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Pozveh SH, Aktary ML, Polsky JY, Moubarac JC, Vanderlee L, Olstad DL. Socioeconomic Inequalities in Intakes of Ultraprocessed and Minimally Processed Foods in Nationally Representative Samples of Adults in Canada: An Analysis of Trends between 2004 and 2015. J Nutr 2024; 154:3088-3104. [PMID: 39053608 DOI: 10.1016/j.tjnut.2024.07.029] [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: 06/07/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Individuals with a lower socioeconomic position (SEP) often have higher intakes of ultraprocessed food (UPF) and lower intakes of minimally processed food (MPF); however, studies have not examined trends in absolute and relative gaps and gradients in UPF and MPF intake using multiple indicators of SEP. OBJECTIVES We examined within-year absolute and relative gaps and gradients in UPF and MPF intake and trends between 2004 and 2015 according to 6 indicators of SEP among nationally representative samples of adults in Canada. METHODS Adults (≥18 y) in the Canadian Community Health Survey-Nutrition 2004 (n = 20,880) or 2015 (n = 13,970) reported SEP (individual and household education, household income adequacy, household food insecurity, neighborhood material and social deprivation) and completed a 24-h dietary recall. Multivariable linear regression assessed within-year absolute and relative gaps and gradients in the proportion of energy from UPF and MPF and trends between 2004 and 2015. RESULTS The largest and most consistent within-year inequities in UPF and MPF intake were for individual and household educational attainment. Overall and among males, higher SEP groups had more favorable intakes over time based on trends in absolute and relative gaps and gradients in UPF and MPF intake by household food insecurity [for example, the absolute gap in UPF intake declined from -1.2% (95% confidence interval: -5.3%, 2.9%) to -7.9% of energy (95% confidence interval: -11.2%, -4.5%) in the overall population]. Overall and among males, lower SEP groups had more favorable intakes over time based on trends in absolute and relative gaps in UPF and MPF intake by neighborhood material deprivation. CONCLUSIONS Socioeconomic inequalities in UPF and MPF intake were most pronounced for individual and household education. Between 2004 and 2015, several inequalities in UPF and MPF intake emerged according to household food insecurity (favoring higher SEP groups) and neighborhood material deprivation (favoring lower SEP groups).
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Affiliation(s)
- Seyed Hosseini Pozveh
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jane Y Polsky
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Jean-Claude Moubarac
- Département de nutrition, Faculté de médecine, Université de Montréal, Pavillon Liliane de Stewart, Montréal, Québec, Canada
| | - Lana Vanderlee
- Centre Nutrition, Santé et Société (NUTRISS), École de Nutrition, Université Laval, Québec, Québec, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Vaillancourt C, Ahmed M, Kirk S, Labonté MÈ, Laar A, Mah CL, Minaker L, Olstad DL, Potvin Kent M, Provencher V, Prowse R, Raine KD, Schram A, Zavala-Mora D, Rancourt-Bouchard M, Vanderlee L. Food environment research in Canada: a rapid review of methodologies and measures deployed between 2010 and 2021. Int J Behav Nutr Phys Act 2024; 21:18. [PMID: 38373957 PMCID: PMC10875887 DOI: 10.1186/s12966-024-01558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024] Open
Abstract
Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.
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Affiliation(s)
- Caroline Vaillancourt
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Sara Kirk
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Kjipuktuk (Halifax), NS, B3H 4R2, Canada
| | - Marie-Ève Labonté
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Leia Minaker
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3T1, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Véronique Provencher
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405 87 Ave Northwest, Edmonton, AB, T6G 1C9, Canada
| | - Ashley Schram
- School of Regulation and Global Governance (RegNet), ANU College of Asia & the Pacific, The Australian National University, 8 Fellows Road, Canberra, Australian Capital Territory, 2600, Australia
| | - Daniela Zavala-Mora
- Science Library, Université Laval, 1045 Avenue de La Médecine, Québec, QC, G1V 0A6, Canada
| | - Maryka Rancourt-Bouchard
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada.
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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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Madlala SS, Hill J, Kunneke E, Lopes T, Faber M. Adult food choices in association with the local retail food environment and food access in resource-poor communities: a scoping review. BMC Public Health 2023; 23:1083. [PMID: 37280606 DOI: 10.1186/s12889-023-15996-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/26/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND There is a growing body of research on local retail food environments globally in both urban and rural settings. Despite this, little research has been conducted on adult food choices, local retail environments, and healthy food access in resource-poor communities. The purpose of this study is therefore to provide an overview of the evidence on adult food choices (measured as dietary intake) in association with the local retail food environment and food access in resource-poor communities (defined as low-income communities and/or households). METHODS We searched nine databases for studies published from July 2005 to March 2022 and identified 2426 records in the primary and updated search. Observational studies, empirical and theoretical studies, focused on adults ≤ 65 years, published in English peer-reviewed journals, examining local retail food environments and food access, were included. Two independent reviewers screened identified articles using the selection criteria and data extraction form. Study characteristics and findings were summarized for all studies and relevant themes summarized for qualitative and mixed methods studies. RESULTS A total of 47 studies were included in this review. Most studies were cross sectional (93.6%) and conducted in the United States of America (70%). Nineteen (40.4%) studies assessed the association between food choice outcomes and local retail food environment exposures, and evidence on these associations are inconclusive. Associations of certain food choice outcomes with healthy food retail environments were positive for healthy foods (in 11 studies) and unhealthy foods (in 3 studies). Associations of certain food choice outcomes with unhealthy retail food environment exposures were positive for unhealthy foods in 1 study and negative for healthy foods in 3 studies. In 9 studies, some of the food choice outcomes were not associated with retail food environment exposures. A healthy food store type and lower food prices were found to be major facilitators for healthy food access in resource-poor communities, while cost and transportation were the main barriers. CONCLUSIONS More research is needed on the local retail food environment in communities in low- and middle-income countries to develop better interventions to improve food choices and access to healthy foods in resource-poor communities.
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Affiliation(s)
- Samukelisiwe S Madlala
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
| | - Jillian Hill
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ernesta Kunneke
- Department of Dietetics and Nutrition, University of the Western Cape, Cape Town, South Africa
| | - Tatum Lopes
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa
| | - Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Dietetics and Nutrition, University of the Western Cape, Cape Town, South Africa
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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Friesen EL, Staykov E, Myran DT. Understanding the association between neighbourhood socioeconomic status and grocery store alcohol sales following market liberalization in Ontario, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:254-263. [PMID: 36214995 PMCID: PMC10036712 DOI: 10.17269/s41997-022-00694-w] [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: 02/08/2022] [Accepted: 08/31/2022] [Indexed: 03/24/2023]
Abstract
OBJECTIVES In 2015, Ontario partially deregulated alcohol sales by allowing grocery stores to sell alcohol. The purpose of this study was to evaluate (1) whether neighbourhood-level socioeconomic status (SES) impacted the likelihood that a grocery store began selling alcohol, and (2) whether increases in alcohol retail availability following deregulation differed between neighbourhoods based on SES. METHODS This was a repeated cross-sectional analysis of 1062 grocery stores in 17,096 neighbourhoods in urban Ontario. The association between neighbourhood-level SES and whether a grocery store began selling alcohol was modeled using mixed effect logistic regression. The annual change in drive-distance from a neighbourhood to the closest off-premise alcohol outlet between 2015 and 2020 was modeled using mixed effect linear regression. An interaction between time and SES was included to evaluate whether this change differed between neighbourhoods based on SES. RESULTS Grocery stores in neighbourhoods in the lowest SES quintile were 39% less likely to start selling alcohol than grocery stores in neighbourhoods in the highest SES quintile (odds ratio (OR): 0.61, 95% confidence interval (CI): 0.39-0.94). As grocery store sales expanded, the distance to the closest off-premise alcohol outlet decreased by 51.8 m annually (95% CI: 48.8-54.9, p < 0.01). A significant interaction between year and SES was observed whereby this trend was more pronounced in high- versus low-SES neighbourhoods. CONCLUSION The expansion of grocery store alcohol sales increased alcohol availability, but this increase was proportionately larger in high- versus low-SES neighbourhoods. This reduced historic disparities in alcohol availability between low- and high-SES neighbourhoods.
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Affiliation(s)
- Erik Loewen Friesen
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Emiliyan Staykov
- Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Thomas Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, 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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Brimblecombe J, Miles B, Chappell E, De Silva K, Ferguson M, Mah C, Miles E, Gunther A, Wycherley T, Peeters A, Minaker L, McMahon E. Implementation of a food retail intervention to reduce purchase of unhealthy food and beverages in remote Australia: mixed-method evaluation using the consolidated framework for implementation research. Int J Behav Nutr Phys Act 2023; 20:20. [PMID: 36803988 PMCID: PMC9938595 DOI: 10.1186/s12966-022-01377-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/08/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Adoption of health-enabling food retail interventions in food retail will require effective implementation strategies. To inform this, we applied an implementation framework to a novel real-world food retail intervention, the Healthy Stores 2020 strategy, to identify factors salient to intervention implementation from the perspective of the food retailer. METHODS A convergent mixed-method design was used and data were interpreted using the Consolidated Framework for Implementation Research (CFIR). The study was conducted alongside a randomised controlled trial in partnership with the Arnhem Land Progress Aboriginal Corporation (ALPA). Adherence data were collected for the 20 consenting Healthy Stores 2020 study stores (ten intervention /ten control) in 19 communities in remote Northern Australia using photographic material and an adherence checklist. Retailer implementation experience data were collected through interviews with the primary Store Manager for each of the ten intervention stores at baseline, mid- and end-strategy. Deductive thematic analysis of interview data was conducted and informed by the CFIR. Intervention adherence scores derived for each store assisted interview data interpretation. RESULTS Healthy Stores 2020 strategy was, for the most part, adhered to. Analysis of the 30 interviews revealed that implementation climate of the ALPA organisation, its readiness for implementation including a strong sense of social purpose, and the networks and communication between the Store Managers and other parts of ALPA, were CFIR inner and outer domains most frequently referred to as positive to strategy implementation. Store Managers were a 'make-or-break' touchstone of implementation success. The co-designed intervention and strategy characteristics and its perceived cost-benefit, combined with the inner and outer setting factors, galvanised the individual characteristics of Store Managers (e.g., optimism, adaptability and retail competency) to champion implementation. Where there was less perceived cost-benefit, Store Managers seemed less enthusiastic for the strategy. CONCLUSIONS Factors critical to implementation (a strong sense of social purpose; structures and processes within and external to the food retail organisation and their alignment with intervention characteristics (low complexity, cost advantage); and Store Manager characteristics) can inform the design of implementation strategies for the adoption of this health-enabling food retail initiative in the remote setting. This research can help inform a shift in research focus to identify, develop and test implementation strategies for the wide adoption of health-enabling food retail initiatives into practice. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN 12,618,001,588,280.
