DESIGN Correlation study with a post-test-only non-equivalent group design based on survey data. The mechanisms underpinning the differences between subscribers and non-subscribers are operationalised as mediation effects. Data availability, theoretical relevance and empirical validation supported the selection and testing of four potential mediators for the effects of subscribing to the box scheme on F&V consumption. These estimations derive from the coefficients of a structural equation model combined with the product coefficient approach and Sobel test. SETTING The study is part of a wider evaluation study on the impact of the PROVE box scheme on sustainability, health and equity. PARTICIPANTS A sample of PROVE box subscribers (n 294) was compared with a matched subsample of non-subscribers (n 571) in a nationally representative survey. RESULTS Subscribing to the PROVE box correlates with an increased probability of eating at least five portions of F&V, irrespective of differences in age, education and perceived economic difficulties. Diet quality perceptions, and more robustly, the strength of meal habits and household availability were identified as relevant mediators. CONCLUSIONS The subscription to an F&V box scheme is connected with proximal context that enables the consumption of F&V by ensuring more readily available F&V and better situational conditions associated with healthier meal habits.
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Affiliation(s)
- Daniela Craveiro
- SOCIUS, Research Centre in Economic and Organizational Sociology, ISEG - School of Economics & Management,Universidade de Lisboa, Rua Miguel Lupi 20, Edifício Bento Jesus Caraça, Office 203, Lisboa1249-078, Portugal
- ISCTE-Instituto Universitário de Lisboa, CIS-IUL, Lisboa, Portugal
| | - Sibila Marques
- ISCTE-Instituto Universitário de Lisboa, CIS-IUL, Lisboa, Portugal
| | - Ruth Bell
- Institute of Health Equity, UCL, London, UK
| | - Matluba Khan
- School of Geography and Planning, Cardiff University, UK
| | - Cristina Godinho
- ISCTE-Instituto Universitário de Lisboa, CIS-IUL, Lisboa, Portugal
- Universidade Católica Portuguesa, Católica Research Centre for Psychological - Family and Social Wellbeing, Portugal
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Social Disparities in Post-diagnosis Health Behaviors of Iranian Breast Cancer Survivors: The Mediating Role of Psychosocial Factors as Potential Buffering Agents. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.104760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Breast cancer (BC) is surging as a public health issue in Iran and engagement in positive health behaviors improves the odds of survival and reduces the risk of concomitant comorbidities in BC survivors. Objectives: The primary purpose of this study was to investigate the impact of socioeconomic inequalities on leisure-time physical activity (LTPA) and fruit and vegetable (F & V) consumption among Iranian BC survivors. Another objective of this study was to examine the role of psychosocial factors, such as stress, self-efficacy, and social support as mediators between socioeconomic status (SES) and these health behaviors. Few studies have investigated social disparities in the health behaviors of cancer survivors. Likewise, the mediating role of psychosocial factors in the SES-health behavior gradient has rarely been explored in the cancer context. Psychosocial factors might have positive implications for socioeconomically disadvantaged survivors. Methods: Cross-sectional data were obtained from 196 patients with BC by a telephone-administrated questionnaire. The Behavioral Risk Factor Surveillance System (BRFSS) 2013 was partially employed to measure exercise and F & V consumption. Cross-sectional analyses (correlation and logistic regression) were conducted to assess the relationship between SES, psychosocial factors, and health behaviors (P < 0.05). Results: Regarding LTPA and F & V consumption, more than half of the survivors complied with the recommended levels, consecutively. Both education and family income exhibited a positive association with LTPA and F & V consumption. Furthermore, self-efficacy and social support showed a positive relationship with LTPA and F & V consumption. Conclusions: The SES impacted health behaviors directly and via intermediary psychosocial factors. The results can inform future studies and interventions; psychosocial factors could buffer the effects of social inequalities on health behaviors. A key policy priority should, therefore, be planning and implementing psychosocial empowerment interventions to promote exercise and a healthy diet among impoverished cancer survivors.
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Hardcastle SJ, Caraher M. The role of foodbanks in the context of food insecurity: Experiences and eating behaviours amongst users. Appetite 2021; 163:105208. [PMID: 33774137 DOI: 10.1016/j.appet.2021.105208] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/24/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
The study aim was to investigate the role of foodbanks in the context of food insecurity and explore food choices and eating behaviours amongst users. Food insecurity is associated with poor diet quality and obesity; however, the dimensions that influence food choices and eating behaviour remain unclear. Face-to-face interviews were conducted with individuals who had visited a faith-based foodbank in Perth, Western Australia. Participants were thirty-three service users who had collected a food hamper from the foodbank. Interview transcripts were analyzed using thematic analysis. Four main themes emerged: Ties you over until pay day; Food hamper supporting meals and fruit and vegetable consumption; Food choices supplementing hamper; Household gatekeeping and food control. Participants were complimentary about the content of the food hamper received which included a variety of fresh produce. A key new finding was the frequent purchase and consumption of meat and processed meat to supplement the food hamper provision. Future work and interventions to improve eating behaviour and reduce food-related financial pressure for those vulnerable to food insecurity include further exploration of the dimensions influencing food choices (i.e., cultural norms, habits, symbols); exposure to healthy and tasty plant-based meals, (i.e., tasting low-cost and tasty vegetable-based meals); parenting training focused on handling child/partner food choice influences, and, enforcing household rules governing food.
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Affiliation(s)
- Sarah J Hardcastle
- Dublin City University, Glasnevin, Dublin, Ireland; Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.
| | - Martin Caraher
- Centre for Food Policy, City, University of London, London, UK
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Dietary inequity? A systematic scoping review of dietary intake in low socio-economic groups compared with high socio-economic groups in Australia. Public Health Nutr 2020; 24:393-411. [PMID: 32883404 DOI: 10.1017/s1368980020003006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Low socio-economic groups (SEG) in Australia suffer poorer diet-related health than the rest of the population. Therefore, it is expected that low SEG are less likely to consume diets conforming to Australian Dietary Guidelines (ADG) than higher SEG. However, dietary intake of low SEG in Australia has not been synthesised methodically. This systematic scoping review aims to explore detailed dietary intake of low SEG in Australia in comparison to higher SEG. DESIGN A systematic search of peer-reviewed literature and websites, since 1999. Data were extracted, synthesised and analysed in relation to study populations, dietary assessment methods, food groups studied, socio-economic measures and dietary intake. SETTING Australia. PARTICIPANTS Persons of any age and gender, differentiated by a socio-economic measure. RESULTS Results from thirty-three included studies confirmed that overall dietary nutritional value/quality tended to be lower in low SEG than higher SEG in Australia. However, findings were inconsistent across studies for all food groups or all socio-economic measures. Large variations were found between study metrics, definitions, dietary assessment methods, granularity of results and conclusions. Quantitative intakes of all ADG food groups by SEG were not reported in most studies and, where reported, were not comparable. CONCLUSION The review showed detailed dietary data are lacking to inform policy and practice and help develop targeted interventions to improve diet-related health of Australian low SEG. There is urgent need for regular, granular assessment of population dietary data to enable comparison of intake between SEG in the context of national food-based dietary guidelines in Australia.
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Wijayaratne S, Westberg K, Reid M, Worsley A. A qualitative study exploring the dietary gatekeeper's food literacy and barriers to healthy eating in the home environment. Health Promot J Austr 2020; 32 Suppl 2:292-300. [PMID: 32761932 DOI: 10.1002/hpja.398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 06/09/2020] [Accepted: 07/31/2020] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Food literacy has been recognised as a collection of interrelated food skills and knowledge to support healthy dietary outcomes. In the home environment, the dietary gatekeeper is the individual most responsible for food preparation, and therefore, has a significant influence on the family diet. This study explored how the dietary gatekeeper's food literacy skills are used to manage dietary barriers to facilitate healthy eating in the home environment. METHODS Qualitative data were collected from a sample of household dietary gatekeepers with children (n = 17). Participants were also instructed to take photographs of family meals prior to the interview and these were used as interview prompts to gain deeper insights into gatekeeper behaviour. RESULTS Participants reported the two most significant barriers to healthy eating in households were time pressure and fussy eating. Four strategies were identified that used gatekeepers' food literacy to manage these barriers: breaking up meal tasks; customising meals for family tastes; camouflaging healthy ingredients; and facilitating food choice autonomy. These strategies incorporated interrelated food literacy skills related to the planning, preparation, selection and eating domains. CONCLUSION The current findings highlight the dietary gatekeeper's food literacy as an interrelated concept and show how it is operationalised to successfully manage barriers to healthy eating experienced in the home environment. SO WHAT?: Future health promotion campaigns must offer tailored communications and interventions that provide resources and support to dietary gatekeepers to foster food literacy and counteract the influence of barriers to healthy eating.
