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Maganja D, de Carle M, Davies T, Gómez Donoso C, Scapin T, Cameron AJ, Louie JCY, Huffman MD, Trieu K, Wu JHY. Healthiness of food products promoted through placement strategies in Australian online supermarkets: a cross-sectional study. BMC Med 2024; 22:341. [PMID: 39183272 DOI: 10.1186/s12916-024-03557-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 08/12/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Prominent product placement is a core promotional tactic in retail food environments. How this practice has been adapted for online supermarkets, and the extent to which it is applied to healthier and less healthy food products in this setting, is largely unknown. We aimed to investigate placement-type promotions of food products in Australian online supermarkets. METHODS We developed a new method to assess placement promotions and applied it to the online stores of the two largest supermarket retailers in Australia. Each online store was audited across six 'locations' (input prior to data collection), including a randomly selected high socio-economic position area and low socio-economic position area from each of the three largest Australian cities. The names, page locations and type of placement strategy of promoted food products were captured, with product healthiness assessed using the Health Star Rating (HSR) nutrient profiling system. Descriptive statistics summarised the page locations of promoted products and the placement strategies used to promote them, and chi-squared tests applied to compare product healthiness by retailer and socio-economic position. RESULTS We recorded 12,152 food products promoted through placement strategies, 99% of which were eligible for a HSR. Overall, 44% of products promoted through placement strategies were unhealthy. Cross-promotions and recommendations was the most common strategy recorded overall (55.9% of all strategies), and advertisements and site content was the strategy most likely to promote unhealthy products (53.7% of products unhealthy). One retailer was more likely to promote unhealthy products (46% v 43%, p = 0.004) and unhealthy products were more likely to be promoted in more disadvantaged than less disadvantaged locations (45% vs 43%, p = 0.05), though the magnitudes of difference were small. CONCLUSIONS A considerable number of unhealthy products are likely presented to online grocery shoppers in Australia. Public health policies targeting unhealthy food promotions may need to be updated, including with consideration of the different ways that products can be prominently displayed online, to avoid exacerbating risks of diet-related disease and health inequalities. Our novel methodology could be used for ongoing monitoring of online supermarkets in Australia and elsewhere to inform such policies.
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Affiliation(s)
- Damian Maganja
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Madeleine de Carle
- School of Rural Medicine, Faulty of Medicine and Health, University of New England, Armidale, Australia
| | - Tazman Davies
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Clara Gómez Donoso
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Burwood, Australia
| | - Tailane Scapin
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Burwood, Australia
| | - Adrian J Cameron
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Burwood, Australia
| | - Jimmy C Y Louie
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Mark D Huffman
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Cardiovascular Division, Global Health Center, Washington University in St. Louis, St. Louis, USA
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- School of Population Health, Faculty of Medicine & Health, University of New South Wales, Kensington, Australia
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Vargas C, Venegas Hargous C, Grainger F, Perera L, Pymer S, Bell C, Whelan J. Applying Systems Thinking to Improve a Hospital Food Retail Environment. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:569-578. [PMID: 38752950 DOI: 10.1016/j.jneb.2024.04.005] [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: 09/26/2023] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVE To identify factors influencing the availability and sales of healthy food and drinks in a café located in a hospital setting in a rural area. METHODS Three online and 1 in-person group model building workshops were conducted with hospital staff members to develop a causal loop diagram. RESULTS Four areas in the causal loop diagram were identified, 5 teams were created to implement 15 identified action ideas, and an action registry was created to track their progress. By May 2023, 4 actions were active, 6 inactive, 4 completed, and 1 abandoned. CONCLUSIONS AND IMPLICATIONS The group model building process identified factors and actions to improve the healthiness of the hospital's café and motivated staff members to act for change. However, progress was limited by staff turnover, recruitment, and inadequate participation from decision-makers. Better leadership and support by senior management can ensure that long-term objectives are achieved and healthier hospital food environments are sustained.
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Affiliation(s)
- Carmen Vargas
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Carolina Venegas Hargous
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia; Faculty of Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Felicity Grainger
- Faculty of Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Lux Perera
- Grampians Health, Horsham, Victoria, Australia
| | - Sally Pymer
- Grampians Health, Horsham, Victoria, Australia
| | - Colin Bell
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia; Faculty of Health, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Jillian Whelan
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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McGrath G. Using the Australian Dietary Guidelines 2&5 education message in supermarket shopping trolleys to nudge shoppers to purchase more fruit and vegetables: A feasibility study using an intervention design. NUTR BULL 2024; 49:189-198. [PMID: 38610075 DOI: 10.1111/nbu.12674] [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: 11/06/2023] [Revised: 03/03/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing chronic diseases; however, only one in 16 Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test the feasibility of modifying shopper purchasing behaviour to purchase more F&Vs using the Australian Dietary Guidelines 2&5 education message covering one-half of the base of shopping trolleys. Placards giving the message that eating 2 fruits and 5 vegetables every day for good health were placed at the base of shopping trolleys as an educational nudge. Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting paper sales receipts to measure the weight (kg), total spending and F&V-specific spending (Australian dollars) for intervention versus control trolleys for one Saturday. We also conducted a short intercept survey that was administered independently from the research study day on non-trial shoppers. Shoppers who selected trolleys with the 2&5 education nudge placards (n = 101) purchased 1.66 kg less weight of F&Vs (Intervention: mean = 3.89 kg, SD = 3.40 kg, 95% CI = 3.21 kg, 4.56 kg, vs. Control: mean 5.55 kg, SD = 4.16 kg, 95% CI = 4.73 kg, 6.37 kg, p = 0.002) and spent less on F&Vs compared to shoppers in the control group (n = 102; Intervention: mean = $26.00, SD = $21.60, 95% CI = $21.78, $30.32 vs. Control: mean $36.00, SD = $27.00, 95% CI = $30.72, $42.36, p = 0.004). Intervention group shoppers also spent less in total spending between groups (Intervention: mean = $115.40, SD = $68.30, 95% CI = $101.95, $128.95 vs. Control: mean $151.30, SD = $79.40, 95% CI = $135.73, $166.93, p = 0.001). The 2&5 education nudge placard had the opposite effect as intended on shoppers' purchases to buy more F&Vs, although there may have been other differences between the intervention and the control groups since they were not randomised. Larger studies are required to elucidate and confirm these findings over the longer term.
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Affiliation(s)
- Greg McGrath
- La Trobe University, Melbourne, Victoria, Australia
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McMahon E, Ferguson M, Wycherley T, Gunther A, Brimblecombe J. Development of a Tool for Reporting Key Dietary Indicators from Sales Data in Remote Australian Aboriginal and Torres Strait Islander Community Stores. Nutrients 2024; 16:1058. [PMID: 38613091 PMCID: PMC11013159 DOI: 10.3390/nu16071058] [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: 02/14/2024] [Revised: 03/20/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Reporting key dietary indicators from sales data can help us guide store decision makers in developing effective store policy to support healthier customer purchases. We aimed to develop a web-based reporting tool of key dietary indicators from sales data to support health-promoting policy and practice in stores in geographically remote Aboriginal and Torres Strait Islander communities. Tool development included identifying key dietary indicators (informed by sales data from 31 stores), community consultation (19 Aboriginal and Torres Strait Islander store directors and two store managers) and a web-build. Tool evaluation involved feedback interviews with stakeholders (25 store managers and two nutritionists). Key dietary indicators aligned with Australian Dietary Guideline food groupings and recommendations. An online portal for accessing and customising reports was built. Stakeholder feedback indicated that the strengths of the reports were the visuals, ease of interpretation, providing information that was not currently available and potential to increase capacity to support healthy food retailing. Difficulties were defining healthiness classification with alignment to other nutrition guidelines used and ensuring reports reached relevant store decision makers. This tool may be valuable to support store decision makers in identifying and prioritising nutrition issues and optimising the health-enabling attributes of stores.
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Affiliation(s)
- Emma McMahon
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia (A.G.)
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, VIC 3168, Australia
| | - Megan Ferguson
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia (A.G.)
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, VIC 3168, Australia
- School of Public Health, University of Queensland, Herston, QLD 4006, Australia
| | - Thomas Wycherley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA 5001, Australia
| | - Anthony Gunther
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia (A.G.)
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia (A.G.)
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, VIC 3168, Australia
- School of Public Health, University of Queensland, Herston, QLD 4006, Australia
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Baker K, Burd L, Figueroa R. Consumer nutrition environment measurements for nutrient-dense food availability and food sustainability: a scoping review. Arch Public Health 2024; 82:7. [PMID: 38225657 PMCID: PMC10789067 DOI: 10.1186/s13690-023-01231-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
Consumer nutrition environments are defined as places in which consumers interact with the food they eat; these food choices can impact human and planetary health. Assessment measures for consumer nutrition environments are numerous, and vary widely on what, and how, they assess the food environment. The objective of this scoping review was to synthesize existing evidence on nutrition environment measurements and their capacity to assess nutrient-dense food access and food sustainability capacity. Eligibility criteria were developed to capture relevant peer-reviewed literature about auditing measures designed to assess nutrient-dense foods and food sustainability capacity in the consumer nutrition environment. A search strategy was conducted to collect articles published between January 1, 2002-June 4, 2022, using PubMed, Web of Science, Scopus, PsycINFO and the Cochrane library electronic databases. After screening 2457 manuscripts, 58 met inclusion criteria. Study aims, funding source(s), types of retailers assessed, assessment format and name, constructs measured, food categories measured, assessment of validity and/or reliability, and other relevant data were extracted from each manuscript. Results showed that most measures use checklists, surveys, questionnaires or similar methods to assess availability, quality, and price of select food items as assessment constructs. Most do not assess nutrient-dense food availability, and even fewer assess food sustainability. Development of comprehensive, reliable, and valid consumer nutrition environment measures that assess nutrient-dense food availability and food sustainability is important for research, planning, evaluation and advocacy aimed at improving consumer food environments for human and planetary health.
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Affiliation(s)
- Katherine Baker
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA.
| | - Laura Burd
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Roger Figueroa
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Chen J, Du Y, Rui JR. How Foods and Beverages Are Promoted Online: A Content Analysis of the Digital Food Environment in China. Nutrients 2023; 15:5067. [PMID: 38140326 PMCID: PMC10745472 DOI: 10.3390/nu15245067] [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: 10/12/2023] [Revised: 11/23/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
Digital platforms such as social media and e-commerce platforms have become a major space where foods and beverages (F&B) are promoted. Prior research has found that online, unhealthy F&B receive more presence than healthy F&B. This obesogenic food environment may increase the obesity rate. Therefore, it is critical to understand how healthy and unhealthy F&B are promoted online. A content analysis of 2906 posts related to F&B via five digital platforms was conducted in China, where the obesity rate has increased in recent years. Firstly, the results show that unhealthy F&B received more presence on digital platforms than healthy F&B. Secondly, healthy F&B posts tended to highlight the healthiness of the products, whereas unhealthy F&B posts leveraged a wide range of promotional strategies, specifically use cues, food cues, chewing sounds, sensory descriptions, friend cues, local cultural appeal, nostalgia appeal, price information, discount information, and trending hashtags or topics. Next, use cues, chewing sounds, sensory descriptions, family cues, and friend cues increased the quantity of audience feedback, whereas price information and using trending hashtags or topics lowered the quantity of audience feedback. Moreover, local cultural appeal and social proof exhibited the opposite impact on audience feedback. Finally, health benefit statements lowered audience feedback for healthy F&B posts, whereas brand visibility and purchase links inhibited audience feedback for unhealthy F&B posts. In addition to describing the digital food environment in China, the present research provides implications on how to promote healthy F&B. Particularly, we suggest that healthy F&B businesses and healthy eating campaigns should leverage the strategies unhealthy F&B use to receive more consumer attention, in order to increase their own products' public visibility and attractiveness.
