1
|
Kanerva N, Kinnunen S, Nevalainen J, Vepsäläinen H, Fogelholm M, Saarijärvi H, Meinilä J, Erkkola M. Building nutritionally meaningful classification for grocery product groups: the LoCard Food Classification process. Br J Nutr 2024:1-28. [PMID: 38634262 DOI: 10.1017/s0007114524000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Analysing customer loyalty card data is a novel method for assessing nutritional quality and changes in a population's food consumption. However, prior to its use, the thousands of grocery products available in stores must be reclassified from the retailer's original hierarchical structure into a structure that is suitable for the use of nutrition and health research. We created LoCard Food Classification (LCFC) and examined how it reflects the nutritional quality of the grocery product groups. Nutritional quality was considered the main criterion guiding the reclassification of the 3574 grocery product groups. Information on the main ingredient of the product group, purpose of use, and carbon footprint were also used at the more granular levels of LCFC. The main challenge in the reclassification was a lack of detailed information on the type of products included in each group, and that some of the groups included products that have opposite health effects. The final LCFC has four hierarchical levels and it is openly available online. After reclassification, the product groups were linked with the Finnish food composition database, and the nutrient profile was assessed by calculating the Nutrient Rich Food Index (NRFI) for each product group. Standard deviation in NRFI decreased from 0.21 of the least granular level to 0.08 of the most granular level of LCFC indicating that the most granular level of LCFC has more homogeneous nutritional quality. Studies that apply LCFC to examine loyalty card data with health and environmental outcomes are needed to further demonstrate its validity.
Collapse
Affiliation(s)
- N Kanerva
- Department of Food and Nutrition, University of Helsinki, PO Box 66, 00014 Helsinki, Finland
| | - S Kinnunen
- Department of Food and Nutrition, University of Helsinki, PO Box 66, 00014 Helsinki, Finland
| | - J Nevalainen
- Department of Food and Nutrition, University of Helsinki, PO Box 66, 00014 Helsinki, Finland
- Faculty of Social Sciences (Health Sciences), Tampere University, Kanslerinrinne 1, 33100 Tampere, Finland
| | - H Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, PO Box 66, 00014 Helsinki, Finland
| | - M Fogelholm
- Department of Food and Nutrition, University of Helsinki, PO Box 66, 00014 Helsinki, Finland
| | - H Saarijärvi
- Faculty of Management and Business, Tampere University, Kanslerinrinne 1, 33100 Tampere, Finland
| | - J Meinilä
- Department of Food and Nutrition, University of Helsinki, PO Box 66, 00014 Helsinki, Finland
| | - M Erkkola
- Department of Food and Nutrition, University of Helsinki, PO Box 66, 00014 Helsinki, Finland
| |
Collapse
|
2
|
Piernas C, Lee C, Hobson A, Harmer G, Payne Riches S, Noreik M, Jebb SA. A Behaviorally Informed Mobile App to Improve the Nutritional Quality of Grocery Shopping (SwapSHOP): Feasibility Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e45854. [PMID: 38206671 PMCID: PMC10811579 DOI: 10.2196/45854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/29/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Interventions targeting the nutritional quality of grocery shopping have the potential to help improve diet and health outcomes. OBJECTIVE This study aims to assess the feasibility and acceptability of receiving advice on healthier food purchases through SwapSHOP, a behaviorally informed smartphone app that allows users to scan barcodes of grocery products from the United Kingdom, providing nutritional information and personalized swap suggestions to encourage healthier purchases. METHODS We randomized adult volunteers in a 6-arm parallel-group controlled feasibility trial. Participants used the SwapSHOP app to record their grocery shopping during a 2-week run-in period and were individually randomized in a 3:1 ratio to either intervention or control arms within 3 strata related to a nutrient of concern of their choice: saturated fat (SFA), sugar, or salt. Participants randomized to the intervention received the SwapSHOP app with a healthier swap function, goal setting, and personalized feedback. Participants in the control group were instructed to use a simpler version of the app to log all their food purchases without receiving any guidance or advice. The primary outcome was the feasibility of progression to a full trial, including app use and follow-up rates at 6 weeks. The secondary outcomes included other feasibility outcomes, process and qualitative measures, and exploratory effectiveness outcomes to assess changes in the nutrient content of the purchased foods. RESULTS A total of 112 participants were randomized into 3 groups: SFA (n=38 intervention and n=13 control), sugar (n=40 intervention and n=15 control), and salt (n=5 intervention and n=1 control, not analyzed). The 2 progression criteria were met for SFA and sugar: 81% (30/37) and 87% (34/39) of intervention participants in the SFA and sugar groups, respectively, used the app to obtain healthier swaps, and 89% (68/76) of intervention participants and 96% (23/24) of control participants completed follow-up by scanning all purchases over the follow-up period. The process and qualitative outcomes suggested that the intervention was acceptable and has the potential to influence shopping behaviors. There were reductions of -0.56 g per 100 g (95% CI -1.02 to -0.19) in SFA and -1 g per 100 g (95% CI -1.97 to -0.03) in total sugars across all food purchases in the intervention groups. CONCLUSIONS People were willing to use the SwapSHOP app to help reduce sugar and SFA (but not salt) in their grocery shopping. Adherence and follow-up rates suggest that a full trial is feasible. Given the suggestive evidence indicating that the intervention resulted in reductions in sugars and SFA, a definitive trial is necessary to target improvements in health outcomes. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number ISRCTN13022312; https://doi.org/10.1186/ISRCTN13022312.
