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Kraak VI. Children and teens must develop digital literacy skills to navigate complex and evolving food ecosystems. Nutr Rev 2023:nuad153. [PMID: 38114093 DOI: 10.1093/nutrit/nuad153] [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: 12/21/2023] Open
Abstract
Ares et al 2023 discussed multisectoral strategies that practitioners could use to foster food literacy competencies (ie, relational, functional, and critical) across the lifespan. This letter encourages the authors to include digital food and nutrition literacy skills to help children and teens navigate a complex food ecosystem shaped by digital technologies. Existing digital food and nutrition literacy models and metrics could be adapted to enable young people to make healthy dietary choices within future sustainable food systems.
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Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, Virginia, USA
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Consavage Stanley K, Hedrick VE, Serrano E, Holz A, Kraak VI. US Adults' Perceptions, Beliefs, and Behaviors towards Plant-Rich Dietary Patterns and Practices: International Food Information Council Food and Health Survey Insights, 2012-2022. Nutrients 2023; 15:4990. [PMID: 38068852 PMCID: PMC10708400 DOI: 10.3390/nu15234990] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Expert groups recommend that populations adopt dietary patterns higher in whole, plant-based foods and lower in red and processed meat as a high-impact climate action. Yet, there is limited understanding of populations' willingness to adopt plant-rich dietary patterns. This study examined United States (US) adults' perceptions, beliefs, and behaviors towards plant-rich dietary patterns and practices over a decade. Fifteen questions from the International Food Information Council's Food and Health Surveys (2012-2022) were analyzed across four sustainability domains (i.e., human health, environmental, social, and economic domains). Most respondents had favorable perceptions of environmentally sustainable food and beverages, but sustainability influenced less than half of consumers' purchase decisions. Plant-rich dietary pattern adherence increased across survey years (12.1% [2019] to 25.8% [2022], p < 0.001). One-quarter (28.1%) of Americans reported reducing their red meat intake over 12 months (2020-2022). Yet, another 15.5% reported greater red meat intake, and 18.8% reported greater plant-based meat alternative (PBMA) intake over 12 months. The percentage of respondents who reported greater red meat and PBMA consumption in the previous 12 months significantly increased across the years surveyed (2020-2022, p < 0.05). IFIC Survey findings highlight growing US consumer awareness of health, environmental, and social sustainability but low adoption of plant-rich dietary patterns and practices. Government leadership and coordinated actions by health professionals, civil society, and businesses are needed to educate and incentivize Americans to adopt plant-rich dietary behaviors, and greater industry transparency is needed to show how food and beverage products support human and planetary health.
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Affiliation(s)
- Katherine Consavage Stanley
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (V.E.H.); (E.S.); (V.I.K.)
| | - Valisa E. Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (V.E.H.); (E.S.); (V.I.K.)
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (V.E.H.); (E.S.); (V.I.K.)
- Virginia Family Nutrition Program, Virginia Tech, Blacksburg, VA 24061, USA
| | - Adrienne Holz
- School of Communication, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (V.E.H.); (E.S.); (V.I.K.)
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Consavage Stanley K, Kraak VI. Comment on Lau et al. Trends in Beef Intake in the United States: Analysis of the National Health and Nutrition Examination Survey, 2001-2018. Nutrients 2023, 15, 2475. Nutrients 2023; 15:3935. [PMID: 37764719 PMCID: PMC10537771 DOI: 10.3390/nu15183935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
We were interested to read the results of Lau et al., 2023 [...].
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Affiliation(s)
- Katherine Consavage Stanley
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA
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Kraak VI. Reply to M Mialon et al. Adv Nutr 2023; 14:1248-1249. [PMID: 37709370 PMCID: PMC10509401 DOI: 10.1016/j.advnut.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 09/16/2023] Open
Affiliation(s)
- Vivica I Kraak
- From the Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), 257 Wallace Hall, 295 West Campus Drive, Blacksburg, VA 24061.
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Kraak VI, Holz A, Woods CL, Whitlow AR, Leary N. A Content Analysis of Persuasive Appeals Used in Media Campaigns to Encourage and Discourage Sugary Beverages and Water in the United States. Int J Environ Res Public Health 2023; 20:6359. [PMID: 37510591 PMCID: PMC10379826 DOI: 10.3390/ijerph20146359] [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] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
The frequent consumption of sugary beverages is associated with many health risks. This study examined how persuasive appeals and graphics were used in different media campaigns to encourage and discourage sugary beverages and water in the United States (U.S.) The investigators developed a codebook, protocol and systematic process to conduct a qualitative content analysis for 280 media campaigns organized into a typology with six categories. SPSS version 28.0 was used to analyze rational and emotional appeals (i.e., positive, negative, coactive) for campaign slogans, taglines and graphic images (i.e., symbols, colors, audiences) for 60 unique campaigns across the typology. Results showed that positive emotional appeals were used more to promote sugary beverages in corporate advertising and marketing (64.7%) and social responsibility campaigns (68.8%), and less to encourage water in social marketing campaigns (30%). In contrast, public awareness campaigns used negative emotional appeals (48.1%), and advocacy campaigns combined rational (30%) and emotional positive (50%) and negative appeals (30%). Public policy campaigns used rational (82.6%) and positive emotional appeals (73.9%) to motivate support or opposition for sugary beverage tax legislation. Chi-square analyses assessed the relationships between the U.S. media campaign typology categories and graphic elements that revealed three variables with significant associations between the campaign typology and race/ethnicity (χ2(103) = 32.445, p = 0.039), content (χ2(103) = 70.760, p < 0.001) and product image (χ2(103) = 11.930, p = 0.036). Future research should examine how positive persuasive appeals in text and graphics can promote water to reduce sugary beverage health risks.
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Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA
| | - Adrienne Holz
- School of Communication, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA
| | - Chelsea L Woods
- School of Communication, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA
| | - Ann R Whitlow
- School of Communication, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA
| | - Nicole Leary
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA
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Kraak VI. Perspective: Examining Conflicts of Interest for Professional Service within the 2020 Dietary Guidelines Advisory Committee. Adv Nutr 2023; 14:432-437. [PMID: 36997092 PMCID: PMC10201810 DOI: 10.1016/j.advnut.2023.03.009] [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: 11/01/2022] [Revised: 02/06/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Abstract
Judgments and integrity uphold professionalism. Failure to manage professional conflicts of interest (COIs) may undermine trust in an individual, practitioner, or institution. This perspective article examines standards for nutrition researchers and practitioners to manage COIs for the Dietary Guidelines for Americans (DGA) process. Thereafter, this article analyzes a study published by Mialon et al. that raised concerns about the expert advisory committee selection process and management of COIs for 20 professionals appointed by the Department of Health and Human Services (HHS) and the USDA, who served on a federal government advisory committee to review evidence for the Dietary Guidelines Advisory Committee (DGAC) 2020 scientific report. The analysis found that Mialon et al. enumerated COIs for each DGAC member with industry, removed from the original context, which prevented readers from assessing the COI risk. Moreover, the USDA ethics office concluded that "the 20 committee members were in full compliance with the federal ethics rules applicable to special government employees." I conclude that Mialon et al. could use institutional mechanisms to encourage the USDA and HHS to strengthen future COI policies and procedures, aligned with the 2022 National Academies of Sciences, Engineering and Medicine report recommendations to improve the DGA 2025 to 2030 process.
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Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, United States.
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Kraak VI, Consavage Stanley K. An economic lens for sustainable dietary guidelines. Lancet Planet Health 2023; 7:e350-e351. [PMID: 37164507 DOI: 10.1016/s2542-5196(23)00075-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, Virginia 24061, USA.
| | - Katherine Consavage Stanley
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, Virginia 24061, USA
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Kraak VI, Davy BM. Multisectoral Strategies Needed to Establish Healthy Portion Size Norms That Disincentivize Hyperpalatable, Energy-Dense Foods and Sugary Beverages in Food Environments Linked to Obesity and Diet-Related Chronic Diseases in the United States. Curr Dev Nutr 2023; 7:100012. [PMID: 37180081 PMCID: PMC10111594 DOI: 10.1016/j.cdnut.2022.100012] [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] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/25/2022] Open
Abstract
Over 40 y, Americans have consumed larger portions of hyperpalatable, energy-dense foods, sugary beverages, and meals prepared at home and away from home, which have contributed to obesity and diet-related chronic diseases in the United States (US). This perspective article explores synergies between the portion size and food matrix effects, and their associated biological, physiological, environmental, and cultural susceptibilities for populations. Thereafter, we describe evidence of US public- and private-sector initiatives to reduce, standardize, and incentivize portion size norms to align with recommended servings to promote a healthy weight for children, adolescents, and adults. Practitioners could use the Individual plus Policy, System, and Environment (I + PSE) Framework to implement multisectoral strategies for the US government, businesses, and civil society organizations to establish healthy portion size norms aligned with servings recommended by the Dietary Guidelines for Americans 2020-2025, and to disincentivize overconsumption of hyperpalatable products to reduce obesity and chronic disease risks.