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Affiliation(s)
| | - Kate Westberg
- School of Economics, Finance & Marketing, RMIT University, Melbourne, Australia
| | - Mike Reid
- School of Economics, Finance & Marketing, RMIT University, Melbourne, Australia
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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MOHAMMADI-NASRABADI M, SADEGHI R, RAHIMI-FORUSHANI A, MOHAMMADI-NASRABADI F, SHOJAEIZADE D, MONTAZERI A. Structural equation modeling analysis of Iranian women’s food consumption: influence of socio-demographic characteristics and the Information, Motivation, and Behavioral skills Model. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e180268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This study aimed at examining whether food consumption varies in accordance with socio-demographic and behavioral factors in the conceptual model, analyzing adult women in Tehran, Iran, for that purpose. Methods This cross-sectional study was conducted with 247 women in childbearing age, who were selected through systematic cluster sampling from five regions in Tehran. Dietary assessment was done through a Food Frequency Questionnaire, and the anthropometric indices were measured. Data on socio-economic status and information-motivation-behavioral skills model were obtained through a questionnaire. Then, subjects were stratified according to the socio-economic status and model components. Statistical analysis was done using analysis of variance and structural equation modeling. Results Consumption of food groups among the participating women differed based on their living region, education, occupation, household expenditure, and model components (p<0.05). Intake of red and processed meat (p<0.05) was at the lowest level in illiterate or low educated women. Those with lower total expenditure had higher consumption of fats and oils (p<0.05). Women with higher perceived social support consumed more milk and dairy products (p<0.05), fats and oils (p<0.05), and less bread and cereals (p<0.05). Model components including information, attitude, social support, self-efficacy, and self-regulation were the most important factors negatively affecting the consumption of unhealthy foods (red and processed meat, fats and oils, sugar, and salty foods). Conclusion Considering the impact of model components on women’s eating behaviors, the specific integration strategies delineated for each construct of the model can be utilized to design model-based interventions targeting the promotion of healthy nutritional behavior.
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Affiliation(s)
| | | | | | | | | | - Ali MONTAZERI
- Iranian Institute for Health Sciences Research, Iran
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James WHM, Lomax N, Birkin M. Local level estimates of food, drink and tobacco expenditure for Great Britain. Sci Data 2019; 6:56. [PMID: 31086192 PMCID: PMC6513822 DOI: 10.1038/s41597-019-0064-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/29/2019] [Indexed: 02/08/2023] Open
Abstract
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.
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Affiliation(s)
- William H M James
- School of Geography and Leeds Institute for Data Analytics, University of Leeds, Woodhouse Lane, Leeds, West Yorkshire, LS2 9JT, UK.
| | - Nik Lomax
- School of Geography and Leeds Institute for Data Analytics, University of Leeds, Woodhouse Lane, Leeds, West Yorkshire, LS2 9JT, UK
| | - Mark Birkin
- School of Geography and Leeds Institute for Data Analytics, University of Leeds, Woodhouse Lane, Leeds, West Yorkshire, LS2 9JT, UK
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Stephens LD, Crawford D, Thornton L, Olstad DL, Morgan PJ, van Lenthe FJ, Ball K. A qualitative study of the drivers of socioeconomic inequalities in men's eating behaviours. BMC Public Health 2018; 18:1257. [PMID: 30428860 PMCID: PMC6236940 DOI: 10.1186/s12889-018-6162-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 10/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background Men of low socioeconomic position (SEP) are less likely than those of higher SEP to consume fruits and vegetables, and more likely to eat processed discretionary foods. Education level is a widely used marker of SEP. Few studies have explored determinants of socioeconomic inequalities in men’s eating behaviours. The present study aimed to explore intrapersonal, social and environmental factors potentially contributing to educational inequalities in men’s eating behaviour. Methods Thirty Australian men aged 18–60 years (15 each with tertiary or non-tertiary education) from two large metropolitan sites (Melbourne, Victoria; and Newcastle, New South Wales) participated in qualitative, semi-structured, one-on-one telephone interviews about their perceptions of influences on their and other men’s eating behaviours. The social ecological model informed interview question development, and data were examined using abductive thematic analysis. Results Themes equally salient across tertiary and non-tertiary educated groups included attitudes about masculinity; nutrition knowledge and awareness; ‘moralising’ consumption of certain foods; the influence of children on eating; availability of healthy foods; convenience; and the interplay between cost, convenience, taste and healthfulness when choosing foods. More prominent influences among tertiary educated men included using advanced cooking skills but having relatively infrequent involvement in other food-related tasks; the influence of partner/spouse support on eating; access to healthy food; and cost. More predominant influences among non-tertiary educated men included having fewer cooking skills but frequent involvement in food-related tasks; identifying that ‘no-one’ influenced their diet; having mobile worksites; and adhering to food budgets. Conclusions This study identified key similarities and differences in perceived influences on eating behaviours among men with lower and higher education levels. Further research is needed to determine the extent to which such influences explain socioeconomic variations in men’s dietary intakes, and to identify feasible strategies that might support healthy eating among men in different socioeconomic groups. Electronic supplementary material The online version of this article (10.1186/s12889-018-6162-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lena D Stephens
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lukar Thornton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Abstract
AbstractObjectiveTo establish the factors that determine food fussiness, to explore if child age determines the extent to which these factors influence food fussiness and to identify whether parental neophobia is an independent determinant of food fussiness.DesignCross-sectional data from the National Children’s Food Survey (2003–2004). The Children’s Eating Behaviour Questionnaire (CEBQ) assessed eating behaviours in children. The Food Neophobia Scale (FNS) assessed parental food neophobia. Young children were classified as 5–8 years old with older children classified as 9–12 years old.SettingRepublic of Ireland.ParticipantsNationally representative sample of Irish children aged 5–12 years (n 594).ResultsParents identifying child’s food preferences as a barrier to providing their child with a healthy diet was significantly associated with increased food fussiness in younger (P<0·001) and older children (P<0·001). Higher levels of parental neophobia were significantly associated with an increase in food fussiness in younger (P<0·05) and older (P<0·001) children. Food advertising as a barrier to providing a healthy diet was inversely associated with food fussiness in younger children (P<0·05). In older children, there was a significant inverse association between child’s BMI and food fussiness (P<0·05), but not to the extent that a difference in weight status was noted. Family mealtimes in older children were associated with significantly lower levels of food fussiness (P<0·05).ConclusionsFindings from the present study identify that a child’s age does determine the extent to which certain factors influence food fussiness and that parental neophobia is an independent determinant of food fussiness.
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van der Vliet N, Staatsen B, Kruize H, Morris G, Costongs C, Bell R, Marques S, Taylor T, Quiroga S, Martinez Juarez P, Máca V, Ščasný M, Zvěřinová I, Tozija F, Gjorgjev D, Espnes GA, Schuit J. The INHERIT Model: A Tool to Jointly Improve Health, Environmental Sustainability and Health Equity through Behavior and Lifestyle Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1435. [PMID: 29986493 PMCID: PMC6068874 DOI: 10.3390/ijerph15071435] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/15/2018] [Accepted: 06/24/2018] [Indexed: 11/18/2022]
Abstract
The need for analysis and action across the interrelated domains of human behaviors and lifestyles, environmental sustainability, health and inequality is increasingly apparent. Currently, these areas are often not considered in conjunction when developing policies or interventions, introducing the potential for suboptimal or conflicting outcomes. The INHERIT model has been developed within the EU-funded project INHERIT as a tool to guide thinking and intersectoral action towards changing the behaviors and lifestyles that play such an important role in today’s multidisciplinary challenges. The model integrates ecological public health and behavioral change models, emphasizing inequalities and those parts of the causal process that are influenced by human behaviors and lifestyles. The model was developed through web-based and live discussions with experts and policy stakeholders. To test the model’s usability, the model was applied to aspects of food consumption. This paper shows that the INHERIT model can serve as a tool to identify opportunities for change in important −food-related behaviors and lifestyles and to examine how they impact on health, health inequalities, and the environment in Europe and beyond. The INHERIT model helps clarify these interrelated domains, creating new opportunities to improve environmental health and health inequality, while taking our planetary boundaries into consideration.
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Affiliation(s)
- Nina van der Vliet
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability, Environment and Health, 3720 BA Bilthoven, The Netherlands.
