Fruit Purchases Research Articles

Perceptions of a food benefit programme that includes financial incentives for the purchase of fruits and vegetables and restrictions on the purchase of foods high in added sugar.

To report perspectives of participants in a food benefit programme that includes foods high in added sugar (FAS) restrictions and FAS restrictions paired with fruits and vegetables (F/V) incentives. Randomised experimental trial in which participant perspectives were an exploratory study outcome. Participants were randomised into one of three Supplemental Nutrition Assistance Program (SNAP)-like food benefit programme groups: (1) restriction: not allowed to buy FAS with benefits; (2) restriction paired with incentive: not allowed to buy FAS with benefits and 30 % financial incentive on eligible F/V purchased using benefits; or (3) control: same food purchasing rules as SNAP. Participants were asked questions to assess programme satisfaction. Adults in the Minneapolis-St. Paul, MN metropolitan area, eligible for but not currently participating in SNAP who completed baseline and follow-up study measures (n 254). Among remaining households in each group, most found the programme helpful in buying nutritious foods (88·2 %-95·7 %) and were satisfied with the programme (89·1 %-93·0 %). Sensitivity analysis results indicate that reported helpfulness and satisfaction with the programme may in some instances be lower among the restriction and the restrictions paired with incentive groups in comparison to the control group. A food benefit programme that includes restriction on purchase of FAS or restriction paired with a financial incentive for F/V purchases may be acceptable to most SNAP-eligible households with children.

The Relationship between Food Security Status and Fruit and Vegetable Intake during the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered food shopping behaviors, and the resulting economic recession has caused a spike in food insecurity. Since food insecurity is associated with poor diet, especially low intake of fruits and vegetables, food-insecure individuals may disproportionately experience negative health impacts related to poor diet during the pandemic. To assess the relationship between food security status and fruit and vegetable intake during the COVID-19 pandemic, we conducted an online survey of adult residents of the US state of Michigan in June of 2020. Among the 484 survey respondents, 36.2% were classified as food-insecure. Food-insecure respondents consumed fruits and vegetables fewer times per day than food-secure respondents and were more likely to report decreasing their consumption of any type of fruits and vegetables (total, fresh, frozen, and canned) since the pandemic started. For those who reduced their purchase of fresh fruit and vegetable, reasons included poor quality, poor availability, high price, reduced store trips, and concerns of contamination. These findings highlight the need for adequate food assistance during the COVID-19 pandemic and in future pandemics, as well as public health messages that promote healthy eating.

Socio-economic and racial/ethnic disparities in the nutritional quality of packaged food purchases in the USA, 2008-2018.

To determine whether disparities exist in the nutritional quality of packaged foods and beverage purchases by household income, education and race/ethnicity and if they changed over time. We used Nielsen Homescan, a nationally representative household panel, from 2008 to 2018 (n = 672 821 household-year observations). Multivariate, multilevel regressions were used to model the association between sociodemographic groups and a set of nutritional outcomes of public health interest, including nutrients of concern (sugar, saturated fat and Na) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, sugar-sweetened beverages and junk foods). Household panel survey. Approximately 60 000 households each year from the USA. Disparities were found by income and education for most outcomes and widened for purchases of fruits, vegetables and the percentage of calories from sugar between 2008 and 2018. The magnitude of disparities was largest by education. Disparities between Black and White households include the consumption of processed meats and the percentage of calories from sugar, while no disparities were found between White and Hispanic households. Disparities have been largely persistent, as any significant changes over time have been substantively small. Policies to improve the healthfulness of packaged foods must be expanded beyond SSB taxes, and future research should focus on what mediates the relationship between education and diet so as not to exacerbate disparities.

