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Adamou H, Robitaille É, Paquette MC, Lebel A. Food environment trajectories: a sequence analysis from the CARTaGENE cohort. Public Health Nutr 2024; 27:e90. [PMID: 38250947 DOI: 10.1017/s1368980024000119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVE The purpose of this study was to create a typology of longitudinal exposure to food environment based on socio-economic context. DESIGN Food environment trajectories were modelled using a sequence analysis method, followed by a logistic regression to describe those trajectories. SETTING The study took place in Quebec, Canada, using food environment data from 2009, 2011 and 2018 merged with participants' demographic and socio-economic characteristics. PARTICIPANT At recruitment, 38 627 participants between the ages of 40 and 69 years from six urban areas in Quebec were included in the CARTaGENE cohort study. The cohort was representative of the Quebec urban population within this age range. RESULTS Our study revealed five trajectories of food access over time: (1) limited access to food stores throughout the study period, (2) limited access improving, (3) good access diminishing, (4) good access throughout the period and (5) low access throughout the period. Logistic regression analysis showed that participants who were unable to work (OR = 1·42, CI = 1·08-1·86), lived in households with five or more persons (OR = 1·69, CI = 1·17-2·42) and those living in low-income households (OR = 1·32, CI = 1·03-1·71) had higher odds of experiencing a disadvantaged food environment trajectory. Additionally, the level of education and age of participants were associated with the odds of experiencing a disadvantaged food environment trajectory. CONCLUSIONS The study demonstrates that people facing socio-economic disadvantage are more likely to experience a disadvantaged food environment trajectory over time.
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Affiliation(s)
- Habila Adamou
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
| | - Éric Robitaille
- Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec, Canada
- ESPUM, Université de Montréal, Montréal, Canada
| | - Marie-Claude Paquette
- Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec, Canada
- Département de nutrition, Université de Montréal, Montréal, Canada
| | - Alexandre Lebel
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
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Schumacher TL, Alderton CA, Brown LJ, Heaney S, Alston L, Kent K, Godrich SL. Development of a Scoring Tool for Australian Rural Food Retail Environments. Nutrients 2023; 15:4660. [PMID: 37960313 PMCID: PMC10648429 DOI: 10.3390/nu15214660] [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: 09/26/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Current tools scoring the healthiness of food retail outlets do not reflect outlets found in rural locations. This study aimed to adapt pre-existing Australian scoring tools to represent non-metropolitan areas. Rural nutrition experts were identified, and a modified Delphi technique was used to adapt two pre-existing, food-scoring tools in five iterative stages. Stages included identifying all relevant outlets, providing a description and score for each, ensuring consistency between outlet scores and pre-existing, metro-centric tools, and providing instructions for correct use. Six rural nutrition experts were identified and engaged in the modified Delphi technique. The final tool consisted of 12 categories of food outlets and listed 35 individual outlets. Consistent with pre-existing Australian tools, scores ranged from +10 to -10 and included descriptions reflective of rural retail outlets. Scores were based on whether the majority of foods offered within the outlet were consistent with foods recommended in national health guidelines. The developed tool was designed to accommodate the diverse nature of food retail outlets found in non-metropolitan areas. This study assists in explaining the link between the food environment and health in populations living rurally.
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Affiliation(s)
- Tracy L. Schumacher
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia; (C.A.A.); (L.J.B.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia;
| | - Carissa A. Alderton
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia; (C.A.A.); (L.J.B.)
| | - Leanne J. Brown
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia; (C.A.A.); (L.J.B.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia;
| | - Susan Heaney
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia;
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Port Macquarie, NSW 2444, Australia
| | - Laura Alston
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, VIC 3220, Australia;
- Research Unit, Colac Area Health, Colac, VIC 3250, Australia
| | - Katherine Kent
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia;
- School of Health Sciences, University of Tasmania, Launceston, TAS 7250, Australia
| | - Stephanie Louise Godrich
- Centre for People, Place, and Planet, Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia;
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Needham C, Strugnell C, Allender S, Alston L, Orellana L. BMI and the Food Retail Environment in Melbourne, Australia: Associations and Temporal Trends. Nutrients 2023; 15:4503. [PMID: 37960156 PMCID: PMC10649206 DOI: 10.3390/nu15214503] [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: 09/06/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
Research into the link between food environments and health is scarce. Research in this field has progressed, and new comprehensive methods (i.e., incorporating all food retail outlets) for classifying food retail environments have been developed and are yet to be examined alongside measures of obesity. In this study, we examine the association and temporal trends between the food environment and BMI of a repeated cross-sectional sample of the adult population between 2008 and 2016. Methods: Food retail data for 264 postal areas of Greater Melbourne was collected for the years 2008, 2012, 2014, and 2016, and a container-based approach was used to estimate accessibility to supermarkets, healthy and unhealthy outlets. Data on BMI for postal areas was obtained from the Victorian Population Health Survey (n = 47,245). We estimated the association between the food environment and BMI using linear mixed models. Results indicated that BMI increased as accessibility to healthy outlets decreased by up to -0.69 kg/m2 (95%CI: -0.95, -0.44). BMI was lower with high and moderate access to supermarkets compared to low access by -0.33 kg/m2 (-0.63, -0.04) and -0.32 kg/m2 (-0.56, -0.07), and with high access to unhealthy outlets compared to low access (-0.38 kg/m2: -0.64, -0.12) and moderate access (-0.54 kg/m2: -0.78, -0.30). Conclusion: Our results show that increasing access and availability to a diverse range of food outlets, particularly healthy food outlets, should be an important consideration for efforts to support good health. This research provides evidence that Australia needs to follow suit with other countries that have adopted policies giving local governments the power to encourage healthier food environments.
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Affiliation(s)
- Cindy Needham
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (C.S.); (S.A.)
| | - Claudia Strugnell
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (C.S.); (S.A.)
