Availability Of Unhealthy Foods Research Articles

What Do People Like to “Share” About Obesity? A Content Analysis of Frequent Retweets About Obesity on Twitter

Twitter has been recognized as a useful channel for the sharing and dissemination of health information, owing in part to its “retweet” function. This study reports findings from a content analysis of frequently retweeted obesity-related tweets to identify the prevalent beliefs and attitudes about obesity on Twitter, as well as key message features that prompt retweeting behavior conducive to maximizing the reach of health messages on Twitter. The findings show that tweets that are emotionally evocative, humorous, and concern individual-level causes for obesity were more frequently retweeted than their counterparts. Specifically, tweets that evoke amusement were retweeted most frequently, followed by tweets evoking contentment, surprise, and anger. In regard to humor, derogatory jokes were more frequently retweeted than nonderogatory ones, and in terms of specific types of humor, weight-related puns, repartee, and parody were shared frequently. Consistent with extant literature about obesity, the findings demonstrated the predominance of the individual-level (e.g., problematic diet, lack of exercise) over social-level causes for obesity (e.g., availability of cheap and unhealthy food). Implications for designing social-media-based health campaign messages are discussed.

Nutrition promotion approaches preferred by Australian adolescents attending schools in disadvantaged neighbourhoods: a qualitative study.

BackgroundLinks between socioeconomic disadvantage and unhealthy eating behaviours among adolescents are well established. Little is known about strategies that might support healthy eating among this target group. This study aimed to identify potential strategies and preferred dissemination methods that could be employed in nutrition promotion initiatives focussed on improving eating behaviours among socioeconomically disadvantaged adolescents.MethodsSemi-structured interviews were conducted in 2011 among 22 adolescents (12–15 years) recruited from secondary schools in disadvantaged neighbourhoods in Victoria, Australia.ResultsStrategies suggested by adolescents to support healthy eating included increasing awareness about healthy eating; greater cooking involvement; greater parental and peer support; frequent family meal participation; greater parental and peer role-modelling of healthy eating; increased availability of healthy foods and decreased availability of unhealthy foods in homes and schools. Adolescents preferred electronic media, adolescent-specific recipe books, and school-based methods for distributing nutrition promotion messages and strategies.ConclusionsA number of suggested strategies and methods identified in the present investigation have been employed with success in previous nutrition promotion interventions targeting socioeconomically disadvantaged adolescents. The present study also contributes novel insights into potential strategies and methods that could be employed in initiatives aiming to improve eating behaviours in this vulnerable group, and particularly highlights the importance of incorporating strategies involving parents and modifying the home food environment.

Balancing Act: Approaches to Healthy Eating and Physical Activity Among Boston Public Housing Residents

Boston public housing residents are more likely to report fair or poor health status, been diagnosed with obesity, and to be physically inactive compared with other Boston residents (Digenis-Bury, Brooks, Chen, Ostrem, & Horsburgh, 2008). Little is known about perceptions of and opportunities for healthy eating and physical activity in this population. We conducted eight focus groups at public housing developments to explore residents’ views regarding opportunities and barriers to healthy eating and physical activity. Sixty-seven English- and Spanish-speaking residents participated. Transcripts were analyzed using qualitative content analysis. All residents described the challenge of balancing considerations of food quality, access, and affordability. Other findings included underutilized nutritional resources; abundant availability of unhealthy food; and economic and structural barriers to exercise. Transportation-related challenges were a dominant theme. Building opportunities for physical activity and providing access to affordable and quality food choices may be important interventions for promoting health among public housing residents.

Should support for obesity interventions or perceptions of their perceived effectiveness shape policy?

ObjectivesMost studies suggest the public locate responsibility for the ‘obesity epidemic’ with individuals themselves and support measures promoting greater personal responsibility in the belief these will reduce obesity prevalence. We compared estimates of policy support with estimates of perceived policy effectiveness to test this assumption. MethodsIn an on‐line survey of 534 New Zealanders, we tested support for 15 potential measures to reduce overweight and obesity and compared this with estimates of the effectiveness of these policies, determined by a Best‐Worst choice experiment. ResultsRespondents gave strongest support to measures encouraging people to undertake more exercise and adopt a better diet. However, they saw greater personal responsibility as less effective in reducing obesity than environmental interventions that reduced the costs of healthy food and exercise, and decreased the availability of unhealthy foods. ConclusionsPotentially important differences exist between the measures the general public say they support to address obesity, which favour personal responsibility and education, and those they believe will be effective, which include more environmental interventions. ImplicationsSimply measuring the popularity of measures to reduce obesity produces an incomplete picture of public opinion. Examining the perceived efficacy of different interventions offers a complementary perspective that policy makers should also consider.