Hunger at the End of the Supply Chain

Hunger at the End of the Supply Chain Penelope Kyritsis (bio) and Genevieve LeBaron (bio) A Bangladeshi woman loses her factory job in the wake of the COVID-19 pandemic. Before, she was able to afford the occasional purchase of meat, fish, and fruit for her family. This is no longer the case. “Egg is a luxurious food for us now,” she says. In Indonesia, a garment worker whose monthly income has dropped by 20 percent since the beginning of the pandemic begins her days with a devastating calculus: should she eat, or go hungry to avoid accumulating more debt? A garment worker in Myanmar goes to the market and purchases food that would have lasted her family a week before the pandemic. But because she and her family are rationing their food intake, the same amount of food has to last two weeks instead of one. Far from a handful of rare episodes, these stories illustrate an alarming trend in the global apparel supply chain: the people who sew clothes for major apparel giants around the globe are facing widespread hunger and destitution as a result of falling income and job loss during the COVID-19 pandemic. In September 2020, we launched a survey to understand the impact of changes to garment workers’ employment status and income levels on food security. We interviewed 396 workers in nine garment-exporting countries. Our survey respondents included workers who were temporarily suspended or permanently fired, as well as those still employed. They reported sewing clothes for well-known brands and retailers, such as Adidas, H&M, Inditex (the parent company of Zara), Nike, Target, and Walmart. In late 2020, we published our findings in a report called “Hunger in the Apparel Supply Chain,” which documented job loss, declining incomes, and food insecurity among the world’s garment workforce. Our survey found that hunger is a growing and acute problem not only for workers who have lost their jobs, but also for those who are still working. Of the workers in our survey, 88 percent stated that diminished income—whether the result of losing their jobs without being paid a legally mandated severance, being sent home without pay from a factory that was shutting [End Page 51] down temporarily, or losing income despite still being employed—had forced a reduction in the amount of food consumed per day by members of their households. And 77 percent told us that they or a member of their household have gone hungry since the beginning of the pandemic, while 80 percent of workers with dependent children said they are forced to skip meals or reduce the amount or quality of food they eat in order to feed their children. Three quarters of the survey respondents have borrowed money or accumulated debt in order to buy food since the onset of the pandemic. And 80 percent told us that they anticipate continuing to reduce the amount of food they eat or purchase for their family if the situation does not improve. Garment workers experienced widespread and growing hunger despite the fact that half of them had received some form of public assistance. This growing trend of food insecurity is the result of the chronically low wages and precarity in brands’ supply chains that predated the pandemic, compounded by apparel companies’ irresponsible practices in response to the crisis. Click for larger view View full resolution Garment workers in Dhaka, Bangladesh, protest forced resignations imposed during pandemic-related factory closures. (Mamunur Rashid/NurPhoto via Getty Images) ________ In March 2020, retail stores shuttered their doors due to the spread of COVID-19, which led to a sharp and enduring decline in consumer demand [End Page 52] for clothes. Rising unemployment and inequality wrought by the COVID-19 economic recession also led to a decrease in consumer spending on apparel. Faced with looming sales losses, the immediate response of many apparel companies was to shift the economic pain down the supply chain by abruptly canceling orders to supplier factories. In many cases, they did so retroactively and refused to pay for orders that factories were already manufacturing or had completed. Brands cited dubious force majeure clauses to skirt their contractual...

Associations between shopping patterns, dietary behaviours and geographic information system-assessed store accessibility among small food store customers.

To examine associations between geographic information systems (GIS)-assessed accessibility to small food stores, shopping patterns and dietary behaviours among small food store customers. Residential addresses and customer shopping patterns (frequency of shopping, and previous purchase of fruits and vegetables) were gathered through customer intercept surveys. Addresses were geocoded, and GIS-assessed distance and driving time from the participants' residence to the store were calculated. Dietary status and behaviours were assessed using an objective non-invasive measure of skin carotenoids, the National Cancer Institute Fruit and Vegetable Screener, and items to assess sugary beverage intake. Associations between distance and driving time, demographics, shopping frequency, prior reported purchase of fruits and vegetables at the store and dietary behaviours were examined. Small food stores (n 22) across North Carolina. Cross-sectional convenience samples of English-speaking customers aged 18 years or older (n 692). Participants living closer to the small store had lower income and formal education, were more likely to be Black, more likely to have previously bought fruits and vegetables at the store and more frequently shopped at the store. In adjusted models, skin carotenoids (n 644) were positively associated with distance to the store from home in miles (P = 0·01). Customers who lived closer to the stores were more frequent shoppers and more likely to have previously purchased fruits and vegetables at the store yet had lower skin carotenoids. These results support continued efforts to examine how to increase the availability and promotion of healthful foods at small food retail stores.