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC 3220, Australia
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (C.S.); (S.A.)
| | - Laura Alston
- Colac Area Health, Colac, VIC 3250, Australia;
- Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool, VIC 3280, Australia
| | - Liliana Orellana
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, VIC 3220, Australia;
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Unhealthy Food at Your Fingertips: Cross-Sectional Analysis of the Nutritional Quality of Restaurants and Takeaway Outlets on an Online Food Delivery Platform in New Zealand. Nutrients 2022; 14:nu14214567. [PMID: 36364829 PMCID: PMC9656530 DOI: 10.3390/nu14214567] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/22/2022] Open
Abstract
Online food delivery (OFD) platforms have become increasingly popular due to advanced technology, which is changing the way consumers purchase food prepared outside of the home. There is limited research investigating the healthiness of the digital food environment and its influence on consumer choice and dietary behaviours. This study is the first to examine the nutritional quality and marketing attributes of menu items from popular independent and franchise restaurants and takeaway outlets on New Zealand’s market leading OFD platform (UberEATS®). A total of 374 popular independent and franchise restaurants and takeaway outlets were identified to form a database of complete menus and marketing attributes. All 25,877 menu items were classified into 38 food and beverage categories based on the Australian Dietary Guidelines. Of complete menus, 73.3% (18,955/25,877) were discretionary. Thirty-six percent (9419/25,877) were discretionary cereal-based mixed meals, the largest of the 38 categories. Discretionary menu items were more likely to be categorized as most popular (OR: 2.0, 95% CI 1.7−2.2), accompanied by a photo (OR: 1.7, 95% CI 1.6−1.8), and offered as a value bundle (OR: 4.6, 95% CI 3.2−6.8). Two of the three discretionary mixed meal categories were significantly less expensive than their healthier counterparts (p < 0.001). The overwhelming availability and promotion of discretionary choices offered by restaurants and takeaway outlets on OFD platforms have implications for public health policy. Further research to explore direct associations between nutritional quality and consumers’ dietary choices is required.
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Norriss D, Crossin R, Curl A, Bidwell S, Clark E, Pocock T, Gage R, McKerchar C. Food Outlet Access and the Healthiness of Food Available ‘On-Demand’ via Meal Delivery Apps in New Zealand. Nutrients 2022; 14:nu14204228. [PMID: 36296912 PMCID: PMC9607030 DOI: 10.3390/nu14204228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/23/2022] Open
Abstract
Access to unhealthy commodities is a key factor determining consumption, and therefore influences the prevalence of non-communicable diseases. Recently, there has been an increase in the availability of food ‘on-demand’ via meal delivery apps (MDAs). However, the public health and equity impacts of this shift are not yet well understood. This study focused on three MDAs in New Zealand and aimed to answer (1) what is the health profile of the foods being offered on-demand, (2) how many food outlets are available and does this differ by physical access or neighbourhood demographics and (3) does the health profile of foods offered differ by physical access or neighbourhood demographics? A dataset was created by sampling a set of street addresses across a range of demographic variables, and recording the menu items and number of available outlets offered to each address. Machine learning was utilised to evaluate the healthiness of menu items, and we examined if healthiness and the number of available outlets varied by neighbourhood demographics. Over 75% of menu items offered by all MDAs were unhealthy and approximately 30% of all menu items across the three MDAs scored at the lowest level of healthiness. Statistically significant differences by demographics were identified in one of the three MDAs in this study, which suggested that the proportion of unhealthy foods offered was highest in areas with the greatest socioeconomic deprivation and those with a higher proportion of Māori population. Policy and regulatory approaches need to adapt to this novel mode of access to unhealthy foods, to mitigate public health consequences and the effects on population groups already more vulnerable to non-communicable diseases.
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Affiliation(s)
- Dru Norriss
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Rose Crossin
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Angela Curl
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Susan Bidwell
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Elinor Clark
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Tessa Pocock
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
- School of Nursing, University of Auckland, Auckland 1023, New Zealand
| | - Ryan Gage
- Department of Public Health, University of Otago Wellington, Wellington 6021, New Zealand
| | - Christina McKerchar
- Department of Population Health, University of Otago Christchurch, Christchurch 8013, New Zealand
- Correspondence: ; Tel.: +64-(3)-3643638
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Retail food environment in a Brazilian metropolis over the course of a decade: evidence of restricted availability of healthy foods. Public Health Nutr 2022; 25:2584-2592. [PMID: 35343411 PMCID: PMC9991744 DOI: 10.1017/s1368980022000787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate changes in the retail food environment profile in a Brazilian metropolis over a 10-year period. DESIGN An ecological study was conducted in the city of Belo Horizonte, Minas Gerais, Brazil. The addresses of formal food establishments were geocoded and classified according to their sold-food profile. Density changes were analysed according to neighbourhood, population size, income level and geospatial distribution. SETTING Totally, 468 neighbourhoods in the city of Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS Totally, 83 752 formal food establishments registered for operation in any one or more of those years: 2008, 2011, 2015 and 2018. RESULTS There was an increase in unhealthy establishments (154 %), followed by mixed (51 %) and healthy establishments (32 %), during the period evaluated, in addition to an increase in density according to income categories. There was a higher proportion of unhealthy establishments in relation to healthy establishments, indicating worsening of the community food environment over time. CONCLUSIONS Over the course of 10 years, changes in the neighbourhood's food environment were unfavourable for adequate access to healthy foods in lower-income neighbourhoods. The findings reinforce the need for interventions aimed at increasing the availability of businesses that offer healthy food in the city.
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Physical Activity and Food Environments in and around Schools: A Case Study in Regional North-West Tasmania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106238. [PMID: 35627775 PMCID: PMC9140536 DOI: 10.3390/ijerph19106238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023]
Abstract
A better understanding of the physical activity (PA) infrastructure in schools, the walkability of neighborhoods close to schools, and the food environments around schools, particularly in rural, socioeconomically challenged areas such as the North-West (NW) of Tasmania, could be important in the wider effort to improve the health of school-age children. Accordingly, this research aimed to assess PA resources, walkability, and food environments in and around schools in three socioeconomically disadvantaged, regional/rural Local Government Areas (LGAs) of Tasmania, Australia. A census of schools (including assessment of the PA infrastructure quality within school grounds), a walkability assessment, and a census of food outlets surrounding schools (through geospatial mapping) were executed. Most of the schools in the study region had access to an oval, basketball/volleyball/netball court, and free-standing exercise equipment. In all instances (i.e., regardless of school type), the quality of the available infrastructure was substantially higher than the number of incivilities observed. Most schools also had good (i.e., within the first four deciles) walkability. Numerous food outlets were within the walking zones of all schools in the study region, with an abundance of food outlets that predominantly sold processed unhealthy food.