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Affiliation(s)
- Julie Brimblecombe
- Department of Nutrition Dietetics and Food, Monash University, Level 1 264 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia. .,Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Building 58 Rocklands Drive, Tiwi, NT, 0810, Australia. .,School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Level 4, Herston, QLD, 4006, Australia.
| | - Bethany Miles
- grid.1002.30000 0004 1936 7857Department of Nutrition Dietetics and Food, Monash University, Level 1 264 Ferntree Gully Rd, Notting Hill, Victoria, 3168 Australia
| | - Emma Chappell
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Building 58 Rocklands Drive, Tiwi, NT 0810 Australia ,grid.1003.20000 0000 9320 7537School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Level 4, Herston, QLD 4006 Australia
| | - Khia De Silva
- Arnhem Land Progress Aboriginal Corporation, 70 O’Sullivan Cct, East Arm, NT 0828 Australia
| | - Megan Ferguson
- grid.1002.30000 0004 1936 7857Department of Nutrition Dietetics and Food, Monash University, Level 1 264 Ferntree Gully Rd, Notting Hill, Victoria, 3168 Australia ,Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Building 58 Rocklands Drive, Tiwi, NT 0810 Australia ,grid.1003.20000 0000 9320 7537School of Public Health, Faculty of Medicine, The University of Queensland, Public Health Building, Level 4, Herston, QLD 4006 Australia
| | - Catherine Mah
- grid.55602.340000 0004 1936 8200Dalhousie University, 5850 College Street, Second Floor, PO Box 15000, Halifax, NS B3H 4R2 Canada ,grid.17063.330000 0001 2157 2938University of Toronto, 155 College Street, Toronto, ON M5T 3M7 Canada
| | - Eddie Miles
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Building 58 Rocklands Drive, Tiwi, NT 0810 Australia
| | - Anthony Gunther
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Building 58 Rocklands Drive, Tiwi, NT 0810 Australia
| | - Thomas Wycherley
- grid.1026.50000 0000 8994 5086Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, North Terrace, Adelaide, South Australia 5000 Australia
| | - Anna Peeters
- grid.1021.20000 0001 0526 7079Institute for Health Transformation, Deakin University, Geelong, VIC Australia
| | - Leia Minaker
- grid.46078.3d0000 0000 8644 1405School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - Emma McMahon
- grid.1002.30000 0004 1936 7857Department of Nutrition Dietetics and Food, Monash University, Level 1 264 Ferntree Gully Rd, Notting Hill, Victoria, 3168 Australia ,Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Building 58 Rocklands Drive, Tiwi, NT 0810 Australia
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Seale E, de Groh M, Greene-Finestone L. Fast food consumption in adults living in Canada: alternative measurement methods, consumption choices, and correlates. Appl Physiol Nutr Metab 2023; 48:163-171. [PMID: 36322952 DOI: 10.1139/apnm-2022-0252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Global industries and technological advancements have contributed to the proliferation of fast food (FF) establishments and ultraprocessed food, associated with poorer diet quality and health outcomes. To investigate FF as an indicator, we compared alternative methods to capture self-reported FF consumption and examined associated socio-demographic factors. We conducted a secondary analysis of the 2014-2015 Foodbook study, a cross-sectional survey on foods consumed by Canadians during the previous week. An embedded randomized design compared alternative FF intake questions of varying details. A total of 6062 participants aged 18+ were included, representing 24.7 million Canadian adults. Approximately 48% consumed FF in the past week, and of FF consumers, average frequency was twice. Asking broadly about FF intake without examples resulted in significantly lower reported FF intake compared with the two more detailed questions; the latter two were not significantly different. Burgers, pizza, and submarines/sandwiches were most commonly consumed. Men, younger age, higher BMI, women in central Canada (versus territorial regions), and men with income $30 000-$80 000 (versus >$80 000) were associated with higher FF consumption. Consumption of FF is common among Canadians; some associated factors are gender-specific. Further research examining FF as an indicator, and individual and societal implications of FF consumption, is recommended to inform programs and policies.
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Affiliation(s)
- Emily Seale
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada
| | - Linda Greene-Finestone
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada
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Koschmann A, Wansink B. Food Security, Store Access, and Prices Paid: Do the Poor Pay More for Groceries? JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2021.1997856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Anthony Koschmann
- Assistant Professor of Marketing, Eastern Michigan UniversityCollege of Business, Michigan, USA
| | - Brian Wansink
- Professor and Director of the Food and Brand Lab, Cornell University College of Agriculture and Life Sciences Dyson School of Applied Economics and Management Ithaca, New York, USA
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Lynch M, Giles A. Using diffusion of innovations theory to examine a discontinued heathy corner store pilot program. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2105186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Meghan Lynch
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Audrey Giles
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Muzenda T, Dambisya PM, Kamkuemah M, Gausi B, Battersby J, Oni T. Mapping food and physical activity environments in low- and middle-income countries: A systematised review. Health Place 2022; 75:102809. [PMID: 35508088 DOI: 10.1016/j.healthplace.2022.102809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/06/2021] [Accepted: 04/15/2022] [Indexed: 12/27/2022]
Abstract
This systematised literature review synthesised evidence on approaches to mapping food and physical activity (PA) environments in low- and middle-income countries (LMICs). Of the 60 articles included, 25 and 35 mapped food and PA environments respectively. All studies were cross-sectional with researcher-led data collection. Three types of mapping tools were identified - maps (n = 18), GPS (n = 10), and GIS (n = 37). Our findings point to a paucity of research mapping food and PA environments, overall and particularly subjective domains. We highlight a need for future studies that utilise innovative, inexpensive and participatory research methods to understand dynamic exposures to obesogenic environment features in resource-constrained contexts undergoing rapid urbanisation.
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Affiliation(s)
- Trish Muzenda
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
| | - Philip Mbulalina Dambisya
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Monika Kamkuemah
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa; Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Blessings Gausi
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa
| | - Jane Battersby
- African Centre for Cities, University of Cape Town, Cape Town, 7945, South Africa
| | - Tolu Oni
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, 7925, South Africa; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
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Mah CL, Foster K, Jago E, Hajizadeh M, Luongo G, Taylor N, Fuller D, Yi Y, Esan OT, Lukic R, Clarke M, Wranik WD, Brimblecombe JK, Peeters A. Study protocol for CELLAR (COVID-related Eating Limitations and Latent dietary effects in the Atlantic Region): population-based observational study to monitor dietary intakes and purchasing during COVID-19 in four Atlantic Canadian provinces. BMJ Open 2022; 12:e061660. [PMID: 35477873 PMCID: PMC10098265 DOI: 10.1136/bmjopen-2022-061660] [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] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Poor diet is a leading preventable risk for the global burden of non-communicable disease. Robust measurement is needed to determine the effect of COVID-19 on dietary intakes and consumer purchasing, given the widespread changes to consumer food environments and economic precarity. The research objectives are as follows: (1) describe dietary intakes of foods, beverages and nutrients of concern during the COVID-19 pandemic; (2) quantify change in diet during COVID-19 as compared with prepandemic, previously captured in the provincial samples of the population-representative 2015 Canadian Community Health Survey-Nutrition and (3) examine how household purchasing practices predict dietary intakes during COVID-19. METHODS AND ANALYSES Observational study of diet, using a population-based stratified probability sampling strategy allocated via dual-frame (landline and cellphone) calls to random-digit dialled numbers, followed by age-sex group quotas. The base population comprises the four provinces of the Atlantic region of Canada, jurisdictions with an excess burden of pre-existing dietary risk, compared with the rest of Canada. Our aim is n=1000 to obtain reliable estimates at a regional level to describe intakes and compare with prepandemic baseline. Data collection entails 12 weeks participation: (1) enrolment with sociodemographics (key dietary risk predictors such as age, sex, gender, pre-COVID-19 income, employment, household composition, receipt of economic relief, rural residence); (2) two 24hour diet recalls using the online ASA-24 Canada 2018 tool; and (3) online uploads of household food purchase receipts over the 12 weeks enrolled. Participation incentives will be offered. ETHICS AND DISSEMINATION This research protocol received funding from the Canadian Institutes of Health Research (FRN VR5 172691) and ethics review approval from the Dalhousie University Research Ethics Board. Study protocol and instruments and a de-identified dataset will be made publicly available. We will submit the findings to peer-reviewed journals, as well as conferences geared towards scientific and decision-maker audiences.
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Affiliation(s)
- Catherine L Mah
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Karen Foster
- Department of Sociology and Social Anthropology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Emily Jago
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mohammad Hajizadeh
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gabriella Luongo
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Nathan Taylor
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Fuller
- School of Human Kinetics and Recreation, Memorial University, St John's, Newfoundland and Labrador, Canada
| | - Yanqing Yi
- Department of Community Health and Humanities, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Olukorede T Esan
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan Lukic
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Maria Clarke
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Julie Kay Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
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Robitaille É, Paquette MC, Durette G, Bergeron A, Dubé M, Doyon M, Mercille G, Lemire M, Lo E. Implementing a Rural Natural Experiment: A Protocol for Evaluating the Impacts of Food Coops on Food Consumption, Resident's Health and Community Vitality. Methods Protoc 2022; 5:33. [PMID: 35448698 PMCID: PMC9025453 DOI: 10.3390/mps5020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Local food environments are recognized by experts as a determinant of healthy eating. Food cooperatives (coop) can promote the accessibility to healthier foods and thus improve the health of the population, particularly in remote rural communities. OBJECTIVE To measure the effects of implementing a food coop in a disadvantaged community with poor access to food. We have two main research questions: (1). Does the establishment of a food coop in rural areas described as food deserts have an impact on accessibility, frequency of use, food consumption, food quality, and ultimately the health of individuals? (2). Does the establishment of a food coop in rural areas described as food deserts have an impact on food security and community vitality? DESIGN A natural experiment with a mixed pre/post method will be used. The sample is composed of households that came from geographically isolated communities (population: 215 to 885 inhabitants) which qualified as food deserts and located in rural areas of Quebec (Canada). All communities plan to open a food coop (in the years 2022-2023), and as their opening will be staggered over time, participants from communities with a new food coop (intervention) will be compared to communities awaiting the opening of their food coop (control). Data collection was carried out at three time points: (1) before; (2) 1 to 5 months after; and (3) 13 to 17 months after the opening of the coop. Questionnaires were used to measure sociodemographic variables, dietary intake, residents' health, and community vitality. Semi-structured interviews were conducted with community stakeholders. RESULTS Few natural experiments have been conducted regarding the impact of implementing food coops. Gathering concrete data on the effectiveness and processes surrounding these interventions through natural experiments will help to quantify their impact and guide knowledge users and policymakers to make more informed decisions.
