1
|
Cheung ESL. Neighborhood Gentrification and Food Insecurity among Urban Older Adults: Evidence from New York City. Gerontologist 2024:gnae048. [PMID: 38761043 DOI: 10.1093/geront/gnae048] [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: 09/18/2023] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Gentrification is a prevalent neighborhood development process in urban areas across the United States. Prior studies have identified the influence of gentrification on late-life health and quality of life, yet little is known about its relationship with food insecurity, an important public health issue for older adult populations. Using New York City as a case study, this study investigated associations between living in a gentrifying neighborhood and food insecurity, as well as the mediating roles of neighborhood environment factors-social cohesion, public transportation, and food environment. RESEARCH DESIGN AND METHODS This study adopted two waves of annual data from the Poverty Tracker Study (2015-16; N = 703) merged with American Community Survey and spatial datasets to measure gentrification and neighborhood factors. Adjusted logistic regressions were used to examine the associations between gentrification and food insecurity. Further mediation analyses were conducted to test the mechanisms of such associations. RESULTS Older adults in gentrifying neighborhoods were more likely to have food insecurity than those in moderate- to high-income neighborhoods. Compared to low-income neighborhoods, older adults in gentrifying neighborhoods had a lower likelihood of reporting food insecurity. Two significant mediators were found when comparing gentrification with moderate- to high-income neighborhoods: social cohesion and healthy food outlets. DISCUSSION AND IMPLICATIONS This study highlights the importance of gentrification in determining late-life food insecurity and identified possible mechanisms with policy and social service implications to reduce the risk of food insecurity in urban areas.
Collapse
Affiliation(s)
- Ethan Siu Leung Cheung
- Department of Family and Consumer Studies, The University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
2
|
Ganasegeran K, Abdul Manaf MR, Safian N, Waller LA, Abdul Maulud KN, Mustapha FI. GIS-Based Assessments of Neighborhood Food Environments and Chronic Conditions: An Overview of Methodologies. Annu Rev Public Health 2024; 45:109-132. [PMID: 38061019 DOI: 10.1146/annurev-publhealth-101322-031206] [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] [Indexed: 05/22/2024]
Abstract
The industrial revolution and urbanization fundamentally restructured populations' living circumstances, often with poor impacts on health. As an example, unhealthy food establishments may concentrate in some neighborhoods and, mediated by social and commercial drivers, increase local health risks. To understand the connections between neighborhood food environments and public health, researchers often use geographic information systems (GIS) and spatial statistics to analyze place-based evidence, but such tools require careful application and interpretation. In this article, we summarize the factors shaping neighborhood health in relation to local food environments and outline the use of GIS methodologies to assess associations between the two. We provide an overview of available data sources, analytical approaches, and their strengths and weaknesses. We postulate next steps in GIS integration with forecasting, prediction, and simulation measures to frame implications for local health policies.
Collapse
Affiliation(s)
- Kurubaran Ganasegeran
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
- Clinical Research Center, Seberang Jaya Hospital, Ministry of Health Malaysia, Penang, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
| | - Nazarudin Safian
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; ,
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Khairul Nizam Abdul Maulud
- Earth Observation Centre (EOC), Institute of Climate Change, Universiti Kebangsaan Malaysia, Selangor Darul Ehsan, Malaysia
- Department of Civil Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia, Selangor Darul Ehsan, Malaysia
| | - Feisul Idzwan Mustapha
- Public Health Division, Perak State Health Department, Ministry of Health Malaysia, Perak, Malaysia
| |
Collapse
|
3
|
Lima da Silva JM, Oliveira JS, Casagrande Borges D, Honório OS, Mendes LL, Canuto R. Social inequities in food deserts and food swamps in a northeastern Brazilian capital. J Biosoc Sci 2024; 56:493-503. [PMID: 38415307 DOI: 10.1017/s0021932024000087] [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] [Indexed: 02/29/2024]
Abstract
This study identified food deserts and swamps, investigating their associations with socioeconomic and demographic conditions. This ecological study was conducted using data from urban census tracts in the city of Recife, which were considered the unit of analysis. Information on food retail was obtained from government sources in 2019. Census tracts below the 25th percentile in the density of healthy food retail (i.e., those that predominantly sell natural or minimally processed foods, mixed businesses, and super- and hypermarkets) were classified as food deserts. Census tracts above the 25th percentile in the density of unhealthy food retail (i.e., those selling primarily ultra-processed foods) were considered food swamps. The socioeconomic and demographic conditions of the census tracts were evaluated using variables from the 2010 census (per capita income, average income, race, literacy of the head of household, and the availability of essential services) and the Health Vulnerability Index. Census tracts considered food deserts (28.5%) were more vulnerable, characterized by lower income and access to essential services, more illiterate residents and more minorities (Black/Indigenous/mixed race). Food swamps (73.47%) were more prevalent in less vulnerable neighbourhoods characterized by higher percentages of literate residents and Whites, greater purchasing power, and better basic sanitation. The characteristics of Recife's food deserts and swamps demonstrate social inequalities in the food environment. Public facilities could play a vital role in promoting healthy eating within food deserts. Additionally, future implementation of taxes on ultra-processed foods and the provision of tax subsidies to natural or minimally processed food sellers might contribute to fostering healthier dietary choices.
Collapse
Affiliation(s)
| | | | | | | | | | - Raquel Canuto
- Program in Nutrition, Universidade Federal de Pernambuco, Brazil
- Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Brazil
| |
Collapse
|
4
|
Duh-Leong C, Perrin EM, Heerman WJ, Schildcrout JS, Wallace S, Mendelsohn AL, Lee DC, Flower KB, Sanders LM, Rothman RL, Delamater AM, Gross RS, Wood C, Yin HS. Prenatal Risks to Healthy Food Access and High Birthweight Outcomes. Acad Pediatr 2024; 24:613-618. [PMID: 37659601 PMCID: PMC10904668 DOI: 10.1016/j.acap.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE Infants with high birthweight have increased risk for adverse outcomes at birth and across childhood. Prenatal risks to healthy food access may increase odds of high birthweight. We tested whether having a poor neighborhood food environment and/or food insecurity had associations with high birthweight. METHODS We analyzed cross-sectional baseline data in Greenlight Plus, an obesity prevention trial across six US cities (n = 787), which included newborns with a gestational age greater than 34 weeks and a birthweight greater than 2500 g. We assessed neighborhood food environment using the Place-Based Survey and food insecurity using the US Household Food Security Module. We performed logistic regression analyses to assess the individual and additive effects of risk factors on high birthweight. We adjusted for potential confounders: infant sex, race, ethnicity, gestational age, birthing parent age, education, income, and study site. RESULTS Thirty-four percent of birthing parents reported poor neighborhood food environment and/or food insecurity. Compared to those without food insecurity, food insecure families had greater odds of delivering an infant with high birthweight (adjusted odds ratios [aOR] 1.96, 95% confidence intervals [CI]: 1.01, 3.82) after adjusting for poor neighborhood food environment, which was not associated with high birthweight (aOR 1.35, 95% CI: 0.78, 2.34). Each additional risk to healthy food access was associated with a 56% (95% CI: 4%-132%) increase in high birthweight odds. CONCLUSIONS Prenatal risks to healthy food access may increase high infant birthweight odds. Future studies designed to measure neighborhood factors should examine infant birthweight outcomes in the context of prenatal social determinants of health.
Collapse
Affiliation(s)
- Carol Duh-Leong
- NYU Grossman School of Medicine (C Duh-Leong, RS Gross, and HS Yin), Division of General Pediatrics, Department of Pediatrics, New York, NY.
| | - Eliana M Perrin
- Johns Hopkins University (EM Perrin), Division of General Pediatrics, Department of Pediatrics, Schools of Medicine and Nursing, Baltimore, Md
| | - William J Heerman
- Vanderbilt University Medical Center (WJ Heerman and S Wallace), Department of Pediatrics, Nashville, Tenn
| | - Jonathan S Schildcrout
- Vanderbilt University Medical Center (JS Schildcrout), Department of Biostatistics, Nashville, Tenn
| | - Shelby Wallace
- Vanderbilt University Medical Center (WJ Heerman and S Wallace), Department of Pediatrics, Nashville, Tenn
| | - Alan L Mendelsohn
- NYU Grossman School of Medicine (AL Mendelsohn), Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York, NY
| | - David C Lee
- Ronald O. Perelman Department of Emergency Medicine (DC Lee), NYU Grossman School of Medicine, New York, NY
| | - Kori B Flower
- University of North Carolina at Chapel Hill (KB Flower), Division of General Pediatrics and Adolescent Medicine, UNC School of Medicine, Chapel Hill, NC
| | - Lee M Sanders
- Stanford University School of Medicine (LM Sanders), Division of General Pediatrics, Palo Alto, Calif
| | - Russell L Rothman
- Vanderbilt University Medical Center (RL Rothman), Institute of Medicine and Public Health, Nashville, Tenn
| | - Alan M Delamater
- University of Miami Miller School of Medicine (AM Delamater), Department of Pediatrics, Miami, Fla
| | - Rachel S Gross
- NYU Grossman School of Medicine (C Duh-Leong, RS Gross, and HS Yin), Division of General Pediatrics, Department of Pediatrics, New York, NY
| | - Charles Wood
- Duke University School of Medicine (C Wood), Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Durham, NC
| | - Hsiang Shonna Yin
- NYU Grossman School of Medicine (C Duh-Leong, RS Gross, and HS Yin), Division of General Pediatrics, Department of Pediatrics, New York, NY
| |
Collapse
|
5
|
Fei-Zhang DJ, Schellenberg SJ, Bentrem DJ, Wayne JD, Pawlik TM. The associations of food environment with gastrointestinal cancer outcomes in the United States. J Surg Oncol 2024. [PMID: 38648421 DOI: 10.1002/jso.27656] [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: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Social conditions and dietary behaviors have been implicated in the rising burden of gastrointestinal cancers (GIC). The "food environment" reflects influences on a community level relative to food availability, nutritional assistance, and social determinants of health. Using the US Department of Agriculture-Food Environment Atlas (FEA), we sought to characterize the association of food environment on GIC presenting stage and long-term survival. METHODS Patients diagnosed with GIC between 2013 and 2017 were identified using the SEER database. FEA-scores were based on 282 county-level food security variables, store-restaurant availability, SNAP/WIC enrollment, pricing/taxes, and producer vicinity adjusted-for factors of socioeconomic status, race-ethnicity, transportation access, and comorbidities. Relative FEA rankings across US counties were averaged into a composite score and assigned to patients by county-of-residence. The association of FEA, cancer stage, and survival were analyzed using multiple logistic regression and cox-proportional hazard models relative to White/non-White race/ethnicity. RESULTS Among 287,148 patients, the most common GIC-sites were colon (n = 97,942, 34%), pancreas (n = 49,785, 17.3%), liver (n = 31,098, 11.0%) and esophagus (n = 16,271, 5.7%). A worse food environment was independently associated with increased odds of late-stage diagnosis (esophageal odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01-1.05; hepatic OR: 1.06, 95% CI: 1.03-1.08; pancreatic OR: 1.04, 95% CI: 1.01-1.06) among all patients; in contrast, food environment was associated with colorectal cancer stage among non-White patients only (OR: 1.04, 95% CI: 1.03-1.06). Worse food environment was associated with worse 3-year survival (colon OR: 1.03, 95% CI: 1.01-1.04; hepatic OR: 1.12, 95% CI: 1.08-1.17; gastric OR: 1.07, 95% CI: 1.01-1.13). Similar associations were noted relative to overall survival among the entire cohort (biliary tract hazard ratio [HR]: 1.03, 95% CI: 1.01-1.05; esophageal HR: 1.02, 95% CI: 1.01-1.04; hepatic HR: 1.07, 95% CI: 1.06-1.09; pancreatic HR: 1.04, 95% CI: 1.02-1.05; rectum HR: 1.03, 95% CI: 1.01-1.04; gastric HR: 1.05, 95% CI: 1.03-1.07), as well as among non-White patients (biliary HR: 1.04, 95% CI: 1.01-1.07; colon HR: 1.03, 95% CI: 1.01-1.05; esophageal HR: 1.05, 95% CI: 1.02-1.08; hepatic HR: 1.08, 95% CI: 1.06-1.10) (all p < 0.003). CONCLUSIONS Food environment was independently associated with late-stage tumor presentation and worse 3-year and overall survival among GIC patients. Interventions to address inequities across communities relative to food environments are needed to alleviate disparities in cancer care.
Collapse
Affiliation(s)
- David J Fei-Zhang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - David J Bentrem
- Department of Surgery, Division of Surgical Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jeffrey D Wayne
- Department of Surgery, Division of Surgical Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Timothy M Pawlik
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, USA
| |
Collapse
|
6
|
Volpe R, Cai X, Tseng M, Sinclair W. Restaurant outlet density and the healthfulness of food purchases: evidence from FoodAPS. Front Nutr 2024; 11:1369240. [PMID: 38699546 PMCID: PMC11063296 DOI: 10.3389/fnut.2024.1369240] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/26/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The average American household's diet and food purchasing patterns are out of sync with federal recommendations. Researchers have connected this with the large and growing rates of obesity, diabetes, and other diet-related ailments in the U.S. Restaurant food has been discussed a potential contributor to unhealthful diets, as it is often calorically dense. We investigate the association between household access to restaurants and diet quality using USDA FoodAPS data and NPD ReCount data. Methods We define radii around households to measure restaurant outlet counts and apply a regression analysis incorporating household characteristics. Results We find that neither restaurant counts nor openings share many statistically or economically significant associations with average dietary quality. Household characteristics and demographics are far more powerful in explaining variation in diet quality. Discussion Our findings align with the large and growing body of empirical research that suggests that personal preferences and other household characteristics are more important than the food environment in explaining food choices and diet quality. Given the extant research on the importance of access to large supermarkets, our results suggest that access to food retailers is more important in explaining diet quality than access to restaurants.