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Neighbourhood food typologies, fast food outlet visitation and snack food purchasing among adolescents in Melbourne, Australia. Public Health Nutr 2022; 25:729-737. [PMID: 34629138 PMCID: PMC9991780 DOI: 10.1017/s1368980021004298] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Despite the increased attention on neighbourhood food environments and dietary behaviours, studies focusing on adolescents are limited. This study aims to characterise typologies of food environments surrounding adolescents and their associations with fast food outlet visitation and snack food purchasing to/from school. DESIGN The number of food outlets (supermarket; green grocers; butcher/seafood/deli; bakeries; convenience stores; fast food/takeaways; café and restaurants) within a 1 km buffer from home was determined using a Geographic Information System. Adolescents' self-reported frequency of fast food outlet visitation and snack food purchasing to/from school. Latent Profile Analysis was conducted to identify typologies of the food environment. Cross-sectional multilevel logistic regression analyses were conducted to examine the relationships between food typologies, fast food outlet visitations and snack food purchasing to/from school. SETTING Melbourne, Australia. PARTICIPANTS Totally, 410 adolescents (mean age= 15·5 (sd = 1·5) years). RESULTS Four distinct typologies of food outlets were identified: (1) limited variety/low number; (2) some variety/low number; (3) high variety/medium number and (4) high variety/high number. Adolescents living in Typologies 1 and 2 had three times higher odds of visiting fast food outlets ≥1 per week (Typology 1: OR = 3·71, 95 % CI 1·23, 11·19; Typology 2: OR = 3·65, 95 % CI 1·21, 10·99) than those living in Typology 4. No evidence of association was found between typologies of the food environments and snack food purchasing behaviour to/from school among adolescents. CONCLUSION Local government could emphasise an overall balance of food outlets when designing neighbourhoods to reduce propensity for fast food outlet visitation among adolescents.
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Price promotions offered by quick service restaurants in Australia: analysis from an obesity prevention perspective. Public Health Nutr 2022; 25:513-527. [PMID: 34247689 PMCID: PMC9991702 DOI: 10.1017/s1368980021002688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the price promotions offered by major quick service restaurant (QSR) chains in Australia from an obesity prevention perspective. DESIGN Cross-sectional audit of ten of the largest QSR chains in Australia. We collected information regarding temporary price promotions and 'combination deals' offered by each chain over thirteen consecutive weeks in 2019-2020. We assessed the type of promotions, the magnitude of discount, and the energy content and healthiness of items promoted (based on Victorian Government criteria). SETTING Melbourne, Australia. PARTICIPANTS Ten major QSR chains. RESULTS Temporary price promotions (n 196) and combination deals (n 537 on regular menus, n 36 on children's menus) were observed across the ten selected QSR chains. In relation to temporary price promotions, the mean magnitude of discount for main menu items (n 75) was 41·7 %. The price reductions and energy content of combination deals varied substantially the by chain, the meal size and the sides/drinks selected as part of the 'deal'. When the lowest-energy options (e.g. small chips, small sugar-free drink) were included as part of each combination deal, the mean energy content was 2935 kJ, compared to 5764 kJ when the highest-energy options (e.g. large fries, large sugar-sweetened drink) were included. Almost all available products were classified as unhealthy. CONCLUSION Price promotions are ubiquitous in major QSR chains in Australia and provide incentives to consume high levels of energy. The action to restrict price promotions on unhealthy foods and ensure lower-energy default items as part of combination deals should be included as part of efforts to improve population diets and address obesity in Australia.
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Rose N, Reeve B, Charlton K. Barriers and Enablers for Healthy Food Systems and Environments: The Role of Local Governments. Curr Nutr Rep 2022; 11:82-93. [PMID: 35150415 PMCID: PMC8853135 DOI: 10.1007/s13668-022-00393-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 12/01/2022]
Abstract
Purpose of review Food systems at all levels are experiencing various states of dysfunction and crisis, and in turn their governance contributes to other intensifying crises, such as climate change, biodiversity loss and the rapid expansion of dietary-related non-communicable diseases. In many jurisdictions governments at local, state and national levels are taking action to tackle some of the key challenges confronting food systems through a range of regulatory, legislative and fiscal measures. This article comprises a narrative review summarising recent relevant literature with a focus on the intersection between corporate power and public health. The review sought to identify some of the principal barriers for the design and support of healthy food systems and environments, as well as key reforms that can be adopted to address these barriers, with a focus on the role of local governments. Recent findings The review found that, where permitted to do so by authorising legislative and regulatory frameworks, and where political and executive leadership prioritises healthy and sustainable food systems, local governments have demonstrated the capacity to exercise legislative and regulatory powers, such as planning powers to constrain the expansion of the fast food industry. In doing so, they have been able to advance broader goals of public health and wellbeing, as well as support the strengthening and expansion of healthy and sustainable food systems. Summary Whilst local governments in various jurisdictions have demonstrated the capacity to take effective action to advance public health and environmental goals, such interventions take place in the context of a food system dominated by the corporate determinants of health. Accordingly, their wider health-promoting impact will remain limited in the absence of substantive reform at all levels of government.
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Affiliation(s)
- Nicholas Rose
- Faculty of Higher Education, William Angliss Institute, Melbourne, Victoria, Australia.
| | - Belinda Reeve
- The University of Sydney Law School, Sydney, NSW, Australia
| | - Karen Charlton
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, The University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
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Oostenbach LH, Lamb KE, Thornton LE. Is having a 20-minute neighbourhood associated with eating out behaviours and takeaway home delivery? A cross-sectional analysis of ProjectPLAN. BMC Public Health 2022; 22:191. [PMID: 35090427 PMCID: PMC8796524 DOI: 10.1186/s12889-022-12587-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Through improved service provision and accessibility, 20-min neighbourhoods (20MNs) aim to enable people to meet most of their daily (non-work) needs within 20 min from home. Associations between 20MNs and food practices remain unknown. This study examines links with the frequency and location of eating out behaviours as well as the frequency of home food delivery. METHODS This cross-sectional study used data from 769 adults from the Places and Locations for Activity and Nutrition study (ProjectPLAN) conducted in Melbourne and Adelaide, Australia, between 2018 and 2019. Outcomes were 1) visit frequency to i) cafés, ii) restaurants, bars or bistros, iii) major chain fast food outlets and iv) takeaway outlets to purchase food; 2) total number of different types of out-of-home food outlets visited; 3) use frequency of home food delivery services; 4) distance from home to the most frequented out-of-home food outlets. Exposure was whether participants had a 20MN (areas with high service/amenity provision) or a non-20MN (areas with low service/amenity provision). Ordinal regression models were fitted for the frequency outcomes. Poisson regression models were fitted for the number of different outlet types. Linear and spatial regression models were fitted for the distance outcomes. RESULTS Results suggested no differences in frequency of visitations to out-of-home food outlets and use of food delivery services between those with a 20MN and those with a non-20MN. Yet, those with a 20MN were more likely to use a greater number of different types of outlets on a weekly basis. Where a regular eating out location was reported, it was nearer to home for those with a 20MN. CONCLUSIONS This study provides evidence supportive of 20MNs potentially facilitating more localised food practices, however, 20MNs may also encourage greater cumulative frequency of meals out across a variety of out-of-home food providers.