- Tilburg School of Social and Behavioral Sciences, University of Tilburg, 5000 Tilburg, The Netherlands.
| | - Brigit Staatsen
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability, Environment and Health, 3720 BA Bilthoven, The Netherlands.
| | - Hanneke Kruize
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability, Environment and Health, 3720 BA Bilthoven, The Netherlands.
| | - George Morris
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK.
| | | | - Ruth Bell
- Institute of Health Equity, UCL, London WC1E 7HB, UK.
| | - Sibila Marques
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, 1649-026 Lisboa, Portugal.
| | - Timothy Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK.
| | - Sonia Quiroga
- Department of Economics, Universidad de Alcalá, 28801 Alcalá, Spain.
| | | | - Vojtech Máca
- Charles University, Environment Centre (CUNI), 162 00 Prague, Czech Republic.
| | - Milan Ščasný
- Charles University, Environment Centre (CUNI), 162 00 Prague, Czech Republic.
| | - Iva Zvěřinová
- Charles University, Environment Centre (CUNI), 162 00 Prague, Czech Republic.
| | - Fimka Tozija
- The Institute of Public Health of the Republic of Macedonia (IJZRM), 1000 Skopje, Macedonia.
| | - Dragan Gjorgjev
- The Institute of Public Health of the Republic of Macedonia (IJZRM), 1000 Skopje, Macedonia.
| | - Geir Arild Espnes
- NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, 7030 Trondheim, Norway.
| | - Jantine Schuit
- Tilburg School of Social and Behavioral Sciences, University of Tilburg, 5000 Tilburg, The Netherlands.
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Olstad DL, Leech RM, Livingstone KM, Ball K, Thomas B, Potter J, Cleanthous X, Reynolds R, McNaughton SA. Are dietary inequalities among Australian adults changing? a nationally representative analysis of dietary change according to socioeconomic position between 1995 and 2011-13. Int J Behav Nutr Phys Act 2018; 15:30. [PMID: 29606145 PMCID: PMC5879763 DOI: 10.1186/s12966-018-0666-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 03/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing inequalities in rates of obesity and chronic disease may be partly fuelled by increasing dietary inequalities, however very few nationally representative analyses of socioeconomic trends in dietary inequalities exist. The release of the 2011-13 Australian National Nutrition and Physical Activity Survey data allows investigation of change in dietary intake according to socioeconomic position (SEP) in Australia using a large, nationally representative sample, compared to the previous national survey in 1995. This study examined change in dietary intakes of energy, macronutrients, fiber, fruits and vegetables among Australian adults between 1995 and 2011-13, according to SEP. METHODS Cross-sectional data were obtained from the 1995 National Nutrition Survey, and the 2011-13 National Nutrition and Physical Activity Survey. Dietary intake data were collected via a 24-h dietary recall (n = 17,484 adults) and a dietary questionnaire (n = 15,287 adults). SEP was assessed according to educational level, equivalized household income, and area-level disadvantage. Survey-weighted linear and logistic regression models, adjusted for age, sex/gender and smoking status, examined change in dietary intakes over time. RESULTS Dietary intakes remained poor across the SEP spectrum in both surveys, as evidenced by high consumption of saturated fat and total sugars, and low fiber, fruit and vegetable intakes. There was consistent evidence (i.e. according to ≥2 SEP measures) of more favorable changes in dietary intakes of carbohydrate, polyunsaturated and monounsaturated fat in higher, relative to lower SEP groups, particularly in women. Intakes of energy, total fat, saturated fat and fruit differed over time according to a single SEP measure (i.e. educational level, household income, or area-level disadvantage). There were no changes in intake of total sugars, protein, fiber or vegetables according to any SEP measures. CONCLUSIONS There were few changes in dietary intakes of energy, most macronutrients, fiber, fruits and vegetables in Australian adults between 1995 and 2011-13 according to SEP. For carbohydrate, polyunsaturated and monounsaturated fat, more favorable changes in intakes occurred in higher SEP groups. Despite the persistence of suboptimal dietary intakes, limited evidence of widening dietary inequalities is positive from a public health perspective. TRIAL REGISTRATION Clinical trials registration: ACTRN12617001045303 .
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Affiliation(s)
- Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Rebecca M. Leech
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Katherine M. Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Beth Thomas
- National Heart Foundation of Australia, Melbourne, Australia
| | - Jane Potter
- National Heart Foundation of Australia, Melbourne, Australia
| | | | | | - Sarah A. McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Socio-economic factors associated with an increase in fruit and vegetable consumption: a 12-year study in women from the E3N-EPIC study. Public Health Nutr 2017; 21:740-755. [PMID: 29183405 DOI: 10.1017/s1368980017003196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To identify individual and contextual socio-economic factors associated with an increase in fruit and vegetable (F&V) consumption over a 12-year period and evaluate if some socio-economic factors were differentially associated with the change in consumption of some types of F&V. DESIGN Associations between increased F&V consumption and socio-economic factors were studied with multivariate logistic regression. SETTING E3N, a French prospective cohort study of 98 995 women. SUBJECTS E3N participants (n 58 193) with information on diet in 1993 and 2005, and numerous individual and contextual socio-economic factors available. RESULTS Associations between some individual socio-economic factors and changes in F&V consumption were observed. For instance, women who lived in a large household (>3 children v. no child) had higher probability of increasing their vegetable consumption (OR=1·33; 95 % CI 1·24, 1·42). This association was driven by higher consumption of courgette and raw cucumber. Living with a partner was associated with higher odds of increasing consumption of fruits (OR=1·07; 95 % CI 1·02, 1·13) such as pear, peach and grape. CONCLUSIONS Certain individual socio-economic factors, but none of the contextual socio-economic factors examined, were associated with an increase in F&V consumption. Factors associated with an increase in total F&V consumption were not necessarily associated with an increase in fruit or vegetable consumption separately, or with an increase in each subtype of fruit or vegetable. Magnitudes of the different associations observed also differed when F&V were considered together, separately or by subtype. Increases in F&V consumption were mostly observed in women with high socio-economic position. To develop effective nutritional interventions and policies that take the socio-economic environment of individuals into account, we recommend future research to further focus on (i) pathways through which population characteristics might influence changes in F&V consumption and (ii) existing interactions between individual and contextual socio-economic factors.
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Teixeira MG, Mill JG, Pereira AC, Molina MDCB. Dietary intake of antioxidant in ELSA-Brasil population: baseline results. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 19:149-59. [PMID: 27167656 DOI: 10.1590/1980-5497201600010013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 09/15/2015] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE To quantify the antioxidant consumption (vitamins A, C and E and minerals selenium and zinc) and to identify factors associated to low consumption of these nutrients. METHODS Cross-sectional study with 14,660 participants (35 to 74 years-old) investigated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline. Consumption of antioxidants and energy was determined by a Food Frequency Questionnaire and analyzed using the NDSR software. Antioxidant consumption was adjusted to total energy and divided in quintiles. A logistic regression analysis was used to identify socioeconomic factors associated with low intake of these nutrients. RESULTS Consumption of energy (kcal/day) was higher in men (3,152 ± 1,026 versus 2,613 ± 905; p < 0.001) whereas the consumption of all antioxidants (mainly vitamins A and E and selenium) was higher in females. Low antioxidant consumption was associated to male sex (OR = 3.5; 95%CI 3.11 - 4.0) and to lower education (OR = 3.1; 95%CI 2.42 - 3.87), income (OR = 4.4; 95%CI 3.67 - 5.36) and age (OR = 5.5; 95%CI 4.27 - 7.16), as well as to thinness (OR = 2.7; 95%CI 1.36 - 5.18) and when participants did not reported the use of supplements (OR = 1.95; 95%CI 1.6 - 2.38) or change of eating habits in the last six months (OR = 2.0; 95%CI 1.75 - 2.29). CONCLUSION The greater intake of fruits and vegetables is likely to be involved in the higher consumption of antioxidants in females. General policies to increase the consumption of such nutrients should be directed to groups of lower income, education and age.
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Socioeconomic Inequities in Diet Quality and Nutrient Intakes among Australian Adults: Findings from a Nationally Representative Cross-Sectional Study. Nutrients 2017; 9:nu9101092. [PMID: 28976927 PMCID: PMC5691709 DOI: 10.3390/nu9101092] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/29/2017] [Accepted: 09/30/2017] [Indexed: 02/07/2023] Open
Abstract
Poor diet may represent one pathway through which lower socioeconomic position (SEP) leads to adverse health outcomes. This study examined the associations between SEP and diet quality, its components, energy, and nutrients in a nationally representative sample of Australians. Dietary data from two 24-h recalls collected during the cross-sectional Australian Health Survey 2011-13 (n = 4875; aged ≥ 19 years) were analysed. Diet quality was evaluated using the Dietary Guidelines Index (DGI). SEP was assessed by index of area-level socioeconomic disadvantage, education level, and household income. Linear regression analyses investigated the associations between measures of SEP and dietary intakes. Across all of the SEP indicators, compared with the least disadvantaged group, the most disadvantaged group had 2.5–4.5 units lower DGI. A greater area-level disadvantage was associated with higher carbohydrate and total sugars intake. Lower education was associated with higher trans fat, carbohydrate, and total sugars intake and lower poly-unsaturated fat and fibre intake. Lower income was associated with lower total energy and protein intake and higher carbohydrate and trans fat intake. Lower SEP was generally associated with poorer diet quality and nutrient intakes, highlighting dietary inequities among Australian adults, and a need to develop policy that addresses these inequities.