Collapse
Affiliation(s)
- Richard Volpe
- California Polytechnic State University, San Luis Obispo, CA, United States
| | - Xiaowei Cai
- California Polytechnic State University, San Luis Obispo, CA, United States
| | - Marilyn Tseng
- California Polytechnic State University, San Luis Obispo, CA, United States
| | - Wilson Sinclair
- Economic Research Service, United States Department of Agriculture (USDA), Washington, DC, United States
| |
Collapse
|
7
|
Donovan B, Wiese D, Henry KA, Wu J, Rae L, Anderson J. Evaluating the Effects of Food Deserts and Food Swamps in an Urban Burn Patient Population. J Burn Care Res 2024:irae058. [PMID: 38630546 DOI: 10.1093/jbcr/irae058] [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: 11/16/2023] [Indexed: 04/19/2024]
Abstract
Poverty is a known risk factor for burn injury and is associated with residency in food deserts and food swamps. Our aim was to determine the prevalence of residency in food deserts and food swamps and to investigate the relationship between food environment, comorbidities, and wound healing in burn patients. We performed a retrospective chart review of all burn patients age ≥ 18 seen in the emergency department or admitted to the burn service at an ABA-verified urban academic center between January 2016 and January 2022. Patient GeoIDs were used to classify residency in food deserts and food swamps and comorbidities and demographics were recorded. A subset of patients with less than 20% total body surface area burns who underwent single-operation split-thickness skin grafting was identified for wound healing analysis. A total of 3,063 patients were included, with 206 in the heal-time analysis. 2,490 (81.3%) lived in food swamps and 96 (3.1%) lived in food deserts. Diabetes, hypertension, and tobacco smoking were more prevalent in food swamps than food deserts or good access areas. While there was no significant effect of food environment on wound healing, diabetes was associated with longer heal times. Most burn patients reside in food swamps, which are associated with a higher prevalence of hypertension, diabetes, and smoking. Food environment was not significantly associated with wound healing. Not having diabetes was associated with a shorter time to wound healing.
Collapse
Affiliation(s)
- Brienne Donovan
- Department of Surgery, Temple University Hospital, Philadelphia, USA
| | - Daniel Wiese
- Department of Geography and Urban Studies, Temple University College of Liberal Arts, Philadelphia, USA
| | - Kevin A Henry
- Department of Geography and Urban Studies, Temple University College of Liberal Arts, Philadelphia, USA
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, USA
| | - Lisa Rae
- Department of Surgery, Temple University Hospital, Philadelphia, USA
| | - Jeffrey Anderson
- Department of Surgery, Temple University Hospital, Philadelphia, USA
| |
Collapse
|
8
|
Fazzino TL, Summo C, Pasqualone A. The Italian food environment may confer protection from hyper-palatable foods: evidence and comparison with the United States. Front Nutr 2024; 11:1364695. [PMID: 38694228 PMCID: PMC11061459 DOI: 10.3389/fnut.2024.1364695] [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: 01/02/2024] [Accepted: 04/08/2024] [Indexed: 05/04/2024] Open
Abstract
Background Multi-national food corporations may saturate country-level food systems with hyper-palatable foods. However, the degree to which global food corporations have been integrated into country-level food systems may vary. Italy has largely retained local food production and may have low hyper-palatable food (HPF) availability in the food supply. The study quantified the prevalence of HPF in the Italian food system and compared the hyper-palatability of similar foods across Italy and the United States, which has wide HPF saturation. Methods A national food system dataset was used to characterize HPF availability in Italy. A representative sample of foods commonly consumed in both Italy and the US were collected and compared. Foods represented six categories: cookies/biscotti, cakes/merendine, salty snacks, industrial bread, frozen pizza and protein/cereal bars. A standardized definition from Fazzino et al. identified HPF. Results Less than one third (28.8%) of foods in the Italian food system were hyper-palatable. US HPF items had significantly higher fat, sugar, and/or sodium across most food categories (p values = 0.001 to 0.0001). Italian HPF items had higher fiber and/or protein relative to US HPF from the same category (p values = 0.01 to 0.0001). Conclusion The Italian food system may confer protection from HPF exposure. HPF products in Italy had lower palatability-related nutrients and higher satiety-promoting nutrients.
Collapse
Affiliation(s)
- Tera L. Fazzino
- Department of Psychology, University of Kansas, Lawrence, KS, United States
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, United States
| | - Carmine Summo
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Antonella Pasqualone
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| |
Collapse
|
9
|
Bradford CPJ, O'Malley CL, Moore HJ, Gray N, Townshend TG, Chang M, Mathews C, Lake AA. 'Acceleration' of the food delivery marketplace: Perspectives of local authority professionals in the North-East of England on temporary COVID regulations. NUTR BULL 2024. [PMID: 38605430 DOI: 10.1111/nbu.12672] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 02/28/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024]
Abstract
In January 2021, we assessed the implications of temporary regulations in the United Kingdom allowing pubs and restaurants to operate on a takeaway basis without instigating a change of use. Local authorities (LAs) across the North-East of England were unaware of any data regarding the take-up of these regulations, partially due to ongoing capacity issues; participants also raised health concerns around takeaway use increasing significantly. One year on, we repeated the study aiming to understand the impact of these regulations on the policy and practice of key professional groups. Specifically, we wanted to understand if LAs were still struggling with staff capacity to address the regulations, whether professionals still had public health trepidations, and if any unexpected changes had occurred across the local food environment because of the pandemic. We conversed with 16 public health professionals, planners and environmental health officers across seven LAs throughout the North-East of England via focus groups and interviews. Data collated were analysed via an inductive and semantic, reflexive-thematic approach. Through analysis of the data, three themes were generated and are discussed throughout: popular online delivery services as a mediator to increased takeaway usage; potential long-term health implications and challenges; continued uncertainty regarding the temporary regulations. This paper highlights important changes to local food environments, which public health professionals should be aware of, so they are better equipped to tackle health inequalities across urban and sub-urban areas.
Collapse
Affiliation(s)
- Callum P J Bradford
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Claire L O'Malley
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Helen J Moore
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Nick Gray
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Tim G Townshend
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- School of Architecture, Planning & Landscape, Newcastle University, Newcastle upon Tyne, UK
| | - Michael Chang
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, UK
| | - Claire Mathews
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, UK
| | - Amelia A Lake
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| |
Collapse
|
10
|
O'Malley SF, Ambikapathi R, Ghosh S, Galvin L, Jeong J, Mosha D, PrayGod G, Mapendo F, Shively G, Murray-Kolb LE, Gunaratna NS. Contribution of Food from Market Purchases and Home Production to Child Nutrient Intake: Evidence from the EFFECTS Study Baseline Data. J Nutr 2024:S0022-3166(24)00218-9. [PMID: 38608871 DOI: 10.1016/j.tjnut.2024.04.015] [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: 10/17/2023] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Child undernutrition is prevalent in Tanzania, and households rely primarily on local markets and home production as food sources. However, little is known about the contribution of food market purchases to nutrient intakes among children consuming complementary foods. OBJECTIVES To quantify the relationships between diversity of foods purchased and produced by households and adequate child nutrient intake in Mara, Tanzania. METHODS Cross-sectional baseline dietary and household food source data from the Engaging Fathers for Effective Child Nutrition and Development in Tanzania study were collected from mothers of 586 children aged 9-23 mo clustered in 80 villages in Mara, Tanzania. We conducted mixed effects linear regressions to quantify the association between the diversity of foods consumed at home, from market purchases and home production, and nutrient intake adequacy (based on 24-h food recalls). RESULTS Children had inadequate diets, with fewer than half of children consuming adequate amounts of vitamin A, vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B9 (folate), calcium, iron, and zinc. Breastfeeding was associated with higher overall mean adequacy (b = 0.15-0.19 across models, P < 0.001). Diversity of foods purchased was positively associated with the intake of vitamin B12 and calcium (both P < 0.001); this effect was attenuated among breastfed children. Among nonbreastfed children, production diversity was positively associated with vitamin A intake (b=0.04; P < .05) but not with intake of other nutrients. CONCLUSIONS Both household food purchase and food production diversities were positively associated with children's nutrient intake in rural Mara, Tanzania. Nutrition programming should consider the role of food markets in addition to home food production to improve child diets. This trial was registered at clinicaltrials.gov as NCT03759821, https://clinicaltrials.gov/study/NCT03759821.
Collapse
Affiliation(s)
- Savannah F O'Malley
- Department of Public Health, Purdue University, West Lafayette, IN, United States; Department of Nutrition Science, Purdue University, West Lafayette, IN, United States.
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, United States; Department of Global Development, Cornell University, Ithaca, NY, United States
| | - Susmita Ghosh
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Lauren Galvin
- Global Communities, Program Quality and Accountability Department, Silver Spring, MD, United States
| | - Joshua Jeong
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Dominic Mosha
- Department of Global Health, BeVera Solutions LLC, Riverdale, GA, United States
| | - George PrayGod
- National Institute for Medical Research, Muhimbili Medical Research Centre, Tanzania
| | - Frank Mapendo
- Africa Academy for Public Health, Research and Program Unit, Tanzania
| | - Gerald Shively
- Department of Agricultural Economics, Purdue University, West Lafayette, IN, United States
| | - Laura E Murray-Kolb
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Nilupa S Gunaratna
- Department of Public Health, Purdue University, West Lafayette, IN, United States
| |
Collapse
|
11
|
Martinez-Perez N, Torheim LE, Arroyo-Izaga M. Availability and properties of commercially produced food products offered in European public universities: A North-South comparison. J Food Sci 2024; 89:2494-2511. [PMID: 38488725 DOI: 10.1111/1750-3841.17022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 04/12/2024]
Abstract
To date, there are no studies that have compared university food environments (FEs) with different sociocultural contexts. Therefore, we analyzed differences in the availability and properties of commercially produced foods, in a northern and a southern European university (located in Norway and Spain, respectively). A cross-sectional observational study was conducted at OsloMet-Oslo Metropolitan University and at the University of the Basque Country UPV/EHU. The nutritional quality of food products was estimated through the following nutrient profiling models (NPMs): those proposed by the Spanish Agency for Consumer Affairs, Food Safety and Nutrition (AECOSAN), the UK nutrient profiling model (UK NPM), the Norwegian Food and Drink Industry Professional Practices Committee (Matbransjens Fagligle Utvalg [MFU]), and a combination of them. In addition, food items were classified using the NOVA system. A total of 251 and 1051 products were identified at OsloMet and the UPV/EHU, respectively. The percentage categorized as low nutritional quality (LNQ) was higher at the UPV/EHU (almost 54.5% of the total products) compared with at OsloMet (almost 40%) (p < 0.001). Most of the products were categorized as ultra-processed, and there were no differences in the percentage of ultra-processed foods between the two universities (OsloMet 86.1%, UPV/EHU 83.3%, p > 0.05). A higher proportion of LNQ products was found at the UPV/EHU than at OsloMet, probably due to the government policies and actions for creating healthy FEs. Consequently, there is a need to develop interventions to improve the FE at the UPV/EHU, adapted to its sociocultural context. PRACTICAL APPLICATION: This study reveals north-south differences in terms of the availability of low nutritional quality food products. In particular, a higher proportion of this type of product was found at the University of the Basque Country UPV/EHU than at OsloMet-Oslo Metropolitan University. Our exploratory hypothesis is that this phenomenon is a consequence of the Nordic government policies that have great potential to create healthy FEs.
Collapse
Affiliation(s)
- Naiara Martinez-Perez
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain
- BIOMICs Research Group, Microfluidics & BIOMICs Cluster, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Marta Arroyo-Izaga
- BIOMICs Research Group, Microfluidics & BIOMICs Cluster, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Department of Pharmacy and Food Sciences, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Bioaraba, BA04.03, Vitoria-Gasteiz, Spain
| |
Collapse
|
12
|
Hayabuchi H, Takemi Y, Ohta M, Sakata I, Sakaguchi K, Kubo A, Yoshita K, Kitaoka K, Okami Y, Ohkubo T, Okamura T, Node K, Miura K. [Development of a new method for assessing the availability of low-sodium foods in Japan]. Nihon Koshu Eisei Zasshi 2024. [PMID: 38556361 DOI: 10.11236/jph.23-094] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Objectives Food environment improvement involving salt reduction requires improving access to and labeling low-sodium foods. Assessing the implementation status of these measures is also necessary. However, to date, no established methods exist for assessing the availability of low-sodium foods in communities. In this study, we aimed to devise a survey on the availability of low-sodium foods as a community food environment assessment method in order to establish common assessment methods, criteria, and practical measures, as well as standardization nationwide.Methods A preliminary survey on the availability of low-sodium foods was conducted in Kitakyushu City in four stores with nationwide representation. Consent for providing information on handled product lists was obtained. The on-site lists collected through direct investigation by surveyors were compared with the handled product lists provided by the stores and analyzed to identify survey challenges and examine feasibility and the potential for accuracy. The definition of low-sodium foods, which emerged as a challenge in the preliminary survey, was confirmed. Preliminary survey data were carefully reviewed to establish classification criteria for low-sodium foods and create a low-sodium food list to serve as a reference for on-site surveys. Forms for recording the results of on-site surveys and a survey manual were developed. Registered dietitians conducted on-site surveys using the manual to confirm its applicability.Results The preliminary survey results revealed that the on-site lists had fewer omissions and greater feasibility than store-provided lists. After clearly defining low-sodium foods, we established classification criteria (three major categories, seven subcategories, and 37 minor categories) considering the ease of on-site investigations and purchases. Three forms for recording survey results were developed, including a standard input form allowing detailed documentation of the availability of individual low-sodium foods, an aggregation form for a quantitative assessment of low-sodium foods availability, and a display form visualizing the availability of low-sodium foods by store. Furthermore, a survey manual was developed explaining the purpose and approach of the low-sodium foods availability survey, definition and classification criteria for low-sodium foods, and the three forms for recording survey results. Findings indicated that all registered dietitians could conduct on-site surveys using the manual and successfully collect and organize data.Conclusion On-site surveys using the manual and documentation forms enabled easy and accurate assessments of low-sodium foods availability. Thus, this standardized method to assess the availability of low-sodium foods could be a food environment assessment method for regional salt reduction initiatives.