Collapse
Affiliation(s)
- Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Department of Biochemistry and Molecular Biology II, Center for Biomedical Research (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, Granada, Spain
| | - Charlotte Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Alice Hobson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Georgina Harmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Sarah Payne Riches
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Michaela Noreik
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Faculty of Food and Nutrition Sciences, Hochschule Niederrhein, Mönchengladbach, Germany
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
3
|
Domínguez-Barreto AP, Farah I, López-Olmedo N, Perez-Ferrer C, Ramírez-Toscano Y, Barrientos-Gutiérrez T, Stern D. Trends in food and beverage purchases in informal, mixed, and formal food outlets in Mexico: ENIGH 1994-2020. Front Public Health 2023; 11:1151916. [PMID: 37293617 PMCID: PMC10244666 DOI: 10.3389/fpubh.2023.1151916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Background The retail food environment in Mexico is characterized by the co-existence of both, formal and informal food outlets. Yet, the contribution of these outlets to food purchases over time has not been documented. Understanding the longitudinal trends where Mexican households purchase their foods is critical for the development of future food retail policies. Methods We used data from Mexico's National Income and Expenditure Survey from 1994 to 2020. We categorized food outlets as formal (supermarkets, chain convenience stores, restaurants), informal (street markets, street vendors, acquaintances), and mixed (fiscally regulated or not. i.e., small neighborhood stores, specialty stores, public markets). We calculated the proportion of food and beverage purchases by food outlet for each survey for the overall sample and stratified by education level and urbanicity. Results In 1994, the highest proportion of food purchases was from mixed outlets, represented by specialty and small neighborhood stores (53.7%), and public markets (15.9%), followed by informal outlets (street vendors and street markets) with 12.3%, and formal outlets from which supermarkets accounted for 9.6%. Over time, specialty and small neighborhood stores increased 4.7 percentage points (p.p.), while public markets decreased 7.5 p.p. Street vendors and street markets decreased 1.6 p.p., and increased 0.5 p.p. for supermarkets. Convenience stores contributed 0.5% at baseline and increased to 1.3% by 2020. Purchases at specialty stores mostly increased in higher socioeconomic levels (13.2 p.p.) and metropolitan cities (8.7 p.p.) while public markets decreased the most in rural households and lower socioeconomic levels (6.0 p.p. & 5.3 p.p.). Supermarkets and chain convenience stores increased the most in rural localities and small cities. Conclusion In conclusion, we observed an increase in food purchases from the formal sector, nonetheless, the mixed sector remains the predominant food source in Mexico, especially small-neighborhood stores. This is concerning, since these outlets are mostly supplied by food industries. Further, the decrease in purchases from public markets could imply a reduction in the consumption of fresh produce. In order to develop retail food environment policies in Mexico, the historical and predominant role of the mixed sector in food purchases needs to be acknowledged.
Collapse
Affiliation(s)
| | - Irene Farah
- Department of City and Regional Planning, University of California, Berkeley, Berkeley, CA, United States
| | - Nancy López-Olmedo
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Carolina Perez-Ferrer
- CONACyT–Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Yenisei Ramírez-Toscano
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Dalia Stern
- CONACyT–Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| |
Collapse
|
4
|
Jacobs J, Holcomb J, Margellos-Anast H, Martinez L, San Miguel C. An Evaluation of the Implementation of the Women, Infants, and Children (WIC) Farmers Market Nutrition Program at Four Chicago WIC Sites. Nutrients 2023; 15:nu15051122. [PMID: 36904124 PMCID: PMC10004737 DOI: 10.3390/nu15051122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
The Farmers Market Nutrition Program (FMNP), a program of the U.S. Department of Agriculture (USDA), provides coupons to individuals/families enrolled in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC) to purchase fresh produce from approved farmers markets. While some studies suggest FMNP may improve nutrition for WIC clients, there is limited research on program implementation in practice. A mixed-methods equitable evaluation framework was utilized to: (1) better understand the FMNP in practice at four WIC clinics on Chicago's west and southwest sides that serve predominately Black and Latinx families; (2) detail facilitators and barriers to participation in the FMNP; and (3) describe the potential impact on nutrition. In this manuscript, we present qualitative findings from Aim 1. We identified six steps for how the FMNP has been implemented in our study setting and opportunities to improve the implementation of the program. Findings suggest that well-defined and consistent guidelines on: (1) how to seek state approval for farmers markets; and (2) coupon distribution and redemption, are necessary to optimize utilization. Future research should explore the impact of newly offered electronic coupons on redemption rates and fresh fruit and vegetable purchasing behaviors.
Collapse
|
5
|
Le Bouthillier M, Perron J, Pomerleau S, Gagnon P, Labonté MÈ, Plante C, Guével MH, Provencher V. Nutritional Content of Sliced Bread Available in Quebec, Canada: Focus on Sodium and Fibre Content. Nutrients 2021; 13:nu13124196. [PMID: 34959748 PMCID: PMC8704778 DOI: 10.3390/nu13124196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/15/2021] [Accepted: 11/19/2021] [Indexed: 01/01/2023] Open
Abstract
Bread is a highly consumed food and an important source of nutrients in the diet of Canadians, underlining the need to improve its nutritional quality. The Food Quality Observatory (Observatory) aimed to evaluate the nutritional value of the sliced bread products available in Quebec (Canada), according to their grain type and main flour. Analyses included comparing the bread’s sodium content to Health Canada’s daily values (DV) and sodium voluntary targets, comparing the bread’s fibre content thresholds with the source of fibre mentioned, and assessing whether the main flour was associated with the nutrient content. The nutritional values of 294 sliced breads available in Quebec were merged with sales data (from October 2016 to October 2017), with 262 products successfully cross-referenced. The results showed that 64% of the breads purchased were ‘low’ in fibre (i.e., below 2 g per two slices), while 47% were ‘high’ in sodium (i.e., above 15% DV per two slices). Attention should be paid to 100% refined grain bread and to bread with refined flour as the main flour, since they are great sellers, while showing a less favourable nutrient content. This study shows that there is room for improvement in the nutritional content of Quebec’s bread offer, particularly regarding sodium and fibre content.
