Healthy Food Access Research Articles

Looking to the past: Investigating 10-year place histories as a determinant of home food environments in the Healthy Communities Study

Emerging research suggests there is a need to consider the importance of place histories in studying neighborhood effects. Guided by a life course of place framework, the objective of this study is to investigate the relationship between two place history exposures and three contemporary home food environment outcomes. Exposures included 10-year neighborhood socioeconomic status (SES) histories and multi-year nutrition community programming and policy (CPP) histories. Outcomes included the availability of healthy foods in the home, the availability of unhealthy foods in the home, and household food insecurity. Associations are investigated using cross-sectional and retrospective data on 4210 US families in the national, observational Healthy Communities Study (2013–2015). Multilevel regression models, adjusted for household income and other factors, were fit for each exposure and outcome. Households residing in neighborhoods with intermittently low, consistently moderate, intermittently high, and consistently high SES histories had greater availability of healthy foods in the home than households in neighborhoods with consistently low SES histories (adjusted βs: 0.11 [95% CI: 0.02, 0.20], 0.13 [95% CI: 0.06, 0.21], 0.23 [95% CI: 0.13, 0.34], and 0.24 [95% CI: 0.15, 0.33], respectively). Households in consistently high SES neighborhoods also had a lower likelihood of household food insecurity than those in consistently low SES neighborhoods (adjusted OR: 0.54 [95% CI: 0.42, 0.71]). Neighborhood SES histories were not significantly associated with the availability of unhealthy foods in the home. Nutrition CPP histories were not significantly associated with food insecurity or the availability of unhealthy foods in the home. However, more intense nutrition CPP histories were significantly associated with greater availability of healthy foods in the home. Moreover, effect estimates increased with more long-term historical accounts of CPPs (adjusted βs: 1-year CPP histories, 0.21 [95% CI: 0.03, 0.39]; 3-year CPP histories, 0.22 [95% CI: 0.03, 0.41]; 6-year CPP histories, 0.25 [95% CI: 0.04, 0.46]; 10-year CPP histories, 0.28 [95% CI: 0.05, 0.50]). To curb food insecurity and promote the availability of healthy foods, the findings suggest considering how neighborhoods develop and evolve over time with respect to SES and nutrition CPP implementation.

Restaurants as Environments for Healthy Eating: Factors That Contribute to Restaurant-Based Healthy Eating Program Adoption.

Purpose. This study identified restaurant manager/owner factors that may contribute to adoption of a restaurant-based healthy eating program, Eat Fit. Findings may be used to engage restaurants in efforts to increase access to and availability of healthy foods, promote healthy food choices, and work toward improving diet and lowering obesity and chronic disease risk in the community. Methods. Cross-sectional survey data were collected from restaurant managers/owners interested in partnering with Eat Fit. Variables included restaurant manager/owner beliefs, perceived staff knowledge/skills, support, self-efficacy, outcome expectancies, and barriers and facilitators to implementation. Results. Forty-nine managers/owners participated. Most managers/owners held positive beliefs about offering healthy food items in restaurants (83.7%). Most agreed that restaurants could influence eating behaviors (83.7%) and that restaurants have a responsibility to offer healthy options (77.6%). Most managers/owners perceived high levels of support (83.7%) and were confident in their ability (95.9%) to implement the Eat Fit program. The most cited barriers were customer preference, ingredient availability, staff knowledge, and operational challenges. The most common reasons for involvement in the program were a desire to increase access to healthy food, to entice customers looking for healthier food, a belief that restaurants should offer healthy food, and opportunities to market through Eat Fit. Conclusions. This research contributes to knowledge about beliefs and perceptions of restaurant manager/owners. Efforts to engage restaurants should focus on benefits of offering healthy food and the role restaurants can play in promoting health. Furthermore, programs may benefit from enhanced restaurant staff training, customer-targeted marketing, and educational efforts.