Collapse
Affiliation(s)
| | | | | | - Ikuko Sakata
- Fukuoka Women's University
- Seinan Jo Gakuin University
| | - Keiko Sakaguchi
- Faculty of Nutrition, Kagawa Nutrition University
- Shukutoku University
| | - Akiko Kubo
- Faculty of Nutrition, Kagawa Nutrition University
| | | | | | | | | | | | - Koichi Node
- Saga University
- The Japanese Society of Hypertension
| | - Katsuyuki Miura
- Shiga University of Medical Science
- The Japanese Society of Hypertension
| |
Collapse
|
13
|
Tiboni-Oschilewski O, Abarca M, Santa Rosa Pierre F, Rosi A, Biasini B, Menozzi D, Scazzina F. Strengths and weaknesses of food eco-labeling: a review. Front Nutr 2024; 11:1381135. [PMID: 38600991 PMCID: PMC11005915 DOI: 10.3389/fnut.2024.1381135] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Food labeling is increasingly expanding and adding more information to the food package. There is strong evidence about nutrition labeling effectiveness in driving food choice, especially if displayed in the front of package (FoP). Despite the growing attention to nutrition and sustainable diets, few countries have implemented sustainable labels or eco-labels that could address economic, social and/or environmental concerns. Implementing new techniques of eco-labeling emerges as a consumer-focused solution. However, evidence of the effectiveness of eco-labeling in driving consumers' choices is heterogeneous and not univocal. Thus, this review aims to summarize the evidence about the effectiveness of FoP eco-labeling in driving food choice and provide a reference framework of the eco-labeling initiatives relative to food package labeling. This narrative review addresses both the potential benefits as well as the main concerns that arise from the use of eco-labels. Although eco-labeling seems to provide a series of sustainability benefits for producers and consumers, the implementation of such policies should take into consideration potential trade-offs and inter-sectorial coordination to obtain bigger impacts, assuming that a policy itself cannot transform the whole food system. Eco-labeling could be encouraged and implemented within a set of policies shaping sustainable food systems.
Collapse
Affiliation(s)
| | | | | | - Alice Rosi
- Department of Food and Drug, University of Parma, Parma, Italy
| | | | - Davide Menozzi
- Department of Food and Drug, University of Parma, Parma, Italy
| | | |
Collapse
|
14
|
Ludwig-Borycz E, Baylin A, Jones AD, Webster A, Stratton AE, Bauer KW. Changing sustainable diet behaviours during the COVID-19 Pandemic: inequitable outcomes across a sociodemographically diverse sample of adults. J Nutr Sci 2024; 13:e16. [PMID: 38572371 PMCID: PMC10988137 DOI: 10.1017/jns.2024.9] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/03/2024] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
The objective of this study was to describe changes in sustainable dietary behaviours (those that support environmental, economic, and physical health) among a sample of US adults during the COVID-19 pandemic and to examine differences in changes by individuals' race/ethnicity and socioeconomic status. Therefore, a cross-sectional online survey study was conducted in April 2021 (N = 1,488, mean age = 42.7 (SD = 12.6)) receiving outpatient care from Michigan Medicine, the University of Michigan health system. Enrolment quotas were established to ensure a diverse sample-one-third of participants identified as African American/Black, one-third Hispanic/Latino, one-third White, and one-third low-income. Participants reported engaging in more behaviours that are supportive of a sustainable diet one year into the COVID-19 pandemic compared to before. This is particularly true regarding ecologically and economically sustaining behaviours such as taking fewer trips to the grocery store, increased use of home grocery delivery, increased cooking at home, and greater consumption of healthy foods. Not all behaviour changes promoted sustainable food systems; namely, the use of farmer's markets and Community Supported Agriculture (CSAs) declined. White and high-income participants were more likely than African American/Black, Hispanic/Latino, and low-income individuals to engage in ecologically and economically sustainable dietary behaviours during the pandemic. Meanwhile, African American/Black participants reported large increases in physical health sustainable dietary behaviours. To support the continuation of greater engagement with sustainable diets, policies that increase access to public transportation, limit the frequency with which consumers have groceries delivered, increase work-from-home options, and improve access for low-income populations should be prioritised.
Collapse
Affiliation(s)
| | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, USA
| | - Andrew D. Jones
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, USA
| | | | | | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, USA
| |
Collapse
|
15
|
Rosin M, Mackay S, Gerritsen S, Te Morenga L, Terry G, Ni Mhurchu C. Barriers and facilitators to implementation of healthy food and drink policies in public sector workplaces: a systematic literature review. Nutr Rev 2024; 82:503-535. [PMID: 37335857 PMCID: PMC10925903 DOI: 10.1093/nutrit/nuad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
CONTEXT Many countries and institutions have adopted policies to promote healthier food and drink availability in various settings, including public sector workplaces. OBJECTIVE The objective of this review was to systematically synthesize evidence on barriers and facilitators to implementation of and compliance with healthy food and drink policies aimed at the general adult population in public sector workplaces. DATA SOURCES Nine scientific databases, 9 grey literature sources, and government websites in key English-speaking countries along with reference lists. DATA EXTRACTION All identified records (N = 8559) were assessed for eligibility. Studies reporting on barriers and facilitators were included irrespective of study design and methods used but were excluded if they were published before 2000 or in a non-English language. DATA ANALYSIS Forty-one studies were eligible for inclusion, mainly from Australia, the United States, and Canada. The most common workplace settings were healthcare facilities, sports and recreation centers, and government agencies. Interviews and surveys were the predominant methods of data collection. Methodological aspects were assessed with the Critical Appraisal Skills Program Qualitative Studies Checklist. Generally, there was poor reporting of data collection and analysis methods. Thematic synthesis identified 4 themes: (1) a ratified policy as the foundation of a successful implementation plan; (2) food providers' acceptance of implementation is rooted in positive stakeholder relationships, recognizing opportunities, and taking ownership; (3) creating customer demand for healthier options may relieve tension between policy objectives and business goals; and (4) food supply may limit the ability of food providers to implement the policy. CONCLUSIONS Findings suggest that although vendors encounter challenges, there are also factors that support healthy food and drink policy implementation in public sector workplaces. Understanding barriers and facilitators to successful policy implementation will significantly benefit stakeholders interested or engaging in healthy food and drink policy development and implementation. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021246340.
Collapse
Affiliation(s)
- Magda Rosin
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Sarah Gerritsen
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Gareth Terry
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
16
|
Odoms-Young A, Brown AGM, Agurs-Collins T, Glanz K. Food Insecurity, Neighborhood Food Environment, and Health Disparities: State of the Science, Research Gaps and Opportunities. Am J Clin Nutr 2024; 119:850-861. [PMID: 38160801 DOI: 10.1016/j.ajcnut.2023.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024] Open
Abstract
Food insecurity and the lack of access to affordable, nutritious food are associated with poor dietary quality and an increased risk of diet-related diseases, including cardiovascular disease, diabetes, and certain types of cancer. Those of lower socioeconomic status and racial and ethnic minority groups experience higher rates of food insecurity, are more likely to live in under-resourced food environments, and continue to bear the greatest burden of diet-related chronic diseases in the United States. Despite the growing body of literature in this area, there are still significant gaps in our understanding of the various pathways that link food insecurity and neighborhood food environments to racial/ethnic and socioeconomic disparities in health and the most effective intervention strategies to address these disparities. To better understand the science in this area, the National Institutes of Health, in collaboration with the Centers for Disease Control (CDC) and Prevention and the United States Department of Agriculture (USDA), convened a virtual 3-d workshop 21-23 September 2021: Food Insecurity, Neighborhood Food Environment, and Nutrition Health Disparities: State of the Science. The workshop brought together a diverse group of researchers, practitioners, policymakers, and federal partners with expertise in nutrition, the food environment, health and social policy, and behavioral and social sciences. The workshop had the following 3 research objectives: 1) summarize the state of the science and knowledge gaps related to food insecurity, neighborhood food environments, and nutrition health disparities, 2) identify research opportunities and strategies to address research gaps, and 3) examine evidence-based interventions and implementation approaches to address food insecurity and neighborhood food environments to promote health equity. This article summarizes workshop proceedings and describes research gaps and future opportunities that emerged from discussions.
Collapse
Affiliation(s)
- Angela Odoms-Young
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Alison G M Brown
- National Heart Lung and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States.
| | - Tanya Agurs-Collins
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
17
|
Caruso OT, McEachern LW, Minaker LM, Gilliland JA. The Influence of the School Neighborhood Food Retail Environment on Unhealthy Food Purchasing Behaviors Among Adolescents: A Systematic Review. J Nutr Educ Behav 2024; 56:145-161. [PMID: 38284954 DOI: 10.1016/j.jneb.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Adolescents are often exposed to food retailers selling unhealthy food items during their lunch breaks and school commutes. This systematic review examines the influence of school neighborhood food retail environments on adolescent food purchasing. METHODS A systematic search of 6 databases. Observational studies published from January 2012 to December 2022 that measured food availability, accessibility, or exposure, measured food purchasing, and focused on adolescents (aged 10-19 years) were eligible for inclusion. RESULTS Twelve studies with 97 findings were included. Thirty-one findings indicated that a school neighborhood with a high density of unhealthy food retail, a school with unhealthy food retail nearby, or exposure to unhealthy food retail on the journey to/from school was associated with higher prevalence and frequency of unhealthy food purchases. DISCUSSION Adolescents' food purchasing behaviors may be meaningfully affected by their school neighborhood food retail environment; however, the included studies have many methodological shortcomings. IMPLICATIONS FOR RESEARCH AND PRACTICE Results identify the need for new studies that measure food purchasing, use comprehensive definitions of food retail environments, and adopt more rigorous methods to approximate exposure to food retail. More robust evidence would strengthen the rationale for policy or program interventions and potentially indicate specific targets for intervention.
Collapse
Affiliation(s)
- Olivia T Caruso
- Department of Geography and Environment, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada
| | - Louise W McEachern
- Department of Geography and Environment, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Jason A Gilliland
- Department of Geography and Environment, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Department of Pediatrics, Western University, London, Ontario, Canada; School of Health Studies, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
| |
Collapse
|
18
|
Bennett R, Keeble M, Zorbas C, Sacks G, Driessen C, Grigsby-Duffy L, Adams J, Burgoine T, Backholer K. The potential influence of the digital food retail environment on health: A systematic scoping review of the literature. Obes Rev 2024; 25:e13671. [PMID: 38104965 DOI: 10.1111/obr.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/01/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The digital food retail environment (defined in this study as a digital platform, app or website where food can be purchased by individuals for personal consumption) is an emerging component of the wider food system. We aimed to systematically search and review the literature to understand the potential influence of the digital food retail environment on population diets and health. METHODS Four databases (across health, business, and marketing) and grey literature were searched using terms relating to "food and beverages," "digital," and "purchasing." Identified studies were included if they examined any aspect of the digital food retail environment where outcomes were examined with a health-related focus and were published before September 2023. All study designs were included (quantitative, qualitative, observational, and experimental). Reviews and conference abstracts were excluded. RESULTS We identified 21,382 studies, of which 57 articles were eligible for inclusion. Of the 57 included studies, 30 studies examined online grocery retail, 22 examined online food delivery platforms, and five examined meal kit subscription services. Of the 30 studies examining online grocery retail, six studies reported that customers believed they purchased fewer unhealthy food and beverages when shopping online, compared with shopping in-store. Nevertheless, customers also reported that their ability to choose healthy foods and beverages was reduced when shopping online due to difficulty in product comparison. Studies that examined online food delivery platforms primarily found that they promoted unhealthy foods and beverages more often than healthy options, through extensive use of marketing practices such as price discounts and images, and that unhealthy food offerings on these platforms dominate. Meal kit subscription services offered mostly healthy meals, with studies suggesting that these types of services may help individuals alleviate some of their "mental load" and stress related to cooking meals for their families. CONCLUSIONS The literature describing the digital food retail environment was found to be diverse, with different aspects having potential to impact health in different ways. Some evidence suggests that online grocery retail and meal kit subscription services may have positive population dietary impacts, whereas online food delivery platforms appear likely to promote unhealthy food purchasing. However, the current evidence base is fragmented, with many knowledge gaps. Further research is required to understand the influence of the digital food retail environment on population diets and how these environments can be designed to support healthy food choices.
Collapse
Affiliation(s)
- Rebecca Bennett
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Matthew Keeble
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Christine Driessen
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Lily Grigsby-Duffy
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Thomas Burgoine
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
19
|
Gilcharan Singh HK, Sinnasamy P, Wan Yi T, Chiao Wei C, Chee Siew Swee W, Shyam S. Understanding the Food Environment and Its Impact on Diet and Health in Asia: A Scoping Review. Asia Pac J Public Health 2024; 36:172-183. [PMID: 38483070 DOI: 10.1177/10105395241237635] [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] [Indexed: 04/05/2024]
Abstract
Food environment (FE), an interface where people interact with a broader food system, is critical to health. Understanding the Asian FE may help to tackle the "triple burden of malnutrition" through informed research and policy. This review identifies FE domains assessed in the Asian context and collates the tools/measures used in these evaluations. We further synthesized the reported associations of FE with diet and health outcomes and identified knowledge gaps. Forty-two articles were reviewed (East Asia, n = 25, 60%; South Asia, n = 8, 19%; and Southeast Asia, n = 9, 21%). The results showed that FE was frequently examined in children, adolescents, or adults, but data were scarce in older adults. Food availability (n = 30) and accessibility (n = 19) were popularly studied domains. Furthermore, FE was measured using geographic information systems (n = 18), market (n = 7), or stakeholder (n = 21) surveys. Twenty-eight (67%) articles assessed associations of FE exposures with diet (n = 12) and health (n = 21). Increased food availability and accessibility were associated with poorer dietary and health outcomes despite nonexisting validity and reliability reporting in 62% of articles. Limited high-quality studies emphasize the need for harmonized definitions, better study designs, and validated FE measures/tools in Asia. Improving the quality of FE research is critical to designing effective interventions to improve public health nutrition in Asia.
