Food Acquisition Practices Research Articles

Drivers of food acquisition practices among adolescents in suburban food environments of Lao People’s Democratic Republic

ABSTRACT Background Dietary shifts among adolescents in low- and middle-income countries are exacerbating the double burden of malnutrition. Understanding the drivers of adolescent food acquisition and consumption practices and their lived experiences of the food environment is crucial for the effective development of targeted interventions and policies. Objective To explore drivers of food acquisition and consumption practices among adolescents from two suburban schools in the food environments of Phonhong District, Lao People’s Democratic Republic. Methods We implemented a Qualitative-Geographical Information System methodology, featuring participatory photography, follow-up photo-elicitation interviews and focus group discussions with 30 adolescents from April to July 2022. Thematic analysis triangulated key themes from photos, maps, and transcripts. Results Drivers of food acquisition and consumption included interactions across external, interpersonal, and intrapersonal domains. The six key themes were food availability and accessibility, product properties and convenience, peers and social media, caregivers and household practices, affordability, desirability, and autonomy, and perceptions, beliefs, and social norms. Consumption of ultra-processed foods was driven by the availability and accessibility of these affordable products in schools. By contrast, consumption of fruits and vegetables was driven by parental food practices at home. Conclusion A comprehensive multi-scalar approach is required to improve adolescent diets and nutrition in the suburban food environment of Lao PDR. This includes restricting the sale of ultra-processed foods in schools, promoting home gardening, increasing caregivers’ awareness and engagement with adolescents about the benefits of healthy food choices, and leveraging social media to encourage healthy eating behaviors.

Healthy eating in globalized food environments: market access and consumer behavior in the Galápagos Islands of Ecuador

Abstract Food environments are the interface between food systems and consumers. Although market access contributes to diet intake, consumer behavior determines food acquisition practices yet is often neglected in food environment research. Implementing sustainable food system transformations in climate-vulnerable, trade-dependent settings requires effective integration of both geographic and experienced-based measures of access. This study in the Galápagos Islands (i) develops measures for geographic and experience-based food environments (EFEs) and (ii) links diet outcomes to these food environment measures independently and when interacted. Cross-sectional household data including diet recalls come from 388 participants in the Healthy Family Study from San Cristóbal Island, Galápagos in 2018. Geocoded market inventory and price data were obtained in 2018 using the Nutritional Environment Measurement Survey for Stores (n = 60). Geographic food environments were created from market scores and distribution. EFEs were based on factor analyzed consumer behavior strategies. Diet quality was defined using the global dietary recommendations score. Adjusted linear regressions tested the relationships between diet and food environment measures and included sociodemographic covariates. Interactions between geographic and EFEs were tested. This study showed that higher prioritization of convenience when food shopping was associated with lower healthy food intake. However, the relationship between food environment measures and diet is strongly modified by consumer behavior. For convenience-prioritizing households, the nearest market proved most associated with healthy diet outcomes. For households with a food-driven purchasing strategy, the preferred market was most associated with healthy diet outcomes. These findings show that market inventory can be healthful or deleterious to diets, depending on how individuals navigate their food environments. Empirical measures of food access that neglect to consider consumer behavior may fail to capture realistic representations of food environment and diet relationships. These findings underscore the importance of tailoring food system changes to incorporate context-specific consumer behavior.

A comparison of online and in-store grocery shopping behaviour and its effects on household food waste

The rapid growth of online grocery shopping can have significant economic, social and environmental implications. However, the influence of changing consumer food acquisition practices on household food waste has received less attention in the literature. Moreover, there is a dearth of household studies that account for zero values of self-reported food waste. Using a large national-level dataset (n = 5272) and a robust zero-inflated ordered probit modelling approach, this paper compares the influence of online grocery shopping and in-store grocery shopping behaviours on household food waste. Findings indicate that there is a strong positive and statistically significant relationship between online grocery shopping and household food waste. More frequent grocery shopping and higher grocery spending are associated with generating greater household food waste. Formulating strategies to help consumers to minimise food waste at home could provide a strategic competitive advantage for retailers.

Characteristics of food environments that influence food acquisition and diets of women in low- and middle-income countries: a scoping review protocol.