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Affiliation(s)
- Laura H Oostenbach
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Karen E Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Lukar E Thornton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Marketing, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium
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Needham C, Strugnell C, Allender S, Orellana L. Beyond food swamps and food deserts: exploring urban Australian food retail environment typologies. Public Health Nutr 2022; 25:1-13. [PMID: 35022093 PMCID: PMC9991784 DOI: 10.1017/s136898002200009x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE 'Food deserts' and 'food swamps' are food retail environment typologies associated with unhealthy diet and obesity. The current study aimed to identify more complex food retail environment typologies and examine temporal trends. DESIGN Measures of food retail environment accessibility and relative healthy food availability were defined for small areas (SA2s) of Melbourne, Australia, from a census of food outlets operating in 2008, 2012, 2014 and 2016. SA2s were classified into typologies using a two-stage approach: (1) SA2s were sorted into twenty clusters according to accessibility and availability and (2) clusters were grouped using evidence-based thresholds. SETTING The current study was set in Melbourne, the capital city of the state of Victoria, Australia. SUBJECTS Food retail environments in 301 small areas (Statistical Area 2) located in Melbourne in 2008, 2012, 2014 and 2016. RESULTS Six typologies were identified based on access (low, moderate and high) and healthy food availability including one where zero food outlets were present. Over the study period, SA2s experienced an overall increase in accessibility and healthiness. Distribution of typologies varied by geographic location and area-level socio-economic position. CONCLUSION Multiple typologies with contrasting access and healthiness measures exist within Melbourne and these continue to change over time, and the majority of SA2s were dominated by the presence of unhealthy relative to healthy outlets, with SA2s experiencing growth and disadvantage having the lowest access and to a greater proportion of unhealthy outlets.
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Affiliation(s)
- Cindy Needham
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong3220, Australia
| | - Claudia Strugnell
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong3220, Australia
| | - Steven Allender
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong3220, Australia
| | - Liliana Orellana
- Deakin University, Biostatistics Unit, Faculty of Health, Geelong, Australia
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Winkler MR, Mui Y, Hunt SL, Laska MN, Gittelsohn J, Tracy M. Applications of Complex Systems Models to Improve Retail Food Environments for Population Health: A Scoping Review. Adv Nutr 2021; 13:1028-1043. [PMID: 34999752 PMCID: PMC9340968 DOI: 10.1093/advances/nmab138] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/10/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Retail food environments (RFEs) are complex systems with important implications for population health. Studying the complexity within RFEs comes with challenges. Complex systems models are computational tools that can help. We performed a systematic scoping review of studies that used complex systems models to study RFEs for population health. We examined the purpose for using the model, RFE features represented, extent to which the complex systems approach was maximized, and quality and transparency of methods employed. The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines were followed. Studies using agent-based modeling, system dynamics, discrete event simulations, networks, hybrid, or microsimulation models were identified from 7 multidisciplinary databases. Fifty-six studies met the inclusion criteria, including 23 microsimulation, 13 agent-based, 10 hybrid, 4 system dynamics, 4 network, and 2 discrete event simulation models. Most studies (n = 45) used models for experimental purposes and evaluated effects of simulated RFE policies and interventions. RFE characteristics simulated in models were diverse, and included the features (e.g., prices) customers encounter when shopping (n = 55), the settings (e.g., restaurants, supermarkets) where customers purchase food and beverages (n = 30), and the actors (e.g., store managers, suppliers) who make decisions that influence RFEs (n = 25). All models incorporated characteristics of complexity (e.g., feedbacks, conceptual representation of multiple levels), but these were captured to varying degrees across model types. The quality of methods was adequate overall; however, few studies engaged stakeholders (n = 10) or provided sufficient transparency to verify the model (n = 12). Complex systems models are increasingly utilized to study RFEs and their contributions to public health. Opportunities to advance the use of these approaches remain, and areas to improve future research are discussed. This comprehensive review provides the first marker of the utility of leveraging these approaches to address RFEs for population health.
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Affiliation(s)
| | - Yeeli Mui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shanda L Hunt
- Health Sciences Library, University of Minnesota, Minneapolis, MN, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Joel Gittelsohn
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA
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Keeble M, Adams J, Vanderlee L, Hammond D, Burgoine T. Associations between online food outlet access and online food delivery service use amongst adults in the UK: a cross-sectional analysis of linked data. BMC Public Health 2021; 21:1968. [PMID: 34719382 PMCID: PMC8557109 DOI: 10.1186/s12889-021-11953-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/06/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Online food delivery services facilitate 'online' access to food outlets that typically sell lenergy-dense nutrient-poor food. Greater online food outlet access might be related to the use of this purchasing format and living with excess bodyweight, however, this is not known. We aimed to investigate the association between aspects of online food outlet access and online food delivery service use, and differences according to customer sociodemographic characteristics, as well as the association between the number of food outlets accessible online and bodyweight. METHODS In 2019, we used an automated data collection method to collect data on all food outlets in the UK registered with the leading online food delivery service Just Eat (n = 33,204). We linked this with contemporaneous data on food purchasing, bodyweight, and sociodemographic information collected through the International Food Policy Study (analytic sample n = 3067). We used adjusted binomial logistic, linear, and multinomial logistic regression models to examine associations. RESULTS Adults in the UK had online access to a median of 85 food outlets (IQR: 34-181) and 85 unique types of cuisine (IQR: 64-108), and 15.1% reported online food delivery service use in the previous week. Those with the greatest number of accessible food outlets (quarter four, 182-879) had 71% greater odds of online food delivery service use (OR: 1.71; 95% CI: 1.09, 2.68) compared to those with the least (quarter one, 0-34). This pattern was evident amongst adults with a university degree (OR: 2.11; 95% CI: 1.15, 3.85), adults aged between 18 and 29 years (OR: 3.27, 95% CI: 1.59, 6.72), those living with children (OR: 1.94; 95% CI: 1.01; 3.75), and females at each level of increased exposure. We found no association between the number of unique types of cuisine accessible online and online food delivery service use, or between the number of food outlets accessible online and bodyweight. CONCLUSIONS The number of food outlets accessible online is positively associated with online food delivery service use. Adults with the highest education, younger adults, those living with children, and females, were particularly susceptible to the greatest online food outlet access. Further research is required to investigate the possible health implications of online food delivery service use.
