Promotion Of Healthy Foods Research Articles

Instrument for measuring home cooking skills in primary health care.

ABSTRACTOBJECTIVE To develop and validate an instrument for measuring the home cooking skills of health professionals involved with guidelines for promoting adequate and healthy food in primary health care.METHODS This is a methodological study with a psychometric approach, carried out in the city of São Paulo between January and November 2020, to develop and validate a self-applied online instrument. The data of the 472 participants were presented by descriptive statistics. Content validation was performed by expert judgment using the two round Delphi technique and empirical statistics for consensus evidence. Exploratory factor analysis was used for construct validation and reliability analysis, and the model adjustment rates and composite reliability were analyzed.RESULTS The instrument presented satisfactory content validity for CVRc indices and 𝜅 in the two rounds of the Delphi technique. After the factor analysis, the final model of the Primary Health Care Home Cooking Skills Scale presented 29 items with adequate factorial loads (> 0.3). Bartlett’s and Kaiser-Meyer-Olkin’s (KMO) tests of sphericity performed in exploratory factorial analysis suggested interpretability in the correlation matrix, the parallel analysis indicated four domains and explained variance of 64.1%. The composite reliability of the factors was adequate (> 0.70) and the H-index suggested replicable factors in future studies. All adjustment rates proved to be adequate.CONCLUSIONS The Primary Health Care Home Cooking Skills Scale presented evidence of validity and reliability. It is short and easy to apply and will make it possible to reliably ascertain the need for qualification of the workforce, favoring the planning of actions and public policies of promotion of adequate and healthy food in primary health care.

Desenvolvimento infantil como elemento intermediário nas políticas públicas de alimentação e nutrição

Abstract Objectives: to carry out a reflection in relation between food and nutrition along with child development. Methods: a bibliographic survey of Brazilian public policies on food and nutrition, followed by a descriptive-reflexive analysis about its nuances facing child development. Results: food and nutritional policies, although they do not bring the theme as the central axis of their actions, contemplating as an intermediate element dealing with the promotion of adequate and healthy food for the Brazilian population and the control and prevention of nutritional deficiencies, through food and nutritional education actions, national supplementation programs, addressed to the maternal and child population and the mandatory fortification of food. Conclusions: despite the emphasis on food and nutritional programs, it is imperative to draw attention to the necessary integration along with other areas related to child development promoting them entirety.

Assessment of Healthy Food Availability and Promotion Among Baltimore, Maryland Corner Stores

ObjectivesUnder-resourced neighborhoods in Baltimore, Maryland tend to have low healthy food availability. Residents of these neighborhoods often frequent corner stores, which are ubiquitous and primarily stock energy-dense foods and sugar-sweetened beverages. The Baltimore Urban food Distribution (BUD) trial aims to improve access to healthy foods by corner store owners and their customers. As part of the baseline assessment of BUD, this study aims to (1) measure the pre-intervention availability of promoted foods and beverages (fruits, vegetables, whole grains, low-sugar beverages) at participating corner stores; and (2) describe current promotional strategies used by participating corner store owners for healthy foods and beverages. MethodsWe expect to have baseline data from 38 corner stores recruited to participate in BUD by April 2022. During data collection, trained researchers will conduct in-depth interviews and a Store Environmental Checklist based on similar tools used in the previous B’more Healthy Communities for Kids (BHCK) trial. Subsequently, corner store Healthy Food Availability Index (HFAI) scores will be analyzed quantitatively using Stata, and qualitative data regarding promotional strategies will be analyzed using Atlas.ti. ResultsAt the time BHCK was implemented, Baltimore corner stores had a low average HFAI score of 9.1 out of 28.5. Now, nearly a decade later, it is crucial to understand the current landscape of healthy food availability in order to inform the context in which BUD is intervening. Regarding promotional practices, we expect to see corner stores having a larger social media presence. A recent uptake of social media use among corner store owners could signify greater acceptance of technology, and a new medium for customer engagement and promotion of foods. Further quantitative and qualitative analyses will be completed by late Spring 2022. ConclusionsThe gap in healthy food availability among corner stores compared to supermarkets is well-documented, especially in under-resourced urban settings. Recent advances in the use of social media and greater acceptance of technology by small store owners is promising. Our findings here will help to inform the strategies undertaken by the BUD intervention in an upcoming randomized controlled trial. Funding SourcesNHLBI, NIH, award number R34HL145368.