Collapse
Affiliation(s)
- Harvinder Kaur Gilcharan Singh
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Pavitra Sinnasamy
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Teoh Wan Yi
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Chang Chiao Wei
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Sangeetha Shyam
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Reus, Spain
| |
Collapse
|
20
|
Briggs R, Rowden H, Lagojda L, Robbins T, Randeva HS. The lived experience of food insecurity among adults with obesity: a quantitative and qualitative systematic review. J Public Health (Oxf) 2024:fdae016. [PMID: 38409966 DOI: 10.1093/pubmed/fdae016] [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: 04/08/2023] [Revised: 11/16/2023] [Accepted: 12/01/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Food insecurity and obesity are increasing both globally and in the UK. In thisreview we systematically assess the lived experiences of people with obesity who are food insecure and often turn to foodbanks. METHODS We systematically searched electronic databases from January 2007 until October 2022. Data from eligible studies were extracted and the studies assessed for quality. Thematicanalysis and narrative synthesis approach was used to analyse the extracted data. RESULTS Six themes were identified among 25 included studies, including: the financial cost of food; psychological aspects related to food insecurity; geographical access and the foodenvironment; food practices in the home; experience of food assistance; and parental-childrelationships. The cost of healthy food and psychological factors were identified as keydriving factors of the relationship between food insecurity and obesity. Psychological factorssuch as depression, low self-esteem and stress played an important part in the livedexperience of people with obesity and food insecurity. CONCLUSION The food environment provides context in which food decisions are made,therefore, systems change is necessary to ensure families can afford the food that enables ahealthy diet. For clinicians, identification, and attention to the impact of food insecurity onpeople with obesity are important.
Collapse
Affiliation(s)
- Rebecca Briggs
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Hope Rowden
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Lukasz Lagojda
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Clinical Evidence-Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Timothy Robbins
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Harpal S Randeva
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
- Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| |
Collapse
|
21
|
Downs S, Manohar S, Staromiejska W, Keo C, Say S, Chhinh N, Fanzo J, Sok S. Centering context when characterizing food environments: the potential of participatory mapping to inform food environment research. Front Nutr 2024; 11:1324102. [PMID: 38450238 PMCID: PMC10914972 DOI: 10.3389/fnut.2024.1324102] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 03/08/2024] Open
Abstract
Food environments are a critical place within the food system to implement interventions aimed at enabling sustainable diets. In this perspective article, we argue for the need for food environment research to more comprehensively examine the different types of food environments that people access within their communities to ensure that interventions and programs are better aligned with people's lived experiences. We highlight the potential ways in which participatory mapping (PM) can be leveraged to better design food environment research by: (1) identifying the different food environment types that are accessed within a given community; (2) providing insight into the timing for data collection; (3) informing the prioritization of where to conduct food environment assessments; and (4) highlighting the dynamism of food environments over time (e.g., across a given day or across seasons). We provide a case study example of the application of PM and the lessons learned from it in Cambodia. By conceptualizing food environments in a more comprehensive way, from the perspective of the people living within a given community, we will be able to measure food environments in a way that more closely aligns with people's lived experiences.
Collapse
Affiliation(s)
- Shauna Downs
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Swetha Manohar
- Global Food Ethics Policy Program, School of Advanced International Studies, Washington, DC, United States
- Nutrition, Diets and Health Unit, International Food Policy Research Institute, Washington, DC, United States
| | - Wiktoria Staromiejska
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Newark, NJ, United States
| | - Chanvuthy Keo
- Faculty of Social Science and Humanities, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
| | - Sophea Say
- Department of Tourism, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Nyda Chhinh
- Department of Economic Development, Faculty of Development Studies, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
| | - Jessica Fanzo
- Columbia’s Climate School, Columbia University, New York, NY, United States
| | - Serey Sok
- Research Office, Royal University of Phnom Penh, Russian Federation Boulevard, Khan Toul Kork, Cambodia
| |
Collapse
|
22
|
Farmer N, Tuason R, Middleton KR, Ude A, Tataw-Ayuketah G, Flynn S, Kazmi N, Baginski A, Mitchell V, Powell-Wiley TM, Wallen GR. Assessing Acceptability: The Role of Understanding Participant, Neighborhood, and Community Contextual Factors in Designing a Community-Tailored Cooking Intervention. Nutrients 2024; 16:463. [PMID: 38337747 PMCID: PMC10857272 DOI: 10.3390/nu16030463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Cooking is an identified dietary strategy that is positively associated with optimal diet quality. Prior to initiating cooking interventions, evaluating the prospective acceptability of the intervention among community members living within low food access areas and understanding geospatial food shopping locations may aid in designing community-tailored interventions. METHODS A sequential mixed methods study was conducted to determine the prospective acceptability of a planned community-located cooking intervention among African American adults living in a low food access area and with at least one cardiovascular disease risk factor. A semi-structured guide was used to conduct five virtual focus groups. Qualitative data were analyzed using thematic analysis and validated through participant check-in interviews. Survey responses were analyzed based on descriptive data. Geospatial analysis of participant locations that were reported for food shopping was conducted to show food environment utilization. RESULTS Focus groups with study participants (n = 20, all female, mean age 60.3, SD 9.3, mean cooking frequency per week 4.0, food insecure n = 7) were conducted between March and April, 2021. Thematic analysis of the focus group transcripts identified five main themes as follows: (A) Barriers to Cooking (family and caregiving, transportation, COVID-19 pandemic, time availability, household composition); (B) Motivators for Cooking (family, caregiving, health, enjoyment, COVID-19 pandemic); (C) Strategies (food shopping, social support, social media, meal planning); (D) Neighborhood (gentrification, perceived safety, stigmatization, disparities in grocery stores); (E) and Acceptability of the Intervention (reasons to participate, barriers, recruitment, intervention delivery). Participant validation interviews confirmed the themes and subthemes as well as the illustrative quotes. Geospatial analysis showed a majority of locations were outside of the participants' residential areas. CONCLUSIONS Prospective acceptability of a community-tailored cooking intervention found that the planned intervention could be modified to address individual level factors, such as caregiving and health, community contextual factors, such as perceived safety, and the general health needs of the community.
Collapse
Affiliation(s)
- Nicole Farmer
- Translational Biobehavioral and Health Disparities Branch, The National Institutes of Health, Clinical Center, Bethesda, MD 20892, USA; (R.T.); (K.R.M.); (N.K.); (A.B.); (G.R.W.)
| | - Ralph Tuason
- Translational Biobehavioral and Health Disparities Branch, The National Institutes of Health, Clinical Center, Bethesda, MD 20892, USA; (R.T.); (K.R.M.); (N.K.); (A.B.); (G.R.W.)
| | - Kimberly R. Middleton
- Translational Biobehavioral and Health Disparities Branch, The National Institutes of Health, Clinical Center, Bethesda, MD 20892, USA; (R.T.); (K.R.M.); (N.K.); (A.B.); (G.R.W.)
| | - Assumpta Ude
- Clinical Center Nursing Department, The National Institutes of Health, Bethesda, MD 20892, USA; (A.U.); (G.T.-A.); (S.F.)
| | - Gladys Tataw-Ayuketah
- Clinical Center Nursing Department, The National Institutes of Health, Bethesda, MD 20892, USA; (A.U.); (G.T.-A.); (S.F.)
| | - Sharon Flynn
- Clinical Center Nursing Department, The National Institutes of Health, Bethesda, MD 20892, USA; (A.U.); (G.T.-A.); (S.F.)
| | - Narjis Kazmi
- Translational Biobehavioral and Health Disparities Branch, The National Institutes of Health, Clinical Center, Bethesda, MD 20892, USA; (R.T.); (K.R.M.); (N.K.); (A.B.); (G.R.W.)
| | - Alyssa Baginski
- Translational Biobehavioral and Health Disparities Branch, The National Institutes of Health, Clinical Center, Bethesda, MD 20892, USA; (R.T.); (K.R.M.); (N.K.); (A.B.); (G.R.W.)
| | - Valerie Mitchell
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Bethesda, MD 20892, USA; (V.M.); (T.M.P.-W.)
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Bethesda, MD 20892, USA; (V.M.); (T.M.P.-W.)
- Intramural Research Program, National Institute on Minority Health and Health Disparities, Bethesda, MD 20892, USA
| | - Gwenyth R. Wallen
- Translational Biobehavioral and Health Disparities Branch, The National Institutes of Health, Clinical Center, Bethesda, MD 20892, USA; (R.T.); (K.R.M.); (N.K.); (A.B.); (G.R.W.)
| |
Collapse
|
23
|
Parekh T, Xue H, Al-Kindi S, Nasir K, Cheskin LJ, Cuellar AE. Food Environment Quality and Cardiovascular Disease Mortality in the United States: a County-Level Analysis from 2017 to 2019. J Gen Intern Med 2024; 39:176-185. [PMID: 37507552 PMCID: PMC10853151 DOI: 10.1007/s11606-023-08335-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Upstream socioeconomic circumstances including food insecurity and food desert are important drivers of community-level health disparities in cardiovascular mortality let alone traditional risk factors. The study assessed the association between differences in food environment quality and cardiovascular mortality in US adults. DESIGN Retrospective analysis of the association between cardiovascular mortality among US adults aged 45 and above and food environment quality, measured as the food environment index (FEI), in 2615 US counties. FEI was measured by equal weights of food insecurity (limited access to a reliable food source) and food desert (limited access to healthy food), ranging from 0 (worst) to 10 (best). Age-adjusted cardiovascular mortality rates per 100,000 adults aged 45 and above in the calendar year 2017-2019. County-level association between CVD mortality rate and FEI was modeled using generalized linear regression. Data were weighted using county population. RESULT Median CVD deaths per 100,000 population were 645.4 (IQR 561.5, 747.0) among adults aged 45 years and above across US counties in 2017-2019. About 12.8% (IQR 10.7%, 15.1%) of residents were food insecure and 6.3% (IQR 3.6%, 9.9%) were living in food desert areas. Comparing counties by FEI quartiles, the CVD mortality rate was higher in the least healthy FE counties (704.3 vs 598.6 deaths per 100,000 population) compared to the healthiest FE counties. One unit increase in FEI was associated with - 12.95 CVD deaths/100,000 population. In the subgroup analysis of counties with higher income inequality, the healthiest food environment was associated with 46.4 lower CVD deaths/100,000 population than the least healthy food environment. One unit increase in FEI in counties with higher income inequality was associated with a fivefold decrease in CVD mortality difference in African American counties (- 18.4 deaths/100,000 population) when compared to non-African American counties (- 3.63 deaths/100,000 population). CONCLUSION In this retrospective multi-county study in the USA, a higher food environment index was significantly associated with lower cardiovascular mortality.
Collapse
Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA.
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Sadeer Al-Kindi
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Khurram Nasir
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Lawrence J Cheskin
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
| | - Alison E Cuellar
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| |
Collapse
|
24
|
Atoloye AT, Akinsola O, Murillo M. Examining Factors Associated with the Use of Community Food Resources: An Application of the Andersen Model to Inform Future Interventions. Int J Environ Res Public Health 2024; 21:76. [PMID: 38248540 PMCID: PMC10815130 DOI: 10.3390/ijerph21010076] [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] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
The role of the food environment in shaping nutrition and health has gained substantial attention from policymakers, public health researchers, and advocacy groups. To promote equities in food access and nutrition outcomes, understanding factors linked with the utilization of local community food resources is crucial. Using Andersen's service utilization model, we explained how adults use their neighborhood food resources. In a cross-sectional study design, an online survey was conducted in REDCap Version 13.4.0 via the Amazon Mechanical Turk (MTurk) involving 1830 adults with a mean age of 37.9 ± 12.1 years. Participants answered questions on predisposing, enabling, and need factors that influence their use of different community food resources. The predisposing factors that were statistically significant included age, family size, marital status, race, and ethnicity. The enabling factors included travel time, travel mode, income, and shopping decision motivators (such as being able to use Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) vouchers, delivery services, great sales, and coupons). Food security and community food resources need for lower food price were the significant need factors. However, these factors vary by the types of food resources. In conclusion, enhancing the utilization of community-based food access initiatives and programs among underserved families requires consideration of family composition, racial and ethnic diversity, and transportation access.
Collapse
Affiliation(s)
- Abiodun T. Atoloye
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, UT 84322, USA
| | | | | |
Collapse
|
25
|
de França FCO, Zandonadi RP, da Silva Santana ÍA, da Silva ICR, Akutsu RDCCDA. Food and Consumers' Environment Inside and around Federal Public Schools in Bahia, Brazil. Nutrients 2024; 16:201. [PMID: 38257094 PMCID: PMC10821399 DOI: 10.3390/nu16020201] [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: 11/13/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
The food environment plays a crucial role in shaping people's eating habits and, in and around schools, this influence becomes even more critical due to the time students spend daily in these spaces. This study aimed to analyze the food and consumer environments inside and around federal institutes in Bahia, Brazil. Ecological study and audit methodologies were combined, with all the 35 federal institutes in Bahia as the sample universe. To delimit the food environment around the school, the establishments were mapped in a 1000 m buffer, with the school as the centroid. The geographic coordinates of schools and food outlets were initially obtained using Google Maps and later confirmed on-site. The data were collected in WGS 84 and converted to UTM zone 23S SIRGAS 2000. To map the consumer environment, establishments found in a 250 m buffer and also canteens within schools were audited, using the ESAO-r instrument that considers the availability and prices of healthy and unhealthy foods; availability of nutritional information near the point of purchase or on the menu; and presence of internal marketing of healthy and unhealthy foods. The healthy meal-restaurant index (HMRI) was also measured. This index ranges from 0 to 8 points and positively scores items related to healthy consumption and fails to score those related to unhealthy consumption and behavior. The establishments were grouped into four categories (healthy, unhealthy, mixed, and supermarkets). The surrounding area with four or more unhealthy establishments within the 250 m buffer was considered a food swamp. Descriptive analyses were carried out with frequency measurements, measures of central tendency (mean and median), and dispersion (standard deviation). Around the analyzed schools, 732 food establishments were identified, 73.8% (n = 540) formal and 26.2% (n = 192) informal. Considering the characteristics of existing commerce, there was a predominance of snack bars (45%), grocery stores (23%), and bars (7.8%), with a smaller number of supermarkets identified (4.1%). School canteens were found in 20 schools analyzed and only 15% had a variety of healthy foods. When evaluating the availability of healthy foods, a median HMRI of 3 (1-7) was observed. When analyzing this index according to the type of establishment, it was found that fruit and vegetables presented higher values (HMRI = 7; P25-P75: 4-8) compared to large chain supermarkets (HMRI = 5; P25-P75: 2-6; p < 0.001) and local markets (HMRI = 4; P25-P75: 2-5; p < 0.001). From the analysis of the food and consumer environments, it was possible to make inferences about the quality of the food offered to students in these locations, as well as the potential health outcomes arising from this exposure and the need to carry out food education activities and nutritional activities.