Disparities in Access to Healthy and Unhealthy Foods in Central Massachusetts: Implications for Public Health Policy

Objectives: To analyze geographic and income disparities in access to healthy foods in central Massachusetts.Methods: We surveyed 106 (92% of all) food stores longitudinally in the study area between 2007 and 2010. We analyzed the geographic and temporal variations in community- and store-level healthy food availability indices (HFAI) and unhealthy food availability indices (UFAI) overall and by select store and community characteristics.Results: Twenty-seven of 68 communities in the study area (39.7%) had no food store and 5 (8.3%) had one or few stores with very limited availability of healthy foods, affecting 23.7% of the county population. Lack of food stores was associated strongly with lower housing density and upper tertile of median household income. About 45% of the surveyed stores had inadequate availabilities of healthy food. Store-level HFAI and UFAI scores were highly correlated, and higher among larger stores affiliated with a chain (vs independent). Though healthy foods were usually most available in larger stores, unhealthy foods were widely available in all stores.Conclusions: Over half of central Massachusetts communities, mostly rural and small, had either no food store or few stores with limited availabilities of healthy foods. Immediate policy interventions on the food environment are necessary in these communities. Further, without examining what is actually sold in stores, analysis of disparities in access to healthy food relies on the number of food stores, which can lead to a distorted picture of accessibility and mislead community health policies.

Associations of the Home Food Environment with Eating Behaviors and Weight Status among Children and Adolescents

Primary objective: Understanding the aspects of the home food environment of children and adolescents such as the availability, accessibility, and visibility of home healthy and unhealthy foods and the frequency and quality of family meals is necessary for developing direct interventions for weight management. This review examined the literature on associations of home food environment including availability, accessibility, and visibility of home healthy and unhealthy foods and frequency and quality of family meals with children’s eating behaviors and weight status and methods to assess the availability and accessibility of foods in the home. Main outcomes and results: Research suggests:1) the availability and/or accessibility of home healthy or unhealthy foods were associated with children or adolescents’ dietary intakes; 2) the link between home food availability and accessibility with weight status is weak; 3) the evidence on associations of frequency or nutritional quality of family meals with weight status is inconsistent; 4) the in-home assessments for food availability, accessibility and visibility appear to be necessary; however the assessment tools may need to be further improved to capture the quantity of the healthy and unhealthy foods in the home; and 5) repeated in-home assessments are needed to help determine the stability of foods routinely purchased at home. Conclusions: The obesogenic home environment is complex. This review aims to provide valuable insights for designing direct interventions for weight management in children and adolescents by improving their home food environment.

What factors are associated with frequent unhealthy snack-food consumption among Australian secondary-school students?

To examine demographic and behavioural correlates of unhealthy snack-food consumption among Australian secondary-school students and the association between their perceptions of availability, convenience and intake with consumption. Cross-sectional survey of students' eating, physical activity and sedentary behaviours using validated instruments administered via an online questionnaire. Australian secondary schools across all states/territories. Secondary-school students aged 12-17 years participating in the 2009-10 National Secondary Students' Diet and Activity (NaSSDA) survey (n 12 188). Approximately one in five students (21 %) reported consuming unhealthy snack foods ≥14 times/week ('frequent snackers'). After adjusting for all covariates, older students and those with a BMI of ≥25 kg/m² were less likely to be frequent snackers, while students who reported high fast-food and high sugar-sweetened beverage consumption and those who watched television for >2 h/d were more likely to snack frequently. Furthermore, after adjusting for all covariates and demographic factors, students who agreed that snack foods are usually available at home, convenient to buy and that they eat too many snack foods were more likely to be snacking frequently. Conversely, students who agreed that fruit is a convenient snack were less likely to be frequent snackers. Frequent unhealthy snack-food consumption appears to cluster with other poor health behaviours. Perceptions of availability and convenience are factors most readily amenable to change, and findings suggest interventions should focus on decreasing the availability of unhealthy snack foods in the home and promoting healthier options such as fruit as convenient snacks.