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Affiliation(s)
- Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, West Campus Drive, Virginia Tech, Blacksburg, VA, USA
| | - Brenda M. Davy
- Department of Human Nutrition, Foods, and Exercise, West Campus Drive, Virginia Tech, Blacksburg, VA, USA
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Houghtaling B, Englund T, Chen S, Pradhananga N, Kraak VI, Serrano E, Harden SM, Davis GC, Misyak S. Supplemental Nutrition Assistance Program (SNAP)-authorized retailers received a low score using the Business Impact Assessment for Obesity and population-level nutrition (BIA-Obesity) tool. BMC Public Health 2022; 22:1225. [PMID: 35725448 PMCID: PMC9208119 DOI: 10.1186/s12889-022-13624-9] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 06/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Supplemental Nutrition Assistance Program (SNAP) supports Americans with lower income to purchase dietary products at authorized retailers. This research aimed to evaluate SNAP-authorized retailers' public commitments in support of nutrition security and to examine differences between traditional grocers and nontraditional (e.g., convenience, drug, dollar) SNAP-authorized retailers' public commitments. METHODS Prominent United States (U.S.) SNAP-authorized retailers nationally and in two U.S. states (California and Virginia) were identified based on number of store locations (n = 61). Public information available in grey literature were reviewed and scored using the Business Impact Assessment for Obesity and population-level nutrition (BIA-Obesity) tool. SNAP-authorized retailers were classified as traditional (e.g., grocery) or nontraditional (e.g., non-grocery) retailers. Total BIA-Obesity from 0 to 615, representing low to optimal support) and category scores were calculated for corporate strategy, relationships with external organizations, product formulation, nutrition labeling, product and brand promotion, and product accessibility. Descriptive statistics were used to describe BIA-Obesity scores overall and by category. Mann-Whitney U was used to test for potential differences in median BIA-Obesity total scores between traditional and nontraditional SNAP-authorized retailers (a priori, p < 0.05). RESULTS Average total BIA-Obesity scores for SNAP-authorized retailers ranged from 0 to 112 (16.5 ± 23.3). Total BIA-Obesity scores for traditional SNAP-authorized retailers (32.7 ± 33.6; median 25) were higher than nontraditional SNAP-authorized retailer scores (11.2 ± 16; median 5) (p = 0.008). For BIA-Obesity categories, average scores were highest for the category relationships with external organizations (8.3 ± 10.3) and lowest for promotion practices (0.6 ± 2.1). CONCLUSIONS Results of this research underscore a dearth of available evidence and substantial opportunity for improvement regarding SNAP-authorized retailer strategies to support nutrition security among Americans with lower income.
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Affiliation(s)
- Bailey Houghtaling
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, 70803, US.
| | - Tessa Englund
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, US
| | - Susan Chen
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, CA, 95192, US
| | - Nila Pradhananga
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, 70803, US
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, 24061, US
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, 24061, US.,The Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, 24061, US
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, 24061, US
| | - George C Davis
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, 24061, US.,Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA, 24061, US
| | - Sarah Misyak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, 24061, US.,The Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, 24061, US
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Kraak VI, Consavage Stanley K, Harrigan PB, Zhou M. How have media campaigns been used to promote and discourage healthy and unhealthy beverages in the United States? A systematic scoping review to inform future research to reduce sugary beverage health risks. Obes Rev 2022; 23:e13425. [PMID: 35142020 PMCID: PMC9286342 DOI: 10.1111/obr.13425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/01/2022] [Accepted: 01/01/2022] [Indexed: 12/29/2022]
Abstract
Sugary beverage consumption is associated with many health risks. This study used a proof-of-concept media campaign typology to examine U.S. beverage campaigns that promoted healthy beverages and encouraged or discouraged sugary beverages. We used a three-step systematic scoping review to identify, organize, analyze, and synthesize evidence. Step 1 used Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines to search four electronic databases and gray literature through 2021. Step 2 categorized relevant media campaigns using a media campaign typology. Step 3 examined campaign evaluation outcomes. We identified 280 campaigns organized into six campaign typology categories. The media landscape was dominated by corporate marketing campaigns for branded sugary beverages (65.8%; n = 184) followed by public awareness (9.6%; n = 27), public policy (8.2%; n = 23), social marketing (7.1%; n = 20), corporate social responsibility (5.7%; n = 16), and countermarketing (3.6%; n = 10) campaigns. Evaluations for 20 unique campaigns implemented over 30 years (1992-2021) across 14 states showed reduced sugary beverage or juice and increased water or low-fat milk sales and intake. Positive short-term cognitive and mid-term retail and behavioral changes were reported. There was limited evidence for long-term policy, social norm, and population health outcomes. Future research is needed to use media campaigns in strategic communications to reduce sugary beverage health risks for Americans.
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Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | | | - Paige B Harrigan
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Mi Zhou
- Department of Public Health, University of California Merced, Merced, California, USA
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Consavage Stanley K, Harrigan PB, Serrano EL, Kraak VI. A systematic scoping review of the literacy literature to develop a digital food and nutrition literacy model for low-income adults to make healthy choices in the online food retail ecosystem to reduce obesity risk. Obes Rev 2022; 23:e13414. [PMID: 35092142 PMCID: PMC9286643 DOI: 10.1111/obr.13414] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/28/2022]
Abstract
Adults with lower incomes are disproportionately affected by poverty, food insecurity, obesity, and diet-related non-communicable diseases (NCDs). In 2020-2021 amid the coronavirus disease 2019 (COVID-19) pandemic, the United States Department of Agriculture (USDA) expanded the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot program to enable eligible participants to purchase groceries online in 47 states. This expansion underscores the need for SNAP adults to have digital literacy skills to make healthy dietary choices online. Currently, a digital literacy model does not exist to help guide USDA nutrition assistance policies and programs, such as SNAP. We conducted a systematic scoping review of the academic and gray literature to identify food, nutrition, health, media, financial, and digital literacy models. The search yielded 40 literacy models and frameworks that we analyzed to develop a Multi-dimensional Digital Food and Nutrition Literacy (MDFNL) model with five literacy levels (i.e., functional, interactive, communicative, critical, and translational) and a cross-cutting digital literacy component. Utilization of the MDFNL model within nutrition assistance policies and programs may improve cognitive, behavioral, food security, and health outcomes and support equity, well-being, digital inclusion, and healthy communities to reduce obesity and NCD risks.
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Affiliation(s)
| | - Paige B Harrigan
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Elena L Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA.,Virginia Family Nutrition Program, Virginia Tech, Blacksburg, Virginia, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
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Kraak VI. Advice for Food Systems Governance Actors to Decide Whether and How to Engage With the Agri-Food and Beverage Industry to Address Malnutrition Within the Context of Healthy and Sustainable Food Systems Comment on "Challenges to Establish Effective Public-Private Partnerships to Address Malnutrition in All Its Forms". Int J Health Policy Manag 2022; 11:401-406. [PMID: 34273934 PMCID: PMC9278466 DOI: 10.34172/ijhpm.2021.70] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/13/2021] [Indexed: 11/21/2022] Open
Abstract
The effectiveness of public-private partnerships (PPPs) to address malnutrition will depend on the issue, engagement purpose, policy context and actors' interactions. This commentary offers advice for governments, United Nations (UN) and civil society organizations to decide whether and how to engage with industry actors to improve diets for populations. First, food systems governance actors must acknowledge and reconcile competing visions, harmonize numerous corporate-engagement principles, and support a shared narrative to motivate collective actions toward healthy sustainable diets. Second, food systems governance actors have tools to guide engagement through many alliances, networks, coalitions and multi-stakeholder platforms with different levels of risk and trust. Third, food systems governance actors must prioritize accountability by setting corporate-performance threshold scores to justify private-sector engagement; evaluating engagement processes, outcomes and consequences; using incentives, financial penalties and social media advocacy to accelerate time-bound changes; and revoking UN consultative status for corporate actors who undermine healthy people and planet.
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Affiliation(s)
- Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Chen S, Kraak VI, Price TT, Love K, Byker Shanks C, Serrano EL. Exploring Food Waste at a Residential Youth Summer Camp: A Mixed-Methods Study. Journal of Hunger & Environmental Nutrition 2022. [DOI: 10.1080/19320248.2020.1806981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Susan Chen
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Tonya T. Price
- 4-H Youth Development, Virginia Tech, Harrisonburg, Virginia, USA
| | - Kenner Love
- Virginia Cooperative Extension, Rappahanock County Office, Washington, Virginia, USA
| | - Carmen Byker Shanks
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Elena L. Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
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Steketee A, Chen S, Nelson RA, Kraak VI, Harden SM. A mixed-methods study to test a tailored coaching program for health researchers to manage stress and achieve work-life balance. Transl Behav Med 2021; 12:369-410. [PMID: 34718809 DOI: 10.1093/tbm/ibab134] [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: 11/13/2022] Open
Abstract
Dissemination and implementation (D&I) researchers serve critical scientific, practical, and personal roles in translating science to public health benefit. However, they face multifaceted barriers that may erode their capacity to plan, lead, and evaluate implementation. Individualized coaching focused on human flourishing is an unexplored approach to fully actualize D&I researchers' capacity to bridge the research-practice gap. The purpose of this exploratory pilot study was to investigate a tailored coaching program to support human flourishing among D&I researchers. A pragmatic, mixed-methods approach guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework was used to evaluate an individualized, nine session coaching program called FUEL (Focus, Unplug, Exercise, Love). Reach and Implementation were assessed through descriptive statistics and rapid qualitative analysis of surveys and coaching logs. Effectiveness and Maintenance were assessed through descriptive statistics and iterative content analysis of participant surveys, as well as iterative content analysis of proxy (e.g., colleague) semi-structured interviews. Reach results indicated that demand for coaching exceeded study enrollment capacity (n = 16 participants). Implementation results showed that the coach spent 12.96 ± 2.82 hr per participant over 3 months. Effectiveness and Maintenance results indicated that FUEL was well-received and provided participants with myriad psychological and professional benefits. Preliminary evidence suggests that the FUEL coaching program is a promising and feasible approach to enhance flourishing among D&I researchers. Future research is needed to evaluate Adoption and scalability. This pilot study may inform future D&I capacity-building initiatives that address researchers' holistic situatedness within the implementation process.