A cross-sectional study of the relative availability and prominence of shelf space allocated to healthy and unhealthy foods in supermarkets in urban Ireland, by area-level deprivation

BackgroundDiet-related noncommunicable diseases (NCDs) are a leading cause of ill-health and death across Europe. In Ireland, dietary intakes of saturated fat, free sugar and salt exceed World Health Organization recommendations, and excess consumption follows a social gradient increasing population risk of diet-related NCDs. The retail food environment can influence consumer food choice and subsequent dietary intakes. In high income countries, supermarkets are an increasingly influential actor in consumer food availability, choice, purchase, and subsequent food intake. This study aims to assess the relative availability and prominence of healthy and unhealthy foods in Irish supermarkets, by area-level deprivation.MethodsThis study used a cross-sectional study design, and applied a validated measure, as described in the INFORMAS Protocol: Food Retail – Food availability in supermarkets. Between October 2021 and February 2022, shelf space (m2) (height or depth (cm) × length (cm)) and prominence (visibility), of foods, classified as healthy and unhealthy and represented by a proxy indicator, were collected in supermarkets (n = 36) in County Dublin, Ireland. Overall the proportion of mean relative shelf space (m2), allocated to healthy and unhealthy foods, and its prominence, by area-level deprivation, and retailer, were determined. We used t-tests and one-way ANOVA to analyse possible differences between the proportion of relative shelf space available to healthy and unhealthy foods, and its prominence, by area-level deprivation and retailer.ResultsThe study found the proportion of shelf space measured allocated to unhealthy food was 68.0% (SD 10.6). Unhealthy foods were more likely to be in areas of high prominence. Overall, there was no statistically significant difference between the proportion of relative shelf space available to unhealthy foods in areas of high and low deprivation. A statistically significant difference in the proportion of relative shelf space allocated to healthy and unhealthy food by area level deprivation was found in one retailer.ConclusionUnhealthy foods had a higher proportion of shelf space and were more prominent than healthy foods in supermarkets in County Dublin, Ireland. The current availability and prominence of foods in supermarkets does not align with Food Based Dietary Guideline recommendations and does not support consumers to make healthier food choices. There is a need for supermarkets in Ireland to improve the availability and prominence of healthy foods to support consumers to make healthier food choices.

Dietary Restriction, Socioeconomic Factors, Access to Kidney Transplantation, and Waitlist Mortality.

Dietary restrictions for patients with end-stage kidney disease (ESKD) are burdensome. Kidney transplantation (KT) candidates who lack neighborhood resources and are burdened by dietary restrictions may have decreased access to KT. In our two-center prospective cohort study (2014-2023), 2471 ESKD patients who were evaluated for KT (candidates) reported their perceived burden of dietary restrictions (not at all, somewhat/moderately, or extremely bothered). Neighborhood-level socioeconomic factors were derived from residential ZIP codes. We quantified the association of perceived burden of the dietary restrictions with a chance of listing using Cox models and risk of waitlist mortality using competing risks models. Then we tested whether these associations differed by neighborhood-level socioeconomic factors. At evaluation, 18% of KT candidates felt extremely bothered by dietary restrictions. Those who felt extremely bothered were less likely to be listed for KT (adjusted hazard ratio [aHR]=0.75, 95% confidence interval [CI]: 0.64-0.87); this association did not differ by neighborhood-level socioeconomic factors. Overall, the burden of dietary restrictions was not associated with waitlist mortality (p=0.62). However, among candidates living in high food insecurity neighborhoods, those who felt extremely bothered had higher waitlist mortality (adjusted subhazard ratio [aSHR]=2.07, 95% CI: 1.14-3.75, p[interaction]=0.02). The association between dietary burden and waitlist mortality did not differ by neighborhood-level healthy food access. The perceived burden of dietary restrictions is associated with a lower chance of listing for KT, and higher waitlist mortality only among candidates residing in neighborhoods with high food insecurity. Transplant centers should identify vulnerable patients and support them with nutrition education and access to food assistance programs.

Abstract B143: Associations between the food environment and food insecurity on fruit and vegetable intake among urban-dwelling Latina breast cancer survivors participating in the Mi Vida Saludable trial