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Affiliation(s)
- Éric Robitaille
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
- Département de Médecine Sociale et Préventive, Université de Montréal, École de Santé Publique de l’Université de Montréal, Montréal, QC H3T 1A8, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3T 1A8, Canada;
| | - Marie-Claude Paquette
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
- Département de Nutrition, Université de Montréal, Montréal, QC H3T 1A8, Canada
| | - Gabrielle Durette
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Amélie Bergeron
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Marianne Dubé
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Mélanie Doyon
- Département de Géographie, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada;
| | - Geneviève Mercille
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H3T 1A8, Canada;
- Département de Nutrition, Université de Montréal, Montréal, QC H3T 1A8, Canada
| | - Marc Lemire
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
| | - Ernest Lo
- Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada; (M.-C.P.); (G.D.); (A.B.); (M.D.); (M.L.); (E.L.)
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1G1, Canada
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Food deserts and food swamps in a Brazilian metropolis: comparison of methods to evaluate the community food environment in Belo Horizonte. Food Secur 2021. [DOI: 10.1007/s12571-021-01237-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lynch M, Knezevic I, Mah CL. Exploring food shopping behaviours through a study of Ottawa social media. Appetite 2021; 168:105695. [PMID: 34534591 DOI: 10.1016/j.appet.2021.105695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022]
Abstract
This study explored the important attributes of the local food retail environments that residents from Ottawa, Ontario, Canada, used in recommending where to purchase fresh produce, including fruits and vegetables, in the Ottawa area. Drawing upon an approach originating in marketing and consumer research, qualitative thematic analysis was used to analyze 79 discussions from three social media platforms that occurred between 2015 and 2018. We identified three patterns of conversations about food shopping, characterized by participants describing important factors of their local retail food environments that shaped their recommendations for different retail food establishments: 1) Pleasant represented discussions where having a pleasurable food shopping experience was the main discussion point. 2) Thrifty discussions were marked primarily by economical management and discussed food shopping in pragmatic terms. 3) Compromise represented a group where discussions described needing to find a middle ground between affordability and quality. While not without limitations, our study was the first exploration of whether social media data could be useful for qualitatively evaluating local retail food environments. Our findings add to the conclusions of other researchers that social media data does not compromise on the breadth of views captured and can parallel findings from traditional methods. These findings have implications for nutrition researchers and practitioners who we encourage to consider social media discussion data in their work.
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Affiliation(s)
- Meghan Lynch
- Dalla Lana School of Public Health, 155 College St, University of Toronto, Toronto, M5T 3M7, Canada.
| | - Irena Knezevic
- School of Journalism and Communication, Carleton University, Ottawa, Canada
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, Halifax, Canada
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Quayyum F, Dombrowski SU. Barriers to nutritional pregnancy preparation and support needs in women and men: Qualitative study based on the Theoretical Domains Framework. ACTA ACUST UNITED AC 2021; 17:17455065211042182. [PMID: 34465253 PMCID: PMC8414608 DOI: 10.1177/17455065211042182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Purpose: Eating behaviours prior to conception may impact the health of the offspring
at birth and throughout life. Women and men of childbearing age often follow
a nutritionally poor preconception diet. Nutritional support before
pregnancy has the potential to improve the health of future offspring. This
study examined barriers to nutritional preparation for pregnancy and
perceived support needs of women and men of childbearing age. Design: Qualitative interviews based on the Theoretical Domains Framework. Setting: Online. Participants: Eligible individuals were (1) New Brunswick residents (all genders), (2) over
19 years old, and (3) intended to have offspring in the future. Methods: Interviews were conducted via online instant messenger and analysed
thematically. Results: Interviews of participants (n = 19, age = 19–23 years, 14 women, 5 men) gave
rise to five key theoretical domains: lack of knowledge; lack of beliefs
about capabilities; suboptimal environmental context and resources;
unfavourable social influences; and restrictive social roles. Suggestions to
address pregnancy preparation support needs included healthcare professional
consultations; accessible and credible references; increasing access to
healthy food; proactive engagement; and gender-specific support. Conclusion: Women and men called for various types of preconception support to address
identified barriers, ranging from healthcare professional advice and
credible informational resources to broader interventions such as making
healthy food more affordable and normalizing discussion of preconception
health throughout the life course.
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Affiliation(s)
- Fareeha Quayyum
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
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17
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Ma Y, McRae C, Wu YH, Dubé L. Exploring Pathways of Socioeconomic Inequity in Vegetable Expenditure Among Consumers Participating in a Grocery Loyalty Program in Quebec, Canada, 2015-2017. Front Public Health 2021; 9:634372. [PMID: 34409001 PMCID: PMC8365471 DOI: 10.3389/fpubh.2021.634372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 07/08/2021] [Indexed: 01/04/2023] Open
Abstract
Vegetable consumption remains consistently low despite supportive policy and investments across the world. Vegetables are available in great variety, ranging in their processing level, availability, cost, and arguably, nutritional value. A retrospective longitudinal study was conducted in Quebec, Canada to explore pathways of socioeconomic inequity in vegetable expenditure. Data was obtained for consumers who participated in a grocery loyalty program from 2015 to 2017 and linked to the 2016 Canadian census. Vegetable expenditure share (%) was examined as a fraction of the overall food basket and segmented by processing level. Panel random effects and tobit models were used overall and to estimate the stratified analysis by median income split. Consumers allocated 8.35% of their total food expenditure to vegetables, which was mostly allocated to non-processed fresh (6.88%). Vegetable expenditure share was the highest in early winter and lowest in late summer. In the stratified analysis, the low-income group exhibited less seasonal variation, allocated less to fresh vegetables, and spent more on canned and frozen compared to the high-income group. Measures of socioeconomic status were all significant drivers of overall vegetable consumption. Consumers with high post-secondary education in the low-income group spent 2% more on vegetables than those with low education. The complexity of observed expenditure patterns points to a need for more specific vegetable consumption guidelines that include provisions by processing level. Implications for education, marketing, intersectional policies, and the role of government are discussed. Governments can scale present efforts and catalyze health-promoting investments across local, state, national, and global food systems.
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Affiliation(s)
- Yu Ma
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada.,McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Cameron McRae
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada.,McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Yun-Hsuan Wu
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada.,Department of Public Health, China Medical University, Taichung, Taiwan
| | - Laurette Dubé
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada.,McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
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Sawyer ADM, van Lenthe F, Kamphuis CBM, Terragni L, Roos G, Poelman MP, Nicolaou M, Waterlander W, Djojosoeparto SK, Scheidmeir M, Neumann-Podczaska A, Stronks K. Dynamics of the complex food environment underlying dietary intake in low-income groups: a systems map of associations extracted from a systematic umbrella literature review. Int J Behav Nutr Phys Act 2021; 18:96. [PMID: 34256794 PMCID: PMC8276221 DOI: 10.1186/s12966-021-01164-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/25/2021] [Indexed: 02/08/2023] Open
Abstract
Background Inequalities in obesity pertain in part to differences in dietary intake in different socioeconomic groups. Examining the economic, social, physical and political food environment of low-income groups as a complex adaptive system – i.e. a system of multiple, interconnected factors exerting non-linear influence on an outcome, can enhance the development and assessment of effective policies and interventions by honouring the complexity of lived reality. We aimed to develop and apply novel causal loop diagramming methods in order to construct an evidence-based map of the underlying system of environmental factors that drives dietary intake in low-income groups. Methods A systematic umbrella review was conducted on literature examining determinants of dietary intake and food environments in low-income youths and adults in high/upper-middle income countries. Information on the determinants and associations between determinants was extracted from reviews of quantitative and qualitative studies. Determinants were organised using the Determinants of Nutrition and Eating (DONE) framework. Associations were synthesised into causal loop diagrams that were subsequently used to interpret the dynamics underlying the food environment and dietary intake. The map was reviewed by an expert panel and systems-based analysis identified the system paradigm, structure, feedback loops and goals. Results Findings from forty-three reviews and expert consensus were synthesised in an evidence-based map of the complex adaptive system underlying the food environment influencing dietary intake in low-income groups. The system was interpreted as operating within a supply-and-demand, economic paradigm. Five sub-systems (‘geographical accessibility’, ‘household finances’, ‘household resources’, ‘individual influences’, ‘social and cultural influences’) were presented as causal loop diagrams comprising 60 variables, conveying goals which undermine healthy dietary intake. Conclusions Our findings reveal how poor dietary intake in low-income groups can be presented as an emergent property of a complex adaptive system that sustains a food environment that increases the accessibility, availability, affordability and acceptability of unhealthy foods. In order to reshape system dynamics driving unhealthy food environments, simultaneous, diverse and innovative strategies are needed to facilitate longer-term management of household finances and socially-oriented practices around healthy food production, supply and intake. Ultimately, such strategies must be supported by a system paradigm which prioritises health. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01164-1.
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Affiliation(s)
- Alexia D M Sawyer
- Department of Public and Occupational Health, Amsterdam University Medical Centres, University of Amsterdam, Room J2-211, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands.
| | - Frank van Lenthe
- Department of Public Health, Erasmus Medical Centre, Rotterdam, 3000 CA, The Netherlands
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, 3584 CH, The Netherlands
| | - Laura Terragni
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Gun Roos
- Consumer Research Institute, Oslo Metropolitan University, 0170, Oslo, Norway
| | - Maartje P Poelman
- Department of Social Sciences, Wageningen University, Wageningen, 6706 KN, The Netherlands
| | - Mary Nicolaou
- Department of Public and Occupational Health, Amsterdam University Medical Centres, University of Amsterdam, Room J2-211, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
| | - Wilma Waterlander
- Department of Public and Occupational Health, Amsterdam University Medical Centres, University of Amsterdam, Room J2-211, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
| | - Sanne K Djojosoeparto
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, 3584 CB, The Netherlands
| | - Marie Scheidmeir
- Psychology Institute, Johannes Gutenberg University Mainz, D-55122, Mainz, Germany
| | | | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam University Medical Centres, University of Amsterdam, Room J2-211, Meibergdreef 15, Amsterdam, 1105 AZ, The Netherlands
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Brown JA, Ferdinands AR, Prowse R, Reynard D, Raine KD, Nykiforuk CI. Seeing the food swamp for the weeds: Moving beyond food retail mix in evaluating young people's food environments. SSM Popul Health 2021; 14:100803. [PMID: 34041350 PMCID: PMC8142271 DOI: 10.1016/j.ssmph.2021.100803] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 12/12/2022] Open
Abstract
Nutritional health of children and youth is an increasing cause for concern in Canada. Through food and beverage messaging in multiple environments, young people develop eating behaviours with ramifications throughout their life course. Unhealthy food retailers near schools, recreation facilities, and childcare centres-key activity settings for healthy eating promotion-present repeated, compounding exposures to commercial geomarketing. Geomarketing impacts nutritional health by promoting highly processed, calorie-dense, and nutrient-poor foods and beverages across urban landscapes. While food retail mix (as a ratio of healthy to unhealthy food retailers) can be used to assess food environments at multiple scales, such measures may misrepresent young people's unique experience of these geographic phenomena. Moving beyond uniform conceptualization of food environments, new research methods and tools are needed for children and youth. We investigated young people's food environments in the major Canadian cities of Calgary and Edmonton. Using government-initiated nutrition guidelines, we categorized 55.8% of all food retailers in Calgary, and 59.9% in Edmonton as 'unhealthy'. A Bernoulli trial at the 0.05 alpha level indicated few differences in prevalence proximal to activity settings versus elsewhere in both cities, demonstrating the limited applicability of food retail mix for characterizing young people's food environments. To model unhealthy food retailers geomarketing to children and youth, we considered their proximity to multiple activity settings, using overlapping radial buffers at the 250 m, 500 m, 1000 m, and 1500 m scales. Examining young people's food environments relative to the spaces where they learn and play, we determined that as many as 895 out of 2663 unhealthy food retailers fell within 1500 m of 21+ activity settings. By conceptualizing, measuring, and problematizing these "super-proximal" unhealthy food retailers, urban planners and public health researchers can use these techniques to pinpoint unhealthy food retailers, or "weeds in the food swamp," as a critical site for healthy eating promotion in municipalities.