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Affiliation(s)
- Abby Steketee
- Department of Human Nutrition, Foods, and Exercise at Virginia Polytechnic Institute and State University (Virginia Tech) in Blacksburg, Blacksburg, VA, USA
| | - Susan Chen
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, CA, USA
| | - Rachel A Nelson
- Department of Human Nutrition, Foods, and Exercise at Virginia Polytechnic Institute and State University (Virginia Tech) in Blacksburg, Blacksburg, VA, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise at Virginia Polytechnic Institute and State University (Virginia Tech) in Blacksburg, Blacksburg, VA, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise at Virginia Polytechnic Institute and State University (Virginia Tech) in Blacksburg, Blacksburg, VA, USA
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Kraak VI. Perspective: Unpacking the Wicked Challenges for Alternative Proteins in the United States: Can Highly Processed Plant-Based and Cell-Cultured Food and Beverage Products Support Healthy and Sustainable Diets and Food Systems? Adv Nutr 2021; 13:38-47. [PMID: 34662900 PMCID: PMC8803483 DOI: 10.1093/advances/nmab113] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/14/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
Over the past decade, a plethora of alternative protein (AP) products has entered the US food system as plant-based food and beverage products. These AP products, which include plant-based meat and dairy alternatives and cell-cultured meat and seafood products, are being developed for the marketplace to simulate the appearance, texture, taste, and flavor and nutritional profiles of animal products. The new generation of AP plant-based and cell-cultured food and beverage products are part of a market-driven narrative that has embraced technology to address future human health, environmental, ethical, and planetary health challenges. This perspective article synthesizes evidence about the benefits of adopting minimally processed plant-based diets that support sustainable food systems and human and planetary health. Thereafter, it examines 4 wicked challenges related to AP products in the US context that include 1) a confusing marketing landscape for the public; 2) diverse views and varying acceptance among consumers about the health and environmental benefits of these products; 3) inadequate education and labeling provided by federal agencies to enable consumers to understand how these may support healthy sustainable diets; and 4) slow federal policy and regulatory actions to address the range of AP products and provide industry guidance. The article concludes with suggested policies and actions for government agencies and food system actors to address these challenges. Future research and actions are needed to balance the human health, equity, animal welfare, and economic viability goals and to clarify how AP products may support safe, healthy, sustainable diets and food systems.
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Consavage Stanley K, Harrigan PB, Serrano EL, Kraak VI. Applying a Multi-Dimensional Digital Food and Nutrition Literacy Model to Inform Research and Policies to Enable Adults in the U.S. Supplemental Nutrition Assistance Program to Make Healthy Purchases in the Online Food Retail Ecosystem. Int J Environ Res Public Health 2021; 18:ijerph18168335. [PMID: 34444084 PMCID: PMC8394533 DOI: 10.3390/ijerph18168335] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
The United States (U.S.) Department of Agriculture (USDA)-administered Supplemental Nutrition Assistance Program (SNAP) made substantial changes in response to the coronavirus disease 2019 (COVID-19) pandemic. These changes highlight the need to identify the digital literacy skills and capacities of SNAP adults to purchase healthy groceries online. We conducted a scoping review of four electronic databases, Google and Google Scholar to identify studies that measured food and nutrition literacy outcomes for U.S. adults. We applied a multi-dimensional digital food and nutrition literacy (MDFNL) model to assess six literacy levels and components. Of 18 studies published from 2006-2021, all measured functional and interactive literacy but no study measured communicative, critical, translational, or digital literacy. Six studies examined SNAP or SNAP-Education outcomes. Adults with higher food or nutrition literacy scores had better cognitive, behavioral, food security and health outcomes. We suggest how these findings may inform research, policies, and actions to strengthen the multi-dimensional literacy skills of SNAP participants and SNAP-eligible adults to support healthy purchases in the online food retail ecosystem.
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Affiliation(s)
- Katherine Consavage Stanley
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
- Correspondence: ; Tel.: +1-540-231-9638
| | - Paige B. Harrigan
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
| | - Elena L. Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
- Virginia Family Nutrition Program, Virginia Tech, Blacksburg, VA 24061, USA
| | - Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
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Englund TR, Hedrick VE, Patiño SRG, Kennedy LE, Hosig KW, Serrano EL, Kraak VI. Awareness and outcomes of the fruits and veggies (FNV) campaign to promote fruit and vegetable consumption among targeted audiences in California and Virginia: a cross-sectional study. BMC Public Health 2021; 21:1100. [PMID: 34107896 PMCID: PMC8191097 DOI: 10.1186/s12889-021-11055-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/05/2020] [Accepted: 05/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background In 2015, the Partnership for a Healthier America launched the branded Fruits & Veggies (FNV) Campaign to apply a unique industry-inspired marketing approach to promote fruit and vegetable sales and intake to moms and teens in two US pilot markets: Fresno, California and Hampton Roads, Virginia. The aims of this cross-sectional study were to: 1) assess brand awareness and fruit- and vegetable-related outcomes among FNV Campaign target audiences in the California and Virginia market locations; and 2) examine whether reported awareness of the FNV Campaign was associated with differences in fruit- and vegetable-related cognitive and behavioral outcomes. Methods Data for this cross-sectional study were collected using an online survey administered to a non-probability convenience sample (n = 1604; February–July 2017) of youth aged 14–20 years (n = 744) and moms aged 21–36 years (n = 860) in the two pilot markets. Descriptive statistics were computed and outcomes compared between unaware and aware respondents, controlling for sociodemographic covariates. Multivariate analysis of covariance (MANCOVA) was conducted to assess whether fruit- and vegetable-related attitude, belief, and encouragement outcomes differed by FNV Campaign awareness; logistic regression was used to examine associations between FNV brand awareness and dichotomous variables (fruit- and vegetable-related behavioral intentions, trying new fruits and vegetables); and ANCOVA was used to assess associations with daily fruit and vegetable intake frequency. Results Approximately 20% (n = 315/1604) of respondents reported awareness of the FNV Campaign. Youth that reported awareness of the FNV Campaign (n = 167, 22.4%) had higher intentions to buy (p = 0.003) and eat (p = 0.009) fruits and vegetables than unaware respondents. Mothers that reported awareness of the FNV Campaign (n = 148, 17.2%) reported greater encouragement for friends and family to eat fruits and vegetables (p = 0.013) and were approximately 1.5 times more likely to report trying a new fruit or vegetable (p = 0.04) than mothers unaware of the Campaign. Daily fruit and vegetable intake frequency did not differ by Campaign awareness. Conclusions FNV Campaign awareness was associated with limited but positive short- and intermediate-term cognitive and behavioral outcomes among target audience respondents. These findings can inform future research to enhance understanding and improve the FNV Campaign as it is expanded to new markets nationwide. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11055-6.
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Affiliation(s)
- Tessa R Englund
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300, Thurston Building, CB 7280, Chapel Hill, NC, 27599, USA.
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 335-A Wallace Hall, 295 West Campus Drive, Blacksburg, Virginia, 24061, USA
| | - Sofía Rincón-Gallardo Patiño
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 338 Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, Virginia, 24061, USA
| | - Lauren E Kennedy
- Michigan State University Extension, Justin S. Morrill Hall of Agriculture, 446 W. Circle Drive, Room 409, East Lansing, MI, 48824-1039, USA
| | - Kathryn W Hosig
- Department of Population Health Sciences, Virginia Tech, Virginia-Maryland College of Veterinary Medicine, Room 334, 205 Duck Pond Drive, Blacksburg, VA, 24061, USA
| | - Elena L Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 327 Wallace Hall, 295 West Campus Drive, Blacksburg, Virginia, 24061, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 257 Wallace Hall, 295 West Campus Drive, Blacksburg, Virginia, 24061, USA
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Kraak VI, Consavage Stanley K. A Systematic Scoping Review of Media Campaigns to Develop a Typology to Evaluate Their Collective Impact on Promoting Healthy Hydration Behaviors and Reducing Sugary Beverage Health Risks. Int J Environ Res Public Health 2021; 18:ijerph18031040. [PMID: 33503920 PMCID: PMC7908303 DOI: 10.3390/ijerph18031040] [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] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 12/23/2022]
Abstract
Interventions to discourage sugary beverages and encourage water consumption have produced modest and unsustainable behavioral changes to reduce obesity and noncommunicable disease risks. This systematic scoping review examined media campaigns to develop a typology to support healthy hydration nonalcoholic beverage behaviors. Our three-step methodology included the following: (1) review and summarize expert-recommended healthy beverage guidelines; (2) review six English-language electronic databases guided by PRISMA to describe existing campaign types by issue, goal and underlying theory; and (3) develop a media campaign typology to support policies, systems and environments to encourage healthy hydration behaviors. Results showed no international consensus for healthy beverage guidelines, though we describe expert-recommended healthy beverage guidelines for the United States. Of 909 records identified, we included 24 articles describing distinct media campaigns and nine sources that defined models, schemes or taxonomies. The final media campaign typology included: (1) corporate advertising, marketing or entertainment; (2) corporate social responsibility, public relations/cause marketing; (3) social marketing; (4) public information, awareness, education/ health promotion; (5) media advocacy/countermarketing; and (6) political or public policy. This proof-of-concept media campaign typology can be used to evaluate their collective impact and support for a social change movement to reduce sugary beverage health risks and to encourage healthy hydration behaviors.