Abstract Socioeconomic disparities prevalent in Hispanic populations may cause inequities in cancer outcomes and risk factors. We explored the association of access to healthy foods (AHF) and food insecurity (FI) with changes in fruit and vegetable (FV) intake in Latina breast cancer (BC) survivors living in New York City who participated in the Mi Vida Saludable trial. Mi Vida Saludable was a 2x2 factorial trial (n=167) that tested the effects of an in-person and/or eHealth intervention on FV intake and physical activity (PA). Main study results showed only the in-person intervention had modest increases in FV intake. Eligibility criteria included being female, self-identifying as Latina/Hispanic, ³18 years old, history of stage 0-III BC, >3 months post-treatment, <5 daily serving of FV and/or <150 minutes/week of moderate-vigorous PA. FV intake was assessed via 3 24-hour diet recalls at baseline and 12 months. AHF was from a modified validated Access to Healthy Food scale. FI was assessed via questions about eating less or going hungry due to lack of money. Generalized estimating equations examined whether baseline AHF and FI were associated with change in daily FV intake, adjusting for baseline age, marital status, education, and study arm. Three-way interaction terms (AHF or FI with time and study arm) were included to test if associations of AHF and FI with change in FV intake varied by intervention arms. FV intake was log-transformed due to a non-normal distribution; percent changes from baseline were described. AHF was measured in 86 women with 58% and 42% reporting low-medium and high access, respectively. Women with high AHF were more likely to be older (59 vs. 53 years, p=.002) and scored lower on a 5-point acculturation scale (higher score suggests higher acculturation, 1.8 vs. 2.1, p=.01). FI, measured in 157 participant, was prevalent in 23% of women. Women with FI were more likely to be single (44% vs. 16%, p=.003), renting (100% vs. 86%, p=.02), and have higher mean BMI (31 vs. 29 kg/m2, p=.02). 3-way interactions were not statistically significant, though analyses were likely underpowered. In the control group, the adjusted daily FV intake decreased by 79% (p=.01) from baseline to 12 months for women with low-medium AHF and by 49% (p=.10) for those with high AHF; similarly, daily FV intake decreased by 64% (p=.01) for women with FI and by 58% (p=.01) for women without FI. Most Latina BC survivors in New York City who participated in a 12-month diet and PA intervention trial had low-medium AHF at baseline; nearly 1/4 had FI. Associations of AHF or FI with changes in FV intake did not vary significantly by study arm, although sample sizes across strata were small. In the control arm, women with low-medium AHF and FI had larger decreases in FV intake after 12 months. Future dietary intervention studies in Latina BC survivors, and other underserved or under-resourced populations, should account for AHF and FI in the study design, and develop strategies to connect people to healthy food resources. Citation Format: Zachary O. Kadro, Eileen Rillamas-Sun, Blake Langley, Pam Koch, Isobel Contento, Ann Ogden Gaffney, Allison Meisner, Heather Greenlee. Associations between the food environment and food insecurity on fruit and vegetable intake among urban-dwelling Latina breast cancer survivors participating in the Mi Vida Saludable trial [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B143.

Abstract C009: An exploratory ecologic analysis of the association of neighborhood obesogenic factors with prostate cancer mortality in Chicago, Illinois: Challenges and opportunities

Abstract Introduction: Obesity has been associated with aggressive prostate cancer (PCa). Environments that promote obesity, known as obesogenic environments, may also contribute to PCa progression at the population level. However, studies exploring these factors are limited. The purpose of this study was to examine the association between neighborhood obesogenic factors with PCa mortality rates in Chicago. Methods: We used an ecological study design with Chicago Community Areas (n=77) serving as the geographical area unit of analysis. All community area-level data were obtained from the Chicago Health Atlas public data portal. For each area, two obesogenic factors were examined: food environment and park access. The number of healthy and unhealthy grocery stores was used to characterize the food environment. The retail food establishments data was retrieved for the year 2013. The stores were classified into chain grocery stores, non-chain grocery stores, liquor stores, and convenience stores which included dollar tsores, corner stores and gas stations. Chain and non-chain grocery stores were grouped as healthy food access, and other (convenience store, dollar store and liquor store) as unhealthy food access. The area of public parks per 100,000 community area population was used as a measure of park access. An exclusive park area for each community was calculated by intersecting the community area and park area shape files from the year 2016. The outcome variable was community area-level PCa mortality rate age-adjusted to the community area male population. To normalize the data, all included variables were standardized to zero mean and unit standard deviation. Linear regression models analyzed the association of the standardized measures of obesogenic environment (individually and simultaneously) with age-adjusted rates using the Statistical Analysis Software 9.4. Results: The mean number of healthy (0 - 11) and unhealthy (0 - 10) food stores in each community area were 3.1 and 2.6 respectively and mean park area (14.0 - 4096.5 acres) available in each community area was 453.5 acres per 100,000 population. The mean (0 – 29.6) PCa mortality was 9.8 per 100,000 population. Healthy food access was inversely associated with PCa mortality rates, where for every for one 1-standard deviation increase in healthy food access standard deviation, there is a 0.40 unit decrease in community area PCa mortality rate standard deviation (p=0.002) while accounting for the other obesogenic factors (unhealthy food access and park access). Conclusion: The findings of this study suggest that the neighborhood access to healthy food may be a determinant of neighborhood PCa mortality rates. Ecological studies are helpful to understand the impact at the geographical level. Methodological challenges and opportunity in ecological analyses, such as addressing bias and multivariable control of confounding, will be discussed. Citation Format: Ravneet Kaur, Jiehuan Sun, Nebiyou Y. Tilahun, Vincent L. Freeman. An exploratory ecologic analysis of the association of neighborhood obesogenic factors with prostate cancer mortality in Chicago, Illinois: Challenges and opportunities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C009.

