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Ogland-Hand CM, Ciesielski TH, Bensken WP, Poppe KI, Love TE, Freedman DA. The Impact of Gardening on Dietary Inflammation: Mixed-Effect Models and Propensity Score Analyses. AJPM FOCUS 2024; 3:100264. [PMID: 39224790 PMCID: PMC11367025 DOI: 10.1016/j.focus.2024.100264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Introduction Gardening has been found to increase vegetable intake and reduce BMI; this suggests that it may improve diets by lowering inflammatory content. The goal of this study goal was to evaluate the effect of gardening on Dietary Inflammatory Index scores. Methods Longitudinal data were collected annually between 2015 and 2018 from adults in low-income, urban neighborhoods of Cleveland and Columbus, Ohio. The authors measured the association between gardening and Dietary Inflammatory Index in the full data set using multivariable mixed-effect models with a random intercept for participant (Model 1; n=409). To further explore potential causation, the author used propensity score analyses in a subset of the data by building a 1-to-1 matched model (Model 2; n=339). Results Of 409 adults, 30.3% were gardeners with Dietary Inflammatory Index scores ranging from -6.228 to +6.225. Participating in gardening was associated with lower Dietary Inflammatory Index scores in the mixed-effects model (-0.45; 95% CI= -0.85, -0.04; Model 1) and the 1-to-1 matched model (-0.77; 95% CI= -1.40, -0.14; Model 2). Conclusions The analyses indicate that gardeners had lower Dietary Inflammatory Index scores than nongardeners, implying lower diet-driven inflammation. These findings highlight the potential for a causal relationship between gardening and Dietary Inflammatory Index, which should be confirmed in future studies. If this relationship is validated, strategies to increase gardening may be worth testing as primary prevention tools for diet-driven chronic disease.
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Affiliation(s)
- Callie M. Ogland-Hand
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Mary Ann Swetland Center for Environmental Health, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Timothy H. Ciesielski
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Mary Ann Swetland Center for Environmental Health, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Wyatt P. Bensken
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Kathryn I. Poppe
- Mary Ann Swetland Center for Environmental Health, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Thomas E. Love
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Population Health and Equity Research Institute, The MetroHealth System, Cleveland, Ohio
| | - Darcy A. Freedman
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Mary Ann Swetland Center for Environmental Health, Case Western Reserve University School of Medicine, Cleveland, Ohio
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2
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Singleton CR. Exploring the Interconnectedness of Crime and Nutrition: Current Evidence and Recommendations to Advance Nutrition Equity Research. J Acad Nutr Diet 2024; 124:1249-1254. [PMID: 38492635 DOI: 10.1016/j.jand.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/21/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Affiliation(s)
- Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, Louisiana.
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Langellier BA, Argibay S, Henson RM, Kravitz C, Eastus A, Stankov I, Headen I. Participatory Systems Thinking to Elucidate Drivers of Food Access and Diet Disparities among Minoritized Urban Populations. J Urban Health 2024:10.1007/s11524-024-00895-3. [PMID: 39046675 DOI: 10.1007/s11524-024-00895-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/25/2024]
Abstract
The purpose of this study was to use participatory systems thinking to develop a dynamic conceptual framework of racial/ethnic and other intersecting disparities (e.g., income) in food access and diet in Philadelphia and to identify policy levers to address these disparities. We conducted three group model building workshops, each consisting of a series of scripted activities. Key artifacts or outputs included qualitative system maps, or causal loop diagrams, identifying the variables, relationships, and feedback loops that drive diet disparities in Philadelphia, Pennsylvania. We used semi-structured methods informed by inductive thematic analysis and network measures to synthesize findings into a single causal loop diagram. There were twenty-nine participants with differing vantages and expertise in Philadelphia's food system, broadly representing the policy, community, and research domains. In the synthesis model, participants identified 14 reinforcing feedback loops and one balancing feedback loop that drive diet and food access disparities in Philadelphia. The most highly connected variables were upstream factors, including those related to racism (e.g., residential segregation) and community power (e.g., community land control). Consistent with existing frameworks, addressing disparities will require a focus on upstream social determinants. However, existing frameworks should be adapted to emphasize and disrupt the interdependent, reinforcing feedback loops that maintain and exacerbate disparities in fundamental social causes. Our findings suggest that promising policies include those that empower minoritized communities, address socioeconomic inequities, improve community land control, and increase access to affordable, healthy, and culturally meaningful foods.
