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Dixon J, Stage VC, Truesdale KP, Wu Q, Kolasa K, Haynes-Maslow L, McGuirt JT, Jilcott Pitts S. Associations between food and beverage purchases and skin carotenoids among diverse small food retail store customers. Public Health Nutr 2023; 26:2211-2217. [PMID: 37548230 DOI: 10.1017/s1368980023001581] [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: 08/08/2023]
Abstract
OBJECTIVE To determine if customer purchases at small food stores are associated with healthfulness of the diet as approximated by skin carotenoids. DESIGN This is a cross-sectional survey of customers in small food stores regarding demographics and food purchases. Food and beverage purchases were classified as 'healthy' or 'non-healthy' and 'carotenoid' v. 'non-carotenoid' using a systematic classification scheme. Fruit and vegetable intake was objectively assessed using a non-invasive device to measure skin carotenoids. Associations between variables of interest were examined using Pearson's correlation coefficients, t tests and multiple linear regression analyses. SETTING Twenty-two small food retail stores in rural (n 7 stores) and urban (n 15) areas of North Carolina. PARTICIPANTS Customers of small food stores. RESULTS Of study participants (n 1086), 55·1 % were male, 60·0 % were African American/Black and 4·2 % were Hispanic, with a mean age of 43·5 years. Overall, 36 % purchased at least one healthy item, and 7·6 % of participants purchased a carotenoid-containing food/beverage. Healthy foods and beverages purchased included produce, lean meats, 100 % juices, plain popcorn, plain nuts, milk and yogurt. Unhealthy items included non-100 % juices, crackers, chips, candy, cakes and donuts. Purchase of a healthy or carotenoid-containing item was positively associated with skin carotenoid scores (P = 0·002 and 0·006, respectively). CONCLUSIONS A relatively small proportion of customers purchased any healthy or carotenoid-containing foods and beverages, and those who did purchase healthy options had higher skin carotenoid scores. Future research should confirm these findings in different populations.
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Affiliation(s)
- Jocelyn Dixon
- Departments of Nutrition Science and Public Health, East Carolina University, Greenville, USA
- North Carolina State University, Raleigh, NC, USA
| | | | | | - Qiang Wu
- Department of Public Health, ECU, Greenville27834, USA
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Lo AE, Duffy EW, Ng SW. Differences in a Chain Supermarket's Sales to SNAP Shoppers Before and Since the COVID-19 Pandemic. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:343-353. [PMID: 37164550 PMCID: PMC10228633 DOI: 10.1016/j.jneb.2023.02.006] [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: 06/06/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This study 1) compares grocery sales to Supplemental Nutrition Assistance Program (SNAP) shoppers in rural and urban grocery stores and 2) estimates changes in sales to SNAP shoppers in North Carolina (NC) since the pandemic. DESIGN Weekly transaction data among loyalty shoppers at a large grocery chain across NC from October 2019 to December 2020 (n = 32; 182 store weeks) to assess nutritional outcomes. SETTING North Carolina large chain grocery stores. PARTICIPANTS Large chain grocery store/SNAP shoppers. INTERVENTION Rural/urban status of the stores and COVID-19 pandemic onset. MAIN OUTCOME MEASURES Share of total calories sold from fruits, vegetables, nuts, and legumes (FVNL) with and without additives, sugar-sweetened beverages (SSB), less healthful foods (LHF), and processed meats (PM). ANALYSIS Multivariate random effects models with robust standard errors to examine the association of rural/urban status before and since coronavirus disease 2019 with the share of calories sold to SNAP shoppers from each food category. We controlled for county-level factors (eg, sociodemographic composition, food environment) and store-level factors. RESULTS We did not find significant rural-urban differences in the composition of sales to SNAP shoppers in adjusted models. There was a significant decrease in the mean share of total calories from sugar-sweetened beverages (-0.43%) and less healthful food (-1.32%) and an increase in the share from processed meats (0.09%) compared with before the pandemic (P < 0.05). CONCLUSIONS AND IMPLICATIONS Urban-rural definitions are insufficient to understand nuances in food environments, and more support is needed to ensure healthy food access.