Collapse
Affiliation(s)
- Fabiana Chagas Oliveira de França
- Nutrition School, Federal University of Bahia-Augusto Viana, s/n-Palácio da Reitoria, Canela, Salvador 40110-907, Brazil; (F.C.O.d.F.); (Í.A.d.S.S.)
| | | | - Ívenes Ariele da Silva Santana
- Nutrition School, Federal University of Bahia-Augusto Viana, s/n-Palácio da Reitoria, Canela, Salvador 40110-907, Brazil; (F.C.O.d.F.); (Í.A.d.S.S.)
| | | | - Rita de Cassia Coelho de Almeida Akutsu
- Nutrition School, Federal University of Bahia-Augusto Viana, s/n-Palácio da Reitoria, Canela, Salvador 40110-907, Brazil; (F.C.O.d.F.); (Í.A.d.S.S.)
- Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil;
| |
Collapse
|
26
|
Palmer S, Burton-Obanla A, Goon S, Allison T, Mitchell A, Bogdonas K, Fombelle M, Hoffman A, Smith J, McCaffrey J, Prescott MP. Policy, Systems, and Environmental Changes in Child Nutrition Programs: A Systematic Literature Review. Adv Nutr 2024; 15:100116. [PMID: 37716534 PMCID: PMC10700153 DOI: 10.1016/j.advnut.2023.09.004] [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: 11/04/2022] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023] Open
Abstract
The National School Lunch Program (NSLP) provides healthy food to millions of children annually. To promote increased lunch consumption, policy, systems, and environmental (PSE) change strategies are being implemented in child nutrition programs. An evaluation of the current evidence supporting PSE interventions in school nutrition programs is needed to facilitate evidence-based practices across the nation for programs. This systematic review aims to determine the quality and breadth of available evidence of the effectiveness of PSE strategies on the consumption and waste of fruits, vegetables, milk, and water in the NSLP. The inclusion criteria required studies to occur in a United States K-12 school setting, data collection after 2012, report consumption and waste findings for fruit, vegetable, milk, or water, and be an original research article. Articles included in the review are restricted to positive or neutral quality. Thirty studies are included, policy level (n = 4), systems level (n = 8), environmental level (n = 10), and multi-category (n = 8). Results from positively rated policy-level studies suggest that recess before lunch may increase milk consumption, whereas removing flavored milk may decrease consumption. System-level studies of offering vegetables first in isolation of other meal components and offering spiced vegetables compared with traditional preparations may increase vegetable consumption, and locally procuring produce may increase fruit and vegetable consumption. Environmental-level studies such as water promotion strategies such as placing cups near drinking fountains may increase water consumption. Improving the convenience, attractiveness, and palatability of fruits and vegetables may increase consumption. Future PSE research in child nutrition programs should incorporate implementation aides and metrics into their study designs to allow a better understanding of how to sustain interventions from the perspective of school nutrition professionals.
Collapse
Affiliation(s)
- Shelly Palmer
- Department of Food Science and Human Nutrition, University of Illinois Urbana Champaign, Champaign, IL, United States
| | - Amirah Burton-Obanla
- Division of Nutritional Sciences, University of Illinois Urbana Champaign, Champaign, IL, United States
| | - Shatabdi Goon
- University of Illinois Extension, Urbana, IL, United States
| | | | - Ana Mitchell
- Division of Nutritional Sciences, University of Illinois Urbana Champaign, Champaign, IL, United States
| | | | | | - Ashley Hoffman
- University of Illinois Extension, Urbana, IL, United States
| | - Jenna Smith
- University of Illinois Extension, Urbana, IL, United States
| | | | | |
Collapse
|
27
|
Thorisdottir B, Odinsdottir T, Thorsdottir I. A repeated cross-sectional analysis of the Icelandic baby food market surveyed in 2016, 2019 and 2021. Matern Child Nutr 2024; 20 Suppl 2:e13476. [PMID: 36738133 PMCID: PMC10765347 DOI: 10.1111/mcn.13476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/29/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023]
Abstract
World Health Organisation (WHO) has stated that countries need to know their local commercial baby food (CBF) market. Data from other countries suggest rapid changes in CBF options, highlighting the need for repeated analysis. In that context, this repeated cross-sectional study analysed the options and nutrient quality of different CBF types available in Iceland in years 2016, 2019 and 2021. Data was gathered on formulas, porridge flours, foods in jars and pouches, finger-foods, other CBF. They were classified into 26 subgroups based on ingredients and taste (sweet/savoury). Minimum consumer age as suggested by the manufacturers and nutritional content were registered. In each data-collection, 250-275 products were available. Over a third of products (37%-44%) were in pouches. Availability of products intended for 4-11-month-old infants decreased, driven largely by a 65% decrease in availability of food in jars (sweet/savoury) between 2016 and 2021. Availability of products intended from 12+ months or without age-labels increased, driven largely by quadrupling of finger-foods (predominantly sweet) between 2016 and 2021. The overall percentage of products classified as sweet increased from 65% (2016) to 73% (2019) and 77% (2021). Some finger-foods had high sugar content (up to 72 g/100 g), partly from fruit concentrate or sugar/syrup. Like other countries, the Icelandic CBF market has moved towards less availability of food intended in the first year and more availability of sweet finger-foods for an expanded consumer age. As sugar is added to some CBF, stronger regulations on promotion of foods for young consumers and updated recommendations for parents/caregivers may be needed.
Collapse
Affiliation(s)
- Birna Thorisdottir
- Faculty of Food Science and Nutrition, School of Health SciencesUniversity of IcelandReykjavikIceland
| | - Tinna Odinsdottir
- Health Science Institute, School of Health SciencesUniversity of IcelandReykjavikIceland
| | - Inga Thorsdottir
- Faculty of Food Science and Nutrition, School of Health SciencesUniversity of IcelandReykjavikIceland
- Health Science Institute, School of Health SciencesUniversity of IcelandReykjavikIceland
| |
Collapse
|
28
|
Fazzino TL, Jun D, Chollet-Hinton L, Bjorlie K. US tobacco companies selectively disseminated hyper-palatable foods into the US food system: Empirical evidence and current implications. Addiction 2024; 119:62-71. [PMID: 37682074 DOI: 10.1111/add.16332] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/13/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND AND AIMS US tobacco companies owned leading US food companies from 1980 to 2001. We measured whether hyper-palatable foods (HPF) were disproportionately developed in tobacco-owned food companies, resulting in substantial tobacco-related influence on the US food system. DESIGN The study involved a review of primary industry documents to identify food brands that were tobacco company-owned. Data sets from the US Department of Agriculture were integrated to facilitate longitudinal analyses estimating the degree to which foods were formulated to be hyper-palatable, based on tobacco ownership. SETTING AND CASES United States Department of Agriculture data sets were used to identify HPF foods that were (n = 105) and were not (n = 587) owned by US tobacco companies from 1988 to 2001. MEASUREMENTS A standardized definition from Fazzino et al. (2019) was used to identify HPF. HPF items were identified overall and by HPF group: fat and sodium HPF, fat and sugar HPF and carbohydrates and sodium HPF. FINDINGS Tobacco-owned foods were 29% more likely to be classified as fat and sodium HPF and 80% more likely to be classified as carbohydrate and sodium HPF than foods that were not tobacco-owned between 1988 and 2001 (P-values = 0.005-0.009). The availability of fat and sodium HPF (> 57%) and carbohydrate and sodium HPF (> 17%) was high in 2018 regardless of prior tobacco-ownership status, suggesting widespread saturation into the food system. CONCLUSIONS Tobacco companies appear to have selectively disseminated hyper-palatable foods into the US food system between 1988 and 2001.
Collapse
Affiliation(s)
- Tera L Fazzino
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Daiil Jun
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Lynn Chollet-Hinton
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kayla Bjorlie
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| |
Collapse
|
29
|
Moore HJ, Lake AA, O’Malley CL, Bradford C, Gray N, Chang M, Mathews C, Townshend TG. The impact of COVID-19 on the hot food takeaway planning regulatory environment: perspectives of local authority professionals in the North East of England. Perspect Public Health 2024; 144:52-60. [PMID: 35929588 PMCID: PMC10757382 DOI: 10.1177/17579139221106343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Planning regulations have been used to prevent the over-proliferation of hot food takeaways, minimising the impact of local obesogenic environments. To help mitigate the effects of lockdown, the UK government introduced temporary changes in March 2020 to Planning Regulations for England, allowing food retailers to open for takeaway services beyond 'ancillary' level without needing to apply for planning permission through permitted development rights (PDR). Businesses are required to notify their local authority (LA) when they implement PDRs. To better understand the impact of regulations on the policy and practice of key professional groups, Public Health England commissioned Teesside University to undertake scoping research in the North East of England. METHODS A focus group and interviews were conducted with 15 professionals from 7 of 12 North East LAs. Professions included Planners, Public Health Leads, Environmental Health Officers and Town Centre Managers. Data were analysed using a codebook thematic analysis approach. An interpretation meeting with some participants was conducted. RESULTS LAs were not aware of most businesses notifying them of new regulation adherence despite taking up PDRs, but were considered low-priority with many lacking formal recording procedures. There were concerns about health consequences of the changes, and consensus relating to ongoing issues with capacity across all professional groups, largely due to the continuing pandemic and absence of a strategy out of temporary measures. Concerns existed around ensuring cessation of restaurants trading as takeaways, and hygiene inspections backlog. Many (personally) saw new takeaways as a lifeline, offering broader menus and preserving local economies. CONCLUSION Lack of information around the number of restaurants/pubs using PDR to trade as takeaway services, ongoing capacity issues of LAs and, at the time, the absence of a strategy post regulation changes, meant there were high levels of uncertainty regarding the impacts of these temporary measures.
Collapse
Affiliation(s)
- HJ Moore
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - AA Lake
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough TS1 3BA, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - CL O’Malley
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - C Bradford
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - N Gray
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - M Chang
- Healthy Places, Public Health England, London, UK WHO Collaborating Centre for Healthy Urban Environments, University of the West of England, Bristol, UK
| | - C Mathews
- Health and Wellbeing, North East, Public Health England, Newcastle upon Tyne, UK
| | - TG Townshend
- School of Architecture, Planning & Landscape, Newcastle University, Newcastle upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| |
Collapse
|
30
|
Kain J, Sandoval MH, Orellana Y, Cruz N, Díez J, Weisstaub G. Socio-Spatial Segregation of Unhealthy Food Environments across Public Schools in Santiago, Chile. Nutrients 2023; 16:108. [PMID: 38201938 PMCID: PMC10780824 DOI: 10.3390/nu16010108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Santiago, Chile is a very segregated city, with higher childhood obesity rates observed in vulnerable areas. We compared the counts and proximity of unhealthy food outlets (UFOs) around a 400 m buffer of 443 public schools (municipal and subsidized) located in socioeconomically diverse neighborhoods in 14 municipalities of Santiago. This was a cross-sectional study in which the socioeconomic status (SES) of the population living inside the buffer was classified as middle-high, middle, and low. We used the Kruskal-Wallis test for comparisons of density and proximity between type of school, SES, and population density. We used a negative binomial model (unadjusted and adjusted by population density) to determine the expected change in counts of UFOs by SES, which was compared to the reference (middle-high). Low SES neighborhoods had significantly more counts of UFOs, and these were located much closer to schools. Low and middle SES neighborhoods had an 88% and 48% higher relative risk of having UFOs compared to middle-high SES areas; (IRR = 1.88; 95% CI 1.59-2.23) and (IRR = 1.48; 95% CI 1.20-1.82), respectively. A socio-spatial segregation of UFOs associated with childhood obesity across public schools was observed in Santiago.
Collapse
Affiliation(s)
- Juliana Kain
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul 7830490, Chile; (J.K.); (Y.O.); (G.W.)
| | - Moisés H. Sandoval
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul 7830490, Chile; (J.K.); (Y.O.); (G.W.)
| | - Yasna Orellana
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul 7830490, Chile; (J.K.); (Y.O.); (G.W.)
| | - Natalie Cruz
- The Institute of Geography of the Pontifical Catholic University of Chile, Macul 7820436, Chile;
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28801 Madrid, Spain;
| | - Gerardo Weisstaub
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul 7830490, Chile; (J.K.); (Y.O.); (G.W.)
| |
Collapse
|
31
|
Seo D, Horn A, Abeliuk A, Burghardt K. What's On the Menu? Towards Predicting Nutritional Quality of Food Environments. medRxiv 2023:2023.12.08.23299691. [PMID: 38106109 PMCID: PMC10723558 DOI: 10.1101/2023.12.08.23299691] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Unhealthy diets are a leading cause of major chronic diseases including obesity, diabetes, cancer, and heart disease. Food environments-the physical spaces in which people access and consume food-have the potential to profoundly impact diet and related diseases. We take a step towards better understanding the nutritional quality of food environments by developing MINT: Menu Item to NutrienT model. This model utilizes under-studied data sources on recipes and generic food items, along with state-of-the-art word embedding and deep learning methods, to predict the nutrient density of never-before-seen food items using only their name as input. The model achieves an R 2 = 0.77 , a substantial improvement over comparable models. We illustrate the utility of MINT by applying it to the Los Angeles restaurant food environment, and discover close agreement between predicted and ground truth nutrient density of restaurant menu items. This model represents a significant step towards a policy toolkit needed to precisely identify and target food environments characterized by poor nutritional quality.
