1
|
Dawson E, Chung A, Vargas C, Backholer K, Lee A, Lewis M, Brooks R, Schultz S, Bennett R, Martino F, Zorbas C. The Price of Foods, Beverages, and Diets in Australia: An Updated Systematic Review. Nutr Rev 2024:nuae129. [PMID: 39301622 DOI: 10.1093/nutrit/nuae129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024] Open
Abstract
CONTEXT The price and affordability of food are priorities for public health and health equity; however, Australia lacks a consistent method to evaluate healthy versus unhealthy diets, creating a gap in routine food price reporting. OBJECTIVE This review aimed to identify and summarize recent methods used to assess and monitor the price and/or affordability of food and beverages in Australia using a health lens. DATA SOURCES Four academic databases (MEDLINE Complete, Global Health, CINAHL Complete, and Business Source Complete) were searched in English from 2016 to 2022. Relevant gray literature was searched through Google Scholar and government websites. DATA EXTRACTION Five reviewers screened titles and abstracts, and full-text screening was conducted by 1 reviewer, with eligibility confirmed by a second reviewer. The quality of studies was assessed using the Joanna Briggs Institute "Checklist for Analytical Cross-Sectional Studies." DATA ANALYSIS Twenty-five eligible studies were identified. Eleven studies used a version of the Healthy Diets Australian Standardized Affordability and Pricing protocol to collect prices for a "healthy" diet modelled on dietary guidelines and an "unhealthy" diet based on a habitual Australian diet. These studies consistently found unhealthy diets to be more expensive than healthy diets. Other identified methods included assessing the price of household diets across healthy baskets (n = 6), store types (n = 5), a planetary health diet (n = 1), packaged foods according to their Health Star Rating (n = 1), a fruit and vegetable basket (n = 1), school canteen foods against a traffic light system (n = 1), and weekly healthy meal plans (n = 1). Healthy diets tended to be less costly than less healthy diets, but both diets were often unaffordable in regional areas, for people on low incomes, and for First Nations peoples. CONCLUSION Consistent country-wide application of methods for monitoring the price and affordability of foods and diets in Australia is needed-including tailored approaches for priority groups. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022333531.
Collapse
Affiliation(s)
- Emily Dawson
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| | - Alexandra Chung
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia
| | - Carmen Vargas
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| | - Amanda Lee
- The School of Public Health, The University of Queensland, Brisbane, 4006, Australia
| | - Meron Lewis
- The School of Public Health, The University of Queensland, Brisbane, 4006, Australia
| | - Ruby Brooks
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| | - Sally Schultz
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| | - Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| | - Florentine Martino
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, 3220, Australia
| |
Collapse
|
2
|
Dharmayani PNA, Williams M, Lopes CVA, Ronto R, Chau JY, Partridge SR, Mihrshahi S. Exploring reasons for high levels of food insecurity and low fruit and vegetable consumption among university students post-COVID-19. Appetite 2024; 200:107534. [PMID: 38825015 DOI: 10.1016/j.appet.2024.107534] [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: 12/20/2023] [Revised: 05/15/2024] [Accepted: 05/28/2024] [Indexed: 06/04/2024]
Abstract
High rates of food insecurity and low consumption of fruit and vegetables among university students have been observed prior to the COVID-19 pandemic and intensified during the pandemic. This study aimed to investigate food insecurity among university students and its associations with sociodemographic factors, fruit and vegetable consumption behaviours, and preferred campus programs to address these issues. A convenience sample of 237 Australian university students completed a cross-sectional online survey from October to December 2022. Food insecurity was assessed using the 10-item US Adult Food Security Module, applying the Canadian classification scheme. Sociodemographic variables, fruit and vegetable consumption behaviours, and perceptions of fruit and vegetable access and their affordability were included in the survey. Students were also asked to select the most suitable program(s) and provide reasons for their choice using open-ended questions. Approximately half of respondents (46.4%) were identified as food insecure. The proportion of students meeting the recommended intake of vegetables as specified in the Australian Dietary Guidelines was very low (5.1%) compared with fruit (46.2%). Low fruit consumption was significantly associated with food insecurity (OR = 1.81; 95%CI 1.03, 3.18, p = 0.038). Factors such as the perceived lower accessibility and higher price of fruit and vegetables were significantly associated with higher odds of food insecurity. In terms of potential programs, a free fruit and vegetable campaign was the most popular program, with affordability and physical access being the most frequently cited reasons. These findings suggest that food insecurity is associated with low fruit and vegetable consumption in university students. Therefore, transforming campus food environments and developing food policies at the university level must be considered to address food and nutrition security in university students.