Colonization by kale: marginalization, sovereignty, and experiential learning in critical food systems education

ABSTRACT In increasingly cross-cultural global settings, the performance and promotion of healthy food, “good” food (comida saludable) have become conflated with a narrowing range of iconic vegetable and “superfood” trends that often reflect the health and dietary preferences of an affluent and/or aspirational consumer culture. These colonizing cultivars, and the haute cuisine trends they embody, often displace indigenous food knowledge, techniques, and products already compromised by the penetration of processed foods. Through experiential pedagogical examples from Guatemala and Vermont, this paper explores the ways in which participatory, indigenous food and seed sovereignty curricula can help decolonize these newest kinds of hegemonic impositions and reaffirm traditional food systems.

Case Study of an African American Woman With Heart Failure: Ethical and Palliative Care Considerations.

Heart failure affects an estimated 6.2 million adults in the United States. African Americans have a higher incidence of heart failure at an earlier age and more rapid disease progression than other ethnicities. African Americans also often receive lower-quality, end-of-life care and less often receive palliative and advanced-care planning than Whites. Several barriers exist for effective heart failure evaluation and treatment among African Americans, including ineffective patient-provider communication, mistrust, health care providers' lack of understanding of palliative care services, and potential downstream effects of social determinants of health (eg, access barriers to healthy food and community health promotion resources). Despite the recognized benefits of palliative care, few adults with heart failure are receiving early discussions about palliative and advanced care planning to ensure delivery of goal-concordant care. This article presents a fictitious case study focused on an African American woman, Ms T, with heart failure who has been given 6 months to live. Racial inequities are presented surrounding Ms T's inadequate access to necessary health care resources and in receiving delayed communication about palliative and advanced care services. The case study also highlights ethical principles of concern, the role of an interdisciplinary team approach for patients with heart failure, and the advocacy role of nurses.

Healthy, But Say It Out Loud? The Messaging Effect on Restaurants’ Healthy Food Promotion

This research aims to examine the role of menu messaging (implicit vs. explicit) used to disclose the healthy food item in shifting diner perceptions and purchase intentions. Drawing on a consumer experiment, the results establish a menu messaging effect on diners’ purchase intentions of healthy items and the underlying mechanism via psychological reactance and perceived attractiveness. Explicit (vs. implicit) messaging negatively affects consumer purchase intentions, which is due to 1) increased psychological reactance (i.e., perceived threat of freedom and counterarguing) and 2) decreased perceived attractiveness. The menu messaging effect is further conditioned by diners’ goal orientation (pleasure vs. goal). Under a goal-driven mindset, the messaging effect is more pronounced compared to a pleasure-driven mindset. This research is among the first to establish a significant role of menu messaging in healthy item communication at restaurants. Theoretical and managerial are further elaborated.

Community support for policy interventions targeting unhealthy food environments in public institutions.

Understanding community support for obesity prevention policy is important for developing effective preventive health action. This study assessed support for a range of obesity prevention interventions, including food environment policies designed to improve healthy food and drink availability and promotion within public institutions. An online cross-sectional survey was completed by 2006 NSW adults. Questions explored attitudes and beliefs about obesity, the importance of government-led prevention and support for eight obesity prevention interventions. Regression analyses examined associations between intervention support and sociodemographic, attitudinal and behavioural characteristics. Most respondents (80%) believed obesity was a large problem and that poor individual choices (86%) and the widespread availability of unhealthy food and drink (78%) contributed to the issue. There was moderate to high support for most (n=7) initiatives. Support for food environment policies was highest for schools (76%-82%) and hospitals (67%-79%). Supporters and opponents rationalised opinions based on perceived effectiveness, the government's role and cost benefits. Opponents were a minority, but principles of autonomy were predominant. Attributing obesity to environment-related factors, and personal lower SSB consumption strongly predicted support. There is a significant recognition of the obesity issue and strong support for policies designed to improve the availability and promotion of healthy food and drink in public institutions, particularly in schools and hospitals. SO WHAT?: Substantial community support for healthy food environment policies in schools and hospitals warrants continued implementation in NSW. This may foster further acceptance for wider implementation. Our findings could inform the framing of policy advocacy messages.