Are food and nutrition assistance programs fostering an equitable early care and education (ECE) food environment? A systematic review utilizing the RE-AIM framework

BackgroundHealth inequities related to poor diet, food insecurity, and obesity negatively affect children from low-income minority families. The USDA administers Food and Nutrition Assistance Programs (FNAPs) in Early Care and Education settings (ECEs) to safeguard the health of vulnerable children. However, the extent to which FNAPs provide an equitable food environment in ECEs remains unclear. ObjectiveExamine FNAPs’ association with young children's (2–6 years) food environment in ECE through a systematic review using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The primary focus is to operationalize RE-AIM in ECE context and evaluate FNAPs' association with the ECE food environment using an equity lens. Measurable outcomesFood environment dimensions were assessed at three levels: ECE setting (availability, accessibility, affordability, acceptability, accommodation); ECE provider (feeding practices); and child (dietary intake, food insecurity, BMI percentile). ResultsThe review included 38 articles (cross-sectional=30, mixed method=1, pre-post=5, longitudinal=2) with Child and Adult Care Food Program (CACFP; n = 35), Farm to ECE (n = 2), and Food Bank-ECE program partnership (n = 1). No study addressed all RE-AIM indicators. CACFP participation showed positive association with healthy food availability (n = 28), feeding practices (n = 12), child dietary intake (n = 6), and reduced risk of being overweight (n = 1). Farm to ECE interventions showed increased local food affordability (n = 1) and children's acceptance of healthy foods (n = 1). No study addressed foods served in ECEs to accommodate cultural diversity, special dietary needs, developmental disabilities, or reported child food insecurity. ConclusionCACFP emerges as the most prevalent FNAP nationally for having potential to improve ECE food availability and feeding practices, but further research is needed to address equity gaps by examining its impact on child outcomes (dietary intake, BMI percentile) across diverse geographic locations (urban vs. rural), ECE organizational structures (center-based vs. home-based), and demographic characteristics of ECE providers and children.

Barriers and Enablers for Equitable Healthy Food Access in Baltimore Carryout Restaurants: A Qualitative Study in Healthy Food Priority Areas.

Black neighborhoods in the U.S., historically subjected to redlining, face inequitable access to resources necessary for health, including healthy food options. This study aims to identify the enablers and barriers to promoting equitable healthy food access in small, independently owned carryout restaurants in under-resourced neighborhoods to address health disparities. Thirteen in-depth interviews were conducted with restaurant owners in purposively sampled neighborhoods within Healthy Food Priority Areas (HFPAs) from March to August 2023. The qualitative data were analyzed using inductive coding and thematic analysis with Taguette software (Version 1.4.1). Four key thematic domains emerged: interpersonal, sociocultural, business, and policy drivers. Owners expressed mixed perspectives on customers' preferences for healthy food, with some perceiving a community desire for healthier options, while others did not. Owners' care for the community and their multicultural backgrounds were identified as potential enablers for tailoring culturally diverse menus to meet the dietary needs and preferences of their clientele. Conversely, profit motives and cost-related considerations were identified as barriers to purchasing and promoting healthy food. Additionally, owners voiced concerns about taxation, policy and regulation, information access challenges, and investment disparities affecting small business operations in HFPAs. Small restaurant businesses in under-resourced neighborhoods face both opportunities and challenges in enhancing community health and well-being. Interventions and policies should be culturally sensitive, provide funding, and offer clearer guidance to help these businesses overcome barriers and access resources needed for an equitable, healthy food environment.