Collapse
Affiliation(s)
- Putu Novi Arfirsta Dharmayani
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia.
| | - Miriam Williams
- Geography and Planning, Macquarie School of Social Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia.
| | - Carla Vanessa Alves Lopes
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia.
| | - Rimante Ronto
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia.
| | - Josephine Y Chau
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Stephanie R Partridge
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Macquarie Park, NSW 2109, Australia.
| |
Collapse
|
3
|
Marshall N, Bendotti C, Charlesworth J, Mullan B, Maxwell-Smith C. Food Banks as a "Treasure Trove": Users' Experiences of a Western Australian Food Relief Organization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1079. [PMID: 39200688 PMCID: PMC11354397 DOI: 10.3390/ijerph21081079] [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: 07/09/2024] [Revised: 08/07/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024]
Abstract
Food banks are providing crucial relief as food insecurity increases worldwide. While these services are essential for vulnerable populations, there is variability in foods available and users may experience poor nutritional quality, and an overabundance of discretionary foods, contributing to public health risks including overnutrition and obesity. Understanding how customers perceive food availability, variety, and quality is important to inform relief services and health interventions. This study reports the findings of a convergent parallel mixed-methods investigation of user experiences and perceptions of food availability, variety, and quality at a major food bank in Western Australia. Food bank customers (N = 207) at a food bank branch and mobile van locations completed a survey, with an option to complete a subsequent semi-structured interview (n = 15). Approximately 80% of the survey sample had low (48%) or very low (30%) food security, half of the sample had been using the food bank for longer than 6 months, and 77% reported the food bank as their first choice for food. Three-quarters (77%) reported financial barriers to a balanced diet in the past twelve months and described how limited availability and variety complicated shopping. Interviewees explained complex perceptions of these issues, including favouring healthy food while considering discretionary food as a "luxury" that enhanced their quality of life. Our findings suggest that food bank users experience barriers to maintaining a balanced diet, encounter variable supplies of healthy and nutritious foods, and have concerns about the impacts of frequent discretionary food consumption. These findings have implications for public health promotion.
Collapse
Affiliation(s)
| | | | | | | | - Chloe Maxwell-Smith
- Behavioural Science & Health Group, School of Population Health, Curtin University, Bentley, WA 6102, Australia; (N.M.); (C.B.); (B.M.)
| |
Collapse
|
4
|
Liang B, Yang D, Tan F, Sun D, Li J. How psychological ownership over nutritional products affects purchase intentions of high-pressure working groups. Front Nutr 2024; 11:1401035. [PMID: 39176026 PMCID: PMC11338884 DOI: 10.3389/fnut.2024.1401035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024] Open
Abstract
This study aims to investigate the influence of psychological ownership of nutritional products on the purchase intention of high-pressure working groups, as well as the underlying mechanisms and boundary conditions of this influence. This study aims to investigate the impact of psychological ownership of nutritional products on the purchase intention of high-pressure working groups, as well as the underlying mechanisms and boundary conditions of this influence. The research contributes through the use of variance analysis, mediation models, and moderation models on data from adult participants over the age of 18, across three experiments. Experiment 1, conducted on the Credamo platform, randomly recruited 285 participants, with 148 males (51.9%) and 137 females (48.1%), and the results indicated a direct impact of psychological ownership on purchase intention. Building upon this, Experiment 2, which also utilized the Credamo platform and recruited 280 participants consisting of 136 males (48.6%) and 144 females (51.4%), further revealed the mediating role of perceived value. Experiment 3, with 265 participants randomly recruited on the Credamo platform, including 131 males (49.4%) and 134 females (50.6%), identified the moderating effect of nutritional awareness. The theoretical contribution of this study lies primarily in its in-depth exploration of the impact of psychological ownership of nutritional products. By integrating the factors of perceived value and nutritional awareness, it provides a systematic explanation for better understanding the purchase intentions of high-pressure working groups. Additionally, this study offers valuable strategies for merchants to enhance the purchase intentions of high-pressure living groups.