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Silveira EA, Martins BB, de Abreu LRS, Cardoso CKDS. [Low consumption of fruit, vegetables and greens: associated factors among the elderly in a Midwest Brazilian city]. CIENCIA & SAUDE COLETIVA 2017; 20:3689-99. [PMID: 26691794 DOI: 10.1590/1413-812320152012.07352015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 07/09/2015] [Indexed: 11/22/2022] Open
Abstract
The scope of the study was to evaluate the prevalence of daily consumption of fruit, vegetables and greens by the elderly and its association with sociodemographic, lifestyle, morbidity and hospitalization variables. The study was part of the multiple-stage sampling cross-sectional research entitled the Goiânia Elderly Project (Projeto Idosos Goiânia). 416 elderly people were interviewed in their homes. Multivariate analysis was conducted using Poisson regression to analyze statistical associations. P values of <.05 were considered statistically significant. Daily consumption of fruit, vegetables and greens was 16.6%: fruit accounted for 44%, vegetables 39.7% and greens 32.5%. Factors statistically associated with daily consumption of fruits and vegetables were female sex, age between 70 and 79, higher education level, social class A/B and C, alcohol consumption, use of sweeteners, regular physical activity during leisure time, abdominal obesity and hospitalization. Public policies to promote health should develop strategies that encourage adequate intake of fruit, vegetables and greens among the elderly, since regular consumption of same can improve quality of life and prevent/control diseases.
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Bibiloni MDM, González M, Julibert A, Llompart I, Pons A, Tur JA. Ten-Year Trends (1999-2010) of Adherence to the Mediterranean Diet among the Balearic Islands' Adult Population. Nutrients 2017; 9:E749. [PMID: 28708083 PMCID: PMC5537863 DOI: 10.3390/nu9070749] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/07/2017] [Accepted: 07/11/2017] [Indexed: 01/14/2023] Open
Abstract
The aim of this work was to assess ten-year trends (1999-2010) of adherence to the Mediterranean dietary pattern (MDP) among the Balearic Islands' adult population. Two independent cross-sectional dietary surveys (1999-2000, n = 1200 and 2009-2010 n = 1388, including participants aged 16-65 years) were carried out in the Balearic Islands, Spain. Dietary habits were assessed by means of two 24 h diet recalls and a validated semi-quantitative food-frequency questionnaire that covers 145 food items. Adherence to the MDP was defined according to a score constructed considering the consumption of nine MDP characteristic components: high monounsaturated fatty acids:saturated fatty acids (MUFA:SFA) ratio, moderate ethanol consumption, high legumes, cereals and roots, fruits, vegetables, and fish consumption, and low consumption of meat and milk. Socio-economic status, education level, lifestyle factors and health status were also assessed. Adherence to the MDP was 43.1% (SD 5.8) in 1999-2000 and 44.6% (SD 8.3) in 2009-2010. Higher age was directly associated with higher adherence to the MDP, and this association was stronger in males than in females. Young generations and smokers showed the lowest adherence to MDP, whereas people with higher educational and socio-economic level, and who were physically active showed the highest adherence. According to the place of birth, the increase in the percentage of the adherence to the MDP was observed to be smaller among the Balearic Island's natives than among people born abroad. In 2009-2010, individuals in the MDP's fourth quartile were more likely to be older (aged 46-65 years), and were less likely to have a low occupational level, to have a light physical activity level and to be smoker than in 1999-2000. The adherence to the MDP has been stabilized and slightly recovered among the Balearic Islands' adult population in the last decade.
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Affiliation(s)
- Maria Del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, and CIBEROBN CB12/03/30038, Guillem Colom Bldg Campus, E-07122 Palma de Mallorca, Spain.
| | - Mónica González
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, and CIBEROBN CB12/03/30038, Guillem Colom Bldg Campus, E-07122 Palma de Mallorca, Spain.
| | - Alicia Julibert
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, and CIBEROBN CB12/03/30038, Guillem Colom Bldg Campus, E-07122 Palma de Mallorca, Spain.
| | - Isabel Llompart
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, and CIBEROBN CB12/03/30038, Guillem Colom Bldg Campus, E-07122 Palma de Mallorca, Spain.
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, and CIBEROBN CB12/03/30038, Guillem Colom Bldg Campus, E-07122 Palma de Mallorca, Spain.
| | - Josep A Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, and CIBEROBN CB12/03/30038, Guillem Colom Bldg Campus, E-07122 Palma de Mallorca, Spain.
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21
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Kim SA, Hei Y, Jun S, Wie GA, Shin S, Hong E, Joung H. Estimated flavonoid intakes according to socioeconomic status of Korean adults based on the Korea National Health and Nutrition Examination Survey 2007~2012. ACTA ACUST UNITED AC 2017. [DOI: 10.4163/jnh.2017.50.4.391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Seong-Ah Kim
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Yang Hei
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Shinyoung Jun
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Gyung-Ah Wie
- Department of Clinical Nutrition, Research Institute & Hospital, National Cancer Center, Goyang-si 10408, Korea
| | - Sangah Shin
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul 03080, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Eunju Hong
- Department of Economics and Finance, Hanyang Cyber University, Seoul 04763, Korea
| | - Hyojee Joung
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea
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Conklin AI, Monsivais P, Khaw KT, Wareham NJ, Forouhi NG. Dietary Diversity, Diet Cost, and Incidence of Type 2 Diabetes in the United Kingdom: A Prospective Cohort Study. PLoS Med 2016; 13:e1002085. [PMID: 27433799 PMCID: PMC4951147 DOI: 10.1371/journal.pmed.1002085] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 06/10/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diet is a key modifiable risk factor for multiple chronic conditions, including type 2 diabetes (T2D). Consuming a range of foods from the five major food groups is advocated as critical to healthy eating, but the association of diversity across major food groups with T2D is not clear and the relationship of within-food-group diversity is unknown. In addition, there is a growing price gap between more and less healthy foods, which may limit the uptake of varied diets. The current study had two aims: first, to examine the association of reported diversity of intake of food groups as well as their subtypes with risk of developing T2D, and second, to estimate the monetary cost associated with dietary diversity. METHODS AND FINDINGS A prospective study of 23,238 participants in the population-based EPIC-Norfolk cohort completed a baseline Food Frequency Questionnaire in 1993-1997 and were followed up for a median of 10 y. We derived a total diet diversity score and additional scores for diversity within each food group (dairy products, fruits, vegetables, meat and alternatives, and grains). We used multivariable Cox regression analyses for incident diabetes (892 new cases), and multivariable linear regression for diet cost. Greater total diet diversity was associated with 30% lower risk of developing T2D (Hazard ratio [HR] 0.70 [95% CI 0.51 to 0.95]) comparing diets comprising all five food groups to those with three or fewer, adjusting for confounders including obesity and socioeconomic status. In analyses of diversity within each food group, greater diversity in dairy products (HR 0.61 [0.45 to 0.81]), fruits (HR 0.69 [0.52 to 0.90]), and vegetables (HR 0.67 [0.52 to 0.87]) were each associated with lower incident diabetes. The cost of consuming a diet covering all 5 food groups was 18% higher (£4.15/day [4.14 to 4.16]) than one comprising three or fewer groups. Key limitations are the self-reported dietary data and the binary scoring approach whereby some food groups contained both healthy and less healthy food items. CONCLUSIONS A diet characterized by regular consumption of all five food groups and by greater variety of dairy, fruit, and vegetable subtypes, appears important for a reduced risk of diabetes. However, such a diet is more expensive. Public health efforts to prevent diabetes should include food price policies to promote healthier, more varied diets.
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Affiliation(s)
- Annalijn I. Conklin
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
- WORLD Policy Analysis Center, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
| | - Pablo Monsivais
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas J. Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Nita G. Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
- * E-mail:
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Hardcastle SJ, Blake N. Influences underlying family food choices in mothers from an economically disadvantaged community. Eat Behav 2016; 20:1-8. [PMID: 26554510 DOI: 10.1016/j.eatbeh.2015.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 10/12/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this qualitative study was to explore the perceptions and attitudes that underlie food choices, and, the impact of a school-based healthy eating intervention in mothers from an economically-disadvantaged community. The aim of the intervention was to educate children to act as 'health messengers' to their families. METHOD Sixteen semi-structured phone interviews were conducted with mothers with four receiving a second interview. Interviews were conducted following their child's participation in a six-week after school healthy cooking intervention. RESULTS Thematic content analysis revealed four main themes: Cost and budget influence on food choices, diversity in household rules controlling food, role of socialisation on diet, and improved cooking skills and confidence to make homemade meals. The interview findings demonstrated the positive influence of the after-school cooking intervention on children and their families in cooking skills, promoting healthier cooking methods and increasing confidence to prepare homemade meals. CONCLUSIONS The findings demonstrated the wider economic and social influences on food choices and eating practices. Socialisation into, and strong cultural norms around, eating habits were significant influences on family diet and on parental decisions underpinning food choices and attitudes towards the control of food within the family. The intervention was perceived to be successful in terms of improving nutritional knowledge, cooking skills and increasing confidence to make healthy and tasty homemade meals. The study demonstrates the importance of parental involvement in school-based interventions if improvements in healthy eating are to be evidenced at the family level and maintained.