This scoping review aims to identify and map characteristics of food environments that influence food acquisition practices and dietary intake of women of reproductive age in low- and middle-income countries. Due to the disproportionate burden of malnutrition on women of reproductive age in low- and middle-income countries, accelerated progress in improving women's nutrition is required to achieve Sustainable Development Goal 2 "Zero hunger" by 2030. Food environments are increasingly recognized as the key interface between consumers and food systems; however, little is known about the characteristics that influence women's food acquisition and diets in low- and middle-income countries, especially during physiological stages of heightened nutritional requirement, such as pre-conception, pregnancy, and breastfeeding. This review will consider quantitative, qualitative, mixed methods, or review studies that report on the influence of food environment characteristics on food acquisition practices and dietary intake of women aged 15 to 49 years in any low- or middle-income country, as defined by the World Bank in 2021. Twenty-one databases across EBSCO, Web of Science Core Collection, and PubMed platforms will be searched. Screening, selection, and data extraction will be performed in duplicate by 2 members of the team, with any discrepancies resolved by group discussion. The patterns of food acquisition and dietary intake in relation to food environment characteristics will be charted, mapped, and summarized in tabular and graphical formats. Findings will inform the refinement of effective food environment conceptual frameworks for this nutritionally vulnerable group.

History and Approaches to Heritage Studies, Pedagogy and Practice in Heritage Studies

History and Approaches to Heritage Studies, Pedagogy and Practice in Heritage Studies

Drivers of food acquisition practices in the food environment of peri-urban Hyderabad, India: A qualitative investigation.

This study investigates drivers of food acquisition practices in the food environment of peri-urban Hyderabad, India. We used a multi-method qualitative methodology that included in-depth interviews (n=18) and an innovative qualitative geographical information systems (Q-GIS) approach, featuring participatory photo mapping and follow-up graphic-elicitation interviews (n=22). Secondary data from eight focus group discussions (n=94) was used to corroborate findings related to fruits and vegetables. Thematic analysis identified three primary drivers of food acquisition practices among adults: 1) Food prices and affordability; 2) Vendor and product properties, including (a) quality and freshness, and (b) adulteration and contamination; and 3) Social capital. Drivers of food acquisition and consumption among children and adolescents were a key concern for our participants, and included food availability and accessibility, desirability, and convenience. Findings reveal a need for targeted interventions in external and personal food environments to improve diets, nutrition, and health in this setting.

The Orthodox and Unorthodox Food Acquisition Practices and Coping Strategies Used by Food Insecure Adults: A Scoping Review

ABSTRACT Unorthodox food acquisition practices are increasing globally and to date, none have been documented. This review summarizes unorthodox as well as orthodox strategies used by food insecure adults. A database search confirmed the existence of coping strategies that ranged from legal (orthodox) to illegal and risky (unorthodox) practices used during episodes of food insecurity. The scoping review revealed the drivers of unorthodox food acquisition practices are neither fully understood, nor investigated to identify the tipping point at which this behavior becomes acceptable, or where we can intervene to preserve dignity and the human right to food.

Consumer experiences of food environments during the Covid-19 pandemic: Global insights from a rapid online survey of individuals from 119 countries

This study investigates consumer experiences of food environments and food acquisition practices during the Covid-19 pandemic. Our rapid assessment online survey featured a convenience sample of 2015 individuals from 119 countries, spanning Western Europe, North America, Latin America, Asia-Pacific, and Africa. Data collection took place in April 2020 during the second month of the pandemic. Participants were recruited via existing networks of the United Nations System Standing Committee on Nutrition, through social media, and by snowballing. The majority of participants were female (71.9%), from low- and middle-income countries (51.0%), and working in nutrition or healthcare (39.3%). Qualitative thematic analysis and descriptive statistics reveal a series of common global experiences related to food availability and accessibility, food prices and affordability, food acquisition practices, and food preparation and consumption. The importance of community food participation, food sharing, and resource allocation are highlighted, along with increasing awareness of healthy diets and food waste. We identify ten synergistic policy entry points to: 1) build resilient and equitable food environments resistant to stresses and shocks; 2) harness positive dietary-related behaviors manifested during the pandemic; and, 3) mitigate the projected nutrition crisis and promote sustainable healthy diets for all.