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Affiliation(s)
| | | | - Jian Raymond Rui
- Center for Public Health Risk Surveillance and Information Communication in Guangdong Province, South China University of Technology, 382 Waihuan East Rd, Guangzhou 510006, China; (J.C.); (Y.D.)
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McGrath G. Using a divider nudge in supermarket shopping trolleys to increase fruit and vegetable purchases: A feasibility study using an intervention design. NUTR BULL 2023; 48:513-522. [PMID: 37864781 DOI: 10.1111/nbu.12642] [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: 03/24/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/23/2023]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in 16 Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test the feasibility of covertly modifying shopper purchasing behaviour to purchase more F&Vs using a visual divider nudge message (prompts) covering the entire base of shopping trolleys. Placards provided a visual representation of the recommended proportion of the trolley base that should be allocated to fruits and vegetables (implied social norm). Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the weight (kg), total spending and F&V specific spending (Australian dollars) for intervention versus control trolleys for one weekend day only. We also conducted a short intercept survey that was administered independently from the research study day on non-trial shoppers. Shoppers who selected trolleys with the divider nudge placards (n = 102) purchased equal weight of F&Vs (Intervention: mean = 6.25 kg, SD = 5.60 kg, 95% CI = 5.14 kg, 7.35 kg, vs. Control: mean 6.03 kg, SD = 5.17 kg, 95% CI = 5.01 kg, 7.04 kg, p = 0.768) and spent equal amounts on F&Vs compared to shoppers in the control group (n = 102) (Intervention: mean = $41.46, SD = $36.68, 95% CI = $34.25, $48.66, vs. Control: mean $39.85, SD = $33.30, 95% CI = $33.34, $46.39, p = 0.744). There was no difference in the total spending between groups (Intervention: mean = $135.99, SD = $90.10, 95% CI = $118.29, $153.68, vs. Control: mean $155.68, SD = $96.46, 95% CI = $136.73, $174.63, p = 0.133). The divider nudge placard did not lead to any difference in shoppers' purchases of F&Vs. However, this study demonstrates the feasibility of testing a cheap, simple and easy supermarket nutrition intervention. Larger studies are required to elucidate and confirm these findings over the longer term.
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Affiliation(s)
- Greg McGrath
- La Trobe University, Melbourne, Victoria, Australia
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Jardim MZ, Mendes LL, Cordeiro NG, Claro RM, Pessoa MC, Andrade ACDS, Costa BVDL. Food and nutrition public establishments: assessment of the food environment. CIENCIA & SAUDE COLETIVA 2023; 28:3311-3320. [PMID: 37971013 DOI: 10.1590/1413-812320232811.17002022] [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: 06/06/2022] [Accepted: 02/09/2023] [Indexed: 11/19/2023] Open
Abstract
This article aims to assess the community food environment around areas with and without Food and Nutrition Public Establishments (FNPE). Cross-sectional study carried out in Belo Horizonte, Brazil. The unit of analysis was the buffer (500m) around the FNPE and the census tracts without FNPE. The investigated establishments should market food for consumption at home and be located within the buffer of the areas with and without FNPE. Data collection performed by direct observation (active search) in August to October 2019. Data collected were location and type of commercial establishments, the density of the establishments was calculated. Descriptive analysis, spatial distribution (Kernel estimator) and Nearest Neighbor analysis were performed. Of the evaluated establishments, 60.5% were in the areas without FNPE and 39.6% in the areas with FNPE, showing a random distribution pattern. Of these, 24.2% were convenience stores and bakeries, 21.0% butcher stores, and 19.0% street markets. Seven FNPE were close to commercial establishments. There were fewer establishments around the FNPE, with convenience stores and bakeries predominating.
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Affiliation(s)
- Mariana Zogbi Jardim
- Departamento de Nutrição, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Larissa Loures Mendes
- Departamento de Nutrição, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Nayhanne Gomes Cordeiro
- Departamento de Nutrição, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Rafael Moreira Claro
- Departamento de Nutrição, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Milene Cristine Pessoa
- Departamento de Nutrição, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | | | - Bruna Vieira de Lima Costa
- Departamento de Nutrição, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Vandevijvere S, Van Dam I, Inaç Y, Smets V. Unhealthy food availability, prominence and promotion in a representative sample of supermarkets in Flanders (Belgium): a detailed assessment. Arch Public Health 2023; 81:154. [PMID: 37608383 PMCID: PMC10463948 DOI: 10.1186/s13690-023-01175-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023] Open
Abstract
INTRODUCTION The supermarket food environment is a key setting for potential public health interventions. This study assessed food availability, prominence and promotion in a representative sample of supermarkets in Flanders (Belgium). METHODS A sample of 55 supermarkets across five chains and 16 Flemish municipalities was selected in 2022, about 64% in the most deprived socioeconomic areas. Healthiness indicators related to food availability (ratio of cumulative linear shelf length for healthy versus unhealthy foods), prominence (proportion of unhealthy foods at check-outs and end-of-aisle endcaps), and promotion (food marketing on food packages) were measured. RESULTS Overall, the average ratio of healthy/unhealthy foods in supermarkets in Flanders was 0.36, meaning that for every 10m of shelf length of unhealthy foods there was 3.6m of healthy foods. There was a large variation in ratio's across supermarket chains. Of all foods available, 97.5% were ultra-processed at the check outs, while 72.2% and 58.5% were ultra-processed at the front and back end-of-aisle end-caps, respectively. Confectionery and sweet biscuits were the food categories with on average the highest number of marketing messages on pack per 10m of shelf length. CONCLUSION Supermarket in-store food environments in Flanders were found generally unhealthy, with those located in low income areas having unhealthier in-store food environments than supermarkets located in medium and high income areas. Despite commitments of all large supermarket chains in Flanders to promote and create healthier in-store food environments, our findings indicate that currently consumers are incentivized to buy unhealthy rather than healthy food products.
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Affiliation(s)
- Stefanie Vandevijvere
- Department of Epidemiology and Public Health, J. Wytsmanstraat 14, 1050, Brussels, Belgium.
| | - Iris Van Dam
- Department of Epidemiology and Public Health, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Yasemin Inaç
- Department of Epidemiology and Public Health, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Vincent Smets
- Department of Epidemiology and Public Health, J. Wytsmanstraat 14, 1050, Brussels, Belgium
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Forde H, Chavez-Ugalde Y, Jones RA, Garrott K, Kotta PA, Greaves F, Targett V, White M, Adams J. The conceptualisation and operationalisation of 'marketing' in public health research: a review of reviews focused on food marketing using principles from critical interpretive synthesis. BMC Public Health 2023; 23:1419. [PMID: 37488556 PMCID: PMC10367353 DOI: 10.1186/s12889-023-16293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Extensive public health research reports the nature, scope and effects of various marketing activities used by food and drinks companies to support the sale of their products. Such literature informs the regulation of food marketing that encourages unhealthy eating behaviours and poor diet-related health outcomes. However, it is not clear whether this literature consistently conceptualises and applies marketing, which could in turn influence the approach and efficacy of policies to regulate food marketing. We aimed to understand the conceptualisation and operationalisation of marketing in public health research of food marketing, eventually focusing on the conceptualisation of integrated marketing. METHODS We conducted a review of reviews that drew on scoping review methods and applied principles of critical interpretive synthesis. Five databases of peer-reviewed literature and websites of relevant organisations were searched in June - August 2020. Articles were screened against inclusion criteria to identify reviews examining food marketing in a health context. Informative text segments from included articles were coded using NVivo. Codes were grouped into synthetic constructs and a synthesising argument. RESULTS After screening against inclusion criteria, 60 publications were eligible for inclusion. Informative text segments from 24 publications were coded, after which no new codes were identified. Our synthesising argument was that the understanding of integrated marketing appeared inconsistent across publications, such as by differences in use of underlying conceptual frameworks and in the application of terms such as marketing strategy and tactics. CONCLUSIONS Using our synthesising argument, we suggest ways to improve the future study of food marketing in public health research, for example by using in-depth case studies to understand the integrated operation and effect of multi-component marketing strategies. Improving conceptual clarity in the study of food marketing in public health research has the potential to inform policy that is more reflective of the true nature of marketing, and thus more effective in combating food marketing effects and protecting public health. PROTOCOL REGISTRATION The review protocol was made publicly available on Open Science Framework prior to the start of the study (DOI: https://doi.org/10.17605/OSF.IO/VSJCW ).
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Affiliation(s)
- Hannah Forde
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
| | - Yanaina Chavez-Ugalde
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
- Bristol Medical School, University of Bristol, First Floor, 5 Tyndall Avenue, Bristol, BS8 1UD, UK
| | - Rebecca A Jones
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
| | - Kate Garrott
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
| | - Prasanti Alekhya Kotta
- Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Felix Greaves
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Hospital, London, W6 8RP, UK
- National Institute for Health and Care Excellence, 2 Redman Place, London, E20 1JQ, UK
| | - Victoria Targett
- Department of Health and Social Care, London, UK
- Public Health England, London, UK
| | - Martin White
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
| | - Jean Adams
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Box 285, Cambridge, CB2 0QQ, UK
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Ferdinands AR, Brown JA, Nielsen CC, Nykiforuk CIJ, Raine KD. What counts? Adding nuance to retail food environment measurement tools in a Canadian context. Public Health Nutr 2023; 26:1326-1337. [PMID: 37073692 PMCID: PMC10346037 DOI: 10.1017/s1368980023000733] [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: 09/23/2022] [Revised: 02/20/2023] [Accepted: 03/24/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Limitations of traditional geospatial measures, like the modified Retail Food Environment Index (mRFEI), are well documented. In response, we aimed to: (1) extend existing food environment measures by inductively developing subcategories to increase the granularity of healthy v. less healthy food retailers; (2) establish replicable coding processes and procedures; and (3) demonstrate how a food retailer codebook and database can be used in healthy public policy advocacy. DESIGN We expanded the mRFEI measure such that 'healthy' food retailers included grocery stores, supermarkets, hypermarkets, wholesalers, bulk food stores, produce outlets, butchers, delis, fish and seafood shops, juice/smoothie bars, and fresh and healthy quick-service retailers; and 'less healthy' food retailers included fast-food restaurants, convenience stores, coffee shops, dollar stores, pharmacies, bubble tea restaurants, candy stores, frozen dessert restaurants, bakeries, and food trucks. Based on 2021 government food premise licences, we used geographic information systems software to evaluate spatial accessibility of healthy and less healthy food retailers across census tracts and in proximity to schools, calculating differences between the traditional v. expanded mRFEI. SETTING Calgary and Edmonton, Canada. PARTICIPANTS N/A. RESULTS Of the 10 828 food retailers geocoded, 26 % were included using traditional mRFEI measures, while 53 % were included using our expanded categorisation. Changes in mean mRFEI across census tracts were minimal, but the healthfulness of food environments surrounding schools significantly decreased. CONCLUSIONS Overall, we show how our mRFEI adaptation, and transparent reporting on its use, can promote more nuanced and comprehensive food environment assessments to better support local research, policy and practice innovations.