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Affiliation(s)
- Matthew Keeble
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Jean Adams
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Lana Vanderlee
- grid.23856.3a0000 0004 1936 8390École de Nutrition, Université Laval, Pavillon des Services, bureau 2729-E, 2440 boul. Hochelaga, Quebec City, QC G1V 0A6 Canada
| | - David Hammond
- grid.46078.3d0000 0000 8644 1405School of Public Health and Health Systems, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G1 Canada
| | - Thomas Burgoine
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
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Keeble M, Adams J, Bishop TR, Burgoine T. Socioeconomic inequalities in food outlet access through an online food delivery service in England: A cross-sectional descriptive analysis. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2021; 133:None. [PMID: 34345056 PMCID: PMC8288297 DOI: 10.1016/j.apgeog.2021.102498] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/04/2021] [Accepted: 06/21/2021] [Indexed: 05/05/2023]
Abstract
Online food delivery services facilitate 'online' access to food outlets selling food prepared away-from-home. Online food outlet access has not previously been investigated in England or across an entire country. Systematic differences in online food outlet access could exacerbate existing health inequalities, which is a public health concern. However, this is not known. Across postcode districts in England (n = 2118), we identified and described the number of food outlets and unique cuisine types accessible online from the market leader (Just Eat). We investigated associations with area-level deprivation using adjusted negative binomial regression models. We also compared the number of food outlets accessible online with the number physically accessible in the neighbourhood (1600m Euclidean buffers of postcode district geographic centroids) and investigated associations with deprivation using an adjusted general linear model. For each outcome, we predicted means and 95% confidence intervals. In November 2019, 29,232 food outlets were registered to accept orders online. Overall, the median number of food outlets accessible online per postcode district was 63.5 (IQR; 16.0-156.0). For the number of food outlets accessible online as a percentage of the number accessible within the neighbourhood, the median was 63.4% (IQR; 35.6-96.5). Analysis using negative binomial regression showed that online food outlet access was highest in the most deprived postcode districts (n = 106.1; 95% CI: 91.9, 120.3). The number of food outlets accessible online as a percentage of those accessible within the neighbourhood was highest in the least deprived postcode districts (n = 86.2%; 95% CI: 78.6, 93.7). In England, online food outlet access is socioeconomically patterned. Further research is required to understand how online food outlet access is related to using online food delivery services.
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Affiliation(s)
- Matthew Keeble
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jean Adams
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Tom R.P. Bishop
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Thomas Burgoine
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
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Tavares LF, Perez PMP, dos Passos MEA, de Castro Junior PCP, da Silva Franco A, de Oliveira Cardoso L, de Castro IRR. Development and Application of Healthiness Indicators for Commercial Establishments That Sell Foods for Immediate Consumption. Foods 2021; 10:foods10061434. [PMID: 34205645 PMCID: PMC8235135 DOI: 10.3390/foods10061434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
Studies of food environments lack easy-to-apply indicators for their characterization and monitoring. This study aimed to create and assess the applicability of an a priori classification of establishments that sell foods for immediate consumption and to develop and apply indicators for assessment of the establishments’ healthiness. The indicators were grouped by the types of foods sold most frequently at these establishments, according to the extent and purpose of the foods’ industrial processing. Four indicators were developed, based on the availability of unprocessed/minimally processed foods (MPF) and ultra-processed foods (UPF) in the establishments. The classification and indicators were applied to commercial food establishments at two Brazilian universities. Descriptive analyses were performed to characterize the food environment for all the establishments and by university. Two proportion indicators assess the relative availability of subgroups of MPF and UPF. The UPF/MPF ratio expresses the relative advantage/disadvantage of the availability of MPF compared to that of UPF. The Healthiness Index or summary score expresses the availability of MPF and the unavailability of UPF. The classification and indicators present good discriminatory power and are easy to operationalize, interpret, and adapt.
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Affiliation(s)
- Letícia Ferreira Tavares
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Patrícia Maria Périco Perez
- Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro 20559-900, Brazil; (P.M.P.P.); (I.R.R.d.C.)
| | - Maria Eliza Assis dos Passos
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Paulo Cesar Pereira de Castro Junior
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Amanda da Silva Franco
- Nutrition Coordination, Health Sciences Center, Centro Universitário Serra dos Órgãos (UNIFESO), Rio de Janeiro 25964-000, Brazil;
| | - Letícia de Oliveira Cardoso
- Oswaldo Cruz Foundation (FIOCRUZ), National School of Public Health, Rio de Janeiro 21041-210, Brazil
- Correspondence: ; Tel.: +55-212-598-2619
| | - Inês Rugani Ribeiro de Castro
- Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro 20559-900, Brazil; (P.M.P.P.); (I.R.R.d.C.)