The Best Practices for Designing Built Environments to Promote Healthy Food Access and Dietary Behaviors in Low-Income and Underserved Communities

Background: The built environment can influence health outcomes, including access to good dietary options. Aims: The current study intends to thoroughly evaluate the literature on best practices for building environments that promote healthy food access and nutritional behaviors in low-income and underserved communities in Indonesia. Method: To discover relevant studies on this topic, a thorough literature review was done using databases from PubMed, Web of Science, and Scopus extracting. Result: The final analysis included 32 studies after removing duplicates and applying inclusion and exclusion criteria. Extracting and assessing data from the chosen research and thematic synthesis was applied. The data was extracted and processed into a detailed narrative that provided an overview of the best practices. Conclusion: According to the findings of the literature study, built environment design can have a considerable impact on healthy food availability and eating patterns in Indonesian communities. It might be possible to develop effective interventions that enhance health outcomes for all Indonesians by addressing these gaps in the evidence.

In vitro Bioaccesibility of Phenolic Compounds from the Halophytes Suaeda Edulis and Suaeda Esteroa: Opportunity for the Development of Novel Foods

Halophytic plants grow in high salinity environments and present phytochemicals with antioxidant properties, such as phenolic compounds; due to the uncertain availability of healthy foods, there is a growing interest in their nutritional potential. However, their bioactive compounds with beneficial health effects are limited in their bioaccessibility. The objective of this study was to subject S. edulis and S. esteroa to an in vitro digestion process to evaluate the bioaccessibility and total antioxidant capacity of phenolic compounds during three phases of digestion. We determined phenolic compounds, flavonoids, and antioxidant capacity by colorimetric methods and phenolic composition by UHPLC-DAD. Total phenols, total flavonoids, and total antioxidant capacity by DPPH and TEAC in the three phases of digestion (oral, gastric, and intestinal) of S. esteroa were higher than in S. edulis, founding 4.84 % higher in total phenol content, and 0.05 % in total flavonoid content; also, and 28.94 and 23.93 % higher in total antioxidant capacity by DPPH and TEAC, respectively in the intestinal digestion phase. The bioaccessibility of S. edulis was higher than in S. esteroa; the intestinal was the phase reflecting more bioaccessible compounds. The bioaccessibility percentages of total phenols and flavonoids were 590.16 and 1012.93 %, and the percentage recovery of total antioxidant capacity by DPPH and TEAC were 181.37 and 139.74 %. We identified phenolic acids ferulic, p-Coumaric, and synaptic (hydroxycinnamic), gallic and protocatechuic (hydroxybenzoic), the flavonoids catechin (flavan-3-oles), myricetin and ruthin (flavonols), naringenin and naringin (flavonones). S. esteroa presented bioactive compounds in higher concentrations than S. edulis due to the stress imposed by its habitat; nevertheless, the determined bioactive compounds of S. edulis showed a higher bioaccessibility because it was managed under local improvement.

Initiatives and exposures associated with food security in remote and isolated communities: a scoping review.

Chronic household food insecurity (HFI) and lack of food availability and accessibility in isolated communities are longstanding public health crises. This review aims to paint a more fulsome picture of food security initiatives in remote and isolated communities by examining programs across circumpolar countries, Australia, and Aotearoa New Zealand. This synthesis of research will contribute to an understanding of what types of initiatives exist and aid in the identification of best practices. The authors conducted a scoping review identifying articles that include either (1) an evaluation of an initiative with a quantitative food security outcome in remote and isolated communities, or (2) quantitative associations between exposure factors with food security outcomes. Inclusion criteria included English and French articles focused on remote and isolated communities in Canada, the US, Australia, New Zealand, Sweden, Norway, Finland, Greenland, and Russia from January 1997 to July 2022. The article search yielded 1882 results, of which 96 fulfilled the inclusion criteria, including 26 studies evaluating initiatives, 66 studies evaluating exposure factors, and four studies that included both initiatives and exposure factors. The majority of the studies included in this review were conducted in Canada and Australia. No initiative studies conducted in Russia, Greenland, Norway, Finland, or Sweden fulfilled the criteria for inclusion in this review. The most common types of initiatives evaluated included school-based programs, market subsidies, and education initiatives, though a small number (<5) of other programs were evaluated, including traditional food programs and greenhouses. Though multiple programs resulted in lower food costs or increases in healthy food consumption in remote regions, the cost of a healthy diet in these areas remained high, as do levels of HFI. Factors associated with improved food security outcomes included higher income level, access to adequate housing, higher education level, access to transportation for harvesting, and the level of remoteness of a community. The studies included in this review also stressed the importance of access to and affordability of harvesting traditional foods in these regions. Those living in remote and isolated communities are particularly vulnerable to food insecurity and lack of access and availability of healthy foods, which are compounded by a variety of socioeconomic factors. This study highlights the lack of quantitative evaluations of food security initiatives in remote and isolated communities, as well as the wide variety in measured outcomes. Authors of several of the included articles note that community-led initiatives, with strong partnerships and local champions, were recommended in these populations, given the culturally and geographically diverse groups living in remote and isolated areas.

