A continuous indicator of food environment nutritional quality

Food environments can profoundly impact diet and related diseases. Effective, robust measures of food environment nutritional quality are required by researchers and policymakers investigating their effects on individual dietary behavior and designing targeted public health interventions. The most commonly used indicators of food environment nutritional quality are limited to measuring the binary presence or absence of entire categories of food outlet type, such as 'fast-food' outlets, which can range from burger joints to salad chains. This work introduces a summarizing indicator of restaurant nutritional quality that exists along a continuum, and which can be applied at scale to make distinctions between diverse restaurants within and across categories of food outlets. Verified nutrient data for a set of over 500 chain restaurants is used as ground-truth data to validate the approach. We illustrate the use of the validated indicator to characterize food environments at the scale of an entire jurisdiction, demonstrating how making distinctions between different shades of nutritiousness can help to uncover hidden patterns of disparities in access to high nutritional quality food.

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Association between junk food consumption and fast-food outlet access near school among Quebec secondary-school children: findings from the Quebec Health Survey of High School Students (QHSHSS) 2010–11

Public Health Nutrition ◽

10.1017/s136898001600286x ◽

2016 ◽

Vol 20 (5) ◽

pp. 927-937 ◽

Cited By ~ 14

Author(s):

Nicoleta Cutumisu ◽

Issouf Traoré ◽

Marie-Claude Paquette ◽

Linda Cazale ◽

Hélène Camirand ◽

...

Keyword(s):

High School ◽

High School Students ◽

Secondary School ◽

School Children ◽

Food Environment ◽

Fast Food ◽

Junk Food ◽

Food Outlet ◽

School Students ◽

Food Outlets

AbstractObjectiveWe investigated the association between junk food consumption at lunchtime (JCL) and fast-food outlet access near school among secondary-school children in Quebec.DesignA geographic information system database was used to characterize the food environment around a sub-sample of 374 public schools in which 26 655 students were enrolled. The outcome variable was JCL during the previous week, dichotomized into low JCL (none or once)v. high JCL (twice or more). Access to fast-food outlets near school was assessed using an existing database of fast-food outlets in Quebec. Covariates included student (age, sex and self-rated perceived health), family (familial status and parental education) and school (urban/rural status and deprivation) variables. Hierarchical logistic regression models were employed for analyses using PROC GLIMMIX of SAS version 9.3.SettingProvince of Quebec, Canada.SubjectsWe used data from the Quebec Health Survey of High School Students (QHSHSS) 2010–11, a survey of secondary-school Quebec students.ResultsExposure to two or more fast-food outlets within a radius of 750 m around schools was associated with a higher likelihood of excess JCL (OR=1·50; 95 % CI 1·28, 1·75), controlling for the characteristics of the students, their families and their schools.ConclusionsThe food environment surrounding schools can constitute a target for interventions to improve food choices among secondary-school children living in the province of Quebec. Transforming environments around schools to promote healthy eating includes modifying zoning regulations that restrict access to fast-food outlets around schools.

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Neighborhood food typologies, fast food outlet visitation and snack food purchasing among adolescents in Melbourne, Australia

Public Health Nutrition ◽

10.1017/s1368980021004298 ◽

2021 ◽

pp. 1-24

Author(s):

Venurs HY Loh ◽

Maartje P Poelman ◽

Jenny Veitch ◽

Sarah A McNaughton ◽

Rebecca M Leech ◽

...