Collapse
Affiliation(s)
- Marie Le Bouthillier
- Centre NUTRISS—Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, QC G1V 0A6, Canada; (M.L.B.); (J.P.); (S.P.); (P.G.); (M.-È.L.)
- École de Nutrition, Université Laval, Quebec, QC G1V 0A6, Canada
| | - Julie Perron
- Centre NUTRISS—Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, QC G1V 0A6, Canada; (M.L.B.); (J.P.); (S.P.); (P.G.); (M.-È.L.)
| | - Sonia Pomerleau
- Centre NUTRISS—Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, QC G1V 0A6, Canada; (M.L.B.); (J.P.); (S.P.); (P.G.); (M.-È.L.)
| | - Pierre Gagnon
- Centre NUTRISS—Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, QC G1V 0A6, Canada; (M.L.B.); (J.P.); (S.P.); (P.G.); (M.-È.L.)
| | - Marie-Ève Labonté
- Centre NUTRISS—Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, QC G1V 0A6, Canada; (M.L.B.); (J.P.); (S.P.); (P.G.); (M.-È.L.)
- École de Nutrition, Université Laval, Quebec, QC G1V 0A6, Canada
| | - Céline Plante
- Institut National de Santé Publique du Québec, Quebec, QC G1V 5B3, Canada;
| | - Marc-Henri Guével
- Faculté des Sciences de l’agriculture et de l’alimentation, Université Laval, Quebec, QC G1V 0A6, Canada;
| | - Véronique Provencher
- Centre NUTRISS—Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Quebec, QC G1V 0A6, Canada; (M.L.B.); (J.P.); (S.P.); (P.G.); (M.-È.L.)
- École de Nutrition, Université Laval, Quebec, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +418-656-2131 (ext. 404607)
| |
Collapse
|
6
|
Li Z, Zhao A, Li J, Ke Y, Huo S, Ma Y. Food and Nutrition Related Concerns Post Lockdown during COVID-19 Pandemic and Their Association with Dietary Behaviors. Foods 2021; 10:2858. [PMID: 34829137 DOI: 10.3390/foods10112858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/17/2021] [Accepted: 11/16/2021] [Indexed: 01/13/2023] Open
Abstract
This study aimed to explore food and nutrition related concerns during the post-lockdown period and their impacts on food shopping, preparation, and eating behaviors. DESIGN A cross-sectional study was conducted through online questionnaire. We collected data on food and nutrition related concerns, socio-demographic characteristics, and changes in dietary behaviors. PARTICIPANTS A total of 2267 responses were received from people living in 31 provinces across mainland China and 1994 participants were included in the final analysis. ANALYSIS Linear and multinomial logistic regression analyses were performed to evaluate the association among food and nutrition related concerns, socio-demographic factors, and dietary behaviors Results: About 56% of participants reported moderate to high levels of concerns related to food and nutrition. Contracting the virus when dining out or through contaminated foods were the top two concerns, followed by overnutrition. Higher levels of concerns were found among people who were older, overweight, or obese, having lower income and education, and living in urban areas, or whose family contained vulnerable individuals. Compared with the pre-COVID-19 period, people who were more concerned about food and nutrition were more likely to report changes in their food purchases and consumption; they were also more likely to eat from individual plates, using serving chopsticks, and separating plates and utensils for raw and cooked foods during the post COVID-19 lockdown period. CONCLUSION AND IMPLICATION Food and nutrition related concerns during the post-lockdown period were prevalent and associated with changes in dietary behaviors. Preventative policies and nutritional guidance should be developed to address these concerns in order to reduce inappropriate dietary behaviors amid public health crises.
Collapse
|
7
|
Dunford EK, Miles DR, Popkin B, Ng SW. Whole Grain and Refined Grains: An Examination of US Household Grocery Store Purchases. J Nutr 2021; 152:550-558. [PMID: 34718663 PMCID: PMC8826838 DOI: 10.1093/jn/nxab382] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/15/2021] [Accepted: 10/26/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The health benefits related to intake of whole grain foods are well established. Consumption of whole grains in the US population is low, and whole grain content can vary greatly depending upon the specific products that are purchased. OBJECTIVES To examine the proportion of products purchased by US households containing whole grain and refined grain ingredients using time-specific food composition data, and examine whether purchases differ between income, race or ethnicity, and household make-up. METHODS Nationally representative Nielsen Homescan 2018 data were used. Each barcoded product captured in Nielsen Homescan 2018 was linked with ingredient information using commercial nutrition databases in a time-relevant manner. Packaged food products containing whole grain ingredients, refined grain ingredients, neither, or both were identified. The percentage of packaged food products containing whole grain and refined grain ingredients purchased by US households was determined overall, by demographic subgroup, and by food category. RESULTS The proportion of packaged food purchases containing refined grain ingredients was significantly higher than whole grain ingredients (30.9% compared with 7.9%; P < 0.0001). Lower income households and households with children purchased a significantly higher proportion of products containing refined grain ingredients, with no nutritionally meaningful racial or ethnic differences observed. Concerningly, across all demographic subgroups >90% of bread purchases contained refined grain ingredients, and the 5 categories with the largest proportion of whole grain ingredients contributed to <20% of overall US household packaged food purchases. CONCLUSIONS US households are purchasing a significantly higher proportion of packaged food products containing refined grain ingredients than whole grain ingredients. Future policy changes are needed to provide incentives and information (e.g., front-of-pack labels) to aid in encouraging manufacturers to increase whole grain product offerings while decreasing refined grain offerings, and to encourage consumers to substitute away from refined grain products toward whole grain products.