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Affiliation(s)
- Jennifer Ann Brown
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Rachel Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Darcy Reynard
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Kim D. Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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20
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Kholina K, Grant A, Waddington M, Egbe M, Grant S, Terashima M, Williams PL. In-store food environment for adults and children in Nova Scotia, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:430-439. [PMID: 33237485 PMCID: PMC8076380 DOI: 10.17269/s41997-020-00431-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 10/06/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This paper examines the retail food environment in grocery and convenience stores across Nova Scotia with specific attention to prominence and promotion of foods and beverages, as well as in-store promotion of foods and beverages to children. METHODS A descriptive cross-sectional analysis of data on the availability, price, prominence, and promotion of foods and beverages classified as "healthier" and "less healthy" was undertaken as a part of a Nova Scotia Consumer Food Environment (NS-CFE) project. Data were collected in a random stratified sample of 47 grocery stores and 59 convenience stores by trained research assistants working in pairs using adapted Nutrition Environment Measures Survey Toronto grocery store (NEMS-S) and NEMS Corner Store (NEMS-CS) tools. RESULTS "Less healthy" snack foods and sugar-sweetened beverages were more prominently displayed than "healthier" options with an exception of cereal, at both grocery and convenience stores (all p < 0.001). Coke™ and fruit juice were more expensive than water in both grocery and convenience stores (both p ≤ 0.05). Significantly more child-specific strategies were used to promote "less healthy" compared with "healthier" options in both grocery and convenience stores (both p < 0.001). CONCLUSION Results of this study demonstrate that "less healthy" options are significantly more prominently displayed and more heavily marketed to all Nova Scotians, including children, in the retail food environment compared with items classified as "healthier". These findings indicate that there is a need for comprehensive structural changes to the retail food environment in Nova Scotia, to support population health.
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Affiliation(s)
- Ksenia Kholina
- Food Action Research Centre (FoodARC) and Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Amy Grant
- Maritime SPOR Support Unit and Nova Scotia Health Authority, Halifax, Canada
| | | | - Manfred Egbe
- Food Action Research Centre (FoodARC) and Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Canada
- Department of Pediatrics, IWK Health Centre and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Mikiko Terashima
- School of Planning, Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Patricia L Williams
- Food Action Research Centre (FoodARC) and Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
- Healthy Populations Institute, Dalhousie University, Halifax, Canada.
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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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Dixon BN, Ugwoaba UA, Brockmann AN, Ross KM. Associations between the built environment and dietary intake, physical activity, and obesity: A scoping review of reviews. Obes Rev 2021; 22:e13171. [PMID: 33369097 PMCID: PMC8629168 DOI: 10.1111/obr.13171] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
There exists a large body of literature examining the association between built environment factors and dietary intake, physical activity, and weight status; however, synthesis of this literature has been limited. To address this gap, we conducted a scoping review of reviews and identified 74 reviews and meta-analyses that investigated the association between built environment factors and dietary intake, physical activity, and/or weight status. Results across reviews were mixed, with heterogeneous effects demonstrated in terms of strength and statistical significance; however, preliminary support was identified for several built environment factors. For example, quality of dietary intake appeared to be associated with the availability of grocery stores, higher levels of physical activity appeared to be most consistently associated with greater walkability, and lower weight status was associated with greater diversity in land-use mix. Overall, reviews reported substantial concern regarding methodological limitations and poor quality of existing studies. Future research should focus on improving study quality (e.g., using longitudinal methods, including natural experiments, and newer mobile sensing technologies) and consensus should be drawn regarding how to define and measure both built environment factors and weight-related outcomes.
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Affiliation(s)
- Brittney N. Dixon
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Umelo A. Ugwoaba
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Andrea N. Brockmann
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Kathryn M. Ross
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
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Brar K, Minaker LM. Geographic reach and nutritional quality of foods available from mobile online food delivery service applications: novel opportunities for retail food environment surveillance. BMC Public Health 2021; 21:458. [PMID: 33676458 PMCID: PMC7937239 DOI: 10.1186/s12889-021-10489-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Online Food Delivery Services (OFDS) have rapidly expanded in North America, but their implications for geographic access to food and potential dietary outcomes of their use are poorly understood. The purpose of this paper is to examine the extent to which OFDS may geographically expand retail food environments. A secondary objective is to evaluate the healthfulness of foods available on mobile OFDS in a large Canadian city using the Healthy Eating Index-2015 (HEI-2015). METHODS Retailers' distance from delivery location was assessed on a large ODFS platform using 24 randomly selected urban postal codes in Ontario, Canada (n = 480 retailers). Distance to the first 10 and the last 10 listed retailers in each postal code was examined in relation to a) city population, b) city population density, and c) whether retailers appeared first or last. Second, to determine the healthfulness of food items available, menus of twelve retailers (n = 759 menu items) from four popular OFDS platforms available in Mississauga, Ontario, were coded using the Food and Nutrient Database for Dietary Studies-2015, and Food Patterns Equivalents Database-2015. Coded items were used to derive HEI-2015 scores. RESULTS Delivery distances from the sample of postal codes in Ontario ranged from 0.3 km to 9.4 km (mean 3.7 km), and the total number of retailers available to each postal code ranged from 33 to 472. Substantial, positive correlations existed between total number of retailers available and both city population (r = 0.71), and population density (r = 0.51). HEI-2015 scores for retailers' full menus were typically low, and ranged from 19.95 to 50.78 out of 100. CONCLUSIONS OFDS substantially increases geographic access to foods prepared away from home (by up to 9 km and 472 restaurants). Food offerings on OFDS applications do not meet healthy eating recommendations. Given the projected continued rapid expansion of OFDS, particularly in the midst of a global pandemic, surveillance and future research on OFDS and population dietary health is warranted.
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Affiliation(s)
- Keshbir Brar
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Leia Michelle Minaker
- School of Planning, University of Waterloo, 200 University Ave W, Environment 3 Rm. 3239, Waterloo, ON, N2L 3G1, Canada.
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Christie CD, Consoli A, Ronksley PE, Vena JE, Friedenreich CM, McCormack GR. Associations between the built environment and physical activity among adults with low socio-economic status in Canada: a systematic review. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:152-165. [PMID: 32833139 PMCID: PMC7851286 DOI: 10.17269/s41997-020-00364-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To synthesize literature on the associations between the built environment and physical activity among adults with low socio-economic status (SES) in Canada. METHODS Using a pre-specified study protocol (PROSPERO ID: CRD42019117894), we searched seven databases from inception to November 2018, for peer-reviewed quantitative studies that (1) included adults with low SES living in Canada and (2) estimated the association between self-reported or objectively measured built characteristics and self-reported or objectively measured physical activity. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Findings were synthesized using a narrative approach. SYNTHESIS Of the 8338 citations identified by our search, seven studies met the inclusion criteria. Most studies included adults living in one province (Alberta, British Columbia, Ontario, or Quebec), with one study including a national sample. All studies were cross-sectional, and none controlled for residential self-selection. Sampling designs and data collection strategies were heterogeneous. Sample sizes ranged between 78 and 37,241 participants. Most studies measured SES using household income. Street connectivity, greenness, destination density, and walkability were positively associated with physical activity. Relative to the objectively measured built environment, associations between the self-reported built environment and physical activity were less consistent. Studies were of fair to good quality. CONCLUSION Findings suggest that the neighbourhood built environment is associated with physical activity among adults with low SES in Canada. More rigorous study designs are needed to determine whether or not the built environment and physical activity are causally related within this vulnerable population.
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Affiliation(s)
- Chelsea D Christie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Anna Consoli
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Jennifer E Vena
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- CancerControl Alberta, Alberta Health Services, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta, T2T 5C7, Canada
| | - Christine M Friedenreich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, 2210 2nd St SW, Calgary, Alberta, T2S 3C3, Canada
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- School of Architecture, Planning and Landscape, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N 4N1, Canada
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Han HY, Paquet C, Dubé L, Nielsen DE. Diet Quality and Food Prices Modify Associations between Genetic Susceptibility to Obesity and Adiposity Outcomes. Nutrients 2020; 12:E3349. [PMID: 33143186 PMCID: PMC7692602 DOI: 10.3390/nu12113349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022] Open
Abstract
The role of the retail food environment in obesity risk is unclear, which may be due in part to the lack of consideration of individual differences in the responsivity to food cues. This cross-sectional investigation geo-temporally linked the CARTaGENE biobank (including genetic, dietary, lifestyle, and anthropometric data) with in-store retail food environment data to examine interactions between a polygenic risk score (PRS) for obesity and (1) diet quality (n = 6807) and (2) in-store retail food measures (n = 3718). The outcomes included adiposity-related measures and diet quality assessed using the 2010 Canadian-adapted Healthy Eating Index. A vegetable:soft drink ratio was constructed for each retail measure to assess the relative healthfulness of exposures. Generalized linear models adjusted for individual and neighborhood socio-demographic factors were used to evaluate main and interactive effects. Diet quality significantly modified the association between polygenic risk of obesity and body mass index, waist circumference, and body fat percent. A significant interaction was also observed between PRS and frequency of price discount of vegetables in relation to soft drinks on waist circumference. These results replicate previous reports of diet moderating polygenic risk of obesity and suggest that prices of low vs. high-energy density foods are an intervention target to address population obesity rates.