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Affiliation(s)
- Sarah J Hardcastle
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth WA6845, Australia.
| | - Nicola Blake
- Health Improvement, Public Health, East Sussex County Council, St Anne's Crescent, Lewes BN7 1UE, UK
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Food rejections in children: Cognitive and social/environmental factors involved in food neophobia and picky/fussy eating behavior. Appetite 2016; 96:347-357. [DOI: 10.1016/j.appet.2015.09.008] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 07/20/2015] [Accepted: 09/08/2015] [Indexed: 11/17/2022]
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Pessoa MC, Mendes LL, Gomes CS, Martins PA, Velasquez-Melendez G. Food environment and fruit and vegetable intake in a urban population: a multilevel analysis. BMC Public Health 2015; 15:1012. [PMID: 26437719 PMCID: PMC4595198 DOI: 10.1186/s12889-015-2277-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 09/14/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Environmental, social and individual factors influence eating patterns, which in turn affect the risk of many chronic diseases. This study aimed to estimate associations between environmental factors and the consumption of fruit and vegetables among adults in a Brazilian urban context. METHODS Data from the surveillance system for risk factors for chronic diseases (VIGITEL) of Brazilian Ministry of Health were used. A cross-sectional telephone survey (VIGITEL - 2008-2010) was carried out with 5826 adults in the urban area of Belo Horizonte. Individual variables were collected. The frequency of fruit and vegetables consumption was assessed from number of servings, weekly frequency and an intake score was calculated. Georeferenced variables were used to characterize the food environment. The density of healthy food outlets (stores specialized in selling fruit and vegetables), unhealthy food outlets (bars, snack bars and food trucks/trailers) and the neighborhood family income were investigated and associated with fruit and vegetables intake score. Weighted multilevel linear regression was used to evaluate the associations between the environment variables and the fruit and vegetables intake score. RESULTS Higher fruit and vegetables intake scores were observed in neighborhoods with higher density of healthy food outlets and higher income. Lower scores were observed in neighborhood with higher density of unhealthy food outlets. These associations were adjusted by individual variables such as gender, age, physical activity, sugar sweetened beverages consumption, education level and smoking. DISCUSSION The food environment might explain some of the socioeconomic disparities with respect to healthy food intake and health outcomes. Healthy food stores are less common in socially disadvantaged neighborhoods, and therefore, healthy foods such as fruits and vegetables are less available or are of a lower quality in lower income areas. CONCLUSION Food environment characteristics and neighborhood socioeconomic level had significant associations with fruit and vegetable intake score. These are initial findings that require further investigation within the middle income world populations and the role of the environment with respect to both healthy and unhealthy food acquisition and intake.
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Affiliation(s)
- Milene Cristine Pessoa
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
| | - Larissa Loures Mendes
- Departamento de Nutrição, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
| | - Crizian Saar Gomes
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Belo Horizonte, Minas Gerais, Brasil, 30130-100.
| | - Paula Andréa Martins
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, São Paulo, Brazil.
| | - Gustavo Velasquez-Melendez
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Belo Horizonte, Minas Gerais, Brasil, 30130-100.
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Koh GA, Scott JA, Woodman RJ, Kim SW, Daniels LA, Magarey AM. Maternal feeding self-efficacy and fruit and vegetable intakes in infants. Results from the SAIDI study. Appetite 2014; 81:44-51. [DOI: 10.1016/j.appet.2014.06.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 06/02/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022]
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McKinnon L, Giskes K, Turrell G. The contribution of three components of nutrition knowledge to socio-economic differences in food purchasing choices. Public Health Nutr 2014; 17:1814-24. [PMID: 23920283 PMCID: PMC10282305 DOI: 10.1017/s1368980013002036] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 05/29/2013] [Accepted: 06/13/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To assess socio-economic differences in three components of nutrition knowledge, i.e. knowledge of (i) the relationship between diet and disease, (ii) the nutrient content of foods and (iii) dietary guideline recommendations; furthermore, to determine if socio-economic differences in nutrition knowledge contribute to inequalities in food purchasing choices. DESIGN The cross-sectional study considered household food purchasing, nutrition knowledge, socio-economic and demographic information. Household food purchasing choices were summarised by three indices, based on self-reported purchasing of sixteen groceries, nineteen fruits and twenty-one vegetables. Socio-economic position (SEP) was measured by household income and education. Associations between SEP, nutrition knowledge and food purchasing were examined using general linear models adjusted for age, gender, household type and household size. SETTING Brisbane, Australia in 2000. SUBJECTS Main household food shoppers (n 1003, response rate 66·4 %), located in fifty small areas (Census Collectors Districts). RESULTS Shoppers in households of low SEP made food purchasing choices that were less consistent with dietary guideline recommendations: they were more likely to purchase grocery foods comparatively higher in salt, sugar and fat, and lower in fibre, and they purchased a narrower range of fruits and vegetables. Those of higher SEP had greater nutrition knowledge and this factor attenuated most associations between SEP and food purchasing choices. Among nutrition knowledge factors, knowledge of the relationship between diet and disease made the greatest and most consistent contribution to explaining socio-economic differences in food purchasing. CONCLUSIONS Addressing inequalities in nutrition knowledge is likely to reduce socio-economic differences in compliance with dietary guidelines. Improving knowledge of the relationship between diet and disease appears to be a particularly relevant focus for health promotion aimed to reduce socio-economic differences in diet and related health inequalities.
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Affiliation(s)
- Loretta McKinnon
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia
| | - Katrina Giskes
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia
| | - Gavin Turrell
- School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, QLD 4059, Australia
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Fruit and vegetable intake and body mass index in a large sample of middle-aged Australian men and women. Nutrients 2014; 6:2305-19. [PMID: 24941447 PMCID: PMC4073152 DOI: 10.3390/nu6062305] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 05/23/2014] [Accepted: 05/23/2014] [Indexed: 12/11/2022] Open
Abstract
Dietary guidelines around the world recommend increased intakes of fruits and non-starchy vegetables for the prevention of chronic diseases and possibly obesity. This study aimed to describe the association between body mass index (BMI) and habitual fruit and vegetable consumption in a large sample of 246,995 Australian adults aged 45 + year who had been recruited for the “45 and Up” cohort study. Fruit and vegetable intake was assessed using validated short questions, while weight and height were self-reported. Multinomial logistic regression was used, by sex, to assess the association between fruit and vegetable intake and BMI. Compared to the referent normal weight category (BMI 18.5 to 24.9), the odds ratio (OR) of being in the highest vegetable intake quartile was 1.09 (95% confidence interval (CI) 1.04–1.14) for overweight women (BMI 25.0–29.9) and 1.18 (95% CI 1.12–1.24) for obese women. The association was in the opposite direction for fruit for overweight (OR 0.85; 95% CI 0.80–0.90) and obese women (OR 0.75; 95% CI 0.69–0.80). Obese and overweight women had higher odds of being in the highest intake quartile for combined fruit and vegetable intake, and were more likely to meet the “2 and 5” target or to have five or more serves of fruit and vegetables per day. In contrast, overweight men were less likely to be in high intake quartiles and less likely to meet recommended target of 5 per day, but there was no consistent relationship between obesity and fruit and vegetable intake. Underweight women and underweight men were less likely to be in the highest intake quartiles or to meet the recommended targets. These data suggest that improving adherence to dietary targets for fruit and vegetables may be a dietary strategy to overcome overweight among men, but that overweight and obese women are already adhering to these targets. The association between fruit and vegetable intake and underweight in adults suggests that improving fruit and vegetables intakes are important for the overall dietary patterns of people in this group.
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Zarnowiecki DM, Dollman J, Parletta N. Associations between predictors of children's dietary intake and socioeconomic position: a systematic review of the literature. Obes Rev 2014; 15:375-91. [PMID: 24433310 DOI: 10.1111/obr.12139] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 11/05/2013] [Accepted: 12/02/2013] [Indexed: 12/16/2022]
Abstract
Socioeconomically disadvantaged children are at higher risk of consuming poor diets, in particular less fruits and vegetables and more non-core foods and sweetened beverages. Currently the drivers of socioeconomically related differences in children's dietary intake are not well understood. This systematic review explored whether dietary predictors vary for children of different socioeconomic circumstances. Seven databases and reference lists of included material were searched for studies investigating predictors of 9-13-year-old children's diet in relation to socioeconomic position. Individual- and population-based cross-sectional, cohort and epidemiological studies published in English and conducted in developed countries were included. Twenty-eight studies were included in this review; most were conducted in Europe (n = 12) or North America (n = 10). The most frequently used indicators of socioeconomic position were parent education and occupation. Predictors of children's dietary intake varied among children of different socioeconomic circumstances. Socioeconomic position was consistently associated with children's nutrition knowledge, parent modelling, home food availability and accessibility. Indeterminate associations with socioeconomic position were observed for parent feeding practices and food environment near school. Differences in the determinants of eating between socioeconomic groups provide a better understanding of the drivers of socioeconomic disparities in dietary intake, and how to develop targeted intervention strategies.
