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Kilandeka V, Mosha T, Kulwa K. Relationship Between School Food Environment and Eating Behaviors of Primary School Children in Dodoma: A Cross-Sectional Study. Ecol Food Nutr 2024; 63:304-322. [PMID: 38776870 DOI: 10.1080/03670244.2024.2357792] [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: 05/25/2024]
Abstract
This cross-sectional study assesses the relationship between school food environment and eating behaviors of primary school children in Dodoma among 248 primary school children aged 6-13 years. School characteristics information and socio-demographic characteristics were collected. Multilevel modeling was employed to assess the individual-level variance in eating behaviors. Most of the variances in the investigated eating behaviors were at the personal level. Significant associations (p < .05) were between protein-rich food intake and fats and sugar-rich food with the death of either parent. And association between intake of vitamin and mineral-rich foods and the number of people living in household.
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Affiliation(s)
- Vivian Kilandeka
- Department of Human Nutrition and Consumer Science, College of Agriculture, Morogoro, Tanzania
| | - Theobald Mosha
- Department of Human Nutrition and Consumer Science, College of Agriculture, Morogoro, Tanzania
| | - Kissa Kulwa
- Department of Human Nutrition and Consumer Science, College of Agriculture, Morogoro, Tanzania
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2
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Zeitler L, Downs S, Powell B. Adapting food environment frameworks to recognize a wild-cultivated continuum. Front Nutr 2024; 11:1343021. [PMID: 38655545 PMCID: PMC11035871 DOI: 10.3389/fnut.2024.1343021] [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: 11/22/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Food environments, or interfaces between consumers and their food systems, are a useful lens for assessing global dietary change. Growing inclusivity of nature-dependent societies in lower-and middle-income countries is driving recent developments in food environment frameworks. Downs et al. (2020) propose a food environment typology that includes: wild, cultivated, informal and formal market environments, where wild and cultivated are "natural food environments." Drawing from transdisciplinary perspectives, this paper argues that wild and cultivated food environments are not dichotomous, but rather exist across diverse landscapes under varying levels of human management and alteration. The adapted typology is applied to a case study of Indigenous Pgaz K'Nyau food environments in San Din Daeng village, Thailand, using the Gallup Poll's Thailand-adapted Diet Quality Questionnaire with additional food source questions. Wild-cultivated food environments, as classified by local participants, were the source of more food items than any other type of food environment (37% of reported food items). The case of Indigenous Pgaz K'Nyau food environments demonstrates the importance of understanding natural food environments along a continuum from wild to cultivated.
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Affiliation(s)
- Lilly Zeitler
- Department of Geography, The Pennsylvania State University, University Park, PA, United States
| | - Shauna Downs
- Department of Health Behavior, Society and Policy, Newark, NJ, United States
| | - Bronwen Powell
- Department of Geography, The Pennsylvania State University, University Park, PA, United States
- African Studies Program, The Pennsylvania State University, University Park, PA, United States
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3
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Martinez-Perez N, Torheim LE, Arroyo-Izaga M. Availability and properties of commercially produced food products offered in European public universities: A North-South comparison. J Food Sci 2024; 89:2494-2511. [PMID: 38488725 DOI: 10.1111/1750-3841.17022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 04/12/2024]
Abstract
To date, there are no studies that have compared university food environments (FEs) with different sociocultural contexts. Therefore, we analyzed differences in the availability and properties of commercially produced foods, in a northern and a southern European university (located in Norway and Spain, respectively). A cross-sectional observational study was conducted at OsloMet-Oslo Metropolitan University and at the University of the Basque Country UPV/EHU. The nutritional quality of food products was estimated through the following nutrient profiling models (NPMs): those proposed by the Spanish Agency for Consumer Affairs, Food Safety and Nutrition (AECOSAN), the UK nutrient profiling model (UK NPM), the Norwegian Food and Drink Industry Professional Practices Committee (Matbransjens Fagligle Utvalg [MFU]), and a combination of them. In addition, food items were classified using the NOVA system. A total of 251 and 1051 products were identified at OsloMet and the UPV/EHU, respectively. The percentage categorized as low nutritional quality (LNQ) was higher at the UPV/EHU (almost 54.5% of the total products) compared with at OsloMet (almost 40%) (p < 0.001). Most of the products were categorized as ultra-processed, and there were no differences in the percentage of ultra-processed foods between the two universities (OsloMet 86.1%, UPV/EHU 83.3%, p > 0.05). A higher proportion of LNQ products was found at the UPV/EHU than at OsloMet, probably due to the government policies and actions for creating healthy FEs. Consequently, there is a need to develop interventions to improve the FE at the UPV/EHU, adapted to its sociocultural context. PRACTICAL APPLICATION: This study reveals north-south differences in terms of the availability of low nutritional quality food products. In particular, a higher proportion of this type of product was found at the University of the Basque Country UPV/EHU than at OsloMet-Oslo Metropolitan University. Our exploratory hypothesis is that this phenomenon is a consequence of the Nordic government policies that have great potential to create healthy FEs.
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Affiliation(s)
- Naiara Martinez-Perez
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain
- BIOMICs Research Group, Microfluidics & BIOMICs Cluster, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Marta Arroyo-Izaga
- BIOMICs Research Group, Microfluidics & BIOMICs Cluster, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Department of Pharmacy and Food Sciences, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Bioaraba, BA04.03, Vitoria-Gasteiz, Spain
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Bogard JR, Downs S, Casey E, Farrell P, Gupta A, Miachon L, Naughton S, Staromiejska W, Reeve E. Convenience as a dimension of food environments: A systematic scoping review of its definition and measurement. Appetite 2024; 194:107198. [PMID: 38176442 DOI: 10.1016/j.appet.2023.107198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/12/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024]
Abstract
Convenience is a major driver of food choice throughout the world, yet it is often inconsistently conceptualised, defined and measured. This limits the scope for food systems policy and interventions to leverage convenience to improve diet and nutrition outcomes. We conducted a systematic literature review to determine how convenience is both defined and measured in food environment and nutrition research. Six databases were systematically searched and studies were screened by two independent reviewers based on pre-defined eligibility criteria, yielding 243 studies for inclusion in the final review. 77% of studies did not explicitly define convenience. Among those that did, the dimensions and components within definitions varied. 83% of studies used perceived measures of convenience rather than objective measures. Convenience was most commonly measured in high income countries (64%) and in relation to the home food environment (53%), followed by formal retail (40%). Very few studies measured convenience in relation to the informal retail or cultivated food environments, and no studies considered convenience in relation to wild food environments. The vast majority of studies did not consider the validity or reliability of the measures of convenience. Based on our findings we propose a definition of convenience as a characteristic that results in reduced requirement for resources including time, physical effort, mental effort and skills by the consumer in relation to the planning, acquisition, preparation, storage, transport, consumption or clean-up of food. This definition can be used to help guide the development of measurement tools that can be used to assess convenience across different dimensions and contexts in a more comprehensive way. We also propose a framework for considering convenience as an entry point in food systems to improve diets and nutrition outcomes.
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Affiliation(s)
- Jessica R Bogard
- Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia.
| | - Shauna Downs
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Elodie Casey
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Penny Farrell
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Lais Miachon
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Shaan Naughton
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Wiktoria Staromiejska
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Erica Reeve
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Gilcharan Singh HK, Sinnasamy P, Wan Yi T, Chiao Wei C, Chee Siew Swee W, Shyam S. Understanding the Food Environment and Its Impact on Diet and Health in Asia: A Scoping Review. Asia Pac J Public Health 2024; 36:172-183. [PMID: 38483070 DOI: 10.1177/10105395241237635] [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: 04/05/2024]
Abstract
Food environment (FE), an interface where people interact with a broader food system, is critical to health. Understanding the Asian FE may help to tackle the "triple burden of malnutrition" through informed research and policy. This review identifies FE domains assessed in the Asian context and collates the tools/measures used in these evaluations. We further synthesized the reported associations of FE with diet and health outcomes and identified knowledge gaps. Forty-two articles were reviewed (East Asia, n = 25, 60%; South Asia, n = 8, 19%; and Southeast Asia, n = 9, 21%). The results showed that FE was frequently examined in children, adolescents, or adults, but data were scarce in older adults. Food availability (n = 30) and accessibility (n = 19) were popularly studied domains. Furthermore, FE was measured using geographic information systems (n = 18), market (n = 7), or stakeholder (n = 21) surveys. Twenty-eight (67%) articles assessed associations of FE exposures with diet (n = 12) and health (n = 21). Increased food availability and accessibility were associated with poorer dietary and health outcomes despite nonexisting validity and reliability reporting in 62% of articles. Limited high-quality studies emphasize the need for harmonized definitions, better study designs, and validated FE measures/tools in Asia. Improving the quality of FE research is critical to designing effective interventions to improve public health nutrition in Asia.
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Affiliation(s)
- Harvinder Kaur Gilcharan Singh
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Pavitra Sinnasamy
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Teoh Wan Yi
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Chang Chiao Wei
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Sangeetha Shyam
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Reus, Spain
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Cooper GS, Davies-Kershaw H, Dominguez-Salas P, Fahmida U, Faye B, Ferguson E, Grace D, Häsler BN, Kadiyala S, Konapur A, Kulkarni B, Chengat Prakashbabu B, Pramesthi IL, Rowland D, Selvaraj K, Sudibya ARP, Tine RC, Yadav DMD, Zahra NL, Shankar B, Heffernan C. Investigating market-based opportunities for the provision of nutritious and safe diets to prevent childhood stunting: a UKRI-GCRF action against stunting hub protocol paper. BMJ Paediatr Open 2024; 8:e001671. [PMID: 38417923 PMCID: PMC10900371 DOI: 10.1136/bmjpo-2022-001671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/13/2022] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Inadequate access to affordable, safe, desirable and convenient nutrient-dense food is one of the underlying causes of child stunting. While targeted nutrition-sensitive interventions (eg, backyard 'nutri-gardens') may increase dietary diversity within farming households, such interventions have limited scalability across the wider food system where markets remain underdeveloped. This research aims to develop and assess market-based interventions for key nutrient-dense foods to help improve the diets of women and children in the first 1000 days of life. METHODS Data collection uses four parallel approaches in each of the three study countries (India, Indonesia and Senegal). (1) A novel food environment tool will be developed to characterise the accessibility and affordability of nutrient-dense foods in the study countries. The tool will be validated through pretesting using cognitive interviewing and piloting in purposively sampled households, 10 (cognitive interviewing) and 30 (piloting) households in each country; (2) stakeholder interviews (eg, with producers, intermediaries and retailers) will be conducted to map out nutrition-sensitive entry points of key value chains (eg, animal-sourced foods), before hotspots of potential food safety hazards will be identified from food samples collected along the chains; (3) the Optifood and Agrifood tools will be used to identify foods that can address food system nutrient gaps and engage key stakeholders to prioritise market interventions to improve nutrition outcomes. Optifood and Agrifood parameters will be informed by publicly available data, plus interviews and focus groups with value chain stakeholders; (4) informed by the previous three approaches and a campaign of participatory 'group model building', a novel system dynamics model will evaluate the impact of alternative market-based solutions on the availability and affordability of nutrient-dense foods over time. ETHICS AND DISSEMINATION The study has received ethical approval in the United Kingdom, Senegal, Indonesia and India. Dissemination comprises peer-reviewed journals, international disciplinary conferences and multistakeholder dissemination workshops.