Collapse
Affiliation(s)
| | - Donna R Miles
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Barry Popkin
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shu Wen Ng
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
8
|
Kowalczuk I, Gębski J. Impact of Fear of Contracting COVID-19 and Complying with the Rules of Isolation on Nutritional Behaviors of Polish Adults. Int J Environ Res Public Health 2021; 18:1631. [PMID: 33572068 PMCID: PMC7914452 DOI: 10.3390/ijerph18041631] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/26/2022]
Abstract
The aim of the study was to examine whether, and to what extent, fear of contracting Covid-19 and compliance with the mandatory rules of isolation affected Polish adults' nutritional behaviors. The online study was carried out during the first wave of the pandemic on a sample of 926 adults. Through cluster analysis, three groups of respondents were isolated: 1. People who fear a Covid-19 infection and follow the isolation rules (FFR), 2. People moderately afraid of the disease and following the rules loosely (MFFR), 3. People who are not afraid of the infection and do not follow the rules of isolation. (NFFR). The clusters were profiled with consideration of different aspects of eating behaviors as well as socio-demographic and economic features. The results of the study show a close relationship between the level of fear of contracting Covid-19 and the degree to which isolation rules are followed. These two factors were found to have a significant impact on eating behaviors, such as food purchases, eating patterns, and levels of consumption. It was stated that the FFR group changed their eating behaviors the most in terms of food purchasing, eating habits (excluding diversity and quality of diet), and food product consumption. The greatest stability in the majority of the analyzed areas of nutritional behaviors was observed in the MFFR cluster. The NFFR group shown the greatest decrease both in regularity and quality of their meals. This group also exhibited a significant increase in the consumption of alcoholic beverages. The results of the study can be useful in the decision making process when introducing restrictions or managing information. They also point to the need for extensive nutritional education focused on explaining the relationship between nutrition and health during a pandemic.
Collapse
Affiliation(s)
| | - Jerzy Gębski
- Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland;
| |
Collapse
|
9
|
Egnell M, Boutron I, Péneau S, Ducrot P, Touvier M, Galan P, Buscail C, Porcher R, Ravaud P, Hercberg S, Kesse-Guyot E, Julia C. Randomised controlled trial in an experimental online supermarket testing the effects of front-of-pack nutrition labelling on food purchasing intentions in a low-income population. BMJ Open 2021; 11:e041196. [PMID: 33558350 PMCID: PMC7871692 DOI: 10.1136/bmjopen-2020-041196] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Nutri-Score, a front-of-pack nutrition label, has been adopted in 2017 in France but its impact on low-income populations is unknown, and they are more at risk of having unhealthy diets. The present study assessed the effects of the Nutri-Score on the nutritional quality of purchasing intentions among low-income individuals, compared with the current French labelling situation: references intakes (RIs) and no label, using a three-arm parallel-group randomised controlled trial. METHODS Low-income active adults from the NutriNet-Santé cohort (household income below €1200/month) were asked to perform a shopping task in an experimental online supermarket after being randomised in one of the three conditions (Nutri-Score, RIs or no labelling). The main outcome was the overall nutritional quality of the virtual shopping cart, assessed with the French-modified Food Standards Agency Nutrient Profiling System (FSAm-NPS), and secondary outcomes were the nutrient content of the shopping carts. 524 subjects were randomised, and 336 included in the analyses. RESULTS The Nutri-Score resulted in the highest overall nutritional quality of the shopping cart, as reflected by a FSAm-NPS score (1.86 (SD 3.59) points) significantly lower (reflecting higher nutritional quality) than the RIs (3.21 (SD 4.14) points, p≤0.05) but not significantly lower than no label (2.60 (SD 3.09) points, p=0.3). The Nutri-Score also resulted into significantly lower contents in calories and saturated fatty acids in the shopping cart, compared with the RIs only (p≤0.05). CONCLUSION The implementation of the front of pack nutrition label Nutri-Score, adopted in France and in different European countries, appears to have the potential to encourage purchasing intentions of foods from higher nutritional quality among low-income individuals, compared with the RIs label promoted by food manufacturers.Trial registration number: NCT02769455.
Collapse
Affiliation(s)
- Manon Egnell
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Isabelle Boutron
- METHODS team, Epidemiology and Biostatistics Centre, Inserm UMR 1153, Paris, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | | | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Camille Buscail
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Raphaël Porcher
- METHODS team, Epidemiology and Biostatistics Centre, Inserm UMR 1153, Paris, France
| | - Philippe Ravaud
- METHODS team, Epidemiology and Biostatistics Centre, Inserm UMR 1153, Paris, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny cedex, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Centre -University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny cedex, France
| |
Collapse
|
10
|
Huitink M, Poelman MP, Seidell JC, Kuijper LDJ, Hoekstsra T, Dijkstra C. Can Healthy Checkout Counters Improve Food Purchases? Two Real-Life Experiments in Dutch Supermarkets. Int J Environ Res Public Health 2020; 17:ijerph17228611. [PMID: 33228189 PMCID: PMC7699573 DOI: 10.3390/ijerph17228611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 11/16/2022]
Abstract
Most snacks displayed at supermarket checkouts do not contribute to a healthy diet. We investigated the effects of introducing healthier snack alternatives at checkouts in supermarkets on purchasing behavior. In Study 1, we investigated the effect of completely substituting less healthy with healthier snacks (one supermarket). In Study 2, we investigated the effect of placing and discounting healthier snacks while the less healthy snacks remain in place (two supermarkets). In both studies, the number of purchased snacks (per 1000 customers) was used as the outcome variable. Results for Study 1 showed that the absolute number of purchased checkout snacks was 2.4 times lower (95% confidence interval (CI): 1.9-2.7) when healthier snacks instead of less healthy snacks were placed at the supermarket checkouts. Results for Study 2 showed that when additional healthier snacks were placed near the checkouts, the absolute number of healthier purchased snacks increased by a factor of 2.1 (95% CI: 1.3-3.3). When additional healthier snacks were placed near the checkouts and discounted, the absolute number of healthier purchased snacks increased by a factor of 2.7 (95% CI: 2.0-3.6), although this was not statistically significant higher than placement only (ratio: 1.1, 95% CI: 0.7-1.9). Purchases of less healthy snacks did not decline, and even slightly increased, during the intervention period (ratio: 1.3, 95% CI: 1.1-1.5). If supermarkets want to promote healthier snack purchases, additional healthier products can be positioned near the checkouts. However, this does not discourages the purchase of less healthy snacks. Therefore, to discourage unhealthy snack purchases at supermarket checkouts, a total substitution of less healthy snacks with healthier alternatives is most effective.