The Development and Implementation of Nourish to Rank and Track the Nutritional Quality of Food Bank Foods

Describe the value of Nourish to help food banks rank and track the nutritional quality of food bank foods. Underemployment, stagnant wages, and most recently the COVID-19 pandemic, have led to an unprecedented number of Americans relying on charitable food assistance. The Blue Ridge Area Food Bank (BRAFB), located in central and western Virginia, feeds nearly 130,000 Virginians each month with help from 200 food pantries and 175 feeding programs. The connections between hunger and health are undeniable and access to nutritious food is paramount in preventing and managing chronic disease, especially for those who rely on pantries as a primary source of nutrition. The BRAFB has developed policies and systems that prioritize the acquisition of nutrient-dense foods. In 2019, the BRAFB and academic partners developed and implemented Nourish, a unique cloud-based platform that ranks and tracks the nutritional quality of food bank foods and recently updated Nourish to reflect Healthy Eating Research Nutrition Guidelines for the Charitable Food System. Nourish reliably and quickly searches for foods using USDA’s Food Data Central, automatically ranks foods using a stop-light hierarchy for easy visualization and integrates with inventory management for tracking. Nourish provides BRAFB with important data to make adjustments to food acquisition practices and meet nutrition goals consistent with the strategic operating plan. The nutrition information created through Nourish is disseminated to BRAFB partner agencies through the food bank’s ordering process. Pantries focused on nutrition and health can leverage stoplight ranking as an element of their educational efforts with clients. Multiple stakeholders are currently exploring additional collaborations to enhance the utility of the system at pantries and for clients.

Facilitators and Barriers to Healthy Eating Among American Indian and Alaska Native Adults with Type 2 Diabetes: Stakeholder Perspectives

ABSTRACTBackgroundAmerican Indian and Alaska Native (AI/AN) adults have a higher prevalence of type 2 diabetes (T2D) and related complications than non-AI/AN adults. As healthy eating is a cornerstone of diabetes self-management, nutrition education plays an important role in diabetes self-management education.ObjectiveTo understand stakeholder perspectives on facilitators and barriers to healthy eating for AI/AN adults with T2D in order to inform the cultural adaptation of an existing diabetes nutrition education curriculum.MethodsIndividual interviews were conducted with 9 national content experts in diabetes nutrition education (e.g. registered dietitians, diabetes educators, experts on AI/AN food insecurity) and 10 community-based key informants, including tribal health administrators, nutrition/diabetes educators, Native elders, and tribal leaders. Four focus groups were conducted with AI/AN adults with T2D (n = 29) and 4 focus groups were conducted with their family members (n = 22). Focus groups and community-based key informant interviews were conducted at 4 urban and reservation sites in the USA. Focus groups and interviews were recorded and transcribed verbatim. We employed the constant comparison method for data analysis and used Atlas.ti (Mac version 8.0) to digitalize the analytic process.ResultsThree key themes emerged. First, a diabetes nutrition education program for AI/ANs should accommodate diversity across AI/AN communities. Second, it is important to build on AI/AN strengths and facilitators to healthy eating (e.g. strong community and family support systems, traditional foods, and food acquisition and preparation practices). Third, it is important to address barriers to healthy eating (e.g. food insecurity, challenges to preparation of home-cooked meals, excessive access to processed and fast food, competing priorities and stressors, loss of access to traditional foods, and traditional food-acquisition practices and preparation) and provide resources and strategies for mitigating these barriers.ConclusionsFindings were used to inform the cultural adaptation of a nutrition education program for AI/AN adults with T2D.

Food Acquisition Practices, Body Mass Index, and Dietary Outcomes by Level of Rurality.