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Affiliation(s)
- Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, 3rd Floor, Office 356, Philadelphia, PA, 19104, USA.
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Sofia Argibay
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, 3rd Floor, Office 356, Philadelphia, PA, 19104, USA
| | - Rosie Mae Henson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, 3rd Floor, Office 356, Philadelphia, PA, 19104, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Caroline Kravitz
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, 3rd Floor, Office 356, Philadelphia, PA, 19104, USA
| | - Alexandra Eastus
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, 3rd Floor, Office 356, Philadelphia, PA, 19104, USA
| | - Ivana Stankov
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Irene Headen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Headrick G, Abdul K, Guru S, DeHonney A, Moran AJ, Surkan PJ, Raja S, Mui Y. "We Want to Eat and be Healthy just like Everybody Else:" How Social Infrastructures Affect Nutrition Equity in a Racialized Urban Community in the United States. Curr Dev Nutr 2024; 8:102106. [PMID: 38486713 PMCID: PMC10937309 DOI: 10.1016/j.cdnut.2024.102106] [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: 10/03/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/17/2024] Open
Abstract
Background Food security and nutrition equity, 2 social determinants of health, are impacted by the coronavirus disease 2019 (COVID-19) pandemic and the racialization of urban communities. Few studies to date have examined how the use of social infrastructures in the United States during COVID-19 affected the ability to achieve food security and nutrition equity. Objectives To describe how the use of social infrastructures impacts food security and nutrition equity in a majority Black and urban community in the United States. Methods Semistructured in-depth interviews were conducted with 40 low-income, urban, and predominately Black people living in Buffalo, New York in May-July 2022.A thematic analysis using a phronetic iterative approach informed by the Social Ecological Model, Walsh's Family Resilience Framework, and a framework focused on the advancement of nutrition equity. Results We identified 9 themes mapped across 3 interrelated domains that impact nutrition equity, including 1) meeting food needs with dignity, 2) supply and demand for fresh and healthy foods, and 3) community empowerment and food sovereignty. We found that people used coping strategies, such as food budgeting and cooking skills, paired with different social infrastructures to meet food needs. People commonly used the Supplemental Nutrition Assistance Program and food pantries to meet food needs over receiving support from family members or friends outside of the household. Poverty, challenges accessing and affording healthy food, and the inability to reciprocate support to others undermined the advancement of nutrition equity despite social infrastructures being available for use. Historical and ongoing acts of disempowerment and disinvestment also hindered the advancement of nutrition equity. Conclusions Sustained, community-led investment is needed to address structural inequities preventing the advancement of nutrition equity. Social infrastructures should be expanded to inclusively support low-income populations, so wealth generation is possible to address the root cause of food insecurity.
