The Impact of Proximity to Wet Markets and Supermarkets on Household Dietary Diversity in Nanjing City, China

Understanding the Food Environment and Its Impact on Diet and Health in Asia: A Scoping Review

Food environment (FE), an interface where people interact with a broader food system, is critical to health. Understanding the Asian FE may help to tackle the "triple burden of malnutrition" through informed research and policy. This review identifies FE domains assessed in the Asian context and collates the tools/measures used in these evaluations. We further synthesized the reported associations of FE with diet and health outcomes and identified knowledge gaps. Forty-two articles were reviewed (East Asia, n = 25, 60%; South Asia, n = 8, 19%; and Southeast Asia, n = 9, 21%). The results showed that FE was frequently examined in children, adolescents, or adults, but data were scarce in older adults. Food availability (n = 30) and accessibility (n = 19) were popularly studied domains. Furthermore, FE was measured using geographic information systems (n = 18), market (n = 7), or stakeholder (n = 21) surveys. Twenty-eight (67%) articles assessed associations of FE exposures with diet (n = 12) and health (n = 21). Increased food availability and accessibility were associated with poorer dietary and health outcomes despite nonexisting validity and reliability reporting in 62% of articles. Limited high-quality studies emphasize the need for harmonized definitions, better study designs, and validated FE measures/tools in Asia. Improving the quality of FE research is critical to designing effective interventions to improve public health nutrition in Asia.

Governing for food security during the COVID-19 pandemic in Wuhan and Nanjing, China

The global COVID-19 pandemic has elicited a range of public health governance responses. One common result has been an associated disruption of food supply chains and growing urban food insecurity. Policy responses to this situation have not yet received sufficient research attention. This paper therefore focuses on the urban food security implications of China's zero-COVID public health measures and the response of central, provincial and municipal government to the governance challenge of ensuring a stable and sufficient food supply to urban consumers. During the COVID-19 outbreak in early 2020 in China, zero-COVID lockdown measures aimed to contain and eliminate the spread of the virus. This paper examines the associated policy responses around urban food security in early 2020, with a particular focus on two cities: Wuhan (where SARS-CoV-2 was first identified) and Nanjing (a neighbouring city). The analysis is based on an inventory of policy-related documents providing a wide range of information about governance responses to the pandemic. Four major governance challenges are addressed: agricultural production, food transportation, stabilization of food prices, and new contactless methods in purchasing foods. Key recommendations for post-pandemic policy responses around urban food security include: ensuring consistency throughout all levels of government, strengthening existing food reserves to leverage emergency responses, addressing the root causes of pandemic-related food insecurity by focusing on access at the household level, and improving food utilization.

Impacts of community-level grassroots organizations on household food security during the COVID-19 epidemic period in China

Purchasing food via community-level grassroots organizations was a new pattern of food patronage for Wuhan residents during the COVID-19 lockdown in 2020, but little attention was paid to it. The study examined the relationship between community-level grassroots organizations and household food insecurity based on an online survey of household food insecurity in Wuhan in March 2020. The study found that problems in all three domains of food insecurity including food anxiety, insufficient quality and inadequate quantity existed but were uneven. Community-level grassroots organizations played an important role in promoting food security including reducing worries about food supply and providing enough food intake, but did not ensure households had adequate food quality due to increasing food prices, fewer varieties of food and decreased food freshness. Compared to other grassroots organizations, the community committee had actually become an extension of the government to run administrative grassroots affairs before the epidemic, so its tight relationship with local government made it become the major grassroots power in ensuring household food security at the residential community level.

Changes in Food Environment Patterns in the Metropolitan Area of the Valley of Mexico, 2010–2020

The concept of food environment refers to the opportunities; environments; and physical, economic, political, and socio-cultural conditions that frame the interaction of people with the food system and shape decisions about food acquisition and consumption. This study analyzes the relationships between the characteristics of urban environments and the availability of retail food through the evaluation of physical and financial access to food in the Metropolitan Area of the Valley of Mexico (MAVM) between 2010 and 2020. Using Geographic Information Systems (GISs), both physical access through network distance to economic food retail units and financial access through socioeconomic status at the block scale were evaluated. The network distance and socioeconomic status results were used as criteria for the spatially explicit classification of the MAVM into food deserts, oases, and swamps. Food deserts are the most abundant food environments but only increased in the third and fourth metropolitan contours. Swamps have increased throughout the city, related to the proliferation of convenience stores that have replaced grocery stores. This study contributes evidence at a local and regional scale required for the future urban planning of the MAVM and for public health and sustainability programs focusing on treating food-related diseases.

Social Innovation for Food Security and Tourism Poverty Alleviation: Some Examples From China

The COVID-19 pandemic has brought hunger to millions of people around the world. Social distancing measures coupled with national lockdowns have reduced work opportunities and the overall household incomes. Moreover, the disruption in agricultural production and supply routes is expected to continue into 2021, which may leave millions without access to food. Coincidentally, those who suffer the most are poor people. As such, food security and tourism poverty alleviation are interlinked when discussing social problems and development. While the corporate interest in tourism poverty alleviation is as old as the industrial revolution, little research has been conducted to show how social innovation can be leveraged to reinforce food security and alleviate poverty. Thus, this case study examines the food industry in rural China to establish how it conducts social innovation in food production and distribution to facilitate social development and mitigate poverty.