Effects of determinants of dried fruit purchase intention and the related consumer segmentation on e-commerce in China

PurposeIn this study, a comprehensive theoretical framework was developed to investigate the influence of the determinants of online dried fruit purchase intention in China.Design/methodology/approachThe dried fruit eating experiences of 1,160 participants from China were collected using an online survey.FindingsSignificant differences were noted in the sociodemographic distributions among three age-based consumer segments. Furthermore, the cost of the marketing strategy had the strongest effect on online dried fruit purchase intention. Finally, different patterns of online dried fruit purchase intention were observed among the three consumer segments: consumers aged below 24 years regarded dried fruits as a new and healthy snack choice and favoured companies with high-quality communication with consumers; consumers aged 25–29 years viewed dried fruits as a healthy eating habit, reflecting their strong self-control over their lifestyle; and consumers aged over 30 years valued the convenience marketing strategies applied by dried fruit manufacturers.Originality/valueOverall, the results indicate that dried fruits are considered a niche market of snacks that provides added value for core products in the Chinese e-commerce (EC) market; therefore, developing cost-effective strategies to raise consumer awareness of dried fruits is crucial. Furthermore, marketing strategies should target different consumer segments.

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review.

Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies’ effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing.

Assessment of the place of purchase of vegetables and fruits as expressed by consumers

According to studies, Poland is the leader in the production of certain fruits and vegetables as well as certain food products. The development of discount chains is where the changes are visibly heading. The article presents the results of the most common places to buy fruits and vegetables. The research was carried out on a sample of 812 people. Research shows that consumers most often buy fruits and vegetables in super and hypermarkets, with supermarkets being chosen most often when purchasing all food products. The smallest percentage of respondents declared making food purchases in bazaars and markets. The place of purchase is an important factor for choosing food.

Perfil socioeconômico dos consumidores e comerciantes de frutas de Barra-BA

Objetivou-se identificar o perfil dos consumidores e dos comerciantes de frutas da cidade de Barra-BA, de forma a gerar dados informativos acerca do comércio e consumo de frutas, com vistas à proposição de melhorias e exploração de novos nichos do mercado de frutas da cidade. As entrevistas foram realizadas por meio de aplicação de questionário socioeconômico, aplicado no comércio varejista de frutas e feiras livres da cidade. 60,5 % dos consumidores são do sexo feminino, sendo 45% com idade entre 20 e 35 anos. A frequência de compra de frutas é semanal (62,5%), e a maioria dos consumidores (36%) gasta em média de R$ 21 a 30 por compra de frutas. Para 69% a qualidade das frutas atende a suas exigências parcialmente. Os sacolões se destacam como local de preferência para compra de frutas, representando 51%. A banana é a fruta mais consumida pelos entrevistados (82%). 60,4% dos comerciantes não compram frutas na cidade, por não encontrar, sendo a cidade de Irecê-BA a principal fonte fornecedora de frutas (92,6%), que são transportadas em caminhões baú fechado (46,4%) e caminhões com carroceria aberta (43,9%). A perda pós-colheita é unanime entre os comerciantes, sendo que a maioria não sabe como resolver o problema. A frequência de compras do consumidor de frutas é influenciada pela logística dos comerciantes que costumam renovar as prateleiras apenas uma vez por semana. Melhorias nos comércios de frutas na cidade devem ser incentivadas para atender melhor a população e evitar perdas pós-colheita.

Longitudinal Fruit and Vegetable Sales in Small Food Retailers: Response to a Novel Local Food Policy and Variation by Neighborhood Socioeconomic Status.