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A state-wide audit of unhealthy sponsorship within junior sporting clubs in Victoria, Australia. Public Health Nutr 2021; 24:3797-3804. [PMID: 34034837 DOI: 10.1017/s1368980021002159] [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 To systematically audit the extent of unhealthy sponsorship within junior community sporting clubs and ascertain whether differences exist across geographical areas and sport types. DESIGN Club sponsorship data were assessed to determine the extent of unhealthy food/beverage, alcohol and gambling sponsorship using a cross-sectional design. Differences across geographical areas were assessed using logistic regressions. SETTING A stratified random sampling procedure was used to select thirty communities across the state of Victoria, Australia. Within each community, local clubs across the top eight participating junior sports were selected for audit. PARTICIPANTS Sponsorship data were collected from 191 club websites and Facebook pages in September-November 2019. RESULTS Unhealthy sponsorships represented 8·9 % of all identified sponsorship arrangements. A quarter of all clubs accepted alcohol (25·6 %) and unhealthy food sponsors (25·9 %), and one-fifth of all clubs accepted high-risk food (unhealthy brands with large market share) (18·1 %) and gambling sponsors (20·4 %). Acceptance of unhealthy sponsorship differed across sport types with football, netball, cricket and soccer clubs having the greatest numbers. Compared with metro areas, a significantly greater proportion of sporting clubs in regional areas were affiliated with unhealthy food (32·7 % v. 19·6 %) and high-risk food sponsors (26·9 % v. 9·8 %). A higher proportion of clubs in low socio-economic status (SES), compared with the high SES areas, were affiliated with alcohol (33·9 % v. 16·5 %) and gambling sponsors (27·4 % v. 12·6 %). CONCLUSION Victorian children participating in community junior sports are being exposed to marketing of unhealthy brands and products. Public health intervention is necessary to protect children from this exposure.
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Cerin E, Yin S, Choi WK, Ngan W, Tham R, Barnett A. Development of Measures of Perceived Neighborhood Environmental Attributes Influencing, and Perceived Barriers to Engagement in, Healthy Behaviors for Older Chinese Immigrants to Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094531. [PMID: 33923306 PMCID: PMC8123107 DOI: 10.3390/ijerph18094531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/16/2022]
Abstract
Environmental correlates, barriers, and facilitators of physical activity, healthy eating, and socializing are understudied in older immigrants to developed countries. This study developed/adapted and validated measures of perceived barriers and neighborhood environmental characteristics related to these health-enhancing behaviors appropriate for older Chinese immigrants to Australia and similar Western countries. Older Chinese immigrants living in Melbourne (Australia) were recruited from neighborhoods varying in walkability and percentage of Chinese residents. Versions of the Neighborhood Environment for Healthy Aging–Chinese Immigrants to Australia (NEHA-CIA) questionnaire (20 subscales) and the Perceived Barriers to Health-Enhancing Behaviors questionnaire (four subscales) were developed from extant validated scales and information collected in formative qualitative research. Thirty-one participants took part in cognitive interviews aimed to pilot-test and refine the questionnaires. The modified questionnaires were administered to 52 participants twice, two weeks apart. Test-retest reliability (intraclass correlation coefficients), internal consistency (Cronbach’s α), and construct validity (associations with theoretically-relevant constructs) were examined. Most items and subscales of both questionnaires had good test-retest reliability and internal consistency, while the NEHA-CIA also showed good construct validity. Future studies need to further examine the construct validity of the questionnaire of perceived barriers and determine the factorial validity of both measures on large representative samples.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (W.K.C.); (R.T.); (A.B.)
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong, China
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- Correspondence: ; Tel.: +61-3-9230-8260
| | - Shiyuan Yin
- School of Exercise and Nutrition Science, Deakin University, Burwood, VIC 3125, Australia; (S.Y.); (W.N.)
| | - Wing Ka Choi
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (W.K.C.); (R.T.); (A.B.)
| | - Winsfred Ngan
- School of Exercise and Nutrition Science, Deakin University, Burwood, VIC 3125, Australia; (S.Y.); (W.N.)
| | - Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (W.K.C.); (R.T.); (A.B.)
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (W.K.C.); (R.T.); (A.B.)
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Wang C, Korai A, Jia SS, Allman-Farinelli M, Chan V, Roy R, Raeside R, Phongsavan P, Redfern J, Gibson AA, Partridge SR. Hunger for Home Delivery: Cross-Sectional Analysis of the Nutritional Quality of Complete Menus on an Online Food Delivery Platform in Australia. Nutrients 2021; 13:nu13030905. [PMID: 33799532 PMCID: PMC8002002 DOI: 10.3390/nu13030905] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/24/2021] [Accepted: 03/06/2021] [Indexed: 01/04/2023] Open
Abstract
Online food delivery (OFD) platforms have changed how consumers purchase food prepared outside of home by capitalising on convenience and smartphone technology. Independent food outlets encompass a substantial proportion of partnering outlets, but their offerings’ nutritional quality is understudied. Little is also known as to how OFD platforms influence consumer choice. This study evaluated the nutritional quality and marketing attributes of offerings from independent takeaway outlets available on Sydney’s market-leading OFD platform (UberEats®). Complete menus and marketing attributes from 202 popular outlets were collected using web scraping. All 13841 menu items were classified into 38 food and beverage categories based on the Australian Dietary Guidelines. Of complete menus, 80.5% (11,139/13,841) were discretionary and 42.3% (5849/13,841) were discretionary cereal-based mixed meals, the largest of the 38 categories. Discretionary menu items were more likely to be categorised as most popular (OR: 2.5, 95% CI 1.9–3.2), accompanied by an image (OR: 1.3, 95% CI 1.2–1.5) and offered as a value bundle (OR: 6.5, 95% CI 4.8–8.9). Two of the three discretionary food categories were more expensive than their healthier Five Food Group counterparts (p < 0.02). The ubiquity of discretionary choices offered by independent takeaways and the marketing attributes employed by OFD platforms has implications for public health policy. Further research on the contribution of discretionary choices and marketing attributes to nutritional intakes is warranted.
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Affiliation(s)
- Celina Wang
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (M.A.-F.); (V.C.)
- Correspondence: (C.W.); (A.K.)
| | - Andriana Korai
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (M.A.-F.); (V.C.)
- Correspondence: (C.W.); (A.K.)
| | - Si Si Jia
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (S.S.J.); (R.R.); (J.R.); (S.R.P.)
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (M.A.-F.); (V.C.)
| | - Virginia Chan
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (M.A.-F.); (V.C.)
| | - Rajshri Roy
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1011, New Zealand;
| | - Rebecca Raeside
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (S.S.J.); (R.R.); (J.R.); (S.R.P.)
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Julie Redfern
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (S.S.J.); (R.R.); (J.R.); (S.R.P.)
- The George Institute for Global Health, The University of New South Wales, Camperdown, NSW 2006, Australia
| | - Alice A. Gibson
- Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Stephanie R. Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2145, Australia; (S.S.J.); (R.R.); (J.R.); (S.R.P.)