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Affiliation(s)
- Gregory S Cooper
- Institute of Sustainable Food, Department of Geography, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Hilary Davies-Kershaw
- Department of Population Health, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Paula Dominguez-Salas
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Nairobi, Kenya
- Food and Markets Department, Natural Resources Institute, University of Greenwich, London, UK
| | - Umi Fahmida
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition, Jakarta, DKI Jakarta, Indonesia
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Babacar Faye
- Department of Parasitology-Mycology, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Elaine Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Delia Grace
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Nairobi, Kenya
- Food and Markets Department, Natural Resources Institute, University of Greenwich, London, UK
| | - Barbara N Häsler
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Suneetha Kadiyala
- Department of Population Health, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Archana Konapur
- Department of Population Health, London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
| | - Bharati Kulkarni
- Department of Population Health, London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
| | | | - Indriya L Pramesthi
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition, Jakarta, DKI Jakarta, Indonesia
| | - Dominic Rowland
- Center for International Forestry Research, Bogor Barat, Indonesia
- Centre for Environment, Development and Policy (CeDEP), SOAS, London, UK
| | | | - Arienta R P Sudibya
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition, Jakarta, DKI Jakarta, Indonesia
| | - Roger C Tine
- Department of Parasitology-Mycology, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - D M Dinesh Yadav
- Department of Population Health, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Nur L Zahra
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition, Jakarta, DKI Jakarta, Indonesia
| | - Bhavani Shankar
- Institute of Sustainable Food, Department of Geography, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Claire Heffernan
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Hertfordshire, UK
- London International Development Centre, London, UK
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7
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Downs S, Manohar S, Staromiejska W, Keo C, Say S, Chhinh N, Fanzo J, Sok S. Centering context when characterizing food environments: the potential of participatory mapping to inform food environment research. Front Nutr 2024; 11:1324102. [PMID: 38450238 PMCID: PMC10914972 DOI: 10.3389/fnut.2024.1324102] [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: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 03/08/2024] Open
Abstract
Food environments are a critical place within the food system to implement interventions aimed at enabling sustainable diets. In this perspective article, we argue for the need for food environment research to more comprehensively examine the different types of food environments that people access within their communities to ensure that interventions and programs are better aligned with people's lived experiences. We highlight the potential ways in which participatory mapping (PM) can be leveraged to better design food environment research by: (1) identifying the different food environment types that are accessed within a given community; (2) providing insight into the timing for data collection; (3) informing the prioritization of where to conduct food environment assessments; and (4) highlighting the dynamism of food environments over time (e.g., across a given day or across seasons). We provide a case study example of the application of PM and the lessons learned from it in Cambodia. By conceptualizing food environments in a more comprehensive way, from the perspective of the people living within a given community, we will be able to measure food environments in a way that more closely aligns with people's lived experiences.
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Affiliation(s)
- Shauna Downs
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Swetha Manohar
- Global Food Ethics Policy Program, School of Advanced International Studies, Washington, DC, United States
- Nutrition, Diets and Health Unit, International Food Policy Research Institute, Washington, DC, United States
| | - Wiktoria Staromiejska
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Chanvuthy Keo
- Faculty of Social Science and Humanities, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
| | - Sophea Say
- Department of Tourism, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Nyda Chhinh
- Department of Economic Development, Faculty of Development Studies, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
| | - Jessica Fanzo
- Columbia’s Climate School, Columbia University, New York, NY, United States
| | - Serey Sok
- Research Office, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
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Vaillancourt C, Ahmed M, Kirk S, Labonté MÈ, Laar A, Mah CL, Minaker L, Olstad DL, Potvin Kent M, Provencher V, Prowse R, Raine KD, Schram A, Zavala-Mora D, Rancourt-Bouchard M, Vanderlee L. Food environment research in Canada: a rapid review of methodologies and measures deployed between 2010 and 2021. Int J Behav Nutr Phys Act 2024; 21:18. [PMID: 38373957 PMCID: PMC10875887 DOI: 10.1186/s12966-024-01558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024] Open
Abstract
Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.
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Affiliation(s)
- Caroline Vaillancourt
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Sara Kirk
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Kjipuktuk (Halifax), NS, B3H 4R2, Canada
| | - Marie-Ève Labonté
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Leia Minaker
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3T1, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Véronique Provencher
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405 87 Ave Northwest, Edmonton, AB, T6G 1C9, Canada
| | - Ashley Schram
- School of Regulation and Global Governance (RegNet), ANU College of Asia & the Pacific, The Australian National University, 8 Fellows Road, Canberra, Australian Capital Territory, 2600, Australia
| | - Daniela Zavala-Mora
- Science Library, Université Laval, 1045 Avenue de La Médecine, Québec, QC, G1V 0A6, Canada
| | - Maryka Rancourt-Bouchard
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada.
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9
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Omachi BA, van Onselen A, Kolanisi U. Nutrition knowledge and health vulnerability of mothers of pre-school children in north-central, Nigeria. PLoS One 2024; 19:e0292252. [PMID: 38295048 PMCID: PMC10829998 DOI: 10.1371/journal.pone.0292252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/15/2023] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE This study explores the contribution of nutrition knowledge to the health status of pre-school children's mothers in Niger State, North-Central, Nigeria. DESIGN The study is a descriptive cross-sectional design using a quantitative data collection method. SETTING/PARTICIPANTS A multi-stage sampling technique was used to recruit 450 mothers of pre-school children across Niger state, Nigeria. Chi-square and linear regression were used to test the level of statistical significance (at p < 0.05). Socioeconomic and demographic information, anthropometric indices and nutrition knowledge were obtained using semi-structured questionnaires. Feeding patterns were also assessed using a qualitative 7-day dietary recall. RESULT The results showed that the majority (63.8%) of the mothers were within 26-35 years, and more than half (51.6%) of the mothers lacked knowledge of a "balanced diet". Fruits, vegetables, and dairy products were the least consumed food group among the mothers (7.1% and 9.1%, respectively). Place of residence, occupation, and method of waste disposal were significantly associated with maternal minimum dietary diversity adequacy (p<0.05). Over half (57.6%) of the mothers were within the normal BMI range, and the mean waist/hip ratio was 0.82± 0.08. Social media/online was the most (36.4%) explored source of nutrition information among the mothers. This study shows no significant association between nutrition knowledge and adequacy of minimum dietary diversity among the mothers of preschool children (p = 0.09, χ2 = 13.682). CONCLUSION Dietary diversity among mothers was associated with the socioeconomic status and BMI of the mothers, which were strong determinants of meal quality and health outcomes in Nigeria and other developing countries experiencing food insecurity.
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Affiliation(s)
| | | | - Unathi Kolanisi
- University of Zululand, eMpageni, Kwazulu-Natal, South Africa
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10
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Akl C, El-Helou N, Safadi G, Semaan A, El Sammak A, Trabelsi T, Sassi S, Akik C, El Ati J, Traissac P, Ghattas H. Urban school neighbourhoods dominated by unhealthy food retailers and advertisements in Greater Tunis: a geospatial study in the midst of the nutrition transition. Public Health Nutr 2024; 27:e44. [PMID: 38169454 PMCID: PMC10882541 DOI: 10.1017/s1368980023002860] [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: 01/05/2024]
Abstract
OBJECTIVE Food environments are a major determinant of children's nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia - an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity. DESIGN In this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network buffer of each school. Retailers and advertisement sets were categorised as healthy or unhealthy according to a NOVA-based classification. Associations between school characteristics and retailers or advertisement sets were explored using multinomial regression models. SETTING Greater Tunis, Tunisia. PARTICIPANTS Random sample of fifty (thirty-five public and fifteen private) primary schools. RESULTS Overall, 3621 food retailers and 2098 advertisement sets were mapped. About two-thirds of retailers and advertisement sets were labelled as unhealthy. Most retailers were traditional corner stores (22 %) and only 6 % were fruit and vegetable markets. The prevailing food group promoted was carbonated and sugar-sweetened beverages (22 %). The proportion of unhealthy retailers was significantly higher in the richest v. poorest areas. CONCLUSIONS School neighbourhood food environments included predominantly unhealthy retailers and advertisements. Mapping of LMIC food environments is crucial to document the impact of the nutrition transition on children's nutritional status. This will inform policies and interventions to curb the emergent childhood obesity epidemic.
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Affiliation(s)
- Christelle Akl
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nehmat El-Helou
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gloria Safadi
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Aline Semaan
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Aya El Sammak
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Tarek Trabelsi
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, Tunis1007, Tunisia
| | - Sonia Sassi
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, Tunis1007, Tunisia
| | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, Tunis1007, Tunisia
| | - Pierre Traissac
- MoISA - University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
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Chuvileva YE, Manangan A, Chew A, Rutherford G, Barillas-Basterrechea M, Barnoya J, Breysse PN, Blanck H, Liburd L. What North American retail food environment indices miss in Guatemala: Cultural considerations for the study of place and health. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2024; 164:10.1016/j.apgeog.2024.103204. [PMID: 38532832 PMCID: PMC10964928 DOI: 10.1016/j.apgeog.2024.103204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
We evaluated the cross-context validity and equivalence of the US- and Canada-originated Retail Food Environment Index (RFEI) and modified RFEI (mRFEI) against a retail food environment dataset from the indigenous-majority city of Quetzaltenango (Xela), Guatemala. The RFEI/mRFEI failed to identify 77% of retailers and misclassified the healthiness of 42% of the remaining retailers in Xela, inaccurately labeling the city a food swamp. The RFEI/mRFEI are not currently suitable for mapping retail food environments in places like Quetzaltenango. Alternative functional and temporal classifications of retail food environments may provide measures with greater contextual fit, highlighting important cultural considerations for the study of place and dietary health.
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Affiliation(s)
- Yulia E. Chuvileva
- Division of Adolescent and School Health (DASH), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), USA
| | - Arie Manangan
- Division of Environmental Health Science and Practice (DEHSP), National Center for Environmental Health (NCEH), CDC, Atlanta, GA, USA
| | - Aiken Chew
- Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - George Rutherford
- University of California San Francisco (UCSF), San Francisco, CA, USA
| | | | - Joaquín Barnoya
- Unidad de Cirugía Cardiovascular de Guatemala and Universidad Rafael Landivar, Guatemala City, Guatemala
| | - Patrick N. Breysse
- NCEH/Agency for Toxic Substances and Disease Registry (ATSDR), CDC, Atlanta, GA, USA
| | - Heidi Blanck
- Division of Nutrition, Physical Activity, and Obesity (DNPAO), NCCDPHP, CDC, Atlanta, GA, USA
| | - Leandris Liburd
- Office of Minority Health and Health Equity (OMHHE), CDC, Atlanta, GA, USA
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Mendes LL, Rocha LL, Botelho LV, de Menezes MC, Júnior PCPDC, da Camara AO, Cardoso LDO, de Castro IRR, Horta PM, Pessoa MC, Veiros MB, Canella DS. Scientific research on food environments in Brazil: a scoping review. Public Health Nutr 2023; 26:2056-2065. [PMID: 37232243 PMCID: PMC10564610 DOI: 10.1017/s1368980023000836] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/20/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To map the scientific research on food environments in Brazil, based on the following questions: How many studies have addressed food environments?; What study designs and methodological approaches were applied?; What is the geographic scope of the studies?; What scenarios and dimensions of food environments were studied?; Which population groups were studied?; How were food environments conceptualised?; What are the main limitations of the studies? DESIGN Scoping review conducted in four databases, from January 2005 to December 2022, using different food environment-related terms to cover the main types and dimensions proposed in the literature. The studies were independently selected by two authors. A narrative synthesis was used to summarise the findings. SETTING Brazil. PARTICIPANTS 130 articles. RESULTS Scientific research on Brazilian food environments has been increasing. The analytical quantitative approach and the cross-sectional design were the most frequently used. Most articles were published in English. The majority of studies evaluated the community food environment, addressed aspects of the physical dimension, sampled the adult population, had food consumption as an outcome, used primary data, and were carried out in capital cities in the Southeast region. Furthermore, in most articles, no conceptual model was explicitly adopted. CONCLUSIONS Gaps in literature are related to the need for conducting studies in the Brazilian countryside, the support for the formulation of research questions based on conceptual models, the use of valid and reliable instruments to collect primary data, in addition to the need for a greater number of longitudinal, intervention and qualitative studies.