Implementing Food Environment Policies at Scale: What Helps? What Hinders? A Systematic Review of Barriers and Enablers.

Background: Policies that support healthier food environments, including healthy retail food availability and promotion, are an important strategy for obesity prevention. The aim of this systematic review was to examine the evidence for barriers and enablers to successful implementation of healthy food and drink policies, delivered at scale. Methods: MEDLINE, SCOPUS and INFORMIT were searched to May 2019 for peer-reviewed studies. Google and Google Scholar were searched for grey literature. Studies of any design relating to a healthy food and drink policy delivered at scale (≥10 sites) in non-commercial food settings, for specific retail outlets (e.g., vending machines, cafes, cafeterias, school canteens), and that reported on implementation barriers and/or enablers were included. Studies in commercial food retail environments (e.g., supermarkets) were excluded. Studies were appraised for quality and key information was extracted and summarised. Extracted information on barriers and enablers was further grouped into overarching themes relating to perceptions of the policy itself, organisational and contextual factors influencing policy implementation, stakeholder responses to the implemented policy and perceived policy impacts. Results: Of 19 studies, 16 related to policies implemented in schools, two in hospital/health facilities and one in a sport/recreation setting. Most studies were conducted in North America or Australia, and policy implementation occurred mainly at state/regional or federal levels. The most commonly cited barriers across overarching themes and intervention settings were: lack of stakeholder engagement or prioritisation of the policy (11 studies); resistance to change from school stakeholders or customers (8 studies); and concern over profitability, revenue and/or commercial viability (8 studies). Few studies reported on mitigation of barriers. Enablers most commonly raised were: stakeholder engagement, whole-school approach and/or prioritisation of the policy (9 studies); policy level or higher-level support in the form of information, guidance and/or training (5 studies); and leadership, school/policy champion, management commitment and/or organisational capacity (4 studies). Conclusions: Key considerations for policy implementation ranged from building stakeholder support, prioritising policy implementation within organisations, to implementing strategies that address financial concerns and implementation barriers.

Bringing disgust in through the backdoor in healthy food promotion: a phenomenological perspective

Obesity has been pointed out as one of the main current health risks leading to calls for a so-called “war on obesity”. As we show in this paper, activities that attempt to counter obesity by persuading people to adjust a specific behavior often employ a pedagogy of regret and disgust. Nowadays, however, public healthcare campaigns that aim to tackle obesity have often replaced or augmented the explicit negative depictions of obesity and/or excessive food intake with the positive promotion of healthy food items. In this paper, we draw on a phenomenological perspective on disgust to highlight that food-related disgust is connected to the character and behavior of a perceived individual even in the context of promoting healthy food items. We argue that the focus on “making the healthy food choice the easy choice” might be an important step towards the de-stigmatization of people that are affected by obesity. However, so we suggest, this focus threatens to bring back an image of individuals affected by obesity as disgusting “through the backdoor”. It does so not by portraying bodies with overweight as disgusting, but instead by implying that lifestyle choices, character and habits of people that are affected by obesity are markers of a lack of control. We argue that the close relationship between disgust and the perception of self-control in the context of obesity should be taken into consideration in the context of assessing the implications of new health promotion strategies to minimize the risk of stigmatizing people.