Rural residents are more likely to be obese than urban residents. Research on how people navigate their local food environments through food acquisition behaviors, such as food shopping and restaurant use, in different types of communities may help to create a deeper understanding of the multilevel determinants of obesity. Data are from a national sample of US adults ages 18-75. Respondents were recruited from an online survey panel in 2015 and asked about food shopping, restaurant use, diet and weight (N = 3,883). Comparisons were made by level of rurality as assessed by Rural-Urban Continuum Codes (RUCC) and self-reported rurality of the area around their home. Food acquisition behaviors varied minimally by RUCC-defined level of rurality, with the exceptions of type and distance to primary food store. Rural residents drove further and were more likely to shop at small grocery stores and supercenters than were residents of semiurban or urban counties. In contrast, all of the food acquisition behaviors varied by self-reported rurality of residential areas. Respondents living in rural areas shopped for groceries less frequently, drove further, more commonly shopped at small grocery stores and supercenters, and used restaurants less frequently. In multivariable analyses, rural, small town, and suburban areas were each significantly associated with BMI and fruit and vegetable intake, but not percent energy from fat. Findings show that self-reported rurality of residential area is associated with food acquisition behaviors and may partly explain rural-urban differences in obesity and diet quality.

A Mixed-method Examination of Reported Benefits of Online Grocery Shopping in the United States and Germany: Is Health a Factor?

ABSTRACT The growth in online grocery shopping has prompted research into why consumers are shifting food acquisition practices. Most research has relied on either confirmatory approaches (i.e., multiple choice surveys) that limit consumer input or ethnographic approaches that provide more in-depth understanding of consumer experience but are limited to a handful of participants. The present study fills a gap in the existing literature by using open-ended responses from many participants to derive and quantify consumer motivations and benefits of online grocery shopping. Data about online grocery shopping was collected in the United States and Germany from participants who were 18 years of age or older and the primary household food shopper. A qualitatively driven, mixed-methods approach using a bottom-up, content analysis methodology with emergent coding resulted in over 1,000 open-ended responses provided by almost 400 individuals. Data synthesis yielded 51 separate benefits that clustered into eight motivation categories. Findings demonstrate that consumers are grocery shopping online for an array of reasons, ranging from economizing to expressing aspects of their social identity. The benefits that were most often mentioned are functional, utilitarian needs such as saving of money and time, or the increased availability and accessibility of products.

Assessment of Food Safety Knowledge and Behaviors of Cancer Patients Receiving Treatment.

Cancer patients receiving treatment are at a higher risk for the acquisition of foodborne illness than the general population. Despite this, few studies have assessed the food safety behaviors, attitudes, risk perceptions, and food acquisition behaviors of this population. Further, no studies have, yet, quantified the food safety knowledge of these patients. This study aims to fill these gaps in the literature by administering a thorough questionnaire to cancer patients seeking treatment in three hospitals in a Midwest, metropolitan area. Demographic, treatment, food security, and food safety knowledge, behaviors, attitudes, risk perceptions, and acquisition information was assessed for 288 patients. Specific unsafe attitudes, behaviors, and acquisition practices were identified. Most notable is that 49.4% (n = 139) of participants were not aware that they were at increased risk of foodborne infection, due to their disease and treatment. Additionally, though patients exhibited a general understanding of food safety, the participant average for correctly answering the food safety questions was 74.77% ± 12.24%. The section concerning food storage showed lowest participant knowledge, with an average score of 69.53% ± 17.47%. Finally, patients reporting low food security also reported a higher incidence of unsafe food acquisition practices (P < 0.05). These findings will help healthcare providers to better educate patients in the food safety practices necessary to decrease risk of foodborne infection, and to provide targeted food safety education to low-food-security patients.

Long-Term Food Insecurity, Hunger and Risky Food Acquisition Practices: A Cross-Sectional Study of Food Charity Recipients in an Australian Capital City.

Inadequate social protection, stagnant wages, unemployment, and homelessness are associated with Australian household food insecurity. Little is known about the recipients of food charity and whether their needs are being met. This cross-sectional study of 101 food charity recipients in Perth, Western Australia, measured food security, weight status, sociodemographic characteristics and food acquisition practices. Seventy-nine percent were male, aged 21–79 years, 90% were unemployed, 87% received social assistance payments, and 38% were homeless. Ninety-one percent were food insecure, 80% with hunger, and 56% had gone a day or more without eating in the previous week. Fifty-seven percent had used food charity for ≥1 year, and, of those, 7.5 years was the mode. Charitable services were the main food source in the previous week, however 76% used multiple sources. Begging for money for food (36%), begging for food (32%), stealing food or beverages (34%), and taking food from bins (28%) was commonplace. The omnipresence and chronicity of food insecurity, reliance on social security payments, and risky food acquisition suggest that both the social protection and charitable food systems are failing. Urgent reforms are needed to address the determinants of food insecurity (e.g., increased social assistance payments, employment and housing support) and the adequacy, appropriateness and effectiveness of food charity.