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Affiliation(s)
- Larissa Loures Mendes
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais30130-100, Brazil
| | - Luana Lara Rocha
- Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Laís Vargas Botelho
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Alex Oliveira da Camara
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Paula Martins Horta
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais30130-100, Brazil
| | - Milene Cristine Pessoa
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais30130-100, Brazil
| | - Marcela Boro Veiros
- Department of Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Daniela Silva Canella
- Department of Applied Nutrition, Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
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13
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Salvo D, Kepper M, Hunter R, Jáuregui A. Built environment and obesity prevention research: moving from niche to norm. Lancet Diabetes Endocrinol 2023; 11:631-633. [PMID: 37620061 DOI: 10.1016/s2213-8587(23)00226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023]
Affiliation(s)
- Deborah Salvo
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA.
| | - Maura Kepper
- Prevention Research Center, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Ruth Hunter
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Alejandra Jáuregui
- Department of Physical Activity and Healthy Lifestyles, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Boxer B, Trübswasser U, Lesi V, Naika A, Dahal P, Sagan S, Joshi K, Irache A, Singh P, Nand D, Kama A, Deo A, Goudet S. Rapid review of factors influencing dietary behaviors in Fiji. Front Nutr 2023; 10:1164855. [PMID: 37621737 PMCID: PMC10445140 DOI: 10.3389/fnut.2023.1164855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction In Fiji, multiple burdens of malnutrition including undernutrition, overweight/obesity, and micronutrient deficiencies coexist at the individual, household, and population levels. The diets of children, adolescents, and adults are generally unhealthy. The objective of this review was to understand how the dietary behaviors of children, adolescents, and women in Fiji are influenced by individual, social, and food environment factors. Methods This rapid review was conducted to synthesize existing evidence, identify research gaps in the evidence base, and make recommendations for future research. The Cochrane Rapid Reviews Methods and the updated guideline for reporting systematic reviews were used. The search strategy for this rapid review was based on the Population Context Outcome [P(E)CO] framework, including search terms for population (children, adolescents, and adults), context (Fiji), and outcome (dietary behaviors). Searches were conducted in PubMed, Scopus, PsycINFO, and Google Scholar. Results The 22 studies included in this review identified different factors influencing dietary behaviors in Fiji. Individual preferences for processed and imported foods, especially of younger generations, and social dynamics, especially gender norms and social pressure, to serve meat and overeat appeared to be prominent in driving dietary habits. The ongoing nutrition transition has led to increasing availability and affordability of ultra-processed and fast foods, especially in urban areas. Concerns about food safety and contamination and climate change and its effect on local food production also appear to influence dietary choices. Discussion This review identified different dynamics influencing dietary behaviors, but also research gaps especially with regard to the food environment, calling for an integrated approach to address these factors more systemically.
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Affiliation(s)
| | | | - Viola Lesi
- Nutrition Research, Dikoda, London, United Kingdom
| | - Asaeli Naika
- Nutrition Research, Dikoda, London, United Kingdom
| | | | | | | | - Ana Irache
- Nutrition Research, Dikoda, London, United Kingdom
| | - Pragya Singh
- School of Public Health and Primary Care, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Devina Nand
- Ministry of Health and Medical Services, Suva, Fiji
| | - Ateca Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | - Alvina Deo
- National Food and Nutrition Centre, Suva, Fiji
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15
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Shinde S, Harling G, Assefa N, Bärnighausen T, Bukenya J, Chukwu A, Darling AM, Manu A, Millogo O, Mwanyika-Sando M, Ncayiyana J, Nurhussien L, Patil R, Tang K, Fawzi W. Counting adolescents in: the development of an adolescent health indicator framework for population-based settings. EClinicalMedicine 2023; 61:102067. [PMID: 37448809 PMCID: PMC10336247 DOI: 10.1016/j.eclinm.2023.102067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Changing realities in low- and middle-income countries (LMICs) in terms of inequalities, urbanization, globalization, migration, and economic adversity shape adolescent development and health, as well as successful transitions between adolescence and young adulthood. It is estimated that 90% of adolescents live in LMICs in 2019, but inadequate data exist to inform evidence-based and concerted policies and programs tailored to address the distinctive developmental and health needs of adolescents. Population-based data surveillance such as Health and Demographic Surveillance Systems (HDSS) and school-based surveys provide access to a well-defined population and provide cost-effective opportunities to fill in data gaps about adolescent health and well-being by collecting population-representative longitudinal data. The Africa Research Implementation Science and Education (ARISE) Network, therefore, systematically developed adolescent health and well-being indicators and a questionnaire for measuring these indicators that can be used in population-based LMIC settings. We conducted a multistage collaborative and iterative process led by network members alongside consultation with health-domain and adolescent health experts globally. Seven key domains emerged from this process: socio-demographics, health awareness and behaviors; nutrition; mental health; sexual and reproductive health; substance use; and healthcare utilization. For each domain, we generated a clear definition; rationale for inclusion; sub-domain descriptions, and a set of questions for measurement. The ARISE Network will implement the questionnaire longitudinally (i.e., at two time-points one year apart) at ten sites in seven countries in sub-Saharan Africa and two countries in Asia. Integrating the questionnaire within established population-based data collection platforms such as HDSS and school settings can provide measured experiences of young people to inform policy and program planning and evaluation in LMICs and improve adolescent health and well-being.
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Affiliation(s)
- Sachin Shinde
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, USA
| | - Guy Harling
- Institute of Global Health, University College of London, United Kingdom
- Africa Health Research Institute, South Africa
- Department of Epidemiology, T. H. Chan School of Public Health, Harvard University, USA
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, South Africa
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, South Africa
| | - Nega Assefa
- College of Health and Medical Sciences, Harmaya University, Ethiopia
| | - Till Bärnighausen
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, USA
- Africa Health Research Institute, South Africa
- Heidelberg Institute of Global Health, Heidelberg University, Germany
| | | | - Angela Chukwu
- Department of Statistics, University of Ibadan, Nigeria
| | - Anne Marie Darling
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, USA
| | - Adom Manu
- Department of Population, Family, and Reproductive Health, University of Ghana, Ghana
| | | | | | - Jabulani Ncayiyana
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Lina Nurhussien
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, USA
| | | | - Kun Tang
- Vanke School of Public Health, Tsinghua University, China
| | - Wafaie Fawzi
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, USA
- Department of Epidemiology, T. H. Chan School of Public Health, Harvard University, USA
- Department of Nutrition, T. H. Chan School of Public Health, Harvard University, USA
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Allen CK, Assaf S, Namaste S, Benedict RK. Estimates and trends of zero vegetable or fruit consumption among children aged 6-23 months in 64 countries. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001662. [PMID: 37368873 DOI: 10.1371/journal.pgph.0001662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Children require a diverse diet, that includes vegetables and fruits, to support growth and development and prevent non-communicable diseases. The WHO-UNICEF established a new infant and young child feeding (IYCF) indicator: zero vegetable or fruit (ZVF) consumption among children aged 6-23 months. We estimated the prevalence, trends, and factors associated with ZVF consumption using nationally representative, cross-sectional data on child health and nutrition in low-and-middle-income countries. We examined 125 Demographic and Health Surveys in 64 countries conducted between 2006-2020 with data on whether a child ate vegetables or fruits the previous day. Prevalence of ZVF consumption was calculated by country, region, and globally. Country trends were estimated and tested for statistical significance (p<0.05). Logistic regression analysis was used to examine the relationship between ZVF and child, mother, household, and survey cluster characteristics by world region and globally. Using a pooled estimate of the most recent survey available in each country, we estimate the global prevalence of ZVF consumption as 45.7%, with the highest prevalence in West and Central Africa (56.1%) and the lowest in Latin America and the Caribbean (34.5%). Recent trends in ZVF consumption varied by country (16 decreasing, eight increasing, 14 no change). Country trends in ZVF consumption represented diverse patterns of food consumption over time and may be affected by the timing of surveys. Children from wealthier households and children of mothers who are employed, more educated, and have access to media were less likely to consume ZVF. We find the prevalence of children aged 6-23 months who do not consume any vegetables or fruits is high and is associated with wealth and characteristics of the mother. Areas for future research include generating evidence from low-and-middle-income countries on effective interventions and translating strategies from other contexts to improve vegetable and fruit consumption among young children.
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Affiliation(s)
- Courtney K Allen
- Sociology Department, University of Washington, Seattle, Washington, United States of America
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Shireen Assaf
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Sorrel Namaste
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Rukundo K Benedict
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
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Pemjean I, Mediano F, Ferrer P, Garmendia ML, Corvalán C. Food access, domestic environments, and dietary quality of low-middle income Chilean children during the COVID-19 pandemic. Front Public Health 2023; 11:1164357. [PMID: 37408742 PMCID: PMC10319070 DOI: 10.3389/fpubh.2023.1164357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Food access is associated with dietary quality; however, people living in similar physical environments can have different food access profiles. Domestic environments may also influence how food access relates to dietary quality. We studied food access profiles of 999 low-middle income Chilean families with children during the COVID-19 lockdown and how these profiles relate to dietary quality; secondarily, we also explore the role of the domestic environment in this relationship. Materials and methods Participants of two longitudinal studies conducted in the southeast of Santiago, Chile, answered online surveys at the beginning and end of the COVID-19 pandemic lockdown. Food access profiles were developed by a latent class analysis considering food outlets and government food transfers. Children's dietary quality was estimated by self-reported compliance with the Chilean Dietary Guidelines of Americans (DGA) and daily ultra-processed food (UPF) consumption. Logistic and linear regressions were used to assess the association between food access profiles and dietary quality. Domestic environment data (i.e., the sex of the person who buys food and cooks, meal frequency, cooking skills, etc.) were incorporated in the models to assess their influence on the relationship between food access and dietary quality. Results We have categorized three food access profiles: Classic (70.2%), Multiple (17.9%), and Supermarket-Restaurant (11.9%). Households led by women are concentrated in the Multiple profile, while families from higher income or education levels are focused on the Supermarket-Restaurant profile. On average, children presented poor dietary quality, with a high daily UPF consumption (median = 4.4; IQR: 3) and low compliance with national DGA recommendations (median = 1.2; IQR: 2). Except for the fish recommendation (OR = 1.77, 95% CI:1.00-3.12; p: 0.048 for the Supermarket-Restaurant profile), the food access profiles were poorly associated with children's dietary quality. However, further analyses showed that domestic environment variables related to routine and time use influenced the association between food access profiles and dietary quality. Conclusion In a sample of low-middle income Chilean families, we identified three different food access profiles that presented a socioeconomic gradient; however, these profiles did not significantly explain children's dietary quality. Studies diving deeper into household dynamics might give us some clues on intra-household behaviors and roles that could be influencing how food access relates to dietary quality.
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Affiliation(s)
- Isabel Pemjean
- Doctoral Program in Public Health, School of Public Health, University of Chile, Santiago, Chile
| | - Fernanda Mediano
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, United States
| | - Pedro Ferrer
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - María Luisa Garmendia
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Camila Corvalán
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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Madlala SS, Hill J, Kunneke E, Lopes T, Faber M. Adult food choices in association with the local retail food environment and food access in resource-poor communities: a scoping review. BMC Public Health 2023; 23:1083. [PMID: 37280606 DOI: 10.1186/s12889-023-15996-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/26/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND There is a growing body of research on local retail food environments globally in both urban and rural settings. Despite this, little research has been conducted on adult food choices, local retail environments, and healthy food access in resource-poor communities. The purpose of this study is therefore to provide an overview of the evidence on adult food choices (measured as dietary intake) in association with the local retail food environment and food access in resource-poor communities (defined as low-income communities and/or households). METHODS We searched nine databases for studies published from July 2005 to March 2022 and identified 2426 records in the primary and updated search. Observational studies, empirical and theoretical studies, focused on adults ≤ 65 years, published in English peer-reviewed journals, examining local retail food environments and food access, were included. Two independent reviewers screened identified articles using the selection criteria and data extraction form. Study characteristics and findings were summarized for all studies and relevant themes summarized for qualitative and mixed methods studies. RESULTS A total of 47 studies were included in this review. Most studies were cross sectional (93.6%) and conducted in the United States of America (70%). Nineteen (40.4%) studies assessed the association between food choice outcomes and local retail food environment exposures, and evidence on these associations are inconclusive. Associations of certain food choice outcomes with healthy food retail environments were positive for healthy foods (in 11 studies) and unhealthy foods (in 3 studies). Associations of certain food choice outcomes with unhealthy retail food environment exposures were positive for unhealthy foods in 1 study and negative for healthy foods in 3 studies. In 9 studies, some of the food choice outcomes were not associated with retail food environment exposures. A healthy food store type and lower food prices were found to be major facilitators for healthy food access in resource-poor communities, while cost and transportation were the main barriers. CONCLUSIONS More research is needed on the local retail food environment in communities in low- and middle-income countries to develop better interventions to improve food choices and access to healthy foods in resource-poor communities.