Collapse
Affiliation(s)
- DongHyeon Seo
- Information Sciences Institute, Marina del Rey, CA, USA
| | - Abigail Horn
- Information Sciences Institute, Marina del Rey, CA, USA
- Department of Industrial and Systems Engineering, University of Southern California, LA, CA, USA
| | - Andrés Abeliuk
- Department of Computer Science, University of Chile, Santiago, Chile
| | | |
Collapse
|
32
|
Farrell P, Bogard J, Thow AM, Boylan S, Johnson E, Tutuo J. Food price and availability in Solomon Islands during COVID-19: A food environment survey. Nutr Health 2023; 29:611-619. [PMID: 37365874 PMCID: PMC10293874 DOI: 10.1177/02601060231183592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Background: In Solomon Islands, the retail food environment is an important food source, for instance, the dominant source of fresh fruit and vegetables for urban consumers is open markets. The effects of COVID-19 mitigation measures (such as restriction of human movement and border closures) in early 2020 placed food security at risk in many parts of the community. Of particular concern was the risk of price gouging in an already price-sensitive market. Aims: The study aimed to provide rapid and policy-relevant information on the pricing of foods in the urban food environment in Solomon Islands in the context of the unfolding COVID-19 pandemic. Methods: A vendor survey was conducted in July to August 2020 and repeated in July 2021 using a survey tool that collected information on type, quantity, and price of food on offer. Findings: We found price reductions among the majority of fresh fruit and non-starchy vegetables available. A trend of rising prices was reported for some other commodities, such as fresh locally caught fish. Conclusion: Our findings highlight the impact of 'schocks to the system' on food prices as a potential barrier or enabler to consumption of fresh foods purchased from urban areas - an important finding in a price sensitive market. The survey design was successful in collecting pricing data from the retail food environment during a time of external 'shock to the system'. Our approach is applicable to other settings needing a rapid survey of the external food environment.
Collapse
Affiliation(s)
- Penny Farrell
- Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Jessica Bogard
- Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Sinead Boylan
- Agriculture and Food, Commonwealth Scientific and Industrial Research Organisation, Eveleigh, NSW, Australia
| | - Ellen Johnson
- Menzies Centre for Health Policy and Economics, Charles Perkins Centre (D17), Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | | |
Collapse
|
33
|
Jia SS, Allman-Farinelli M, Roy R, Phongsavan P, Hyun K, Gibson AA, Partridge SR. Using Mobile Ecological Momentary Assessment to Understand Consumption and Context Around Online Food Delivery Use: Pilot Feasibility and Acceptability Study. JMIR Mhealth Uhealth 2023; 11:e49135. [PMID: 38019563 PMCID: PMC10719819 DOI: 10.2196/49135] [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: 05/22/2023] [Revised: 10/18/2023] [Accepted: 11/05/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Mobile ecological momentary assessment (EMA) is a powerful tool for collecting real-time and contextual data from individuals. As our reliance on online technologies to increase convenience accelerates, the way we access food is changing. Online food delivery (OFD) services may further encourage unhealthy food consumption habits, given the high availability of energy-dense, nutrient-poor foods. We used EMA to understand the real-time effects of OFD on individuals' food choices and consumption behaviors. OBJECTIVE The primary aims of this pilot study were to assess the feasibility and acceptability of using EMA in young users of OFD and compare 2 different EMA sampling methods. The secondary aims were to gather data on OFD events and their context and examine any correlations between demographics, lifestyle chronic disease risk factors, and OFD use. METHODS This study used EMA methods via a mobile app (mEMASense, ilumivu Inc). Existing users of OFD services aged 16 to 35 years in Australia who had access to a smartphone were recruited. Participants were randomly assigned to 1 of 2 groups: signal-contingent or event-contingent. The signal-contingent group was monitored over 3 days between 7 AM and 10 PM. They received 5 prompts each day to complete EMA surveys via the smartphone app. In contrast, the event-contingent group was monitored over 7 days and was asked to self-report any instance of OFD. RESULTS A total of 102 participants were analyzed, with 53 participants in the signal-contingent group and 49 participants in the event-contingent group. Compliance rates, indicating the feasibility of signal-contingent and event-contingent protocols, were similar at 72.5% (574/792) and 73.2% (251/343), respectively. Feedback from the participants suggested that the EMA app was not easy to use, which affected their acceptability of the study. Participants in the event-contingent group were 3.53 (95% CI 1.52-8.17) times more likely to have had an OFD event captured during the study. Pizza (23/124, 18.5%) and fried chicken (18/124, 14.5%) comprised a bulk of the 124 OFD orders captured. Most orders were placed at home (98/124, 79%) for 1 person (68/124, 54.8%). Age (incidence rate ratio 0.95, 95% CI 0.91-0.99; P=.03) and dependents (incidence rate ratio 2.01, 95% CI 1.16-3.49; P=.01) were significantly associated with the number of OFD events in a week after adjusting for gender, socioeconomic status, diet quality score, and perceived stress levels. CONCLUSIONS This pilot study showed that EMA using an event-contingent sampling approach may be a better method to capture OFD events and context than signal-contingent sampling. The compliance rates showed that both sampling methods were feasible and acceptable. Although the findings from this study have gathered some insight on the consumption and context of OFD in young people, further studies are required to develop targeted interventions.
Collapse
Affiliation(s)
- Si Si Jia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics, Sydney School of Nursing, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Rajshri Roy
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Karice Hyun
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Concord Hospital, ANZAC Research Institute, The University of Sydney, Sydney, Australia
| | - Alice Anne Gibson
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Stephanie Ruth Partridge
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| |
Collapse
|
34
|
Kibe LW, Schrode K, Bazargan M, Shaheen M. Impact of food insecurity and food environment on the diet quality of older African Americans during the COVID-19 pandemic. Front Public Health 2023; 11:1268961. [PMID: 38035278 PMCID: PMC10682682 DOI: 10.3389/fpubh.2023.1268961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction A high quality diet is vital in promoting wellbeing and ensuring good health, particularly for those living with chronic conditions. Older African Americans, already burdened with a higher prevalence of chronic conditions, also face a higher risk for suboptimal diets. The COVID-19 pandemic had lasting effects on access to healthy food for all Americans, but some demographic groups were disproportionately affected. Older African Americans, who already experienced reduced access to healthy food pre-pandemic, were particularly afflicted, but the full extent of the pandemic's impact on their food insecurity and food environment remains unclear. Methods To address this gap, we conducted a study among 102 older African Americans in South Los Angeles between October 2021 and July 2022 during the COVID-19 pandemic. Participants completed surveys on dietary intake, food insecurity, and neighborhood food environment. We measured dietary quality using the healthy eating index (HEI)-2015. The analysis included descriptive, bivariate chi-square, t-tests, analysis of variance, and multiple linear and logistic regression. Results While overall dietary quality was suboptimal, most participants met the guidelines for fruit and vegetable consumption. Food insecurity was associated with lower overall diet quality and lower total fruit and whole fruit intake. However, there was no association between food environment and diet quality. Discussion In light of our findings, further intervention is critical to improving diet quality, especially among older African Americans living with chronic conditions in the post-pandemic era.
Collapse
Affiliation(s)
- Lucy W. Kibe
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Katrina Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Mohsen Bazargan
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Magda Shaheen
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| |
Collapse
|
35
|
Pelly FE, Thurecht RL. Evaluation of an Environmental Nutrition Intervention at the 2018 Commonwealth Games. Nutrients 2023; 15:4678. [PMID: 37960331 PMCID: PMC10647693 DOI: 10.3390/nu15214678] [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: 09/10/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
There has been an increasing expectation that the food provided for athletes at major competition events meets the specific dietary and performance needs of athletes. The aim of this study was to map the range of food service nutrition schemes that were implemented prior to and during a major competition event (2018 Commonwealth Games) and evaluate these schemes through staff training satisfaction, athlete feedback, and quality assurance checks. This study followed a case study design with nutrition schemes as follows: informing (nutrition labelling), enabling (staff training, nutrition service), and engineering (modification to menus and recipes). Overall, participants reported that they easily found items on the menu that met their nutritional/dietary needs. When asked how useful the schemes were in helping them to identify items that meet their needs, the majority of participants found the nutrition cards (n = 227, 71%) and serving staff (n = 212, 66%) 'useful/very useful'. 'Good/very good' ratings were received by >90% of respondents for speed of service, staff politeness, and knowledge of the menu. Participants (n = 316) who rated the nutrition staff as 'useful/very useful' gave a higher median rating for the menu. Past events have focused on the impact of a single component in the food environment; however, taking a whole systems approach resulted in more suitable food provision to meet the dietary needs of athletes.
Collapse
Affiliation(s)
- Fiona E. Pelly
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia;
| | | |
Collapse
|
36
|
Schumacher TL, Alderton CA, Brown LJ, Heaney S, Alston L, Kent K, Godrich SL. Development of a Scoring Tool for Australian Rural Food Retail Environments. Nutrients 2023; 15:4660. [PMID: 37960313 PMCID: PMC10648429 DOI: 10.3390/nu15214660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Current tools scoring the healthiness of food retail outlets do not reflect outlets found in rural locations. This study aimed to adapt pre-existing Australian scoring tools to represent non-metropolitan areas. Rural nutrition experts were identified, and a modified Delphi technique was used to adapt two pre-existing, food-scoring tools in five iterative stages. Stages included identifying all relevant outlets, providing a description and score for each, ensuring consistency between outlet scores and pre-existing, metro-centric tools, and providing instructions for correct use. Six rural nutrition experts were identified and engaged in the modified Delphi technique. The final tool consisted of 12 categories of food outlets and listed 35 individual outlets. Consistent with pre-existing Australian tools, scores ranged from +10 to -10 and included descriptions reflective of rural retail outlets. Scores were based on whether the majority of foods offered within the outlet were consistent with foods recommended in national health guidelines. The developed tool was designed to accommodate the diverse nature of food retail outlets found in non-metropolitan areas. This study assists in explaining the link between the food environment and health in populations living rurally.
Collapse
Affiliation(s)
- Tracy L. Schumacher
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia; (C.A.A.); (L.J.B.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia;
| | - Carissa A. Alderton
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia; (C.A.A.); (L.J.B.)
| | - Leanne J. Brown
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Tamworth, NSW 2340, Australia; (C.A.A.); (L.J.B.)
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia;
| | - Susan Heaney
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia;
- Department of Rural Health, College of Health, Medicine and Wellbeing, University of Newcastle, Port Macquarie, NSW 2444, Australia
| | - Laura Alston
- Deakin Rural Health, School of Medicine, Deakin University, Geelong, VIC 3220, Australia;
- Research Unit, Colac Area Health, Colac, VIC 3250, Australia
| | - Katherine Kent
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia;
- School of Health Sciences, University of Tasmania, Launceston, TAS 7250, Australia
| | - Stephanie Louise Godrich
- Centre for People, Place, and Planet, Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia;
| |
Collapse
|
37
|
O'Connor LE, Higgins KA, Smiljanec K, Bergia R, Brown AW, Baer D, Davis C, Ferruzzi MG, Miller K, Rowe S, Rueda JMW, Andres A, Cash SB, Coupland J, Crimmins M, Fiecke C, Forde CG, Fukagawa NK, Hall KD, Hamaker B, Herrick KA, Hess JM, Heuven LA, Juul F, Malcomson FC, Martinez-Steele E, Mattes RD, Messina M, Mitchell A, Zhang FF. Perspective: A Research Roadmap about Ultra-Processed Foods and Human Health for the United States Food System: Proceedings from an Interdisciplinary, Multi-Stakeholder Workshop. Adv Nutr 2023; 14:1255-1269. [PMID: 37722488 PMCID: PMC10721509 DOI: 10.1016/j.advnut.2023.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023] Open
Abstract
Our objective was to convene interdisciplinary experts from government, academia, and industry to develop a Research Roadmap to identify research priorities about processed food intake and risk for obesity and cardiometabolic diseases (CMD) among United States populations. We convened attendees at various career stages with diverse viewpoints in the field. We held a "Food Processing Primer" to build foundational knowledge of how and why foods are processed, followed by presentations about how processed foods may affect energy intake, obesity, and CMD risk. Breakout groups discussed potential mechanistic and confounding explanations for associations between processed foods and obesity and CMD risk. Facilitators created research questions (RQs) based on key themes from discussions. Different breakout groups convened to discuss what is known and unknown for each RQ and to develop sub-RQs to address gaps. Workshop attendees focused on ultra-processed foods (UPFs; Nova Group 4) because the preponderance of evidence is based on this classification system. Yet, heterogeneity and subjectivity in UPF classification was a challenge for RQ development. The 6 RQs were: 1) What objective methods or measures could further categorize UPFs, considering food processing, formulation, and the interaction of the two? 2) How can exposure assessment of UPF intake be improved? 3) Does UPF intake influence risk for obesity or CMDs, independent of diet quality? 4) What, if any, attributes of UPFs influence ingestive behavior and contribute to excess energy intake? 5) What, if any, attributes of UPFs contribute to clinically meaningful metabolic responses? 6) What, if any, external environmental factors lead people to consume high amounts of UPFs? Uncertainty and complexity around UPF intake warrant further complementary and interdisciplinary causal, mechanistic, and methodological research related to obesity and CMD risk to understand the utility of applying classification by degree of processing to foods in the United States.