Collapse
Affiliation(s)
- Boyu Liang
- College of Art, Hebei University of Economics and Business, Shijiazhuang, Heibei, China
| | - Dajun Yang
- School of Administration, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Fuqiang Tan
- Research Center for Industry Digitalization, Huainan Normal University, Huainan, Anhui, China
| | - Dajun Sun
- Research Center for Industry Digitalization, Huainan Normal University, Huainan, Anhui, China
| | - Jianshu Li
- Research Center for Industry Digitalization, Huainan Normal University, Huainan, Anhui, China
| |
Collapse
|
5
|
Bennett R, Driessen C, Zorbas C, Sacks G, Gupta A, Cameron A, Gomez-Donoso C, Peeters A, Backholer K. ' Healthier options tend to get lost in the noise of online' - Australian shoppers' experiences with online grocery platforms. Public Health Nutr 2024; 27:e134. [PMID: 38742445 PMCID: PMC11148825 DOI: 10.1017/s1368980024001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/30/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE We aimed to understand what influences parents' purchasing behaviours when shopping for groceries online and potential ways to improve the healthiness of online grocery platforms. DESIGN We conducted semi-structured interviews, guided by the Marketing Mix framework. Reflexive thematic analysis was used to analyse data. SETTING Online interviews were conducted with primary grocery shoppers. PARTICIPANTS Parents (n 14) or caregivers (n 2) using online grocery platforms at least every 2 weeks. RESULTS Most participants perceived purchasing healthy food when shopping for groceries online to be more challenging compared to in physical stores. They expressed concerns about the prominence of online marketing for unhealthy food. Participants from lower socio-economic backgrounds often depended on online supermarket catalogues to find price promotions, but healthy options at discounted prices were limited. Across socio-economic groups, fresh items like meat and fruit were preferred to be purchased instore due to concerns about online food quality.Participants believed online grocery platforms should make healthy foods more affordable and supported regulations on supermarket retailers to promote healthy options and limit unhealthy food promotion online. CONCLUSIONS Participants had varied experiences with online grocery shopping, with both positive and negative aspects. Efforts to improve population diets need to include mechanisms to create health-enabling online grocery retail platforms. Government interventions to restrict marketing of unhealthy foods and promote marketing of healthy options on these platforms warrant investigation.
Collapse
Affiliation(s)
- Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christine Driessen
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | | | - Clara Gomez-Donoso
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute of Health Transformation, Deakin University, Geelong, Australia
| |
Collapse
|
6
|
Truby H, Allman-Farinelli M, Beck EJ, Beckett EL, Bondonno C, Dordevic AL, Livingstone KM, Willcox J, Wilkinson SA. Advancing the decadal plan for the science of nutrition: Progressing a framework for implementation. Nutr Diet 2024; 81:133-148. [PMID: 38665098 DOI: 10.1111/1747-0080.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/10/2024] [Accepted: 03/15/2024] [Indexed: 06/29/2024]
Abstract
AIMS In 2019, the Australian Academy of Science in collaboration with the nutrition community published the decadal plan for the science of nutrition. This article aims to review progress towards each of its pillar goals (societal determinants, nutrition mechanisms, precision and personalised nutrition, and education and training) and two enabling platforms (a national data capability and a trusted voice for nutrition science), prioritise actions, and conceptualise program logic implementation models. This process also brought together public health nutrition researchers to reflect on societal determinants of health, and advise how the next 5 years of the decadal plan could reflect contemporary issues. METHODS Two engagement events, in 2023, brought together experienced and mid- and early-career nutrition professionals for co-creation of implementation logic models. RESULTS One hundred and nine early and mid-career professionals were involved. A revised model for the decadal plan pillars emerged from synthesis of all logic models. This new model integrated the precision and personalised nutrition pillar with nutrition mechanisms pillar. These combined pillars build towards the national data capability enabling platform and created new cross-cutting themes for education and training. The need arose for greater focus on respectful engagement with Aboriginal and Torres Strait Islander communities and sustained effort to build cross-disciplinary collaboration to realise the plan's societal determinants goals. A new alliance for nutrition science is proposed to become a unified advocacy voice and build trust in nutrition professionals. CONCLUSIONS A programmatic approach provides a road map for implementing the decadal plan for the final 5 years.