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Affiliation(s)
- Samukelisiwe S Madlala
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
| | - Jillian Hill
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ernesta Kunneke
- Department of Dietetics and Nutrition, University of the Western Cape, Cape Town, South Africa
| | - Tatum Lopes
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa
| | - Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Dietetics and Nutrition, University of the Western Cape, Cape Town, South Africa
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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Uruchima J, Renehan C, Castro N, Cevallos W, Levy K, Eisenberg JNS, Lee GO. A Qualitative Study of Food Choice in Urban Coastal Esmeraldas, Ecuador. Curr Dev Nutr 2023; 7:100093. [PMID: 37234101 PMCID: PMC10206432 DOI: 10.1016/j.cdnut.2023.100093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 01/20/2023] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
Background Constraints on food choice increase risk of malnutrition worldwide. Residents of secondary cities within low- and middle-income countries are a population of particular concern because they often face high rates of food insecurity and multiple nutritional burdens. Within this context, effective and equitable interventions to support healthy diets must be based on an understanding of the lived experience of individuals and their interactions with the food environment. Objectives The primary objectives of this study were to describe considerations that drive household decision making around food choice in the city of Esmeraldas, Ecuador; to identify trade-offs between these considerations; and to understand how an evolving urban environment influences these trade-offs. Methods Semistructured interviews were conducted with 20 mothers of young children to explore drivers in food choice throughout the purchase, preparation, and consumption chain. Interviews were transcribed and coded to identify key themes. Results Personal preference, economic access (costs), convenience, and perceptions of food safety were key influencers of decision making related to food. In addition, concerns about personal safety in the urban environment limited physical access to food. This, combined with the need to travel long distances to obtain desirable foods, increased men's participation in food purchasing. Women's increasing engagement in the workforce also increased men's participation in food preparation. Conclusions Policies to promote healthy food behavior in this context should focus on increasing access to health foods, such as affordable fresh produce, in convenient and physically safe locations. CurrDev Nutr 2023;x:xx.
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Affiliation(s)
- Jessica Uruchima
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Cala Renehan
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Nancy Castro
- Carrera de Nutrición y Dietética, Universidad de San Francisco de Quito, Quito, Ecuador
| | - William Cevallos
- Centro de Biomedicina, Carrera de Medicina, Universidad Central, Quito, Ecuador
| | - Karen Levy
- Department of Environmental and Occupational Health, University of Washington, Seattle, WA, United States
| | - Joseph NS. Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Gwenyth O. Lee
- Rutgers Global Health Institute, Rutgers University, New Brunswick, NJ, United States
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Kinra S, Mallinson PA, Debbarma A, Walls HL, Lieber J, Bhogadi S, Addanki S, Pande R, Kurpad AV, Kannuri NK, Aggarwal S, Kulkarni B, Finkelstein EA, Deo S. Impact of a financial incentive scheme on purchase of fruits and vegetables from unorganised retailers in rural India: a cluster-randomised controlled trial. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 12:100140. [PMID: 37384059 PMCID: PMC10305860 DOI: 10.1016/j.lansea.2022.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/28/2022] [Accepted: 12/22/2022] [Indexed: 06/30/2023]
Abstract
Background Inadequate intake of fruits and vegetables is prevalent in rural areas of India, where around 65% of the population reside. Financial incentives have been shown to increase the purchase of fruits and vegetables in urban supermarkets, but their feasibility and effectiveness with unorganised retailers in rural India is unclear. Methods A cluster-randomised controlled trial of a financial incentive scheme involving ∼20% cashback on purchase of fruits and vegetables from local retailers was conducted in six villages (3535 households). All households in three intervention villages were invited to participate in the scheme which ran for three months (February-April 2021), while no intervention was offered in control villages. Self-reported (pre-intervention and post-intervention) data on purchase of fruits and vegetables were collected from a random sub-sample of households in control and intervention villages. Findings A total of 1109 households (88% of those invited) provided data. After the intervention, the weekly quantity of self-reported fruits and vegetables purchased were (i) 18.6 kg (intervention) and 14.2 kg (control), baseline-adjusted mean difference 4 kg (95% CI: -6.4 to 14.4) from any retailer (primary outcome); and (ii) 13.1 kg (intervention) and 7.1 kg (control), baseline-adjusted mean difference 7.4 kg (95% CI: 3.8-10.9) from local retailers participating in the scheme (secondary outcome). There was no evidence of differential effects of the intervention by household food security or by socioeconomic position, and no unintended adverse consequences were noted. Interpretation Financial incentive schemes are feasible in unorganised food retail environments. Effectiveness in improving diet quality of the household likely hinges on the percentage of retailers willing to participate in such a scheme. Funding This research has been funded by the Drivers of Food Choice (DFC) Competitive Grants Program, which is funded by the UK Government's Department for International Development and the Bill & Melinda Gates Foundation, and managed by the University of South Carolina, Arnold School of Public Health, USA; however, the views expressed do not necessarily reflect the UK Government's official policies.
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Affiliation(s)
- Sanjay Kinra
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | | | - Arindam Debbarma
- Indian School of Business, Hyderabad, 500111, India
- University of Minnesota, Minneapolis, MN, 55455, USA
| | - Helen L. Walls
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Judith Lieber
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Santhi Bhogadi
- Indian Institute of Public Health, Hyderabad, 500033, India
| | | | - Richa Pande
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 50007, India
| | | | | | | | - Bharati Kulkarni
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 50007, India
| | | | - Sarang Deo
- Indian School of Business, Hyderabad, 500111, India
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Rousham E, Clark M, Latham M, Oo SP, Read S, Griffiths P, Blankenship J, Goudet S. Resilience and vulnerabilities of urban food environments in the Asia-Pacific region. MATERNAL & CHILD NUTRITION 2023:e13513. [PMID: 37097115 DOI: 10.1111/mcn.13513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/26/2023]
Abstract
Rapid urbanisation in the Asia-Pacific region is associated with complex changes to urban food environments. The impact of changing food environments on food purchasing and consumption and the diets and nutritional status of vulnerable groups, especially women and young children, is not well researched in low- and middle-income country cities. This paper aimed to examine: the risks and opportunities for healthy diets for low income populations offered by modernising urban centres; the concept of food deserts in relation to urban food environments in the Asia-Pacific region and how these could be mitigated; and measures to strengthen the resilience of food environments in the region using a case study of the impact of COVID-19 on informal food vendors. Our findings indicate that the dynamic changes in urban food environments in the Asia- Pacific region need to be understood by examining not only modern retail food outlets but also wet markets and informal food outlets, including street foods. Efforts should be made to ensure both modern and traditional outlets provide complementary platforms for convenient, affordable and accessible nutritious foods for urban populations. The resilience of urban food environments to environmental, physical and socio-economic shocks can be strengthened by shortening food supply chains and maximising food production in cities. Support mechanisms targeting urban informal food outlets and street vendors can also strengthen resilience and improve food security. Further research is needed on the impact of urbanising food environments on consumer choices, preferences, diets and health outcomes.
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Affiliation(s)
- Emily Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | | | | | | | - Paula Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jessica Blankenship
- Nutrition Section, UNICEF East Asia and the Pacific Regional Office, Bangkok, Thailand
| | - Sophie Goudet
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Nutrition Research, Dikoda, London, UK
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22
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Osei AN, Djekic-Ivankovic M, Larson CP, Agbemafle I, Agbozo F. Effect of school-based nutrition interventions among primary school children in sub-Saharan Africa: a systematic review protocol. BMJ Open 2023; 13:e068901. [PMID: 37072365 PMCID: PMC10124275 DOI: 10.1136/bmjopen-2022-068901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION Preadolescents are passing through an intensive growth and development period that will benefit from healthy eating practices. For those attending school, school environments offer several potential benefits and have been demonstrated to influence the quality of dietary intakes and consequentially, nutritional status of school-aged children (SAC). Considering the amount of time children spend in school and the enormous potential of evidence-based interventions, the purpose of this review is to critically appraise peer-reviewed literature addressing the impact of school-based interventions on the nutritional status of SAC aged 6-12 years in sub-Saharan Africa. METHODS AND ANALYSIS A systematic search will be conducted in the following databases and online search records: Medline, CINAHL, Web of Science, Embase, Global health, Global Index Medicus, Cochrane library, Hinari and Google Scholar using search terms and keywords codeveloped with two librarians. An additional search will also be conducted from the reference list of identified literature. Search results of titles and abstracts will be initially screened for eligibility criteria by two independent reviewers and where there is disagreement, a third reviewer will be consulted. Articles meeting these criteria will then undergo a full-text review for the eligibility and exclusion criteria. The Joanna Briggs Institute critical appraisal tool will be used to assess the risk of bias. Data from articles meeting all study criteria will be extracted, analysed and synthesised. A meta-analysis will also be conducted if sufficient data are available. ETHICS AND DISSEMINATION This systematic review is limited to publicly accessible data bases not requiring prior ethical approval to access. The results of the systematic review will be disseminated through publications in peer-reviewed journals as well as conference and stakeholder presentations. PROSPERO REGISTRATION NUMBER CRD42022334829.
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Affiliation(s)
- Angela Nyamekye Osei
- School of Population and Global Health, McGill University, Montreal, Québec, Canada
| | | | - Charles P Larson
- School of Population and Global Health, McGill University, Montreal, Québec, Canada
| | - Isaac Agbemafle
- Fred N Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Faith Agbozo
- Fred N Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
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Stadlmayr B, Trübswasser U, McMullin S, Karanja A, Wurzinger M, Hundscheid L, Riefler P, Lemke S, Brouwer ID, Sommer I. Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review. Front Nutr 2023; 10:1113013. [PMID: 37113298 PMCID: PMC10126510 DOI: 10.3389/fnut.2023.1113013] [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: 11/30/2022] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.
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Affiliation(s)
- Barbara Stadlmayr
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- World Agroforestry (ICRAF), Nairobi, Kenya
| | - Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | | | | | - Maria Wurzinger
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Laura Hundscheid
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Petra Riefler
- Institute for Marketing and Innovation, Department of Economics and Social Science, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Stefanie Lemke
- Institute for Development Research, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences, Vienna, Austria
- Center for Agroecology, Water and Resilience, Coventry University, Coventry, United Kingdom
| | - Inge D. Brouwer
- Division of Human Nutrition and Health/CGIAR Initiative Sustainable Healthy Diets (SHiFT), Wageningen University, Wageningen, Netherlands
| | - Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education, Krems, Austria
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Aarthi GR, Mehreen Begum TS, Moosawi SA, Kusuma D, Ranjani H, Paradeepa R, Padma V, Mohan V, Anjana RM, Fecht D. Associations of the built environment with type 2 diabetes in Asia: a systematic review. BMJ Open 2023; 13:e065431. [PMID: 37015791 PMCID: PMC10083821 DOI: 10.1136/bmjopen-2022-065431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia. DESIGN Systematic review of the literature. DATA SOURCES Online databases Medline, Embase and Global Health were used to identify peer-reviewed journal articles published from inception to 23 January 2023. ELIGIBILITY CRITERIA Eligible studies included cohort, cross-sectional and case-control studies that explored associations of built environment characteristics with T2D among adults 18 years and older in Asia. DATA EXTRACTION AND SYNTHESIS Covidence online was used to remove duplicates and perform title, abstract and full-text screening. Data extraction was carried out by two independent reviewers using the OVID database and data were imported into MS Excel. Out of 5208 identified studies, 28 studies were included in this systematic review. Due to heterogeneity in study design, built environment and outcome definitions, a semiqualitative analysis was conducted, which synthesised results using weighted z-scores. RESULTS Five broad categories of built environment characteristics were associated with T2D in Asia. These included urban green space, walkability, food environment, availability and accessibility of services such as recreational and healthcare facilities and air pollution. We found very strong evidence of a positive association of particulate matter (PM2.5, PM10), nitrogen dioxide and sulfur dioxide (p<0.001) with T2D risk. CONCLUSION Several built environment attributes were significantly related to T2D in Asia. When compared with Western countries, very few studies have been conducted in Asia. Further research is, therefore, warranted to establish the importance of the built environment on T2D. Such evidence is essential for public health and planning policies to (re)design neighbourhoods and help improve public health across Asian countries. PROSPERO REGISTRATION NUMBER CRD42020214852.
