Public support for healthy supermarket initiatives focused on product placement: a multi-country cross-sectional analysis of the 2018 International Food Policy Study

Abstract Background Food retail environments have an influential role in shaping purchasing behavior and could contribute to improving dietary patterns at a population level. However, little is known about the level of public support for different types of initiatives to encourage healthy food choices in supermarkets, and whether this varies across countries or context. The current study aimed to explore the level of support for three potential supermarket initiatives focused on product placement across five countries, and factors that may influence this support. Methods A total of 22,264 adults from Australia, Canada, Mexico, the United Kingdom and the United States (US) provided information on support for three supermarket initiatives related to product placement (targeting product positioning: ‘checkouts with only healthy products’, ‘fewer end-of-aisle displays containing unhealthy foods or soft drinks’ or availability: ‘more shelf space for fresh and healthier foods’) as part of the online 2018 International Food Policy Study. The proportion of respondents that supported each initiative was assessed across countries, and multivariable logistic regression analyses were conducted to evaluate the influence of sociodemographic factors on support. Results The initiative that received the highest support was ‘more shelf space for fresh and healthier foods’: 72.0% [95% CI 71.3–72.7], whereas ‘checkouts with only healthy products’ received the lowest support: 48.6% [95% CI 47.8–49.4]. The level of support differed between countries (p < 0.001 for all initiatives), with the US generally showing the lowest support and Mexico the highest. Noteworthy, in the overall sample, there was not much opposition to any of the initiatives (2.5–14.2%), whereas there was a large proportion of neutral responses (25.5–37.2%). Respondents who were older, female, highly educated, and those who reported having more nutrition knowledge tended to be more supportive, with several differences between countries and initiatives. Conclusions Most people in the assessed five countries showed a generally high level of support for three placement initiatives in supermarkets to encourage healthy food choices. Support varied by type of initiative (i.e., product positioning or availability) and was influenced by several factors related to country context and sociodemographic characteristics. This evidence could prompt and guide retailers and policy makers to take stronger action to promote healthy food choices in stores.

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Recall of government healthy eating campaigns by consumers in five countries

Public Health Nutrition ◽

10.1017/s1368980021001415 ◽

2021 ◽

pp. 1-31

Author(s):

Samantha Goodman ◽

Gabriela Armendariz ◽

Adele Corkum ◽

Laura Arellano ◽

Alejandra Jáuregui ◽

...

Keyword(s):

Healthy Eating ◽

Fruits And Vegetables ◽

Food Policy ◽

Logistic Models ◽

Population Level ◽

Policy Study ◽

Cross Sectional ◽

Sugary Drinks ◽

Income Adequacy ◽

Low Education

ABSTRACT Objective: To examine awareness and recall of healthy eating public education campaigns in five countries. Design: Data were cross-sectional and collected as part of the 2018 International Food Policy Study. Respondents were asked whether they had seen government healthy eating campaigns in the past year; if yes (awareness), they were asked to describe the campaign. Open-ended descriptions were coded to indicate recall of specific campaigns. Logistic models regressed awareness of healthy eating campaigns on participant country, age, sex, ethnicity, education, income adequacy and BMI. Analyses were also stratified by country. Setting: Online surveys. Participants: Participants were Nielsen panelists aged ≥18 years in Australia, Canada, Mexico, UK and US (n=22,463). Results: Odds of campaign awareness were higher in Mexico (50.9%) than UK (18.2%), Australia (17.9%), US (13.0%) and Canada (10.2%) (P<0.001). Awareness was also higher in UK and Australia versus Canada and US, and US versus Canada (P<0.001). Overall, awareness was higher among males versus females and respondents with medium or high versus low education (P<0.001 for all). Similar results were found in stratified models, although no sex difference was observed in Australia or UK (P>0.05), and age was associated with campaign awareness in UK (P<0.001). Common key words in all countries included sugar/sugary drinks, fruits and vegetables, and physical activity. The top five campaigns recalled were Chécate, mídete, muévete (Mexico), PrevenIMSS (Mexico), Change4Life (UK), LiveLighter® (Australia), and Actívate, Vive Mejor (Mexico). Conclusions: In Mexico, UK and Australia, comprehensive campaigns to promote healthy lifestyles appear to have achieved broad, population-level reach.

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Associations between Food Policy Councils and Policies That Support Healthy Food Access: A National Survey of Community Policy Supports

Nutrients ◽

10.3390/nu13020683 ◽

2021 ◽

Vol 13 (2) ◽

pp. 683

Author(s):

Samantha J. Lange ◽

Larissa Calancie ◽

Stephen J. Onufrak ◽

Katherine T. Reddy ◽

Anne Palmer ◽

...