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Affiliation(s)
- Hannah Yang Han
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada;
| | - Catherine Paquet
- Faculté des Sciences de l’Administration, Université Laval, Québec, QC G1V 0A6, Canada;
- Australian Centre for Precision Health, University of South Australia, Adelaide 5001, Australia
| | - Laurette Dubé
- Desautels Faculty of Management, McGill University, Montreal, QC H3A 1G5, Canada;
| | - Daiva E Nielsen
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada;
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Luongo G, Skinner K, Phillipps B, Yu Z, Martin D, Mah CL. The Retail Food Environment, Store Foods, and Diet and Health among Indigenous Populations: a Scoping Review. Curr Obes Rep 2020; 9:288-306. [PMID: 32780322 DOI: 10.1007/s13679-020-00399-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF THE REVIEW Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.
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Affiliation(s)
- Gabriella Luongo
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Kelly Skinner
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Breanna Phillipps
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Ziwa Yu
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS, B3H 4R2, Canada
| | - Debbie Martin
- School of Health and Human Performance, Dalhousie University, Stairs House, 6230 South Street, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada
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How Neighbourhood Food Environments and a Pay-as-You-Throw (PAYT) Waste Program Impact Household Food Waste Disposal in the City of Toronto. SUSTAINABILITY 2020. [DOI: 10.3390/su12177016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Household food waste has negative, and largely unnecessary, environmental, social and economic impacts. A better understanding of current household food waste disposal is needed to help develop and implement effective interventions to reduce food wasting. A four-season waste characterization study was undertaken with 200 single-family households across eight neighbourhoods in Toronto, Ontario, Canada. The City of Toronto provides residents with a pay-as-you-throw (PAYT) waste program that includes a choice of four garbage cart sizes (Small [S], Medium [M], Large [L], Extra Large [XL]), with increasing annual user fees ($18.00–$411.00 CAD), as well as a green cart (organic waste) and blue cart (recycling). On average, each household disposed 4.22 kg/week of total food waste, 69.90% of which was disposed in the green cart, and disposal increased significantly (p = 0.03) by garbage cart size to L but not XL garbage carts. Of this total, 61.78% consisted of avoidable food waste, annually valued at $630.00–$847.00 CAD/household. Toronto’s PAYT waste program has been effective at diverting food waste into the green cart but not at reducing its generation. Higher median incomes were positively correlated, while higher neighbourhood dwelling and population density were negatively correlated, with total and avoidable food waste disposal. Regression analyses explained 40–67% of the variance in total avoidable food waste disposal. Higher supermarket density and distance to healthier food outlets were associated with more, while dwelling density was related to less, total and avoidable food waste disposal. Distance to fast food restaurants and less healthy food outlet density were both negatively associated with avoidable food waste disposal in the garbage and green cart, respectively. Avoidable food waste reduction interventions could include increasing garbage cart fees, weight-based PAYT, or messaging to households on the monetary value of avoidable food waste, and working with food retailers to improve how households shop for their food.
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Availability and affordability of healthy and less healthy food in Nova Scotia: where you shop may affect the availability and price of healthy food. Public Health Nutr 2020; 24:2345-2353. [PMID: 32524938 DOI: 10.1017/s1368980020000841] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study aimed to examine the availability and price of healthier compared with less healthy foods by geography, store category and store type for convenience stores, and by store size for grocery stores in Nova Scotia. DESIGN A cross-sectional study that examined differences in the overall availability and price of healthier compared to less healthy foods in grocery and convenience stores in Nova Scotia. The Nova Scotia Consumer Food Environment project was part of a larger initiative of the Nova Scotia government (Department of Health and Wellness) to assess the food and beverage environment in Nova Scotia in 2015/16. SETTING Four geographic zones (Nova Scotia Health Authority Management Zones) in Nova Scotia, Canada. PARTICIPANTS A sample of forty-seven grocery stores and fifty-nine convenience stores were selected from a list of 210 grocery stores and 758 convenience stores in Nova Scotia to ensure geographic and store type representation in our sample. RESULTS Findings indicate that rurality had a significant effect on food availability as measured by the Nutrition Environment Measures Surveys (NEMS) score (P < 0·01); there was a higher availability of healthy foods in rural compared to urban areas for convenience stores but not grocery stores. Healthier foods were also more available in chain stores compared to independent stores (P < 0·01) and in large stores compared to small and medium stores (P < 0·001 and P < 0·01, respectively). CONCLUSIONS The availability of and accessibility to less healthy foods in Nova Scotia food environment suggests that there is a need for government policy action to support a food environment that contributes to healthier diets.
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Aktary ML, Caron-Roy S, Sajobi T, O'Hara H, Leblanc P, Dunn S, McCormack GR, Timmins D, Ball K, Downs S, Minaker LM, Nykiforuk CI, Godley J, Milaney K, Lashewicz B, Fournier B, Elliott C, Raine KD, Prowse RJ, Olstad DL. Impact of a farmers' market nutrition coupon programme on diet quality and psychosocial well-being among low-income adults: protocol for a randomised controlled trial and a longitudinal qualitative investigation. BMJ Open 2020; 10:e035143. [PMID: 32371514 PMCID: PMC7228519 DOI: 10.1136/bmjopen-2019-035143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/19/2020] [Accepted: 04/02/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Low-income populations have poorer diet quality and lower psychosocial well-being than their higher-income counterparts. These inequities increase the burden of chronic disease in low-income populations. Farmers' market subsidies may improve diet quality and psychosocial well-being among low-income populations. In Canada, the British Columbia (BC) Farmers' Market Nutrition Coupon Programme (FMNCP) aims to improve dietary patterns and health among low-income participants by providing coupons to purchase healthy foods from farmers' markets. This study will assess the impact of the BC FMNCP on the diet quality and psychosocial well-being of low-income adults and explore mechanisms of programme impacts. METHODS AND ANALYSIS In a parallel group randomised controlled trial, low-income adults will be randomised to an FMNCP intervention (n=132) or a no-intervention control group (n=132). The FMNCP group will receive 16 coupon sheets valued at CAD$21/sheet over 10-15 weeks to purchase fruits, vegetables, dairy, meat/poultry/fish, eggs, nuts and herbs at farmers' markets and will be invited to participate in nutrition skill-building activities. Overall diet quality (primary outcome), diet quality subscores, mental well-being, sense of community, food insecurity and malnutrition risk (secondary outcomes) will be assessed at baseline, immediately post-intervention and 16 weeks post-intervention. Dietary intake will be assessed using the Automated Self-Administered 24-hour Dietary Recall. Diet quality will be calculated using the Healthy Eating Index-2015. Repeated measures mixed-effect regression will assess differences in outcomes between groups from baseline to 16 weeks post-intervention. Furthermore, 25-30 participants will partake in semi-structured interviews during and 5 weeks after programme completion to explore participants' experiences with and perceived outcomes from the programme. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Calgary Conjoint Health Research Ethics Board, Rutgers University Ethics and Compliance, and University of Waterloo Office of Research Ethics. Findings will be disseminated through policy briefs, conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT03952338.
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Affiliation(s)
- Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | | | - Tolulope Sajobi
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Heather O'Hara
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Peter Leblanc
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Sharlette Dunn
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gavin R McCormack
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta, Canada
| | - Dianne Timmins
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Shauna Downs
- School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Jenny Godley
- Department of Sociology, University of Calgary, Calgary, Alberta, Canada
| | - Katrina Milaney
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Fournier
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Charlene Elliott
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Communication Media and Film, University of Calgary, Calgary, Alberta, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel Jl Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Dana Lee Olstad
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
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Validation of a province-wide commercial food store dataset in a heterogeneous predominantly rural food environment. Public Health Nutr 2020; 23:1889-1895. [PMID: 32295655 DOI: 10.1017/s1368980019004506] [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: 11/07/2022]
Abstract
OBJECTIVE Commercially available business (CAB) datasets for food environments have been investigated for error in large urban contexts and some rural areas, but there is a relative dearth of literature that reports error across regions of variable rurality. The objective of the current study was to assess the validity of a CAB dataset using a government dataset at the provincial scale. DESIGN A ground-truthed dataset provided by the government of Newfoundland and Labrador (NL) was used to assess a popular commercial dataset. Concordance, sensitivity, positive-predictive value (PPV) and geocoding errors were calculated. Measures were stratified by store types and rurality to investigate any association between these variables and database accuracy. SETTING NL, Canada. PARTICIPANTS The current analysis used store-level (ecological) data. RESULTS Of 1125 stores, there were 380 stores that existed in both datasets and were considered true-positive stores. The mean positional error between a ground-truthed and test point was 17·72 km. When compared with the provincial dataset of businesses, grocery stores had the greatest agreement, sensitivity = 0·64, PPV = 0·60 and concordance = 0·45. Gas stations had the least agreement, sensitivity = 0·26, PPV = 0·32 and concordance = 0·17. Only 4 % of commercial data points in rural areas matched every criterion examined. CONCLUSIONS The commercial dataset exhibits a low level of agreement with the ground-truthed provincial data. Particularly retailers in rural areas or belonging to the gas station category suffered from misclassification and/or geocoding errors. Taken together, the commercial dataset is differentially representative of the ground-truthed reality based on store-type and rurality/urbanity.
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Food Retail Environments in Greater Melbourne 2008-2016: Longitudinal Analysis of Intra-City Variation in Density and Healthiness of Food Outlets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041321. [PMID: 32092853 PMCID: PMC7068484 DOI: 10.3390/ijerph17041321] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 11/16/2022]
Abstract
Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of ‘healthy’ to ‘unhealthy’ food outlets and food outlet ‘types’ by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both ‘unhealthy’ and ‘healthy’ outlets. Across all years, ratios of ‘unhealthy’ to ‘healthy’ outlets were highest in LGAs located in designated Growth Areas. Melbourne’s metropolitan food environment is saturated by ‘unhealthy’ and ‘less healthy’ food outlets, relative to ‘healthy’ ones. Melbourne’s urban growth areas had the least healthy food environments.
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Needham C, Sacks G, Orellana L, Robinson E, Allender S, Strugnell C. A systematic review of the Australian food retail environment: Characteristics, variation by geographic area, socioeconomic position and associations with diet and obesity. Obes Rev 2020; 21:e12941. [PMID: 31802612 DOI: 10.1111/obr.12941] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/12/2019] [Accepted: 08/07/2019] [Indexed: 02/04/2023]
Abstract
There is strong support across multiple sectors for the implementation of policies to create healthier food environments as part of comprehensive strategies to address obesity and improve population diets. The existing evidence base describing food retail environments and their relationship with health outcomes is limited in several respects. This systematic review examines the current evidence regarding food retail environments in Australia, including associations with diet and people with obesity, and socioeconomic and geographic disparities. Three databases were searched and independently screened. Studies were included if they were undertaken in Australia and objectively measured the food retail environment. Sixty papers were included. The broad range of methodological approaches used across studies limited the ability to synthesize the evidence and draw conclusions. Results indicated that there is some evidence that disparities exist in food retail environments across measures of socioeconomic position and geographic area in parts of Australia. Overall, there were inconsistent findings regarding the association between the healthiness of food retail environments and diet or people with obesity. Findings support previous calls for standardized tools and measures for monitoring the healthiness of food retail environments. This is imperative to inform evidence-based policy and evaluation in this critical component of recommended obesity prevention strategies.