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Affiliation(s)
- Amy Elizabeth Lo
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emily Welker Duffy
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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VanHise K, Chan JL, Wertheimer S, Handelsman RG, Clark E, Buttle R, Wang ET, Azziz R, Pisarska MD. Regional Variation in Hormonal and Metabolic Parameters of White and Black Women With PCOS in the United States. J Clin Endocrinol Metab 2023; 108:706-712. [PMID: 36218376 DOI: 10.1210/clinem/dgac515] [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: 06/06/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Ongoing research is needed to determine geo-epidemiologic differences of polycystic ovary syndrome (PCOS). OBJECTIVE Determine hormonal and metabolic parameters of women with PCOS in 2 environments. METHODS Prospective cohort study. SETTING Tertiary-care based specialty clinics in Alabama and California. PATIENTS OR OTHER PARTICIPANTS A total of 1610 women with PCOS by National Institutes of Health Criteria from 1987 to 2010. INTERVENTIONS Interview, physical examination, laboratory studies. MAIN OUTCOMES MEASURES Demographic data, menstrual cycle history, and hormonal and metabolic parameters were collected. Hirsutism was defined as modified Ferriman-Gallwey scores ≥4. Androgen values greater than laboratory reference ranges or >95th percentile of all values were considered elevated (hyperandrogenemia). Metabolic parameters included body mass index (BMI), waist-hip-ratio (WHR), glucose tolerance test, and homeostatic model assessment for insulin resistance (HOMA-IR) scores. RESULTS Alabama women with PCOS were younger with a higher BMI. After adjustment for age and BMI, Alabama women with PCOS were more likely hirsute (adjusted odds ratio [aOR], 1.8; 95% CI, 1.4-2.4; P < 0.001), with elevated HOMA-IR scores (adjusted beta coefficient 3.6; 95% CI, 1.61-5.5; P < 0.001). California women with PCOS were more likely to have hyperandrogenemia (free testosterone aOR, 0.14; 95% CI, 0.11-0.18; P < 0.001; total testosterone aOR, 0.41; 95% CI, 0.33-0.51). Results were similar when stratified by White race. In Black women with PCOS, BMI and WHR did not differ between locations, yet differences in androgen profiles and metabolic dysfunction remained. CONCLUSION Alabama women with PCOS, regardless of Black or White race, were more likely hirsute with metabolic dysfunction, whereas California women with PCOS were more likely to demonstrate hyperandrogenemia, highlighting potential environmental impacts on PCOS.
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Affiliation(s)
| | | | | | | | | | - Rae Buttle
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Erica T Wang
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ricardo Azziz
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Alabama at Birmingham, Birmingham, AL 35233, USA
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Albany, SUNY, Albany, NY 12208, USA
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Becker TB, Contreras D, Porth O. Differences in Eating and Physical Activity Behaviors, and Perceived Accessibility and Availability Barriers between Midwestern Rural and Urban Adults. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2021.1930318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tyler Brian Becker
- Department of Food Science and Human Nutrition, Michigan State University(MSU), East Lansing, Michigan, USA
- Health and Nutrition Institute, Michigan State University(MSU), East Lansing, Michigan, USA
| | - Dawn Contreras
- Health and Nutrition Institute, Michigan State University(MSU), East Lansing, Michigan, USA
| | - Olivia Porth
- Department of Food Science and Human Nutrition, Michigan State University(MSU), East Lansing, Michigan, USA
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Boys KA, Haynes-Maslow L, McGuirt JT, Ammerman AS, Van Fleet EE, Johnson NS, Kelley CJ, Donadio VE, Fleischhacker SE, Truesdale KP, Bell RA, Jilcott Pitts SB. Perceived barriers and facilitators to participating in the North Carolina Healthy Food Small Retailer Program: a mixed-methods examination considering investment effectiveness. Public Health Nutr 2021; 24:6555-6565. [PMID: 34509178 PMCID: PMC11148602 DOI: 10.1017/s1368980021003955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The North Carolina Legislature appropriated funds in 2016-2019 for the Healthy Food Small Retailer Program (HFSRP), providing small retailers located in food deserts with equipment to stock nutrient-dense foods and beverages. The study aimed to: (1) examine factors facilitating and constraining implementation of, and participation in, the HFSRP from the perspective of storeowners and (2) measure and evaluate the impact and effectiveness of investment in the HFSRP. DESIGN The current analysis uses both qualitative and quantitative assessments of storeowner perceptions and store outcomes, as well as two innovative measures of policy investment effectiveness. Qualitative semi-structured interviews and descriptive quantitative approaches, including monthly financial reports and activity forms, and end-of-programme evaluations were collected from participating HFSRP storeowners. SETTING Eight corner stores in North Carolina that participated in the two cohorts (2016-2018; 2017-2019) of the HFSRP. PARTICIPANTS Owners of corner stores participating in the HFSRP. RESULTS All storeowners reported that the HFSRP benefitted their stores. In addition, the HFSRP had a positive impact on sales across each category of healthy food products. Storeowners reported that benefits would be enhanced with adjustments to programme administration and support. Specific suggestions included additional information regarding which healthy foods and beverages to stock; inventory management; handling of perishable produce; product display; modified reporting requirements and a more efficient process of delivering and maintaining equipment. CONCLUSIONS All storeowners reported several benefits of the HFSRP and would recommend that other storeowners participate. The barriers and challenges they reported inform potential approaches to ensuring success and sustainability of the HFSRP and similar initiatives underway in other jurisdictions.
