scholarly journals Snapshots of Urban and Rural Food Environments: EPOCH-Based Mapping in a High-, Middle-, and Low-Income Country from a Non-Communicable Disease Perspective

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 484
Author(s):  
Mark Spires ◽  
Aravinda Berggreen-Clausen ◽  
Francis Xavier Kasujja ◽  
Peter Delobelle ◽  
Thandi Puoane ◽  
...  
Keyword(s):  
South Africa ◽  
Low Income ◽  
Food Environment ◽  
Communicable Disease ◽  
Matched Pair ◽  
Food Environments ◽  
Unhealthy Food ◽  
Food Retail ◽  
Food Items ◽  
Retail Outlets

A changing food environment is implicated as a primary contributor to the increasing levels of non-communicable diseases (NCDs). This study aimed to generate snapshots of selected external food environments to inform intervention strategies for NCD prevention in three countries: Uganda (low income), South Africa (middle income) and Sweden (high income), with one matched pair of urban–rural sites per country. Fifty formal and informal food retail outlets were assessed, and descriptive and comparative statistical analyses were performed. We found that formal food retail outlets in these countries had both positive and negative traits, as they were the main source of basic food items but also made unhealthy food items readily available. The Ugandan setting had predominantly informal outlets, while the Swedish setting had primarily formal outlets and South Africa had both, which fits broadly into the traditional (Uganda), mixed (South Africa) and modern (Sweden) conceptualized food systems. The promotion of unhealthy food products was high in all settings. Uganda had the highest in-community advertising, followed by South Africa and Sweden with the lowest, perhaps related to differences in regulation and implementation. The findings speak to the need to address contextual differences in NCD-related health interventions by incorporating strategies that address the food environment, and for a critical look at regulations that tackle key environment-related factors of food on a larger scale.

scholarly journals Shaping Physical, Economic, and Policy Components of the Food Environment to Create Sustainable Healthy Diets

2020 ◽  
Vol 41 (2_suppl) ◽  
pp. 74S-86S
Author(s):  
Adam Drewnowski ◽  
Eva C. Monterrosa ◽  
Saskia de Pee ◽  
Edward A. Frongillo ◽  
Stefanie Vandevijvere
Keyword(s):  
Low Income ◽  
Food Environment ◽  
Food System ◽  
Well Being ◽  
Food Environments ◽  
Healthy Foods ◽  
Equitable Access ◽  
Nutrition Labels ◽  
Healthy Diets ◽  
Physical Spaces

Background: Sustainable healthy diets are those dietary patterns that promote all dimensions of individuals’ health and well-being; have low environmental pressure and impact; are accessible, affordable, safe, and equitable; and are culturally acceptable. The food environment, defined as the interface between the wider food system and consumer’s food acquisition and consumption, is critical for ensuring equitable access to foods that are healthy, safe, affordable, and appealing. Discussion: Current food environments are creating inequities, and sustainable healthy foods are generally more accessible for those of higher socioeconomic status. The physical, economic, and policy components of the food environment can all be acted on to promote sustainable healthy diets. Physical spaces can be modified to improve relative availability (ie, proximity) of food outlets that carry nutritious foods in low-income communities; to address economic access certain actions may improve affordability, such as fortification, preventing food loss through supply chain improvements; and commodity specific vouchers for fruits, vegetables, and legumes. Other policy actions that address accessibility to sustainable healthy foods are comprehensive marketing restrictions and easy-to-understand front-of-pack nutrition labels. While shaping food environments will require concerted action from all stakeholders, governments and private sector bear significant responsibility for ensuring equitable access to sustainable healthy diets.

scholarly journals Race, Ethnicity, and Neighborhood Food Environment Are Associated with Adolescent Sugary Drink Consumption During a 5-Year Community Campaign

2021 ◽  
Author(s):  
Rebecca Boehm ◽  
Kristen Cooksey Stowers ◽  
Glenn E. Schneider ◽  
Marlene B. Schwartz
Keyword(s):  
Black Students ◽  
Food Environment ◽  
Fast Food ◽  
Food Environments ◽  
Unhealthy Food ◽  
Beverage Consumption ◽  
Convenience Stores ◽  
Neighborhood Food Environment ◽  
Race Ethnicity ◽  
Sugary Drink