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Affiliation(s)
- Garudam Raveendiran Aarthi
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Thaharullah Shah Mehreen Begum
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
- School of Public Health, Imperial College London, London, UK
| | | | - Dian Kusuma
- Centre for Health Economics and Policy Innovations, Imperial College Business School, London, UK
| | - Harish Ranjani
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajendra Paradeepa
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Venkatasubramanian Padma
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
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Manohar S, Downs S, Shaikh S, Mak S, Sok S, Graham E, Miachon L, Fanzo J. Riverine food environments and food security: a case study of the Mekong River, Cambodia. Bull World Health Organ 2023; 101:140-148. [PMID: 36733629 PMCID: PMC9874365 DOI: 10.2471/blt.22.288830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/14/2022] [Accepted: 11/27/2022] [Indexed: 02/04/2023] Open
Abstract
Rivers are critical, but often overlooked, parts of food systems. They have multiple functions that support the food security, nutrition, health and livelihoods of the communities surrounding them. However, given current unsustainable food system practices, damming and climate change, the majority of the world's largest rivers are increasingly susceptible to environmental degradation, with negative implications for the communities that rely on them. Here we describe the dynamism and multifaceted nature of rivers as food environments (i.e. the place within food systems where people obtain their food) and their role in securing food security including improved diets and overall health. We also provide a conceptual framework that explain rivers as food environments within the broader food system and describe approaches to characterizing these food environments to better inform our understanding of how they influence food security and nutrition outcomes. Applying this framework to the Mekong River in Cambodia, we describe rivers as multifaceted wild food environments embedded within ecosystems, sociocultural and political environments and sectors of influence. We also explain the ways in which individual factors might influence how communities interact with this food environment. Developing and articulating food-related, ecosystem-specific frameworks and their constructs can guide implementation of policies aimed to improve specific public health or environmental sustainability outcomes. Our conceptual framework incorporates the multiple dimensions of rivers, which will aid future work and public health policy framing to better describe, understand and intervene to ensure protection of rivers' biodiversity and ecosystems as well as food security, health and livelihoods.
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Affiliation(s)
- Swetha Manohar
- Global Food Ethics Policy Program, School of Advanced International Studies, 1776 Massachusetts Avenue, WashingtonDC, 20007, United States of America (USA)
| | - Shauna Downs
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, USA
| | - Sabina Shaikh
- Committee on Environment, Geography and Urbanization, University of Chicago, Chicago, USA
| | - Sithirith Mak
- Department of Natural Resource Management, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Serey Sok
- Research Office, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Elizabeth Graham
- Global Food Ethics Policy Program, Johns Hopkins School of Public Health, WashingtonDC, USA
| | - Lais Miachon
- Global Food Ethics Policy Program, Johns Hopkins School of Public Health, WashingtonDC, USA
| | - Jessica Fanzo
- Global Food Ethics Policy Program, School of Advanced International Studies, 1776 Massachusetts Avenue, WashingtonDC, 20007, United States of America (USA)
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O'Meara L, de Bruyn J, Dominguez-Salas P, Hope T, Turner C, Stoynova M, Wellard K, Ferguson E. Characteristics of food environments that influence food acquisition and diets of women in low-and middle-income countries: a scoping review protocol. JBI Evid Synth 2023:02174543-990000000-00123. [PMID: 36642974 DOI: 10.11124/jbies-22-00299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This scoping review aims to identify and map characteristics of food environments that influence food-acquisition practices and dietary intake of women of reproductive age in low- and middle-income countries. INTRODUCTION Due to the disproportionate burden of malnutrition on women of reproductive age in low- and middle-income countries, accelerated progress in improving women's nutrition is required to achieve Sustainable Development Goal 2 "Zero hunger" by 2030. Food environments are increasingly recognized as the key interface between consumers and food systems; however, little is known about the characteristics that influence women's food acquisition and diets in low- and middle-income countries, especially during physiological stages of heightened nutritional requirement, such as pre-conception, pregnancy, and breastfeeding. INCLUSION CRITERIA This review will consider quantitative, qualitative, mixed method, or review studies that report on the influence of food environment characteristics on food-acquisition practices and dietary intakes of women aged 15 to 49 years in any low- and middle-income country, as defined by the World Bank in 2021. Studies published in English, Spanish, Portuguese, or French from January 2010 onwards will be included. METHODS Twenty-one databases across EBSCO, Web of Science Core Collection, and PubMed will be searched. Screening, selection, and data extraction will be performed in duplicate by 2 members of the team, with any discrepancies resolved by group discussion. The patterns of food-acquisition and dietary intake in relation to food environment characteristics will be charted, mapped, and summarized in tabular and graphical formats. Findings will inform the refinement of effective food environment conceptual frameworks for this nutritionally vulnerable group.
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Affiliation(s)
- Lydia O'Meara
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom
| | - Julia de Bruyn
- ARC Centre of Excellence for Children and Families over the Life Course, University of Melbourne, Melbourne, Vic, Australia
| | - Paula Dominguez-Salas
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Tammy Hope
- School of Health, Medical and Applied Sciences, CQUniversity, Bundaberg, Queensland, Australia
| | - Christopher Turner
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom
| | - Mina Stoynova
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom
| | - Kate Wellard
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom
| | - Elaine Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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de Jager I, Harrison M, Wit RF, Sonneveld A, Hesen R, Uyar BTM, Verger EO, Ramos AI, Vargas M, Wijesinha‐Bettoni R, Hachem F, Brouwer ID. PROTOCOL: Measuring diet-related consumer behaviours relevant to low- and middle-income countries to advance food systems research: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1283. [PMID: 36908847 PMCID: PMC9551704 DOI: 10.1002/cl2.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a evidence and gap map. The main objective of this evidence and gap map is to provide access to a systematic overview of available indicators for diet-related consumer behaviours relevant to LMICs, to support policy makers and researchers to develop, monitor and revise food policies and programmes to leverage food systems transformations for healthier and more sustainable diets.
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Affiliation(s)
- Ilse de Jager
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenThe Netherlands
| | - Megan Harrison
- Food and Nutrition DivisionFood and Agriculture Organization of the United NationsRomeItaly
| | - Renate F. Wit
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenThe Netherlands
| | - Anne Sonneveld
- Wageningen Economic ResearchWageningen University and ResearchWageningenThe Netherlands
| | - Rosil Hesen
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenThe Netherlands
| | - Betül T. M. Uyar
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenThe Netherlands
| | - Eric O. Verger
- MoISA, Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | - Ana Islas Ramos
- Food and Nutrition DivisionFood and Agriculture Organization of the United NationsRomeItaly
| | - Melissa Vargas
- Food and Nutrition DivisionFood and Agriculture Organization of the United NationsRomeItaly
| | | | - Fatima Hachem
- Food and Nutrition DivisionFood and Agriculture Organization of the United NationsRomeItaly
| | - Inge D. Brouwer
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenThe Netherlands
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28
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Pikosky MA, Ragalie-Carr J, Miller GD. Recognizing the importance of protein quality in an era of food systems transformation. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.1012813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A transformation of current food systems is needed to nourish the growing global population in more sustainable ways. To support this, some are advocating for a shift to plant-based or -exclusive diets. These recommendations – typically borne out of concerns for the environment – often fail to account for unintended nutritional consequences, which could be particularly pronounced for protein intake. While there is enough protein to meet current global needs, the issue of protein quality is often overlooked and oversimplified. High-quality protein, including from animal source foods (ASF), is needed to meet nutritional demands in low- and middle-income countries (LMIC), particularly among vulnerable population groups. In high-income countries (HIC), protein quality is important for at-risk populations who have higher protein requirements and lower energy and/or protein intakes. Further, as the global population increases, driven primarily by population growth in LMIC, it is possible that protein production will need to increase in HIC to support exports to help feed the global population. The global dialogue and resulting dietary recommendations must therefore become more nuanced to consider the interaction between nutritional value and environmental impact to help better reflect trade-offs across multiple domains of sustainability. Nutritional life cycle assessments are one way to help accomplish this nuance and evaluate how all types of food production systems should be refocused to improve their environmental efficiency and nutritional impact.
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29
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Type, density, and healthiness of food-outlets in a university foodscape: a geographical mapping and characterisation of food resources in a Ghanaian university campus. BMC Public Health 2022; 22:1912. [PMID: 36229836 PMCID: PMC9563792 DOI: 10.1186/s12889-022-14266-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Food environments are viewed as the interface where individuals interact with the wider food system to procure and/or consume food. Institutional food environment characteristics have been associated with health outcomes including obesity and nutrition-related non-communicable diseases (NR-NCDs) in studies from high-income countries. The objectives of this study were (1) to map and characterise the food-outlets within a Ghanaian university campus; and (2) to assess the healthiness of the food outlets. Methods Data collection was undertaken based on geospatial open-source technologies and the collaborative mapping platform OpenStreetMap using a systematic approach involving three phases: remote mapping, ground-truthing, and food-outlet survey. Spatial analyses were performed using Quantum Geographical Information System (QGIS) and comprised kernel density, buffer, and average nearest neighbour analyses to assess outlet distribution, density, and proximity. A classification system was developed to assess the healthiness of food-outlets within the University foodscape. Results Food-outlets were unevenly distributed over the University foodscape, with many outlets clustered closer to student residencies. Informal food-outlets were the most frequent food-outlet type. Compared to NCD-healthy food-outlets, NCD-unhealthy food-outlets dominated the foodscape (50.7% vs 39.9%) with 9.4% being NCD-intermediate, suggesting a less-healthy university foodscape. More NCD-unhealthy food outlets than NCD-healthy food outlets clustered around student residences. This difference was statistically significant for food outlets within a 100-m buffer (p < 0.001) of student residence and those within 100 and 500 m from departmental buildings/lecture halls (at 5% level of significance). Conclusion Further action, including research to ascertain how the features of the University’s food environment have or are influencing students’ dietary behaviours are needed to inform interventions aimed at creating healthier foodscapes in the study University and other campuses and to lead the way towards the creation of healthy food environments at the home, work, and community levels. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14266-7.
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Chaparro MP, Lopez MA, Hernandez J, Brewer JD, Santos MP, Paz-Soldan VA. The association between the observed and perceived neighbourhood food environment and household food insecurity in a low-income district in Lima, Peru. J Nutr Sci 2022; 11:e86. [PMID: 36304828 PMCID: PMC9554428 DOI: 10.1017/jns.2022.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 12/14/2022] Open
Abstract
The objective of the present study was to assess the association between the observed and perceived food environment and food insecurity among households with children <18 years in Lima, Peru. This was a cross-sectional study including an income-stratified random sample of households (n 329) in Villa el Salvador, a low-income district in Lima, Peru. Data were collected with a household questionnaire - including the Household Food Insecurity Access Scale (HFIAS) and the University of Pennsylvania's Perceived Nutrition Environment Survey (NEMS-P) - and a neighbourhood food outlet census, including recording of food outlets' GPS coordinates. Three-quarters of the households interviewed were food insecure. Compared with food secure households and adjusting for socio-demographic covariates, food insecure households were more likely to disagree to having easy access (OR 5⋅4; 95 % CI 2⋅1, 13⋅4), high quality (OR 3⋅1; 95 % CI 1⋅7, 5⋅5) and variety (OR 2⋅5; 95 % CI 1⋅4, 4⋅6) of fresh fruits and vegetables in their neighbourhood. About 60 % (513 out of 861) of the food outlets identified in participants' neighbourhoods were classified as fresh, including markets, bodegas, and fruit and vegetable vendors. There was no difference in distance to fresh food outlets by household food insecurity; all households were on average within 52-62 m from a fresh food outlet (~2-min walk). Despite negative perceptions of their neighbourhood food environment, food insecure households had similar physical access to fresh food sources than their food secure counterparts. Thus, changes to the food environment may not alleviate food insecurity in urban poor areas of Peru.