Keyword(s):

Fast Food ◽

Latent Profile Analysis ◽

Profile Analysis ◽

Snack Food ◽

Food Environments ◽

Food Outlet ◽

Cross Sectional ◽

Food Purchasing ◽

Fast Food Outlet ◽

Food Outlets

Abstract Objective: Despite the increased attention on neighborhood food environments and dietary behaviors, studies focusing on adolescents are limited. This study aims to characterize typologies of food environments surrounding adolescents and their associations with fast food outlet visitation and snack food purchasing to/from school. Design: The number of food outlets (supermarket; green grocers; butcher/seafood/deli; bakeries; convenience stores; fast food/takeaways; café and restaurants) within a 1km buffer from home were determined using a Geographic Information System. Adolescents self-reported frequency of fast food outlet visitation and snack food purchasing to/from school. Latent Profile Analysis was conducted to identify typologies of the food environment. Cross-sectional multilevel logistic regression analyses were conducted to examine the relationships between food typologies, fast food outlet visitations and snack food purchasing to/from school. Setting: Melbourne, Australia Participants: 410 adolescents (mean age= 15.5 (SD=1.5) years) Results: Four distinct typologies of food outlets were identified: 1) limited variety/low number; 2) some variety/low number; 3) high variety/medium number; 4) high variety/high number. Adolescents living in Typologies 1 and 2 had three times higher odds of visiting fast food outlets ≥1 per week (Typology 1: OR= 3.71, 95%CI 1.23, 11.19; Typology 2: OR= 3.65, 95% CI 1.21, 10.99) than those living in Typology 4. No evidence of association was found between typologies of the food environments and snack food purchasing behavior to/from school among adolescents. Conclusion: Local government could emphasize an overall balance of food outlets when designing neighborhoods to reduce propensity for fast food outlet visitation among adolescents.

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Obesogenic neighbourhoods: the impact of neighbourhood restaurants and convenience stores on adolescents’ food consumption behaviours

Public Health Nutrition ◽

10.1017/s1368980012000584 ◽

2012 ◽

Vol 15 (12) ◽

pp. 2331-2339 ◽

Cited By ~ 57

Author(s):

Meizi He ◽

Patricia Tucker ◽

Jennifer D Irwin ◽

Jason Gilliland ◽

Kristian Larsen ◽

...

Keyword(s):

Food Environment ◽

Fast Food ◽

Healthy Eating Index ◽

Convenience Store ◽

Food Outlet ◽

Fast Food Outlet ◽

Food Outlets ◽

Convenience Stores ◽

Close Proximity ◽

The Impact

AbstractObjectiveTo examine the relationship between the neighbourhood food environment and dietary intake among adolescents.DesignCross-sectional design using: (i) a geographic information system to assess characteristics of the neighbourhood food environment and neighbourhood socio-economic status; (ii) the modified Healthy Eating Index (HEI) to assess participants’ overall diet quality; and (iii) generalized linear models to examine associations between HEI and home and school food environmental correlates.SettingMid-sized Canadian city in Ontario, Canada.ParticipantsGrade 7 and 8 students (n810) at twenty-one elementary schools.ResultsStudents living in neighbourhoods with a lower diversity of land-use types, compared with their higher diversity counterparts, had higher HEI scores (P< 0·05). Students with more than 1 km between their home and the nearest convenience store had higher HEI scores than those living within 1 km (P< 0·01). Students attending schools with a distance further than 1 km from the nearest convenience store (P< 0·01) and fast-food outlet (P< 0·05) had higher HEI scores than those within 1 km. Those attending schools with three or more fast-food outlets within 1 km had lower HEI scores than those attending schools with no fast-food outlet in the school surroundings (P< 0·05).ConclusionsClose proximity to convenience stores in adolescents’ home environments is associated with low HEI scores. Within adolescents’ school environments, close proximity to convenience and fast-food outlets and a high density of fast-food outlets are associated with low HEI scores.

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A temporal analysis of the spatial clustering of food outlets around schools in Christchurch, New Zealand, 1966 to 2006

Public Health Nutrition ◽

10.1017/s1368980013002863 ◽

2013 ◽

Vol 18 (1) ◽

pp. 135-142 ◽

Cited By ~ 7

Author(s):

Peter L Day ◽

Jamie R Pearce ◽

Amber L Pearson

Keyword(s):

