Abstract
Street food (SF) and takeaway food (TAF) are important sources of out-of-home meals in urban Bosnia and Herzegovina, where diet-related non-communicable diseases are growing rapidly. This study aimed to characterise SF and TAF purchased in urban areas of Bosnia and Herzegovina, regarding customers’ characteristics and the nutritional composition of the foods and beverages. A cross-sectional study was conducted in Sarajevo and Banja Luka in 2017. SF (n = 194) and TAF vending sites (n = 154) were selected through random and systematic sampling. Data on the food items purchased and customers’ characteristics were collected by direct observation. Nutritional composition was estimated using data from chemical analyses of the foods most commonly available. Two-thirds of the customers observed (n = 755) were aged ≥35 years, half were women and 27.7% were overweight/obese. A total of 929 food items were purchased. The most commonly bought SFs were confectionery (30.5%), water (27.9%) and soft drinks/juices (22.2%). TAF customers purchased mostly savoury pastries (39.8%), breads (27.1%) and main dishes (21.4%). Almost half of customers purchased industrial food (i.e., pre-packaged foods and beverages produced by the food industry). The purchases presented median contents of 18.7 g of fat (39.6% saturated, 32.3% monounsaturated, 22.1% polyunsaturated, 1.5% trans), 838 mg of sodium and 285 mg of potassium. Saturated-fat contribution was higher in SF purchases (60.4% vs. 30.2%, p < 0.001), whereas TAF purchases presented higher trans-fat proportion (1.8% vs. 0.6%, p < 0.001), sodium (1241 vs. 89 mg, p < 0.001) and sodium-potassium ratio (6.1 vs. 0.6, p < 0.001). Generally, SF and TAF bought in Sarajevo and Banja Luka were rich in saturated and trans fatty-acids and sodium, and poor in potassium. Nutrition policies promoting use of healthier fats and salt reduction in SF and TAF may contribute to the prevention of diet-related diseases in these settings.
Highlights
Non-communicable diseases (NCD) are the leading cause of mortality and morbidity worldwide, representing one of the major threats to global sustainable development in the 21st century [1]
(43.7%) of the customers purchased at least one industrial food item; this frequency was significantly higher for street food customers (78.2% vs. 21.2%, p < 0.001)
In the two main urban areas of Bosnia and Herzegovina, the purchase of street food and takeaway food was frequent, as demonstrated by the large number of foods and beverages bought within a limited observation period
Summary
Non-communicable diseases (NCD) are the leading cause of mortality and morbidity worldwide, representing one of the major threats to global sustainable development in the 21st century [1]. In Eastern Europe, NCD are estimated to account for approximately. 90% of all deaths in the region, mostly cardiovascular diseases and cancer [2]. The prevalence of obesity in South-Eastern Europe is the highest when compared to the rest of the European sub-regions, with a 30% growth between 2000 and 2014 [3]. The prevalence of diet-related NCD is rising steeply in low- and middle-income countries (LMIC) [5,6], where Western dietary patterns rich in calorie-dense industrialized foods and beverages are supplanting traditional local diets [7]. In Eastern European countries, the supply of sugar-sweetened beverages and packaged processed foods have increased abruptly [8], as well as the availability of dietary energy, animal fats and sugar [6]
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