Collapse
Affiliation(s)
- Marlijn Huitink
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
- Correspondence:
| | - Maartje P. Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN Wageningen, The Netherlands;
| | - Jacob C. Seidell
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Lothar D. J. Kuijper
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Trynke Hoekstsra
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| | - Coosje Dijkstra
- Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (L.D.J.K.); (T.H.); (C.D.)
| |
Collapse
|
11
|
Muller L, Ruffieux B. What Makes a Front-of-Pack Nutritional Labelling System Effective: The Impact of Key Design Components on Food Purchases. Nutrients 2020; 12:nu12092870. [PMID: 32961760 PMCID: PMC7551239 DOI: 10.3390/nu12092870] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/07/2020] [Accepted: 09/16/2020] [Indexed: 01/12/2023] Open
Abstract
The relative impacts on food purchases of many alternative front-of-pack nutritional labelling systems were tested, with various methods—from opinion pool to nationwide experiments. Clearly, some systems induce better purchasing responses, having better nutritional impacts on food baskets. Nonetheless, we still ignore what the ingredients of an efficient label are. Here, we propose guidance for label designers. To do so, we first propose a typology that breaks down established labelling systems into four elementary components: Directiveness, Scope and Gradation, Set of Reference and Sign. On this basis, we then build seven alternative generic labelling systems that we test in a framed-field experiment enabling us to measure the effect of each component on food purchases in isolation. Our results show that an effective front-of-pack labelling system should be Food-Directive (instead of Diet-Directive) and be displayed on both healthy and unhealthy food. The reference set, which is across categories or within categories, produces the same average nutrition score but generates contrasting behavioural responses.
Collapse
|
12
|
Vadiveloo MK, Parker HW, Juul F, Parekh N. Sociodemographic Differences in the Dietary Quality of Food-at-Home Acquisitions and Purchases among Participants in the U.S. Nationally Representative Food Acquisition and Purchase Survey (FoodAPS). Nutrients 2020; 12:nu12082354. [PMID: 32784537 PMCID: PMC7468991 DOI: 10.3390/nu12082354] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022] Open
Abstract
Insufficient research has explored whether sociodemographic differences in self-reported, individual-level diet quality are similarly reflected by grocery purchase quality. This cross-sectional analysis of n = 3961 U.S. households from the nationally representative Food Acquisition and Purchase Survey (FoodAPS) compared Healthy Eating Index (HEI)-2015 scores from 1 week of food-at-home acquisitions across self-reported demographic factors (race/ethnicity, Supplemental Nutrition Assistance Program (SNAP) participation, food security, and household-level obesity status). Multivariable-adjusted, survey-weighted regression models compared household HEI-2015 scores across sociodemographic groups. Respondents were primarily White and female, with a mean age of 50.6 years, 14.0% were food insecure, and 12.7% were SNAP-participating. Mean HEI-2015 scores were 54.7; scores differed across all sociodemographic exposures (p < 0.05). Interactions (p < 0.1) were detected between SNAP participation and (1) food insecurity and (2) household-level obesity, and race/ethnicity and (1) household-level obesity. HEI-2015 scores were higher among food secure, non-SNAP households than among food insecure, SNAP-participating households (53.9 ± 0.5 vs. 50.3 ± 0.7, p = 0.007); non-SNAP households without obesity had significantly higher HEI-2015 scores than other households. Household-level obesity was associated with lower HEI-2015 scores in White (50.8 ± 0.5 vs. 52.5 ± 0.7, p = 0.046) and Black (48.8 ± 1.5 vs. 53.1 ± 1.4, p = 0.018) but not Hispanic households (54.4 ± 1.0 vs. 52.2 ± 1.2, p = 0.21). Sociodemographic disparities in household HEI-2015 scores were consistent with previous research on individual-level diet quality.
Collapse
Affiliation(s)
- Maya K. Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA;
- Correspondence:
| | - Haley W. Parker
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA;
| | - Filippa Juul
- School of Global Public Health, New York University, New York, NY 10012, USA; (F.J.); (N.P.)
| | - Niyati Parekh
- School of Global Public Health, New York University, New York, NY 10012, USA; (F.J.); (N.P.)
- New York University School of Medicine, New York, NY 10016, USA
| |
Collapse
|
13
|
Rebouillat P, Bonin S, Kestens Y, Chaput S, Drouin L, Mercille G. Fruit and Vegetable Purchases in Farmer's Market Stands: Analysing Survey and Sales Data. Int J Environ Res Public Health 2019; 17:ijerph17010088. [PMID: 31877682 PMCID: PMC6981572 DOI: 10.3390/ijerph17010088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 12/06/2019] [Accepted: 12/15/2019] [Indexed: 11/16/2022]
Abstract
Farmers' market implementation holds promise for increasing access to healthy foods. Although rarely measured, purchase data constitute an intermediate outcome between food environment and actual consumption. In a study conducted with two seasonal Fruits and Vegetables (FV) stands in a disadvantaged area of Montréal (Canada), we analysed how accessibility, perception, and mobility-related factors were associated with FV purchase. This analysis uses a novel measure of FV purchasing practices based on sales data obtained from a mobile application. A 2016 survey collected information on markets' physical access, perceived access to FV in the neighbourhood, usual FV consumption and purchases. Multivariate models were used to analyse three purchasing practice indicators: number of FV portions, FV variety and expenditures. Average shoppers purchased 12 FV portions of three distinct varieties and spent 5$. Shoppers stopping at the market on their usual travel route spent less (p = 0.11), bought fewer portions (p = 0.03) and a lesser FV variety (p < 0.01). FV stands may complement FV dietary intake. Individuals for whom the market is on their usual travel route might make more frequent visits and, therefore, smaller purchases. The novel data collection method allowed analysis of multiple purchase variables, is precise and easy to apply at unconventional points of sales and could be transposed elsewhere.