Small food retailers, including corner/convenience stores, pharmacies, gas-marts, and dollar stores, have historically stocked limited fruits and vegetables, though this may be changing. We examined increases in sales, customer purchasing, and stocking of fresh and/or frozen fruits and vegetables in small food stores over time and in relation to: (a) a local food policy (the Minneapolis Staple Foods Ordinance) and (b) neighborhood socioeconomic status (SES). We used longitudinal data (2014–2017) from 147 randomly-sampled stores in Minneapolis/St. Paul, USA, collected using interviewer-administered manager surveys (measuring sales and stocking) and customer intercepts/observations (measuring purchasing, n = 3039). The local policy required Minneapolis stores to meet minimum stocking standards for fresh/frozen produce and other healthy foods. No ordinance existed in St. Paul. Mixed regression models examined overall change over time and change by city and neighborhood SES. We observed significant increases over time (p < 0.05) in sales and purchasing of fresh fruit and in stocking of fresh fruit, frozen fruit, and frozen vegetables. We did not identify consistent statistical evidence for differential change in sales, purchasing, or stocking by city or neighborhood SES. Key study findings suggest limited differential effects of the local ordinance and/or neighborhood SES. However, findings also indicate significant time trends for some products, including consistent improvements in sales, customer purchasing, and stocking of fresh fruit. Given the ready-to-eat convenience of many fresh fruits and their broad appeal, fresh fruit appears a promising target for advancing the healthfulness of small food retailers.

Increasing organic food consumption: An integrating model of drivers and barriers

A survey of 620 Swiss households was conducted to investigate the determinants of purchases of organic fruits and vegetables and identify subjectively perceived requirements for more environmentally friendly and healthier food consumption. An integrative behavior model incorporating various psychological and socio-structural variables was applied to explain the ratio of organic vs. non-organic purchases. The theory of planned behavior was considered fundamental for the development of this integrative model, and supplementary variables were included, accounting for moral justifications, education level, income, and further aspects. The resulting model accounted for 42% of the variance of organic food consumption. Financial and environmental justifications for purchasing non-organic food resulted as the most important predictors, followed by recent consumption changes, health-related aspects of attitudes and social norms, perceived behavioral control, environmental values, income, and education level. The participants considered more knowledge and information and having more money at their disposal to be important requirements for achieving more environmentally friendly and healthier food consumption. Furthermore, they considered having more time to prepare meals oneself as particularly important to achieving healthier food consumption.

Factors Determining Consumers’ Purchase Intentions Towards Dried Fruits

ABSTRACT Two studies were conducted to investigate the factors determining consumers’ purchase intentions toward dried fruit in Taiwan. In the first study, we identified the most appropriate scale structure by using exploratory factor analysis on data from 306 participants. In the second study, the factor structures were verified by performing a confirmatory factor analysis of a sample comprising 575 participants. Structural equation modeling was then applied to test the hypothesized relationships, followed by a correspondence analysis to associate the eating experience of dried fruits with all participant sociodemographics. The results revealed that first, the high purchase intention toward dried fruits is positively influenced by autonomy motivation, relatedness motivation, and perceived convenience value, whereas it is negatively influenced by competence motivation and perceived health value. Second, the eating attitude mediates the effects of autonomy and competence motivation as well as perceived emotional and health values on the purchase intention. Third, marked differences are present in the choice and eating habit of dried fruits in the analysis of socioeconomic variables. Overall, the study results imply that dried fruit purchasing is a hedonistic-oriented behavior, and that consumers are confused regarding the products that are considered dried fruits; hence, a clear definition of dried fruits and effective consumer education are necessary. Furthermore, dried fruit manufacturers must improve the utilitarian values of health and convenience.

Nebraska Double Up Food Bucks Increases Purchases of Fresh Fruits and Vegetables Among SNAP Users