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Affiliation(s)
- M. Pia Chaparro
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210-16, mail code #8319, New Orleans, LA 70112, USA
| | - Miguel A. Lopez
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210-16, mail code #8319, New Orleans, LA 70112, USA
| | - Julie Hernandez
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210, New Orleans, LA 70112, USA
| | - Jessica D. Brewer
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210-16, mail code #8319, New Orleans, LA 70112, USA
| | - Maria P. Santos
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2000, New Orleans, LA 70112, USA
| | - Valerie A. Paz-Soldan
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., suite 2210, New Orleans, LA 70112, USA
- Asociación Benéfica PRISMA, Av. Santo Toribio 115, 5to piso, San Isidro, Lima, Peru
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Akter MS, Talsma EF, Feskens EJM, Thilsted SH, Rasheed S. How did the COVID-19 pandemic affect food environment, food purchase, and fish consumption among low-income urban households in Bangladesh-A path analysis. Front Public Health 2022; 10:994236. [PMID: 36187611 PMCID: PMC9521681 DOI: 10.3389/fpubh.2022.994236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/18/2022] [Indexed: 01/26/2023] Open
Abstract
Background Animal source foods, especially fish is the most commonly consumed and an important source of macro and micronutrients in the diet of the urban low-income residents. The COVID-19 pandemic has disrupted the food environment in Bangladesh but little is known about how food access and food prices (affordability) have affected the purchase and consumption of fish. The objective of the study was to understand the impact of the first wave of the COVID-19 pandemic on urban food environment with a specific focus on fish consumption. Methods A cross-sectional survey was conducted among 586 homogeneous adults (288 females and 298 males) from separate households from five informal settlements in Dhaka city, Bangladesh during October-November 2020. Data were collected on: (1) food access and affordably; and (2) food purchase and fish consumption. The associations between food access, price, food purchase, and fish consumption were evaluated using path analysis. Results The majority of respondents reported that food access was more difficult, food prices increased, and food purchase decreased during the COVID-19 pandemic compared to pre-COVID (84-89% of respondents). Fish and meat were more difficult to access, more expensive and purchased less compared to other foods (74-91% of respondents). Compared to pre-COVID period, households consumed less fish during the COVID-19 pandemic, and reported compromised the variety and quality of fish. In the path analysis, food access was associated with food purchase (b = 0.33, p < 0.001). Food purchase was associated with quantity, variety, and quality of fish consumed. Food price was inversely associated with the quality of fish consumed (b = -0.27, p < 0.001). Conclusions The COVID-19 pandemic negatively affected the food environment, particularly food access, price (affordability), purchase, and consumption, especially of fish. Limited food access negatively affected the quantity, variety and quality of fish consumed. An increase in food prices directly affected the quality of fish consumed. Policy actions are essential to ensure equal access to nutritious foods, such as fish. These policies need to focus on diversity and quality along with preventing increases in food prices during emergencies to mitigate future threats to the nutrition and health of the urban low-income residents.
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Affiliation(s)
- Mahsina Syeda Akter
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands,*Correspondence: Mahsina Syeda Akter
| | - Elise F. Talsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | | | - Sabrina Rasheed
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Erzse A, Rwafa-Ponela T, Kruger P, Wayas FA, Lambert EV, Mapa-Tassou C, Ngwa E, Goldstein S, Foley L, Hofman KJ, Teguia S, Oni T, Assah F, Shung-King M, Abdool Karim S. A Mixed-Methods Participatory Intervention Design Process to Develop Intervention Options in Immediate Food and Built Environments to Support Healthy Eating and Active Living among Children and Adolescents in Cameroon and South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10263. [PMID: 36011902 PMCID: PMC9408217 DOI: 10.3390/ijerph191610263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/05/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Rates of obesity and related non-communicable diseases are on the rise in sub-Saharan Africa, associated with sub-optimal diet and physical inactivity. Implementing evidence-based interventions targeting determinants of unhealthy eating and physical inactivity in children and adolescents' immediate environments is critical to the fight against obesity and related non-communicable diseases. Setting priorities requires a wide range of stakeholders, methods, and context-specific data. This paper reports on a novel participatory study design to identify and address contextual drivers of unhealthy eating and physical inactivity of children and adolescents in school and in their home neighborhood food and built environments. We developed a three-phase mixed-method study in Cameroon (Yaoundé) and South Africa (Johannesburg and Cape Town) from 2020-2021. Phase one focused on identifying contextual drivers of unhealthy eating and physical inactivity in children and adolescents in each setting using secondary analysis of qualitative data. Phase two matched identified drivers to evidence-based interventions. In phase three, we worked with stakeholders using the Delphi technique to prioritize interventions based on perceived importance and feasibility. This study design provides a rigorous method to identify and prioritize interventions that are tailored to local contexts, incorporating expertise of diverse local stakeholders.
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Affiliation(s)
- Agnes Erzse
- SAMRC/Wits Centre for Health Economics and Decision Science—PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa
| | - Teurai Rwafa-Ponela
- SAMRC/Wits Centre for Health Economics and Decision Science—PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa
| | - Petronell Kruger
- SAMRC/Wits Centre for Health Economics and Decision Science—PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa
| | - Feyisayo A. Wayas
- Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Estelle Victoria Lambert
- Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa
| | - Clarisse Mapa-Tassou
- Health of Population in Transition Research Group, University of Yaoundé, Yaoundé P.O. Box 812, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang P.O. Box 67, Cameroon
| | - Edwin Ngwa
- Health of Population in Transition Research Group, University of Yaoundé, Yaoundé P.O. Box 812, Cameroon
| | - Susan Goldstein
- SAMRC/Wits Centre for Health Economics and Decision Science—PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK
| | - Karen J. Hofman
- SAMRC/Wits Centre for Health Economics and Decision Science—PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa
| | - Stephanie Teguia
- Health of Population in Transition Research Group, University of Yaoundé, Yaoundé P.O. Box 812, Cameroon
| | - Tolu Oni
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK
| | - Felix Assah
- Health of Population in Transition Research Group, University of Yaoundé, Yaoundé P.O. Box 812, Cameroon
| | - Maylene Shung-King
- Health Policy and Systems Division, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Safura Abdool Karim
- SAMRC/Wits Centre for Health Economics and Decision Science—PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa
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Rodríguez-Guerra AI, López-Olmedo N, Medina C, Hernández-Alcaraz C, Ortega-Avila AG, Barquera S. Association between density of convenience and small grocery stores with diet quality in adults living in Mexico City: A cross sectional study. Front Public Health 2022; 10:857754. [PMID: 35991079 PMCID: PMC9389155 DOI: 10.3389/fpubh.2022.857754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/19/2022] [Indexed: 12/03/2022] Open
Abstract
There is evidence of the association between different retail stores and food consumption, yet research is still limited in low- and medium-income countries, where the context of the food retail environment is different from that observed in high-income countries. Specifically, less is known about how convenience and small grocery stores, which offer products with immediate access, are associated with the diet as a whole. The present study assessed the association between density of convenience and small grocery stores and diet quality in adults from the Mexico City Representative Diabetes Survey 2015. A final sample size of 1,023 adults aged 20–69 years was analyzed. The density of stores was measured using Euclidean buffers within 500 meters of each participant's home. The Mexican Alternate Healthy Eating Index (MxAHEI) was used to assess diet quality. Multivariable Poisson models were used to test the association of convenience and small grocery stores densities with the MxAHEI. Although our results were not statistically significant, we observed a lower diet quality score among adults from Mexico City living in areas with a higher density of small grocery and convenience stores. More research is needed on the influence of environmental food retail on food consumption.
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Affiliation(s)
| | - Nancy López-Olmedo
- Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
- *Correspondence: Nancy López-Olmedo
| | - Catalina Medina
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - César Hernández-Alcaraz
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Ana G. Ortega-Avila
- Institute of Geography, National Autonomous University of Mexico, Ciudad de Mexico, Mexico
| | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
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Babashahi M, Omidvar N, Joulaei H, Zargaraan A, Veisi E, Kelishadi R. Food Products with the Child-Targeted Packaging in Food Stores around Primary Schools in Tehran, Iran. JOURNAL OF PREVENTION (2022) 2022; 43:513-527. [PMID: 35476310 DOI: 10.1007/s10935-022-00679-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
The local retail food environment around schools can have an important role in encouraging children to low-quality food choices; and may act as a potential risk factor in their diet. Thus, evaluating the food environment is essential for adopting policies and programs that support healthy nutrition in children. This study aimed to investigate the frequency and nutritional characteristics of packaged processed/ultra-processed food and beverage products with child-oriented marketing attributes in food stores around primary schools in Tehran, Iran. This cross-sectional study was conducted on 239 food stores located within a 500-meter buffer around 64 primary schools in Tehran province. The presence of marketing strategies directed at children and nutrition information from traffic light labels of packaged foods available in these stores were extracted. Data were analyzed overall and separately for the subset of foods placed on front shelves at the entrance of stores. Among 445 discrete food products marketed to children via their packaging, 198 (44.49%) were placed on shelves in front of the stores entrance. Potato chips and bulky cereals group had the highest energy density (507.15 ± 44.05 Kcal/100gr). Due to the color code of traffic light labels, 100% of fruit juices had high levels of sugar. Of potato chips and bulky cereals, 89.38% were assigned a red color traffic light for total fat levels. Moreover, 62.50% of processed fruit and vegetables contained high levels of salt. The level of trans-fatty acids were not high in any of the food products. The high amount of sugar, salt, and fat in a remarkable proportion of food products marketed to children can be considered a risk factor for children's health. Initiation and implementation of appropriate policies to control the food environment around schools in Iran is recommended.
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Affiliation(s)
- Mina Babashahi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elnaz Veisi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Sousa S, de Morais IL, Albuquerque G, Gelormini M, Filipović-Hadžiomeragić A, Stojisavljevic D, Damasceno A, Moreira P, Breda J, Lunet N, Padrão P. Street Food and Takeaway Food Purchasing Patterns in Bosnia and Herzegovina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159086. [PMID: 35897456 PMCID: PMC9330047 DOI: 10.3390/ijerph19159086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to describe street food and takeaway food purchasing patterns in Sarajevo and Banja Luka, throughout the day and by city location. A cross-sectional evaluation of street food and takeaway food customers was conducted in 2017. All eligible vending sites (n = 348) in the vicinity of selected markets and bus stops were included. Data on the food items purchased, and time and geographic location of the purchases were collected. A total of 755 customers purchased 929 food items. Takeaway venues showed higher customer influx (5.0 vs. 2.0 customers observed per 10 min of observation, p < 0.001) and buying rates (6.7 vs. 2.0 items bought per 10 min of observation, p < 0.001; 1.5 vs. 1.0 items bought per customer, p < 0.001) than street food sites. These rates were higher in city peripheries for street food venues, and in city centres for takeaway establishments. The purchase of industrial food products prevailed throughout the day in street food venues, whereas most takeaway purchases comprised homemade foods, with or without industrial beverages. The proportion of customers buying foods and beverages together was higher in takeaway venues (15.3% vs. 6.0%, p < 0.001), especially during lunchtime and in city centres. In street food vending sites, sweet and savoury snacks seemed to be preferred in the afternoon, whereas in takeaway food establishments, savoury pastries and main dishes were mostly purchased at breakfast or lunch, and bread during the morning. Soft drinks and industrial juices were frequently purchased in both types of vending site and at all hours of the day, particularly in the afternoon. Our findings provide an overview of street food and takeaway food buying habits and consumer demands in these cities, reflecting local food culture and dietary behaviours. The identification of the meal contexts and city sub-regions in which specific purchasing practices emerge point to potential priority targets. These insights can be useful when designing interventions adapted to the specificities of these food environments and the food habits of customers.