Keyword(s):

National Survey ◽

Food Access ◽

Food Systems ◽

Food Policy ◽

Healthy Food ◽

Farmers Markets ◽

Cross Sectional ◽

Food Policy Councils ◽

Nationally Representative ◽

Healthy Food Access

Food policy councils (FPCs) are one form of community coalition that aims to address challenges to local food systems and enhance availability, accessibility, and affordability of healthy foods for local residents. We used data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living, a nationally representative survey of US municipalities (n = 2029), to examine the prevalence of FPCs and cross-sectional associations between FPCs and four types of supports for healthy food access (approaches to help food stores, practices to support farmers markets, transportation-related supports, and community planning documents). Overall, 7.7% of municipalities reported having a local or regional FPC. FPCs were more commonly reported among larger municipalities with ≥50,000 people (29.2%, 95% Confidence Interval (CI): 21.6, 36.8) and western region municipalities (13.2%, 95% CI: 9.6, 16.8). After multivariable adjustment, municipalities with FPCs had significantly higher odds of having all four types of supports, compared to those without FPCs (adjusted odds ratio (aOR) range: 2.4–3.4). Among municipalities with FPCs (n = 156), 41% reported having a local government employee or elected official as a member, and 46% had a designated health or public health representative. Although FPCs were uncommon, municipalities that reported having a local or regional FPC were more likely to report having supports for healthy food access for their residents.

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Nutrition menu labelling in Terengganu: a cross-sectional study of knowledge, attitudes, perception and their relationship with healthy food choices

Food Research ◽

10.26656/fr.2017.4(5).138 ◽

2020 ◽

Vol 4 (5) ◽

pp. 1573-1581

Author(s):

Marina M. ◽

Asma' A. ◽

S.N.A. Jaafar ◽

Abdul Wahab M.R. ◽

Wan Zainal Shukri W.H.

Keyword(s):

Positive Attitude ◽

Food Choices ◽

Cross Sectional Study ◽

Healthy Food ◽

Median Score ◽

Consumer Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Nutrition Labelling ◽

Significant Relationships

Nutrition menu labelling has been implemented in a number of restaurants in Malaysia. However, no known empirical research has focused on assessing the knowledge, attitude and perception (KAP) of nutrition menu labelling among consumers. Therefore, this cross -sectional study was conducted with 155 consumers (age 18 and above) from several selected cafeterias that were equipped with menu nutrition labelling to determine their KAP. Questionnaires consisting of socio-demographic, knowledge, attitude and perception of consumers on menu nutrition labelling, and consumers’ healthy food choices were given to the respondents through a self-administrated approach. The data collected were analysed using SPSS 21. The results show that respondent knowledge was predominantly moderate (54.8%), with a median score of 12 out of 25. Both the attitudes (87.1%) and perceptions (85.2%) of the respondents were mainly positive towards nutrition menu labelling. Attitude (r=0.547, p=0.001) and perception (r=0.539, p=0.001) had positive significant relationships towards healthy food choices among the respondents at p<0.05. In conclusion, most consumers have a positive attitude and perception of nutrition menu labelling and may significantly influence towards healthy food choices. Further strategies are needed to increase consumer knowledge of nutrition menu labelling to promote greater usage of this information among Malaysian consumers.

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Public acceptability of the UK Soft Drinks Industry Levy: repeat cross-sectional analysis of the International Food Policy Study (2017–2019)

BMJ Open ◽

10.1136/bmjopen-2021-051677 ◽

2021 ◽

Vol 11 (9) ◽

pp. e051677

Author(s):

Jean Adams ◽

David Pell ◽

Tarra L Penney ◽

David Hammond ◽

Lana Vanderlee ◽

...

Keyword(s):

Logistic Regression ◽

Regression Model ◽

Logistic Regression Model ◽

Food Policy ◽

Perceived Effectiveness ◽

Policy Study ◽

Cross Sectional ◽

Public Acceptability ◽

Adjusted Logistic Regression ◽

The Uk

ObjectivesTo determine whether public acceptability, in terms of both support for and perceived effectiveness of, the UK Soft Drinks Industry Levy (SDIL) changed between 4 months prior to, and 8 and 20 months after, implementation.DesignRepeat cross-sectional online survey.SettingThe UK.ParticipantsUK respondents to the International Food Policy Study aged 18–64 years who provided information on all variables of interest in November–December 2017 (4 months prior to SDIL implementation), 2018 (8 months after) or 2019 (20 months after; n=10 284).Outcome measuresSelf-reported support for, and perceived effectiveness of, the SDIL.ResultsThe adjusted logistic regression model predicted that 70% (95% CI: 68% to 72%) of participants supported the SDIL in 2017, 68% (95% CI: 67% to 70%) in 2018 and 68% (95% CI: 66% to 70%) in 2019. There was no evidence of a difference in support in 2018 vs 2017 (OR: 0.93; 95% CI: 0.81 to 1.05); or in 2019 vs 2017 (OR: 0.90; 95% CI: 0.78 to 1.03). The adjusted logistic regression model predicted that 72% (95% CI: 70% to 74%) of participants perceived the SDIL to be effective in 2017, 67% (95% CI: 65% to 69%) in 2018 and 67% (95% CI: 64% to 69%) in 2019. There was evidence that perceived effectiveness decreased a small amount in 2018 vs 2017 (OR: 0.78; 95% CI: 0.69 to 0.88). The difference in 2019 vs 2017 was similar.ConclusionsWe found high support for the SDIL among UK adults and this did not change between 4 months before implementation and 8 or 20 months after. While perceived effectiveness remained high, there was evidence that this decreased slightly after implementation in 2018, but no further in 2019. Greater understanding of influences on public acceptability of effective structural public health interventions is required.