Understanding the healthfulness of outlets providing lunch and dinner meals: a census of a rural food retail environment in Victoria, Australia

ObjectiveTo undertake a census of the healthfulness of food venues providing lunch or dinner meals in a rural Australian setting and compare healthfulness by remoteness, using two measurement tools. MethodsA census of the rural local government area food venues was undertaken using two validated tools: the Healthfulness Rating Classification System (HRCS) and the Nutrition Environment Measures Survey (NEMS‐R). Data were collected covering an area of 3,438 square kilometres in Victoria, Australia, with a population of >21,000. Healthfulness by remoteness was described and variability between tools was explored. ResultsData were collected from all 95 eligible food venues. Both tools classified the food venues as relatively unhealthy. The mean HRCS score was ‐2.9 (unhealthy) and the mean NEMS‐R score was 10.8 (SD 7.0; possible range ‐27 to 64). There were no significant differences in healthiness of venues by remoteness (as measured by the Modified Monash Model), although the outer‐rural region had lower scores. ConclusionsThis census of a rural food retail environment showed low access to healthy menu options along with minimal provision of nutrition information and promotion of healthy food in food venues. This environment has the potential to affect the dietary intake of more than 21,000 rural‐dwelling Australians and action to improve rural food environments is desperately needed. Implications for public healthIf unhealthful rural food environments are not addressed, inequalities in the diet‐related disease burden for rural Australians will continue to persist. This study shows that interventions are needed for independent venues that could be targeted by researchers, local health promotion officers, community nutritionists or community education programs.

Healthy Food Promotion for Populations?? Wellbeing: The Saudi National Initiative

Obesity, diabetes, and other significant consequences of unhealthy diet added financial and social burden to all countries. Therefore, active communities found that healthy diet promotion through governmental and non-governmental organizations can effectively raise the populations’ level of awareness and provide access to healthy food options. This will eventually facilitate the adoption of healthy eating habits and significantly impact the population’s health. A Healthy Food Promotion (HFP) national program will be conducted in Saudi Arabia as a part of the 2030 vision, which aims at offering a fulfilling and healthy life. The program will include designing and implementing several initiatives that aim at enhancing the eating habits and the wellbeing of the Saudi population.

Het promoten van gezonde voeding met behulp van vlogs

AbstractThe promotion of healthy food with the use of vlogsNumerous studies have consistently shown that children do not consume the recommended amount of fruit and vegetables to grow up healthily. The aim of this research was to discover if, and how, vlogs can contribute as a health promotion strategy. A qualitative study with 25 interviews including experts, marketeers, parents and teachers was conducted. Participants were benevolent to promote fruit and vegetables through vlogs. Vlogs have the power to contribute inspiration, motivation, information, and activation to stimulate fruit and vegetables consumption among young children. To develop the vlogs, co-creation with children in the target group is considered to be necessary. In general, the use of vlogs to stimulate fruit and vegetable consumption seems promising.

Instruments of support in promotion of healthy food and food safety culture

Food is imperative for biological survival. It is a necessity and a source of health and vitality if taken with the awareness of all the correlations between food and health and development. This paper aims to research the correlation between food, health, and longevity, and the factors in the chain of food safety and healthy food and diet to determine their role and significance and offer recommendations based on results and conclusions. Since children and adolescents are more likely to be affected by an unhealthy diet in the long term, their dietary habits were also researched. The paper identified the elements of importance for this problem - individuals, family, education system, media, food producers, state and international organizations. After analysis of the roles of all the elements and stakeholders in the chain of food safety and healthy diet, recommendations for each link in that chain were given.

Healthy Food Promotion for Populations Wellbeing: The Saudi National Initiative

Obesity, diabetes, and other significant consequences of unhealthy diet added financial and social burden to all countries. Therefore, active communities found that healthy diet promotion through governmental and non-governmental organizations can effectively raise the populations’ level of awareness and provide access to healthy food options. This will eventually facilitate the adoption of healthy eating habits and significantly impact the population’s health. A Healthy Food Promotion (HFP) national program will be conducted in Saudi Arabia as a part of the 2030 vision, which aims at offering a fulfilling and healthy life. The program will include designing and implementing several initiatives that aim at enhancing the eating habits and the wellbeing of the Saudi population.