Abstract Background A multi-level county-wide campaign to reduce sugary drink consumption was associated with significant decreases in retail sales of soda and fruit drinks. The aim of the current study was to examine changes in adolescent beverage consumption during the campaign by race/ethnicity and neighborhood food environment. Methods Beverage consumption among adolescents was evaluated at four time points in a repeated cross-sectional survey of a racially and ethnically diverse sample of sixth graders (N = 13,129) from public middle schools in the county. Each school’s surrounding attendance zone (i.e., neighborhoods where students live) was characterized as providing high or low exposure to unhealthy food retail (e.g., convenience stores, fast-food restaurants). Logistic and multiple linear regression models were used to evaluate changes in beverage consumption over time by student race/ethnicity and high versus low unhealthy food exposure. Results Over the 5 years, there were significant declines in the overall share of students who reported daily sugary drink consumption (49.4 to 36.9%) and their reported daily calories from these products (220 to 158 calories). However, disparities were observed, with higher levels of consumption among Black and Hispanic youth and among youth living in neighborhoods with more unhealthy food retail. Notably, Black students living in healthier neighborhood food environments reported significant decreases in daily consumption and calories after 5 years, while Black students living in neighborhoods with more convenience stores and fast-food outlets did not. Conclusion These findings suggest that both race/ethnicity and neighborhood food environments are important considerations when designing interventions to reduce sugary drink consumption among adolescents.

scholarly journals Urban v. suburban perceptions of the neighbourhood food environment as correlates of adolescent food purchasing

2011 ◽  
Vol 15 (2) ◽  
pp. 299-306 ◽  
Author(s):  
Mary O Hearst ◽  
Keryn E Pasch ◽  
Melissa N Laska
Keyword(s):  
Fast Food ◽  
Dietary Habits ◽  
Descriptive Analysis ◽  
Convenience Store ◽  
Food Retail ◽  
Cross Sectional ◽  
Food Items ◽  
Food Outlets ◽  
Retail Outlets ◽  
Pedestrian Infrastructure

AbstractObjectiveTo assess the relationship between adolescent perception of time to walk to neighbourhood food retail outlets and purchasing of sugar-sweetened beverages (SSB), fast and convenience food items, and to test for differences by urban v. suburban environment.DesignCross-sectional observational study.SettingTwin Cities Metropolitan Area, Minnesota, USA.SubjectsAdolescents from two studies completed survey-based measures on perceptions of time to walk to food retail outlets from home, purchasing patterns of SSB and fast and convenience store items, perceptions of personal safety and pedestrian infrastructure, and demographic characteristics. Descriptive analysis, Spearman correlations and multivariate linear regression, accounting for clustering, were conducted.ResultsThere were 634 adolescents, approximately half male, predominantly white, with a middle-class background. Greater perceived time to food outlets was associated with less frequent purchasing of SSB, convenience store foods and fast-food items. Multivariate models showed that a perceived shorter walking time (i.e. 1−5 v. 31+ min) was significantly associated with more SSB purchasing. SSB purchases were also significantly associated with the number of food outlets within a 10 min walk (B = 0·05, P = 0·02).ConclusionsA reduction in consumption of SSB and other energy-dense snacks is an important obesity prevention approach. An approach offering alternatives or reducing exposure in addition to education to alter purchasing habits may contribute to improving dietary habits and reducing the obesity epidemic.

scholarly journals Double-duty solutions for optimising maternal and child nutrition in urban South Africa: a qualitative study