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia;
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Carroll SJ, Turrell G, Dale MJ, Daniel M. Associations between supermarket availability and body size in Australia: a cross-sectional observational study comparing state and territory capital cities. BMC Public Health 2021; 21:407. [PMID: 33632182 PMCID: PMC7908780 DOI: 10.1186/s12889-021-10458-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/17/2021] [Indexed: 11/22/2022] Open
Abstract
Background Residential environment features such as availability of supermarkets may shape dietary behaviour and thus overweight and obesity. This relationship may not be consistent between cities. This Australian national-level study examined: 1) the relationship between supermarket availability and body size; and 2) whether this relationship varied by capital city. Methods This study used 2017–18 Australian National Health Survey data including individual-level socio-demographic information (age, sex, country of birth, education, occupation, household income), and measured body size (height and weight to derive body mass index [BMI], and waist circumference [WC]). Objectively-expressed measures of residential environments included: counts of supermarkets (major chain outlets), counts of amenities (representing walkable destinations including essential services, recreation, and entertainment), and area of public open space - each expressed within road-network buffers at 1000 m and 1500 m; population density (1km2 grid cells); and neighbourhood disadvantage (Index of Relative Socioeconomic Disadvantage) expressed within Statistical Area Level 1 units. Data for adult respondents ≥18 years residing in each of Australia’s state and territory capital cities (n = 9649) were used in multilevel models to estimate associations between supermarket availability and body size sequentially accounting for individual and other environment measures. An interaction term estimated city-specific differences in associations between supermarket availability and body size. Models were consequently repeated stratified by city. Results Body size (BMI and WC) and supermarket availability varied between cities. Initial inverse associations between supermarket availability and body size (BMI and WC) were attenuated to null with inclusion of all covariates, except for BMI in the 1000 m buffer model (beta = − 0.148, 95%CI -0.27, − 0.01, p = 0.025). In stratified analyses, the strengths of associations varied between cities, remaining statistically significant only for some cities (BMI: Melbourne, Brisbane Hobart; WC: Brisbane, Hobart) in fully adjusted models. Different patterns of attenuation of associations with inclusion of covariates were evident for different cities. Conclusions For Australian capital cities, greater availability of supermarkets is associated with healthful body size. Marked between-city variations in body size, supermarket availability, and relationships between supermarket availability and body size do not, however, support universal, “one-size-fits-all” solutions to change built environments to support healthful body size.
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Affiliation(s)
- Suzanne J Carroll
- Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, 23B21, 11 Kirinari St, Bruce, ACT, Australia.
| | - Gavin Turrell
- Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, 23B21, 11 Kirinari St, Bruce, ACT, Australia
| | - Michael J Dale
- Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, 23B21, 11 Kirinari St, Bruce, ACT, Australia
| | - Mark Daniel
- Australian Geospatial Health Laboratory, Health Research Institute, University of Canberra, 23B21, 11 Kirinari St, Bruce, ACT, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
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Tran HNQ, McMahon E, Moodie M, Ananthapavan J. A Systematic Review of Economic Evaluations of Health-Promoting Food Retail-Based Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031356. [PMID: 33540905 PMCID: PMC7908088 DOI: 10.3390/ijerph18031356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND While the number of retail interventions with impacts on diet- and/or health-related outcomes is increasing, the economic evaluation literature is limited. This review investigated (i) the cost-effectiveness of health-promoting food retail interventions and (ii) key assumptions adopted in these evaluations. METHODS A systematic review of published academic studies was undertaken (CRD42020153763). Fourteen databases were searched. Eligible studies were identified, analysed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS Eight studies that evaluated 30 retail interventions were included in the review. Common outcomes reported were cost per healthy food item purchased/served or cost per disability-adjusted life year (DALY) averted. Four studies undertook cost-utility analyses and half of these studies concluded that retail interventions were cost-effective in improving health outcomes. Most studies did not state any assumptions regarding compensatory behaviour (i.e., purchases/consumption of non-intervention foods or food purchases/consumption from non-intervention settings) and presumed that sales data were indicative of consumption. CONCLUSION The cost-effectiveness of retail-based health-promoting interventions is inconclusive. Future health-promoting retail interventions should regularly include an economic evaluation which addresses key assumptions related to compensatory behaviour and the use of sales data as a proxy for consumption.
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Affiliation(s)
- Huong Ngoc Quynh Tran
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC 3217, Australia; (M.M.); (J.A.)
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, VIC 3217, Australia
- Correspondence: ; Tel.: +613-9244-5578
| | - Emma McMahon
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia;
| | - Marj Moodie
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC 3217, Australia; (M.M.); (J.A.)
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, VIC 3217, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC 3217, Australia; (M.M.); (J.A.)
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, VIC 3217, Australia
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Partridge SR, Gibson AA, Roy R, Malloy JA, Raeside R, Jia SS, Singleton AC, Mandoh M, Todd AR, Wang T, Halim NK, Hyun K, Redfern J. Junk Food on Demand: A Cross-Sectional Analysis of the Nutritional Quality of Popular Online Food Delivery Outlets in Australia and New Zealand. Nutrients 2020; 12:nu12103107. [PMID: 33053705 PMCID: PMC7601596 DOI: 10.3390/nu12103107] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/02/2020] [Accepted: 10/09/2020] [Indexed: 01/22/2023] Open
Abstract
The demand for convenience and the increasing role of digital technology in everyday life has fueled the use of online food delivery services (OFD’s), of which young people are the largest users globally. OFD’s are disrupting traditional food environments, yet research evaluating the public health implications of such services is lacking. We evaluated the characteristics and nutritional quality of popular food outlets on a market-leading platform (UberEATS®) in a cross-sectional observational study conducted in two international cities: Sydney (Australia) and Auckland (New Zealand). A systematic search using publicly available population-level data was used to identify geographical areas with above-average concentrations (>30%) of young people (15–34-years). A standardized data extraction protocol was used to identify the ten most popular food outlets within each area. The nutritional quality of food outlets was assessed using the Food Environment Score (FES) (range: −10 ‘unhealthiest’ to 10 ‘healthiest’). Additionally, the most popular menu items from each food outlet were classified as discretionary or core foods/beverages according to the Australian Dietary Guidelines. The majority of popular food outlets were classified as ‘unhealthy’ (FES range −10 to −5; 73.5%, 789/1074) and were predominately takeaway franchise stores (59.6%, 470/789, e.g., McDonald’s®). 85.9% of all popular menu items were discretionary (n = 4958/5769). This study highlights the pervasion and accessibility of discretionary foods on OFD’s. This study demonstrated that the most popular food outlets on the market-leading online food delivery service are unhealthy and popular menu items are mostly discretionary foods; facilitating the purchase of foods of poor nutritional quality. Consideration of OFD’s in public health nutrition strategies and policies in critical.