New Zealand ◽

Fast Food ◽

Spatial Clustering ◽

Overweight And Obesity ◽

School Level ◽

Walking Distance ◽

Grocery Stores ◽

Food Environments ◽

Food Outlet ◽

Food Outlets

AbstractObjectiveTo explore changes in urban food environments near schools, as potential contributors to the rising prevalence of overweight and obesity among children.DesignAddresses of food premises and schools in 1966, 1976, 1986, 1996 and 2006 were geo-coded. For each year, the number and proportion of outlets by category (supermarket/grocery; convenience; fast-food outlet) within 800 m of schools were calculated. The degree of spatial clustering of outlets was assessed using a bivariate K-function analysis. Food outlet categories, school level and school social deprivation quintiles were compared.SettingChristchurch, New Zealand.SubjectsAll schools and food outlets at 10-year snapshots from 1966 to 2006.ResultsBetween 1966 and 2006, the median number of supermarkets/grocery stores within 800 m of schools decreased from 5 to 1, convenience stores decreased from 2 to 1, and fast-food outlets increased from 1 to 4. The ratio of fast-food outlets to total outlets increased from 0·10 to 0·67. The clustering of fast-food outlets was greatest within 800 m of schools and around the most socially deprived schools. Over the 40-year study period, school food environments in Christchurch can be characterized by increased densities of fast-food outlets within walking distance of schools, especially around the most deprived schools.ConclusionsSince the 1960s, there have been substantial changes to the food environments around schools which may increasingly facilitate away-from-home food consumption for children and provide easily accessible, cheap energy-dense foods, a recognized contributor to the rise in prevalence of overweight and obesity among young people.

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Food procurement in English-language Canadian public schools: Opportunities and challenges

Canadian Food Studies / La Revue canadienne des études sur l alimentation ◽

10.15353/cfs-rcea.v6i1.265 ◽

2019 ◽

Vol 6 (1) ◽

pp. 75-99

Author(s):

Shawna Holmes

Keyword(s):

Public Schools ◽

Food Environment ◽

Nutritional Quality ◽

English Language ◽

Nutrient Content ◽

Food Environments ◽

School Food ◽

Provincial Level ◽

School Food Environment

This paper examines the changes to procurement for school food environments in Canada as a response to changes to nutrition regulations at the provincial level. Interviews with those working in school food environments across Canada revealed how changes to the nutrition requirements of foods and beverages sold in schools presented opportunities to not only improve the nutrient content of the items made available in school food environments, but also to include local producers and/or school gardens in procuring for the school food environment. At the same time, some schools struggle to procure nutritionally compliant foods due to increased costs associated with transporting produce to rural, remote, or northern communities as well as logistic difficulties like spoilage. Although the nutrition regulations have facilitated improvements to food environments in some schools, others require more support to improve the overall nutritional quality of the foods and beverages available to students at school.

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Moderation by Neighborhood Food Outlets on Relationships between Meal Sources and Diet

American Journal of Health Behavior ◽

10.5993/ajhb.45.2.9 ◽

2021 ◽

Vol 45 (2) ◽

pp. 290-308

Author(s):

Jessica L. Thomson ◽

Alicia S. Landry ◽

Tameka I. Walls ◽

Melissa H. Goodman

Keyword(s):

Dietary Intake ◽

Fast Food ◽

Linear Models ◽

Grocery Store ◽

Grocery Stores ◽

Food Outlet ◽

Added Sugars ◽

Food Outlets ◽

Food And Beverage ◽

Fast Food Restaurants

Objectives: In this study, we tested for moderation by neighborhood food outlet presence on relationships between food outlet shopping or meal sources and dietary intake. Methods: We used generalized linear models to analyze parent-adolescent (12-17 years) dyad data from the 2014 Family Life, Activity, Sun, Health and Eating. Questions included food outlet presence in home (parent) and school (adolescent) neighborhoods (yes or no), shopping at food outlets (parent) (never, rarely, sometimes, often or always), and sources of food consumed away from and at home (weekly frequency). We captured food and beverage intakes via a dietary screener. Results: Relationships between adolescent added sugar intake and scratch cooked evening meals and meals away from home were found only when grocery stores and fast food restaurants, respectively, were present in adolescents' school neighborhoods. Shopping at fruit and vegetable (FV) markets and scratch cooked evening meals were associated with the largest increases in parent and adolescent FV intakes, respectively. Meals away from home at convenience stores were associated with the largest increases in parent and adolescent intakes of added sugars. Conclusions: Neighborhood grocery store and fast food restaurant presence moderated relationships between meal sources and dietary intake only in adolescents.