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Agnes Erzse ◽  
Susan Goldstein ◽  
Shane A Norris ◽  
Daniella Watson ◽  
Sarah H Kehoe ◽  
...  
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Low Income ◽  
Food Environment ◽  
Social Protection ◽  
Health Sector ◽  
Structured Interview ◽  
Healthy Diet ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Abstract Objective: To obtain a community perspective on key nutrition-specific problems and solutions for mothers and children. Design: A qualitative study comprising nine focus group discussions (FGD) following a semi-structured interview guide. Setting: The township of Soweto in South Africa with a rising prevalence of double burden of malnutrition. Participants: Men and women aged ≥18 years (n 66). Three FGD held with men, six with women. Results: Despite participants perceived healthy diet to be important, they felt their ability to maintain a healthy diet was limited. Inexpensive, unhealthy food was easier to access in Soweto than healthier alternatives. Factors such as land use, hygiene and low income played a fundamental role in shaping access to foods and decisions about what to eat. Participants suggested four broad areas for change: health sector, social protection, the food system and food environment. Their solutions ranged from improved nutrition education for women at clinic visits, communal vegetable gardens and government provision of food parcels to regulatory measures to improve the healthiness of their food environment. Conclusions: South Africa’s current nutrition policy environment does not adequately address community-level needs that are often linked to structural factors beyond the health sector. Our findings suggest that to successfully address the double burden of malnutrition among women and children, a multifaceted approach is needed combining action on the ground with coherent policies that address upstream factors, including poverty. Further, there is a need for public engagement and integration of community perspectives and priorities in developing and implementing double-duty actions to improve nutrition.

scholarly journals Longitudinal geo-referenced field evidence for the heightened BMI responsiveness of obese women to price discounts on carbonated soft drinks

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261749
Author(s):  
Yun-Hsuan Wu ◽  
Spencer Moore ◽  
Yu Ma ◽  
Laurette Dube
Keyword(s):  
Weight Gain ◽  
Food Environment ◽  
Soft Drinks ◽  
Food Environments ◽  
Unhealthy Food ◽  
Obese Women ◽  
Price Discount ◽  
Price Discounts ◽  
Carbonated Soft Drinks ◽  
Field Evidence

There is increasing interest in the effect that food environments may have on obesity, particularly through mechanisms related to the marketing and consumption of calorie-dense, nutrient-poor foods and sugary beverages. Price promotions, such as temporary price discounts, have been particularly effective in the marketing of carbonated soft drinks (CSDs) among consumers. Research has also suggested that the purchasing behavior of consumer groups may be differentially sensitive to price discounts on CSDs, with obese women particularly sensitive. In addition, the intensity of price discount in a person’s food environment may also vary across geography and over time. This study examines whether the weight change of obese women, compared to overweight or normal BMI women, is more sensitive to the intensity of price discounts on CSDs in the food environment. This study used longitudinal survey data from 1622 women in the Montreal Neighborhood Networks and Health Aging (MoNNET-HA) Panel. Women were asked to report their height and weight in 2008, 2010 and 2013 in order to calculate women’s BMI in 2008 and their change of weight between 2008 and 2013. Women’s exposure to an unhealthy food environment was based on the frequency in which their neighborhood food stores placed price discounts on CSDs in 2008. The price discount frequency on CSDs within women’s neighborhoods was calculated from Nielsen point-of sales transaction data in 2008 and geocoded to participant’s forward sortation area. The prevalence of obesity and overweight among MoNNET-HA female participants was 18.3% in 2008, 19.9% in 2010 and 20.7% in 2013 respectively. Results showed that among obese women, exposure to unhealthy food environments was associated with a 3.25 kilogram (SE = 1.35, p-value = 0.02) weight gain over the five-year study period. Exposure to price discounts on CSDs may disproportionately affect and reinforce weight gain in women who are already obese.

scholarly journals Foodscapes, Finance and Faith: A Qualitative Investigation of Multi-Sectoral Stakeholder Perspectives on a New Mall and Supermarket in Kenya

2021 ◽  
Author(s):  
Pamela Wadende ◽  
Oliver Francis ◽  
Rosemary Musuva ◽  
Ebele Mogo ◽  
Eleanor Turner-Moss ◽  
...  
Keyword(s):  
Fast Food ◽  
Local Community ◽  
Local Economy ◽  
Small Scale ◽  
Unhealthy Food ◽  
Food Retail ◽  
Food Items ◽  
Stakeholder Perspectives ◽  
Community Stakeholders ◽  
The Impact