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Affiliation(s)
- Kathryn A Boys
- Department of Agricultural & Resource Economics, North Carolina State University, 4306 Nelson Hall, Campus Box 8109, Raleigh, NC27695-8109, USA
| | - Lindsey Haynes-Maslow
- Department of Agricultural & Human Sciences, North Carolina State University, Raleigh, NC, USA
| | - Jared T McGuirt
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin E Van Fleet
- Department of Agricultural & Resource Economics, North Carolina State University, 4306 Nelson Hall, Campus Box 8109, Raleigh, NC27695-8109, USA
| | - Nevin S Johnson
- Department of Public Health, East Carolina University, Greenville, NC, USA
| | - Casey J Kelley
- Department of Public Health, East Carolina University, Greenville, NC, USA
| | - Victoria E Donadio
- Department of Public Health, East Carolina University, Greenville, NC, USA
| | | | - Kimberly P Truesdale
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ronny A Bell
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Haynes-Maslow L, McGuirt J, Trippichio G, Armstrong-Brown J, Ammerman AS, Leone LA. Examining commonly used perceived and objective measures of fruit and vegetable access in low-income populations and their association with consumption. Transl Behav Med 2021; 10:1342-1349. [PMID: 33421088 DOI: 10.1093/tbm/ibaa077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Perception-based and objective food access measures are often examined as factors influencing individuals' shopping decisions and dietary habits, but the relative influence of these two factors on behaviors needs further examination. This study sought to (a) determine if perception-based and objective measures of fruit and vegetable (F&V) access were related and (b) examine perception-based and objective access measures as predictors of F&V consumption. Participants were recruited as part of a larger intervention study from 12 sites across three urban North Carolina counties. Perception-based food access measured included self-reported perceptions of convenience, variety, and quality of F&V within a neighborhood. Food outlet density was used as the objective measure. This was derived by summing the total number of geocoded convenience stores, grocery stores, supermarkets, and supercenters located within 1 road network mile of participants' home address. Associations between perception-based and objective measures were examined using Pearson's correlations, and associations of F&V access and intake were examined using linear regression models. Pearson correlations between perception-based and objective measures revealed that F&V variety was associated with supermarkets. Regression results show that perception-based barriers to F&V access were not significantly associated with intake, but supercenter density within 1 mile was significantly associated with decreased F&V intake. Common measures of perception-based and objective measures of food access may not be the best predictor of F&V intake. Understanding the relationships of these factors for lower-income populations can offer guidance for future policies and programs.
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Affiliation(s)
- Lindsey Haynes-Maslow
- Department of Agricultural & Human Sciences, North Carolina State University, Raleigh, NC, USA
| | - Jared McGuirt
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Gina Trippichio
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | | | - Alice S Ammerman
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lucia A Leone
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
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Haynes-Maslow L, Jilcott Pitts SB, Boys KA, McGuirt JT, Fleischhacker S, Ammerman AS, Johnson N, Kelley C, Donadio VE, Bell RA, Laska MN. Qualitative perspectives of the North Carolina healthy food small retailer program among customers in participating stores located in food deserts. BMC Public Health 2021; 21:1459. [PMID: 34315470 PMCID: PMC8317385 DOI: 10.1186/s12889-021-11509-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/10/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The North Carolina Healthy Food Small Retailer Program (NC HFSRP) was established through a policy passed by the state legislature to provide funding for small food retailers located in food deserts with the goal of increasing access to and sales of healthy foods and beverages among local residents. The purpose of this study was to qualitatively examine perceptions of the NC HFSRP among store customers. METHODS Qualitative interviews were conducted with 29 customers from five NC HFSRP stores in food deserts across eastern NC. Interview questions were related to shoppers' food and beverage purchases at NC HFSRP stores, whether they had noticed any in-store efforts to promote healthier foods and beverages, their suggestions for promoting healthier foods and beverages, their familiarity with and support of the NC HFSRP, and how their shopping and consumption habits had changed since implementation of the NC HFSRP. A codebook was developed based on deductive (from the interview guide questions) and inductive (emerged from the data) codes and operational definitions. Verbatim transcripts were double-coded and a thematic analysis was conducted based on code frequency, and depth of participant responses for each code. RESULTS Although very few participants were aware of the NC HFSRP legislation, they recognized changes within the store. Customers noted that the provision of healthier foods and beverages in the store had encouraged them to make healthier purchase and consumption choices. When a description of the NC HFSRP was provided to them, all participants were supportive of the state-funded program. Participants discussed program benefits including improving food access in low-income and/or rural areas and making healthy choices easier for youth and for those most at risk of diet-related chronic diseases. CONCLUSIONS Findings can inform future healthy corner store initiatives in terms of framing a rationale for funding or policies by focusing on increased food access among vulnerable populations.