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Zhou M, Rincón-Gallardo Patiño S, Hedrick VE, Kraak VI. An accountability evaluation for the responsible use of celebrity endorsement by the food and beverage industry to promote healthy food environments for young Americans: A narrative review to inform obesity prevention policy. Obes Rev 2020; 21:e13094. [PMID: 32686243 DOI: 10.1111/obr.13094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/20/2020] [Accepted: 06/12/2020] [Indexed: 12/31/2022]
Abstract
Research has shown that celebrity endorsement is a marketing strategy primarily used to promote highly processed food and beverage products to children and adolescents, which negatively influences their diet quality and increases their risks of obesity. This study conducted an accountability evaluation to examine government, expert, and industry policies, guidelines, recommendations, and practices regarding using celebrity endorsement to support healthy marketing environment for young Americans. This study used the National Academy of Medicine's LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) to identify and synthesize relevant evidence between January 2000 and December 2019. We categorized the evidence in a five-step accountability framework and assigned each step a progress score (i.e., none, limited, some, and extensive). The findings showed that the US government made no progress to appoint an independent empowered body to evaluate celebrity endorsement practices. Stakeholders made some progress to take and hold industry and government to account and limited progress to share the account and to strengthen accountability structures. We suggest actions for diverse stakeholders to substantially strengthen accountability structures to ensure that celebrity endorsement is used to promote only healthy food environments to reduce obesity risks for young Americans.
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Affiliation(s)
- Mi Zhou
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
| | | | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
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Houghtaling B, Serrano E, Chen S, Kraak VI, Harden SM, Davis GC, Misyak S. Supplemental Nutrition Assistance Program (SNAP)-Authorized Retailers' Perceived Costs to Use Behavioral Economic Strategies to Encourage Healthy Product Sales. Ecol Food Nutr 2020; 60:212-224. [PMID: 33164562 DOI: 10.1080/03670244.2020.1833873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
SNAP-authorized retailers could use marketing-mix and choice-architecture (MMCA) strategies to improve SNAP purchases, but associated costs are unknown. Perceived cost and inconvenience to implement eight MMCA strategies were assessed among 29 U.S. retailers. Differences in perspective were explored (owners vs. managers, corporate vs. independent retailers, and by format). Place changes (e.g., added refrigeration) were perceived more costly and prompting (e.g., shelf labeling) less costly. Managers rated the perceived inconvenience to make proximity changes higher than owners (3.78 ± 1.4 and 2.33 ± 1.2, respectively) (p < .05). Results can inform strategies to improve the adoption and implementation of healthy food retail programs.
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Affiliation(s)
- Bailey Houghtaling
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, Louisiana, USA
| | - Elena Serrano
- Virginia Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Susan Chen
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - George C Davis
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA.,Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, Virginia, USA
| | - Sarah Misyak
- Virginia Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
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Abstract
Most Americans consume dietary sodium exceeding age-specific government-recommended targets of 1,500–2,300 mg/day per person. The majority (71%) of US dietary sodium comes from restaurant and packaged foods. Excess sodium intake contributes to hypertension and cardiovascular disease, which is the leading cause of death in the United States. This review summarizes evidence for policy progress to reduce sodium in the US food supply and the American diet. We provide a historical overview of US sodium-reduction policy (1969–2010), then examine progress toward implementing the 2010 National Academy of Medicine (NAM) sodium report's recommendations (2010–2019). Results suggest that the US Food and Drug Administration made no progress in setting mandatory sodium-reduction standards, industry made some progress in meeting voluntary targets, and other stakeholders made some progress on sodium-reduction actions. Insights from countries that have significantly reduced population sodium intake offer strategies to accelerate US progress toward implementing the NAM sodium-reduction recommendations in the future.
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Affiliation(s)
- Aviva A. Musicus
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
| | - Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - Sara N. Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
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Kraak VI. Star Trek Offers Insights That Illuminate Actor Engagement in Global Nutrition Governance Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool". Int J Health Policy Manag 2020; 11:233-238. [PMID: 32861233 PMCID: PMC9278616 DOI: 10.34172/ijhpm.2020.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/01/2020] [Indexed: 11/09/2022] Open
Abstract
This commentary describes insights from Star Trek’s fictional television series to understand how state and non-state actors address conflicts of interest (COIs) through global nutrition governance. I examine the findings of Ralston and colleagues for 44 state and non-state actors who responded to the World Health Organization’s (WHO’s) consultation for a COI risk-assessment tool, developed for member states to engage effectively with non-state actors to address malnutrition in all forms. Star Trek reveals that actor engagement is inevitable in a shared universe. The Prime Directive is a non-interference principle reflecting a moral commitment to reduce harm, respect autonomy and protect rights. Engagement principles are relevant to all actors who influence nutrition policies and programs, and must be held accountable when their actions undermine healthy and sustainable food systems. Certain actors use COI to justify non-engagement with commercial actors yet competing interests, biases, corruption and regulatory capture are distinct challenges to manage. Finally, Star Trek’s characters serve as allegories to understand actors’ motives and actions to promote healthy and sustainable food systems. Unlike non-state actors, states are legally required to achieve their commitments and targets in the United Nations’ (UN) Decade of Action on Nutrition (2016-2025) and Sustainable Development Goals (SDGs) 2030 Agenda.
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Affiliation(s)
- Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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23
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Englund TR, Zhou M, Duffey KJ, Kraak VI. A Qualitative Study to Understand Stakeholders' Views About the Fruits & Veggies (FNV) Social Marketing Campaign to Promote Fruit and Vegetable Consumption in the United States. J Acad Nutr Diet 2020; 120:1986-1997.e3. [PMID: 32788099 DOI: 10.1016/j.jand.2020.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND In 2015, the Partnership for a Healthier America (PHA) piloted a branded social marketing communications initiative called the FNV (Fruits & Veggies) Campaign to promote the sale and consumption of fruits and vegetables among mom and teen target audiences in 2 California and Virginia pilot markets. After the first year, FNV was expanded to multiple markets across the United States through diverse partnerships. Factors, resources, and strategies that contribute to the effectiveness and sustainability of the campaign need to be identified. OBJECTIVE The purpose of this qualitative study was to explore diverse stakeholders' views and expectations about the FNV Campaign design, reach, effectiveness, and impact and prospects for expansion, scale-up, and sustainability. DESIGN Semistructured interviews were conducted between July and October 2016 with stakeholders to elicit their perspectives and expectations of the FNV Campaign. PARTICIPANTS/SETTING A purposive sample of diverse stakeholders (n = 22) affiliated with national, state, and local industry and government and nongovernmental organizations. ANALYSIS Data were recorded, transcribed, input into NVivo 11 software (QSR International. Melbourne, Australia), coded and organized thematically using a conceptual framework that examined campaign design, reach, effectiveness, adoption, implementation, expansion, scaling up, and sustainability. RESULTS Opportunities, challenges, and expectations of stakeholders were reported for the FNV Campaign related to engaging future partners from different levels of community, government, and industry; conducting and disseminating findings from multifaceted evaluations; ensuring campaign effectiveness; and developing and improving campaign elements for target audiences and partner adoption. Conducting formative research, partner, and audience engagement, implementation, and evaluation are essential to the ensure effectiveness and sustainability of the FNV Campaign. CONCLUSIONS Insights from this study can inform the strategic use of social marketing campaign elements to facilitate the effectiveness and sustainability of the FNV Campaign as it expands and is scaled up across markets nationwide.