Abstract IntroductionThe nutritional transition is fuelling a concerning rise in Non-Communicable Diseases (NCDs) in Low and Middle-Income Countries (LMICs). These countries lack strong health infrastructure capable of supporting the long-term and expensive medical treatment for those living with NCDs. It is important to identify stakeholders involved in influencing food retail and dietary choices as part of a population-level strategy to reduce the burden of NCDs in LMICs. The aim of this study is to explore stakeholder perspectives on the impacts of new and existing food retail on local diets in Kenya.MethodsRegulatory and local community stakeholders from Kisumu and Homabay Counties of Western Kenya in this study responded to a semi-structured, open-ended interview schedule. We sought their perspectives on the impact of a proposed new mall and supermarket in Kisumu and existing supermarkets in Homabay on local dietary practices. Digital voice recorders captured the responses, which were transcribed verbatim then translated from Kiswahili or Dholuo languages into English. NVivo12 PRO software was used to analyse the coded responses using a thematic discourse analysis approach. FindingsBoth regulatory and local community stakeholders were similarly concerned that supermarkets make unhealthy food items (including fast food) more accessible and therefore easily incorporated into local diets, with the result that more people develop diet-related NCDs. At the same time, both groups of stakeholders indicated the usefulness of supermarkets as a reliable food source, albeit requiring that the shopper discern healthy from unhealthy food items. Overall, they were unsure whether such aspects as the pricing and convenience of supermarkets would be sufficient to cause the local population to stop patronising their usual small-scale food vendors, and had similarly mixed views on wider impacts on the local economy and livelihoods.ConclusionThe prominent themes identified in our analysis were fear of fast food and health implications, supermarkets as reliable (but selective) food outlets, and uncertainty and differences of opinion about the potential mixed impacts of supermarkets on local communities. We found evidence of a multi-sectoral approach with a widely held interest in potential impacts on health.

Healthy and unhealthy food environments are linked with neighbourhood socio-economic disadvantage: an innovative geospatial approach to understanding food access inequities

2020 ◽  
Vol 23 (17) ◽  
pp. 3190-3196
Author(s):  
Shirelle H Hallum ◽  
S Morgan Hughey ◽  
Marilyn E Wende ◽  
Ellen W Stowe ◽  
Andrew T Kaczynski
Keyword(s):  
Food Environment ◽  
Grocery Stores ◽  
Economic Disadvantage ◽  
Food Environments ◽  
Unhealthy Food ◽  
Block Group ◽  
Food Outlets ◽  
Southeastern Us ◽  
Total Food ◽  
Block Groups

AbstractObjective:This study examined the separate relationships between socio-economic disadvantage and the density of multiple types of food outlets, and relationships between socio-economic disadvantage and composite food environment indices.Design:Cross-sectional data were analysed using geospatial kernel density techniques. Food outlet data included convenience stores, discount stores, fast-food and fast casual restaurants, and grocery stores. Controlling for urbanicity and race/ethnicity, multivariate linear regression was used to examine the relationships between socio-economic disadvantage and density of food outlets.Setting:This study occurred in a large Southeastern US county containing 255 census block groups with a total population of 474 266, of which 77·1 % was Non-Hispanic White, the median household income was $48 886 and 15·0 % of residents lived below 125 % of the federal poverty line.Participants:The unit of analysis was block groups; all data about neighbourhood socio-economic disadvantage and food outlets were publicly available.Results:As block group socio-economic disadvantage increased, so too did access to all types of food outlets. The total food environment index, calculated as the ratio of unhealthy food outlets to all food outlets, decreased as block group disadvantage increased.Conclusions:Those who reside in more disadvantaged block groups have greater access to both healthy and unhealthy food outlets. The density of unhealthy establishments was greater in more disadvantaged areas; however, because of having greater access to grocery stores, disadvantaged populations have less obesogenic total food environments. Structural changes are needed to reduce access to unhealthy food outlets to ensure environmental injustice and reduce obesity risk.

scholarly journals Assessments of residential and global positioning system activity space for food environments, body mass index and blood pressure among low-income housing residents in New York City

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Kosuke Tamura ◽  
Brian Elbel ◽  
Jessica K. Athens ◽  
Pasquale E. Rummo ◽  
Basile Chaix ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Global Positioning System ◽  
Low Income ◽  
Food Environment ◽  
Activity Space ◽  
Food Environments ◽  
Positioning System ◽  
Cvd Risk ◽  
Global Positioning