Enhancing food access in a comprehensive cancer center area of influence through local partner capacity building.

Food insecurity, an economic and social condition of limited food access, is associated with poor diet quality-a risk factor for several common cancers. The University of Texas MD Anderson Cancer Center supports healthy food access through community-led evidence translation by actively partnering with community-based organizations (CBOs). These partnerships aim to enhance the capacity of food assistance CBOs to effectively implement evidence-based food insecurity mitigation programs in the cancer center's area of influence. This case study aims to describe the cancer center's model for local food access capacity building and detail operationalization in the context of a whole-community cancer prevention effort (Be Well Baytown) in Baytown, Texas. Elements central to the capacity building model include (i) assessment of baseline needs and capacity, (ii) empowering a community champion within a relevant CBO, (iii) mapping inter-sectoral community partnerships, collaborations, and linkages, and (iv) leveraging systems, connections, and resources to provide an enabling environment for overall food access systems growth. Through this process, Be Well Baytown enhanced the capacity of a local food pantry leading to increases in total reach, pounds of food distributed, and number of food distribution events in collaboration with intersectoral partners from 2018 to 2023. This case study highlights the model's implementation as a co-benefit community partnership strategy to maximize the impact of food security programs integrated with comprehensive cancer center prevention efforts.

Black and Latina women’s lived experiences with navigating neighborhood food swamps to find healthy food: A photovoice approach

ABSTRACT To understand the perspectives of individuals living within food swamps and how they may perceive their access to healthy vs. unhealthy foods before and during the COVID-19 pandemic. Additionally, we examine how they may navigate their food environment to feed themselves and their families. We recruited women of color living within a food swamp neighborhood to share their perspectives on healthy and unhealthy food access, healthy eating, neighborhood resources, and community support. We employed the Photovoice model to engage participants to take photographs and document their experiences through two surveys. A focus group was completed to identify solutions and priorities to improve healthy food access. Nine themes related to food access including marketing, food quality, and affordability were identified. Participants conveyed the “saddening” or “frustrating” experience of taking images, which allowed them to document what they feel is the unfair experience of purchasing food in their own neighborhood. Participants highlighted goals they believed would improve outcomes for their neighborhood while discussing potential stakeholders who may assist the community. Participants identified several existing community assets such as local markets and schools that should be leveraged and expanded to enhance the overall health-promoting aspects of their neighborhood. Community members are able to identify the prevalence of unhealthy foods in their neighborhoods and work diligently to combat issues of food access. After completion of the Photovoice study, participants felt more confident about their ability to influence community.

Fast Food Consumption Patterns Nutritional Status and Anemia Among Female

This study aims to analyze the patterns of fastfood consumption, nutritional status, and prevalence of anemia among female students in the Nutrition Department of Poltekkes Medan. An observational method with a cross-sectional design was used on 73 female students. Data on the frequency of fastFood consumption was collected using a semi-quantitative FFQ, nutritional status was assessed based on BMI, and hemoglobin levels were measured using the Cyanmethemoglobin method. The results showed that 45.20% of respondents frequently consumed fast food, with an obesity prevalence of 35.70% and anemia prevalence of 35.60%. There was a significant relationship between fast food consumption and nutritional status (p=0.042), but not with anemia status (p=0.540). In conclusion high fastfood consumption correlates with obesity and anemia. Efforts are needed to increase the availability of healthy food on campus and further research on the long-term impact of ast Food consumption on student health.