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Relationships between physical activity, food choices, gender and BMI in Southern Californian teenagers

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2017-0067 ◽

2017 ◽

Vol 31 (5) ◽

Cited By ~ 5

Author(s):

Jaclyn B. Gaylis ◽

Susan S. Levy ◽

Shiloah Kviatkovsky ◽

Rebecca DeHamer ◽

Mee Young Hong

Keyword(s):

Physical Activity ◽

Healthy Lifestyle ◽

Food Choices ◽

Cross Sectional Study ◽

Red Meat ◽

Overweight And Obesity ◽

Healthy Food ◽

Processed Meat ◽

Healthy Weight ◽

Cross Sectional

Abstract Given the increased prevalence of pediatric obesity and risk of developing chronic disease, there has been great interest in preventing these conditions during childhood by focusing on healthy lifestyle habits, including nutritious eating and physical activity (PA). The purpose of this study was to determine the relationship between PA, body mass index (BMI) and food choices in adolescent males and females. This cross-sectional study, using a survey questionnaire, evaluated 1212 Southern Californian adolescents’ self-reported PA, BMI and food frequency. Results revealed that even though males are more active than females, they have higher BMI percentile values (p < 0.05). Females consumed salad, vegetables and fruit more frequently than males (p < 0.05), where males consumed hamburgers, pizza, red meat, processed meat, eggs, fish, fruit juice, soda and whole milk more frequently than females (p < 0.05). Overweight/obese teens consumed red meat, processed meat and cheese more frequently than healthy weight teens (p < 0.05), yet there was no difference in PA between healthy and overweight/obese teens. These results demonstrate that higher levels of PA may not counteract an unhealthy diet. Even though PA provides numerous metabolic and health benefits, this study suggests that healthy food choices may have a protective effect against overweight and obesity. Healthy food choices, along with PA, should be advocated to improve adolescent health by encouraging maintenance of a healthy weight into adulthood.

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Does Government Support Respond to Governments’ Social Welfare Rhetoric or their Spending? An Analysis of Government Support in Britain, Spain and the United States

British Journal of Political Science ◽

10.1017/s0007123417000199 ◽

2017 ◽

Vol 49 (4) ◽

pp. 1407-1429 ◽

Cited By ~ 2

Author(s):

Luca Bernardi ◽

James Adams

Keyword(s):

United States ◽

Social Welfare ◽

Public Support ◽

The United States ◽

Government Support ◽

Right Wing ◽

Left Wing ◽

Cross Sectional ◽

Welfare Spending ◽

Left And Right

Issue ownership theory posits that when social welfare is electorally salient, left-wing parties gain public support by rhetorically emphasizing social welfare issues. There is less research, however, on whether left-wing governing parties benefit from increasing social welfare spending. That is, it is not known whether leftist governments gain from acting on the issues they rhetorically emphasize. This article presents arguments that voters will not react to governments’ social welfare rhetoric, and reviews the conflicting arguments about how government support responds to social welfare spending. It then reports time-series, cross-sectional analyses of data on government support, governments’ social welfare rhetoric and social welfare spending from Britain, Spain and the United States, that support the prediction that government rhetoric has no effects. The article estimates, however, that increased social welfare spending sharply depresses support for both left- and right-wing governments. These findings highlight a strategic dilemma for left-wing governments, which lose public support when they act on their social welfare rhetoric by increasing welfare spending.