Research has examined how the food environment affects the risk of cardiovascular disease (CVD). Many studies have focused on residential neighbourhoods, neglecting the activity spaces of individuals. The objective of this study was to investigate whether food environments in both residential and global positioning system (GPS)-defined activity space buffers are associated with body mass index (BMI) and blood pressure (BP) among low-income adults. Data came from the New York City Low Income Housing, Neighborhoods and Health Study, including BMI and BP data (n=102, age=39.3±14.1 years), and one week of GPS data. Five food environment variables around residential and GPS buffers included: fast-food restaurants, wait-service restaurants, corner stores, grocery stores, and supermarkets. We examined associations between food environments and BMI, systolic and diastolic BP, controlling for individual- and neighbourhood-level sociodemographics and population density. Within residential buffers, a higher grocery store density was associated with lower BMI (β=- 0.20 kg/m2, P<0.05), and systolic and diastolic BP (β =-1.16 mm Hg; and β=-1.02 mm Hg, P<0.01, respectively). In contrast, a higher supermarket density was associated with higher systolic and diastolic BP (β=1.74 mm Hg, P<0.05; and β=1.68, P<0.01, respectively) within residential buffers. In GPS neighbourhoods, no associations were documented. Examining how food environments are associated with CVD risk and how differences in relationships vary by buffer types have the potential to shed light on determinants of CVD risk. Further research is needed to investigate these relationships, including refined measures of spatial accessibility/exposure, considering individual’s mobility.

scholarly journals Dietary Intake, Attitudes toward Healthy Food, and Dental Pain in Low-Income Youth

2018 ◽  
Vol 3 (3) ◽  
pp. 279-287
Author(s):  
N.E. Nicksic ◽  
A.W. Massie ◽  
C.E. Byrd-Williams ◽  
S.H. Kelder ◽  
S.V. Sharma ◽  
...  
Keyword(s):  
Oral Health ◽  
Nutrition Education ◽  
Low Income ◽  
Self Efficacy ◽  
Longitudinal Research ◽  
Dental Pain ◽  
Healthy Food ◽  
Unhealthy Food ◽  
Cross Sectional ◽  
Food Items

Few studies have examined the relation between food consumption and related attitudes and dental pain among children. The objective of this study is to examine the associations of healthy and unhealthy food items, attitudes toward healthy food, and self-efficacy of eating healthy with dental pain among children. A cross-sectional analysis was performed using child survey data from the Texas Childhood Obesity Research Demonstration (TX CORD) project. Fifth-grade students ( n = 1,020) attending 33 elementary schools in Austin and Houston, Texas, completed the TX CORD Child Survey, a reliable and valid survey instrument focused on nutrition and physical activity behaviors. All nutrition questions ask about the number of times food and beverage items were consumed on the previous day. Dental pain was reported as mouth or tooth pain in the past 2 wk that made their mouth hurt so much that they could not sleep at night. Mixed-effects logistic regression models were used to test the association between 10 unhealthy food items, 9 healthy food items, 2 health attitudes, and self-efficacy with dental pain. All models controlled for sociodemographic variables. In total, 99 (9.7%) students reported dental pain. Dental pain was associated with intake of the following unhealthy items: soda, fruit juice, diet soda, frozen desserts, sweet rolls, candy, white rice/pasta, starchy vegetables, French fries/chips, and cereal (adjusted odds ratio [AOR], 1.27–1.81, P < 0.01). The intake of other vegetables (AOR, 1.56; P < 0.01), a healthy item, and the attitude that healthy food tastes good (AOR, 1.59; P = 0.04) were also positively associated with dental pain. The attitude of eating healthier leads to fewer health problems (AOR, 0.50) and self-efficacy for healthy eating (AOR, 0.44) were negatively associated with dental pain ( P < 0.01). Interventions should focus on improving oral health by reducing intake of unhealthy foods and educating children and families on the importance of diet as a means of reducing dental caries. Knowledge Transfer Statement: The results of this study can be used to inform researchers on potential food items and psychosocial measures to examine in low-income, minority populations for longitudinal research. These results would also be useful to educators who could incorporate oral health care and nutrition education into school curriculums.

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