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Affiliation(s)
- Sofia Sousa
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; (S.S.); (G.A.); (A.D.); (P.M.); (N.L.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal
| | - Inês Lança de Morais
- Nutrition, Physical Activity and Obesity Programme, Division of Noncommunicable Diseases and Life-Course, World Health Organization (WHO) Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark; (I.L.d.M.); (M.G.)
| | - Gabriela Albuquerque
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; (S.S.); (G.A.); (A.D.); (P.M.); (N.L.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Marcello Gelormini
- Nutrition, Physical Activity and Obesity Programme, Division of Noncommunicable Diseases and Life-Course, World Health Organization (WHO) Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark; (I.L.d.M.); (M.G.)
| | - Aida Filipović-Hadžiomeragić
- Public Health Institute of the Federation of Bosnia and Herzegovina, Tahtali Sokak 17, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Dragana Stojisavljevic
- Public Health Institute of the Republika Srpska, Jovana Dučića 1, 78000 Banja Luka, Bosnia and Herzegovina;
- Faculty of Medicine, University of Banja Luka, 14 Save Mrkalja, 78000 Banja Luka, Bosnia and Herzegovina
| | - Albertino Damasceno
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; (S.S.); (G.A.); (A.D.); (P.M.); (N.L.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Faculdade de Medicina, Universidade Eduardo Mondlane, Avenida Salvador Allende 702, Maputo 1100, Mozambique
| | - Pedro Moreira
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; (S.S.); (G.A.); (A.D.); (P.M.); (N.L.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal
- Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - João Breda
- WHO Regional Office for Europe, 10675 Athens, Greece;
| | - Nuno Lunet
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; (S.S.); (G.A.); (A.D.); (P.M.); (N.L.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Patrícia Padrão
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; (S.S.); (G.A.); (A.D.); (P.M.); (N.L.)
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal
- Correspondence: ; Tel.: +351-225074320; Fax: +351-225074329
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Vignola R, Oosterveer P. Street food environmental sustainability in a urbanizing global south: A social practice perspective. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.910547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Selling and buying street food is an every-day practice for millions of urban poor living in cities across Africa, Asia, and Latin America. These practices are embedded in social routines (e.g., for producing food to consuming it and disposing waste) that are dependent on and influence the environmental performance of urban food systems as agents make use of resources (e.g., soil, water, energy, ingredients, etc.). A social science theory being increasingly applied to food systems and sustainability transformations, social practice theory focuses attention on the cultural, institutional, and physical embeddedness of social routines that characterize street food systems. It allows identifying barriers and lock-ins as well as opportunities to de-routinize unsustainable practices and help visualize the linkages and opportunities to nudge the routinization of sustainable practices. Through three examples of social practices in street food systems of the global south, we illustrate those linkages and propose a research agenda to step up the use of these perspective in promoting the contribution of urban street food system to sustainability.
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Characterizing Retail Food Environments in Peri-Urban Pakistan during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148614. [PMID: 35886466 PMCID: PMC9324779 DOI: 10.3390/ijerph19148614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: To date, there are limited data in low- and middle-income countries (LMICs) that collect, monitor, and evaluate food environments in standardized ways. The development of a pilot survey tool, tailored to LMICs and focused on retail food environments, is necessary for improving public health nutrition. (2) Methods: A novel survey tool was developed and piloted in a sample of village retail food environments (n = 224) in Matiari, Pakistan between October 2020 to April 2021. Villages were randomly selected, and food outlets were surveyed within a 500-m radius from each village center. Descriptive statistics (counts and percentages) were used to describe the characteristics of food outlets and the availability of food. To test whether there was a difference in characteristics or in the mean of number of healthy, unhealthy, and total food items available by village size, a χ2 test or one-way ANOVA was conducted, respectively. (3) Results: In total, 1484 food outlets were surveyed for food accessibility, availability, and promotion across small (n = 54), medium (n = 112), and large villages (n = 58). In small and medium-sized villages, mobile food vendors were the predominant food outlet type (47.8% and 45.1%, respectively), whereas in large villages, corner stores (36%) were more prominent. The mean number of total food items (p < 0.006) and unhealthy food items (p < 0.001) available in food outlets differed by village size. The proportion of food outlets with available fruits, meat and poultry, water, and sugar-sweetened beverages also differed by village size (p < 0.001). (4) Conclusions: This study informs the global evidence gap in the current understanding of food environments in various ethnically diverse and dynamic LMICs, and the developed methodology will be useful to other LMICs for measuring and monitoring the food environment, especially among vulnerable population groups. This work complements current national and provincial survey efforts in Pakistan.
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Konapur A, Gavaravarapu SM, Nair KM. The 5 A's Approach for Contextual Assessment of Food Environment. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:621-635. [PMID: 35623938 DOI: 10.1016/j.jneb.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To develop a context-specific methodology to assess the 5 A's of food environment: availability, accessibility, affordability, acceptability, and accommodation. DESIGN Cross-sectional mixed-methods study. Availability of foods was assessed by on-site observation and interviewing vendors. To assess accessibility, buffer zones around food stores were created using geographic information systems. Affordability was controlled by selecting participants from the middle-income group. Accommodation and acceptability were assessed by interviewing vendors and caregivers. SETTING Villages of Ghatkesar subdistrict (n = 4), Telangana, South India. PARTICIPANTS Caregivers of children aged 6-10 years (n = 160) and food vendors (n = 68). ANALYSIS The quality of the 5 A's was graded on the basis of concurrence between actual and perceived measures. RESULTS The actual and perceived 5 A's for semiperishable foods matched, and hence the food environment was graded as good across the villages. However, for perishable foods, the food environment was graded as poor with respect to accommodation and acceptability in all villages; and with respect to availability and affordability in at least 2 villages as the actual and perceived measures did not match. CONCLUSIONS AND IMPLICATIONS This study demonstrated the use of context-specific methods to assess the 5 key dimensions of the food environment, which can be attempted in other contexts with suitable modifications.
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Affiliation(s)
- Archana Konapur
- Nutrition Information, Communication, and Health Education Division, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad, Telangana, India
| | - SubbaRao M Gavaravarapu
- Nutrition Information, Communication, and Health Education Division, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad, Telangana, India.
| | - Krishnapillai Madhavan Nair
- Micronutrient Research Group, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad, Telangana, India
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Cong N, Zhao A, Kwan MP, Yang J, Gong P. An Indicator Measuring the Influence of the Online Public Food Environment: An Analytical Framework and Case Study. Front Nutr 2022; 9:818374. [PMID: 35845771 PMCID: PMC9281549 DOI: 10.3389/fnut.2022.818374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
The online public food environment (OPFE) has had a considerable impact on people's lifestyles over the past decade; however, research on its exposure is sparse. The results of the existing research on the impact of the food environment on human health are inconsistent. In response to the lack of food elements in the definition of the food environment and the lack of a clear method to assess the health attributes and the impact degree of the food environment, we proposed a new analytical framework based on the latest disease burden research, combining the characteristics of China's current food environment, from the perspective of environmental science. We redefined the food environment and proposed that food and its physical space are two core elements of the food environment. Accordingly, we extracted four domains of characteristics to describe the basic components of the food environment. Using the sales records, we designed an approach by referring to the standard process of environmental health indicators, including the health attributes and the impact degree of the food environment, to measure the OPFE of takeaway food outlets. Further, we conducted a case study and extracted three domains of characteristics for more than 18,000 effective takeaway meals from 812 takeaway food outlets located in 10 administrative subdivisions in the Haidian District and Xicheng District of Beijing Municipality. The results showed that more than 60% of single meals sold by takeaway food outlets were considered as healthy, and only 15% of takeaway food outlets sold healthy meals exclusively. Additionally, there were significant differences in health effects among different types of food environments, and high-risk areas of different types of food environments can be spatially identified. Compared with the counting method in the availability of food environment, the proposed new approach can depict food environment characteristics not only in the macro-scale like the counting method but also in the meal-scale. The indicators could be useful for large-scale and long-term monitoring of food environmental changes due to their simple calculation and design depending on the food delivery platform.
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Affiliation(s)
- Na Cong
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Mei-Po Kwan
- Department of Geography and Resource Management and Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jun Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing, China
| | - Peng Gong
- Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing, China
- Department of Geography and Earth Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- *Correspondence: Peng Gong
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Food Environments and Their Influence on Food Choices: A Case Study in Informal Settlements in Nairobi, Kenya. Nutrients 2022; 14:nu14132571. [PMID: 35807752 PMCID: PMC9268418 DOI: 10.3390/nu14132571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
The food environments that people have access to shape their food choices. The purpose of this study was to use mixed methods to characterize the external food environment in informal settlements in Nairobi, Kenya and to examine the individual factors that influence the way in which women interact with those environments to make food choices. We used a combination of food environment assessments (vendor mapping, collection of food prices, food quality assessments) and five focus group discussions with women (n = 26) in four villages within two informal settlements in Nairobi (Mukuru and Kibera) to better understand the drivers of food choice. We found a large number (n = 1163) of vendors selling a variety of food within the settlements. The highest number of vendors were selling fruits and/or vegetables; however, there was limited diversity of fruits available. Animal-source foods were considered relatively expensive as compared to plant-based foods, including prepared fried snacks. We found that the way women interacted with their food environments was influenced by individual factors such as income, time, convenience, and preferences. Our findings suggest that interventions targeting both the external food environment as well as individual factors such as income will be necessary to support healthy diets among low-income populations living in informal settlements in Kenya.
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School Food Environment in Urban Zambia: A Qualitative Analysis of Drivers of Adolescent Food Choices and Their Policy Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127460. [PMID: 35742706 PMCID: PMC9224334 DOI: 10.3390/ijerph19127460] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023]
Abstract
Identifying context specific points for reforming policy to promote healthier food environments and consumer behavior in critical life stages like adolescence is crucial in addressing the double burden of malnutrition. Using a qualitative study design, we conducted 20 focus group discussions with grade 10 pupils from ten secondary schools in Lusaka. Turner’s framework which conceptualizes the food environment into two domains—the external domain (availability, pricing, vendor and product properties, and marketing and regulation of food) and the internal domain (accessibility, affordability, convenience, and desirability of food)—was used to guide thematic data analysis and results interpretation. Adolescents stated their food choices are largely based on personal preference linked to the need for social acceptability among peers. Adolescents felt their food choice is limited to ‘cheap junk foods’ which are affordable and readily available at school. Healthy foods like fruits were said to be inaccessible and unaffordable by the majority of adolescents. Some adolescents stated they were attracted to certain foods by adverts they see on TV and social media. School food environments in urban Lusaka do not support healthy food choices. Policy reforms are required to increase access to affordable healthy food options in schools, and to curb the indiscriminate marketing of unhealthy foods to adolescents.
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Golfin F, Murillo C, Jensen ML, Frongillo EA. Adaptation and Validation of the Nutrition Environment Measures Survey in Stores (NEMS-S) in Costa Rica. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2088262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Francesca Golfin
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | - Carla Murillo
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | - Melissa L. Jensen
- School of Nutrition, University of Costa Rica, San José, Costa Rica
- UConn Rudd Center for Food Policy and Health, Hartford, Connecticut, USA
| | - Edward A. Frongillo
- Arnold School of Public Health, University of South Carolina Columbia, South Carolina, USA
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Cawley J, Daly M, Thornton R. The effect of beverage taxes on youth consumption and body mass index: Evidence from Mauritius. HEALTH ECONOMICS 2022; 31:1033-1045. [PMID: 35297120 DOI: 10.1002/hec.4497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
Taxes on sugar-sweetened beverages (SSBs) are relatively new and there is limited evidence about their impact on SSB consumption or body mass index (BMI) (as opposed to prices, purchases, or sales), their impact on youth (as opposed to adults), or their impact in non-Western nations. This paper adds to the evidence across all these dimensions by estimating the effect of an SSB tax on SSB consumption and the BMI of youth in Mauritius, an island nation in the Indian Ocean, which we compare to Maldives, another island nation which did not implement an SSB tax during the time of our data. Results of difference-in-differences models indicate that the tax in Mauritius had no detectable impact on the consumption of SSBs or the BMI of the pooled sample of boys and girls. However, models estimated separately by sex indicate that the probability that boys consumed SSBs fell by 9.4 percentage points (11%). These are among the first estimates of the effect of SSB taxes on youth consumption and contribute to the limited evidence on the impact of SSB taxes on weight, and in non-Western countries.