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Affiliation(s)
- Gabby Headrick
- The Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Kiera Abdul
- The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Shireen Guru
- The University at Buffalo School of Architecture and Planning, The University at Buffalo State University of New York, Buffalo, NY, United States
| | | | - Alyssa J. Moran
- The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Pamela J. Surkan
- The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Samina Raja
- The University at Buffalo School of Architecture and Planning, The University at Buffalo State University of New York, Buffalo, NY, United States
| | - Yeeli Mui
- The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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5
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Singleton CR, Wright LA, McDonald M, Archer IG, Bell CN, McLoughlin GM, Houghtaling B, Cooksey Stowers K, Anderson Steeves E. Structural racism and geographic access to food retailers in the United States: A scoping review. Health Place 2023; 83:103089. [PMID: 37557002 DOI: 10.1016/j.healthplace.2023.103089] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/16/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023]
Abstract
This scoping review summarized findings and key measures from U.S.-based studies that 1) examined associations between geographic indicators of structural racism (e.g., redlining, racial segregation) and access to food retailers (e.g., supermarkets, convenience stores) or 2) documented disparities in access by neighborhood racial/ethnic composition. In 2022, relevant scientific literature was reviewed using Covidence software. Independent reviewers examined 13,069 citations; 163 citations advanced to the full-text review stage and 70 were selected for inclusion. Twenty-one studies (30%) linked one or more indicator of structural racism to food retailer access while 49 (70%) solely examined differences in access by neighborhood racial/ethnic composition. All studies featuring indicators of structural racism reported significant findings; however, indicators varied across studies making it difficult to make direct comparisons. Key indicators of structural racism in the food access literature included redlining (n = 3), gentrification (n = 3), and racial segregation (n = 4). Many U.S.-based studies have evaluated food retailer access by neighborhood racial/ethnic composition. Moving forward, studies should model indicators of structural racism and determine their influence on geographic access to large and small food retailers.
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Affiliation(s)
- Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA.
| | - Laura A Wright
- Rudolph Matas Library of the Health Sciences, Tulane University, New Orleans, LA, USA
| | - Meredith McDonald
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Isabel G Archer
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Caryn N Bell
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Gabriella M McLoughlin
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA; Implementation Science Center for Cancer Control, Washington University in St. Louis, St. Louis, MO, USA
| | - Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA; Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Kristen Cooksey Stowers
- Department of Allied Health Sciences, College of Agriculture, Health, And Natural Resources, University of Connecticut, Storrs, CT, USA
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6
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Yamoah O, Schulte J, Osborn L, Ogland-Hand C, Zubieta AC, Freedman DA. Pantry clients and Supplemental Nutrition Assistance Program-Education practitioners' perspectives on factors influencing healthy eating policy, system and environmental interventions in food pantries. J Nutr Sci 2023; 12:e81. [PMID: 37528826 PMCID: PMC10388411 DOI: 10.1017/jns.2023.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 08/03/2023] Open
Abstract
The Supplemental Nutrition Assistance Program-Education identified food pantries as a targeted setting for policy, system, and environmental (PSE) interventions to promote healthy eating among households who rely on pantries to supplement their food needs. The present study sought to identify factors influencing capacity and readiness to implement healthy eating PSE interventions in food pantries. Qualitative interviews were conducted via zoom with twenty-six community residents with experience receiving SNAP benefits and twelve SNAP-Ed staff in rural and urban counties in Ohio to identify themes and indicators related to community/organisational capacity and readiness to implement healthy eating PSE interventions in food pantries. Themes and related indicators generated based on inductive and deductive coding of interview transcripts were prioritised and weighted by eleven community nutrition experts during a virtual consensus conference. Five themes emerged; expert-derived weights (scaled low, 0 to high, 1) reflect the perceived importance of each to implementation of healthy eating PSE interventions in food pantries: food pantry capacity and logistics [0â‹…252], networks and relationships [0â‹…228], community nutrition practitioner capacity [0â‹…212], food pantry user characteristics [0â‹…156], and stigma and stereotypes [0â‹…1â‹…52]. Overall, seventeen indicators were identified reflecting these themes. Successful and sustained PSE interventions at food pantries will require a tailored approach that considers food pantries' capacity, needs and opportunities within the community, and capacity of community nutrition practitioners. The themes and indicators identified provide guidance for responsive PSE approaches in food pantries that meet communities where they are.