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Rincón-Gallardo Patiño S, Zhou M, Da Silva Gomes F, Lemaire R, Hedrick V, Serrano E, Kraak VI. Effects of Menu Labeling Policies on Transnational Restaurant Chains to Promote a Healthy Diet: A Scoping Review to Inform Policy and Research. Nutrients 2020; 12:nu12061544. [PMID: 32466387 PMCID: PMC7352298 DOI: 10.3390/nu12061544] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 04/30/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 01/06/2023] Open
Abstract
There is insufficient evidence that restaurant menu labeling policies are cost-effective strategies to reduce obesity and diet-related non-communicable diseases (NCDs). Evidence suggests that menu labeling has a modest effect on calories purchased and consumed. No review has been published on the effect of menu labeling policies on transnational restaurant chains globally. This study conducted a two-step scoping review to map and describe the effect of restaurant menu labeling policies on menu reformulation. First, we identified national, state, and municipal menu labeling policies in countries from global databases. Second, we searched four databases (i.e., PubMed, CINHAL/EBSCO, Web of Science, and Google Scholar) for peer-reviewed studies and gray-literature sources in English and Spanish (2000–2020). Step 1 identified three voluntary and eight mandatory menu labeling policies primarily for energy disclosures for 11 upper-middle and high-income countries, but none for low- or middle-income countries. Step 2 identified 15 of 577 studies that met the inclusion criteria. The analysis showed reductions in energy for newly introduced menu items only in the United States. We suggest actions for governments, civil society organizations, and the restaurant businesses to develop, implement, and evaluate comprehensive menu labeling policies to determine whether these may reduce obesity and NCD risks worldwide.
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Affiliation(s)
- Sofía Rincón-Gallardo Patiño
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (M.Z.); (V.H.); (E.S.); (V.I.K.)
- Correspondence:
| | - Mi Zhou
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (M.Z.); (V.H.); (E.S.); (V.I.K.)
| | - Fabio Da Silva Gomes
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, World Health Organization, Washington, DC 20037, USA;
| | - Robin Lemaire
- Center for Public Administration and Policy, School of Public and International Affairs, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Valisa Hedrick
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (M.Z.); (V.H.); (E.S.); (V.I.K.)
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (M.Z.); (V.H.); (E.S.); (V.I.K.)
| | - Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (M.Z.); (V.H.); (E.S.); (V.I.K.)
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Kraak VI. The US Chain Restaurant Industry Must Transform Its Business Model to Market Healthy Menu Items to Americans to Reduce Obesity and Chronic Disease Risks. J Nutr 2020; 150:656-657. [PMID: 32091588 DOI: 10.1093/jn/nxaa041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/28/2020] [Accepted: 02/05/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
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Houghtaling B, Serrano E, Dobson L, Chen S, Kraak VI, Harden SM, Davis GC, Misyak S. Rural independent and corporate Supplemental Nutrition Assistance Program (SNAP)-authorized store owners' and managers' perceived feasibility to implement marketing-mix and choice-architecture strategies to encourage healthy consumer purchases. Transl Behav Med 2020; 9:888-898. [PMID: 31570926 DOI: 10.1093/tbm/ibz091] [Citation(s) in RCA: 15] [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] [Indexed: 11/14/2022] Open
Abstract
Supplemental Nutrition Assistance Program (SNAP) participants could benefit from exposure to marketing-mix and choice-architecture (MMCA) strategies that encourage healthy consumer purchases. However, the perceived feasibility of independent and corporate SNAP-authorized store owners and managers (e.g., retailers) to implement healthy MMCA strategies is understudied. The purpose of this study was to inform a healthy food retail program that meets both public health and business expectations by prioritizing retailer perspectives. A mixed methods approach was used. Retailers completed a card sorting exercise to determine perceived feasibility to implement MMCA strategies place, profile, portion, pricing, promotion, priming, prompting, and proximity. This process was audio-recorded. Chi-square was used to identify potential differences in perceived feasibility to implement healthy MMCA strategies between independent and corporate SNAP-authorized retailers. Qualitative data were coded among a panel to construct themes. Themes were organized by barriers and facilitators and coded for strategy acceptability, appropriateness, and feasibility. SNAP-authorized retailers' (n = 29) considered prompting (e.g., labeling; 83%) and proximity (e.g., location; 90%) strategies to encourage healthy consumer purchases highly feasible. Few differences were detected between independent and corporate retailers' perceived feasibility to implement healthy MMCA strategies. The largest barriers to implementing healthy MMCA strategies were related to strategy appropriateness. Priorities for healthy food retail initiatives included prompting and proximity changes that highlight products aligned with the DGA, without altering products available to consumers that are misaligned with the DGA. Future work is required to understand how other healthy MMCA strategies may be adapted to enhance their appropriateness for these settings.
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Affiliation(s)
- Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Elena Serrano
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Liza Dobson
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Susan Chen
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - George C Davis
- Department of Agricultural and Applied Economics, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Sarah Misyak
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, USA
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Englund TR, Hedrick VE, Duffey KJ, Kraak VI. Evaluation of integrated marketing communication strategies used for the Fruits & Veggies Campaign in California and Virginia. Prev Med Rep 2020; 18:101062. [PMID: 32140384 PMCID: PMC7049653 DOI: 10.1016/j.pmedr.2020.101062] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/23/2020] [Accepted: 02/08/2020] [Indexed: 11/28/2022] Open
Abstract
About one-fifth of target audience respondents were aware of the FNV Campaign. More teens were aware of the FNV Campaign than moms. Social media was the most frequently recalled FNV marketing strategy. Stakeholders’ views on FNV marketing strategies aligned with respondents’ recall.
In 2015, the Partnership for a Healthier America launched the branded Fruits & Veggies (FNV) Campaign to promote fruit and vegetable sales and intake to moms and teens in two California and Virginia pilot markets. The FNV Campaign used a novel, creative approach to promote fruits and vegetables through integrated marketing communication (IMC) strategies. Findings from a mixed-methods process evaluation conducted between 2016 and 2017 were used to explore congruence between stakeholders’ expectations of IMC strategy potential and FNV brand awareness and reach among target audiences. Awareness and recall of IMC strategies were assessed through a cross-sectional survey of target audience respondents (n = 1604) from the pilot markets. Qualitative data regarding IMC strategy potential and influential factors were gathered from stakeholder interviews (n = 22). Approximately 19.6% (n = 315) of respondents were aware of the FNV Campaign. Stakeholders’ perspectives regarding IMC potential aligned with findings that the proportion of aware respondents was significantly (p = 0.008) higher among teens (22%) than moms (17%). Qualitative results also converged with higher proportions of survey respondents recalling brand exposure through social media (46%) and retail settings (30%) than community activities (18%), word of mouth (17.5%), and traditional media advertisements (9.5%). IMC recall did not differ between mom and teen respondents except for significantly (p = 0.02) higher word of mouth recall among teen respondents. Findings support using selected IMC strategies and future involvement of diverse stakeholders. Evaluation results can inform future research and practice to improve IMC strategy reach and influence as the FNV Campaign expands to new markets nationwide.
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Affiliation(s)
- Tessa R Englund
- Department of Human Nutrition, Foods, and Exercise, 338 Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, VA 24061, USA
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, 335-A Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, VA 24061, USA
| | - Kiyah J Duffey
- Department of Human Nutrition, Foods, and Exercise, 338 Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, VA 24061, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, 257 Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, VA 24061, USA
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Houghtaling B, Serrano E, Dobson L, Kraak VI, Harden SM, Davis GC, Misyak S. Perceptions of Rural SNAP-Authorized Food Store Owners and Managers About Healthy Product Availability. J Nutr Educ Behav 2020; 52:171-179. [PMID: 31732431 DOI: 10.1016/j.jneb.2019.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 09/24/2019] [Accepted: 09/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Supplemental Nutrition Assistance Program (SNAP)-authorized retailers' healthy perceptions and store availability of healthy products were explored to plan a healthy food retail program. METHODS Cognitive anthropology (free list) and quantitative (food environment measure) methods were used to assess retailers' healthy product perceptions and the availability of store products aligned with dietary guidance. Cultural domain analysis techniques and descriptive and inferential statistics were used to interpret data. RESULTS SNAP-authorized retailers (n = 29) of rural grocery (17%), dollar (14%), convenience (66%), and specialty (3%) stores participated. There was low salience for what constituted healthy and misalignments with dietary guidance and inventory. Dried beans, nuts, and seeds were widely available products across all stores and were listed less frequently by retailers. CONCLUSIONS AND IMPLICATIONS Engagement with SNAP-authorized retailers to develop retailer-focused nutrition education and/or training protocols is warranted to improve the capacity for retailers to market store products aligned with dietary guidance.
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Affiliation(s)
- Bailey Houghtaling
- School of Nutrition and Food Sciences, Louisiana State University AgCenter, Baton Rouge, LA.
| | - Elena Serrano
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Liza Dobson
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - George C Davis
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA
| | - Sarah Misyak
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
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Englund TR, Zhou M, Hedrick VE, Kraak VI. How Branded Marketing and Media Campaigns Can Support a Healthy Diet and Food Well-Being for Americans: Evidence for 13 Campaigns in the United States. J Nutr Educ Behav 2020; 52:87-95. [PMID: 31672282 DOI: 10.1016/j.jneb.2019.09.018] [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] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/04/2019] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
This report summarizes the available evidence for strategies used in large-scale, branded marketing campaigns to promote healthy dietary behaviors to Americans between 1990 and 2016. An adapted health-branding framework guided the 3-step mixed-methods approach to identify evidence for campaigns using a scoping review, comprehensive literature review, and key-informant interviews (n = 11). Results show that industry, government, and nongovernmental organizations supported 13 campaigns that used various health-branding strategies. The authors suggest opportunities that may inform the design and evaluation of diet-related campaigns to improve understanding and application of health-branding strategies to promote a healthy diet and to advance consumer health and well-being.