662-P: Facilitators and Barriers to Healthy Eating among American Indian/Alaska Native Adults with Type 2 Diabetes: Stakeholder Perspectives

American Indian and Alaska Native (AIAN) adults have a higher rate of type 2 diabetes (T2D) and related complications than non-AIAN adults. Nutrition is the cornerstone of diabetes self-management and nutrition education is a key component of diabetes self-management education. The purpose of this research was to understand stakeholder perspectives on how to adapt the American Diabetes Association (ADA) newly developed nutrition education program entitled “What Can I Eat? Choices for People with T2D and their Families” (WCIE) for AIAN adults. Using focus group and individual interview methods, we interviewed experts in AIAN diabetes nutrition education (n=9); AIAN educators, Native elders, and tribal leaders (n=11); and AIAN adults with T2D (n=29) and their family members (n=22) at 4 geographically distinct urban and reservation sites nationwide. Focus groups and interviews were recorded and transcribed verbatim. We employed the constant comparison method for data analysis and used Atlas.ti (Mac version 8.0) to digitalize the analytical process. Qualitative analysis identified specific facilitators and barriers to healthy eating in Native communities. Facilitators included: strong community and family support systems, traditional values of balance and gratitude, Native pride, and community-based wellness goals. Barriers included: food insecurity, challenges to preparation of home-cooked meals, high consumption of fast food and sugar-sweetened beverages, and loss of access to traditional foods and food-acquisition practices. Findings will be used to culturally adapt the existing ADA WCIE diabetes nutrition education program for AIAN adults with T2D. Disclosure K.R. Moore: None. S.A. Stotz: None. A.G. Brega: None. K.L. Gonzales: None. Funding American Diabetes Association (4-18-SMSC-01 to K.R.M.)

Promoting access to fresh fruits and vegetables through a local market intervention at a subway station.

Alternative food sources (AFS) such as local markets in disadvantaged areas are promising strategies for preventing chronic disease and reducing health inequalities. The present study assessed how sociodemographic characteristics, physical access and fruit and vegetable (F&V) consumption are associated with market use in a newly opened F&V market next to a subway station in a disadvantaged neighbourhood. Two cross-sectional surveys were conducted among adults: (i) on-site, among shoppers who had just bought F&V and (ii) a telephone-based population survey among residents living within 1 km distance from the market. One neighbourhood in Montreal (Canada) with previously limited F&V offerings. Respectively, 218 shoppers and 335 residents completed the on-site and telephone-based population surveys. Among shoppers, 23 % were low-income, 56 % did not consume enough F&V and 54 % did not have access to a car. Among all participants living 1 km from the market (n 472), market usage was associated (OR; 95 % CI) with adequate F&V consumption (1·86; 1·10, 3·16), living closer to the market (for distance: 0·86; 0·76, 0·97), having the market on the commute route (2·77; 1·61, 4·75) and not having access to a car (2·96; 1·67, 5·26). When implemented in strategic locations such as transport hubs, AFS like F&V markets offer a promising strategy to improve F&V access among populations that may be constrained in their food acquisition practices, including low-income populations and those relying on public transportation.

Food Acquisition through Private and Public Social Networks and Its Relationship with Household Food Security among Various Socioeconomic Statuses in South Korea.

This study was conducted to understand food acquisition practices from social networks and its relationship with household food security. In-depth interviews and a survey on food security were conducted with twenty-nine mothers and one father in metropolitan areas of South Korea. Many families acquired food from their extended families, mainly participants’ mothers. Between low-income and non-low-income households, there was a pattern of more active sharing of food through private networks among non-low-income households. Most of the low-income households received food support from public social networks, such as government and charity institutions. Despite the assistance, most of them perceived food insecurity. We hypothesized that the lack of private social support may exacerbate the food security status of low-income households, despite formal food assistance from government and social welfare institutions. Interviews revealed that certain food items were perceived as lacking, such as animal-based protein sources and fresh produce, which are relatively expensive in this setting. Future programs should consider what would alleviate food insecurity among low-income households and determine the right instruments and mode of resolving the unmet needs. Future research could evaluate the quantitative relationship between private resources and food insecurity in households with various income statuses.