Abstract Objectives Nebraska Double Up Food Bucks (NDUFB) is an incentive program intended to increase the purchase of fresh fruits and vegetables (F&amp;V) by Supplemental Nutrition Assistance Program (SNAP) recipients. The objective of the NDUFB program is to provide evidence and best practices for implementing a sustainable Policy, System, and Environmental (PSE) program to improve food security and diet quality among SNAP recipients. Methods Program site selection was dependent on the availability of funding, organizational capacity, and technology levels (POS machine) of the business, geographical location, and the capacity of local Extension staff in the area. At participating sites, SNAP recipients use the program by purchasing qualifying items with their federal benefits (EBT card) to earn NDUFB in equal amounts (in $2 increments) up to $20 per day. NDUFB can be used to purchase fresh fruits, vegetables, and herbs (F&amp;V) at any participating site that day or any day in the future during site's normal business hours. Evaluation includes a mixed methods approach including customer, vendor and manager surveys, tracking purchases (customer logs and receipts) and redemptions (bank records) as well as qualitative feedback and satisfaction. Intervention took place June 2017- December 2019. Results On average, 74% of NDUFB customer survey respondents (n = 96) self-identified as food insecure. There were positive and significant (P &amp;lt; 0.05) correlations between how long respondents reported using NDUFB and the following: ease of using NDUFB to buy F&amp;V and consumption of green leafy or lettuce salads, non-fried kinds of potatoes, and other vegetables. In total, SNAP recipients used NDUFB to purchase over $40,000 worth of F&amp;V. This dollar amount is on top of the money they spent on F&amp;V ($67,052) to earn NDUFB. All together, the program contributed to over $107,000 worth of F&amp;V spending among 1342 families. Redemption rate for NDUFB is 80%, an industry leader in nutrition incentive programs. Conclusions The primary outcomes of the study include increased purchases of fresh fruits and vegetables, with an emphasis on locally grown produce among SNAP recipients. In addition, we show an increased use of the program by customers and retailers each year. Funding Sources Children's Hospital &amp; Medical Center, CHI Health, SNAP-Ed, USDA NIFA.

Abstract P283: Where You Shop and Neighborhood Access to Fruit and Vegetables are Associated With Self-rated and Cardiometabolic Health

Introduction: The food environment, including food retail venues, has been shown to be associated with diet, and many disadvantaged neighborhoods lack access to high quality and affordable healthy foods. Research has sought to understand whether and how the food retail environment influences diet, and it is possible that shopping at different types of stores (e.g. full-service vs discount grocery store) influences diet and self-reported health outcomes. There is limited understanding of whether factors of the food environment and primary shopping location impact cardiometabolic health (blood pressure, HbA1c, cholesterol) and self-rated health. Methods: We report on 459 individuals who participated in a blood draw in 2018 as part of the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health, a longitudinal natural-experiment study among African American adults from two socioeconomically similar neighborhoods. Participants reported their perceived access to fruit and vegetables within their neighborhood and where they did their primary food shopping. Outcomes include measured height, weight, blood pressure, cholesterol (HDL, Total), HbA1c, and participant’s self-rated health. We employed logistic regression to examine associations between 1) perceived fruit and vegetable availability, quality, and price and 2) primary food shopping store type and reason for shopping there, with cardiometabolic and self-rated health outcomes. Covariates were neighborhood, years lived in neighborhood, age, race, income, education, and marital status. Results: Participants were on average, 60.7 years old (SD=13.9); 81.7% (375 of 459) female; 80.4% (369 of 459) overweight/obese. After covariate adjustment, both more perceived accessibility of purchasing (OR: 0.47, 95% CI: 0.28, 0.79) and pricing of fruits and vegetables (OR: 0.59, 95% CI: 0.36, 0.96) within one’s neighborhood were associated with lower odds of high blood pressure. More accessible purchasing (OR: 0.59, 95% CI: 0.39, 0.90), pricing (OR: 0.62, 95% CI: 0.41, 0.94), and higher quality of fruits and vegetables (OR: 0.64, 95% CI: 0.42, 0.97) within one’s neighborhood were associated with lower odds of poor self-rated health. Doing one’s primary food shopping at a discount grocery store compared to a full-service grocery store was associated with lower odds of being overweight (OR: 0.51, 95% CI: 0.26, 0.99). Choosing a primary food store based on price rather than quality of food was associated with increased odds of high cholesterol (OR: 2.02, 95% CI: 1.19, 3.45). Conclusion: These results suggest that higher perceptions of access to fruits and vegetables in one’s neighborhood and choice of primary food shopping store are important correlates of cardiometabolic health. Further research should look towards understanding how direct food choices made at stores impact cardiometabolic outcomes within this population.