Collapse
Affiliation(s)
- Pauline Rebouillat
- Institut de Santé Publique d’Épidémiologie et de Développement (ISPED), Université de Bordeaux, 33000 Bordeaux, France
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
| | - Sarah Bonin
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Yan Kestens
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Sarah Chaput
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Louis Drouin
- Direction régionale de santé publique, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l’Ile-de-Montréal, Montréal, QC H2L 1M3, Canada
| | - Geneviève Mercille
- Département de nutrition, Université de Montréal, 2450 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada
- Centre de recherche en santé publique, 1301 Sherbrooke Est, Montréal, QC H2L 1M3, Canada
- Correspondence:
| |
Collapse
|
14
|
Güsewell S, Floris J, Berlin C, Zwahlen M, Rühli F, Bender N, Staub K. Spatial Association of Food Sales in Supermarkets with the Mean BMI of Young Men: An Ecological Study. Nutrients 2019; 11:nu11030579. [PMID: 30857247 PMCID: PMC6470871 DOI: 10.3390/nu11030579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 11/18/2022] Open
Abstract
Supermarket food sales data might serve as a simple indicator of population-level dietary habits that influence the prevalence of excess weight in local environments. To test this possibility, we investigated how variation in store-level food sales composition across Switzerland is associated with the mean Body Mass Index (BMI) of young men (Swiss Army conscripts) living near the stores. We obtained data on annual food sales (2011) for 553 stores from the largest supermarket chain in Switzerland, identified foods commonly regarded as “healthy” or “unhealthy” based on nutrient content, and determined their contribution to each store’s total sales (Swiss francs). We found that the sales percentages of both “healthy” and “unhealthy” food types varied by 2- to 3-fold among stores. Their balance ranged from −15.3% to 18.0% of total sales; it was positively associated with area-based socioeconomic position (r = 0.63) and negatively associated with the mean BMI of young men in the area (r = −0.42). Thus, even though we compared supermarkets from a single chain, different shopping behaviors of customers caused stores in privileged areas to sell relatively more healthy food. Knowledge about such patterns could help in designing in-store interventions for healthier nutrition and monitoring their effects over time.
Collapse
Affiliation(s)
- Sabine Güsewell
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland.
| | - Joël Floris
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland.
| | - Claudia Berlin
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, CH-3012 Bern, Switzerland.
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, CH-3012 Bern, Switzerland.
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland.
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland.
| | - Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland.
| |
Collapse
|
15
|
Pedraza LS, Popkin BM, Salgado JC, Taillie LS. Mexican Households' Purchases of Foods and Beverages Vary by Store-Type, Taxation Status, and SES. Nutrients 2018; 10:E1044. [PMID: 30096817 DOI: 10.3390/nu10081044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 02/02/2023] Open
Abstract
Where people shop for food is often linked to the healthiness of food purchases. In Mexico, no research has examined the connection between where people shop, what they buy, and their socioeconomic status (SES). Mexico’s sugary beverage and junk food taxes have made households decrease purchases of taxed products. However, whether households have changed where they shop is unknown. To address this gap, we use a repeated cross-sectional analysis of household packaged food and beverage purchases from the Nielsen Mexico Consumer Panel Survey from 2012 to 2015 (n > 5500 households). We examine changes in the volume of the purchase of taxed and untaxed products from different store-types (i.e., convenience stores, supermarkets, traditional retailers, wholesalers, home water-delivery, and others) by SES using multivariate linear regression models. Results show that high-SES households purchased more foods and beverages at all store-types except for low-SES who purchased the most foods and taxed beverages at traditional retailers. Purchases of taxed foods and beverages from traditional retailers significantly decreased for low-SES and middle-SES households and from supermarkets for middle-SES and high-SES households. Purchases of untaxed beverages from wholesalers significantly increased for middle-SES households and from convenience stores for high-SES households. Our findings suggest that consumers choose different stores to purchase beverages than to purchase foods and that taxes may have differentially affected each store-type.
Collapse
|
16
|
Leischner K, McCormack LA, Britt BC, Heiberger G, Kattelmann K. The Healthfulness of Entrées and Students' Purchases in a University Campus Dining Environment. Healthcare (Basel) 2018; 6:healthcare6020028. [PMID: 29565273 PMCID: PMC6023427 DOI: 10.3390/healthcare6020028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study is to determine the availability of “more healthful” (MH) versus “less healthful” (LH) entrée items in the campus dining and if students’ purchases are reflective of what is offered. This is an observational study in which purchases of the available entrée items in the campus dining at South Dakota State University in one academic year were collected and categorized as either MH or LH according to the American Heart Association guidelines. Chi-square tests were used to determine the differences between the proportion of purchased MH and LH versus those available. Odds ratio estimates with 95% confidence limits were used to determine the associations between the demographics and MH and LH purchases. Of the total entrée items available, 15.0% were MH and 85.0% were LH. In the fall, 8.0% of purchases were MH and 92.0% purchases were LH as compared to 8.9% MH and 91.1% LH in the spring. Whites were less likely than non-whites to purchase a MH entrée. Females were two times more likely to choose MH entrées than males. The campus dining offerings and students’ purchases of entrees were primarily LH. Work with campus dining providers to create profitable, yet healthful, dining entrees is needed to improve the healthfulness of offerings.