Collapse
Affiliation(s)
- Helen Truby
- University of Queensland, Brisbane, Australia
| | | | | | - Emma L Beckett
- University of New South Wales, Sydney, Australia
- FoodiQ Global, Sydney, Australia
| | | | | | | | - Jane Willcox
- Royal Women's Hospital, Melbourne, Parkville, Australia
| | - Shelley A Wilkinson
- University of Queensland, Brisbane, Australia
- Mater Health, Brisbane, Australia
| |
Collapse
|
7
|
Hadidi M, Aghababaei F, Gonzalez-Serrano DJ, Goksen G, Trif M, McClements DJ, Moreno A. Plant-based proteins from agro-industrial waste and by-products: Towards a more circular economy. Int J Biol Macromol 2024; 261:129576. [PMID: 38253140 DOI: 10.1016/j.ijbiomac.2024.129576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024]
Abstract
There is a pressing need for affordable, abundant, and sustainable sources of proteins to address the rising nutrient demands of a growing global population. The food and agriculture sectors produce significant quantities of waste and by-products during the growing, harvesting, storing, transporting, and processing of raw materials. These waste and by-products can sometimes be converted into valuable protein-rich ingredients with excellent functional and nutritional attributes, thereby contributing to a more circular economy. This review critically assesses the potential for agro-industrial wastes and by-products to contribute to global protein requirements. Initially, we discuss the origins and molecular characteristics of plant proteins derived from agro-industrial waste and by-products. We then discuss the techno-functional attributes, extraction methods, and modification techniques that are applied to these plant proteins. Finally, challenges linked to the safety, allergenicity, anti-nutritional factors, digestibility, and sensory attributes of plant proteins derived from these sources are highlighted. The utilization of agro-industrial by-products and wastes as an economical, abundant, and sustainable protein source could contribute towards achieving the Sustainable Development Agenda's 2030 goal of a "zero hunger world", as well as mitigating fluctuations in food availability and prices, which have detrimental impacts on global food security and nutrition.
Collapse
Affiliation(s)
- Milad Hadidi
- Department of Organic Chemistry, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; Department of Physiological Chemistry, Faculty of Chemistry, University of Vienna, Vienna 1090, Austria.