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Affiliation(s)
- D M Zarnowiecki
- Exercise for Health and Human Performance Group, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Zarnowiecki D, Ball K, Parletta N, Dollman J. Describing socioeconomic gradients in children's diets - does the socioeconomic indicator used matter? Int J Behav Nutr Phys Act 2014; 11:44. [PMID: 24674231 PMCID: PMC3986827 DOI: 10.1186/1479-5868-11-44] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 03/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children of low socioeconomic position (SEP) generally have poorer diets than children of high SEP. However there is no consensus on which SEP variable is most indicative of SEP differences in children's diets. This study investigated associations between diet and various SEP indicators among children aged 9-13 years. METHOD Families (n=625) were recruited from 27 Adelaide primary schools in 2010. Children completed semi-quantitative food frequency questionnaires providing intake scores for fruit, vegetables, non-core foods, sweetened drinks, and healthy and unhealthy eating behaviours. Parents reported demographic information by telephone interview. Differences in dietary intake scores were compared across parental education, income, occupation, employment status and home postcode. RESULTS Across most SEP indicators, lower SEP was associated with poorer dietary outcomes, including higher intake of non-core foods and sweetened drinks, and more unhealthy behaviours; and lower intake of fruit and vegetables, and fewer healthy behaviours. The number and type of significant SEP-diet associations differed across SEP indicators and dietary outcomes. Mother's education appeared most frequently as a predictor of children's dietary intake, and postcode was the least frequent predictor of children's dietary intake. CONCLUSION Socioeconomic gradients in children's dietary intake varied according to the SEP indicator used, suggesting indicator-specific pathways of influence on children's dietary intake. Researchers should consider multiple indicators when defining SEP in relation to children's eating.
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Affiliation(s)
- Dorota Zarnowiecki
- School of Population Health, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
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Brimblecombe J, Ferguson M, Liberato SC, O'Dea K, Riley M. Optimisation modelling to assess cost of dietary improvement in remote Aboriginal Australia. PLoS One 2013; 8:e83587. [PMID: 24391790 PMCID: PMC3877064 DOI: 10.1371/journal.pone.0083587] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 11/05/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations. OBJECTIVE We used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods. DESIGN A twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet. RESULTS Simultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (-90%) and refined cereals (-90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals. CONCLUSION This modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.
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Affiliation(s)
- Julie Brimblecombe
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Megan Ferguson
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Selma C. Liberato
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Kerin O'Dea
- Menzies School of Health Research, Darwin, Northern Territory, Australia
- Division of Health Sciences (School of Population Health), University of South Australia, Adelaide, South Australia, Australia
| | - Malcolm Riley
- Commonwealth Scientific Industrial Research Organisation (Animal, Food and Health Sciences), Parkville, Victoria, Australia
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Casini L, Contini C, Marone E, Romano C. Food habits. Changes among young Italians in the last 10years. Appetite 2013; 68:21-9. [DOI: 10.1016/j.appet.2013.04.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 03/15/2013] [Accepted: 04/10/2013] [Indexed: 11/29/2022]
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Franchini B, Poínhos R, Klepp KI, Vaz de Almeida MD. Fruit and vegetables: intake and sociodemographic determinants among Portuguese mothers. ANNALS OF NUTRITION AND METABOLISM 2013; 63:131-8. [PMID: 23969424 DOI: 10.1159/000351987] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 05/06/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Fruit and vegetable intake is crucial in health promotion and disease prevention. Inadequate intake is found among adult populations worldwide. AIMS To assess fruit and vegetable intake among Portuguese mothers and to examine its association with sociodemographic determinants. METHODS A national cross-sectional survey was performed in Portugal as part of the Pro Children study. Data from self-administrated precoded 24-hour recall and food frequency questionnaires answered by 1,853 mothers of 11- to 13-year-old children were analyzed. Descriptive analysis of the data was followed by logistic regression to assess associations between daily fruit and vegetable intake and sociodemographic determinants. RESULTS The mean fruit and vegetable intake was 221.2 and 170.0 g/day, respectively. Only 46% of the mothers met the WHO recommendations (≥400 g fruit and vegetables/day). Daily fruit intake was significantly higher among mothers who live with a spouse/partner, and who belong to a higher social class. For vegetables, daily intake was significantly higher among mothers with a higher education and social class. CONCLUSIONS This study shows that the mean intake of fruit and vegetables among Portuguese mothers is far below international recommendations. Effective strategies to promote fruit and vegetable intake are needed, especially for mothers belonging to lower social classes and educational levels.
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Affiliation(s)
- Bela Franchini
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
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Socio-economic differences in food group and nutrient intakes among young women in Ireland. Br J Nutr 2013; 110:2084-97. [PMID: 23721781 DOI: 10.1017/s0007114513001463] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study aimed to investigate socio-economic disparities in food and nutrient intakes among young Irish women. A total of 221 disadvantaged and seventy-four non-disadvantaged women aged 18-35 years were recruited. Diet was assessed using a diet history protocol. Of the total population, 153 disadvantaged and sixty-three non-disadvantaged women were classified as plausible dietary reporters. Food group intakes, nutrient intakes and dietary vitamin and mineral concentrations per MJ of energy consumed were compared between the disadvantaged and non-disadvantaged populations, as was compliance with dietary fibre, macronutrient and micronutrient intake guidelines. The disadvantaged women had lower intakes than the non-disadvantaged women of fruit, vegetables, fish, breakfast cereals, low-fat milk and wholemeal bread (all P< 0·001), yogurt (P= 0·001), low-fat spread (P= 0·002) and fresh meat (P= 0·003). They also had higher intakes of butter, processed red meats, white bread, sugar-sweetened beverages, fried potatoes and potato-based snacks (all P< 0·001) and full-fat milk (P= 0·014). Nutritionally, the disadvantaged women had higher fat, saturated fat and refined sugar intakes; lower dietary fibre, vitamin and mineral intakes; and lower dietary vitamin and mineral densities per MJ than their more advantaged peers. Non-achievement of carbohydrate (P= 0·017), fat (P< 0·001), saturated fat (P< 0·001), refined sugar (P< 0·001), folate (P= 0·050), vitamin C (P< 0·001), vitamin D (P= 0·047) and Ca (P= 0·019) recommendations was more prevalent among the disadvantaged women. Both groups showed poor compliance with Fe and Na guidelines. We conclude that the nutritional deficits present among these socially disadvantaged women are significant, but may be potentially ameliorated by targeted food-based interventions.
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Pomerleau J, Knai C, Foster C, Rutter H, Darmon N, Derflerova Brazdova Z, Hadziomeragic A, Pekcan G, Pudule I, Robertson A, Brunner E, Suhrcke M, Gabrijelcic Blenkus M, Lhotska L, Maiani G, Mistura L, Lobstein T, Martin B, Elinder L, Logstrup S, Racioppi F, McKee M. Measuring the food and built environments in urban centres: Reliability and validity of the EURO-PREVOB Community Questionnaire. Public Health 2013; 127:259-67. [DOI: 10.1016/j.puhe.2012.12.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 11/02/2012] [Accepted: 12/21/2012] [Indexed: 11/29/2022]
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Rauber F, da Costa Louzada ML, Feldens CA, Vitolo MR. Maternal and family characteristics associated with the Healthy Eating Index among low socioeconomic status Brazilian children. J Hum Nutr Diet 2012. [DOI: 10.1111/jhn.12005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F. Rauber
- Federal University of Health Sciences of Porto Alegre (UFCSPA); Porto Alegre RS Brazil
| | | | - C. A. Feldens
- Lutheran University of Brazil (ULBRA); Bairro São José Canoas RS Brazil
| | - M. R. Vitolo
- Federal University of Health Sciences of Porto Alegre (UFCSPA); Porto Alegre RS Brazil
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Abstract
OBJECTIVE To examine the feasibility of using point-of-sale data to assess dietary quality of food sales in remote stores. DESIGN A multi-site cross-sectional assessment of food and nutrient composition of food sales. Point-of-sale data were linked to Australian Food and Nutrient Data and compared across study sites and with nutrient requirements. SETTING Remote Aboriginal Australia. SUBJECT Six stores. RESULTS Point-of-sale data were readily available and provided a low-cost, efficient and objective assessment of food and nutrient sales. Similar patterns in macronutrient distribution, food expenditure and key food sources of nutrients were observed across stores. In all stores, beverages, cereal and cereal products, and meat and meat products comprised approximately half of food sales (range 49–57 %). Fruit and vegetable sales comprised 10.4 (SD 1.9) % on average. Carbohydrate contributed 54.4 (SD 3.0) % to energy; protein 13.5 (SD 1.1) %; total sugars 28.9 (SD 4.3) %; and the contribution of total saturated fat to energy ranged from 11.0 to 14.4% across stores. Mg, Ca, K and fibre were limiting nutrients, and Na was four to five times higher than the midpoint of the average intake range. Relatively few foods were major sources of nutrients. CONCLUSIONS Point-of-sale data enabled an assessment of dietary quality within stores and across stores with no burden on communities and at no cost, other than time required for analysis and reporting. Similar food spending patterns and nutrient profiles were observed across the six stores. This suggests potential in using point-of-sale data to monitor and evaluate dietary quality in remote Australian communities.