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Affiliation(s)
- Alexa Rae Ferdinands
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Jennifer Ann Brown
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Charlene C Nielsen
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Candace IJ Nykiforuk
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Kim D Raine
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
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Co-creation Approach in Practice: Naming a Cafe Located within a Rural Health Service Provides Added Value to a Health Strategy. ADVANCES IN PUBLIC HEALTH 2023. [DOI: 10.1155/2023/9989552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Objective. The Victorian Government in Australia has developed Healthy Choices guidelines to ensure that healthy foods and drinks are offered and promoted in places such as hospitals. This brief report aims to present complex theoretical attributes related to cocreation through an accessible example of a competition to create a new name for the previously understated hospital “kiosk.” Methods. A mixed-methods approach using an online survey and semistructured interviews were used to obtain detailed insights from hospital staff members to engage in a naming competition for a hospital-based cafe. Results. The level of engagement in this activity was higher than anticipated by the management staff. Conclusions. Active involvement of staff members through a cocreation process can enable the development of innovative healthy eating strategies and increase staff engagement to further changes in the cafe. Implications for public health cocreation in public health promises effective stakeholder engagement and requires significant scientific advancement. This brief report illustrates theoretical constructs of cocreation through a naming competition activity that occurred as part of a larger project to improve Wimmera Base Hospital’s food environment.
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McGrath GM. Using social norm nudges in supermarket shopping trolleys to increase fruit and vegetable purchases. NUTR BULL 2023; 48:115-123. [PMID: 36842136 DOI: 10.1111/nbu.12604] [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: 10/29/2022] [Revised: 01/02/2023] [Accepted: 01/09/2023] [Indexed: 02/27/2023]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in twenty Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test if shopper purchasing behaviour can be modified to purchase more F&Vs using social norm nudge messages (prompts) placed in shopping trolleys. Placards giving the message that the majority of shoppers purchased F&Vs at each shop were placed in shopping trolleys. Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the quantity (kg), total and F&V spending (Australian dollars) for intervention versus control trolleys. We also conducted a short intercept survey that was administered independently from the research study day. Shoppers who selected trolleys with the social norm nudge placards (n = 109) purchased 1.25 kg more F&Vs (Intervention: mean = 5.45 kg, SD = 4.23 kg, 95% CI 4.65 kg, 6.26 kg vs. Control: mean 4.19 kg, SD = 3.75 kg, 95% CI 3.48 kg, 4.90 kg, p = 0.020, Cohen's d = 0.32) and spent an extra $9.10 more on F&Vs compared to shoppers in the control group (n = 109; Intervention: mean = $36.20, SD = $26.30, 95% CI = $31.24, $41.26 vs. Control: mean $27.10, SD = $24.00, 95% CI = $22.50, $31.67, p = 0.008, Cohen's d = 0.36). The social norm nudge placard shows promise in modifying shoppers' purchases to buy more F&Vs. Larger studies are required to elucidate and confirm these findings over the longer term.
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14
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Longitudinal association between density of retail food stores and body mass index in Mexican school children and adolescents. Int J Obes (Lond) 2023; 47:365-374. [PMID: 36792910 PMCID: PMC10147568 DOI: 10.1038/s41366-023-01273-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Obesity is rapidly increasing in Mexican children and adolescents, while food environments are rapidly changing. We evaluated the association between changes in retail food stores and change in body mass index (BMI) in Mexican children and adolescents. METHODS Data on 7507 participants aged 5-19 years old came from the Mexican Family Life Survey 2002-2012. Density of food stores at the municipal-level (number of food stores/area in km2) came from the Economic Censuses of 1999, 2004 and 2009. We categorized food stores as small food retail (small neighborhood stores, tiendas de abarrotes in Mexico), specialty foods, fruit/vegetables, convenience foods, and supermarkets. Associations between change in food stores and change in BMI were estimated using five longitudinal linear fixed-effects regression models (one per type of food store) adjusted for age, parental education, municipal-level socioeconomic deprivation and population density. Density of each food store type was operationalized as quartiles. Analyses were stratified by urbanization. RESULTS There was an inverse dose-response association between increases in fruit/vegetable store density and BMI (β = -0.455 kg/m2, β = -0.733 kg/m2, and β = -0.838 kg/m2 in the second, third, and fourth quartile). In non-urban areas, children living in municipalities with the highest density of small food retail stores experienced a reduction in BMI (β = -0.840 kg/m2). In urban areas, there was an inverse association between specialty food stores with BMI (β = -0.789 kg/m2 in third quartile, and β = -1.204 kg/m2 in fourth quartile). We observed dynamic associations with age; results suggested stronger associations in adolescents. CONCLUSIONS The availability of fruit/vegetable stores may influence a reduction in children and adolescents BMI. These results indicate that policy approaches could be tailored by type of food store - with some consideration for level of urbanization and children's age.
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Duthie C, Pocock T, Curl A, Clark E, Norriss D, Bidwell S, McKerchar C, Crossin R. Online on-demand delivery services of food and alcohol: A scoping review of public health impacts. SSM Popul Health 2023; 21:101349. [PMID: 36845670 PMCID: PMC9950721 DOI: 10.1016/j.ssmph.2023.101349] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/19/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023] Open
Abstract
The increase in availability of online on-demand food and alcohol delivery services has changed the way unhealthy commodities are accessed and understood. We conducted a systematic scoping review of academic and grey literature to map the current knowledge of public health and regulatory/policy outcomes arising from on-demand food and alcohol delivery (defined as delivery within 2 h). We systematically searched three electronic databases and completed supplementary forward citation searches and Google Scholar searches. In total, we screened 761 records (de-duplicated) and synthesised findings from 40 studies by commodity types (on-demand food or alcohol) and outcome focus (outlet, consumer, environmental, labour). Outlet-focused outcomes were most common (n = 16 studies), followed by consumer (n = 11), environmental (n = 7), and labour-focused (n = 6) outcomes. Despite geographical and methodological diversity of studies, results indicate that on-demand delivery services market unhealthy and discretionary foods, with disadvantaged communities having reduced access to healthy commodities. Services that deliver alcohol on-demand can also subvert current alcohol access restrictions, particularly through poor age verification processes. Underpinning these public health impacts is the multi-layered nature of on-demand services and context of the COVID-19 pandemic, which creates ongoing complications as to how populations access food and alcohol. Changing access to unhealthy commodities is an emerging issue in public health. Our scoping review considers priority areas for future research to better inform policy decisions. Current regulation of food and alcohol may not appropriately cover emerging on-demand technologies, necessitating a review of policy.
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Affiliation(s)
- Cassian Duthie
- University of Otago Medical School, Christchurch, New Zealand
| | - Tessa Pocock
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand,Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Angela Curl
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Elinor Clark
- University of Otago Medical School, Christchurch, New Zealand
| | - Dru Norriss
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Susan Bidwell
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Christina McKerchar
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Rose Crossin
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand,Corresponding author. Department of Population Health University of Otago (Christchurch), 34 Gloucester St, Christchurch, 8140, New Zealand.
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Rossi CE, Pinho MGM, Corrêa EN, de Abreu ÂH, Rech CR, Ferreira JRDC, de Vasconcelos FDAG. Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents. Food Nutr Bull 2023; 44:12-26. [PMID: 36601667 DOI: 10.1177/03795721221146215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.
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Affiliation(s)
| | - Maria Gabriela M Pinho
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands.,Upstream Team, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Elizabeth Nappi Corrêa
- Universidade Federal de Santa Catarina. Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n-Centro de Ciências da Saúde, Trindade, Florianópolis-Santa Catarina, Brazil
| | - Ângelo Horta de Abreu
- Gis Especialist. Imagem-Enterprise for Geographic Intelligence Solutions. Belo Horizonte-Minas Gerais, Brazil
| | - Cassiano Ricardo Rech
- Programa de Pós-Graduação em Educação Física (PPGEF), Campus Universitário Trindade, Florianópolis-Santa Catarina, Brazil
| | | | - Francisco de Assis Guedes de Vasconcelos
- Universidade Federal de Santa Catarina. Rua Engenheiro Agronômico Andrei Cristian Ferreira, s/n-Centro de Ciências da Saúde, Trindade, Florianópolis-Santa Catarina, Brazil
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Pauuvale AF, Vickers MH, Pamaka S, Apelu D, Fehoko ‘A, ‘Ofanoa M, Bay JL. Exploring the Retail Food Environment Surrounding Two Secondary Schools with Predominantly Pacific Populations in Tonga and New Zealand to Enable the Development of Mapping Methods Appropriate for Testing in a Classroom. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15941. [PMID: 36498013 PMCID: PMC9739248 DOI: 10.3390/ijerph192315941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/14/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Rates of noncommunicable diseases (NCDs) are disproportionately high among people of Pacific ethnicity. Nutrition-related environmental exposures including food access and quality contribute to the matrix of factors impacting risk. Preventative interventions in adolescence and the opportunity to integrate health promotion into school-based learning are often overlooked. This study tested the potential of a low-cost method to map the retail food environment in a 1 km radius of two secondary schools in low socioeconomic communities with predominantly Pacific populations, in Tonga and New Zealand (NZ). Mapping utilized Google Earth, Google Maps, government maps, and observations. A rubric was developed to categorize food quality. Outlets within a 1 km radius of each school, (Tonga, n = 150; NZ, n = 52) stocked predominantly unhealthy foods. The NZ data compared favorably to previous studies, indicating the method was valid. The Tongan data is novel and indicates that alternative strategies can be used when access to GIS-type tools is limited. The method produced visual data that has the potential to be analyzed using strategies appropriate for secondary schools. The method should now be tested in classrooms to assess its potential to support school-age students to engage in mapping and critiquing the retail food environment.