Promoting healthy foods in the new digital era on Instagram: an experimental study on the effect of a popular real versus fictitious fit influencer on brand attitude and purchase intentions

BackgroundMost studies on social influencer marketing techniques have focused on the promotion of unhealthy foods whereas little is known about the promotion of healthier foods. The present experimental study investigated whether a popular real versus fictitious fit influencer is more successful in promoting healthy food products. In addition, we examined the role of parasocial interaction as an underlying mechanism of healthy food product endorsement.MethodsWe used a randomized between-subject design with 154 participants (mean age: 24.0 years). Viewers’ product attitude and purchase intention were tested after exposure to an Instagram post by a popular real fit influencer (n = 77) or fictitious fit influencer (n = 77).ResultsResults showed that parasocial interaction mediated the relation between the type of influencer and product attitude as well as purchase intention. Parasocial interaction was higher for participants exposed to the popular real fit influencer compared to the fictitious fit influencer, leading to higher healthy food brand attitude and purchase intention.DiscussionThe findings showed that it is crucial for social influencers to establish a warm personal relationship and connection with the their followers when promoting a healthy product successfully. We suggest that the promotion of healthy foods could be more successful in public health when using popular fit influencers.

Public acceptance of obesity prevention policies in the UK

BackgroundHalf of the UK population will get cancer during their lifetime, with the current survival rate at 50 %. Behavioural factors such as obesity contribute to two-fifths of the UK’s most common cancers. Food ‘pricing’ and ‘place and promotion’ policies aim to avert this risk by reducing the rate of obesity in the UK. MethodsA cross-sectional survey collected data on the acceptance of obesity-related pricing and place and promotion policies from 3293 UK adults in 2016. Cross-tabulations and chi-squared tests were performed to investigate the support for these policies in the four UK countries and different socioeconomic groups. ResultsOnly two-fifths of respondents supported all policies. Food place and promotion policies were better supported by the public than taxation, with over 70 % support for the promotion of healthy foods as opposed to 40 % support for ‘fat tax’. The most deprived social groups were least supportive of all policies. There was not a noticeable difference in policy support between the four UK countries. ConclusionThe support for obesity policies is low, most notably amongst lower socioeconomic groups and for policies involving a price increase, across the UK. Policy summaryObesity prevention policies could reduce the rate of related cancers, but their success requires public support and acceptance. Increasing tax on unhealthy foods is less well supported in the UK population than policies which affect the in-store placement and promotion of these products. Lower levels of support for all these policies among low-income groups, among whom obesity and cancer rates are highest, indicate a particular need for strategies to increase policy support in these groups.

Food Insecurity Among Single Parents and Seniors: a Case Study in an Urban Population in Canada

Single parents and seniors are believed to encounter more food insecurity due to a complex web of disadvantages and discrimination. We carried out a community-based cross-sectional survey of single parents and seniors in an urban population to explore the level of nutritional awareness, household meal practices, challenges, and their coping strategies. The survey questionnaire was adapted from the Canadian Community Health Survey. Fifty single parents and forty-eight seniors were interviewed in the city of St. John’s, Canada. Findings indicate that single parents were more disadvantaged than seniors and more vulnerable to food insecurity. For seniors, in addition to poverty, existing physical disabilities and loneliness limit the use of public transportation to grocery stores and affect their ability/motivation to prepare balanced home-made meals. The jobs of single parents result in time constraints, which limit the attention they can give to the quality of their children’s diets and to accessing information about cheap yet healthy diet alternatives. We conclude by strongly advocating for improving the social safety net, particularly for single parents, for instance by promoting financial security, skill development, flexible working hours, and affordable childcare. Seniors need interaction with peers to encourage the eating of balanced meals, along with the increased promotion of healthy foods.