Collapse
Affiliation(s)
- Krista Leischner
- Health & Nutritional Sciences Department, South Dakota State University, Brookings, SD 57007, USA.
| | - Lacey Arneson McCormack
- Health & Nutritional Sciences Department, South Dakota State University, Brookings, SD 57007, USA.
| | - Brian C Britt
- Journalism & Mass Communications Department, South Dakota State University, Brookings, SD 57007, USA.
| | - Greg Heiberger
- Biology & Microbiology, South Dakota State University, Brookings, SD 57007, USA.
| | - Kendra Kattelmann
- Health & Nutritional Sciences Department, South Dakota State University, Brookings, SD 57007, USA.
| |
Collapse
|
17
|
López-Olmedo N, Popkin BM, Taillie LS. The Socioeconomic Disparities in Intakes and Purchases of Less-Healthy Foods and Beverages Have Changed over Time in Urban Mexico. J Nutr 2018; 148:109-116. [PMID: 29378043 PMCID: PMC6251618 DOI: 10.1093/jn/nxx007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/19/2017] [Indexed: 01/15/2023] Open
Abstract
Background To our knowledge, the association between diet and socioeconomic status (SES), using both purchase and intake data, in the Mexican population has not been examined, which is particularly important given the high prevalence of diet-related diseases in Mexico. Objective Our objective was to examine the SES-diet relation using household food purchases and individual food intake data. Methods We analyzed purchases of packaged food and beverages of 5240 households with the use of the 2012-2014 Nielsen Mexico Consumer Panel Service Dataset, representative of urban areas. Likewise, we examined 9672 individuals over 2 y with food and beverage intake information collected using a single 24-h recall as part of the Mexican National Health and Nutrition Survey 2012. Multivariate linear regression models were conducted to predict per capita daily purchases and intakes of food and beverages classified as healthy and less healthy by SES, and adjusting for sociodemographic variables. Results Per capita daily purchases of healthy and less-healthy foods were, on average, 142% and 55% higher in high- than in low-SES households, respectively, from 2012 to 2014 (P < 0.05). Intakes of healthy and less-healthy foods in urban areas were, on average, 7% and 136% higher in high- than in low-SES groups (P < 0.05). Per capita daily purchases of healthy beverages were, on average, 56% higher in high- than in low-SES households from 2012 to 2014 (P < 0.05), whereas purchases of less-healthy beverages were 27% and 17% higher in low- than in high-SES households in 2012 and 2014, respectively (P < 0.05). Per capita daily intake of healthy beverages was 33% higher in high- than in low-SES groups (P < 0.05). Conclusion Higher-SES groups from urban areas had greater purchases and intakes of less-healthy foods and healthy beverages. Lower-SES households had greater purchases of less-healthy beverages, but also had the largest reduction in these purchases from 2012 to 2014, which could be associated with the beverage tax implemented in Mexico in 2014.
Collapse
Affiliation(s)
| | - Barry M Popkin
- Department of Nutrition, University of North Carolina, Chapel Hill, NC
| | - Lindsey Smith Taillie
- Department of Nutrition, University of North Carolina, Chapel Hill, NC,Address correspondence to LST (e-mail: )
| |
Collapse
|
18
|
Abstract
PURPOSE Diet-related chronic diseases like diabetes can be dangerous and expensive to treat, especially for patients who do not follow a recommended diet. Meanwhile, prescription drugs can alleviate the symptoms of or control many diet-related chronic diseases, but these drugs may also weaken the resolve to follow recommended diets (moral hazard). DESIGN We measure the effect of a diagnosis of chronic disease and subsequent pharmacological treatment on the dietary quality of food purchases using a large panel data set of US consumers. We estimate the effect of prescription drug utilization on food purchases for the following chronic diseases: type 2 diabetes, high cholesterol, heart disease, and obesity. PARTICIPANTS Panelists of the Information Resources, Inc consumer panel. MEASURES Dietary quality is measured as purchases of (1) food groups (ie, fruit, vegetables, and sweets) and (2) nutrients (ie, saturated fat, fiber, sodium, sugar, and total calories). ANALYSIS Linear regression with mixed effects on pooled panel (household random effects, city fixed effects). RESULTS/CONCLUSION We do not find strong effects of either diagnosis or pharmacological treatment of diet-related disease on food purchases.
Collapse
|
19
|
Neal B, Crino M, Dunford E, Gao A, Greenland R, Li N, Ngai J, Ni Mhurchu C, Pettigrew S, Sacks G, Webster J, Wu JH. Effects of Different Types of Front-of-Pack Labelling Information on the Healthiness of Food Purchases-A Randomised Controlled Trial. Nutrients 2017; 9:E1284. [PMID: 29186803 DOI: 10.3390/nu9121284] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/10/2017] [Accepted: 11/19/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Front-of-pack nutrition labelling may support healthier packaged food purchases. Australia has adopted a novel Health Star Rating (HSR) system, but the legitimacy of this choice is unknown. Objective: To define the effects of different formats of front-of-pack labelling on the healthiness of food purchases and consumer perceptions. Design: Individuals were assigned at random to access one of four different formats of nutrition labelling—HSR, multiple traffic light labels (MTL), daily intake guides (DIG), recommendations/warnings (WARN)—or control (the nutrition information panel, NIP). Participants accessed nutrition information by using a smartphone application to scan the bar-codes of packaged foods, while shopping. The primary outcome was healthiness defined by the mean transformed nutrient profile score of packaged foods that were purchased over four weeks. Results: The 1578 participants, mean age 38 years, 84% female recorded purchases of 148,727 evaluable food items. The mean healthiness of the purchases in the HSR group was non-inferior to MTL, DIG, or WARN (all p < 0.001 at 2% non-inferiority margin). When compared to the NIP control, there was no difference in the mean healthiness of purchases for HSR, MTL, or DIG (all p > 0.07), but WARN resulted in healthier packaged food purchases (mean difference 0.87; 95% confidence interval 0.03 to 1.72; p = 0.04). HSR was perceived by participants as more useful than DIG, and easier to understand than MTL or DIG (all p < 0.05). Participants also reported the HSR to be easier to understand, and the HSR and MTL to be more useful, than NIP (all p < 0.03). Conclusions: These real-world data align with experimental findings and provide support for the policy choice of HSR. Recommendation/warning labels warrant further exploration, as they may be a stronger driver of healthy food purchases.