Collapse
Affiliation(s)
- Lauren E O'Connor
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States.
| | - Kelly A Higgins
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | | | - Robert Bergia
- Archer Daniels Midland (ADM), Decatur, IL, United States
| | - Andrew W Brown
- University of Arkansas for Medical Sciences and Arkansas Children's Research Institute, Little Rock, AR, United States
| | - David Baer
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | - Cindy Davis
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | - Mario G Ferruzzi
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States; Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Kevin Miller
- Bell Institute of Health & Nutrition, General Mills, Minneapolis, MN, United States
| | | | | | - Aline Andres
- University of Arkansas for Medical Sciences and Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, United States
| | - John Coupland
- Penn State University, University Park, PA, United States
| | - Meghan Crimmins
- University of Arkansas for Medical Sciences and Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Chelsey Fiecke
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States; Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Ciarán G Forde
- Wageningen University and Research, Wageningen, The Netherlands
| | - Naomi K Fukagawa
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, United States
| | - Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Bruce Hamaker
- Purdue University, West Lafayette, IN, United States
| | - Kirsten A Herrick
- National Cancer Institute, National Institutes of Health, Rockville, MD, United States
| | - Julie M Hess
- Agricultural Research Service, US Department of Agriculture, Grand Forks, ND, United States
| | - Lise Aj Heuven
- Wageningen University and Research, Wageningen, The Netherlands
| | - Filippa Juul
- New York University School of Global Public Health, New York, NY, United States
| | | | | | | | - Mark Messina
- Soy Nutrition Institute Global, Pittsfield, MA, United States
| | - Alyson Mitchell
- Food Science and Technology, University of California at Davis, CA, United States
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, United States
| |
Collapse
|
38
|
Ares G, Natero V, Gugliucci V, Machín L, Alcaire F, de León C, Otterbring T. Health-Washing of Ultraprocessed Products on Instagram: Prevalence and Strategies in an Emerging Market. J Nutr Educ Behav 2023; 55:815-822. [PMID: 37777932 DOI: 10.1016/j.jneb.2023.09.001] [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] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE To evaluate the prevalence of health-related cues as part of the digital marketing of ultraprocessed foods on Instagram among food companies in Uruguay. METHODS Cross-sectional exploratory study. All content posted by 118 Instagram accounts of companies promoting ultraprocessed foods in Uruguay over 6 months (from August 2020 to February 2021) was retrieved. The content of 1,893 Instagram posts was coded considering visual and textual cues conveying health-related associations. The number and percentage of posts, including cues within each category and theme, were calculated. RESULTS More than half of all posts contained at least 1 visual or textual cue conveying health-related associations. Three main themes emerged: i) product composition, ii) healthy lifestyle, and iii) health and health benefits. The prevalence of health-related cues differed dramatically across product categories, ranging from 100% to 1.5%. CONCLUSIONS AND IMPLICATIONS Health-washing constitutes an integral part of the digital marketing of ultraprocessed foods on Instagram in Uruguay. The inclusion of health-related cues can potentially undermine public health efforts targeted at reducing consumption of these foods. These findings suggest that strict and comprehensive regulations on the digital marketing of such products are needed in policies promoting healthy eating habits globally.
Collapse
Affiliation(s)
- Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Uruguay; Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay.
| | - Virginia Natero
- Departamento de Alimentos, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Vanessa Gugliucci
- Espacio Interdisciplinario, Universidad de la República, Montevideo, Uruguay
| | - Leandro Machín
- Centro de Investigación Básica en Psicología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Uruguay
| | | | - Tobias Otterbring
- School of Business and Law, Department of Management, University of Agder, Kristiansand, Norway; Institute of Retail Economics, Stockholm, Sweden
| |
Collapse
|
39
|
Magdaleno L, Rolling T, Waits Galia S, Ayala GX. Evaluation of a front-of-pack food labeling intervention on a college campus. J Am Coll Health 2023; 71:2417-2425. [PMID: 34519632 DOI: 10.1080/07448481.2021.1970563] [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] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 07/28/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
Objective: To evaluate the process of implementation and impact of a front-of-pack labeling intervention on purchases of labeled food products. Participants: A convenience sample of 111 college students were recruited to complete a survey as they exited markets where the intervention was being implemented. Participants had to have purchased at least one consumable item. Methods: Intercept surveys and audits were conducted at three markets, two times each over a period of three weeks. Results: The audits indicated high implementation fidelity (82% overall). However, customer surveys revealed that only 42% noticed the front-of-pack sticker, and the majority (89%) did not purchase an item with the sticker. However, customers who noticed the sticker were significantly more likely to purchase an item with the sticker (p = .002). Conclusions: These findings provide preliminary evidence for the feasibility and effectiveness of a front-of-pack labeling intervention in a university market setting.
Collapse
Affiliation(s)
- Lauren Magdaleno
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, California, USA
| | - Tyler Rolling
- Well-being and Health Promotion Department, San Diego State University, San Diego, California, USA
| | - Stephanie Waits Galia
- Well-being and Health Promotion Department, San Diego State University, San Diego, California, USA
| | - Guadalupe X Ayala
- Division of Health Promotion and Behavioral Science, School of Public Health, The Institute for Behavioral and Community Health, and SDSU HealthLINK Center, San Diego State University, San Diego, California, USA
| |
Collapse
|
40
|
Needham C, Strugnell C, Allender S, Alston L, Orellana L. BMI and the Food Retail Environment in Melbourne, Australia: Associations and Temporal Trends. Nutrients 2023; 15:4503. [PMID: 37960156 PMCID: PMC10649206 DOI: 10.3390/nu15214503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
Research into the link between food environments and health is scarce. Research in this field has progressed, and new comprehensive methods (i.e., incorporating all food retail outlets) for classifying food retail environments have been developed and are yet to be examined alongside measures of obesity. In this study, we examine the association and temporal trends between the food environment and BMI of a repeated cross-sectional sample of the adult population between 2008 and 2016. Methods: Food retail data for 264 postal areas of Greater Melbourne was collected for the years 2008, 2012, 2014, and 2016, and a container-based approach was used to estimate accessibility to supermarkets, healthy and unhealthy outlets. Data on BMI for postal areas was obtained from the Victorian Population Health Survey (n = 47,245). We estimated the association between the food environment and BMI using linear mixed models. Results indicated that BMI increased as accessibility to healthy outlets decreased by up to -0.69 kg/m2 (95%CI: -0.95, -0.44). BMI was lower with high and moderate access to supermarkets compared to low access by -0.33 kg/m2 (-0.63, -0.04) and -0.32 kg/m2 (-0.56, -0.07), and with high access to unhealthy outlets compared to low access (-0.38 kg/m2: -0.64, -0.12) and moderate access (-0.54 kg/m2: -0.78, -0.30). Conclusion: Our results show that increasing access and availability to a diverse range of food outlets, particularly healthy food outlets, should be an important consideration for efforts to support good health. This research provides evidence that Australia needs to follow suit with other countries that have adopted policies giving local governments the power to encourage healthier food environments.
Collapse
Affiliation(s)
- Cindy Needham
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (C.S.); (S.A.)
| | - Claudia Strugnell
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (C.S.); (S.A.)
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC 3220, Australia
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (C.S.); (S.A.)
| | - Laura Alston
- Colac Area Health, Colac, VIC 3250, Australia;
- Faculty of Health, Deakin Rural Health, Deakin University, Warrnambool, VIC 3280, Australia
| | - Liliana Orellana
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, VIC 3220, Australia;
| |
Collapse
|
41
|
Lyu W, Seok N, Chen X, Xu R. Using Crowdsourced Food Image Data for Assessing Restaurant Nutrition Environment: A Validation Study. Nutrients 2023; 15:4287. [PMID: 37836570 PMCID: PMC10574450 DOI: 10.3390/nu15194287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/18/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
Crowdsourced online food images, when combined with food image recognition technologies, have the potential to offer a cost-effective and scalable solution for the assessment of the restaurant nutrition environment. While previous research has explored this approach and validated the accuracy of food image recognition technologies, much remains unknown about the validity of crowdsourced food images as the primary data source for large-scale assessments. In this paper, we collect data from multiple sources and comprehensively examine the validity of using crowdsourced food images for assessing the restaurant nutrition environment in the Greater Hartford region. Our results indicate that while crowdsourced food images are useful in terms of the initial assessment of restaurant nutrition quality and the identification of popular food items, they are subject to selection bias on multiple levels and do not fully represent the restaurant nutrition quality or customers' dietary behaviors. If employed, the food image data must be supplemented with alternative data sources, such as field surveys, store audits, and commercial data, to offer a more representative assessment of the restaurant nutrition environment.
Collapse
Affiliation(s)
- Weixuan Lyu
- Department of Geography, University of Connecticut, Storrs, CT 06269, USA; (W.L.); (X.C.)
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Nina Seok
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Xiang Chen
- Department of Geography, University of Connecticut, Storrs, CT 06269, USA; (W.L.); (X.C.)
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| |
Collapse
|
42
|
Barrett EM, Hart AC, Bhat S, Marklund M, Coyle DH, Heenan M, Pettigrew S, Wu JH. The Effect of Retail Food Environment Interventions on Dietary Behavior in Postsecondary Education Settings: A Systematic Review and Meta-analysis. J Nutr 2023; 153:3122-3130. [PMID: 37741633 DOI: 10.1016/j.tjnut.2023.08.034] [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: 06/29/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Postsecondary education institutions, where hundreds of millions of people work and study globally, are a key setting for retail food environment interventions. OBJECTIVE We aimed to synthesize the evidence for the effectiveness of retail food environment interventions in improving the healthiness of dietary behavior of students and staff in postsecondary education settings. METHODS Academic databases were searched for randomized controlled trials (RCTs) and quasi-experimental studies published until August 2023. Studies were eligible if they assessed the impact of a retail food environment intervention on healthiness of dietary behavior (purchases or consumption) in students or staff in postsecondary education settings and targeted one of the following food environment elements: placement, price, product, or promotion. Business-related outcomes (total sales, profit, or revenue) were included as secondary outcomes. Findings were synthesized in narrative form, organized by retail food environment element. Where comparable dietary outcome data were available from ≥10 interventions, findings were pooled using random effects meta-analysis. RESULTS Of 10,126 studies initially identified, 55 (76% quasi-experimental) were included, describing 71 separate interventions (n = 49 single-element and n = 22 multi-element). Two-thirds (n = 47, 66%) of interventions (n = 32 single-element and n = 15 multi-element) demonstrated significant improvements in dietary behavior. Single-element interventions targeting placement (n = 1) and price (n = 3) improved dietary behavior. Most (n = 9/10, 90%) interventions targeting product availability or convenience (product element) improved dietary behavior, while n = 19/35 (54%) targeting promotion did. Pooled findings from 12 interventions reporting changes in energy content demonstrated a significant decrease in purchased or consumed energy (-7.9%; 95% confidence interval: -10.3%, -5.6%). Almost all interventions (n = 11/12, 92%) that evaluated the impact on business-related outcomes found either a significant increase or no change following the intervention. CONCLUSIONS We established encouraging evidence supporting the role of retail food environment interventions in postsecondary education settings to support healthy dietary behaviors of students and staff. REGISTRY PROSPERO (International Prospective Register of Systematic Reviews, URL: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295836; registration number CRD42022295836).
Collapse
Affiliation(s)
- Eden M Barrett
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Ashleigh C Hart
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Saiuj Bhat
- Royal Perth Hospital, Victoria Square, Perth, Western Australia; School of Medicine, The University of Western Australia, Crawley, Western Australia
| | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Daisy H Coyle
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Maddie Heenan
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
43
|
Chen YJM, Haynes A, Scully M, Gascoyne C, McAleese A, Dixon H, Morley B, Wakefield M. Food purchasing practices in various retail settings and dietary intake: A cross-sectional survey of Australian adolescents. Health Promot J Austr 2023; 34:784-790. [PMID: 36625434 DOI: 10.1002/hpja.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND/AIMS Discretionary, energy-dense, nutrient-poor food and drinks are heavily marketed and readily available in retail settings frequented by adolescents. This study examines associations between food purchasing practices in various retail settings and dietary intake among Australian adolescents. METHODS Participants were students in years 8 to 11 (ages 12-17 years) who completed the 2009-10 (n = 13 790), 2012-13 (n = 10 309) or 2018 (n = 9102) National Secondary Students' Diet and Activity (NaSSDA) cross-sectional survey. Multistage stratified random sampling was used. An online survey completed at school assessed self-reported frequency of food purchasing practices in various retail settings and consumption of discretionary food, sugary drinks, fruit and vegetables. Generalised linear regression models examined associations between food purchasing practices and dietary behaviour. RESULTS Relative to students who brought lunch from home, those who purchased lunch from school or nearby outlets reported higher intake of discretionary food and sugary drinks and lower fruit intake. Buying lunch from school was also associated with lower vegetable intake. Buying food or drinks on the school commute, outside school grounds during school hours, from supermarket checkouts, and using mobile phone apps were each associated with higher discretionary food and sugary drink intake (all P < .01). CONCLUSIONS Purchasing food or drink in various retail settings is associated with higher intake of discretionary food and drink among Australian adolescents, and some purchasing practices appeared to displace fruit and vegetable intake. SO WHAT?: These findings highlight a need to improve the accessibility and promotion of healthier food and drink options in schools and other retail settings.