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Affiliation(s)
- Tessa R Englund
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
| | - Mi Zhou
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
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Kraak VI, Rincón-Gallardo Patiño S, Sacks G. An accountability evaluation for the International Food & Beverage Alliance's Global Policy on Marketing Communications to Children to reduce obesity: A narrative review to inform policy. Obes Rev 2019; 20 Suppl 2:90-106. [PMID: 31034139 DOI: 10.1111/obr.12859] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
United Nations (UN) organizations have urged governments to restrict the marketing of unhealthy food and nonalcoholic beverage products to children. This study conducted an accountability evaluation for the International Food & Beverage Alliance's (IFBA's) Global Policy on Marketing Communications to Children (Global Policy) compared with UN and other best-practice recommendations. We used the National Academy of Medicine's LEAD (ie, locate, evaluate, assemble evidence to inform decisions) framework to identify evidence (January 2004 to October 2018). We assigned a progress score (ie, none, limited, some, extensive) for five accountability steps. No progress was made to appoint an empowered body to evaluate IFBA's Global Policy. IFBA and the Access to Nutrition Foundation made some progress to take and share the account. Diverse actors made no progress to hold IFBA to account for nonadherence or to strengthen accountability structures for future compliance. IFBA could strengthen its Global Policy to align with best practices. UN organizations and other stakeholders should encourage IFBA firms to restrict the marketing of unhealthy foods and beverages to reduce children's obesity risk. This evaluation is relevant to all firms and industry associations that market products to children that undermine their diet and health.
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Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | | | - Gary Sacks
- Global Obesity Centre (GLOBE), Deakin University, Geelong, Victoria, Australia
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Affiliation(s)
- Vivica I Kraak
- Vivica I. Kraak is with the Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg
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Kraak VI. Critique of a scoping review of principles to guide interactions between population health researchers and the food industry. Obes Rev 2019; 20:1335-1337. [PMID: 31293040 DOI: 10.1111/obr.12890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
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Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, De Schutter O, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika SK, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed A, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet 2019; 393:791-846. [PMID: 30700377 DOI: 10.1016/s0140-6736(18)32822-8] [Citation(s) in RCA: 1142] [Impact Index Per Article: 228.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/10/2018] [Accepted: 10/29/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand; Global Obesity Centre, School of Health & Social Development, Deakin University, Geelong, VIC, Australia.
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Steven Allender
- Global Obesity Centre, School of Health & Social Development, Deakin University, Geelong, VIC, Australia
| | | | - Phillip I Baker
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Jessica R Bogard
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | | | | | - Olivier De Schutter
- Institute for Interdisciplinary Research in Legal Sciences, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Raji Devarajan
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Canberra, ACT, Australia
| | - Shifalika Goenka
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India
| | - Ross A Hammond
- Center on Social Dynamics & Policy, The Brookings Institution, Washington, DC, USA; Public Health & Social Policy Department, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Gerard Hastings
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Corinna Hawkes
- Centre for Food Policy, City University, University of London, London, UK
| | - Mario Herrero
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Peter S Hovmand
- Social System Design Lab, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Mark Howden
- Climate Change Institute, Australian National University, Canberra, ACT, Australia
| | - Lindsay M Jaacks
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ariadne B Kapetanaki
- Department of Marketing and Enterprise, Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
| | - Matt Kasman
- Center on Social Dynamics & Policy, The Brookings Institution, Washington, DC, USA
| | - Harriet V Kuhnlein
- Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Montreal, QC, Canada
| | | | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Michael W Long
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Victor K R Matsudo
- Physical Fitness Research Laboratory of São Caetano do Sul, São Caetano do Sul, São Paulo, Brazil
| | - Susanna D H Mills
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Alexandra Morshed
- Prevention Research Center, Brown School, Washington University in St Louis, St Louis, MO, USA
| | | | - An Pan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Gary Sacks
- Global Obesity Centre, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Meera Shekar
- Health, Nutrition, and Population Global Practice, The World Bank, Washington, DC, USA
| | | | - Warren Smit
- African Centre for Cities, University of Cape Town, Cape Town, South Africa
| | - Ali Tootee
- Diabetes Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Stefanie Vandevijvere
- School of Population Health, University of Auckland, Auckland, New Zealand; Scientific Institute of Public Health (Sciensano), Brussels, Belgium
| | - Wilma E Waterlander
- Department of Public Health Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - William H Dietz
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Houghtaling B, Serrano EL, Kraak VI, Harden SM, Davis GC, Misyak SA. A systematic review of factors that influence food store owner and manager decision making and ability or willingness to use choice architecture and marketing mix strategies to encourage healthy consumer purchases in the United States, 2005-2017. Int J Behav Nutr Phys Act 2019; 16:5. [PMID: 30642352 PMCID: PMC6332888 DOI: 10.1186/s12966-019-0767-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background Altering food store environments is a promising approach to encourage healthy product purchases by consumers to improve their diet quality and health. Food store owners and managers are intermediaries to ensure that environmental changes are enacted. Despite their role as gatekeepers to implement and sustain healthy food environment changes, no systematic review has been published that examines food store owner and manager (retailer) data. Thus a review of retailer information available within the expansive United States (US) food environment literature was the purpose of this research. Methods The PRISMA protocol was used. A search strategy, including published articles from years 1980–2017, was applied to six databases to locate relevant articles that addressed the perspective of food store retailers in the US. Data were extracted, organized, and agreed upon between two authors based on pre-designed constructs: (1) a social-ecological model to capture factors that influence retailer decision making; and (2) a marketing-mix and choice-architecture framework to examine perspectives of applied (or the prospective application of) strategies at the store-level. Study quality was assessed using quality criteria checklists for qualitative and quantitative research. Results Thirty-one articles met inclusion criteria and most studies (n = 22) were qualitative and conducted in urban food stores (n = 23). Multiple social-ecological factors influenced retailer decision making and ability or willingness to use marketing-mix and choice-architecture strategies to improve consumers’ healthy choices to support dietary quality. These factors included: conflicting training outcomes to enhance retailers’ knowledge and skills (individual, n = 9); the importance of trust (interpersonal, n = 8); views about marketing-mix and choice-architecture strategies in the food environment (n = 25); consumer demand or demographics (community, n = 19); supplier and food store management variables (systems or sectors, n = 18); local and federal policy (n = 8); and support for community health (norms/values, n = 8). Conclusions Research partnerships can support favorable business and public health outcomes to align with retailers’ business models and available resources. A participatory and translational approach to food environment research will likely maximize public health impact. Urban and rural food store retailers are important actors for future research to inform the feasibility of store retailers to apply MMCA strategies that are profitable and promote health. Electronic supplementary material The online version of this article (10.1186/s12966-019-0767-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, 337 Wallace Hall, 295 West Campus Drive, Virginia Tech, Blacksburg, Virginia, VA, 24061, USA.
| | - Elena L Serrano
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - George C Davis
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, Virginia, USA
| | - Sarah A Misyak
- Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
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35
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Affiliation(s)
- Vivica I Kraak
- From the Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
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Kraak VI, Englund T, Misyak S, Serrano EL. A novel marketing mix and choice architecture framework to nudge restaurant customers toward healthy food environments to reduce obesity in the United States. Obes Rev 2017; 18:852-868. [PMID: 28560794 DOI: 10.1111/obr.12553] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/16/2017] [Accepted: 03/20/2017] [Indexed: 01/19/2023]
Abstract
This review identified and adapted choice architecture frameworks to develop a novel framework that restaurant owners could use to promote healthy food environments for customers who currently overconsume products high in fat, sugar and sodium that increase their risk of obesity and diet-related non-communicable diseases. This review was conducted in three steps and presented as a narrative summary to demonstrate a proof of concept. Step 1 was a systematic review of nudge or choice architecture frameworks used to categorize strategies that cue healthy behaviours in microenvironments. We searched nine electronic databases between January 2000 and December 2016 and identified 1,244 records. Inclusion criteria led to the selection of five choice architecture frameworks, of which three were adapted and combined with marketing mix principles to highlight eight strategies (i.e. place, profile, portion, pricing, promotion, healthy default picks, prompting or priming and proximity). Step 2 involved conducting a comprehensive evidence review between January 2006 and December 2016 to identify U.S. recommendations for the restaurant sector organized by strategy. Step 3 entailed developing 12 performance metrics for the eight strategies. This framework should be tested to determine its value to assist restaurant owners to promote and socially normalize healthy food environments to reduce obesity and non-communicable diseases.
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Affiliation(s)
- V I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, USA
| | - T Englund
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, USA
| | - S Misyak
- Virginia Cooperative Extension's Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - E L Serrano
- Virginia Cooperative Extension's Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
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Abstract
To address obesity and diet-related chronic diseases in the United States, organizations such as the Robert Wood Johnson Foundation and the Institute of Medicine have encouraged the use of voluntary engagement strategies among stakeholders. By using public-private partnerships as well as networks, alliances, and coalitions, voluntary engagement can translate evidence-informed dietary recommendations into effective policies and actions and into innovative products and services. We offer six guiding principles and a decision-making framework that stakeholders can use to ensure that partnerships are accountable and effective in their pursuit of health-related goals. We apply the principles and framework to four national partnerships of US food, beverage, and food retail industry stakeholders working to prevent child obesity and to promote healthy food environments through product reformulation and healthy food retail incentives. We conclude that partnerships should be evaluated for their synergy, accountability, and effectiveness at achieving the partners' objectives. Independent evaluations will help build credibility and public trust in the capacity of voluntary engagement strategies to promote healthy food environments and positively influence public health.