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Affiliation(s)
- Lindsey Haynes-Maslow
- Department of Agricultural & Human Sciences, NC State University, 512 Brickhaven Drive, Room 240c, Raleigh, NC, 27695, USA.
| | - Stephanie B Jilcott Pitts
- Department of Public Health, East Carolina University, 115 Heart Drive, Room #2239, Greenville, NC, 27834, USA
| | - Kathryn A Boys
- Department of Agricultural and Resource Economics, North Carolina State University, 4306 Nelson Hall, Raleigh, NC, 27695-8109, USA
| | - Jared T McGuirt
- Department of Nutrition, University of North Carolina Greensboro, 319 Colllege Avenue, 318 Stone Building, Greensboro, NC, 27412, USA
| | | | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, CB# 7426, 1700 MLK Jr. Blvd, Room 239, Chapel Hill, NC, 27599-7426, USA
| | - Nevin Johnson
- Department of Public Health, East Carolina University, 115 Heart Drive, Room #2239, Greenville, NC, 27834, USA
| | - Casey Kelley
- University of North Carolina at Chapel Hill, School of Medicine, Division of Geriatric Medicine, Center for Aging and Health, 5003 Old Clinic CB#7550, Chapel Hill, NC, 27599, USA
| | - Victoria E Donadio
- Department of Public Health, East Carolina University, 115 Heart Drive, Room #2239, Greenville, NC, 27834, USA
| | - Ronny A Bell
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Melissa N Laska
- Epidemiology & Community Health, University of Minnesota, 1300 South 2nd Street, WBOB Suite 300, Minneapolis, MN, 55454-1015, USA
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McGuirt JT, Wu Q, Laska MN, Truesdale KP, Rafferty AP, Bell RA, Ammerman AS, Jilcott Pitts SB. Associations between shopping patterns, dietary behaviours and geographic information system-assessed store accessibility among small food store customers. Public Health Nutr 2020; 25:1-10. [PMID: 33317649 PMCID: PMC9991690 DOI: 10.1017/s1368980020005017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 10/12/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine associations between geographic information systems (GIS)-assessed accessibility to small food stores, shopping patterns and dietary behaviours among small food store customers. DESIGN Residential addresses and customer shopping patterns (frequency of shopping, and previous purchase of fruits and vegetables) were gathered through customer intercept surveys. Addresses were geocoded, and GIS-assessed distance and driving time from the participants' residence to the store were calculated. Dietary status and behaviours were assessed using an objective non-invasive measure of skin carotenoids, the National Cancer Institute Fruit and Vegetable Screener, and items to assess sugary beverage intake. Associations between distance and driving time, demographics, shopping frequency, prior reported purchase of fruits and vegetables at the store and dietary behaviours were examined. SETTING Small food stores (n 22) across North Carolina. PARTICIPANTS Cross-sectional convenience samples of English-speaking customers aged 18 years or older (n 692). RESULTS Participants living closer to the small store had lower income and formal education, were more likely to be Black, more likely to have previously bought fruits and vegetables at the store and more frequently shopped at the store. In adjusted models, skin carotenoids (n 644) were positively associated with distance to the store from home in miles (P = 0·01). CONCLUSIONS Customers who lived closer to the stores were more frequent shoppers and more likely to have previously purchased fruits and vegetables at the store yet had lower skin carotenoids. These results support continued efforts to examine how to increase the availability and promotion of healthful foods at small food retail stores.