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Hong SA, Kim K, Kim MK. Educational attainment and differences in fruit and vegetable consumption among middle-aged adults in the Korean National Health and Nutrition Examination Survey IV. Nutr Res Pract 2012; 6:263-9. [PMID: 22808352 PMCID: PMC3395793 DOI: 10.4162/nrp.2012.6.3.263] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 05/20/2012] [Accepted: 05/20/2012] [Indexed: 11/26/2022] Open
Abstract
We investigated whether socioeconomic differences affect fruit and vegetable (FV) consumption with respect to total intake and intake of various FV subgroups. Our study included 6667 adults aged 40-64 years who completed a dietary survey in the fourth Korean NHANES (2007-2009). FV intake was estimated from 24-hour recalls and food frequency questionnaires. Differences in FV consumption related to educational attainment were analyzed according to different nutritional categories of FV. Both men and women in the low-education group had the lowest intake of total FV and total fruits, and women also had the lowest intake of total vegetables. Also lowest in this group was consumption of mushrooms and vegetables (excluding kimchi) among men, and cruciferous and allium vegetables (excluding Chinese cabbage and radish) among women, while kimchi consumption was the highest in this group. Additionally, an association between educational level and intake of citrus fruits was evident among men. Adults in the low-education group consumed less carotene-rich FV, red fruit and/or vegetables, and dark-green leafy vegetables, fewer total vegetable dishes, and fewer types of fruit than in other groups. Men in this group had the lowest intake of yellow/orange fruit and/or vegetables, and women consumed the least folate-rich FV. There is a clear association between educational attainment and FV intake with regard to total intake, and to specific nutrients, bioactive compounds, colors, and variety.
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Affiliation(s)
- Seo Ah Hong
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 137-791, Korea
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Brennan DS, Singh KA. Dietary, self-reported oral health and socio-demographic predictors of general health status among older adults. J Nutr Health Aging 2012; 16:437-41. [PMID: 22555786 DOI: 10.1007/s12603-012-0006-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Poor dietary habits and nutritional intake are associated with a range of chronic diseases. Oral health may be directly associated with general health status, as well as related to diet. The aims are to assess dietary, self-reported oral health and socio-demographic predictors of general health status among older adults. DESIGN Cross-sectional mailed survey. PARTICIPANTS A random sample of adults in Adelaide, South Australia aged 60-71 years in 2008. MEASUREMENTS Health status was measured using the EuroQol (EQ-5D). Compliance with dietary guidelines was measured using a 16-item index of grocery purchasing. Oral health was measured by self-reported number of teeth, oro-facial pain and sore gums. Socio-demographics included age, sex, birth place and subjective social status. RESULTS Responses were collected from n=444 persons (response rate = 68.8%). The average EQ-5D score was 0.80 (se=0.01). Unadjusted analyses showed (p<0.05) EQ-5D scores were lower in the bottom tertile of compliance with dietary guidelines, for those reporting oro-facial pain, sore gums and fewer teeth, and for the lower social status group. Multivariate analyses showed (p<0.05) lower compliance with dietary guidelines was associated with poorer general health (beta=-0.10), as was oro-facial pain (beta=-0.11), sore gums (beta=-0.17), and lower social status (beta=-0.28). CONCLUSIONS Socio-economic status, oral symptoms and compliance with dietary guidelines were associated with general health status.
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Affiliation(s)
- D S Brennan
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, South Australia.
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Trends in the inequality of fruit and vegetable consumption between education levels indicated by the Korea National Health and Nutrition Examination Surveys. Eur J Clin Nutr 2012; 66:942-9. [DOI: 10.1038/ejcn.2012.39] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Optimising women's diets. An examination of factors that promote healthy eating and reduce the likelihood of unhealthy eating. Appetite 2012; 59:41-6. [PMID: 22446723 DOI: 10.1016/j.appet.2012.03.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 03/01/2012] [Accepted: 03/16/2012] [Indexed: 11/20/2022]
Abstract
The majority of nutrition promotion research that has examined the determinants of unhealthy or healthy dietary behaviours has focused on factors that promote consumption of these foods, rather than factors that may both promote healthy eating and buffer or protect consumption of unhealthy foods. The purpose of this paper is to identify factors that both promote healthy eating and also reduce the likelihood of eating unhealthily amongst women. A community sample of 1013 Australian women participated in a cross-sectional self-report survey that assessed factors associated with diet and obesity. Multiple logistic regressions were used to examine the associations between a range of individual, social and environmental factors and aspects of both healthy and unhealthy eating, whilst controlling for key covariates. Results indicated that women with high self efficacy for healthy eating, taste preferences for fruit and vegetables, family support for healthy eating and the absence of perceived barriers to healthy eating (time and cost) were more likely to consume components of a healthy diet and less likely to consume components of a unhealthy diet. Optimal benefits in overall diet quality amongst women may be achieved by targeting factors associated with both healthy and unhealthy eating in nutrition promotion efforts.
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Brennan DS, Singh KA. Compliance with dietary guidelines in grocery purchasing among older adults by chewing ability and socio-economic status. Gerodontology 2012; 29:265-71. [DOI: 10.1111/j.1741-2358.2012.00631.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Folate status and health behaviours in two Australian Indigenous populations in north Queensland. Public Health Nutr 2012; 15:1959-65. [PMID: 22321761 DOI: 10.1017/s1368980011003661] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess nutritional status using red-cell folate (RCF) and associated health behaviours including fruit and vegetable intake, smoking, drinking and physical activity in two Indigenous populations living in remote northern Australia. DESIGN A cross-sectional survey conducted during 1998-2000. SETTING Twenty-six rural communities in north Queensland, Australia. SUBJECTS A total of 2524 Indigenous people aged 15 years and over was included in the study. Self-reported fruit and vegetable intake, tobacco smoking, alcohol intake and physical activity were recorded. RCF was measured using the Bayer Advia Centaur automated immunoassay system. The association between low RCF (RCF<295 nmol/l) and risk factors was analysed using general linear models adjusted for demographic factors and covariates, namely BMI, diabetes and dyslipidaemia. RESULTS The prevalence of RCF deficiency was higher in Aboriginal participants compared with Torres Strait Islanders (25.6 % v. 14.8 %, P < 0.001). Young women of childbearing age were more likely to have low RCF. Among Aboriginal adults, smoking was strongly associated with low RCF (risk ratio = 1.9, 95 % CI 1.5, 2.5 in females and risk ratio = 2.9, 95 % CI 1.9, 4.2 in males). CONCLUSIONS Indigenous Australians, especially women of childbearing age, had high prevalence of low RCF. Smoking was associated with insufficient folate independent of fruit and vegetable intake and alcohol consumption in the Aboriginal population. This population with an already higher risk of obesity and higher rate of tobacco smoking should be targeted to improve nutrition status to prevent ill health such as diabetes and CVD.
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Is maternal nutrition knowledge more strongly associated with the diets of mothers or their school-aged children? Public Health Nutr 2012; 15:1396-401. [DOI: 10.1017/s1368980011003430] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveMaternal nutrition knowledge has frequently been identified as an important target for nutrition promotion interventions. The aim of the present study was to investigate whether maternal nutrition knowledge is more strongly associated with the mother's own diet or that of her child.DesignCross-sectional multivariate linear regression with interactions analyses of survey data.SettingSocio-economically disadvantaged neighbourhoods in Victoria, Australia.SubjectsFive hundred and twenty-three mothers and their children who participated in the Resilience for Eating and Physical Activity Despite Inequality (READI) study, a cross-sectional survey study conducted in 2009 among women and their children residing in socio-economically disadvantaged neighbourhoods.ResultsIn adjusted models, for three (vegetable, chocolate/lollies and soft drink consumption) out of the seven dietary outcomes assessed, there was a significant association between maternal nutrition knowledge and maternal diet, whereas for the children's diets none of the seven outcomes were associated with maternal nutrition knowledge. Statistical comparison of regression coefficients showed no difference between the maternal nutrition knowledge–maternal diet association and the maternal nutrition knowledge–child diet association.ConclusionsPromoting maternal nutrition knowledge may represent an important avenue for improving diet in mothers from socio-economically disadvantaged neighbourhoods, but more information is needed on how and when this knowledge is translated to benefits for their children's diet.