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Affiliation(s)
- Cindy Needham
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | - Ella Robinson
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Steven Allender
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Claudia Strugnell
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
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Nielsen DE, Han Y, Paquet C, Portella AK, Ma Y, Dube L. Interaction of DRD2/ANKK1 Taq1A Genotype with in-Store Retail Food Environment Exposures on Diet Quality in a Cohort of Quebec Adults. Lifestyle Genom 2019; 13:74-83. [PMID: 31851973 DOI: 10.1159/000504603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/02/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS Gene-environment interactions may be relevant for nutrition outcomes. This study assessed the interaction between DRD2/ANKK1 Taq1A genotype and exposures to in-store retail food environment on diet quality. METHODS CARTaGENE biobank data (n = 3,532) were linked to provincial food retail data. The Canadian adaptation of the Healthy Eating Index 2010 (HEI-C) was calculated from food frequency questionnaires. Generalized linear models adjusted for sociodemographic factors, anthropometrics, and energy intake were used to assess interactions between the Taq1A variant and retail food measures. RESULTS A significant inverse interaction was observed between Taq1A and ice cream store displays on HEI-C score (estimate: -15.46 [95% confidence interval (CI): -24.83, -6.10], p = 0.0012) where, among allele carriers, increasing exposure to ice cream displays was associated with a lower HEI-C score as compared to allele carriers with a lower exposure. A significant positive interaction between Taq1A and price of vegetables was also observed, where, among allele carriers, increasing exposure to a higher price was associated with a higher HEI-C score compared to allele carriers with exposure to a lower price (estimate: 2.46 [95% CI: 0.78, 4.14], p = 0.0041). The opposite pattern was observed among non-carriers. CONCLUSIONS DRD2/ANKK1 Taq1A is associated with adaptive responses to ice cream displays and vegetable prices, suggesting a differential susceptibility to retail environment food cues.
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Affiliation(s)
- Daiva E Nielsen
- School of Human Nutrition, McGill University, Montreal, Québec, Canada,
| | - Yang Han
- School of Human Nutrition, McGill University, Montreal, Québec, Canada
| | - Catherine Paquet
- School of Health Sciences, Centre for Population Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Andre K Portella
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, Québec, Canada
| | - Yu Ma
- Desautels Faculty of Management, McGill University, Montreal, Québec, Canada
| | - Laurette Dube
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, Québec, Canada
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Bowman DD, Minaker LM, Simpson BJK, Gilliland JA. Development of a Teen-Informed Coding Tool to Measure the Power of Food Advertisements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214258. [PMID: 31684019 PMCID: PMC6862172 DOI: 10.3390/ijerph16214258] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 01/22/2023]
Abstract
The food-related information environment, comprised of food and beverage advertising within one’s surroundings, is a growing concern for adolescent health given that food marketing disproportionately targets adolescents. Despite strong public interest concerning the effects of food marketing on child health, there is limited evidence focused on outdoor food advertising in relation to teenage diets, food purchasing, and perceptions. Further, limited research has considered both the exposure to and influence of such advertisements. This study used a novel multi-method approach to identify and quantify the features of outdoor food and beverage advertisements that are most effective at drawing teenagers into retail food establishments. An environmental audit of outdoor advertisements and consultations with youth were used to: (1) identify teen-directed food marketing techniques; (2) validate and weigh the power of individual advertising elements; and, (3) develop a teen-informed coding tool to measure the power of food-related advertisements. Results indicate that marketing power is a function of the presence and size of teen-directed advertisement features, and the relative nature of each feature is an important consideration. This study offers a quantitative measurement tool for food environment research and urges policymakers to consider teen-directed marketing when creating healthy communities.
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Affiliation(s)
- Drew D Bowman
- Human Environments Analysis Laboratory, Western University, London, ON N6A 5C2, Canada.
- Children's Health Research Institute, London, ON N6C 2V5, Canada.
- Department of Geography, Western University, London, ON N6A 5C2, Canada.
| | - Leia M Minaker
- Human Environments Analysis Laboratory, Western University, London, ON N6A 5C2, Canada.
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
| | - Bonnie J K Simpson
- Human Environments Analysis Laboratory, Western University, London, ON N6A 5C2, Canada.
- DAN Department of Management and Organizational Studies, Western University, London, ON N6A 5C2, Canada.
| | - Jason A Gilliland
- Human Environments Analysis Laboratory, Western University, London, ON N6A 5C2, Canada.
- Children's Health Research Institute, London, ON N6C 2V5, Canada.
- Department of Geography, Western University, London, ON N6A 5C2, Canada.
- School of Health Studies, Western University, London, ON N6A 3K7, Canada.
- Department of Paediatrics, Western University, London, ON N6A 5C1, Canada.
- Department of Epidemiology & Biostatistics, Western University, London, ON N6A 5C1, Canada.
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Stevenson AC, Brazeau AS, Dasgupta K, Ross NA. Neighbourhood retail food outlet access, diet and body mass index in Canada: a systematic review. Health Promot Chronic Dis Prev Can 2019; 39:261-280. [PMID: 31600040 PMCID: PMC6814072 DOI: 10.24095/hpcdp.39.10.01] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
INTRODUCTION There is growing interest in the role of food environments in suboptimal diet and overweight and obesity. This review assesses the evidence for the link between the retail food environment, diet quality and body mass index (BMI) in the Canadian population. METHODS We conducted a systematic keyword search in two bibliometric databases. We tabulated proportions of conclusive associations for each outcome and exposure of interest. Absolute and relative measures of exposure to the food environment were compared and theoretical framing of the associations noted. We assessed two key methodological issues identified a priori-measurement of BMI, and validation of the underlying retail food environment data. RESULTS Seventeen studies were included in the review. There was little evidence of a food environment-diet quality relationship and modest evidence of a food environment-BMI relationship. Relative measures of the food environment were more often associated with an outcome in the expected direction than absolute measures, but many results were inconclusive. Most studies adopted ecological theoretical frameworks but methodologies were similar regardless of stated theoretical approaches. Self-reported BMI was common and there was no "gold standard" database of food outlets nor a consensus on best ways to validate the data. CONCLUSION There was limited evidence of a relationship between the food environment and diet quality, but stronger evidence of a relationship between the food environment and BMI for Canadians. Studies with broad geographic scope that adopt innovative methods to measure diet and health outcomes and use relative measures of the food environment derived in geographic information systems are warranted. Consensus on a gold standard food environment database and approaches to its validation would also advance the field.
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Affiliation(s)
| | - Anne-Sophie Brazeau
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
| | - Kaberi Dasgupta
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
- Department of Medicine, McGill University Health Centre, McGill University, Montréal, Quebec, Canada
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, McGill University, Montréal, Quebec, Canada
| | - Nancy A Ross
- Department of Geography, McGill University, Montréal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
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Assessing the Retail Food Environment in Madrid: An Evaluation of Administrative Data against Ground Truthing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193538. [PMID: 31546670 PMCID: PMC6801710 DOI: 10.3390/ijerph16193538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/13/2019] [Accepted: 09/19/2019] [Indexed: 12/30/2022]
Abstract
Previous studies have suggested that European settings face unique food environment issues; however, retail food environments (RFE) outside Anglo-Saxon contexts remain understudied. We assessed the completeness and accuracy of an administrative dataset against ground truthing, using the example of Madrid (Spain). Further, we tested whether its completeness differed by its area-level socioeconomic status (SES) and population density. First, we collected data on the RFE through the ground truthing of 42 census tracts. Second, we retrieved data on the RFE from an administrative dataset covering the entire city (n = 2412 census tracts), and matched outlets using location matching and location/name matching. Third, we validated the administrative dataset against the gold standard of ground truthing. Using location matching, the administrative dataset had a high sensitivity (0.95; [95% CI = 0.89, 0.98]) and positive predictive values (PPV) (0.79; [95% CI = 0.70, 0.85]), while these values were substantially lower using location/name matching (0.55 and 0.45, respectively). Accuracy was slightly higher using location/name matching (k = 0.71 vs 0.62). We found some evidence for systematic differences in PPV by area-level SES using location matching, and in both sensitivity and PPV by population density using location/name matching. Administrative datasets may offer a reliable and cost-effective source to measure retail food access; however, their accuracy needs to be evaluated before using them for research purposes.
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Dean J, Wray AJ, Braun L, Casello JM, McCallum L, Gower S. Holding the keys to health? A scoping study of the population health impacts of automated vehicles. BMC Public Health 2019; 19:1258. [PMID: 31510986 PMCID: PMC6740025 DOI: 10.1186/s12889-019-7580-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/30/2019] [Indexed: 01/20/2023] Open
Abstract
Background Automated Vehicles (AVs) are central to the new mobility paradigm that promises to transform transportation systems and cities across the globe. To date, much of the research on AVs has focused on technological advancements with little emphasis on how this emerging technology will impact population-level health. This scoping study examines the potential health impacts of AVs based on the existing literature. Methods Using Arksey and O’Malley’s scoping protocol, we searched academic and ‘grey’ literature to anticipate the effects of AVs on human health. Results Our search captured 43 information sources that discussed a least one of the five thematic areas related to health. The bulk of the evidence is related to road safety (n = 37), followed by a relatively equal distribution between social equity (n = 24), environment (n = 22), lifestyle (n = 20), and built environment (n = 18) themes. There is general agreement that AVs will improve road safety overall, thus reducing injuries and fatalities from human errors in operating motorized vehicles. However, the relationships with air quality, physical activity, and stress, among other health factors may be more complex. The broader health implications of AVs will be dependent on how the technology is adopted in various transportation systems. Regulatory action will be a significant determinant of how AVs could affect health, as well as how AVs influence social and environmental determinants of health. Conclusion To support researchers and practitioners considering the health implications of AVs, we provide a conceptual map of the direct and indirect linkages between AV use and health outcomes. It is important that stakeholders, including public health agencies work to ensure that population health outcomes and equitable distribution of health impacts are priority considerations as regulators develop their response to AVs. We recommend that public health and transportation officials actively monitor trends in AV introduction and adoption, regulators focus on protecting human health and safety in AV implementation, and researchers work to expand the body of evidence surrounding AVs and population health.