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Affiliation(s)
- Vivica I Kraak
- Vivica I. Kraak is an assistant professor of food and nutrition policy in the Department of Human Nutrition, Foods, and Exercise at Virginia Polytechnic Institute and State University, in Blacksburg, Virginia
| | - Mary Story
- Mary Story is a professor of global health and community and family medicine in the Global Health Institute at Duke University, in Durham, North Carolina
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Kraak VI, Vandevijvere S, Sacks G, Brinsden H, Hawkes C, Barquera S, Lobstein T, Swinburn BA. Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children. Bull World Health Organ 2016; 94:540-8. [PMID: 27429493 PMCID: PMC4933136 DOI: 10.2471/blt.15.158667] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 02/10/2016] [Accepted: 02/12/2016] [Indexed: 12/25/2022] Open
Abstract
In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. We examined the actions taken between 2010 and early 2016 - by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organizations, philanthropic institutions and transnational industries - to help decrease the prevalence of obesity and diet-related noncommunicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organizations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors we investigated appears variable and generally less robust. We suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from noncommunicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030.
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Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 223 Wallace Hall, 295 West Campus Drive, Blacksburg, Virginia 24061, United States of America
| | | | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Burwood, Australia
| | | | - Corinna Hawkes
- Centre for Food Policy, City University London, London, England
| | - Simón Barquera
- National Institute of Public Health of México, Cuernavaca, Mexico
| | | | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
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Kraak VI, Story M. An accountability evaluation for the industry's responsible use of brand mascots and licensed media characters to market a healthy diet to American children. Obes Rev 2015; 16:433-53. [PMID: 25875469 DOI: 10.1111/obr.12279] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/03/2015] [Accepted: 02/22/2015] [Indexed: 11/29/2022]
Abstract
Corporate strategies that target children are controversial given the link between food marketing and childhood obesity. This case study explored diverse stakeholders' accountability expectations and actions for industry policies and practices that used popular cartoon brand mascots and media characters to promote food products to American children. We reviewed five electronic databases and Internet sources between January 2000 and January 2015. Evidence (n = 90) was selected based upon the Institute of Medicine's LEAD principles (i.e. locate, evaluate, assemble evidence to inform decisions) and organized into two tables: peer-reviewed articles, books and grey-literature reports (n = 34); and media stories, news releases and public testimony (n = 56). A four-step accountability framework was used to evaluate accountability structures. The results showed that moderate progress was achieved by stakeholders to take and share the account, limited progress to hold industry and government to account, and limited progress to strengthen accountability structures. Between 2006 and 2015, the U.S. Children's Food and Beverage Advertising Initiative lacked clear policies for companies to use brand mascots and media characters on food packages, in merchandising, and as toy giveaways and premiums. Government, industry and civil society can substantially strengthen their accountability for these food marketing practices to ensure healthy food environments for children.
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Affiliation(s)
- V I Kraak
- Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA, USA
| | - M Story
- Duke Global Health Institute, Duke University, Durham, NC, USA
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Kraak VI, Story M. Influence of food companies' brand mascots and entertainment companies' cartoon media characters on children's diet and health: a systematic review and research needs. Obes Rev 2015; 16:107-26. [PMID: 25516352 PMCID: PMC4359675 DOI: 10.1111/obr.12237] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [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] [Received: 09/03/2014] [Revised: 10/18/2014] [Accepted: 10/29/2014] [Indexed: 11/29/2022]
Abstract
Reducing the extent and persuasive power of marketing unhealthy foods to children worldwide are important obesity prevention goals. Research is limited to understand how brand mascots and cartoon media characters influence children's diet. We conducted a systematic review of five electronic databases (2000-2014) to identify experimental studies that measured how food companies' mascots and entertainment companies' media characters influence up to 12 diet-related cognitive, behavioural and health outcomes for children under 12 years. Eleven studies met the inclusion criteria. Studies used 21 unique popular media characters, but no brand mascots. Results suggest that cartoon media character branding can positively increase children's fruit or vegetable intake compared with no character branding. However, familiar media character branding is a more powerful influence on children's food preferences, choices and intake, especially for energy-dense and nutrient-poor foods (e.g. cookies, candy or chocolate) compared with fruits or vegetables. Future research should use a theoretically grounded conceptual model and larger and more diverse samples across settings to produce stronger findings for mediating and moderating factors. Future research can be used to inform the deliberations of policymakers, practitioners and advocates regarding how media character marketing should be used to support healthy food environments for children.
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Affiliation(s)
- V I Kraak
- Department of Human Nutrition, Foods and Exercise, Virginia Tech (Virginia Polytechnic Institute and State University)Blacksburg, Virginia, USA
| | - M Story
- Global Health and Community and Family Medicine, Duke UniversityDurham, North Carolina, USA
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Kraak VI, Swinburn B, Lawrence M, Harrison P. An accountability framework to promote healthy food environments. Public Health Nutr 2014; 17:2467-83. [PMID: 24564894 PMCID: PMC10282457 DOI: 10.1017/s1368980014000093] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [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: 05/01/2013] [Revised: 11/28/2013] [Accepted: 01/16/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To review the available literature on accountability frameworks to construct a framework that is relevant to voluntary partnerships between government and food industry stakeholders. DESIGN Between November 2012 and May 2013, a desk review of ten databases was conducted to identify principles, conceptual frameworks, underlying theories, and strengths and limitations of existing accountability frameworks for institutional performance to construct a new framework relevant to promoting healthy food environments. SETTING Food policy contexts within high-income countries to address obesity and diet-related non-communicable diseases. SUBJECTS Eligible resources (n 26) were reviewed and the guiding principles of fifteen interdisciplinary frameworks were used to construct a new accountability framework. RESULTS Strengths included shared principles across existing frameworks, such as trust, inclusivity, transparency and verification; government leadership and good governance; public deliberations; independent bodies recognizing compliance and performance achievements; remedial actions to improve accountability systems; and capacity to manage conflicts of interest and settle disputes. Limitations of the three-step frameworks and 'mutual accountability' approach were an explicit absence of an empowered authority to hold all stakeholders to account for their performance. CONCLUSIONS We propose a four-step accountability framework to guide government and food industry engagement to address unhealthy food environments as part of a broader government-led strategy to address obesity and diet-related non-communicable diseases. An independent body develops clear objectives, a governance process and performance standards for all stakeholders to address unhealthy food environments. The empowered body takes account (assessment), shares the account (communication), holds to account (enforcement) and responds to the account (improvements).
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Affiliation(s)
- Vivica I Kraak
- World Health Organization Collaborating Centre for Obesity Prevention, Deakin Population Health Strategic Research Centre, School of Health and Social Development, Faculty of Health, Deakin University, 221 Burwood Highway, Melbourne, Victoria 3125, Australia
| | - Boyd Swinburn
- Population Nutrition and Global Health, University of Auckland, Auckland, New Zealand
| | - Mark Lawrence
- Public Health Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Paul Harrison
- School of Business, Faculty of Business and Law, Deakin University, Burwood, Victoria, Australia
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Affiliation(s)
- Vivica I Kraak
- Vivica I. Kraak is with the World Health Organization Collaborating Centre for Obesity Prevention, Deakin Population Health Strategic Research Centre, School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, Australia. Boyd Swinburn is with the Department of Population Nutrition and Global Health, University of Auckland, Auckland, New Zealand. Mark Lawrence is with the School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University
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Cohen JFW, Rimm EB, Austin SB, Hyatt RR, Kraak VI, Economos CD. A food service intervention improves whole grain access at lunch in rural elementary schools. J Sch Health 2014; 84:212-219. [PMID: 24443783 PMCID: PMC4540181 DOI: 10.1111/josh.12133] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 01/20/2013] [Accepted: 03/03/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Whole grain (WG) options are often limited in schools, which may impact rural, low-income students who rely on school meals for a substantial portion of their food intake. This study examined the changes in the availability and quantity of WG and refined grain foods offered in schools participating in the Creating Healthy, Active and Nurturing Growing-up Environments (CHANGE) study, a randomized, controlled intervention among rural communities (4 intervention and 4 control). METHODS Foods were assessed using production records, recipes, and nutrition labels from breakfast and lunch over 1 week during fall 2008 and spring 2009. Key informant interviews were conducted with school food service directors in the spring 2009. RESULTS The CHANGE intervention schools significantly increased the average percent of school days WGs were offered (p = .047) and the amount of WGs offered/food item (ounces) at lunch compared with control schools (p = .02). There was a significant decrease in the percent of students with access to refined grains at lunch compared with control schools (p = .049), although there were no significant differences in WG availability during breakfast. CONCLUSIONS The CHANGE schools improved WG availability, enabling student's WG consumption to be closer to national recommendations.