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Key Words
- Assessment
- COREQ, the consolidated criteria for reporting qualitative research
- Food pantry
- Healthy eating
- IRB, Institutional Review Board
- NPP, Nutrition Pantry Program
- OSU, Ohio State University
- PSE, policy, system and environmental
- Policy, systems, and environmental (PSE) interventions
- READI, Readiness Assessment and Decision Instrument
- RUCA, Rural–Urban Commuting Area
- Readiness
- SNAP, Supplemental Nutrition Assistance Program
- SNAP-Ed, Supplemental Nutrition Assistance Program Education program
- WIC, Special Supplemental Nutrition Program for Women, Infants and Children
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Affiliation(s)
- Owusua Yamoah
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
| | - Jillian Schulte
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
- Department of Anthropology, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
| | - Lindsay Osborn
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
| | - Callie Ogland-Hand
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
| | - Ana Claudia Zubieta
- College of Food, Agricultural, and Environmental Sciences (CFAES), OSU Extension, 381B Campbell Hall, 1787 Neil Avenue, Columbus, OHÂ 43210, USA
| | - Darcy A. Freedman
- Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OHÂ 44106, USA
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7
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Samuel LJ, Crews DC, Swenor BK, Zhu J, Stuart EA, Szanton SL, Kim B, Dwivedi P, Li Q, Reed NS, Thorpe RJ. Supplemental Nutrition Assistance Program Access and Racial Disparities in Food Insecurity. JAMA Netw Open 2023; 6:e2320196. [PMID: 37358853 PMCID: PMC10293911 DOI: 10.1001/jamanetworkopen.2023.20196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/10/2023] [Indexed: 06/27/2023] Open
Abstract
Importance Racially minoritized people experience disproportionately high rates of food insecurity. The Supplemental Nutrition Assistance Program (SNAP) reduces food insecurity. Objective To evaluate SNAP access with regard to racial disparities in food insecurity. Design, Setting, and Participants This cross-sectional study used data from the 2018 Survey of Income and Program Participation (SIPP). On the basis of random sampling strategies, 44 870 households were eligible for the SIPP, and 26 215 (58.4%) participated. Sampling weights accounted for survey design and nonresponse. Data were analyzed from February 25 to December 12, 2022. Exposures This study examined disparities based on household racial composition (entirely Asian, entirely Black, entirely White, and multiple races or multirace based on SIPP categories). Main Outcomes and Measures Food insecurity during the prior year was measured using the validated 6-item US Department of Agriculture Food Security Survey Module. SNAP participation during the prior year was classified based on whether anyone in the household received SNAP benefits. Modified Poisson regression tested hypothesized disparities in food insecurity. Results A total of 4974 households that were eligible for SNAP (income ≤130% of the poverty threshold) were included in this study. A total of 218 households (5%) were entirely Asian, 1014 (22%) were entirely Black, 3313 (65%) were entirely White, and 429 (8%) were multiracial or of other racial groups. Adjusting for household characteristics, households that were entirely Black (prevalence rate [PR], 1.18; 95% CI, 1.04-1.33) or multiracial (PR, 1.25; 95% CI, 1.06-1.46) were more likely to be food insecure than entirely White households, but associations differed depending on SNAP participation. Among households that did not participate in SNAP, those that were entirely Black (PR, 1.52; 97.5% CI, 1.20-1.93) or multiracial (PR, 1.42; 97.5% CI, 1.04-1.94) were more likely to be food insecure than White households; however, among SNAP participants, Black households were less likely than White households to be food insecure (PR, 0.84; 97.5% CI, 0.71-0.99). Conclusions and Relevance In this cross-sectional study, racial disparities in food insecurity were found among low-income households that do not participate in SNAP but not among those that do, suggesting that access to SNAP should be improved. These results also highlight the need to examine the structural and systemic racism in food systems and in access to food assistance that may contribute to disparities.