Effect of restricted retail merchandising of discretionary food and beverages on population diet: a pragmatic randomised controlled trial

The effectiveness of healthy food promotion on food and beverage sales in real-world food retail settings has been shown in randomised trials. The effectiveness of restrictions on the promotion of unhealthy food is, however, less clear. We aimed to assess the effect of restricted unhealthy food promotion, specifically those items contributing most to free sugar sales, on food and beverage sales. In this community-level pragmatic, partially randomised, parallel group trial, stores were randomly assigned by a statistician using a single sequence of random assignments to the intervention group, in which a co-designed strategy restricted merchandising of unhealthy food, or to a control group of usual retail practice. The trial was done in partnership with an organisation operating 25 stores in remote Australia. The primary analysis was based on difference in weekly sales with the strategy compared with no strategy in free sugar from all foods and beverages (g/total MJ; primary outcome), targeted food or beverages (weight and free sugars; g/total MJ), and gross profit (AU$) using mixed models. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12618001588280. Between June 13 and Aug 15, 2018, 20 stores were recruited; ten stores were randomly assigned to the intervention group and ten stores to the control group. The trial was done between Sept 2 and Dec 2, 2018. The Healthy Stores 2020 strategy resulted in a reduction in sales of free sugar of 2·8% (95% CI -4·9 to -0·7). Targeted beverages were reduced by 8·4% (-12·3 to -4·3) and associated free sugar by 6·8% (-10·9 to -2·6), sugar-sweetened soft drinks by 13·2% (-18·5 to -7·6), and associated free sugar by 13·4% (-18·7 to -7·7). Reductions in sales of free sugar from confectionery of 7·5% (-14·3 to -0·2) and in weight sold (-4·6%, -11·1 to 2·3) resulted; however, the reduction in weight was not statistically significant. No differences in sales of table sugar and sweet biscuits were observed. Gross profit was not impacted adversely; a small increase resulted (5·3%, 0·3 to 10·5). Restricted merchandising of unhealthy foods and beverages, while allowing for complementary merchandising of healthier foods and beverages in a real-world store setting and co-designed with retailers, can achieve both public health and business relevant gains. Australian National Health and Medical Research Council.

Taste and Health Information on Fast Food Menus to Encourage Young Adults to Choose Healthy Food Products: An Experimental Study.

Currently, a great number of people have an unhealthy dietary intake, leading to chronic diseases. Despite the high prevalence of obesity and people being overweight, only a few strategies to promote healthier food products have been proven effective. Therefore, the objective of this study was to test the effect of the presence of health information and its integration into a fast food menu context on young adults’ healthy food choices. An experimental between-subjects design consisting of three conditions—subtle, explicit, and no health information—was conducted among 142 participants aged 18 to 24 (Mage: 21.49, SD = 1.77). The results showed that when health information about healthy products was provided, the level of integration of the information into the menu context had an effect. More specifically, participants exposed to explicit health information about healthy products provided on the fast food menu were more likely to choose a healthy food product compared to participants exposed to subtle integrated health information. No interaction effect for moderating factors was found. In line with the healthy food promotion model, the findings suggest that the provision of explicit health information on healthy products stimulates healthy food choices in a fast food environment.

Ações do Centro Colaborador de Alimentação e Nutrição Escolar

Com o objetivo de contribuir para a efetivação das diretrizes para a promoção da alimentação saudável nas escolas de educação infantil, fundamental e nível médio, e procurando tornar mais eficaz o Programa Nacional de Alimentação Escolar (PNAE), o Fundo Nacional de Desenvolvimento da Educação (FNDE) estabeleceu uma parceria com as instituições federais de ensino superior, culminando na criação dos chamados Centros Colaboradores de Alimentação Escolar (Cecanes). Os centros são unidades de referência e apoio, constituídas no âmbito das instituições federais de ensino superior, para desenvolver ações de interesse e necessidade do PNAE, como projetos de extensão e capacitações dos atores do programa, prestando apoio técnico às entidades executoras. Este trabalho tem como objeto de estudo quantificar a política de alimentação escolar, discutindo os fatores relacionados à execução, partindo do levantamento de dados com base na execução do programa em 22 municípios mineiros e análise das ações desenvolvidas pelo Cecane/IFSULDEMINAS, de modo a garantir uma execução efetiva do PNAE. Foram capacitados 588 atores sociais. Sendo assim, conclui-se que os objetivos do Cecane estão sendo atingidos, na medida em que contribui para a efetivação das diretrizes de promoção da alimentação saudável nas escolas e torna mais eficaz a execução do PNAE, possibilitando a integração da sociedade e do Estado na atuação de políticas públicas.