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Food Retail Environments in Greater Melbourne 2008–2016: Longitudinal Analysis of Intra-City Variation in Density and Healthiness of Food Outlets

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17041321 ◽

2020 ◽

Vol 17 (4) ◽

pp. 1321 ◽

Cited By ~ 3

Author(s):

Cindy Needham ◽

Liliana Orellana ◽

Steven Allender ◽

Gary Sacks ◽

Miranda R. Blake ◽

...

Keyword(s):

Central Business District ◽

Healthy Food ◽

Food Environments ◽

Obesity Prevalence ◽

Food Outlet ◽

Food Outlets ◽

Residential Population ◽

Business District ◽

Location Type ◽

Over Time

Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of ‘healthy’ to ‘unhealthy’ food outlets and food outlet ‘types’ by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both ‘unhealthy’ and ‘healthy’ outlets. Across all years, ratios of ‘unhealthy’ to ‘healthy’ outlets were highest in LGAs located in designated Growth Areas. Melbourne’s metropolitan food environment is saturated by ‘unhealthy’ and ‘less healthy’ food outlets, relative to ‘healthy’ ones. Melbourne’s urban growth areas had the least healthy food environments.

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Are campus food environments healthy? A novel perspective for qualitatively evaluating the nutritional quality of food sold at foodservice facilities at a Brazilian university

Perspectives in Public Health ◽

10.1177/1757913916636414 ◽

2016 ◽

Vol 137 (2) ◽

pp. 122-135 ◽

Cited By ~ 9

Author(s):

Isadora Santos Pulz ◽

Paula Andréa Martins ◽

Charles Feldman ◽

Marcela Boro Veiros

Keyword(s):

Food Environment ◽

Nutritional Quality ◽

Food Choices ◽

Healthy Food ◽

Food Environments ◽

Cross Sectional ◽

Food Ingredients ◽

Nutrition Environment ◽

Food And Beverage

Aims: The purpose of this novel study was to evaluate the food environment at a Brazilian university, encompassing 6 restaurants and 13 snack bars. The investigation uniquely analyses the food environment (barriers, facilitators, type of foods and prices). This was a food-based analysis of the nutritional quality of the products sold on campus. Methods: A cross-sectional descriptive design was used, applying the classic Nutrition Environment Measures Survey–Restaurants (NEMS-R) adapted for Brazil and an original methodology to evaluate and classify qualitatively the nutritional quality and characteristics of the food. A census of all campus food environments was applied. Results: The main results show most food and beverage products were made with processed ingredients and had a lower nutritional quality and price when compared with similar products made on premises, that is, processed iced tea compared with fresh tea ( p < .001), fried refined flour salgados compared with baked wholegrain flour salgados ( p < .001) and refined flour biscuits compared with those made with whole grains ( p = .028). Only 16% of the outlets provided food ingredients or nutritional information of products available. Conclusion: The overall options for healthy food choices and good nutritional quality on campus were mostly limited by the availability and higher prices of products. These findings could be used to develop new policy perspectives for the offering of healthy food items and to facilitate better food choices among students in a healthier food environment.