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Affiliation(s)
- Stephanie R. Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney 2006, Australia
- Correspondence: ; Tel.: +61-2-8890-8187
| | - Alice A. Gibson
- Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
| | - Rajshri Roy
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1011, New Zealand; (R.R.); (J.A.M.)
| | - Jessica A. Malloy
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1011, New Zealand; (R.R.); (J.A.M.)
| | - Rebecca Raeside
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
| | - Si Si Jia
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
| | - Anna C. Singleton
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
| | - Mariam Mandoh
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
| | - Allyson R. Todd
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
| | - Tian Wang
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
| | - Nicole K. Halim
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
| | - Karice Hyun
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
- ANZAC Research Institute, Concord Repatriation General Hospital, The University of Sydney, Sydney 2137, Australia
| | - Julie Redfern
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2145, Australia; (R.R.); (S.S.J.); (A.C.S.); (M.M.); (A.R.T.); (T.W.); (N.K.H.); (K.H.); (J.R.)
- The George Institute for Global Health, The University of New South Wales, Camperdown 2006, Australia
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23
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Bhutta ZA, Akseer N, Keats EC, Vaivada T, Baker S, Horton SE, Katz J, Menon P, Piwoz E, Shekar M, Victora C, Black R. How countries can reduce child stunting at scale: lessons from exemplar countries. Am J Clin Nutr 2020; 112:894S-904S. [PMID: 32692800 PMCID: PMC7487427 DOI: 10.1093/ajcn/nqaa153] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Child stunting and linear growth faltering have declined over the past few decades and several countries have made exemplary progress. OBJECTIVES To synthesize findings from mixed methods studies of exemplar countries to provide guidance on how to accelerate reduction in child stunting. METHODS We did a qualitative and quantitative synthesis of findings from existing literature and 5 exemplar country studies (Nepal, Ethiopia, Peru, Kyrgyz Republic, Senegal). Methodology included 4 broad research activities: 1) a series of descriptive analyses of cross-sectional data from demographic and health surveys and multiple indicator cluster surveys; 2) multivariable analysis of quantitative drivers of change in linear growth; 3) interviews and focus groups with national experts and community stakeholders and mothers; and 4) a review of policy and program evolution related to nutrition. RESULTS Several countries have dramatically reduced child stunting prevalence, with or without closing geographical, economic, and other population inequalities. Countries made progress through interventions from within and outside the health sector, and despite significant heterogeneity and differences in context, contributions were comparable from health and nutrition sectors (40% of change) and other sectors (50%), previously called nutrition-specific and -sensitive strategies. Improvements in maternal education, maternal nutrition, maternal and newborn care, and reductions in fertility/reduced interpregnancy intervals were strong contributors to change. A roadmap to reducing child stunting at scale includes several steps related to diagnostics, stakeholder consultations, and implementing direct and indirect nutrition interventions related to the health sector and nonhealth sector . CONCLUSIONS Our results show that child stunting reduction is possible even in diverse and challenging contexts. We propose that our framework of organizing nutrition interventions as direct/indirect and inside/outside the health sector should be considered when mapping causal pathways of child stunting and planning interventions and strategies to accelerate stunting reduction to achieve the 2030 Sustainable Development Goals.
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Affiliation(s)
- Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
| | - Nadia Akseer
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Emily C Keats
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tyler Vaivada
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shawn Baker
- United States Agency for International Development, Washington, DC, USA
| | - Susan E Horton
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Joanne Katz
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Purnima Menon
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, South Asia Office, New Delhi, India
| | - Ellen Piwoz
- Global Development Division, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Meera Shekar
- Health, Nutrition & Population, World Bank, Washington, DC, USA
| | - Cesar Victora
- Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Robert Black
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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24
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Lourival I, Rose N. From Nar Nar Goon to Koo Wee Rup: Can Participatory Food Policy Making Processes Contribute to Healthier and Fairer Food Systems in the Australian Municipal Context? A Case Study from Cardinia Shire, Melbourne. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1782797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Izo Lourival
- Faculty of Higher Education, William Angliss Institute, Melbourne, Australia
| | - Nick Rose
- Faculty of Higher Education, William Angliss Institute, Melbourne, Australia
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25
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Albury C, Strain WD, Brocq SL, Logue J, Lloyd C, Tahrani A. The importance of language in engagement between health-care professionals and people living with obesity: a joint consensus statement. Lancet Diabetes Endocrinol 2020; 8:447-455. [PMID: 32333880 DOI: 10.1016/s2213-8587(20)30102-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022]
Abstract
Obesity is a chronic condition that requires long-term management and is associated with unprecedented stigma in different settings, including during interactions with the health-care system. This stigma has a negative effect on the mental and physical health of people with obesity and can lead to avoidance of health care and disruption of the doctor-patient relationship. Considerable evidence exists to suggest that simply having a conversation about obesity can lead to weight loss, which translates into health benefits. However, both health-care practitioners and people living with obesity report apprehension in initiating this conversation. We have collaborated with stakeholders from Obesity UK, physicians, dieticians, clinical psychologists, obesity researchers, conversation analysts, nurses, and representatives from National Health Service England Diabetes and Obesity. This group has contributed to the production of this consensus statement, which addresses how people living with obesity wish to have their condition referred to and provides practical guidance for health-care professionals to facilitate collaborative and supportive discussions about obesity. Expert stakeholders consider that changes to language used at the point of care can alleviate the stigma of obesity within the health-care system and support improved outcomes for both people living with obesity and for the health-care system.
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Affiliation(s)
- Charlotte Albury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, Institute of Biomedical and Clinical Science and College of Medicine and Health, University of Exeter, Exeter, UK.
| | | | - Jennifer Logue
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Cathy Lloyd
- School of Health, Wellbeing and Social Care in the Faculty of Wellbeing, Education and Language Studies at the Open University, Milton Keynes, UK
| | - Abd Tahrani
- National Institute for Health Research, University of Birmingham, Birmingham, UK; University Hospitals Birmingham National Health Service Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
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