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Affiliation(s)
- Alvina F. Pauuvale
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Mark H. Vickers
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | | | | | | | - Malakai ‘Ofanoa
- School of Population Health, University of Auckland, Auckland 1142, New Zealand
| | - Jacquie L. Bay
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
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18
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Acciai F, DeWeese RS, Yedidia MJ, Lloyd K, Tulloch D, DeLia D, Ohri-Vachaspati P. Differential Associations Between Changes in Food Environment and Changes in BMI Among Adults Living in Urban, Low-Income Communities. J Nutr 2022; 152:2582-2590. [PMID: 36774124 PMCID: PMC9644168 DOI: 10.1093/jn/nxac186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/12/2022] [Accepted: 08/16/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Food environments can contribute to excess weight gain among adults, but the evidence is mixed. OBJECTIVES This longitudinal study investigated the associations between changes in the food environment and changes in BMI in adults and whether changes in the food environment differentially impact various subgroups. METHODS At 2 time points, BMI was calculated using self-reported height and weight data from 517 adults (mean age, 41 years) living in 4 New Jersey cities. The counts of different types of food outlets within 0.4, 0.8, and 1.6 km of respondents' residences were collected at baseline and tracked until follow-up. A binary measure of social standing (social-advantage group, n = 219; social-disadvantage group, n = 298) was created through a latent class analysis using social, economic, and demographic variables. Multivariable linear regression modeled the associations between changes in BMI with measures of the food environment; additionally, interaction terms between the measures of food environment and social standing were examined. RESULTS Overall, over 18 months, an increase in the number of small grocery stores within 0.4 km of a respondent's residence was associated with a decrease in BMI (β = -1.0; 95% CI: -1.9, -0.1; P = 0.024), while an increase in the number of fast-food restaurants within 1.6 km was associated with an increase in BMI (β = 0.1; 95% CI: 0.01, 0.2; P = 0.027). These overall findings, however, masked some group-specific associations. Interaction analyses suggested that associations between changes in the food environment and changes in BMI varied by social standing. For instance, the association between changes in fast-food restaurants and changes in BMI was only observed in the social-disadvantage group (β = 0.1; 95% CI: 0.02, 0.2; P = 0.021). CONCLUSIONS In a sample of adults living in New Jersey, changes in the food environment had differential effects on individuals' BMIs, based on their social standing.
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Affiliation(s)
- Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Robin S DeWeese
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Michael J Yedidia
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Kristen Lloyd
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - David Tulloch
- Department of Landscape Architecture, Rutgers University, New Brunswick, NJ, USA
| | - Derek DeLia
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC, USA
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19
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Norriss D, Crossin R, Curl A, Bidwell S, Clark E, Pocock T, Gage R, McKerchar C. Food Outlet Access and the Healthiness of Food Available ‘On-Demand’ via Meal Delivery Apps in New Zealand. Nutrients 2022; 14:nu14204228. [PMID: 36296912 PMCID: PMC9607030 DOI: 10.3390/nu14204228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/23/2022] Open
Abstract
Access to unhealthy commodities is a key factor determining consumption, and therefore influences the prevalence of non-communicable diseases. Recently, there has been an increase in the availability of food ‘on-demand’ via meal delivery apps (MDAs). However, the public health and equity impacts of this shift are not yet well understood. This study focused on three MDAs in New Zealand and aimed to answer (1) what is the health profile of the foods being offered on-demand, (2) how many food outlets are available and does this differ by physical access or neighbourhood demographics and (3) does the health profile of foods offered differ by physical access or neighbourhood demographics? A dataset was created by sampling a set of street addresses across a range of demographic variables, and recording the menu items and number of available outlets offered to each address. Machine learning was utilised to evaluate the healthiness of menu items, and we examined if healthiness and the number of available outlets varied by neighbourhood demographics. Over 75% of menu items offered by all MDAs were unhealthy and approximately 30% of all menu items across the three MDAs scored at the lowest level of healthiness. Statistically significant differences by demographics were identified in one of the three MDAs in this study, which suggested that the proportion of unhealthy foods offered was highest in areas with the greatest socioeconomic deprivation and those with a higher proportion of Māori population. Policy and regulatory approaches need to adapt to this novel mode of access to unhealthy foods, to mitigate public health consequences and the effects on population groups already more vulnerable to non-communicable diseases.
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Affiliation(s)
- Dru Norriss
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Rose Crossin
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Angela Curl
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Susan Bidwell
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Elinor Clark
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Tessa Pocock
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
- School of Nursing, University of Auckland, Auckland 1023, New Zealand
| | - Ryan Gage
- Department of Public Health, University of Otago Wellington, Wellington 6021, New Zealand
| | - Christina McKerchar
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
- Correspondence: ; Tel.: +64-(3)-3643638
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Masdor NA, Mohammed Nawi A, Hod R, Wong Z, Makpol S, Chin SF. The Link between Food Environment and Colorectal Cancer: A Systematic Review. Nutrients 2022; 14:nu14193954. [PMID: 36235610 PMCID: PMC9573320 DOI: 10.3390/nu14193954] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Food and diet are critical risk factors for colorectal cancer (CRC). Food environments (FEs) can contribute to disease risk, including CRC. This review investigated the link between FEs and CRC incidence and mortality risk. The systematic search of studies utilised three primary journal databases: PubMed, Scopus, and Web of Science. Retrieved citations were screened and the data were extracted from articles related to the FE-exposed populations who were at risk for CRC and death. We evaluated ecological studies and cohort studies with quality assessment and the Newcastle-Ottawa Quality Assessment Form for Cohort Studies, respectively. A descriptive synthesis of the included studies was performed. Out of 89 articles identified, eight were eligible for the final review. The included studies comprised six ecological studies and two cohort studies published from 2013 to 2021. Six articles were from the US, one was from Africa, and one was from Switzerland. All eight studies were of good quality. The significant finding was that CRC incidence was associated with the availability of specific foods such as red meat, meat, animal fats, energy from animal sources, and an unhealthy FE. Increased CRC mortality was linked with the availability of animal fat, red meat, alcoholic beverages, and calorie food availability, residence in food deserts, and lower FE index. There were a variety of associations between CRC and the FE. The availability of specific foods, unhealthy FE, and food desserts impact CRC incidence and mortality. Creating a healthy FE in the future will require focus and thorough planning.
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Affiliation(s)
- Noor Azreen Masdor
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Correspondence:
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Zhiqin Wong
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Suzana Makpol
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Siok-Fong Chin
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Supplemental Nutrition Assistance Program (SNAP)-authorised store marketing environments in Louisiana encourage the selection of less nutritious foods and beverages. J Nutr Sci 2022; 11:e64. [PMID: 35992571 PMCID: PMC9379931 DOI: 10.1017/jns.2022.60] [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: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022] Open
Abstract
Marketing influences consumers’ dietary purchases. However, little is known about marketing environments in Supplemental Nutrition Assistance Program (SNAP)-authorised stores. The present study explored SNAP-authorised store marketing environments in Louisiana by rurality, store ownership and store type (n 42). Sampling methods were designed to include randomly selected stores in each geographic area of the state. The GroPromo was used to measure placement, promotion, and child-focused aspects of marketing strategies used for healthier (fruits and vegetables) and less healthy products (chips, candy, sugar-sweetened beverages, child-focused cereal) in medium- and high-prominence marketing areas. In using multivariate analysis of variance (MANOVA) (P < 0⋅05) for data analysis, variations in GroPromo scores were found among SNAP-authorised stores by rurality (P < 0⋅05) and store ownership (P < 0⋅001); no differences were found by store type (P > 0⋅05). Future research, practice and policy strategies are required to understand the influence of marketing environments on SNAP participants’ dietary quality and to design responsive public health interventions.
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22
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de Menezes RCE, Oliveira JS, Almendra R, de Lira PIC, Costa EC, Leal VS, Santana P. Influence of food environment on ultra-processed drinks consumption among an economically vulnerable population in a metropolitan area in Brazil: A multilevel analysis. Health Place 2022; 77:102869. [PMID: 35932598 DOI: 10.1016/j.healthplace.2022.102869] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 05/26/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
Ultra-processed drinks (UPDs) consumption is increasing, and this intake has been associated with the risk of illness and death. Data on individuals (n = 430) and food stores (n = 231) were collected in an economically vulnerable area in Recife-Brazil, and multilevel regression models were applied to assess the association between UPDs consumption with food environment characteristics. The results show 29.5% of individuals consume UPDs, higher UPD consumption was significantly associated with age (OR: 0.96), lower educational levels (OR:2.06), high density of stores predominantly selling UPFs (OR:2.34) and lower availability of FV in stores (OR:0.49). The applied methodology can inform food environment interventions to reduce UPDs consumption.
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Affiliation(s)
| | | | - Ricardo Almendra
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Portugal; Department of Geography and Turism, University of Coimbra, Portugal.
| | | | - Emília Chagas Costa
- Physical Education and Sports Science Unit, Vitória Academic Center, Federal University of Pernambuco, Brazil.
| | - Vanessa Sá Leal
- Nutrition Unit, Vitória Academic Center, Federal University of Pernambuco, Brazil.
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Portugal; Department of Geography and Turism, University of Coimbra, Portugal.
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Ramírez-Toscano Y, Pérez-Ferrer C, Bilal U, Auchincloss AH, Barrientos-Gutierrez T. Socioeconomic deprivation and changes in the retail food environment of Mexico from 2010 to 2020. Health Place 2022; 77:102865. [PMID: 35932595 PMCID: PMC7613304 DOI: 10.1016/j.healthplace.2022.102865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/26/2022] [Accepted: 07/12/2022] [Indexed: 11/04/2022]
Abstract
We aimed to analyze the change in the retail food environment of Mexican municipalities from 2010 to 2020, and to assess if these trends were modified by socioeconomic deprivation. We used data from the National Statistical Directory of Economic Units. Changes in the food store count were estimated using fixed-effects Poisson regression models, including coefficients for time, socioeconomic deprivation, and their interaction. We found a rapid growth in convenience stores, seed-grain stores, and supermarkets while small food retail stores declined. Urban areas had a higher count of all types of food stores; however, the steepest increases in food stores were observed in non-urban areas. The increase in convenience stores, supermarkets, specialty food stores, fruit-vegetable stores, and seed-grain stores was greater in the most deprived areas, compared to the least deprived areas. There has been a substantial expansion and rapid change in Mexico's food environment, mainly driven by increases in convenience stores and supermarkets in more deprived and less urbanized areas.
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Affiliation(s)
- Yenisei Ramírez-Toscano
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos, CP 62100, Mexico
| | - Carolina Pérez-Ferrer
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos, CP 62100, Mexico; National Council for Science and Technology (CONACYT), Av. Insurgentes Sur 1582, Crédito Constructor, Benito Juárez, CP 03940, Ciudad de México, Mexico
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market Street, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Nesbitt Hall, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Amy H Auchincloss
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market Street, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Nesbitt Hall, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Tonatiuh Barrientos-Gutierrez
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos, CP 62100, Mexico.
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Ortiz-Hernández L, Romo-Avilés M, Rosales Chavez JB. Main Retailers In Which Mexican Households Acquire Their Food Supply. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:718-727. [PMID: 35953123 DOI: 10.1016/j.jneb.2022.04.213] [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: 04/23/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To describe the frequency of food and beverages purchased made by Mexican households at different types of grocery retailers. DESIGN A national cross-sectional survey. SETTING Mexico. PARTICIPANTS A representative sample of Mexican households (n = 70,311). MAIN OUTCOME MEASURE(S) Household food and beverages purchases. ANALYSIS The association between amounts of food and beverages supply bought in different food retailers (as outcome) and households' sociodemographic characteristics (as covariates) was assessed using logistic and linear regression models. RESULTS Mexican households acquired their food and beverages primarily from abarrotes stores, followed by supermarkets and mercados and tianguis. Abarrotes stores and supermarkets were sources of unprocessed and processed foods. Specialized stores, mercados, and tianguis were primary sources of unprocessed foods. Households with low socioeconomic status and those in the central or southern regions acquired more foods from abarrotes stores, mercados and tianguis, and specialized stores. Households with high socioeconomic status and living in the northern region acquired more foods from supermarkets and convenience stores. CONCLUSIONS AND IMPLICATIONS Abarrotes stores are the primary source of food and beverages for Mexican households; however, some interventions are needed to increase their supply of unprocessed foods. Public health interventions aiming at increasing access to unprocessed foods could be done through traditional retailers.