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Comparison of Geographic Information System and Subjective Assessments of Momentary Food Environments as Predictors of Food Intake: An Ecological Momentary Assessment Study (Preprint)

10.2196/preprints.15948 ◽

2019 ◽

Author(s):

Katherine G Elliston ◽

Benjamin Schüz ◽

Tim Albion ◽

Stuart G Ferguson

Keyword(s):

Information System ◽

Food Intake ◽

Ecological Momentary Assessment ◽

Food Environment ◽

The Self ◽

Food Environments ◽

Food Outlets ◽

Ecological Momentary ◽

Mhealth Apps ◽

Momentary Assessment

BACKGROUND It has been observed that eating is influenced by the presence and availability of food. Being aware of the presence of food in the environment may enable mobile health (mHealth) apps to use geofencing techniques to determine the most appropriate time to proactively deliver interventions. To date, however, studies on eating typically rely on self-reports of environmental contexts, which may not be accurate or feasible for issuing mHealth interventions. OBJECTIVE This study aimed to compare the subjective and geographic information system (GIS) assessments of the momentary food environment to explore the feasibility of using GIS data to predict eating behavior and inform geofenced interventions. METHODS In total, 72 participants recorded their food intake in real-time for 14 days using an ecological momentary assessment approach. Participants logged their food intake and responded to approximately 5 randomly timed assessments each day. During each assessment, the participants reported the number and type of food outlets nearby. Their electronic diaries simultaneously recorded their GPS coordinates. The GPS data were later overlaid with a GIS map of food outlets to produce an objective count of the number of food outlets within 50 m of the participant. RESULTS Correlations between self-reported and GIS counts of food outlets within 50 m were only of a small size (r=0.17; P<.001). Logistic regression analyses revealed that the GIS count significantly predicted eating similar to the self-reported counts (area under the curve for the receiver operating characteristic curve [AUC-ROC] self-report=0.53, SE 0.00 versus AUC-ROC 50 m GIS=0.53, SE 0.00; P=.41). However, there was a significant difference between the GIS-derived and self-reported counts of food outlets and the self-reported type of food outlets (AUC-ROC self-reported outlet type=0.56, SE 0.01; P<.001). CONCLUSIONS The subjective food environment appears to predict eating better than objectively measured food environments via GIS. mHealth apps may need to consider the type of food outlets rather than the raw number of outlets in an individual’s environment.

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The interplay between fast-food outlet exposure, household food insecurity, and diet quality in disadvantaged districts

Public Health Nutrition ◽

10.1017/s1368980020004280 ◽

2020 ◽

pp. 1-20

Author(s):

Laura A. van der Velde ◽

Femke M. P. Zitman ◽

Joreintje D. Mackenbach ◽

Mattijs E. Numans ◽

Jessica C. Kiefte-de Jong

Keyword(s):

Food Insecurity ◽

Food Environment ◽

Fast Food ◽

Estimating Equation ◽

Cross Sectional Study ◽

Dietary Quality ◽

Food Outlet ◽

Cross Sectional ◽

Fast Food Outlet ◽

Outlet Density

Abstract Objective The current study aimed to explore the interplay between food insecurity, fast-food outlet exposure, and dietary quality in disadvantaged neighbourhoods. Design In this cross-sectional study, main associations between fast-food outlet density and proximity, food insecurity status and dietary quality were assessed using Generalized Estimating Equation analyses. We assessed potential moderation by fast-food outlet exposure in the association between food insecurity status and dietary quality by testing for effect modification between food insecurity status and fast-food outlet density and proximity. Setting A deprived urban area in the Netherlands. Participants We included 226 adult participants with at least one child below the age of 18 years living at home. Results Fast-food outlet exposure was not associated with experiencing food insecurity (fast-food outlet density: b=-0.026, 95%CI=-0.076; 0.024; fast-food outlet proximity: b=-0.003, 95%CI=-0.033; 0.026). Experiencing food insecurity was associated with lower dietary quality (b=-0.48 per unit increase, 95%CI=-0.94; -0.012). This association was moderated by fast-food outlet proximity (p-interaction=0.008), and stratified results revealed that the adverse effect of food insecurity on dietary quality was more pronounced for those with the nearest fast-food outlet located closer to the home. Conclusions Food insecurity but not fast-food outlet density is associated with dietary quality. However, the association between food insecurity and dietary quality may be modified by the food environment. These findings could inform policy-makers to promote a healthier food environment including less fast-food outlets, with particular emphasis on areas with high percentages of food insecure households.

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