| | | | - Diego J Gonzalez-Serrano
- Department of Organic Chemistry, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
| | - Gulden Goksen
- Department of Food Technology, Vocational School of Technical Sciences at Mersin Tarsus Organized Industrial Zone, Tarsus University, Mersin, Turkey
| | - Monica Trif
- Food Research Department, Centre for Innovative Process Engineering (CENTIV) GmbH, 28816 Stuhr, Germany; CENCIRA Agrofood Research and Innovation Centre, Ion Mester 6, 400650 Cluj-Napoca, Romania
| | - David Julian McClements
- Department of Food Science, University of Massachusetts Amherst, 102 Holdsworth Way, Amherst, MA 01002, United States
| | - Andres Moreno
- Department of Organic Chemistry, Faculty of Chemical Sciences and Technologies, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
| |
Collapse
|
8
|
Kent K, Schumacher T, Kocar S, Seivwright A, Visentin D, Collins CE, Lester L. Increasing food insecurity severity is associated with lower diet quality. Public Health Nutr 2024; 27:e61. [PMID: 38311345 PMCID: PMC10897580 DOI: 10.1017/s1368980024000417] [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: 05/25/2023] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Food insecurity may reduce diet quality, but the relationship between food insecurity severity and diet quality is under-researched. This study aimed to examine the relationship between diet quality and severity of household food insecurity. DESIGN A cross-sectional, online survey used the United States Department of Agriculture Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately or severely food insecure. The Australian Recommended Food Score (ARFS; scored 0–73) determined diet quality (ARFS total and sub-scale scores). Survey-weighted linear regression (adjusted for age, sex, income, education, location and household composition) was conducted. SETTING Tasmania, Australia. PARTICIPANTS Community-dwelling adults (aged 18 years and over). RESULTS The mean ARFS total for the sample (n 804, 53 % female, 29 % aged > 65 years) was 32·4 (sd = 9·8). As the severity of household food insecurity increased, ARFS total decreased. Marginally food-insecure respondents reported a mean ARFS score three points lower than food-secure adults (B = –2·7; 95 % CI (–5·11, –0·34); P = 0·03) and reduced by six points for moderately (B = –5·6; 95 % CI (–7·26, –3·90); P < 0·001) and twelve points for severely food-insecure respondents (B = –11·5; 95 % CI (–13·21, –9·78); P < 0·001). Marginally food-insecure respondents had significantly lower vegetable sub-scale scores, moderately food-insecure respondents had significantly lower sub-scale scores for all food groups except dairy and severely food-insecure respondents had significantly lower scores for all sub-scale scores. CONCLUSIONS Poorer diet quality is evident in marginally, moderately and severely food-insecure adults. Interventions to reduce food insecurity and increase diet quality are required to prevent poorer nutrition-related health outcomes in food-insecure populations in Australia.
Collapse
Affiliation(s)
- Katherine Kent
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong. Wollongong, NSW2522, Australia
| | - Tracy Schumacher
- Department of Rural Health, University of Newcastle, Tamworth, NSW2340, Australia
| | - Sebastian Kocar
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Ami Seivwright
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Denis Visentin
- School of Health Sciences, University of Tasmania, Launceston, Tasmania7250, Australia
| | - Clare E Collins
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW2305, Australia
| | - Libby Lester
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| |
Collapse
|
9
|
Lacey H, Jain N, Sugimoto M, Shimato M, Zhou SJ, Pirags V, Shakya R, Karmacharya RM, Baral PP. Advancing diabetes primary care education and knowledge in Nepal: A scoping review and case study discussion. Prim Care Diabetes 2024; 18:25-36. [PMID: 38061968 DOI: 10.1016/j.pcd.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024]
Abstract
AIMS Diabetes mellitus (DM) is a chronic disorder of insulin and glucose metabolism. It affects more than 463 million people worldwide and is expected to reach 700 million by 2045. In the Southeast Asian region, the prevalence of DM has tripled to 115 million due to rapid urbanization, unhealthy diet, sedentary lifestyles, and genetic factors. In Nepal, a developing country, DM affects 8.5% of adults, with an alarming increase in recent years. Lack of diabetes education and limited populational adoption of behavioural changes further hamper care. METHODS In the present study, we performed a scoping review to determine the status of awareness, attitudes, and knowledge about diabetes in the Nepalese population with a focus on the educational initiatives that have been implemented. We also conducted a two-week international case study discussion among medical students to brainstorm viable intervention strategies. RESULTS Our findings indicate that limited data is available on the level of education or initiatives to improve knowledge and practice among healthcare professionals and community members. Targeted studies of people with diabetes also present heterogeneous results due to differences in the sample population, geographic location, education, age, and gender. Accordingly, we propose five interrelated education-based strategies that leverage existing networks to expand community outreach and engagement, improve system resilience, and improve health outcomes. CONCLUSIONS Effective education for healthcare professionals, community, and patients with diabetes is vital in improving diabetes outcomes in Nepal and South Asia. Collaboration, funding, and evaluation are key areas needing reform.