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Affiliation(s)
- Jared T McGuirt
- Department of Nutrition, University of North Carolina Greensboro, 319 College Avenue, 318 Stone Building, Greensboro, NC27412, USA
| | - Qiang Wu
- Department of Biostatistics, East Carolina University, Greenville, NC, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Kimberly P Truesdale
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ann P Rafferty
- Department of Public Health, East Carolina University, Greenville, NC, USA
| | - Ronny A Bell
- Department of Public Health, East Carolina University, Greenville, NC, USA
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Sterling SR, Bowen SA. The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States. Nutrients 2019; 11:E2915. [PMID: 31810250 PMCID: PMC6949922 DOI: 10.3390/nu11122915] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/13/2019] [Accepted: 11/21/2019] [Indexed: 02/07/2023] Open
Abstract
Plant-based diets are associated with reduced risks of various chronic diseases in the general population. However, it is unclear how these benefits translate to Blacks living in the United States, who are disproportionately burdened with heart disease, cancer, diabetes, obesity, and chronic kidney disease. The objectives of this study were to: (1) review the general evidence of plant-based diets and health outcomes; (2) discuss how this evidence translates to Blacks following a plant-based diet; and (3) provide recommendations and considerations for future studies in this area. Interestingly, although the evidence supporting plant-based diets in the general population is robust, little research has been done on Blacks specifically. However, the available data suggests that following a plant-based diet may reduce the risk of heart disease and possibly cancer in this population. More research is needed on cardiovascular disease risk factors, cancer subtypes, and other chronic diseases. Further, attention must be given to the unique individual, familial, communal, and environmental needs that Blacks who follow plant-based diets may have. Interventions must be culturally appropriate in order to achieve long-term success, and providing low-cost, flavorful, and nutritious options will be important.
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Jilcott Pitts SB, Wu Q, Truesdale KP, Haynes-Maslow L, McGuirt JT, Ammerman A, Bell R, Laska MN. One-Year Follow-Up Examination of the Impact of the North Carolina Healthy Food Small Retailer Program on Healthy Food Availability, Purchases, and Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2681. [PMID: 30487427 PMCID: PMC6313329 DOI: 10.3390/ijerph15122681] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/17/2018] [Accepted: 11/26/2018] [Indexed: 02/07/2023]
Abstract
We examined the short-term impact of the North Carolina Healthy Food Small Retailer Program (HFSRP), a legislatively appropriated bill providing funding up to $25,000 to small food retailers for equipment to stock and promote healthier foods, on store-level availability and purchase of healthy foods and beverages, as well as customer dietary patterns, one year post-policy implementation. We evaluated healthy food availability using a validated audit tool, purchases using customer bag-checks, and diet using self-reported questionnaires and skin carotenoid levels, assessed via Veggie Meter™, a non-invasive tool to objectively measure fruit and vegetable consumption. Difference-in-difference analyses were used to examine changes in HFSRP stores versus control stores after 1 year. There were statistically significant improvements in healthy food supply scores (availability), with the Healthy Food Supply HFS score being -0.44 points lower in control stores and 3.13 points higher in HFSRP stores pre/post HFSRP (p = 0.04). However, there were no statistically significant changes in purchases or self-reported consumption or skin carotenoids among customers in HFSRP versus control stores. Additional time or other supports for retailers (e.g., marketing and promotional materials) may be needed for HFSRP implementation to influence purchase and consumption.
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Affiliation(s)
- Stephanie B Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Qiang Wu
- Department of Biostatistics, College of Allied Health Sciences, East Carolina University, Greenville, NC 27834, USA.
| | - Kimberly P Truesdale
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Lindsey Haynes-Maslow
- Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC 27695, USA.
| | - Jared T McGuirt
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC 27412, USA.