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Affiliation(s)
- Luis Ortiz-Hernández
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Ciudad de México, México.
| | - Mariana Romo-Avilés
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Ciudad de México, México
| | - Jose B Rosales Chavez
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ
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25
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Children's Community Nutrition Environment, Food and Drink Purchases and Consumption on Journeys between Home and School: A Wearable Camera Study. Nutrients 2022; 14:nu14101995. [PMID: 35631135 PMCID: PMC9146069 DOI: 10.3390/nu14101995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 02/05/2023] Open
Abstract
Children's community nutrition environments are an important contributor to childhood obesity rates worldwide. This study aimed to measure the type of food outlets on children's journeys to or from school, children's food purchasing and consumption, and to determine differences by ethnicity and socioeconomic status. In this New Zealand study, we analysed photographic images of the journey to or from school from a sample of 147 children aged 11-13 years who wore an Autographer camera which recorded images every 7 s. A total of 444 journeys to or from school were included in the analysis. Camera images captured food outlets in 48% of journeys that had a component of active travel and 20% of journeys by vehicle. Children who used active travel modes had greater odds of exposure to unhealthy food outlets than children who used motorised modes; odds ratio 4.2 (95% CI 1.2-14.4). There were 82 instances of food purchases recorded, 84.1% of which were for discretionary foods. Of the 73 food and drink consumption occasions, 94.5% were for discretionary food or drink. Children on their journeys to or from school are frequently exposed to unhealthy food outlets. Policy interventions are recommended to limit the availability of unhealthy food outlets on school routes.
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Maganja D, Miller M, Trieu K, Scapin T, Cameron A, Wu JHY. Evidence Gaps in Assessments of the Healthiness of Online Supermarkets Highlight the Need for New Monitoring Tools: a Systematic Review. Curr Atheroscler Rep 2022; 24:215-233. [PMID: 35138570 PMCID: PMC9023389 DOI: 10.1007/s11883-022-01004-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Online grocery shopping is increasingly popular, but the extent to which these food environments encourage healthy or unhealthy purchases is unclear. This review identifies studies assessing the healthiness of real-world online supermarkets and frameworks to support future efforts. RECENT FINDINGS A total of 18 studies were included and 17 assessed aspects of online supermarkets. Pricing and promotional strategies were commonly applied to unhealthy products, while nutrition labelling may not meet regulated requirements or support consumer decision-making. Few studies investigated the different and specific ways online supermarkets can influence consumers. One framework for comprehensively capturing the healthiness of online supermarkets was identified, particularly highlighting the various ways retailers can tailor the environment to target individuals. Comprehensive assessments of online supermarkets can identify the potential to support or undermine healthy choices and dietary patterns. Common, validated instruments to facilitate consistent analysis and comparison are needed, particularly to investigate the new opportunities the online setting offers to influence consumers.
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Affiliation(s)
- Damian Maganja
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia.
| | - Mia Miller
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia
| | - Tailane Scapin
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
| | - Adrian Cameron
- Global Obesity Centre, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW, 2042, Australia
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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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Phulkerd S, Rachmi CN, Sameeha MJ, Borazon EQ, Thow AM, Trevena H, Saptari AF, Cheah YK, Wel CAC, Marquez VT, Sakulsri T, Thongcharoenchupong N, Poh BK. Identifying Opportunities for Strategic Policy Design to Address the Double Burden of Malnutrition through Healthier Retail Food: Protocol for South East Asia Obesogenic Food Environment (SEAOFE) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:528. [PMID: 35010789 PMCID: PMC8744775 DOI: 10.3390/ijerph19010528] [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: 11/14/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 01/27/2023]
Abstract
Effective policies that address both the supply and demand dimensions of access to affordable, healthy foods are required for tackling malnutrition in South East Asia. This paper presents the Protocol for the South East Asia Obesogenic Food Environment (SEAOFE) study, which is designed to analyze the retail food environment, consumers' and retailers' perspectives regarding the retail food environment, and existing policies influencing food retail in four countries in South East Asia in order to develop evidence-informed policy recommendations. This study was designed as a mixed-methods sequential explanatory approach. The country sites are Malaysia, Indonesia, the Philippines, and Thailand. The proposed study consists of four phases. Phase One describes the characteristics of the current retail food environment using literature and data review. Phase Two interprets consumer experience in the retail food environment in selected urban poor communities using a consumer-intercept survey. This phase also assesses the retail food environment by adapting an in-store audit tool previously validated in higher-income countries. Phase Three identifies factors influencing food retailer decisions, perceptions, and attitudes toward food retail policies using semi-structured interviews with selected retailers. Phase Four recommends changes in the retail food environment using policy analysis and semi-structured interviews with key stakeholders. For the analysis of the quantitative data, descriptive statistics and multiple regression will be used, and thematic analysis will be used to process the qualitative data. This study will engage stakeholders throughout the research process to ensure that the design and methods used are sensitive to the local context.
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Affiliation(s)
- Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand; (S.P.); (T.S.); (N.T.)
| | | | - Mohd Jamil Sameeha
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Elaine Q. Borazon
- International Graduate Program of Education and Human Development (IGPEHD), College of Social Sciences, National Sun Yat-Sen University, Kaohsiung City 80424, Taiwan;
| | - Anne-Marie Thow
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney 2006, Australia; (A.-M.T.); (H.T.)
| | - Helen Trevena
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney 2006, Australia; (A.-M.T.); (H.T.)
| | | | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok 06010, Malaysia;
| | - Che Aniza Che Wel
- Faculty of Economics and Management, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Malaysia;
| | - Vanessa T. Marquez
- School of Economics, University of the Philippines-Diliman, Quezon City 1101, Philippines;
| | - Teeranong Sakulsri
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand; (S.P.); (T.S.); (N.T.)
| | - Natjera Thongcharoenchupong
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand; (S.P.); (T.S.); (N.T.)
| | - Bee Koon Poh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
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A Proposed Research Agenda for Promoting Healthy Retail Food Environments in the East Asia-Pacific Region. Curr Nutr Rep 2021; 10:267-281. [PMID: 34894342 DOI: 10.1007/s13668-021-00381-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW This paper aimed to summarise existing literature on strategies to improve the healthiness of retail food environments in the East Asia and Pacific (EAP) region, and propose a prioritised research agenda on this topic. RECENT FINDINGS Little research on retail food environments has been conducted in the EAP region. Several approaches for measuring retail food environments were identified, although none have been tailored to the EAP context. A small number of policies and initiatives to promote healthy retail food environments have been implemented in EAP. Lessons learnt from successful implementation of initiatives in other regions could be applied in EAP. Retail food environments have a strong influence on food choices and health outcomes. Research can contribute to efforts to improve the healthiness of retail food environments in EAP by (1) describing the current state of retail food environments to highlight areas of good practice and concern and (2) identifying policies and initiatives that are likely to be effective, and mechanisms for their successful implementation.
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30
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Keeble M, Adams J, Vanderlee L, Hammond D, Burgoine T. Associations between online food outlet access and online food delivery service use amongst adults in the UK: a cross-sectional analysis of linked data. BMC Public Health 2021; 21:1968. [PMID: 34719382 PMCID: PMC8557109 DOI: 10.1186/s12889-021-11953-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/06/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Online food delivery services facilitate 'online' access to food outlets that typically sell lenergy-dense nutrient-poor food. Greater online food outlet access might be related to the use of this purchasing format and living with excess bodyweight, however, this is not known. We aimed to investigate the association between aspects of online food outlet access and online food delivery service use, and differences according to customer sociodemographic characteristics, as well as the association between the number of food outlets accessible online and bodyweight. METHODS In 2019, we used an automated data collection method to collect data on all food outlets in the UK registered with the leading online food delivery service Just Eat (n = 33,204). We linked this with contemporaneous data on food purchasing, bodyweight, and sociodemographic information collected through the International Food Policy Study (analytic sample n = 3067). We used adjusted binomial logistic, linear, and multinomial logistic regression models to examine associations. RESULTS Adults in the UK had online access to a median of 85 food outlets (IQR: 34-181) and 85 unique types of cuisine (IQR: 64-108), and 15.1% reported online food delivery service use in the previous week. Those with the greatest number of accessible food outlets (quarter four, 182-879) had 71% greater odds of online food delivery service use (OR: 1.71; 95% CI: 1.09, 2.68) compared to those with the least (quarter one, 0-34). This pattern was evident amongst adults with a university degree (OR: 2.11; 95% CI: 1.15, 3.85), adults aged between 18 and 29 years (OR: 3.27, 95% CI: 1.59, 6.72), those living with children (OR: 1.94; 95% CI: 1.01; 3.75), and females at each level of increased exposure. We found no association between the number of unique types of cuisine accessible online and online food delivery service use, or between the number of food outlets accessible online and bodyweight. CONCLUSIONS The number of food outlets accessible online is positively associated with online food delivery service use. Adults with the highest education, younger adults, those living with children, and females, were particularly susceptible to the greatest online food outlet access. Further research is required to investigate the possible health implications of online food delivery service use.
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Affiliation(s)
- Matthew Keeble
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Jean Adams
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Lana Vanderlee
- grid.23856.3a0000 0004 1936 8390École de Nutrition, Université Laval, Pavillon des Services, bureau 2729-E, 2440 boul. Hochelaga, Quebec City, QC G1V 0A6 Canada
| | - David Hammond
- grid.46078.3d0000 0000 8644 1405School of Public Health and Health Systems, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G1 Canada
| | - Thomas Burgoine
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
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Nutritional value of child-targeted food products: results from the Food Quality Observatory. Public Health Nutr 2021; 24:5329-5337. [PMID: 34348826 DOI: 10.1017/s1368980021003219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To characterise the nutritional quality of food products targeted to children, we aimed: (1) to determine if the nutritional composition of child-targeted food products is different from those for the general population and (2) to verify differences in the nutrient content of child-targeted food products between three selected food categories. DESIGN The present study is part of the work conducted by the Food Quality Observatory, created in 2016 in the province of Quebec (Canada). Ready-to-eat (RTE) breakfast cereals (n 331), granola bars (n 310) and yoghurts and dairy desserts (n 380) were the food categories analysed. SETTING Nutritional values and all packaging information were obtained by purchasing every product available in supermarkets, grocery stores and specialty grocery stores. Free sugars were manually differentiated from total sugars for each product. Products were classified according to two targeted consumer groups: children or general population. RESULTS The nutrient profile of RTE breakfast cereals, granola bars and yoghurts and dairy desserts targeted to children differed from that of products intended at the general population. Child-targeted RTE breakfast cereals had the least favourable nutritional composition, with significantly higher content of carbohydrates, total sugars, free sugars and Na compared with breakfast cereals for the general population as well as child-targeted granola bars and yoghurts and dairy desserts. All child-targeted products analysed contained free sugars. CONCLUSIONS The current study supports the relevance to further regulate marketing to children on food product packages to ensure that such marketing is not present on food products with poor nutritional quality.