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Affiliation(s)
- Juliana F. W. Cohen
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115
| | - Eric B. Rimm
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115
| | - S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Children's Hospital Boston and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115
| | - Raymond R. Hyatt
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111
| | - Vivica I. Kraak
- Deakin Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, Victoria 3125, Australia
| | - Christina D. Economos
- John Hancock Research Center on Physical Activity, Nutrition and Obesity Prevention, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 50 Harrison Avenue, Boston, MA 02111
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Cohen JF, Kraak VI, Choumenkovitch SF, Hyatt RR, Economos CD. The CHANGE study: a healthy-lifestyles intervention to improve rural children's diet quality. J Acad Nutr Diet 2014; 114:48-53. [PMID: 24126295 PMCID: PMC3867589 DOI: 10.1016/j.jand.2013.08.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 08/09/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite the high rates of overweight and obesity among rural children, there have been limited interventions reported to improve the diet quality of rural, low-income children in the United States. OBJECTIVE Our aim was to evaluate students' diet quality at baseline and after implementing the CHANGE (Creating Healthy, Active and Nurturing Growing-Up Environments) study, a 2-year (2007-2009) randomized, controlled, community- and school-based intervention to prevent unhealthy weight gain among rural school-aged children. DESIGN We used a school and community-based group randomized, controlled design. PARTICIPANTS/SETTING Data were collected in eight rural communities in California, Kentucky, Mississippi, and South Carolina (one elementary school per community). Children in grades 1 to 6 participated in the study (n=432; mean age=8.65 years ± 1.6 years). Students' diets were assessed at baseline (spring or early fall 2008) and post intervention (spring 2009) using the Block Food Screener for ages 2 to 17 years. STATISTICAL ANALYSES Mixed-model analysis of variance was used to examine the effect of the CHANGE study intervention on students' diets. Results were adjusted for corresponding baseline dietary values, sex, age, grade, race/ethnicity, and state, with school included as a random effect nested within condition. RESULTS At the end of 1 year, students enrolled in the CHANGE study intervention schools consumed significantly more vegetables (0.08 cups/1,000 kcal/day; P=0.03) and combined fruits and vegetables (0.22 cups/1,000 kcal/day; P<0.05) compared with students in control schools. Students in the intervention schools also showed a reduction in the average daily dietary glycemic index (GI=-1.22; P<0.05) and a trend toward more fruit consumption (0.15 cups/1,000 kcal/day; P=0.07). There were no significant differences in students' consumption of whole grains, legumes, dairy, potatoes/potato products, saturated fat, added sugars, or dietary fiber consumption. CONCLUSIONS The CHANGE study enhanced some aspects of rural students' dietary intake. Implementing similar interventions in rural America can be promising to support vegetable consumption.
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Affiliation(s)
- Juliana F.W. Cohen
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115
| | - Vivica I. Kraak
- Deakin Population Health Strategic Research Centre, School of Health and Social, Development, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC Australia, 3125, T: +61 410 646 941, F: +61 (0) 2 6125 0740,
| | - Silvina F Choumenkovitch
- John Hancock Research Center on Physical Activity, Nutrition, and Obesity, Prevention, Tufts University, 711 Washington Street, Boston, MA 02111-1524, T: 617-556-3288, F: 617-556-3344,
| | - Raymond R. Hyatt
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, 136 Harrison Avenue, Boston, MA 02111, , T: 617-636-3926, F: 617-636-4017
| | - Christina D. Economos
- John Hancock Research Center on Physical Activity, Nutrition and Obesity, Prevention, Gerald J. and, Dorothy R. Friedman School of Nutrition Science and, Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, T: 617-636-3784, F: 617-636-3781,
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Choumenkovitch SF, McKeown NM, Hyatt RR, Kraak VI, Cohen JFW, Economos CD. Food group consumption and its association with BMI z‐score and socioeconomic characteristics in rural school‐aged children. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.617.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Nicola M McKeown
- Nutritional Epidemiology ProgramJean Mayer USDA HNRCA at Tufts UniversityBostonMA
| | - Raymond R Hyatt
- Public Health and Community MedicineTufts University School of MedicineBostonMA
| | - Vivica I Kraak
- School of Health and Social DevelopmentDeakin UniversityBurwoodAustralia
| | | | - Christina D Economos
- John Hancock Research Center on Physical Activity, Nutrition, and Obesity PreventionTufts UniversityBostonMA
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Cohen J, Hyatt RR, Kraak VI, Choumenkovitch SF, Economos CD. A healthy‐lifestyles intervention improves children's diet quality in rural America. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.121.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Juliana Cohen
- Department of NutritionHarvard School of Public HealthBostonMA
| | | | - Vivica I Kraak
- Deakin Population Health Strategic Research CentreDeakin UniversityBurwoodAustralia
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Tovar A, Chui K, Hyatt RR, Kuder J, Kraak VI, Choumenkovitch SF, Hastings A, Bloom J, Economos CD. Healthy-lifestyle behaviors associated with overweight and obesity in US rural children. BMC Pediatr 2012; 12:102. [PMID: 22809332 PMCID: PMC3431239 DOI: 10.1186/1471-2431-12-102] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 07/18/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children's health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child's weight. METHODS A cross-sectional analysis was conducted on a sample of school-aged children (6-11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1-6) in rural America. After measuring children's height and weight, we17 assessed overweight and obesity (BMI ≥ 85th percentile) associations with these behaviors: improving diet quality18 (≥ 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (≥ 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (≤ 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance. RESULTS Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ≥ 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children. CONCLUSIONS Rural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children's health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change.
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Affiliation(s)
- Alison Tovar
- John Hancock Research Center on Physical Activity, Nutrition and Obesity Prevention, Gerald J, and Dorothy R, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave,, Boston, MA 0211, USA.
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Kraak VI, Story M, Wartella EA, Ginter J. Industry progress to market a healthful diet to American children and adolescents. Am J Prev Med 2011; 41:322-33; quiz A4. [PMID: 21855748 DOI: 10.1016/j.amepre.2011.05.029] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 05/06/2011] [Accepted: 05/11/2011] [Indexed: 11/26/2022]
Abstract
CONTEXT The IOM released an expert committee report in 2005 that assessed the nature, extent, and influence of food and beverage marketing practices on the diets and health of American children and adolescents. The report concluded that prevailing marketing practices did not support a healthful diet and offered recommendations for diverse stakeholders to promote a healthful diet. The investigators evaluated progress made by food, beverage, and restaurant companies; trade associations; entertainment companies; and the media to achieve the IOM report recommendations over 5 years. EVIDENCE ACQUISITION A literature review was conducted of electronic databases and relevant government, industry, and media websites between December 1, 2005, and January 31, 2011. Evidence selection was guided by the IOM LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) and five qualitative-research criteria, and it was validated by data and investigator triangulation. The investigators selected and categorized 117 data sources into two evidence tables used to evaluate industry progress (i.e., no, limited, moderate, and extensive). EVIDENCE SYNTHESIS Food and beverage companies made moderate progress; however, limited progress was made by other industry subsectors. Industry stakeholders used integrated marketing communications (IMC) to promote primarily unhealthy products, which threaten children's and adolescents' health and miss opportunities to promote a healthy eating environment. CONCLUSIONS Diverse industry stakeholders have several untapped opportunities to advance progress by promoting IMC to support a healthful diet; substantially strengthening self-regulatory programs; supporting truthful and non-misleading product labeling and health claims; engaging in partnerships; and funding independent evaluations of collective efforts.
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Affiliation(s)
- Vivica I Kraak
- Deakin Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia.
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Hennessy E, Kraak VI, Hyatt RR, Bloom J, Fenton M, Wagoner C, Economos CD. Active living for rural children: community perspectives using PhotoVOICE. Am J Prev Med 2010; 39:537-45. [PMID: 21084074 DOI: 10.1016/j.amepre.2010.09.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 06/16/2010] [Accepted: 09/03/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Active living integrates physical activity into one's daily routine. Current understanding of active living among children and their families living in rural communities is limited. A community perspective is critical to understand the contextual factors that influence children's physical activity in rural areas. PURPOSE The purpose of this study was to identify the perceived environmental factors that support or hinder physical activity among rural children to develop testable hypotheses to inform future interventions for reducing unhealthy weight gain and preventing chronic diseases associated with physical inactivity. METHODS PhotoVOICE was used to explore active living opportunities and barriers for children living in four low-income, rural U.S. communities. In 2007, parents (n=99) and elementary school staff (n=17) received disposable cameras to document their perspective. Using their photographs and narratives, participants developed emergent themes during a facilitated group discussion. In 2008, study authors used the Analysis Grid for Environments Linked to Obesity (ANGELO) framework to categorize the themes. RESULTS Microenvironment themes include physical (e.g., natural features, topography); sociocultural (e.g., isolation); policy (e.g., time for school recess); and economic (e.g., funding for physical activity programs). Macroenvironmental themes related to the built and natural environments and transportation infrastructure. CONCLUSIONS This study identified rural environment elements that community members perceived as influencing children's physical activity patterns. Certain aspects were unique to rural areas, whereas other urban and suburban factors may be generalizable to rural settings. PhotoVOICE was a useful participatory research method to gain insight into perceived factors affecting rural children's physical activity behaviors.
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Affiliation(s)
- Erin Hennessy
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
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