Health motive and the purchase of organic food: A meta‐analytic review

AbstractThere are many empirically determined influential factors known to control the organic food purchase behaviour. Of these known factors‐ health, product quality and concern for natural environmental degradation are seen as the major motives behind the organic food purchase. We, therefore, attempted to investigate the most prominent reason(s) for buying organic food, using the meta‐analyses of studies published during the last 25 years as our basis for conviction. Multilevel meta‐analyses was applied to the studies in review, in order to find the major reason(s) for the purchase of organic grocery, milk, fruits and vegetables. Although the three motivational factors mentioned above have been echoed throughout the history of organic food purchase research, the health factor has always topped the priority chart. The study in its overall empirical scale contributes to managerial implications and sets an agenda for future research.

A Qualitative Evaluation of Double Up Food Bucks Farmers’ Market Incentive Program Access

ObjectiveExplore factors affecting access to and use of Double Up Food Bucks (DUFB), a farmers’ market program that doubles Supplemental Nutrition Assistance Program benefits for use toward the purchase of fruits and vegetables (FV). DesignFocus groups. SettingMetro and nonmetro counties in Utah and western Upstate New York. ParticipantsNine groups composed of 62 low-income adults (3–9/group). Phenomena of InterestSatisfaction with, barriers to, and facilitators of program use; suggestions for improvement. AnalysisTranscribed verbatim and coded thematically in NVivo 11 software according to template analysis. ResultsProgram satisfaction was high and driven by FV affordability, perceived support of local farmers, positive market experiences, and high-quality FV. Primary barriers to using DUFB were lack of program information and inconvenient accessibility. Insufficient program communication was a consistent problem that elicited numerous suggestions regarding expansion of program marketing. Emergent topics included issues related to the token-based administration of DUFB and debate regarding stigma experienced during DUFB participation. Conclusions and ImplicationsResults suggest that although DUFB elicits many points of satisfaction among users, program reach may be limited owing to insufficient program marketing. Even among satisfied users, discussion of barriers was extensive, indicating that program reach and impact may be bolstered by efforts to improve program accessibility.

Fruit and Vegetable Purchases in Farmer's Market Stands: Analysing Survey and Sales Data.

Farmers’ market implementation holds promise for increasing access to healthy foods. Although rarely measured, purchase data constitute an intermediate outcome between food environment and actual consumption. In a study conducted with two seasonal Fruits and Vegetables (FV) stands in a disadvantaged area of Montréal (Canada), we analysed how accessibility, perception, and mobility-related factors were associated with FV purchase. This analysis uses a novel measure of FV purchasing practices based on sales data obtained from a mobile application. A 2016 survey collected information on markets’ physical access, perceived access to FV in the neighbourhood, usual FV consumption and purchases. Multivariate models were used to analyse three purchasing practice indicators: number of FV portions, FV variety and expenditures. Average shoppers purchased 12 FV portions of three distinct varieties and spent 5$. Shoppers stopping at the market on their usual travel route spent less (p = 0.11), bought fewer portions (p = 0.03) and a lesser FV variety (p < 0.01). FV stands may complement FV dietary intake. Individuals for whom the market is on their usual travel route might make more frequent visits and, therefore, smaller purchases. The novel data collection method allowed analysis of multiple purchase variables, is precise and easy to apply at unconventional points of sales and could be transposed elsewhere.