Collapse
Affiliation(s)
- Hester Lacey
- Faculty of Medicine, Brighton and Sussex Medical School, 94 N - S Rd, Falmer, Brighton BN1 9PX, United Kingdom.
| | - Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, 16 Dzirciema Street, Riga LV-1007, Latvia
| | - Mai Sugimoto
- Faculty of Medicine, Queen Mary University of London, Mile End Rd, Bethnal Green, London E1 4NS, United Kingdom
| | - Masako Shimato
- Faculty of Medicine, University College London, Gower St, London WC1E 6BT, United Kingdom
| | - Shi Jia Zhou
- Faculty of Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo 650-0017, Japan
| | - Valdis Pirags
- Faculty of Medicine, University of Latvia, 3 Jelgavas Street, Riga LV-1004, Latvia; Department of Endocrinology and Rheumatology, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, Riga LV-1002, Latvia
| | - Rajani Shakya
- Research & Development Division, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel 45200, Nepal
| | - Robin Man Karmacharya
- Department of Surgery, Kathmandu University School of Medical Sciences, B.P.Highway, Panauti 45209, Nepal
| | - Phanindra Prasad Baral
- Non-Communicable Disease and Mental Health Section, Epidemiology and Disease Control Division (EDCD), Department of Health Services (DoHS), Ministry of Health and Population (MoHP), Government of Nepal, Kathmandu, Nepal
| |
Collapse
|
10
|
Johansen IC, Calvi MF, Luz VG, Segall-Corrêa AM, Arantes CC, Isaac VJ, Utsunomiya R, Reis VCES, Moran EF. Poverty-Food Insecurity Nexus in the Post-Construction Context of a Large Hydropower Dam in the Brazilian Amazon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:155. [PMID: 38397646 PMCID: PMC10888233 DOI: 10.3390/ijerph21020155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Within the 2030 Sustainable Development Agenda, large hydropower dams are positioned as a sustainable energy source, notwithstanding their adverse impacts on societies and ecosystems. This study contributed to ongoing discussions about the persistence of critical social issues, even after the investments of large amounts of resources in areas impacted by the construction of large hydropower dams. Our study focused on food insecurity and evaluated this issue in the city of Altamira in the Brazilian Amazon, which has been profoundly socially and economically impacted by the construction, between 2011 and 2015, of Brazil's second-largest dam, namely, Belo Monte. A survey in Altamira city featured a 500-household random sample. Structural equation modeling showed conditioning factors of 60% of the population experiencing varying food insecurity degrees. Poverty, female-led households, lower education, youth, and unemployment were strongly linked to higher food insecurity. Crowded, officially impacted, and resettled households also faced heightened food insecurity. Our findings underscore the food insecurity conditions in the region impacted by the Belo Monte dam, emphasizing the need to take into account this crucial issue while planning and implementing hydropower dams.
Collapse
Affiliation(s)
- Igor Cavallini Johansen
- Center for Environmental Studies and Research (NEPAM), State University of Campinas (UNICAMP), Campinas 13083-867, SP, Brazil; (V.C.e.S.R.); (E.F.M.)
| | | | - Verônica Gronau Luz
- Faculty of Health Sciences, Grande Dourados Federal University (UFGD), Dourados 79825-070, MS, Brazil;
| | | | - Caroline C. Arantes
- Division of Forestry and Natural Resources, West Virginia University, Morgantown, WV 26506-6125, USA;
| | - Victoria Judith Isaac
- Núcleo de Ecologia Aquática e Pesca, Federal University of Pará, Belém 66077-530, PA, Brazil;
| | - Renata Utsunomiya
- Institute of Energy and Environment (IEE), University of São Paulo (USP), São Paulo 05508-010, SP, Brazil;
| | - Vanessa Cristine e Souza Reis
- Center for Environmental Studies and Research (NEPAM), State University of Campinas (UNICAMP), Campinas 13083-867, SP, Brazil; (V.C.e.S.R.); (E.F.M.)
- Australian Rivers Institute, Griffith University, Nathan, Brisbane, QLD 4111, Australia
| | - Emilio F. Moran
- Center for Environmental Studies and Research (NEPAM), State University of Campinas (UNICAMP), Campinas 13083-867, SP, Brazil; (V.C.e.S.R.); (E.F.M.)