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Affiliation(s)
| | - Deidra C. Crews
- Division of Nephrology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Bonnielin K. Swenor
- Johns Hopkins School of Nursing, Baltimore, Maryland
- The Johns Hopkins Disability Health Research Center, Baltimore, Maryland
| | - Jiafeng Zhu
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Elizabeth A. Stuart
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sarah L. Szanton
- Johns Hopkins School of Nursing, Baltimore, Maryland
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Boeun Kim
- Johns Hopkins School of Nursing, Baltimore, Maryland
| | | | - Qiwei Li
- Johns Hopkins School of Nursing, Baltimore, Maryland
- College of Health and Human Services, University of California, Fresno
| | - Nicholas S. Reed
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Roland J. Thorpe
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Webb P, Livingston Staffier K, Lee H, Howell B, Battaglia K, Bell BM, Matteson J, McKeown NM, Cash SB, Zhang FF, Decker Sparks JL, Blackstone NT. Measurement of diets that are healthy, environmentally sustainable, affordable, and equitable: A scoping review of metrics, findings, and research gaps. Front Nutr 2023; 10:1125955. [PMID: 37077905 PMCID: PMC10106581 DOI: 10.3389/fnut.2023.1125955] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
Introduction Research on the impacts of dietary patterns on human and planetary health is a rapidly growing field. A wide range of metrics, datasets, and analytical techniques has been used to explore the role of dietary choices/constraints in driving greenhouse gas (GHG) emissions, environmental degradation, health and disease outcomes, and the affordability of food baskets. Many argue that each domain is important, but few have tackled all simultaneously in analyzing diet-outcome relationships. Methods This paper reviews studies published between January 2015 and December 2021 (inclusive) that examined dietary patterns in relation to at least two of the following four thematic pillars: (i) planetary health, including, climate change, environmental quality, and natural resource impacts, (ii) human health and disease, (iii) economic outcomes, including diet cost/affordability, and (iv) social outcomes, e.g., wages, working conditions, and culturally relevant diets. We systematically screened 2,425 publications by title and abstract and included data from 42 eligible publications in this review. Results Most dietary patterns used were statistically estimated or simulated rather than observed. A rising number of studies consider the cost/affordability of dietary scenarios in relation to optimized environmental and health outcomes. However, only six publications incorporate social sustainability outcomes, which represents an under-explored dimension of food system concerns. Discussion This review suggests a need for (i) transparency and clarity in datasets used and analytical methods; (ii) explicit integration of indicators and metrics linking social and economic issues to the commonly assessed diet-climate-planetary ecology relationships; (iii) inclusion of data and researchers from low- and middle-income countries; (iv) inclusion of processed food products to reflect the reality of consumer choices globally; and (v) attention to the implications of findings for policymakers. Better understanding is urgently needed on dietary impacts on all relevant human and planetary domains simultaneously.
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Affiliation(s)
- Patrick Webb
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kara Livingston Staffier
- Nutritional Epidemiology Program, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Hyomin Lee
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Brian Howell
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kyra Battaglia
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Brooke M. Bell
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Julia Matteson
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nicola M. McKeown
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- Department of Health Science, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Sean B. Cash
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Fang Fang Zhang
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Jessica L. Decker Sparks
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nicole Tichenor Blackstone
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
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Stankov I, Henson RM, Headen I, Purtle J, Langellier BA. Use of qualitative systems mapping and causal loop diagrams to understand food environments, diet and obesity: a scoping review protocol. BMJ Open 2023; 13:e066875. [PMID: 36931683 PMCID: PMC10030560 DOI: 10.1136/bmjopen-2022-066875] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 02/20/2023] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION Food systems can shape dietary behaviour and obesity outcomes in complex ways. Qualitative systems mapping using causal loop diagrams (CLDs) can depict how people understand the complex dynamics, inter-relationships and feedback characteristic of food systems in ways that can support policy planning and action. To date, there has been no attempt to review this literature. The objectives of this review are to scope the extent and nature of studies using qualitative systems mapping to facilitate the development of CLDs by stakeholders to understand food environments, including settings and populations represented, key findings and the methodological processes employed. It also seeks to identify gaps in knowledge and implications for policy and practice. METHODS AND ANALYSIS This protocol describes a scoping review guided by the Joanna Briggs Institute manual, the framework by Khalil and colleagues and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist reporting guidelines. A search strategy was iteratively developed with two academic librarians and the research team. This strategy will be used to search six databases, including Ovid MEDLINE, Embase, EmCare, Web of Science, Scopus and ProQuest Central. Identified citations will be screened by two independent reviewers; first, by title and abstract, and then full-text articles to identify papers eligible for inclusion. The reference lists of included studies and relevant systematic reviews will be searched to identify other papers eligible for inclusion. Two reviewers will extract information from all included studies and summarise the findings descriptively and numerically. ETHICS AND DISSEMINATION The scoping review will provide an overview of how CLDs developed by stakeholders have been elicited to understand food environments, diet and obesity, the insights gained and how the CLDs have been used. It will also highlight gaps in knowledge and implications for policy and practice. The review will be disseminated through publication in an academic journal and conference presentations.