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Affiliation(s)
- Jennifer Dean
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Alexander J Wray
- Human Environments Analysis Lab, Department of Geography, Western University, London, ON, Canada
| | - Lucas Braun
- Department of Civil and Environmental Engineering, University of Waterloo, 200 University Ave, West, Waterloo, ON, N2L 3G1, Canada
| | - Jeffrey M Casello
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.,Department of Civil and Environmental Engineering, University of Waterloo, 200 University Ave, West, Waterloo, ON, N2L 3G1, Canada
| | - Lindsay McCallum
- Toronto Public Health, 277 Victoria St., 7th Floor, Toronto, ON, M5B 1W2, Canada
| | - Stephanie Gower
- Toronto Public Health, 277 Victoria St., 7th Floor, Toronto, ON, M5B 1W2, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
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Morissette-Desjardins A, Provencher V, Lebel A. Caractériser l'environnement alimentaire d'une municipalité régionale de comté pour identifier les zones prioritaires d'intervention en matière de sécurité alimentaire. Canadian Journal of Public Health 2019; 110:805-815. [PMID: 31452113 DOI: 10.17269/s41997-019-00239-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 06/21/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Food security intervention is particularly complex in rural areas. The local stakeholders of the regional county municipality (RCM) of Portneuf wished to analyze the regional food supply in order to reduce food insecurity. The objective of this study was to characterize the RCM's food environment and to identify potential food deserts and priority intervention areas. METHOD We measured the quality of the food supply in the RCM's food stores, using four indicators: freshness, diversity, economic accessibility and relative availability. We mapped the distance between residences and the nearest food store with a favourable result for all four indices to locate potential food deserts. We then presented the mapping of the food environment to a group of local stakeholders and compared it to their own perception. RESULTS This study reveals three sectors that meet the criteria of a food desert in the RCM. Local actors did not perceive these sectors as food deserts, but thought they were at risk of becoming such in the future. We complemented the measures by taking into account the structuring impact of certain infrastructures as well as the temporal and seasonal accessibility of food stores in rural areas. Only one priority intervention area was suggested. CONCLUSION Presenting geographical analyses to local stakeholders improved the characterization of the studied food environment. The use of a mixed methodology has enabled the particularities of the rural environment to be better accounted for and has facilitated intersectoral mobilization around food insecurity at the regional level.
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Affiliation(s)
- Amélie Morissette-Desjardins
- École supérieure d'aménagement du territoire et de développement régional (ÉSAD), Université Laval, Pavillon Félix-Antoine-Savard, bureau FAS-1616 2325, allée des Bibliothèques, Québec, Québec, G1V 0A6, Canada
| | - Véronique Provencher
- École de nutrition, Institut sur la nutrition et les aliments fonctionnels (INAF), Pavillon des Services, Université Laval, 2440, boul. Hochelaga, Québec, G1V 0A6, Canada
| | - Alexandre Lebel
- Centre de recherche en aménagement et développement (CRAD), Université Laval, Pavillon Félix-Antoine-Savard, bureau FAS-1644 2325, allée des Bibliothèques, Québec, G1V 0A6, Canada.
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Beltrán MDPD, Romero YMH. Healthy eating and restaurants. A review of recent evidence in the literature. CIENCIA & SAUDE COLETIVA 2019; 24:853-864. [PMID: 30892506 DOI: 10.1590/1413-81232018243.03132017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/03/2017] [Indexed: 01/11/2023] Open
Abstract
Food environments influence food consumption and population health. This study sought to establish the outstanding themes in recent scientific literature about healthy eating and restaurants. Studies about the topic published from 2011 to 2016 in seven recognized databases were reviewed systematically. From 999 titles, 20 articles were selected. Content analysis through an inductive method by two independent investigators was performed using Nvivo 10.0. Three dominant subjects were identified: Food supply modifications, promotion of healthy choices and barriers against healthy eating promotion. The findings describe research opportunities in the area, particularly in the Latin American context. It is necessary to make interventions that result in healthy food environments given the impact on collective health.
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40
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Hobbs M, Green M, Roberts K, Griffiths C, McKenna J. Reconsidering the relationship between fast-food outlets, area-level deprivation, diet quality and body mass index: an exploratory structural equation modelling approach. J Epidemiol Community Health 2019; 73:861-866. [PMID: 31171581 DOI: 10.1136/jech-2018-211798] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/14/2019] [Accepted: 04/21/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Internationally, the prevalence of adults with obesity is a major public health concern. Few studies investigate the explanatory pathways between fast-food outlets and body mass index (BMI). We use structural equation modelling to explore an alternative hypothesis to existing research using area-level deprivation as the predictor of BMI and fast-food outlets and diet quality as mediators. METHODS Adults (n=7544) from wave II of the Yorkshire Health Study provided self-reported diet, height and weight (used to calculate BMI). Diet quality was based on sugary drinks, wholemeal (wholegrain) bread and portions of fruit and vegetables. Fast-food outlets were mapped using the Ordnance Survey Points of Interest within 2 km radial buffers around home postcode which were summed to indicate availability. Age (years), gender (female/male) and long-standing health conditions (yes/no) were included as covariates. RESULTS There was little evidence linking fast-food outlets to diet or BMI. An independent association between fast-food outlet availability and BMI operated counterintuitively and was small in effect. There was also little evidence of mediation between fast-food outlet availability and BMI. However, there was more evidence that area-level deprivation was associated with increased BMI, both as an independent effect and through poorer diet quality. CONCLUSION This exploratory study offers a first step for considering complexity and pathways linking fast-food outlets, area-level deprivation, diet quality and BMI. Research should respond to and build on the hypothesised pathways and our simple framework presented within our study.
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Affiliation(s)
- Matthew Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand .,Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Mark Green
- Geography and Planning, University of Liverpool, Liverpool, UK
| | - Kath Roberts
- Public Health Section, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Jim McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Mah CL, Hasdell R, Minaker LM, Soo SD, Cook B, Demaio AR. Entrepreneurialism and health-promoting retail food environments in Canadian city-regions. Health Promot Int 2019; 33:1055-1065. [PMID: 28973674 DOI: 10.1093/heapro/dax049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The retail sector is a dynamic and challenging component of contemporary food systems with an important influence on population health and nutrition. Global consensus is clear that policy and environmental changes in retail food environments are essential to promote healthier diets and reduce the burden of obesity and non-communicable diseases. In this article, we explore entrepreneurialism as a form of social change-making within retail food environments, focusing on small food businesses. Small businesses face structural barriers within food systems. However, conceptual work in multiple disciplines and evidence from promising health interventions tested in small stores suggest that these retail places may have a dual role in health promotion: settings to strengthen regional economies and social networks, and consumer environments to support healthier diets. We will discuss empirical examples of health-promoting entrepreneurialism based on two sets of in-depth interviews we conducted with public health intervention actors in Toronto, Canada, and food entrepreneurs and city-region policy actors in St. John's, Canada. We will explore the practices of entrepreneurialism in the retail food environment and examine the implications for population health interventions. We contend that entrepreneurialism is important to understand on its own and also as a dimension of population health intervention context. A growing social scientific literature offers a multifaceted lens through which we might consider entrepreneurialism not only as a set of personal characteristics but also as a practice in networked and intersectoral cooperation for public and population health.
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Affiliation(s)
- Catherine L Mah
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rebecca Hasdell
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Leia M Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON, Canada
| | - Stephanie D Soo
- Policy and Innovation Branch, Ontario Ministry of Health and Long-Term Care, Toronto, ON, Canada
| | - Brian Cook
- Toronto Food Strategy, Toronto Public Health, Toronto, ON, Canada
| | - Alessandro R Demaio
- Copenhagen School of Global Health, University of Copenhagen, Copenhagen, Denmark
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Mahendra A, Polsky JY, Robitaille É, Lefebvre M, McBrien T, Minaker LM. Status report - Geographic retail food environment measures for use in public health. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:357-362. [PMID: 29043763 DOI: 10.24095/hpcdp.37.10.06] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The Association of Public Health Epidemiologists in Ontario (APHEO) Core Indicators Work Group standardizes definitions and calculation methods for over 120 public health indicators to enhance accurate and standardized community health status reporting across public health units in Ontario. The Built Environment Subgroup is a multi-disciplinary group made up of planners, researchers, policy analysts, registered dietitians, geographic information systems (GIS) analysts and epidemiologists. The Subgroup selected and operationalized a suite of objective, standardized indicators intended to help public health units and regional health authorities assess their community retail food environments. The Subgroup proposed three indicators that use readily available data sources and GIS tools to characterize geographic access to various types of retail food outlets within neighbourhoods in urban settings. This article provides a status report on the development of these food environment indicators.
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Affiliation(s)
| | - Jane Y Polsky
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Éric Robitaille
- Institut national de santé publique du Québec, Montréal, Quebec, Canada
| | - Marc Lefebvre
- Sudbury & District Health Unit, Sudbury, Ontario, Canada
| | - Tina McBrien
- Region of Peel Public Health, Mississauga, Ontario, Canada
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
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Burnett K, Skinner K, Hay T, LeBlanc J, Chambers L. Retail food environments, shopping experiences, First Nations and the provincial Norths. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:333-341. [PMID: 29043760 DOI: 10.24095/hpcdp.37.10.03] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. METHODS We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. RESULTS Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. CONCLUSION There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.
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Affiliation(s)
- Kristin Burnett
- Department of Indigenous Learning, Lakehead University, Thunder Bay, Ontario, Canada
| | - Kelly Skinner
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Travis Hay
- Department of History, York University, Toronto, Ontario, Canada
| | - Joseph LeBlanc
- Social Planning Council of Sudbury, Sudbury, Ontario, Canada
| | - Lori Chambers
- Department of Women's Studies, Lakehead University, Thunder Bay, Ontario, Canada
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Slater J, Epp-Koop S, Jakilazek M, Green C. Food deserts in Winnipeg, Canada: a novel method for measuring a complex and contested construct. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:350-356. [PMID: 29043762 DOI: 10.24095/hpcdp.37.10.05] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION "Food deserts" have emerged over the past 20 years as spaces of concern for communities, public health authorities and researchers because of their potential negative impact on dietary quality and subsequent health outcomes. Food deserts are residential geographic spaces, typically in urban settings, where low-income residents have limited or no access to retail food establishments with sufficient variety at affordable cost. Research on food deserts presents methodological challenges including retail food store identification and classification, identification of low-income populations, and transportation and proximity metrics. Furthermore, the complex methods often used in food desert research can be difficult to reproduce and communicate to key stakeholders. To address these challenges, this study sought to demonstrate the feasibility of implementing a simple and reproducible method of identifying food deserts using data easily available in the Canadian context. METHODS This study was conducted in Winnipeg, Canada in 2014. Food retail establishments were identified from Yellow Pages and verified by public health dietitians. We calculated two scenarios of food deserts based on location of the lowest-income quintile population: (a) living ≥ 500 m from a national chain grocery store, or (b) living ≥ 500 m from a national chain grocery store or a full-service grocery store. RESULTS The number of low-income residents living in a food desert ranged from 64 574 to 104 335, depending on the scenario used. CONCLUSION This study shows that food deserts affect a significant proportion of the Winnipeg population, and while concentrated in the urban core, exist in suburban neighbourhoods also. The methods utilized represent an accessible and transparent, reproducible process for identifying food deserts. These methods can be used for costeffective, periodic surveillance and meaningful engagement with communities, retailers and policy makers.