Features of eating behavior of early school-age children in the context of the implementation of the school meals reform

The aim of this study is to study the peculiarities of the eating behaviour of children of primary school age, their food preferences, choice of products and attitudes towards school meals, food habits in the choice of products and attitudes towards the school canteen in the context of the implementation of the school meal reform. Materials and methods. A large-scale medical and sociological study was conducted, which included children (5,401) of primary school age (from 6 to 10 years old) and their parents (4,347 people) from various schools in Kyiv, Vinnytsia, and Donetsk regions. The questionnaires included questions about food preferences, frequency of consumption of different foods, attitudes towards school meals and factors that influence food choices. The collected data were processed and analyzed using descriptive statistics methods in Excel. Research results indicate a significant level of awareness of the importance of a healthy diet by most children, but an insufficient level of water consumption, an insufficient understanding of the importance of nutrition for maintaining health by children, high popularity of high-carbohydrate products and a low level of satisfaction of some parents with school meals. Conclusions. The conducted analytical research revealed several educational and organizational problems related to the introduction of healthy food in schools, especially within the framework of reforming school food programs. According to the Strategy for reforming the school nutrition system, compliance with the principles of healthy nutrition, ensuring high-quality, safe and healthy nutrition, and improving the taste properties of school nutrition compliance with the principles of healthy nutrition, is extremely important for the preservation of children's health and the prevention of chronic non-infectious diseases. The results of our research indicate the need for additional educational programs for children and parents, the gradual introduction of new food standards, as well as ensuring the availability of healthy food in school canteens, and the implementation of social projects that will contribute to the formation of healthy eating habits

Food service management perspectives on reducing sodium content in foods served: Opportunities and challenges

Abstract Between Fall 2017 and Spring 2018, the Los Angeles County Sodium Reduction Initiative interviewed food service management leaders and staff from eight public and private institutions in Southern California (three universities, four hospitals, and one senior meal program) to identify opportunities and challenges in reducing sodium content for the foods they sell, serve, and produce. Interviews were transcribed, collated, and analyzed using content analysis with thematic sorting and coding. Interviewees identified several opportunities: (1) group purchasing through a large organizational membership; (2) a supportive organizational culture; (3) organized strategies to replace high-sodium products; and (4) access to software resources to manage food inventories. Challenges included (1) negative customer/staff receptivity to low-sodium options; (2) lack of kitchen infrastructure/equipment; (3) low availability of healthy foods; and (4) limited program evaluation capacity. Collectively, these findings provide practice-based insights into how these factors contributed to sodium reduction efforts in these institutions.

Factors and Perceptions Associated with Post-Pandemic Food Sourcing and Dietary Patterns among Urban Corner Store Customers in Baltimore, Maryland.

Diet-related disease is rising, disproportionately affecting minority communities in which small food retail stores swamp supermarkets. Barriers to healthy food access were exacerbated by the pandemic. We examined the following: (1) individual- and household-level factors in a sample of Baltimore community members who regularly shop at corner stores and (2) how these factors are associated with indicators of dietary quality. Cross-sectional data were collected using an online survey to capture sociodemographics, anthropometrics, and food sourcing, spending, and consumption patterns. Concurrent quantitative and qualitative analyses were conducted in Stata 18 and ATLAS.ti. This study was set in Baltimore, Maryland, USA. The participants included adults (n = 127) living or working in Baltimore who identified as regular customers of their neighborhood corner store. The respondents were majority Black and low-income, with a high prevalence of food insecurity (62.2%) and overweight/obesity (66.9%). Most (82.76%) shopped in their neighborhood corner store weekly. One-third (33.4%) of beverage calories were attributed to sugar-sweetened beverages, and few met the recommended servings for fruits and vegetables or fiber (27.2% and 10.4%, respectively). Being Black and not owning a home were associated with lower beverage and fiber intake, and not owning a home was also associated with lower fruit and vegetable intake. Food insecurity was associated with higher beverage intake, while WIC enrollment was associated with higher fruit and vegetable and fiber intakes. Open-ended responses contextualized post-pandemic food sourcing and consumption in this setting. This paper helps characterize the consumers of a complex urban food system. The findings will inform future strategies for consumer-engaged improvement of local food environments.