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Affiliation(s)
- Ivana Stankov
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Rosie Mae Henson
- Department of Health Management and Policy, Drexel University, Philadelphia, Pennsylvania, USA
| | - Irene Headen
- Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jonathan Purtle
- Department of Public Health Policy and Management, New York University, New York, New York, USA
| | - Brent A Langellier
- Department of Health Management and Policy, Drexel University, Philadelphia, Pennsylvania, USA
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10
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Population-Level Nutritional Well-Being: Nutrition Security and Equitability. Healthcare (Basel) 2023; 11:healthcare11060817. [PMID: 36981474 PMCID: PMC10048516 DOI: 10.3390/healthcare11060817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023] Open
Abstract
Nutrition is essential to sustaining the quality of life and a fundamental right of all people [...]
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Silveira VNDC, do Nascimento JBM, Cantanhede NAC, Frota MTBA, Chagas DCD, de Carvalho CA, Viola PCDAF. Racial and regional inequality in the temporal trend of stunting and excess weight in Brazilian children under five years of age. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023; 26:e230004. [PMID: 36629616 PMCID: PMC9838232 DOI: 10.1590/1980-549720230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To analyze the occurrence of racial and regional inequality in the temporal trend of the prevalence of stunting and overweight in Brazilian children under five years of age over the years 2008-2018. METHODS An ecological time-series study with data from the Food and Nutrition Surveillance System on the prevalence of stunting and overweight in children under five years old according to race/skin color, region, and year. To assess differences between median prevalence per year of outcomes, the Kruskal-Wallis test was performed. Linear regression analyses were proposed to assess trends in the prevalence of outcomes over the years. RESULTS In Brazil, black children tended to be overweight (β=4.611; p=0.042). Among black children, there was an increase over the years in stunting in the Southeast (β=3.960; p=0.014) and a decrease in the South (β=-4.654; p=0.022). In Brazil and in most regions, the median prevalence of stunting was higher in black children than in white ones (12.86 vs. 11.54%, p<0.001). In the Southeast and South, black children also had the highest prevalence of overweight (15.48 and 15.99%, respectively). CONCLUSION Children from less developed regions of Brazil and of black skin color/race were more vulnerable to a double burden of malnutrition.
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Silveira VNDC, Nascimento JBMD, Cantanhede NAC, Frota MTBA, Chagas DCD, Carvalho CAD, Viola PCDAF. Racial and regional inequality in the temporal trend of stunting and excess weight in Brazilian children under five years of age. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023. [DOI: 10.1590/1980-549720230004.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
ABSTRACT Objective: To analyze the occurrence of racial and regional inequality in the temporal trend of the prevalence of stunting and overweight in Brazilian children under five years of age over the years 2008–2018. Methods: An ecological time-series study with data from the Food and Nutrition Surveillance System on the prevalence of stunting and overweight in children under five years old according to race/skin color, region, and year. To assess differences between median prevalence per year of outcomes, the Kruskal-Wallis test was performed. Linear regression analyses were proposed to assess trends in the prevalence of outcomes over the years. Results: In Brazil, black children tended to be overweight (β=4.611; p=0.042). Among black children, there was an increase over the years in stunting in the Southeast (β=3.960; p=0.014) and a decrease in the South (β=-4.654; p=0.022). In Brazil and in most regions, the median prevalence of stunting was higher in black children than in white ones (12.86 vs. 11.54%, p<0.001). In the Southeast and South, black children also had the highest prevalence of overweight (15.48 and 15.99%, respectively). Conclusion: Children from less developed regions of Brazil and of black skin color/race were more vulnerable to a double burden of malnutrition.