- Department of Geography, Michigan State University, East Lansing, MI 48823, USA
| |
Collapse
|
11
|
Turner A, LaMonica HM, Moroney C, O'Leary F, Naismith SL, Flood VM. Knowledge, Attitudes, and Behaviours Concerning the Mediterranean Diet Among Older Adults in Australia. J Community Health 2023; 48:951-962. [PMID: 37289354 PMCID: PMC10248335 DOI: 10.1007/s10900-023-01237-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
Despite the growing body of evidence demonstrating the positive health effects of the Mediterranean diet, it is not routinely recommended in practice and adherence is low in the general population in Australia. The knowledge-attitude-behaviour model explains how health behaviours are supported through a process of acquiring knowledge, developing attitudes, and forming behaviours. Evidence has suggested that having a high level of nutrition-related knowledge is associated with more positive attitudes, which is directly linked to positive dietary behaviours. However, reports of knowledge and attitudes towards the Mediterranean diet, and how these directly relate to behaviours in older adults, are lacking. This study explored Mediterranean diet-related knowledge, attitudes, and behaviours among community-dwelling older adults in Australia. Participants were adults aged 55 years and older who completed an online survey that contained three parts: (a) knowledge - Mediterranean Diet Nutrition Knowledge Questionnaire (Med-NKQ); (b) nutrition-related attitudes and behaviours, and barriers and enablers to dietary change; (c) demographics. The sample included 61 adults who ranged in age from 55 to 89 years. The overall knowledge score was 30.5 out of a possible 40 points, with 60.7% classified as having a high level of knowledge. Knowledge was lowest for nutrient content and label reading. Attitudes and behaviours were generally positive and were not associated with level of knowledge. The most common barriers to dietary change were perceived cost and lack of knowledge, and motivational factors. There are a number of key gaps in knowledge that should be addressed through targeted educational programs. Strategies and tools to overcome perceived barriers and improve self-efficacy are needed to facilitate positive dietary behaviours.
Collapse
Affiliation(s)
- Ashlee Turner
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Haley M LaMonica
- Faculty of Medicine and Health, Translational Research Collective, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Carissa Moroney
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Fiona O'Leary
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Discipline of Nutrition and Dietetics, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sharon L Naismith
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Brain and Mind Centre, Healthy Brain Ageing Program, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Victoria M Flood
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia.
- Faculty of Medicine and Health, The University of Sydney, University Centre for Rural Health, Northern Rivers, NSW, 2480, Australia.
| |
Collapse
|
12
|
Herath MP, Murray S, Lewis M, Holloway TP, Hughes R, Jayasinghe S, Soward R, Patterson KAE, Byrne NM, Lee AJ, Hills AP, Ahuja KDK. Habitual Diets Are More Expensive than Recommended Healthy Diets. Nutrients 2023; 15:3908. [PMID: 37764692 PMCID: PMC10538131 DOI: 10.3390/nu15183908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Understanding food prices and affordability is crucial for promoting healthy dietary habits and informing policy actions. We assessed changes in the cost and affordability of habitual and recommended healthy diets in Northwest Tasmania from 2021 to 2023. The recommended diet was 16-22% less expensive than the habitual diet during the period. Notably, 60% of the total cost of the habitual diet was spent on discretionary items. The cost of the habitual diet increased by 9% in this period, whereas the cost of the recommended diet increased by only 2%. The habitual diet was unaffordable for households with median gross, minimum wage disposable or welfare-dependent incomes. The recommended diet, however, was affordable for some groups but posed a risk of food stress for those with median gross and minimum wage disposable income and remained unaffordable for those who were welfare dependent. Our findings reveal that adhering to a healthy Australian Dietary Guidelines-recommended diet can be more cost-effective than following a habitual unhealthy diet. However, adopting a healthy diet can be challenging for low-income families. Interventions such as financial support, nutrition education, community gardens and food hubs, as well as price regulation and subsidies for farmers, can help address food insecurity in Northwest Tasmania.