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Tavares LF, Perez PMP, dos Passos MEA, de Castro Junior PCP, da Silva Franco A, de Oliveira Cardoso L, de Castro IRR. Development and Application of Healthiness Indicators for Commercial Establishments That Sell Foods for Immediate Consumption. Foods 2021; 10:1434. [PMID: 34205645 PMCID: PMC8235135 DOI: 10.3390/foods10061434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
Studies of food environments lack easy-to-apply indicators for their characterization and monitoring. This study aimed to create and assess the applicability of an a priori classification of establishments that sell foods for immediate consumption and to develop and apply indicators for assessment of the establishments' healthiness. The indicators were grouped by the types of foods sold most frequently at these establishments, according to the extent and purpose of the foods' industrial processing. Four indicators were developed, based on the availability of unprocessed/minimally processed foods (MPF) and ultra-processed foods (UPF) in the establishments. The classification and indicators were applied to commercial food establishments at two Brazilian universities. Descriptive analyses were performed to characterize the food environment for all the establishments and by university. Two proportion indicators assess the relative availability of subgroups of MPF and UPF. The UPF/MPF ratio expresses the relative advantage/disadvantage of the availability of MPF compared to that of UPF. The Healthiness Index or summary score expresses the availability of MPF and the unavailability of UPF. The classification and indicators present good discriminatory power and are easy to operationalize, interpret, and adapt.
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Affiliation(s)
- Letícia Ferreira Tavares
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Patrícia Maria Périco Perez
- Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro 20559-900, Brazil; (P.M.P.P.); (I.R.R.d.C.)
| | - Maria Eliza Assis dos Passos
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Paulo Cesar Pereira de Castro Junior
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Amanda da Silva Franco
- Nutrition Coordination, Health Sciences Center, Centro Universitário Serra dos Órgãos (UNIFESO), Rio de Janeiro 25964-000, Brazil;
| | | | - Inês Rugani Ribeiro de Castro
- Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro 20559-900, Brazil; (P.M.P.P.); (I.R.R.d.C.)
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Pineda E, Brunner EJ, Llewellyn CH, Mindell JS. The retail food environment and its association with body mass index in Mexico. Int J Obes (Lond) 2021; 45:1215-1228. [PMID: 33597735 PMCID: PMC8159738 DOI: 10.1038/s41366-021-00760-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 11/24/2020] [Accepted: 01/20/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVE Mexico has one of the highest rates of obesity and overweight worldwide, affecting 75% of the population. The country has experienced a dietary and food retail transition involving increased availability of high-calorie-dense foods and beverages. This study aimed to assess the relationship between the retail food environment and body mass index (BMI) in Mexico. SUBJECTS/METHODS Geographical and food outlet data were obtained from official statistics; anthropometric measurements and socioeconomic characteristics of adult participants (N = 22,219) came from the nationally representative 2012 National Health and Nutrition Survey (ENSANUT). Densities (store count/census tract area (CTA)) of convenience stores, restaurants, fast-food restaurants, supermarkets and fruit and vegetable stores were calculated. The association of retail food environment variables, sociodemographic data and BMI was tested using multilevel linear regression models. RESULTS Convenience store density was high (mean (SD) = 50.0 (36.9)/CTA) compared with other food outlets in Mexico. A unit increase in density of convenience stores was associated with a 0.003 kg/m2 (95% CI: 0.0006, 0.005, p = 0.011) increase in BMI, equivalent to 0.34 kg extra weight for an adult 1.60 m tall for every additional 10% store density increase (number of convenience stores per CTA (km2)). Metropolitan areas showed the highest density of food outlet concentration and the highest associations with BMI (β = 0.01, 95% CI: 0.004-0.01, p < 0.001). A 10% store density increase in these areas would represent a 1 kg increase in weight for an adult 1.60 m tall. CONCLUSIONS Convenience store density was associated with higher mean BMI in Mexican adults. An excessive convenience store availability, that offers unhealthy food options, coupled with low access to healthy food resources or stores retailing healthy food, including fruits and vegetables, may increase the risk of higher BMI. This is the first study to assess the association of the retail food environment and BMI at a national level in Mexico.
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Affiliation(s)
- Elisa Pineda
- Research Department of Epidemiology and Public Health, University College London, London, UK.
- Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, London, UK.
- School of Public Health, Imperial College London, London, UK.
| | - Eric J Brunner
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Jennifer S Mindell
- Research Department of Epidemiology and Public Health, University College London, London, UK
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34
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Carducci B, Oh C, Roth DE, Neufeld LM, Frongillo EA, L'Abbe MR, Fanzo J, Herforth A, Sellen DW, Bhutta ZA. Gaps and priorities in assessment of food environments for children and adolescents in low- and middle-income countries. NATURE FOOD 2021; 2:396-403. [PMID: 37118231 DOI: 10.1038/s43016-021-00299-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 05/06/2021] [Indexed: 04/30/2023]
Abstract
School-aged children and adolescents have complex interactions with their food environments-the point of engagement of individuals with the food system-and are influenced by a diversity of individual, household and organizational factors. Although a wide range of methods have been proposed to define, monitor and evaluate food environments, few are tailored to school-aged children and adolescents. Here, we interrogate published literature on food metrics and methodologies for the characterization of food environments for school-aged children and adolescents living in low- and middle-income counties. We identify key priority actions and potential indicators for better monitoring and evaluation to galvanize policymaking to improve the healthiness of these interactions, which are so crucial to future adult well-being.
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Affiliation(s)
- Bianca Carducci
- Centre for Global Child Health, Peter Gilgan Centre for Research, Learning Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christina Oh
- Centre for Global Child Health, Peter Gilgan Centre for Research, Learning Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daniel E Roth
- Centre for Global Child Health, Peter Gilgan Centre for Research, Learning Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public, Health University of Toronto, Toronto, Ontario, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
| | | | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Mary R L'Abbe
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Fanzo
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Nitze School of Advanced International Studies, Johns Hopkins University, Washington DC, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anna Herforth
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Daniel W Sellen
- Centre for Global Child Health, Peter Gilgan Centre for Research, Learning Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Peter Gilgan Centre for Research, Learning Hospital for Sick Children, Toronto, Ontario, Canada.
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
- Dalla Lana School of Public, Health University of Toronto, Toronto, Ontario, Canada.
- Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada.
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan.
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Are neighbourhood restaurants related to frequency of restaurant meals and dietary quality? Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis. Public Health Nutr 2021; 24:4630-4641. [PMID: 34030763 DOI: 10.1017/s1368980021002196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. DESIGN Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4·8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. SETTING Urbanised areas in multiple regions of the USA, years 2000-2002 and 2010-2012. PARTICIPANTS Participants aged 45-84 years were followed for 10 years (n 3567). RESULTS Median HEI (out of 100) was fifty-nine at baseline and sixty-two at follow-up. The cross-sectional analysis found that residing in areas with a high density of restaurants (highest-ranked quartile) was associated with 52 % higher odds of frequently eating restaurant meals (≥3 times/week, OR: 1·52, 95 % CI 1·18, 1·98) and 3 % higher odds of having lower dietary quality (HEI lowest quartile < 54, OR: 1·03, 95 % CI 1·01, 1·06); associations were not sustained in longitudinal analyses. The cross-sectional analysis found 34 % higher odds of having lower dietary quality for those who frequently ate at restaurants (OR: 1·34, 95 % CI 1·12, 1·61), and more restaurant meals (over time increase ≥ 1 time/week) were associated with higher odds of having worse dietary quality at follow-up (OR: 1·21, 95 % CI 1·00, 1·46). CONCLUSIONS Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.
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Assessing nutritional value of ready-to-eat breakfast cereals in the province of Quebec (Canada): a study from the Food Quality Observatory. Public Health Nutr 2021; 24:2397-2404. [PMID: 33843558 DOI: 10.1017/s1368980021001361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The Food Quality Observatory was created in the province of Quebec (Canada) in 2016. In this study, the Observatory aimed to generate a methodology to (1) test the use of sales data combined with nutrient values to characterise the nutritional composition of ready-to-eat (RTE) breakfast cereals offered and purchased in the province of Quebec (Canada) and (2) verify the extent to which a front-of-pack label based on the percentage of daily value (DV) for total sugar, as a strategy to improve the food supply, would be distributed in this food category. DESIGN Nutritional information were obtained by purchasing each RTE breakfast cereal available in the Greater Montreal area. Cereals were then classified according to their processing type. SETTING The nutritional values of 331 RTE breakfast cereals available in Quebec were merged with sales data covering the period between May 2016 and May 2017. A total of 306 products were successfully cross-referenced. RESULTS Granola and sweetened cereals were the most available (36·6 % and 19·6 %, respectively) and purchased (19·8 % and 40·9 % of sales, respectively). When compared with other types of cereals, granola cereals had a higher energy, fat, saturated fat, protein content and a lower Na content. A larger proportion of chocolate (65 %) and sweetened cereals (49 %) were above 15 % of the DV for sugar. CONCLUSIONS This study showed that the methodology developed generates important data to monitor nutritional quality of the food supply and ultimately contribute to improve the nutritional quality of processed foods.
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Lynch M, Graham M, Taylor K, Mah CL. Corner Store Retailers' Perspectives on a Discontinued Healthy Corner Store Initiative. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021:272684X211004930. [PMID: 33823687 DOI: 10.1177/0272684x211004930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Making fresh fruits and vegetables (FFV) more widely available has been a prominent focus of healthy retail interventions and may have an important role in improving food access and diet quality at the population level. 'Healthy retail' interventions in corner/convenience stores (CS) are increasingly being adopted by public health practitioners to address the diet-related risk factors, improve food access at the community level, and change food retail environments. Private sector retailers are integral to the success of public health retailing interventions, making their perspectives and experiences critical. There is a particular need for greater evidence from retailers in settings where evaluations of these interventions have yielded null or mixed results. Through semi-structured interviews with 8 CS retailers (7 from urban settings and 1 from rural) in Ottawa, Ontario, Canada, this study aimed to describe experiences and critical factors regarding the feasibility and sustainability of a healthy CS program that was not sustained following the pilot testing phase, with a specific focus on the sale of FFV. Thematic analysis was used to analyze the interview data, which indicated that retailers faced two dominant challenges with selling FFV in CS: both relate to how these stores are embedded in the larger local and global food system. We join others in arguing that efforts and support for retail interventions aiming to increase the availability of FFV in CS need to address the structure and relations of the food system, as an upstream determinant of CS retailer interest and motivation.