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Houghtaling B, Greene M, Parab KV, Singleton CR. Improving Fruit and Vegetable Accessibility, Purchasing, and Consumption to Advance Nutrition Security and Health Equity in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11220. [PMID: 36141494 PMCID: PMC9517087 DOI: 10.3390/ijerph191811220] [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] [Received: 06/30/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
In recent years, national and local efforts to improve diet and health in the United States have stressed the importance of nutrition security, which emphasizes consistent access to foods and beverages that promote health and prevent disease among all individuals. At the core of this endeavor is fruit and vegetable (FV) consumption, a dietary practice that is integral to attaining and sustaining a healthy diet. Unfortunately, significant inequities in FV accessibility, purchasing, and consumption exist, particularly among populations that are socially and economically disadvantaged. To achieve nutrition and health equity in the United States, the field must center the goal of nutrition security and initiatives that aim to increase FV consumption, specifically, in future work. The International Journal of Environmental Research and Public Health (IJERPH) Special Issue titled "Nutrition and Health Equity: Revisiting the Importance of Fruit and Vegetable Availability, Purchasing, and Consumption" features several scholarly publications from experts conducting timely research on these topics. In this commentary, we (1) summarize the U.S.-based literature on inequities in FV accessibility, purchasing, and consumption, (2) describe how the contributions to this IJERPH special issue can advance nutrition security and health equity, and (3) outline future research questions from our perspective.
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Affiliation(s)
- Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, NE 68514, USA
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA 70803, USA
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA
| | - Matthew Greene
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA 70803, USA
| | - Kaustubh V. Parab
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Chelsea R. Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
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Vargo L, Ciesielski TH, Embaye M, Bird A, Freedman DA. Understanding SNAP Recipient Characteristics to Guide Equitable Expansion of Nutrition Incentive Programs in Diverse Food Retail Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094977. [PMID: 35564371 PMCID: PMC9101614 DOI: 10.3390/ijerph19094977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 12/04/2022]
Abstract
Structural barriers, such as food costs, reduce access to healthy foods for populations with limited income, including those benefitting from the Supplemental Nutrition Assistance Program (SNAP). Nutrition incentive programs seek to address this barrier. Evaluations of SNAP-based incentive programming often focus on one setting (i.e., either farmers’ markets or grocery stores). We examined use patterns, characteristics, and preferences among 253 SNAP consumers with access to incentive programming at both a farmers’ market and a grocery store located within five miles of their home. Cross-sectional survey data were collected in 2019 in two Ohio cities. Despite geographic access, 45% of those surveyed were not using the incentive program; most non-users (80.5%) were unaware of the program. Program users compared to non-users had higher household incomes (p < 0.001) and knew more people using the program (p < 0.001). Grocery stores were the most common setting of use (59%); 29% used at farmers’ markets; 11% used in both settings. User characteristics varied by store setting based on demographics, program experience, fruit and vegetable purchasing and consumption patterns, and social dynamics related to use. Our findings support comprehensive awareness-raising efforts and tailored implementation of incentive programming that attends to diverse segments of SNAP consumers to promote equity in program reach.
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Affiliation(s)
- Lauren Vargo
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Timothy H Ciesielski
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Milen Embaye
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Ana Bird
- Produce Perks Midwest, Cincinnati, OH 45241, USA
| | - Darcy A Freedman
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
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