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Affiliation(s)
- John Cawley
- Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, New York, USA
| | - Michael Daly
- Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, New York, USA
| | - Rebecca Thornton
- Department of Economics, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Boncyk M, Shemdoe A, Ambikapathi R, Mosha D, Froese SL, Verissimo CK, Mwanyika-Sando M, Killewo J, Leyna GH, Gunaratna NS, Patil CL. Exploring drivers of food choice among PLHIV and their families in a peri-urban Dar es Salaam, Tanzania. BMC Public Health 2022; 22:1068. [PMID: 35637504 PMCID: PMC9150378 DOI: 10.1186/s12889-022-13430-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background A nutritious diet is critical to minimizing disease progression of human immunodeficiency virus (HIV) and maximizing treatment efficacy. In low resource settings, meeting the food preference needs of people living with the HIV (PLHIV) can be achieved with a supportive food environment when HIV status is disclosed. However, less is known about family-level strategies related to building a supportive food environment. The Diet, Environment, and Choices of positive living (DECIDE), a mixed-methods observational study conducted in peri-urban Dar es Salaam, Tanzania, explored food preferences as influenced by the personal, family, and external food domains. Methods We completed a qualitative analysis of data generated from 40 interviews (n = 20 PLHIV and n = 20 family members) aimed at exploring the dynamics of food choice for using a family perspective. We expanded on Turner’s food environment framework and drew on Giddens’ structuration theory to guide our data collection and analysis. Interviews were audio recorded, transcribed, translated from Kiswahili to English, coded, and organized into themes. Results We found PLHIV personal food preferences were influenced by organoleptic properties, medications, disease stage, and gender norms. Family members were knowledgeable about the importance of nutritious food for HIV treatment and prioritized these needs to avoid HIV-related stigma and fulfill family obligations. With high prices of nutritious foods (animal source foods, fruits), family members strategized to secure preferred foods for the PLHIV by, 1) forgoing their own food preferences; 2) reallocating food within the household; 3)making food substitutions; and 4) leveraging external networks. These strategies were increasingly employed as the disease progressed. Conclusion The use of this expanded framework that included a family perspective on PLHIV food choice illuminated the various households decision-making dynamics that took place in this low resource community. Family members of PLHIV tried to buffer the limitations imposed by the external food environment, especially as the disease progressed. In the context of HIV status disclosure, integrating a family perspective into HIV nutrition interventions and programs has the potential to influence health outcomes and slow disease progression.
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Affiliation(s)
- Morgan Boncyk
- Department of Public Health, Purdue University, West Lafayette, USA.
| | | | | | - Dominic Mosha
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Savannah L Froese
- Department of Public Health, Purdue University, West Lafayette, USA.,Department of Nutrition Science, Purdue University, West Lafayette, USA
| | | | | | - Japhet Killewo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Germana H Leyna
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania.,Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Crystal L Patil
- Department of Human Development Nursing Science, University of Illinois Chicago, Chicago, USA
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Traditional Knowledge and Modern Motivations for Consuming Seaweed (Limu) in Samoa. SUSTAINABILITY 2022. [DOI: 10.3390/su14106212] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Seaweeds are a traditional food throughout the Pacific. In Samoa, the edible seaweeds limu fuafua (sea grapes, Caulerpa racemosa and C. chemnitzia) and limu a’au (red seaweed, Halymenia durvillei and Halymenia sp.) are hand-harvested and consumed fresh or cooked, respectively. However, there is limited scientific or traditional documentation of these commodities. Here, we assess the traditional use and cultural value of edible seaweeds and explore modern consumer preferences and perceived nutritional benefits. Structured enumerator-administered questionnaires were used to examine the relationship between consumption and demographics and subsequently to assess the key motivators for consumption, including perceived nutritional benefits. A total of 320 participants were surveyed across 20 village communities, with 95% reporting consumption of Caulerpa and 40% of Halymenia. Consumption was primarily on a weekly to monthly basis, and even once a day. Motivators and barriers for consumption were then assessed in 320 village participants with an additional 203 intercept interviews at fish markets. A content analysis of the open-ended questions revealed the key motivators for eating limu were health and taste (positive), whereas the key barriers were taste (negative) and availability. We identify opportunities to develop a nutrient evidence base for Samoan seaweeds to aid in marketing, especially for youth.
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Trübswasser U, Talsma EF, Ekubay S, Poelman MP, Holdsworth M, Feskens EJM, Baye K. Factors Influencing Adolescents' Dietary Behaviors in the School and Home Environment in Addis Ababa, Ethiopia. Front Public Health 2022; 10:861463. [PMID: 35462798 PMCID: PMC9024113 DOI: 10.3389/fpubh.2022.861463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Malnutrition affects many adolescents in Ethiopia. Over one-third of adolescent girls and two-thirds of boys are thin. Overweight and obesity in Ethiopia is mostly a concern in urban populations of higher wealth quintiles. Urbanization and globalization of diets is shifting food environments. The objective of this study was to assess whether food environments in and around schools in urban Ethiopia influence dietary diversity, quality, BMI status or perceptions of adolescents. Methods Twelve high schools were selected in Addis Ababa (private/government). From each school, 20 pupils aged 15–19 years were randomly selected (n = 217) and interviewed about assets in their households, their diets (categorized into 10 food groups of the Minimum Dietary Diversity, the Global Dietary Recommendations scores and four categories of the NOVA classification based on level of processing) and their use of pocket money. In addition, food environment audits were conducted within the school compound and a 0.5 km radius around each school and types of food outlets. Results On average there were 436 food outlets and 246 food or drink advertisements around each school. The majority of the advertisements (89.9%) were of ultra-processed foods, mostly sugar-sweetened beverages (SSBs). Most were positioned on food outlets (89.1%). SSBs or sweets were visibly on display in 26.3% of the outlets and fresh fruits and vegetables in 17.9% of outlets. Dietary diversity of adolescents was poor with an average of 3.6 food groups out of 10 consumed in the last 24 h. Ultra-processed foods and beverages were consumed by 23.5% of adolescents. The majority of adolescents spent their pocket money on SSBs, sweets or fried foods. Our analysis found that higher assets in adolescents' households were associated with higher dietary diversity and consumption of healthy food groups. We found no association between the food environment and dietary indicators or the BMI-z-score. Conclusion While the school food environments investigated were not conducive with promoting healthy dietary behaviors, we cannot conclude that these environmental factors directly influence adolescents' diets. The pervasive advertising and availability of unhealthy foods and beverages requires policy action for healthy school food environments.
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Affiliation(s)
- Ursula Trübswasser
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- *Correspondence: Ursula Trübswasser
| | - Elise F. Talsma
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Selamawit Ekubay
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Maartje P. Poelman
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University, Wageningen, Netherlands
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-Food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
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O'Meara L, Turner C, Coitinho DC, Oenema S. Consumer experiences of food environments during the Covid-19 pandemic: Global insights from a rapid online survey of individuals from 119 countries. GLOBAL FOOD SECURITY 2022; 32:100594. [PMID: 34812406 PMCID: PMC8598973 DOI: 10.1016/j.gfs.2021.100594] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 02/06/2023]
Abstract
This study investigates consumer experiences of food environments and food acquisition practices during the Covid-19 pandemic. Our rapid assessment online survey featured a convenience sample of 2015 individuals from 119 countries, spanning Western Europe, North America, Latin America, Asia-Pacific, and Africa. Data collection took place in April 2020 during the second month of the pandemic. Participants were recruited via existing networks of the United Nations System Standing Committee on Nutrition, through social media, and by snowballing. The majority of participants were female (71.9%), from low- and middle-income countries (51.0%), and working in nutrition or healthcare (39.3%). Qualitative thematic analysis and descriptive statistics reveal a series of common global experiences related to food availability and accessibility, food prices and affordability, food acquisition practices, and food preparation and consumption. The importance of community food participation, food sharing, and resource allocation are highlighted, along with increasing awareness of healthy diets and food waste. We identify ten synergistic policy entry points to: 1) build resilient and equitable food environments resistant to stresses and shocks; 2) harness positive dietary-related behaviors manifested during the pandemic; and, 3) mitigate the projected nutrition crisis and promote sustainable healthy diets for all.
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Affiliation(s)
- Lydia O'Meara
- Natural Resources Institute, University of Greenwich, UK
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Turner C, Bhogadi S, Walls H, Surendran S, Kulkarni B, Kinra S, Kadiyala S. Drivers of food acquisition practices in the food environment of peri-urban Hyderabad, India: A qualitative investigation. Health Place 2022; 74:102763. [DOI: 10.1016/j.healthplace.2022.102763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/21/2022] [Accepted: 02/03/2022] [Indexed: 11/04/2022]
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Changes in the Retail Food Environment in Mexican Cities and Their Association with Blood Pressure Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031353. [PMID: 35162376 PMCID: PMC8834862 DOI: 10.3390/ijerph19031353] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 01/18/2022] [Indexed: 01/11/2023]
Abstract
Shifting food environments in Latin America have potentially contributed to an increase in the consumption of ultra-processed foods and sugar-sweetened beverages, along with decreases in healthy foods, such as fruits and vegetables. Yet, little is known about the impact that such changes in the food environment have on blood pressure in low- and middle-income countries, including Mexico. We utilized individual-level systolic and diastolic blood pressure (SBP and DBP) measures from the 2016 Mexican Health and Nutrition Survey (ENSANUT, n = 2798 adults). Using an inventory of food stores based on the economic census for 2010 and 2016, we calculated the change in the density of fruit and vegetable stores, convenience stores, and supermarkets. Multilevel regression was used to estimate the association between the 2010–2016 food environment neighborhood-level changes with individual-level blood pressure measured in 2016. Declines in neighborhood-level density of fruit and vegetable stores were associated with higher individual SBP (2.67 mmHg, 95% CI: 0.1, 5.2) in unadjusted models, and marginally associated after controlling for individual-level and area-level covariates. Increases in the density of supermarkets were associated with higher blood pressure outcomes among adults with undiagnosed hypertension. Structural interventions targeting the retail food environment could potentially contribute to better nutrition-related health outcomes in Latin American cities.
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Kebede A, Jirström M, Worku A, Alemu K, Berhane HY, Turner C, Ekström EC, Berhane Y. Residential Food Environment, Household Wealth and Maternal Education Association to Preschoolers' Consumption of Plant-Based Vitamin A-Rich Foods: The EAT Addis Survey in Addis Ababa. Nutrients 2022; 14:296. [PMID: 35057477 PMCID: PMC8778225 DOI: 10.3390/nu14020296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 11/29/2022] Open
Abstract
Vitamin A deficiency is common among preschoolers in low-income settings and a serious public health concern due to its association to increased morbidity and mortality. The limited consumption of vitamin A-rich food is contributing to the problem. Many factors may influence children's diet, including residential food environment, household wealth, and maternal education. However, very few studies in low-income settings have examined the relationship of these factors to children's diet together. This study aimed to assess the importance of residential food availability of three plant-based groups of vitamin A-rich foods, household wealth, and maternal education for preschoolers' consumption of plant-based vitamin A-rich foods in Addis Ababa. A multistage sampling procedure was used to enroll 5467 households with under-five children and 233 residential food environments with 2568 vendors. Data were analyzed using a multilevel binary logistic regression model. Overall, 36% (95% CI: 34.26, 36.95) of the study children reportedly consumed at least one plant-based vitamin A-rich food group in the 24-h dietary recall period. The odds of consuming any plant-based vitamin A-rich food were significantly higher among children whose mothers had a higher education level (AOR: 2.55; 95% CI: 2.01, 3.25), those living in the highest wealth quintile households (AOR: 2.37; 95% CI: 1.92, 2.93), and in residentials where vitamin A-rich fruits were available (AOR: 1.20; 95% CI: 1.02, 1.41). Further research in residential food environment is necessary to understand the purchasing habits, affordability, and desirability of plant-based vitamin A-rich foods to widen strategic options to improve its consumption among preschoolers in low-income and low-education communities.
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Affiliation(s)
- Adane Kebede
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Magnus Jirström
- Department of Human Geography, Lund University, 223 62 Lund, Sweden;
| | - Alemayehu Worku
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa 1176, Ethiopia;
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Hanna Y. Berhane
- Department of Nutrition and Behavioral Sciences, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia;
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Christopher Turner
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Eva-Charlotte Ekström
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Yemane Berhane
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia
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