Factors determining household-level food insecurity during COVID-19 epidemic: a case of Wuhan, China

Background

In coping with the coronavirus disease 2019 (COVID-19) epidemic, cities adopted social isolation and lockdown measures; however, little is known about the impacts of these restrictions on household food security.

Objective

This study provides a timely assessment of household food insecurity (HFI) in the Chinese city of Wuhan during the COVID-19 epidemic period and also investigates its determinant factors.

Design

We collected valid data on food insecurity from 653 households in Wuhan via an online questionnaire in March 2020. The Household Food Insecurity Access Scale Score (HFIASS) was used to measure HFI, and a multiple linear regression model was used to determine the HFIASS.

Results

The mean HFIASS in Wuhan was 9.42 (standard deviation: 5.82), with more than 50% of the households had an HFIASS < 9. Compared with normal conditions, lockdown measures had a huge negative impact on household food security. The results revealed that socio-demographic characteristics remained the underlying determinants of HFIASS during the epidemic. Households in Wuhan with local Hukou (city household registration) and self-owned property had a lower risk of food insecurity.

Discussion and conclusion

After the restriction of conventional food access channels, intermediary food purchase methods such as group purchasing, shopping with the help of neighborhood committees, property management agents, and volunteers became the most important or the only channel for residents to access food. There were similarities in the use of these intermediary channels. Based on the probability that the epidemic will continue and the probability of similar public health-related outbreaks in the future, the study calls for a more resilient and responsive sustainable food supply system by harnessing the capacity of communities, e-commerce and rapid logistics.

Integrating Food Sensitive Planning and Urban Design into Urban Governance Actions

Food access, stability and utilisation are key dimensions of food security at an urban scale. When the majority resided in rural areas, and lived predominantly agrarian lifestyles, it made sense for the state to govern food security through national agricultural ministries, focusing predominantly on the availability dimension of food security. With the transition to a majority urban world, coupled with the food security challenges currently experienced in urban areas, specifically in Africa, these historical policy and governance structures are increasingly inadequate in responding to essential food and nutrition needs. Problematically, urban areas, and specifically urban managers, cite unfunded mandates, and absent authority, as the reasons for not engaging food and nutrition governance responses. This paper argues that this is a false position. Drawing on recent data from household food security and poverty surveys, the paper calls for new and expanded planning and design approaches at the urban scale. The paper argues that spatial planning and urban design principles and actions provide an immediate and effective means through which to engage urban food system questions. Importantly these actions are essential to the transition from the current piecemeal project responses to urban food system inadequacies. Food sensitive planning and urban design is offered as a specific approach that could assist in programming food system–related challenges at the urban scale, responding to conceptual, analytical, organisational and design related dimensions of planning, and in so doing offering a longer term, systematic response to urban food insecurity.

Impact of neighbourhood food environment on diet and obesity in China: a systematic review

OBJECTIVE

This study systematically reviewed literature on the neighbourhood food environment in relation to diet and obesity among residents in China.

DESIGN

A keyword search of peer-reviewed articles was performed in Cochrane Library, PubMed, and Web of Science. Eligibility criteria include study designs: longitudinal/cohort studies or cross-sectional studies; study participants: people of all ages; exposures: neighbourhood food environment (e.g. restaurants, supermarkets, wet markets, fast-food restaurants, or convenience stores); outcomes: diet and/or body weight status; and country: China.

RESULTS

Seventeen studies met all criteria and were included. Among the eight studies that assessed the neighbourhood food environment in relation to diet, six reported at least one statistically significant relationship in the expected direction, whereas the remaining two exclusively reported null effects. Among the eleven studies that assessed the neighbourhood food environment in relation to body weight or overweight/obesity, ten reported a significant association whereas the remaining one reported a null relationship. Variety, density, and proximity of food outlets were positively associated with local residents' dietary diversity, portion size, and daily caloric intake. Density and proximity of fast-food restaurants and convenience stores were positively associated with local residents' adiposity in some but not all studies. Evidence linking any specific food outlet type to diet/obesity remains lacking due to the small number of studies and heterogeneities in food environment measures, geographical locations, and population subgroups.

CONCLUSIONS

The neighbourhood food environment may influence diet and obesity among Chinese residents but the evidence remains preliminary. Future studies adopting an experimental study design and objective/validated environment and dietary measures are warranted.

Modernization of African Food Retailing and (Un)healthy Food Consumption

Food environments in Africa are changing rapidly, with modern retailers—such as supermarkets, hypermarkets, and fast-food restaurants—gaining in importance. Changing food environments can influence consumers’ food choices and dietary patterns. Recent research has suggested that the growth of supermarkets leads to more consumption of processed foods, less healthy diets, and rising obesity. However, relatively little is known about what type of consumers actually use modern supermarkets and to what extent. Moreover, focusing only on supermarkets may be misleading, as most consumers obtain their food from various modern and traditional retailers. We add to the literature by examining relationships between consumers’ socioeconomic status, use of different modern and traditional retailers, and dietary patterns. The analysis uses household survey data from urban Zambia. Results show that two-thirds of the households use modern and traditional retailers simultaneously, but that richer households are more likely than poorer ones to use supermarkets and hypermarkets. Use of modern retailers is positively associated with higher consumption of ultra-processed foods, after also controlling for income and other socioeconomic factors. However, the use of traditional stores and kiosks is also positively associated with the consumption of ultra-processed foods, suggesting that modern retailers are not the only drivers of dietary transitions.