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Affiliation(s)
- Joyce Slater
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Megan Jakilazek
- Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Chris Green
- Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
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Local Retail Food Environment and Consumption of Fruit and Vegetable among Adults in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102247. [PMID: 30322198 PMCID: PMC6210243 DOI: 10.3390/ijerph15102247] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 12/28/2022]
Abstract
Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual's homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04⁻1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11⁻2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04⁻1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people's home is an important environmental factor in meeting fruit and vegetable consumption guidelines. "Food swamps" (areas with an abundance of unhealthy foods) rather than "food deserts" (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong's urban areas. We advanced international literature by providing evidence in a non-western setting.
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Pulker CE, Thornton LE, Trapp GSA. What is known about consumer nutrition environments in Australia? A scoping review of the literature. Obes Sci Pract 2018; 4:318-337. [PMID: 30151227 PMCID: PMC6105710 DOI: 10.1002/osp4.275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/22/2018] [Accepted: 04/04/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Food environments can influence food selection and hold the potential to reduce obesity, non-communicable diseases and their inequalities. 'Consumer nutrition environments' describe what consumers encounter within a food retail outlet, including products, price, promotion and placement. This study aimed to summarize the attributes that have been examined in existing peer-reviewed studies of Australian consumer nutrition environments, identify knowledge gaps and provide recommendations for future research. METHODS A systematic search of peer-reviewed literature was conducted. Sixty-six studies that assessed an aspect of within-store consumer nutrition environments were included. RESULTS Most studies were published from 2011 onwards and were conducted in capital cities and in supermarkets. Studies assessed the domains of product (40/66), price (26/66), promotion (16/66) and placement (6/66). The most common research themes identified were assessment of the impact of area socioeconomic status (13/66), remoteness (9/66) and food outlet type (7/66) on healthy food prices; change in price of healthy foods (6/66); variety of healthy foods (5/66); and prevalence of unhealthy child-orientated products (5/66). CONCLUSIONS This scoping review identified a large number of knowledge gaps. Recommended priorities for researchers are as follows: (1) develop consistent observational methodology, (2) consider consumer nutrition environments in rural and remote communities, (3) develop an understanding of food service outlets, (4) build on existing evidence in all four domains of product, price, placement and promotion and (5) determine effective policy and store-based interventions to increase healthy food selection.
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Affiliation(s)
- C. E. Pulker
- School of Public HealthCurtin UniversityPerthWAAustralia
- Telethon Kids InstituteThe University of Western AustraliaPerthWAAustralia
| | - L. E. Thornton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesDeakin UniversityMelbourneVICAustralia
| | - G. S. A. Trapp
- Telethon Kids InstituteThe University of Western AustraliaPerthWAAustralia
- School of Population and Global HealthThe University of Western AustraliaCrawleyWAAustralia
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Camden A, Levy J, Bassil K, Vanderlinden L, Barnett OW, Minaker LM, Mulligan K, Campbell M. A Census of Midsize to Large Supermarkets in Toronto: A Cross-Sectional Analysis of the Consumer Nutrition Environment. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:573-581. [PMID: 29496398 DOI: 10.1016/j.jneb.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 12/10/2017] [Accepted: 12/11/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Assess the consumer nutrition environment in midsize to large supermarkets by supermarket type and area-level socioeconomic variables. DESIGN Cross-sectional census of 257 supermarkets using the Toronto Nutrition Environment Measures Survey in Stores. SETTING Toronto, Canada. VARIABLES MEASURED Availability; price and linear shelf space of fruits and vegetables vs energy-dense snack foods by supermarket type; after-tax, low-income measure; and neighborhood improvement area. ANALYSIS Multivariate linear regression. RESULTS There was a high availability of fruits (7.7 of 8) and vegetables (9.5 of 11). There was similar linear shelf space for fruits and vegetables vs energy-dense snack foods (ratio, 1.1 m). Adjusted fruit prices were lowest in quintiles 1 (β = -$1.30; P = .008), 2 (β = -$1.41; P = .005), and 3 (β = -$1.89; P < .001) vs quintile 5 (lowest percentage of people living with low income) and in ethnic (β = -$3.47; P < .001) and discount stores (β = -$5.64; P < .001) vs conventional. Adjusted vegetable prices were lowest in quintiles 2 (β = -$1.87; P = .04), 3 (β = -$1.78; P = .03), and 4 (β = -$2.65; P = .001) vs quintile 5 and in ethnic (β = -$7.10; P < .001) and discount (β = -$5.49; P < .001) stores. They were highest in other (β = + $3.08; P = .003) vs conventional stores. Adjusted soda and chips prices were lower in discount (β = -$1.16; P < .001) and higher in other stores (β = + $0.67; P < .001) vs conventional. CONCLUSIONS AND IMPLICATIONS Findings do not indicate inequities in shelf space, availability, or price across diverse neighborhoods. Practitioners can use findings to help consumers navigate supermarkets to make healthy choices.
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Affiliation(s)
- Andi Camden
- Healthy Public Policy, Toronto Public Health, Toronto, Ontario, Canada
| | - Jennifer Levy
- Healthy Public Policy, Toronto Public Health, Toronto, Ontario, Canada
| | - Kate Bassil
- Healthy Public Policy, Toronto Public Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Loren Vanderlinden
- Healthy Public Policy, Toronto Public Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Leia M Minaker
- School of Planning, and Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, Canada
| | - Kate Mulligan
- Healthy Public Policy, Toronto Public Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Monica Campbell
- Healthy Public Policy, Toronto Public Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Mah CL, Pomeroy S, Knox B, Rynard V, Caravan M, Burgess L, Harris R, Minaker L. An assessment of the rural consumer food environment in Newfoundland and Labrador, Canada. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1465000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Catherine L. Mah
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Bruce Knox
- Recreation Division, Community Services Department, City of St. John’s, St. John’s, NL, Canada
| | - Vicki Rynard
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | - Lesley Burgess
- Eastern Health, Health Promotion Division, Mount Pearl, NL, Canada
| | - Rebecca Harris
- Faculty of Medicine, Memorial University, St. John’s, NL, Canada
| | - Leia Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON, Canada
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Jalbert-Arsenault É, Robitaille É, Paquette MC. Development, reliability and use of a food environment assessment tool in supermarkets of four neighbourhoods in Montréal, Canada. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:293-302. [PMID: 28902478 DOI: 10.24095/hpcdp.37.9.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The food environment is a promising arena in which to influence people's dietary habits. This study aimed to develop a comprehensive food environment assessment tool for businesses and characterize the food environment of a low-tomedium income area of Montréal, Canada. METHODS We developed a tool, Mesure de l'environnement alimentaire du consommateur dans les supermarchés (MEAC-S), and tested it for reliability. We used the MEAC-S to assess the consumer food environment of 17 supermarkets in four neighbourhoods of Montréal. We measured the shelf length, variety, price, display counts and in-store positions of fruits and vegetables (FV) and ultra-processed food products (UPFPs). We also assessed fresh FV for quality. Store size was estimated using the total measured shelf length for all food categories. We conducted Spearman correlations between these indicators of the food environment. RESULTS Reliability analyses revealed satisfactory results for most indicators. Characterization of the food environment revealed high variability in shelf length, variety and price of FV between supermarkets and suggested a disproportionate promotion of UPFPs. Display counts of UPFPs outside their normal display location ranged from 7 to 26, and they occupied 8 to 33 strategic in-store positions, whereas the number of display counts of fresh FV outside their normal display location exceeded 1 in only 2 of the 17 stores surveyed, and they occupied a maximum of 2 strategic in-store positions per supermarket. Price of UPFPs was inversely associated with their prominence (p < .005) and promotion (p < .003). Store size was associated with display counts and strategic in-store positioning of UPFPs (p < .001), but not FV, and was inversely associated with the price of soft drinks (p < .003). CONCLUSION This study illustrates the variability of the food environment between supermarkets and underscores the importance of measuring in-store characteristics to adequately picture the consumer food environment.
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Affiliation(s)
| | - Éric Robitaille
- Université de Montréal, Montréal, Quebec, Canada.,Institut national de santé publique du Québec, Montréal, Quebec, Canada
| | - Marie-Claude Paquette
- Université de Montréal, Montréal, Quebec, Canada.,Institut national de santé publique du Québec, Montréal, Quebec, Canada
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Examining associations between school food environment characteristics and sugar-sweetened beverage consumption among Canadian secondary-school students in the COMPASS study. Public Health Nutr 2018; 22:1928-1940. [DOI: 10.1017/s1368980018001246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveTo examine associations between Canadian adolescents’ sugar-sweetened beverage (SSB) consumption and several school food environment characteristics, and to investigate differences in these characteristics between schools in provinces with voluntary (Alberta) v. mandatory (Ontario) provincial school nutrition policies.DesignWe used a questionnaire to assess the number of weekdays participants consumed three SSB categories (soft drinks, sweetened coffees/teas, energy drinks) and various sociodemographic and behavioural characteristics. We examined the in-school water fountain accessibility, vending machines’ contents and presence of various food outlets within schools’ 1 km buffer. We developed hierarchical Poisson regression models to identify associations between student- and school-level characteristics and students’ SSB outcomes.SettingAlberta and Ontario, Canada.SubjectsAdolescents (n 41 829) from eighty-nine secondary schools.ResultsCompared with their Ontarian counterparts, Albertan participants had a significantly higher rate of SSB intake across all drink categories and SSB availability was significantly greater in Albertan schools’ vending machines. Availability of sweetened coffees/teas in school vending machines and access to restaurants within the school’s 1 km buffer were associated with increased SSB intake in three of the final models. Overall, the school food environment-level characteristics examined had a modest to negligible impact on student days of SSB intake.ConclusionsWe identified that the school food environment characteristics examined here had little impact on adolescents’ days of SSB consumption. While schools should adopt or maintain a comprehensive policy approach to discourage students’ SSB intake, population-level interventions focusing on other contexts (e.g. home and community) are needed to complement existing school-based interventions.
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