Healthy Stores Initiative Associated with Produce Purchasing on Navajo Nation

ABSTRACTBackgroundAmerican Indians and Alaska Natives experience diet-related health disparities compared with non-Hispanic whites. Navajo Nation's colonial history and remote setting present unique challenges for healthy food access.ObjectiveThis study aims to understand the impact of the Healthy Navajo Stores Initiative (HNSI) on fruit and vegetable purchasing on Navajo Nation.MethodsWe conducted a cross-sectional survey of 692 customers shopping at 28 convenience stores, trading posts, and grocery stores on Navajo Nation. Individual- and household-level sociodemographic data and food purchasing behaviors were collected. Descriptive and bivariate analyses for customers’ individual- and household-level characteristics were conducted using chi-squared tests. The impact of individual-, household-, and store-level factors on fruit and vegetable purchasing was assessed using multiple logistic regression modeling.ResultsStore participation in the HNSI was significantly associated with customers’ purchase of produce. Customers experienced 150% higher odds of purchasing produce if they shopped in participating stores, compared with nonparticipating stores (P < 0.001). Store type was strongly associated with customers’ purchase of fruits or vegetables. Customers shopping at a grocery store had 520% higher odds of purchasing produce than did customers shopping at convenience stores (P < 0.001). Customers shopping at trading posts had 120% higher odds of purchasing fruits or vegetables than did customers shopping at convenience stores (P = 0.001).ConclusionsOur findings reveal increased produce purchasing at stores participating in the HNSI. Customers were significantly more likely to purchase fruits or vegetables in stores enrolled in a healthy store intervention than in nonenrolled stores, after controlling for quantity of produce stocked and store type. Customers shopping in grocery stores and trading posts were significantly more likely to purchase produce than customers shopping in convenience stores. These findings have implications for food access in rural tribal communities.

Factores asociados al consumo de frutas y verduras en alumnos de medicina de una universidad peruana

Objetivo: determinar la prevalencia y factores asociados al bajo consumo de frutas y verduras en alumnos de la carrera profesional de medicina humana de la Universidad Nacional Hermilio Valdizán (UNHEVAL). Material y métodos: estudio transversal. La población estuvo constituida por los 371 de alumnos de la carrera profesional de Medicina Humana que se encontraban matriculados y cursando estudios en julio de 2018. Se aplicó de un cuestionario autoadministrado el cual permitió obtener información del consumo de frutas y verduras. A partir de los datos recolectados obtuvo la prevalencia y factores asociados al bajo consumo de frutas y verduras. Resultados: la prevalencia de bajo consumo de frutas y verduras fue de 60,1% (IC95%: 55,0%-65,2%). Las principales razones para no consumir frutas y verduras fueron el considerar que es poco frecuente conseguirlas en los cafetines de la universidad (78,71%), el tiempo insuficiente para su selección, compra y preparación (73,58%) y el vivir con alguno de los padres que se encargaban de su alimentación (55,26%). El análisis multivariado encontró que el único factor asociado al bajo consumo de frutas y verduras fue el tiempo insuficiente para la selección, compra y preparación; mientras que, vivir con alguno de los padres constituyó factor protector. Conclusión: existe una alta prevalencia de bajo consumo de frutas y verduras en alumnos de la carrera profesional de medicina humana de la UNHVAL. El tiempo insuficiente para la selección, compra y preparación de frutas y verduras constituye factor asociado y vivir con alguno de los padres constituye factor protector.

The effect of nudges aligned with the renewed Flemish Food Triangle on the purchase of fresh fruits: An on-campus restaurant experiment

ObjectiveThis study examined the effect of nudges, inspired by the recently renewed Flemish Food Triangle, on fruit sales in a Belgian on-campus university restaurant. MethodsIn this mixed-method real-life experiment, nudges were added weekly over a period of four consecutive weeks: placement of (1) Food Triangle posters in the restaurant, (2) ‘green heart’ icons above the fruit stands, and (3) substitution and (4) social norm messages at the fruit stands. During baseline (no intervention) and all intervention weeks, dessert sales were registered. Short interviews were used to ask customers about their perceptions regarding the intervention. Follow-up measurements (7 and 30 weeks later) evaluated the longer-term effectiveness, while all nudges remained in place. Dessert sales were analyzed separately for both sexes, students and staff categories (based on academic degree). ResultsCompared to baseline, the combination of the Food Triangle and the green heart intervention materials in week 2 resulted in significant increases in fruit consumption across almost all subgroups. The other intervention materials used in the current study had rather limited effects in the short term. After 7 weeks of follow-up, significant fruit sale increases were established for all subgroups compared to baseline. At 30 weeks follow-up, the effect for staff B (Bachelor's degree) disappeared. The majority of the respondents (66.4%) had noticed at least one of the nudges, while only 3.4% indicated to have adjusted their dessert choice as a result of the nudges. ConclusionsThe combination of nudges was effective in the long term and increased fruit purchase in nearly all subgroups. Short interviews show that a more active approach may be needed to increase effect sizes.