Collapse
Affiliation(s)
- Yan Jun Michelle Chen
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Claudia Gascoyne
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Alison McAleese
- Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
44
|
Cediel G, Mendonça RDD, Meireles AL, Leite MA, Gombi-Vaca MF, Rauber F. Editorial: Ultra-processed foods and human and planetary health. Front Nutr 2023; 10:1297262. [PMID: 37841412 PMCID: PMC10570797 DOI: 10.3389/fnut.2023.1297262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/17/2023] Open
Affiliation(s)
- Gustavo Cediel
- School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Raquel de Deus Mendonça
- Department of Clinical and Social Nutrition, School of Nutrition, University of Ouro Preto, Ouro Preto, Brazil
- Research and Teaching Group in Nutrition and Public Health, Graduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Adriana Lúcia Meireles
- Department of Clinical and Social Nutrition, School of Nutrition, University of Ouro Preto, Ouro Preto, Brazil
- Research and Teaching Group in Nutrition and Public Health, Graduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Maria Alvim Leite
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Maria F. Gombi-Vaca
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, United States
| | - Fernanda Rauber
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
45
|
Peng Q, Zhang L, Huang X, Wu J, Cheng Y, Xie G, Feng X, Chen X. Environmental Factors Affecting the Diversity and Composition of Environmental Microorganisms in the Shaoxing Rice Wine Producing Area. Foods 2023; 12:3564. [PMID: 37835217 PMCID: PMC10572700 DOI: 10.3390/foods12193564] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 10/15/2023] Open
Abstract
Shaoxing rice wine is a notable exemplar of Chinese rice wine. Its superior quality is strongly correlated with the indigenous natural environment. The results indicated that Firmicutes (75%), Actinobacteria (15%), Proteobacteria (5%), and Bacteroidetes (3%) comprised the prevailing bacterial groups. Among the main bacterial genera, Lactobacillus was the most abundant, accounting for 49.4%, followed by Lactococcus (11.9%), Saccharopolyspora (13.1%), Leuconostoc (4.1%), and Thermoactinomyces (1.1%). The dominant fungal phyla were Ascomycota and Zygomycota. Among the dominant genera, Saccharomyces (59.3%) prevailed as the most abundant, followed by Saccharomycopsis (10.7%), Aspergillus (7.1%), Thermomyces (6.2%), Rhizopus (4.9%), Rhizomucor (2.2%), and Mucor (1.3%). The findings demonstrate that the structure of the bacterial and fungal communities remains stable in the environment, with their diversity strongly influenced by climatic conditions. The continuous fluctuations in environmental factors, such as temperature, air pressure, humidity, rainfall, and light, significantly impact the composition and diversity of microbial populations, particularly the dominant bacterial community.
Collapse
Affiliation(s)
- Qi Peng
- School of Life and Environmental Sciences, Shaoxing University, Shaoxing 312000, China; (Q.P.); (L.Z.); (X.F.); (X.C.)
| | - Lili Zhang
- School of Life and Environmental Sciences, Shaoxing University, Shaoxing 312000, China; (Q.P.); (L.Z.); (X.F.); (X.C.)
| | - Xiaoli Huang
- Shaoxing Testing Institute of Quality and Technical Supervision, Shaoxing 312000, China; (X.H.); (J.W.); (Y.C.)
| | - Jianjiang Wu
- Shaoxing Testing Institute of Quality and Technical Supervision, Shaoxing 312000, China; (X.H.); (J.W.); (Y.C.)
| | - Yujun Cheng
- Shaoxing Testing Institute of Quality and Technical Supervision, Shaoxing 312000, China; (X.H.); (J.W.); (Y.C.)
| | - Guangfa Xie
- Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, College of Biology and Environmental Engineering, Zhejiang Shuren University, Hangzhou 310015, China
| | - Xinxin Feng
- School of Life and Environmental Sciences, Shaoxing University, Shaoxing 312000, China; (Q.P.); (L.Z.); (X.F.); (X.C.)
| | - Xueping Chen
- School of Life and Environmental Sciences, Shaoxing University, Shaoxing 312000, China; (Q.P.); (L.Z.); (X.F.); (X.C.)
| |
Collapse
|
46
|
Wowra P, Joanes T, Gwozdz W. In Which Situations Do We Eat? A Diary Study on Eating Situations and Situational Stability. Nutrients 2023; 15:3967. [PMID: 37764751 PMCID: PMC10537183 DOI: 10.3390/nu15183967] [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: 07/29/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Eating situations are crucial for understanding and changing eating behavior. While research on individual situational dimensions exists, little is known about eating situations as a whole. This study aimed to fill this gap by identifying eating situations as combinations of multiple situational dimensions and describing how stable individuals eat in those situations. In a five-day online diary study, 230 participants reported a total of 2461 meals and described the corresponding eating situation using predefined situational dimensions. Divisive hierarchical cluster analyses were conducted separately for breakfast, lunch, and dinner, resulting in unique cluster solutions that characterized the most common eating situations. The most common breakfast situations were characterized by a combination of the dimensions social, affect, and hunger. The most common lunch and dinner situations were characterized by varying combinations of the dimensions social, affect, and activity. Based on the identified situations, a situational stability index was developed to describe how stable individuals eat in the same situations. The findings suggest high interindividual differences in situational stability, which were associated with socio-demographic characteristics like age or employment. This study enhances our understanding of the situational aspects of eating behavior while offering tools to describe eating situations and situational stability.
Collapse
Affiliation(s)
- Patricia Wowra
- Department of Consumer Research, Communication & Food Sociology, Justus Liebig University, 35390 Giessen, Germany; (T.J.); (W.G.)
| | - Tina Joanes
- Department of Consumer Research, Communication & Food Sociology, Justus Liebig University, 35390 Giessen, Germany; (T.J.); (W.G.)
| | - Wencke Gwozdz
- Department of Consumer Research, Communication & Food Sociology, Justus Liebig University, 35390 Giessen, Germany; (T.J.); (W.G.)
- Department of Management, Society and Communication, Copenhagen Business School, 2000 Frederiksberg, Denmark
| |
Collapse
|
47
|
Hall KD. From dearth to excess: the rise of obesity in an ultra-processed food system. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220214. [PMID: 37482782 PMCID: PMC10363698 DOI: 10.1098/rstb.2022.0214] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/06/2023] [Accepted: 05/23/2023] [Indexed: 07/25/2023] Open
Abstract
More people now have obesity than suffer from starvation thanks to our modern food system. Agriculture was transformed over the 20th century by a variety of technological advancements that relied heavily on fossil fuels. In the United States, government policies and economic incentives led to surplus production of cheap inputs to processed food industries that produced a wide variety of heavily marketed, convenient, rewarding, timesaving, and relatively inexpensive ultra-processed foods. The energy available in the food supply increased by much more than the population needs, albeit with large inequities in nutrition security. While most of the rise in per capita food availability during the late 20th and early 21st centuries in the United States resulted in increased food waste, a variety of mechanisms have been proposed by which changes in the increasingly ultra-processed food environment resulted in excess energy intake disproportionately in people genetically susceptible to obesity. As populations continue to grow, substantial investments in coordinated nutrition and agricultural research are needed to transform our current food system to one that relies less on fossil fuels, preserves biodiversity, ensures environmental health, and provides equitable access to affordable, safe and nutritious food that reduces the prevalence of chronic diet-related diseases like obesity. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
Collapse
Affiliation(s)
- Kevin D. Hall
- Integrative Physiology Section Chief, Laboratory of Biological Modeling, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, 12A South Drive, Room 4007, Bethesda, MD 20892-4007, USA
| |
Collapse
|
48
|
Renner B, Buyken AE, Gedrich K, Lorkowski S, Watzl B, Linseisen J, Daniel H. Perspective: A Conceptual Framework for Adaptive Personalized Nutrition Advice Systems (APNASs). Adv Nutr 2023; 14:983-994. [PMID: 37419418 PMCID: PMC10509404 DOI: 10.1016/j.advnut.2023.06.009] [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: 10/01/2022] [Revised: 05/06/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023] Open
Abstract
Nearly all approaches to personalized nutrition (PN) use information such as the gene variants of individuals to deliver advice that is more beneficial than a generic "1-size-fits-all" recommendation. Despite great enthusiasm and the increased availability of commercial services, thus far, scientific studies have only revealed small to negligible effects on the efficacy and effectiveness of personalized dietary recommendations, even when using genetic or other individual information. In addition, from a public health perspective, scholars are critical of PN because it primarily targets socially privileged groups rather than the general population, thereby potentially widening health inequality. Therefore, in this perspective, we propose to extend current PN approaches by creating adaptive personalized nutrition advice systems (APNASs) that are tailored to the type and timing of personalized advice for individual needs, capacities, and receptivity in real-life food environments. These systems encompass a broadening of current PN goals (i.e., what should be achieved) to incorporate "individual goal preferences" beyond currently advocated biomedical targets (e.g., making sustainable food choices). Moreover, they cover the "personalization processes of behavior change" by providing in situ, "just-in-time" information in real-life environments (how and when to change), which accounts for individual capacities and constraints (e.g., economic resources). Finally, they are concerned with a "participatory dialog between individuals and experts" (e.g., actual or virtual dieticians, nutritionists, and advisors) when setting goals and deriving measures of adaption. Within this framework, emerging digital nutrition ecosystems enable continuous, real-time monitoring, advice, and support in food environments from exposure to consumption. We present this vision of a novel PN framework along with scenarios and arguments that describe its potential to efficiently address individual and population needs and target groups that would benefit most from its implementation.
Collapse
Affiliation(s)
- Britta Renner
- Department of Psychology and Centre for the Advanced Study of Collective Behavior, Psychological Assessment and Health Psychology, University of Konstanz, Konstanz, Germany.
| | - Anette E Buyken
- Public Health Nutrition, Paderborn University, Paderborn, Germany
| | - Kurt Gedrich
- ZIEL-Institute for Food and Health, Technical University of Munich, Freising, Germany
| | - Stefan Lorkowski
- Institute of Nutritional Sciences Friedrich Schiller University Jena, Jena, Germany, and Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Germany
| | - Bernhard Watzl
- Ex. Department of Physiology and Biochemistry of Nutrition, Max Rubner-Institut, Karlsruhe, Germany
| | - Jakob Linseisen
- University Hospital Augsburg, University of Augsburg, Augsburg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Hannelore Daniel
- Ex. School of Life Sciences, Technical University of Munich, Freising, Germany
| |
Collapse
|
49
|
Fong M, Scott S, Albani V, Brown H. The Impact of COVID-19 Restrictions and Changes to Takeaway Regulations in England on Consumers' Intake and Methods of Accessing Out-of-Home Foods: A Longitudinal, Mixed-Methods Study. Nutrients 2023; 15:3636. [PMID: 37630827 PMCID: PMC10459227 DOI: 10.3390/nu15163636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND COVID-19 restrictions significantly impacted the operations of fast food and full-service retailers. Full-service retailers were permitted to operate as takeaway outlets without needing to seek formal changes in planning permissions. We conducted a study to determine consumers' intake and modes of accessing foods from fast food and full-service retailers during various COVID-19 restrictions and changes to takeaway/delivery regulations, as well as their experiences. METHODS We conducted a longitudinal, mixed-methods study comprising three surveys, which examined the intake frequency and modes of accessing retailers, and two rounds of qualitative focus groups, which explored their related experiences. The data were collected at three timepoints (T) from May 2021-March 2022. The participants were adults living in Northern England (n = 701 at T1); a sub-sample participated in the focus groups (n = 22). The intake data were presented descriptively; an ordered logit regression explored the factors associated with the intake frequency. The focus group data were analysed using a framework analysis. RESULTS The mean weekly intake frequency from fast food retailers at T1, T2, and T3 was 0.96 (SD 1.05), 1.08 (SD 1.16), and 1.06 times (SD 1.12), respectively. For full-service retailers, this was 0.36 (SD 0.69), 0.75 (1.06), and 0.71 (SD 0.99) times, respectively. Food access issues (OR (SE): T1 = 1.65 (0.40), T2 = 2.60 (0.66), T = 2.1 (0.62)) and obesity (T1 = 1.61 (0.31), T2 = 2.21 (0.46), T3 = 1.85 (0.42)) were positively associated with intake from fast food, but not full-service retailers. Delivery services were commonly used to access fast food (30-34% participants), but not full-service retailers (6-10% participants). As COVID-19 restrictions eased, participants were eager to socialise on-premises at full-service retailers. CONCLUSIONS Takeaway/delivery services were seldom used to access full-service retailers, but the use of delivery services to access fast food was high. Policymakers must recognise delivery services as a growing part of the food environment, and the challenges they pose to planning policies for obesity prevention.
Collapse
Affiliation(s)
- Mackenzie Fong
- National Institute for Health and Care Research Applied Research Collaboration (North East and North Cumbria), Newcastle-upon-Tyne NE3 3XT, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
| | - Steph Scott
- National Institute for Health and Care Research Applied Research Collaboration (North East and North Cumbria), Newcastle-upon-Tyne NE3 3XT, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
| | - Viviana Albani
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
| | - Heather Brown
- Division Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4AT, UK
| |
Collapse
|
50
|
Polsky JY, Garriguet D. The local restaurant environment in relation to eating out and sugary drink intake among Canadian children and youth. Health Rep 2023; 34:3-15. [PMID: 37647458 DOI: 10.25318/82-003-x202300800001-eng] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Background Accessibility of food retail in communities may play a role in shaping the food choices of local residents. However, previous studies have shown mixed results. This study examined associations between the local restaurant environment and the frequency of eating food from restaurants and intake of sugary drinks among Canadian children and youth. Data and methods The study cohort consisted of 23,776 participants (aged 1 to 17 years) in the 2019 Canadian Health Survey on Children and Youth who resided in large urban population centres across the Canadian provinces. Measures of geographic access to various restaurant types within walking distance of participants' residential areas came from the 2018 Canadian Food Environment Dataset. Poisson regression models with robust standard errors assessed associations between measures of absolute densities (number per km²) of full-service, fast-food and other restaurants, and the relative density of fast-food restaurants (as a percentage of total restaurants) with the frequency of eating food from fast-food or full-service restaurants and sugary drink intake in the previous seven days. Results After adjustment for a range of sociodemographic covariates, there were no consistent associations between absolute and relative measures of restaurant access and the frequency of eating food from restaurants or intake of sugary drinks. Interpretation Results reveal no consistent relationships between local restaurant exposures and the frequency of eating food from restaurants or sugary drink intake among Canadian children and youth. Efforts to create environments that foster healthy food choices among young people will remain important but will likely need to target multiple activity spaces beyond the local neighbourhood.
Collapse
|