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Evidence-Based Approach to Healthy Food Choices for Hispanic Women

Hispanic Health Care International ◽

10.1177/1540415320921471 ◽

2020 ◽

pp. 154041532092147

Author(s):

Beth A. McVey ◽

Raul Lopez ◽

Blanca Iris Padilla

Keyword(s):

Health Care ◽

Body Mass Index ◽

Nutrition Education ◽

Body Mass ◽

Hispanic Women ◽

Food Choices ◽

The United States ◽

Culturally Sensitive ◽

Healthy Food ◽

Obesity Status

Obesity rates have reached epidemic proportions in the United States and Hispanic women, particularly Mexican American women, are disproportionately affected. This quality improvement project, which took place at a clinic in East Los Angeles, California, implemented body mass index calculation, an eight-item starting the conversation (STC) tool, and culturally sensitive nutrition education in an effort to change the overweight/obesity status of these women. There were 36 female Hispanic patients who participated in this study. There was a significant decrease in body mass index percentile from pre implementation to 2-months post implementation. The total STC score decreased significantly from pre implementation to 2-months post implementation, indicating a positive change in dietary behavior. Dietary screening and intervention tools can assist health care providers with early identification of overweight/obesity status and prevention of overweight/obesity-related diseases. The STC tool will allow the health care provider to start the conversation about healthy food choices and provide for further culturally sensitive nutrition education.

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Knowledge of healthy foods does not translate to healthy snack consumption among exercise science undergraduates

Nutrition and Health ◽

10.1177/0260106017704796 ◽

2017 ◽

Vol 23 (2) ◽

pp. 103-110 ◽

Cited By ~ 4

Author(s):

Laura H McArthur ◽

Antonette Valentino ◽

Donald Holbert

Keyword(s):

Food Choices ◽

Healthy Food ◽

Survey Study ◽

Similar Data ◽

Healthy Foods ◽

Exercise Science ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Snack Consumption

This cross-sectional survey study compared the on- and off-campus snack choices and related correlates of convenience samples of exercise science (ES) ( n = 165, M = 45%, F = 55%) and non-exercise science (NES) ( n =160, M = 43%, F = 57%) undergraduates. The hypothesis posed was that knowledge of healthy foods will not translate to healthier snack consumption by the ES students, and that the snack choices and related correlates of ES and NES students will be similar. Data were collected using self-administered questionnaires completed in classrooms (ES sample) and at high-traffic locations on-campus (NES sample). Chi-square and t-test analyses compared ES and NES students on snack correlates. Snacks consumed most often by the ES and NES students on-campus were health bars/squares ( n = 56 vs. n = 48) and savory snacks ( n = 55 vs. n = 71), and off-campus were savory snacks ( n = 60 vs. n = 71) and fruits ( n = 41 vs. n = 34). Over half of both samples believed their snack choices were a mix of unhealthy and healthy. Fruits were considered healthier snacks and chips less healthy by both samples, and fruits were the most often recommended snack. About 20% believed these choices would impact their health unfavorably, and about two thirds self-classified in the action stages for healthy snacking. Since knowledge about healthy food choices did not translate to healthy snack selection, these students would benefit from interventions that teach selection and preparation of healthy snacks on a restricted budget.

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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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The Relationship between Self-Reported Exposure to Sugar-Sweetened Beverage Promotions and Intake: Cross-Sectional Analysis of the 2017 International Food Policy Study

Nutrients ◽

10.3390/nu11123047 ◽

2019 ◽

Vol 11 (12) ◽

pp. 3047 ◽

Cited By ~ 1

Author(s):

Hannah Forde ◽

Martin White ◽

Louis Levy ◽

Felix Greaves ◽

David Hammond ◽

...

Keyword(s):

Food Policy ◽

Multinomial Logistic Regression ◽

Relative Risk Ratio ◽

Policy Study ◽

Cross Sectional ◽

Sugar Sweetened Beverage ◽

Logistic Regression Models ◽

Sweetened Beverage ◽

Cross Sectional Analysis ◽

Sectional Analysis

Sugar-sweetened beverage (SSB) consumption is independently associated with several non-communicable diseases, so policymakers are increasingly implementing measures, such as marketing regulation, to reduce intake. To help understand how such measures work, this study examined the association between SSB consumption and self-reported exposure to SSB promotions, both overall and by type of promotion, and whether these relationships vary between the UK, USA, Canada, Mexico, and Australia. Cross-sectional analysis of the online 2017 International Food Policy Study was performed (n = 15,515). Participants were grouped into 5265 (34%) non-, 5117 (33%) low-, and 5133 (33%) high-SSB consumers. Multinomial logistic regression models examined whether SSB consumption varied by exposure to total SSB promotion and by type: traditional, digital, recreational environment, and functional environment. Multiplicative interactions were included to investigate international variations. An additional unit of total self-reported SSB promotion exposure increased the likelihood of participants being low SSB consumers (relative risk ratio (RRR) = 1.08, 95% confidence interval (CI) = 1.06–1.10) and high SSB consumers (RRR = 1.13, 95% CI = 1.11–1.16). Only exposure to traditional and digital promotion increased the likelihood of participants being SSB consumers, though this may be explained by degree of exposure, which was not measured in this study. Some evidence illustrated international variation in these relationships.

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