Collapse
|
20
|
Abstract
Healthier food initiatives conducted by national food retailers may offer opportunities to improve the nutritional profile of food purchases. Using a longitudinal data set of packaged food purchases made by US households, we examined the effect of a healthier food initiative officially launched by Walmart in 2011. From 2000 to 2013, household-level purchases of packaged foods at Walmart showed major declines in energy, sodium, and total sugar density, as well as in quantities of sugary beverages, grain-based desserts, snacks, and candy. These trends in packaged food purchases were more pronounced than similar concurrent trends seen at other major food retailers. However, the declines seen at Walmart after the initiative's official implementation did not exceed what would have been expected had pre-implementation trends continued, and therefore they cannot be attributed to the initiative. These results suggest that food retailer-based initiatives that purportedly create a healthier food environment may not suffice to improve the nutritional profile of food purchases. More systemic shifts in consumers' characteristics and preferences may be needed.
Collapse
Affiliation(s)
- Lindsey Smith Taillie
- Lindsey Smith Taillie is a research assistant professor in the Department of Nutrition and a fellow at the Carolina Population Center, both at the University of North Carolina at Chapel Hill (UNC-CH)
| | - Shu Wen Ng
- Shu Wen Ng is a research associate professor in the Department of Nutrition and a fellow at the Carolina Population Center, both at UNC-CH
| | - Barry M Popkin
- Barry M. Popkin is the W. R. Kenan, Jr. Distinguished Professor in the Department of Nutrition and a fellow at the Carolina Population Center, both at UNC-CH
| |
Collapse
|
21
|
Stern D, Poti JM, Ng SW, Robinson WR, Gordon-Larsen P, Popkin BM. Where people shop is not associated with the nutrient quality of packaged foods for any racial-ethnic group in the United States. Am J Clin Nutr 2016; 103:1125-34. [PMID: 26912495 PMCID: PMC4807703 DOI: 10.3945/ajcn.115.121806] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/14/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In the literature, it has been suggested that there are race-ethnic disparities in what Americans eat. In addition, some studies have shown that residents of African American and low-income neighborhoods have less access to grocery stores and supermarkets, which tend to stock healthier foods. However, it is unclear whether differences in food shopping patterns contribute to the poorer nutrient profile of food purchases made by racial-ethnic minorities. OBJECTIVES We examined whether the mix of food stores where people shop (i.e., food-shopping patterns) was associated with the nutrient profile of packaged food purchases (PFPs) and the types of foods and beverages purchased, and we determined whether these associations differ across racial-ethnic groups. DESIGN We used PFPs by US households (Nielsen National Consumer Panel) from 2007 to 2012 and implemented a cluster analysis to categorize households according to their food-shopping patterns. Longitudinal random-effects linear regression models were used to examine the association between food shopping patterns and the nutrient qualities and types of packaged foods and beverages purchased by race-ethnicity in US households. RESULTS Shopping primarily at grocery chains was not associated with a better nutrient profile of household PFPs or the food and beverages that households purchased than was shopping primarily at mass merchandisers (value-oriented stores that sell merchandise lines in multiple departments) or at a combination of large and small stores. These results were consistent across racial-ethnic groups. Regardless of where households shopped, non-Hispanic African American households purchased foods with higher energy, total sugar, and sodium densities than did non-Hispanic white and Hispanic households. CONCLUSION Policy initiatives that focus on increasing physical access to stores or helping stores sell healthier products to encourage healthier purchases may be ineffective because other factors may be more important determinants of food and beverage purchases than where people shop or what is available in the store.
Collapse
Affiliation(s)
| | | | - Shu Wen Ng
- Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and USDA Duke-University of North Carolina Collaborative Center for Behavioral Economics and Healthier Food Choice Research (BECR), Durham-Chapel Hill, NC
| | - Whitney R Robinson
- Epidemiology, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Penny Gordon-Larsen
- Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| | - Barry M Popkin
- Departments of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
| |
Collapse
|
22
|
Taillie LS, Ng SW, Popkin BM. Global growth of "big box" stores and the potential impact on human health and nutrition. Nutr Rev 2015; 74:83-97. [PMID: 26714934 DOI: 10.1093/nutrit/nuv062] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 08/03/2015] [Indexed: 01/09/2023] Open
Abstract
Despite a large body of literature on the food environment, little is known about the role of supercenters in human nutrition and health. The objectives of this review are to examine what is currently known about the association between supercenters, nutrition, and obesity, to identify how supercenters may affect disparities in food access and nutritional quality of food purchases, and to document the rapid rise of supercenters as a source of food purchases in the United States. A case study of Wal-Mart, the largest food retailer in the United States, is presented that demonstrates the major and increasing role of supercenters as a source of packaged food purchases in the United States, particularly among low-income households, as well as the role of supercenters in supplying key nutrients. Taken together, this review and case study highlight the dominant role of supercenters in the US diet and the need to better understand how supercenters can be leveraged to improve the nutritional quality of what consumers buy and eat.
Collapse
Affiliation(s)
- Lindsey Smith Taillie
- L.S. Taillie, S.W. Ng, and B.M. Popkin are with the Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Shu Wen Ng
- L.S. Taillie, S.W. Ng, and B.M. Popkin are with the Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Barry M Popkin
- L.S. Taillie, S.W. Ng, and B.M. Popkin are with the Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA.
| |
Collapse
|