Measuring Food Security in Canadian Homeless Adult Men.

To assess whether the current food security measurement tool used in Canada, the Canadian Community Health Survey, is appropriate for use with homeless adults. The Household Food Security Survey Module (HFSSM), a validated measurement tool utilized for determining the food security status of Canadian households, was used with a group of homeless men (n = 40). In-depth interviews were also conducted with participants to obtain particulars about their food acquisition strategies. Data were analyzed by comparing the results of the HFSSM with qualitative data. The HFSSM measurement tool found that 90% (n = 36) of the study participants experienced food insecurity with 67.5% (n = 27) experiencing severe food insecurity and 22.5% (n = 9) experiencing moderate food insecurity. The qualitative data, however, suggested that all participants (n = 40) were food insecure based on food acquisition practices, food accessibility, and diet quality. The HFSSM has validity concerns when applied to homeless populations. Nutrition professionals and other key stakeholders should work to develop valid tools for measuring the food security status of homeless individuals who are highly vulnerable to food insecurity.

Applying a Political Economy of Health standpoint to traditional food acquisition practices and the inequitable prevalence of obesity and diabetes amongst First Nations peoples in British Columbia

The inequitable population prevalence rates of obesity and diabetes being experienced by First Nations peoples in British Columbia require public health protection practitioners to deepen their inquiry into the social determinants of these chronic conditions. These attempts need to be placed within the context of food insecurity that is garnering growing attention from public health at large and, more specifically, within the emerging Indigenous consensus understanding of the relationship between the ongoing nutrition transition and the inequitable prevalence rates of these conditions. We suggest that these reflections are productively theorized from a Political Economy of Health standpoint and supported by representative findings from the First Nations Regional Longitudinal Health Survey. This theoretical perspective supports the viewpoint that the inequitable expression of these chronic conditions can be attributed to the nutrition transition that populations experienced as they were shifted from a traditional subsistence diet to a commoditized, industrialized food production system. This analysis also supports the structural recommendations of the British Columbia Food Systems Network Working Group on Indigenous Food Sovereignty that would remove barriers and threats to traditional food acquisition. These include making environmental protection and conservation of biological diversity a priority in all land use planning; setting aside adequate tracts of land for the protection, conservation, and restoration of Indigenous food systems; giving priority to traditional food and cultural values in contemporary forestry, fisheries, rangeland, and agrarian management policies and practice; and giving priority to Indigenous food and cultural harvesting over commoditized, export-oriented commercial harvesting. Public health protection practitioners will be progressively challenged to support these recommendations by the communities they serve. Although there is no guarantee that implementation of these recommendations will reverse the trend of decreasing participation rates in traditional food harvesting in British Columbia, we suggest that unless many of the systemic irrationalities, vested interests, and historically unjust rationales for maintaining the status quo with respect to Indigenous food sovereignty are interrogated and challenged, an ancient lifeway grounded in demonstrably sustainable traditional food harvesting practices will remain threatened.

Food Acquisition Practices Used by Food-Insecure Individuals When They Are Concerned About Having Sufficient Food for Themselves and Their Households

Food-insecure individuals' food acquisition practices can result in inadequate nutrition, consumption of unsafe foods, and risky behaviors. A survey instrument was developed to collect sociodemographic information and frequency of engagement in different practices. After expert review, cognitive interviewing and pretesting, data were collected from 10 individuals/site at 50 emergency food providers. Descriptive analysis was performed and prevalence of each practice was ascertained for 3 time periods. Participants confirmed use of 78 practices with 50% using 19. Sixty-three percent posed a potential risk, including eating road kill, going to prison to obtain meals, and diluting foods (like baby formula) to extend them. Prevalence and riskiness of practices used by the food-insecure can inform policy and public health decisions regarding issues of food insecurity.