Smorgasbord or symphony? Assessing public health nutrition policies across 30 European countries using a novel framework.

BackgroundCountries across Europe have introduced a wide variety of policies to improve nutrition. However, the sheer diversity of interventions represents a potentially bewildering smorgasbord.We aimed to map existing public health nutrition policies, and examine their perceived effectiveness, in order to inform future evidence-based diet strategies.MethodsWe created a public health nutrition policy database for 30 European countries . National nutrition policies were classified and assigned using the marketing "4Ps" approach Product (reformulation, elimination, new healthier products); Price (taxes, subsidies); Promotion (advertising, food labelling, health education) and Place (schools, workplaces, etc.).We interviewed 71 senior policy-makers, public health nutrition policy experts and academics from 14 of the 30 countries, eliciting their views on diverse current and possible nutrition strategies.ResultsProduct Voluntary reformulation of foods is widespread but has variable and often modest impact. Twelve countries regulate maximum salt content in specific foods.Denmark, Austria, Iceland and Switzerland have effective trans fats bans.Price EU School Fruit Scheme subsidies are almost universal, but with variable implementation.Taxes are uncommon. However, Finland, France, Hungary and Latvia have implemented ‘sugar taxes’ on sugary foods and sugar-sweetened beverages. Finland, Hungary and Portugal also tax salty products.Promotion Dialogue, recommendations, nutrition guidelines, labelling, information and education campaigns are widespread. Restrictions on marketing to children are widespread but mostly voluntary.Place Interventions reducing the availability of unhealthy foods were most commonly found in schools and workplace canteens.Interviewees generally considered mandatory reformulation more effective than voluntary, and regulation and fiscal interventions much more effective than information strategies, but also politically more challenging.ConclusionsPublic health nutrition policies in Europe appear diverse, dynamic, complex and bewildering. The "4Ps" framework potentially offers a structured and comprehensive categorisation.Encouragingly, the majority of European countries are engaged in activities intended to increase consumption of healthy food and decrease the intake of "junk" food and sugary drinks. Leading countries include Finland, Norway, Iceland, Denmark, Hungary, Portugal and perhaps the UK. However, all countries fall short of optimal activities. More needs to be done across Europe to implement the most potentially powerful fiscal and regulatory nutrition policies.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1195) contains supplementary material, which is available to authorized users.

What is the public appetite for healthy eating policies? Evidence from a cross-European survey.

World Health Organization estimates that obesity accounts for 2-8% of health care costs in different parts of Europe, and highlights a key role for national policymaking in curbing the epidemic. A variety of healthy-eating policy instruments are available, ranging from more paternalistic policies to those less intrusive. Our aim is to measure and explain the level of public support for different types of healthy eating policy in Europe, based on data from a probabilistic sample of 3003 respondents in five European countries. We find that the main drivers of policy support are attitudinal factors, especially attribution of obesity to excessive availability of unhealthy foods, while socio-demographic characteristics and political preferences have little explanatory power. A high level of support for healthy eating policy does not translate into acceptance of higher taxes to fund them, however.

Local Concentration of Fast-Food Outlets is Associated with Poor Nutrition and Obesity

We investigated the relationship of the local availability of fast-food restaurant locations with diet and obesity. We geocoded addresses of survey respondents and fast-food restaurant locations to assess the association between the local concentration of fast-food outlets, BMI, and fruit and vegetable consumption. The survey was conducted in Genesee County, Michigan. There were 1345 individuals included in this analysis, and the response rate was 25%. The Speak to Your Health! Community Survey included fruit and vegetable consumption items from the Behavioral Risk Factor Surveillance System, height, weight, and demographics. We used ArcGIS to map fast-food outlets and survey respondents. Stepwise linear regressions identified unique predictors of body mass index (BMI) and fruit and vegetable consumption. Survey respondents had 8 ± 7 fast-food outlets within 2 miles of their home. Individuals living in close proximity to fast-food restaurants had higher BMIs t(1342) = 3.21, p < .001, and lower fruit and vegetable consumption, t(1342) = 2.67, p = .008. Individuals may be at greater risk for adverse consequences of poor nutrition because of the patterns in local food availability, which may constrain the success of nutrition promotion efforts. Efforts to decrease the local availability of unhealthy foods as well as programs to help consumers identify strategies for obtaining healthy meals at fast-food outlets may improve health outcomes.