Barriers and facilitators to healthy eating in disadvantaged adults living in the UK: a scoping review

In the UK people living in disadvantaged communities are less likely than those with higher socio-economic status to have a healthy diet. To address this inequality, it is crucial scientists, practitioners and policy makers understand the factors that hinder and assist healthy food choice in these individuals. In this scoping review, we aimed to identify barriers and facilitators to healthy eating among disadvantaged individuals living in the UK. Additionally, we used the Theoretical Domains Framework (TDF) to synthesise results and provide a guide for the development of theory-informed behaviour change interventions. Five databases were searched, (CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science) for articles assessing healthy dietary intake of disadvantaged adults living in the UK. A total of 50 papers (34 quantitative; 16 qualitative) were included in this review. Across all studies we identified 78 barriers and 49 facilitators found to either impede and/or encourage healthy eating. Both barriers and facilitators were more commonly classified under the Environmental, Context and Resources TDF domain, with 74% of studies assessing at least one factor pertaining to this domain. Results thus indicate that context related factors such as high cost and accessibility of healthy food, rather than personal factors, such as lack of efficiency in healthy lifestyle drive unhealthy eating in disadvantaged individuals in the UK. We discuss how such factors are largely overlooked in current interventions and propose that more effort should be directed towards implementing interventions that specifically target infrastructures rather than individuals.

Policy, Systems, and Environmental Strategies to Support Healthy Eating Behaviors in Early Childhood: A Scoping Review of Existing Evaluation Tools

BackgroundPolicy, systems, and environmental (PSE) change strategies aimed at supporting healthy eating behaviors work to enhance optimal nutrition by making healthy foods more available and accessible in the community. PSE change strategies can complement and strengthen knowledge, skills, and behaviors obtained through individual-level nutrition education. ObjectiveThis scoping review aimed to identify existing literature evaluating early childhood (ie, children younger than age 5 years) PSE change strategies supporting healthy eating behaviors and to describe the evaluation tools used to assess the identified PSE change strategies. MethodsThree databases (PubMed, Cumulated Index in Nursing and Allied Health Literature, and Web of Science) were used to systematically search for articles published between 2013 and 2023 written in English and conducted in the United States that evaluated PSE change strategies supporting healthy eating behaviors in young children (ie, children younger than age 5 years). Two study members conducted the review, discussing and reconciling discrepancies until a consensus was reached for interobserver reliability. ResultsFindings from this review identified 48 studies evaluating early childhood PSE change strategies supporting healthy eating behaviors, with 36 studies using 25 PSE-focused evaluation tools to evaluate these strategies. Most tools (80%) assessed PSE change strategies supporting access and availability of healthy food and beverage options in early childhood education settings. Studies did not evaluate child-level outcomes (ie, attitudes, preferences, and behaviors) to showcase improvement of early childhood nutrition. Only 60% of the tools reported evidence of validity or reliability. ConclusionsMost of the studies identified in this scoping review were aimed to evaluate healthy eating PSE change strategies focused on improving access to and availability of healthy foods and beverages in early childhood education settings. Future research is needed to develop and validate PSE-focused evaluation tools assessing child-level healthy eating practices and behaviors.

Association between participation in the supplemental nutrition assistance program and perception of limited availability and choice of healthy foods.

Nutrition security encompasses stable and equitable access, availability, affordability, and utilization of healthy foods. To evaluate the relationship of two newly created dichotomous measures that represent aspects of nutrition security (i.e., perceived limited availability and healthfulness choice) with Supplemental Nutrition Assistance Program (SNAP) participation. Logistic regression models were run for each outcome separately with adjustment for age, income-to-poverty ratio, gender, education, race, and food security. Adults using social services (e.g., food pantries) were enrolled (N = 402) in this cross-sectional analysis. SNAP participants (61.7%) were not different from non-SNAP participants in perceiving limited availability (aOR [95% CI]: 1.21 [0.75, 1.95]) or limited ability to choose (aOR [95% CI]: 0.69 [0.43, 1.12]) healthy foods. Both SNAP and non-SNAP participants with low socioeconomic status report limited availability of healthy foods in their environment and a limited ability to choose healthy foods.