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Miura K, Giskes K, Turrell G. Contribution of take-out food consumption to socioeconomic differences in fruit and vegetable intake: a mediation analysis. ACTA ACUST UNITED AC 2011; 111:1556-62. [PMID: 21963023 DOI: 10.1016/j.jada.2011.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 03/18/2011] [Indexed: 11/19/2022]
Abstract
Lower fruit and vegetable (F/V) intake among socioeconomically disadvantaged groups has been well documented, and may be a consequence of a higher consumption of take-out foods. This study examined whether, and to what extent, take-out food consumption mediated (explained) the association between socioeconomic position and F/V intake. A cross-sectional postal survey was conducted among 1,500 randomly selected adults aged 25 to 64 years in Brisbane, Australia, during 2009 (response rate 63.7%, N=903). A food frequency questionnaire assessed usual daily servings of F/V (0 to 6), overall take-out consumption (times per week), and the consumption of 22 specific take-out items (never to once per day or more). These specific take-out items were grouped into "less healthy" and "healthy" choices and indexes were created for each type of choice (0 to 100). Socioeconomic position was ascertained by education. The analyses were performed using linear regression, and a bootstrap resampling approach estimated the statistical significance of the mediated effects. Mean daily servings of F/V were 1.89±1.05 and 2.47±1.12, respectively. The least educated group members were more likely to consume fewer servings of fruit (β= -.39, P<0.001) and vegetables (β= -.43, P<0.001) compared with members of the highest educated group. The consumption of "less healthy" take-out food partly explained (mediated) education differences in F/V intake; however, no mediating effects were observed for overall and "healthy" take-out consumption. Regular consumption of "less healthy" take-out items may contribute to socioeconomic differences in F/V intake, possibly by displacing these foods.
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Affiliation(s)
- Kyoko Miura
- School of Public Health, Queensland University of Technology,Victoria Park Rd, Kelvin Grove, QLD, 4059 Australia.
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Morgan EH, Worsley T. Expert Perspectives on Fruit and Vegetable Consumption in Australia. Am J Health Promot 2011; 26:10-3. [DOI: 10.4278/ajhp.090615-qual-189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To examine food system experts' explanations for the consistently low level of fruit and vegetable consumption in Australia and what can be done to increase it. Design. A qualitative survey of food system experts. Setting. The survey was administered online to experts across Australia between August and November 2008 using SurveyMonkey.com . Subjects. Key informants (N = 332) in sectors ranging from farming through food waste disposal; 122 usable responses were analyzed. Measures. Opinions about fruit and vegetable consumption were collected through open-ended questions. Respondent background information was also collected. Analysis. Identification of key themes via qualitative analysis. Results. Many reasons for inadequate consumption were suggested, most of which related to inadequacies in the supply of fruit and vegetables. However, the most commonly cited solutions focused on increasing consumer demand. Conclusion. The incongruence between reasons for inadequate consumption and proposed solutions presents a challenge and suggests a need to shift policy priorities towards improving the supply of fruit and vegetables. Several well-coordinated approaches between the various sectors are needed to maximize outcomes. They include some outside the scope of traditional health promotion efforts.
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Affiliation(s)
- Emily H. Morgan
- Emily H. Morgan, MS, MPH, and Tony Worsley, PhD, were with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia, at the time of the study
| | - Tony Worsley
- Emily H. Morgan, MS, MPH, and Tony Worsley, PhD, were with the School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia, at the time of the study
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Is the objective food environment associated with perceptions of the food environment? Public Health Nutr 2011; 15:291-8. [PMID: 21835079 DOI: 10.1017/s1368980011001947] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study examined whether objective measures of the food environment are associated with perceptions of the food environment and whether this relationship varies by socio-economic disadvantage. DESIGN The study is a cross-sectional analysis of self-report surveys and objective environment data. Women reported their perceptions on the nutrition environment. Participants' homes and food stores were geocoded to measure the objective community nutrition environment. Data on the average price and variety of fruit and vegetables were used to measure the objective consumer nutrition environment. SETTING The study was conducted in Melbourne, Australia, in 2003-2004. SUBJECTS Data presented are from a sample of 1393 women aged 18-65 years. RESULTS Overall the match between the perceived and objective environment was poor, underscoring the limitations in using perceptions of the environment as a proxy for the objective environment. Socio-economic disadvantage had limited impact on the relationship between perceived and objective nutrition environment. CONCLUSIONS Further research is needed to understand the determinants of perceptions of the nutrition environment to enhance our understanding of the role of perceptions in nutrition choices and drivers of socio-economic inequalities in nutrition.
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Williams LK, Veitch J, Ball K. What helps children eat well? A qualitative exploration of resilience among disadvantaged families. HEALTH EDUCATION RESEARCH 2011; 26:296-307. [PMID: 21350037 DOI: 10.1093/her/cyr004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
It is well known that persons of low socioeconomic position consume generally a less healthy diet. Key determinants of unhealthy eating among disadvantaged individuals include aspects of the family and external environment. Much less is known about family and environmental determinants of healthy eating among social disadvantaged children. The aim of this study was to gain insight into the family and environmental factors underlying resilience to poor nutrition among children and their mothers living in disadvantaged neighbourhoods. Semi-structured interviews were conducted with 38 mother-child pairs (N = 76) from disadvantaged neighbourhoods. Children were selected if they were a healthy weight, consumed adequate intakes of fruit and vegetables and were physically active. Two main themes emerged from the interviews: active strategies from parents to promote healthy eating and external barriers and supports to healthy eating. Mothers believed that exercising control over access to unhealthy food, providing education and encouragement for consumption of healthy food and enabling healthy food options aided their child to eat well. Children did not perceive food advertisements to be major influences on their eating preferences or behaviour. The results of the current study offer insight into potential avenues for nutrition promotion among disadvantaged children.
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Affiliation(s)
- Lauren K Williams
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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Pavlica T, Bozic-Krstic V, Rakic R. Body mass index, waist-to-hip ratio and waist/height in adult population from Backa and Banat - the Republic of Serbia. Ann Hum Biol 2010; 37:562-73. [PMID: 20141483 DOI: 10.3109/03014460903512829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Nutritional status is vital in the assessment of physical fitness and health status of populations. AIM This study aimed to describe relationships between BMI, waist-to-hip ratio (WHR) and waist/height (W/Ht) and factors such as education, residence, origin and ethnic belonging among adults in Backa and Banat. SUBJECTS AND METHODS The study was conducted in 47 villages in the north of Serbia. The tested group consisted of 4247 individuals, aged 20+. RESULTS The problem of overweight and obesity was more common among men (66%) than women (49.71%). In the group with normal BMI, the majority of men and women were characterized by normal WHR and W/Ht values, but among them there were also groups with incorrect WHR (males >or= 0.95, females >or= 0.8) and W/Ht (>or= 0.5). Socio-demographic factors had a little impact on BMI, WHR and W/Ht in men in certain age groups while their impact was higher in women. These factors, especially education and origin, had a significant impact on nutritional status in young and middle-aged women, whereas they were not significant in older female participants (> 60). CONCLUSION Despite the fact that this part of the country has undergone intensive social changes since the last decade of 20th century, the nutritional status of the population has not significantly changed.
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Affiliation(s)
- Tatjana Pavlica
- Laboratory for Human Biology, Department for Biology and Ecology, University of Novi Sad, 21000 Novi Sad, Serbia.
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Grocery purchasing among older adults by chewing ability, dietary knowledge and socio-economic status. Public Health Nutr 2010; 14:1279-84. [DOI: 10.1017/s1368980010002508] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectivesNutrition plays a central role in health, with poor dietary habits and nutritional intake being associated with a range of chronic diseases. The aim was to examine grocery purchasing behaviour in relation to chewing ability, dietary knowledge and socio-economic status (SES) among older adults.DesignData were collected by mailed survey in 2008. Grocery purchasing was measured using a sixteen-item index of compliance of food purchasing with dietary guidelines. Self-reported number of teeth was classified as an inadequate dentition if less than twenty-one teeth were present. Chewing ability was based on a five-item chewing index. Dietary knowledge was collected using twenty true/false items. SES was assessed using a subjective social status rating representing where people stand in society.SettingPopulation survey in Adelaide, South Australia.SubjectsAdults aged 60–71 years.ResultsResponses were collected from 444 persons (response rate = 68·8 %). Among dentate persons, 24·4 % had an inadequate dentition with 10·3 % defined as ‘chewing deficient’. Multivariate regression coefficients adjusted for age, sex and income showed chewing deficiency (−5·8) and low SES (−3·6) was associated (P < 0·05) with lower grocery purchasing scores, but dietary knowledge was not statistically significant.ConclusionsFor older adults, chewing deficiency and lower social status were associated with lower compliance with dietary guidelines, independent of dietary knowledge.
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