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Affiliation(s)
- Meghan Lynch
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Marketa Graham
- Chronic Disease and Injury Prevention Unit, Ottawa Public Health, Ottawa, Ontario, Canada
| | - Krystal Taylor
- Chronic Disease and Injury Prevention Unit, Ottawa Public Health, Ottawa, Ontario, Canada
| | - Catherine L Mah
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
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Hirsch JA, Moore KA, Cahill J, Quinn J, Zhao Y, Bayer FJ, Rundle A, Lovasi GS. Business Data Categorization and Refinement for Application in Longitudinal Neighborhood Health Research: a Methodology. J Urban Health 2021; 98:271-284. [PMID: 33005987 PMCID: PMC8079597 DOI: 10.1007/s11524-020-00482-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 12/31/2022]
Abstract
Retail environments, such as healthcare locations, food stores, and recreation facilities, may be relevant to many health behaviors and outcomes. However, minimal guidance on how to collect, process, aggregate, and link these data results in inconsistent or incomplete measurement that can introduce misclassification bias and limit replication of existing research. We describe the following steps to leverage business data for longitudinal neighborhood health research: re-geolocating establishment addresses, preliminary classification using standard industrial codes, systematic checks to refine classifications, incorporation and integration of complementary data sources, documentation of a flexible hierarchical classification system and variable naming conventions, and linking to neighborhoods and participant residences. We show results of this classification from a dataset of locations (over 77 million establishment locations) across the contiguous U.S. from 1990 to 2014. By incorporating complementary data sources, through manual spot checks in Google StreetView and word and name searches, we enhanced a basic classification using only standard industrial codes. Ultimately, providing these enhanced longitudinal data and supplying detailed methods for researchers to replicate our work promotes consistency, replicability, and new opportunities in neighborhood health research.
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Affiliation(s)
- Jana A. Hirsch
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, PA Philadelphia, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Kari A. Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Jesse Cahill
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY USA
| | - James Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY USA
| | - Yuzhe Zhao
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Felicia J. Bayer
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY USA
| | - Gina S. Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, PA Philadelphia, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
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Consumer Food Environment Healthiness Score: Development, Validation, and Testing between Different Types of Food Retailers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073690. [PMID: 33916263 PMCID: PMC8037126 DOI: 10.3390/ijerph18073690] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/13/2021] [Accepted: 03/30/2021] [Indexed: 01/04/2023]
Abstract
The aim of this study was to develop and validate a scoring system, based on AUDITNOVA, to assess the healthiness of the consumer food environment, considering food availability, price, advertising, and placement strategies. Audited data of 650 food retailers were used to develop, validate, and test the consumer food environment healthiness score. To compose the score, the reference was the Dietary Guidelines for the Brazilian Population. The total and subscores were standardized for a scale from 0 to 100. Construct validity was assessed using the Kruskal–Wallis Dunn tests. Cronbach’s alpha coefficients were calculated to determine the consistency of the scores. The median score was 33.7 (p25 = 26.9; p75 = 42.1). The public and private specialized indoor fresh food markets showed the highest medians; otherwise, bakeries and food retailers with the predominant sale of ultra-processed foods showed the lowest. The score was able to satisfactorily classify the extreme food retailer groups by the predominant sale of fresh or minimally processed foods and the predominant sale of ultra-processed foods. The results of Cronbach’s alpha showed excellent internal consistency (α = 0.91). The score helped to provide an overall assessment of consumer food environment healthiness and was able to classify food retailer groups as healthy and unhealthy according to the degree of processing of the available foods.
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Facilitating Factors and Opportunities for Local Food Purchases in School Meals in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042009. [PMID: 33669594 PMCID: PMC7922870 DOI: 10.3390/ijerph18042009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 11/17/2022]
Abstract
The objective of this study is to explore the facilitating factors and opportunities that can promote the implementation of local food purchase (LFP) in Spanish school meals in the opinions of key informants (IK). A qualitative study was carried out based on in-depth interviews with 14 KI capable of influencing Spanish food policy (Representatives of consumers and/or producers, representatives of organizations that promote LFP, and representatives of the government and/or academics). They were asked about opportunities and facilitating factors for implementation of LFP. Interviews were recorded and transcribed. A qualitative content analysis was carried out with Atlas ti. The analysis of the interviews produced two categories that include factors that- in the interviewees' opinions- can promote LFP (social fabric and policy) and three categories that bring together the factors that represent opportunities for implementation in school meal programs in Spain (the policy agenda, regional characteristics and regional context). The overlap between social and political demands were considered to be facilitating factors for LFP. Furthermore, in the opinions of KI, the presence of health and sustainability issues on the public agenda, the existence of a structured productive system and political changes represent an opportunity to implement LFP.
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Elorriaga N, Moyano DL, López MV, Cavallo AS, Gutierrez L, Panaggio CB, Irazola V. Urban Retail Food Environments: Relative Availability and Prominence of Exhibition of Healthy vs. Unhealthy Foods at Supermarkets in Buenos Aires, Argentina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030944. [PMID: 33499044 PMCID: PMC7908167 DOI: 10.3390/ijerph18030944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 01/06/2023]
Abstract
There is growing evidence that the food environment can influence diets. The present study aimed to assess the relative availability and prominence of healthy foods (HF) versus unhealthy products (UP) in supermarkets in Buenos Aires, Argentina and to explore differences by retail characteristics and neighborhood income level. We conducted store audits in 32 randomly selected food retails. Food availability (presence/absence, ratio of cumulative linear shelf length for HF vs. UP) and prominence inside the store (location visibility) were measured based on the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) protocol. On average, for every 1 m of shelf length for UP, there was about 25 cm of shelf length for HF (HF/UP ratio: 0.255, SD 0.130). UP were more frequently available in high-prominence store areas (31/32 retails) than HF (9/32 retails). Shelf length ratio differed across commercial chains (p = 0.0268), but not by store size or type. Retails in the lower-income neighborhoods had a lower HF/UP ratio than those in the higher-income neighborhoods (p = 0.0329). Availability of the selected HF was overcome largely by the UP, particularly in high prominence areas, and in neighborhoods with lower income level, which may pose an opportunity for public health interventions.
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Affiliation(s)
- Natalia Elorriaga
- Institute for Clinical Effectiveness and Health Policy (IECS), Department of Research on Chronic Diseases, Ciudad Autónoma de Buenos Aires C1414CPV, Argentina; (D.L.M.); (M.V.L.); (A.S.C.); (L.G.); (V.I.)
- National Scientific and Technical Research Council (CONICET), Center for Research on Epidemiology and Public Health (CIESP-IECS), Ciudad Autónoma de Buenos Aires C1414CPV, Argentina
- Escuela de Nutrición, Universidad de Buenos Aires (UBA), Ciudad Autónoma de Buenos Aires C1121ABG, Argentina
- Departamento de Salud, Universidad Nacional de La Matanza (UNLaM), San Justo B1754JEC, Argentina;
- Correspondence: ; Tel.: +54-011-4777-8767
| | - Daniela L. Moyano
- Institute for Clinical Effectiveness and Health Policy (IECS), Department of Research on Chronic Diseases, Ciudad Autónoma de Buenos Aires C1414CPV, Argentina; (D.L.M.); (M.V.L.); (A.S.C.); (L.G.); (V.I.)
- Departamento de Salud, Universidad Nacional de La Matanza (UNLaM), San Justo B1754JEC, Argentina;
| | - María V. López
- Institute for Clinical Effectiveness and Health Policy (IECS), Department of Research on Chronic Diseases, Ciudad Autónoma de Buenos Aires C1414CPV, Argentina; (D.L.M.); (M.V.L.); (A.S.C.); (L.G.); (V.I.)
- Departamento de Salud, Universidad Nacional de La Matanza (UNLaM), San Justo B1754JEC, Argentina;
| | - Ana S. Cavallo
- Institute for Clinical Effectiveness and Health Policy (IECS), Department of Research on Chronic Diseases, Ciudad Autónoma de Buenos Aires C1414CPV, Argentina; (D.L.M.); (M.V.L.); (A.S.C.); (L.G.); (V.I.)
| | - Laura Gutierrez
- Institute for Clinical Effectiveness and Health Policy (IECS), Department of Research on Chronic Diseases, Ciudad Autónoma de Buenos Aires C1414CPV, Argentina; (D.L.M.); (M.V.L.); (A.S.C.); (L.G.); (V.I.)
| | - Camila B. Panaggio
- Departamento de Salud, Universidad Nacional de La Matanza (UNLaM), San Justo B1754JEC, Argentina;
| | - Vilma Irazola
- Institute for Clinical Effectiveness and Health Policy (IECS), Department of Research on Chronic Diseases, Ciudad Autónoma de Buenos Aires C1414CPV, Argentina; (D.L.M.); (M.V.L.); (A.S.C.); (L.G.); (V.I.)
- National Scientific and Technical Research Council (CONICET), Center for Research on Epidemiology and Public Health (CIESP-IECS), Ciudad Autónoma de Buenos Aires C1414CPV, Argentina
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Borges CA, Gabe KT, Canella DS, Jaime PC. Caracterização das barreiras e facilitadores para alimentação adequada e saudável no ambiente alimentar do consumidor. CAD SAUDE PUBLICA 2021; 37Suppl 1:e00157020. [DOI: 10.1590/0102-311x00157020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 03/25/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo: O objetivo deste trabalho é explorar potenciais barreiras e facilitadores para alimentação saudável no ambiente alimentar do consumidor e analisar a associação com diferentes tipos de estabelecimentos comerciais tendo como referencial teórico o Guia Alimentar para a População Brasileira. Estudo transversal realizado no Município de Jundiaí, São Paulo, Brasil, com auditoria do ambiente alimentar do consumidor realizada em 650 comércios varejistas. Foram identificados barreiras e facilitadores das escolhas alimentares saudáveis no ambiente interno dos comércios. Análise fatorial foi utilizada para estimar fatores que caracterizassem o ambiente segundo barreiras e facilitadores. Regressão linear foi utilizada para avaliar a associação entre os fatores e as diferentes categorias de estabelecimentos. A maioria dos estabelecimentos tinham venda prioritária de ultraprocessados. Do total de comércios estudados, 75,9% disponibilizavam bebidas açucaradas; 37% arroz, feijão e 30% frutas e hortaliças. O primeiro fator caracterizou-se pela presença tanto de barreiras quanto de facilitadores (fator misto), o segundo fator caracterizou-se por mais facilitadores e o terceiro por maior presença de barreiras no ambiente do consumidor. Supermercados foram associados positivamente com os três fatores (valor de p < 0,001). Os sacolões/hortifrutis públicos e privados, os mercados de bairro tiveram associação positiva com o fator mais facilitadores (valor de p < 0,001). Os mercados e padarias se associaram positivamente ao fator mais barreiras (valor de p < 0,001). Os padrões que caracterizam barreiras e facilitadores para alimentação saudável diferem de forma significativa segundo tipos de comércios.
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Drewnowski A, Monterrosa EC, de Pee S, Frongillo EA, Vandevijvere S. Shaping Physical, Economic, and Policy Components of the Food Environment to Create Sustainable Healthy Diets. Food Nutr Bull 2020; 41:74S-86S. [DOI: 10.1177/0379572120945904] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Sustainable healthy diets are those dietary patterns that promote all dimensions of individuals’ health and well-being; have low environmental pressure and impact; are accessible, affordable, safe, and equitable; and are culturally acceptable. The food environment, defined as the interface between the wider food system and consumer’s food acquisition and consumption, is critical for ensuring equitable access to foods that are healthy, safe, affordable, and appealing. Discussion: Current food environments are creating inequities, and sustainable healthy foods are generally more accessible for those of higher socioeconomic status. The physical, economic, and policy components of the food environment can all be acted on to promote sustainable healthy diets. Physical spaces can be modified to improve relative availability (ie, proximity) of food outlets that carry nutritious foods in low-income communities; to address economic access certain actions may improve affordability, such as fortification, preventing food loss through supply chain improvements; and commodity specific vouchers for fruits, vegetables, and legumes. Other policy actions that address accessibility to sustainable healthy foods are comprehensive marketing restrictions and easy-to-understand front-of-pack nutrition labels. While shaping food environments will require concerted action from all stakeholders, governments and private sector bear significant responsibility for ensuring equitable access to sustainable healthy diets.