Collapse
Affiliation(s)
- Manoja P. Herath
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Sandra Murray
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Meron Lewis
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia; (M.L.); (A.J.L.)
| | - Timothy P. Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Kira A. E. Patterson
- School of Education, College of Arts, Law and Education, University of Tasmania, Launceston, TAS 7250, Australia;
| | - Nuala M. Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Amanda J. Lee
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia; (M.L.); (A.J.L.)
| | - Andrew P. Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
| | - Kiran D. K. Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7248, Australia; (M.P.H.); (S.M.); (T.P.H.); (S.J.); (R.S.); (N.M.B.); (A.P.H.)
- Nutrition Society of Australia, Crows Nest, NSW 1585, Australia
| |
Collapse
|
13
|
Rombach M, Dean DL, Bitsch V. “Got Milk Alternatives?” Understanding Key Factors Determining U.S. Consumers’ Willingness to Pay for Plant-Based Milk Alternatives. Foods 2023; 12:foods12061277. [PMID: 36981203 PMCID: PMC10048559 DOI: 10.3390/foods12061277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Milk is an important dairy product in U.S. food retail. Lifestyle changes toward climate-conscious consumption, animal welfare, and food safety concerns have increased the popularity of plant-based milk alternatives. This study is focused on such beverages and provides insights and best practice recommendations for marketing managers in the U.S. food retail sector. An online survey was distributed to explore factors explaining the intentions of U.S. consumers to purchase and pay a premium for plant-based milk alternatives. Food curiosity and food price inflation were identified as relevant for both willingness to buy and willingness to pay a price premium. In addition, animal welfare concerns and the green and clean product image of plant-based alternatives were relevant to the willingness to pay a premium for plant-based milk.
Collapse
Affiliation(s)
- Meike Rombach
- Department of Land Management and Systems, Lincoln University, Lincoln 7647, New Zealand
- Correspondence:
| | - David L. Dean
- Department of Agribusiness and Markets, Lincoln University, Lincoln 7647, New Zealand
| | - Vera Bitsch
- School of Management and School of Life Sciences, Chair of Economics of Horticulture and Landscaping, Technical University of Munich, 85354 Freising, Germany
| |
Collapse
|
14
|
"I Always Buy the Purple Ones … If I See Them": Socioecological Factors Influencing Anthocyanin-Rich Food Consumption for Cognitive Health in Older Adults. Nutrients 2023; 15:nu15051194. [PMID: 36904196 PMCID: PMC10005612 DOI: 10.3390/nu15051194] [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: 01/27/2023] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
Despite the positive relationship between anthocyanin-rich foods and cognitive health, a dietary deficit exists in older adults. Effective interventions require an understanding of people's dietary behaviors situated in social and cultural contexts. Therefore, the aim of this study was to explore older adults' perceptions about increasing their consumption of anthocyanin-rich foods for cognitive health. Following an educational session and the provision of a recipe and information book, an online survey and focus groups with Australian adults aged 65 years or older (n = 20) explored the barriers and enablers towards eating more anthocyanin-rich foods and potential strategies to achieve dietary change. An iterative, qualitative analysis identified the themes and classified the barriers, enablers and strategies onto the Social-Ecological model levels of influence (individual, interpersonal, community, society). Enabling factors included a desire to eat healthily, taste preference and familiarity of anthocyanin-rich foods (individual), social support (community), and the availability of some anthocyanin-rich foods (society). The barriers included budget, dietary preferences and motivation (individual), household influences (interpersonal), limited availability and access to some anthocyanin-rich foods (community) and the cost and the seasonal variability (society). The strategies included increasing individual-level knowledge, skills, and confidence in utilizing anthocyanin-rich foods, educational initiatives about the potential cognitive benefits, and advocating to increase access to anthocyanin-rich foods in the food supply. This study provides for the first time, insight into the various levels of influence impacting older adults' ability to consume an anthocyanin-rich diet for cognitive health. Future interventions should be tailored to reflect the barriers and enablers and to provide targeted education about anthocyanin-rich foods.
Collapse
|