Abstract P409: Assessing public health nutrition policies using a novel framework across 30 European countries: Lessons for the USA?

Background: Countries across Europe have introduced a wide variety of policies to improve nutrition. However, the sheer diversity of interventions is potentially bewildering. We therefore aimed to map existing public health nutrition policies and identify their perceived effectiveness, in order to inform future evidence-based diet strategies. Methods: Mapping exercise: We created a public health nutrition policy database for 30 European countries (EU 27 plus Iceland, Norway and Switzerland), by summarising policy documents, grey literature, web searches and advice from topic experts. National nutrition policies were then classified using the marketing “4Ps” approach: Product (reformulation, elimination, new healthier products); Price (taxes, subsidies); Promotion (advertising, food labelling and health education) and Place (schools, workplaces, etc.) Policy interviews: We interviewed 71 senior policy-makers, public health nutrition policy experts and academics from 14 of the 30 countries, eliciting their views on diverse current and possible nutrition strategies. Results Product: Voluntary reformulation of foods, (especially salt, sugar and total fat) is widespread but with questionable impact. Denmark, Austria, Iceland and Switzerland have trans fats bans. Twelve countries regulate maximum salt content in specific foods. Price: EU School Fruit Scheme subsidies are almost universal, with variable implementation. Taxes are uncommon. However, Finland, France, Hungary and Latvia have implemented ‘sugar taxes’ on sugary foods and sugar-sweetened beverages. Finland, Hungary and Portugal also tax salty products. Promotion: Dialogue, recommendations, nutrition guidelines, information and education campaigns are widespread (all 30 countries). Labelling information is widespread, but variable. Restrictions on marketing to children are widespread but mostly voluntary. Place: Interventions reducing the availability of unhealthy foods were most commonly found in schools and workplace canteens (e.g. vending machines). Comparative effectiveness: Interviewees generally considered mandatory reformulation more effective than voluntary, and regulation and fiscal interventions much more effective than information strategies, but politically much more challenging. Implications: Public health nutrition policies in Europe appear diverse, dynamic, complex and bewildering. However, the “4Ps” framework potentially offers a structured and comprehensive categorisation. Most European countries are active in nutrition policy. However, exemplars are few, including Finland, Norway, Iceland, Denmark, Hungary, Portugal and the UK. Do these offer any useful lessons for US states addressing similar challenges? In conclusion, fiscal and regulatory nutrition policies appear potentially powerful and should be considered across Europe, and perhaps across the US?

Facilitators to promoting health in schools: is school health climate the key?

Schools can promote healthy eating in adolescents. This study used a qualitative approach to examine barriers and facilitators to healthy eating in schools. Case studies were conducted with 8 low-income Michigan middle schools. Interviews were conducted with 1 administrator, the food service director, and 1 member of the coordinated school health team at each school. Barriers included budgetary constraints leading to low prioritization of health initiatives; availability of unhealthy competitive foods; and perceptions that students would not eat healthy foods. Schools had made improvements to foods and increased nutrition education. Support from administrators, teamwork among staff, and acknowledging student preferences facilitated positive changes. Schools with a key set of characteristics, (presence of a coordinated school health team, nutrition policies, and a school health champion) made more improvements. The set of key characteristics identified in successful schools may represent a school's health climate. While models of school climate have been utilized in the educational field in relation to academic outcomes, a health-specific model of school climate would be useful in guiding school health practitioners and researchers and may improve the effectiveness of interventions aimed at improving student dietary intake and other health behaviors.

Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally

E-mail: c.nimhurchu@nihi.auckland.ac.nz Summary Retail food environments are increasingly considered influential in determining dietary behaviours and health outcomes. We reviewed the available evidence on associations between community (type, availability and accessibility of food outlets) and consumer (product availability, prices, promotions and nutritional quality within stores) food environments and dietary outcomes in order to develop an evidence-based framework for monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in retail food environments. Current evidence is suggestive of an association between community and consumer food environments and dietary outcomes; however, substantial heterogeneity in study designs, methods and measurement tools makes it difficult to draw firm conclusions. The use of standardized tools to monitor local food environments within and across countries may help to validate this relationship. We propose a stepwise framework to monitor and benchmark community and consumer retail food environments that can be used to assess density of healthy and unhealthy food outlets; measure proximity of healthy and unhealthy food outlets to homes/ schools; evaluate availability of healthy and unhealthy foods in-store; compare food environments over time and between regions and countries; evaluate compliance with local policies, guidelines or voluntary codes of practice; and determine the impact of changes to retail food environments on health outcomes, such as obesity.

Obesity and eating disorders

density of healthy and unhealthy food outlets; measure proximity of healthy and unhealthy food outlets to homes/schools; evaluate availability of healthy and unhealthy foods in-store; compare food environments over time and between regions and countries; evaluate compliance with local policies, guidelines or voluntary codes of practice; and determine the impact of changes to retail food environments on health outcomes, such as obesity.

The role of new media in marketing unhealthy food and beverages to children and adolescents

theoretical framework that will enable organisation of current and future universal obesity prevention interventions into their likely impact on the socioeconomic gradient of population weight gain. Methods: We partitioned the framework into two scales; the environment where action is taken (micro and macro environments) and the degree to which an intervention targets individual agency or embedded structures to influence behaviour change (characterised by three predominant policy types: agentic, agento-structural and structural). Results: Agentic interventions, which are heavily reliant on individual agency, are more likely to increase socioeconomic inequalities in population weight. Examples of these types of interventions include social marketing, school nutrition education programs and signage to encourage healthy behaviours. Structural interventions generally describe an equal or greater benefit for lower socioeconomic groups and include food procurement policies, restricting the availability of unhealthy foods in schools and a mandatory increase in school physical education time. Agento-structural interventions are mindful of the environment in which health behaviours take place, but individual agency is nonetheless important. Agento-structural interventions include work place design to encourage incidental exercise and mandatory nutrition labelling. There is a lack of empirical evidence and theoretical clarity regarding the socioeconomic impact of agento-structural interventions, however we hypothesise that those aimed at the macroenvironmental context are more likely to have an equitable impact. Conclusions: Examination of the socioeconomic health impact of obesity prevention interventions is crucial. This is especially true for agentostructural interventions, which show great promise for obesity prevention, but where the greatest uncertainty regarding the socioeconomic health impact remains. Failure to do so runs the risk of widening the socioeconomic gradient in health as we strive to prevent obesity.

Monitoring the availability of healthy and unhealthy foods and non‐alcoholic beverages in community and consumer retail food environments globally

Retail food environments are increasingly considered influential in determining dietary behaviours and health outcomes. We reviewed the available evidence on associations between community (type, availability and accessibility of food outlets) and consumer (product availability, prices, promotions and nutritional quality within stores) food environments and dietary outcomes in order to develop an evidence-based framework for monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in retail food environments. Current evidence is suggestive of an association between community and consumer food environments and dietary outcomes; however, substantial heterogeneity in study designs, methods and measurement tools makes it difficult to draw firm conclusions. The use of standardized tools to monitor local food environments within and across countries may help to validate this relationship. We propose a step-wise framework to monitor and benchmark community and consumer retail food environments that can be used to assess density of healthy and unhealthy food outlets; measure proximity of healthy and unhealthy food outlets to homes/schools; evaluate availability of healthy and unhealthy foods in-store; compare food environments over time and between regions and countries; evaluate compliance with local policies, guidelines or voluntary codes of practice; and determine the impact of changes to retail food environments on health outcomes, such as obesity.