| | - Alice Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Ronny Bell
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
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Haynes-Maslow L, Osborne I, Jilcott Pitts SB. Best Practices and Innovative Solutions to Overcome Barriers to Delivering Policy, Systems and Environmental Changes in Rural Communities. Nutrients 2018; 10:nu10081012. [PMID: 30081482 PMCID: PMC6116016 DOI: 10.3390/nu10081012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 11/16/2022] Open
Abstract
To better understand the barriers to implementing policy; systems; and environmental (PSE) change initiatives within Supplemental Nutrition Assistance Program-Education (SNAP-Ed) programming in U.S. rural communities; as well as strategies to overcome these barriers, this study identifies: (1) the types of nutrition-related PSE SNAP-Ed programming currently being implemented in rural communities; (2) barriers to implementing PSE in rural communities; and (3) common best practices and innovative solutions to overcoming SNAP-Ed PSE implementation barriers. This mixed-methods study included online surveys and interviews across fifteen states. Participants were eligible if they: (1) were SNAP-Ed staff that were intimately aware of facilitators and barriers to implementing programs, (2) implemented at least 50% of their programming in rural communities, and (3) worked in their role for at least 12 months. Sixty-five staff completed the online survey and 27 participated in interviews. Barriers to PSE included obtaining community buy-in, the need for relationship building, and PSE education. Facilitators included finding community champions; identifying early "wins" so that community members could easily see PSE benefits. Partnerships between SNAP-Ed programs and non-SNAP-Ed organizations are essential to implementing PSE. SNAP-Ed staff should get buy-in from local leaders before implementing PSE. Technical assistance for rural SNAP-Ed programs would be helpful in promoting PSE.
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Affiliation(s)
- Lindsey Haynes-Maslow
- Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC 27695, USA.
| | - Isabel Osborne
- Department of Global Studies, University of North Carolina, Chapel Hill, NC 27514, USA.
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Jilcott Pitts SB, Wu Q, Truesdale KP, Laska MN, Grinchak T, McGuirt JT, Haynes-Maslow L, Bell RA, Ammerman AS. Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1189. [PMID: 28991156 PMCID: PMC5664690 DOI: 10.3390/ijerph14101189] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 11/30/2022]
Abstract
In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose of this study was to examine associations between food store environments, shopping patterns, customer purchases, and dietary consumption among corner store customers. We surveyed 479 customers in 16 corner stores regarding demographics, food purchased, shopping patterns, and self-reported fruit, vegetable, and soda consumption. We objectively assessed fruit and vegetable consumption using a non-invasive reflection spectroscopy device to measure skin carotenoids. We examined associations between variables of interest, using Pearson's correlation coefficients and adjusted linear regression analyses. A majority (66%) of participants were African American, with a mean age of 43 years, and a mean body mass index (BMI) of 30.0 kg/m². There were no significant associations between the healthfulness of food store offerings, customer purchases, or dietary consumption. Participants who said they had purchased fruits and vegetables at the store previously reported higher produce intake (5.70 (4.29) vs. 4.60 (3.28) servings per day, p = 0.021) versus those who had not previously purchased fresh produce. The NC Legislature has allocated another $250,000 to the HFSRP for the 2018 fiscal year. Thus, evaluation results will be important to inform future healthy corner store policies and initiatives.
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Affiliation(s)
- Stephanie B Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Qiang Wu
- Department of Biostatistics, College of Allied Health, East Carolina University, Greenville, NC 27834, USA.
| | - Kimberly P Truesdale
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Taras Grinchak
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Jared T McGuirt
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC 27413, USA.
| | - Lindsey Haynes-Maslow
- Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC 27695, USA.
| | - Ronny A Bell
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
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A corner store intervention to improve access to fruits and vegetables in two Latino communities. Public Health Nutr 2017; 20:2249-2259. [PMID: 28578744 DOI: 10.1017/s1368980017001008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Investments have been made to alter the food environment of neighbourhoods that have a disproportionate number of unhealthy food venues. Corner store conversions are one strategy to increase access to fruits and vegetables (F&V). Although the literature shows modest success, the effectiveness of these interventions remains equivocal. The present paper reports on the evaluation of Proyecto MercadoFRESCO, a corner store conversion intervention in two Latino communities. DESIGN A repeated cross-sectional design was employed. Data were stratified by intervention arm and bivariate tests assessed changes over time. Logistic and multiple regression models with intervention arm, time and the interaction of intervention and time were conducted. Supplementary analyses account for clustering of patrons within stores and staggering of store conversions. SETTING Three stores were converted and five stores served as comparisons in East Los Angeles and Boyle Heights, California, USA. SUBJECTS Store patrons were interviewed before (n550) and after (n407) the intervention. RESULTS Relative to patrons of comparison stores, patrons of intervention stores demonstrated more favourable perceptions of corner stores and increased purchasing of F&V during that store visit. Changes were not detected in store patronage, percentage of weekly dollars spent on food for F&V or daily consumption of F&V. CONCLUSIONS Consistent with some extant food environment literature, findings demonstrate limited effects. Investments should be made in multilevel, comprehensive interventions that target a variety retail food outlets rather than focusing on corner stores exclusively. Complementary policies limiting the availability, affordability and marketing of energy-dense, nutrient-poor foods should also be pursued.
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