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Affiliation(s)
- Adam Drewnowski
- University of Washington, Department of Epidemiology, Seattle, WA, USA
| | | | - Saskia de Pee
- UN World Food Programme, Rome, Italy
- Tufts University, Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Edward A. Frongillo
- University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
| | - Stefanie Vandevijvere
- Scientific Institute of Public Health (Sciensano), Department of Epidemiology and Public Health, Brussels, Belgium
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Fox EL, Timmer A. Children's and adolescents' characteristics and interactions with the food system. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2020. [DOI: 10.1016/j.gfs.2020.100419] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Food availability and advertising within food outlets around primary healthcare services in Brazil. J Nutr Sci 2020; 9:e49. [PMID: 33244401 PMCID: PMC7681171 DOI: 10.1017/jns.2020.45] [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: 02/17/2020] [Revised: 09/25/2020] [Accepted: 10/07/2020] [Indexed: 12/03/2022] Open
Abstract
The consumer food environment is changing: an extensive variety of foods are now available in most markets, offering palatability, convenience and novelty. However, little is known about the availability and advertising of food items within food outlets, especially among developing countries. The present study examined these dimensions in 281 food outlets located around eighteen primary healthcare services in Belo Horizonte, Brazil, in 2013. These establishments were classified as large-chain supermarkets; specialised fruits and vegetable (F&V) markets; and local grocery stores, convenience stores or bakeries. Availability of F&V, availability of ultra-processed foods (UPF) and food advertising were compared across the food outlet categories by applying the χ2 test. Almost 60 % of the food outlets were specialised F&V markets, 21⋅4 % were large-chain supermarkets and 19⋅2 % were local grocery stores, convenience stores or bakeries. Almost 80 % contained at least eight types of fruits and vegetables, and 60 % contained UPF. Food advertisement was absent in 59⋅8 % of the food outlets, 19⋅6 % were advertising only F&V and 17⋅4 % were advertising only UPF. Higher F&V availability was noted inside specialised F&V markets and large-chain supermarkets than local grocery stores, convenience stores or bakeries. Advertising of F&V was more common within specialised F&V markets. However, large-chain supermarkets and local grocery stores, convenience stores or bakeries contained more frequent UPF food advertising isolated: 38⋅3 and 35⋅2 %, respectively. Therefore, the availability and advertising of food items within food outlets around primary healthcare services are different according to the type of food outlet.
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Kenny TA, Little M, Lemieux T, Griffin PJ, Wesche SD, Ota Y, Batal M, Chan HM, Lemire M. The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238818. [PMID: 33261090 PMCID: PMC7730644 DOI: 10.3390/ijerph17238818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.
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Affiliation(s)
- Tiff-Annie Kenny
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Correspondence: or
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Tad Lemieux
- Department of English Language and Literature, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - P. Joshua Griffin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Department of American Indian Studies, University of Washington, Seattle, WA 98195, USA
| | - Sonia D. Wesche
- Department of Geography, Environment and Geomatics, Faculty of Arts, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Yoshitaka Ota
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Nippon Foundation Ocean Nexus Center, EarthLab, University of Washington; Seattle, WA 98195, USA
| | - Malek Batal
- Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de recherche en santé publique (CReSP), Montreal, Quebec, QC H3N 1X9, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON K1N 9A7, Canada;
| | - Melanie Lemire
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Quebec, QC G1V 0A6, Canada
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Huitink M, Poelman MP, Seidell JC, Kuijper LDJ, Hoekstsra T, Dijkstra C. Can Healthy Checkout Counters Improve Food Purchases? Two Real-Life Experiments in Dutch Supermarkets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228611. [PMID: 33228189 PMCID: PMC7699573 DOI: 10.3390/ijerph17228611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 11/16/2022]
Abstract
Most snacks displayed at supermarket checkouts do not contribute to a healthy diet. We investigated the effects of introducing healthier snack alternatives at checkouts in supermarkets on purchasing behavior. In Study 1, we investigated the effect of completely substituting less healthy with healthier snacks (one supermarket). In Study 2, we investigated the effect of placing and discounting healthier snacks while the less healthy snacks remain in place (two supermarkets). In both studies, the number of purchased snacks (per 1000 customers) was used as the outcome variable. Results for Study 1 showed that the absolute number of purchased checkout snacks was 2.4 times lower (95% confidence interval (CI): 1.9-2.7) when healthier snacks instead of less healthy snacks were placed at the supermarket checkouts. Results for Study 2 showed that when additional healthier snacks were placed near the checkouts, the absolute number of healthier purchased snacks increased by a factor of 2.1 (95% CI: 1.3-3.3). When additional healthier snacks were placed near the checkouts and discounted, the absolute number of healthier purchased snacks increased by a factor of 2.7 (95% CI: 2.0-3.6), although this was not statistically significant higher than placement only (ratio: 1.1, 95% CI: 0.7-1.9). Purchases of less healthy snacks did not decline, and even slightly increased, during the intervention period (ratio: 1.3, 95% CI: 1.1-1.5). If supermarkets want to promote healthier snack purchases, additional healthier products can be positioned near the checkouts. However, this does not discourages the purchase of less healthy snacks. Therefore, to discourage unhealthy snack purchases at supermarket checkouts, a total substitution of less healthy snacks with healthier alternatives is most effective.
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Affiliation(s)
- Marlijn Huitink
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
- Correspondence:
| | - Maartje P. Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN Wageningen, The Netherlands;
| | - Jacob C. Seidell
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Lothar D. J. Kuijper
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Trynke Hoekstsra
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Coosje Dijkstra
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
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48
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Pulker CE, Trapp GSA, Fallows M, Hooper P, McKee H, Pollard CM. Food Outlets Dietary Risk (FODR) assessment tool: study protocol for assessing the public health nutrition risks of community food environments. Nutr J 2020; 19:122. [PMID: 33183279 PMCID: PMC7663896 DOI: 10.1186/s12937-020-00641-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/02/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Availability and accessibility of nutritious foods can vary according to the food outlets present within a neighbourhood or community. There is increasing evidence that community food environments influence food choice, diet and the risk of diet-related chronic disease, however contemporary community food environments assessments (e.g. unhealthy fast food outlets versus healthy supermarkets or fruit and vegetable shops) may be too simplistic to accurately summarise the complexities of their impacts on food choice. This study protocol describes the development of the Food Outlets Dietary Risk (FODR) assessment tool for use by local government in Perth, Western Australia. METHODS Similar to food safety risk assessment, the FODR assessment tool rates the potential harmful public health nutrition impact of food outlets by identifying and characterising the issues, and assessing the risk of exposure. Scores are attributed to six public health nutrition attributes: 1) availability of nutrient-poor foods; 2) availability of nutritious foods; 3) acceptability and appeal; 4) accessibility; 5) type of business operation; and 6) complex food outlet considerations. Food retail outlets are then classified as having a low, medium, high or very high dietary risk based on their total score. DISCUSSION A local government administered tool to rate the public health nutrition risk of food outlets requires data which can be collected during routine assessments or sourced from the internet. The ongoing categorical classification of foods available within food outlets as either unhealthy or nutritious will require nutrition scientists' input. An objective risk assessment of the dietary impact of food retail outlets can guide local government planning, policies and interventions to create supportive community food environments. It is intended that locally relevant data can be sourced throughout Australia and in other countries to apply the local context to the FODR assessment tool. Utility and acceptability of the tool will be tested, and consultation with environmental health officers and public health practitioners will inform future iterations.
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Affiliation(s)
- Claire Elizabeth Pulker
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia 6845 Australia
- East Metropolitan Health Service, Kirkman House, 20 Murray Street, East Perth, Perth, Western Australia 6004 Australia
| | - Georgina S. A. Trapp
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia 6872 Australia
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Mark Fallows
- Department of Health of Western Australia, Perth, Western Australia 6004 Australia
| | - Paula Hooper
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Heather McKee
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia 6872 Australia
| | - Christina Mary Pollard
- School of Public Health, Curtin University, Kent Street, GPO Box U1987, Perth, Western Australia 6845 Australia
- East Metropolitan Health Service, Kirkman House, 20 Murray Street, East Perth, Perth, Western Australia 6004 Australia
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49
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Payne E, Brown LJ, Crowley E, Rollo M, Schumacher TL. Exploring core food accessibility in Tamworth, NSW, Australia. Inform Health Soc Care 2020; 45:428-443. [PMID: 32706276 DOI: 10.1080/17538157.2020.1793345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A lack of core food accessibility negatively affects diet quality, potentially increasing the prevalence of health risk factors such as obesity. The purpose of this study was to investigate core food access in an Australian regional center through the use of data visualization techniques. METHODS Supermarkets were used as a proxy for core food accessibility and were identified and mapped by town region with a combination of Google Maps and Stata/IC 15.1 software. A statistical analysis comparing the demographics of each town region was also completed using Stata. RESULTS The maps generated suggest that there may be a disparity in core food accessibility between town regions. The analysis of demographics demonstrated that one town region had a greater proportion of disadvantaged residents, with statistically significant variation between regions. CONCLUSION Data visualization and analysis may be a useful tool for clinicians to communicate accessibility information experienced by local residents. This need not be limited to food accessibility and extended to health services.
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Affiliation(s)
- Ellen Payne
- Department of Rural Health, University of Newcastle , Tamworth, Australia
| | - Leanne J Brown
- Department of Rural Health, University of Newcastle , Tamworth, Australia
| | - Elesa Crowley
- Department of Rural Health, University of Newcastle , Tamworth, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle , Callaghan, Australia
| | - Megan Rollo
- Department of Rural Health, University of Newcastle , Tamworth, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle , Callaghan, Australia
| | - Tracy L Schumacher
- Department of Rural Health, University of Newcastle , Tamworth, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle , Callaghan, Australia
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50
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Cunningham-Myrie CA, Younger NO, Theall KP, Greene LG, Lyew-Ayee P, Wilks R. Understanding neighbourhood retail food environmental mechanisms influencing BMI in the Caribbean: a multilevel analysis from the Jamaica Health and Lifestyle Survey: a cross-sectional study. BMJ Open 2020; 10:e033839. [PMID: 32830113 PMCID: PMC7445353 DOI: 10.1136/bmjopen-2019-033839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity. DESIGN Cross-sectional study. SETTING Data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts. PARTICIPANTS A subsample of 2529 participants aged 18-74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded. PRIMARY OUTCOME MEASURE Mean BMI, calculated as weight divided by height squared (kg/m2). RESULTS There was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10-3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity. CONCLUSIONS Higher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations.
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Affiliation(s)
| | - Novie O Younger
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Katherine P Theall
- Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana, USA
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Rainford Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
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