Unhealthy and Healthy Food Consumption Inside and Outside of the School by Pre-school and Elementary School Mexican Children in Tijuana, Mexico

Food from lunch packs (LP) or food available inside and outside of school can play an important role in the development of obesity. The purpose of this study was to evaluate the LP of elementary school (ES) and preschool children (PS) in Tijuana, and the foods available to them inside and outside of school. Eight public schools participated in the study. A random sample of all the groups from a school district was conducted. A questionnaire was administered to children in first through sixth grade (ES) and to the parents of PS. LP and food available inside and outside of the school were classified as healthy, unhealthy, and adequate according to the guidelines set forth by the Secretariat of Health. A total of 2,716 questionnaires were administered and the content of 648 LP was assessed. It was observed that 99% of PS had LP prepared at home, a higher percentage than ES. None of the LP of the ES was classified as healthy, and 1% was classified as adequate. Among PS, 21% of the LP were classified as healthy and 6% as adequate. More than half of the children recognized the brand name of foods high in fat, salt, and added sugar available inside and outside of school grounds. Most of the LP of ES and PS and the foods available inside and outside of school were unhealthy and inadequate. A strategy to prevent the availability of unhealthy and inadequate food in LP and foods available inside and outside schools is recommended.

Impact of a school-based intervention program on obesity risk factors in Mexican children

To evaluate the impact of an 18-month school obesity prevention intervention on the health behaviors of 4th and 5th grade students based on ecological principles and formative research conducted in Mexico. A Randomized Control Trial (RCT), design was used to assign 27 schools to one of three conditions: basic or plus interventions and control. School environment measures, children's eating and physical activity behaviors, and body mass index were assessed four times over a 2-year period in a sample of 830 students. In the intervention schools, the availability of healthy foods increased with a concomitant decrease in unhealthy food availability. Food intake showed the same trend. In the intervention schools, children did not engage in more moderate to vigorous physical activity (MVPA) in physical education (PE) class or recess but increased steps taken. Obesity prevalence did not change. The intervention improved the school food environment and child healthy behaviors.

Clustering of unhealthy food around German schools and its influence on dietary behavior in school children: a pilot study

BackgroundThe availability of fast foods, sweets, and other snacks in the living environment of children is assumed to contribute to an obesogenic environment. In particular, it is hypothesized that food retailers are spatially clustered around schools and that a higher availability of unhealthy foods leads to its higher consumption in children. Studies that support these relationships have primarily been conducted in the U.S. or Australia, but rarely in European communities. We used data of FFQ and 24-HDR of the IDEFICS study, as well as geographical data from one German study region to investigate (1) the clustering of food outlets around schools and (2) the influence of junk food availability on the food intake in school children.MethodsWe geocoded food outlets offering junk food (e.g. supermarkets, kiosks, and fast food restaurants). Spatial cluster analysis of food retailers around child-serving institutions was conducted using an inhomogeneous K-function to calculate global 95% confidence envelopes. Furthermore, a food retail index was implemented considering the kernel density of junk food supplies per service area, adjusted for residential density. We linked the food retail index to FFQ and 24-HDR data of 384 6- to 9-year-old school children in the study region and investigated the impact of the index on food intake, using multilevel regression models adjusted for sex, age, BMI, parent’s education and income, as well as adjusting for over- and underreporting of food intake.ResultsComparing the 95% confidence envelopes to the observed K-function, we showed that food stores and fast food restaurants do not significantly cluster around schools. Apart from this result, the food retail index showed no effect on BMI (β=0.01,p=0.11) or food intake variables assessed by FFQ and 24-HDR.ConclusionIn the built environment of the German study region, clustering of food retailers does not depend on the location of schools. Additionally, the results suggest that the consumption of junk food in young children is not influenced by spatial availability of unhealthy food. However, investigations should be replicated in other European communities to increase environmental variability.

The Role of Cost-Effectiveness Analysis in Developing Nutrition Policy

Concern about the overconsumption of unhealthy foods is growing worldwide. With high global rates of noncommunicable diseases related to poor nutrition and projections of more rapid increases of rates in low- and middle-income countries, it is vital to identify effective but low-cost interventions. Cost-effectiveness studies show that individually targeted dietary interventions can be effective and cost-effective, but a growing number of modeling studies suggest that population-wide approaches may bring larger and more sustained benefits for population health at a lower cost to society. Mandatory regulation of salt in processed foods, in particular, is highly recommended. Future research should focus on lacunae in the current evidence base: effectiveness of interventions addressing the marketing, availability, and price of healthy and unhealthy foods; modeling health impacts of complex dietary changes and multi-intervention strategies; and modeling health implications in diverse subpopulations to identify interventions that will most efficiently and effectively reduce health inequalities.