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Adam Drewnowski - One of the best experts on this subject based on the ideXlab platform.
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Food Environment research in low and middle income countries a systematic scoping review
Advances in Nutrition, 2019Co-Authors: Christopher Turner, Sofia Kalamatianou, Adam Drewnowski, Bharati Kulkarni, Sanjay Kinra, Suneetha KadiyalaAbstract:Food Environment research is increasingly gaining prominence in low- and middle-income countries (LMICs). However, in the absence of a systematic review of the literature, little is known about the emerging body of evidence from these settings. This systematic scoping review aims to address this gap. A systematic search of 6 databases was conducted in December 2017 and retrieved 920 records. In total, 70 peer-reviewed articles met the eligibility criteria and were included. Collectively, articles spanned 22 LMICs, including upper-middle-income countries (n = 49, 70%) and lower-middle-income countries (n = 18, 26%). No articles included low-income countries. Articles featured quantitative (n = 45, 64%), qualitative (n = 17, 24%), and mixed-method designs (n = 11, 8%). Studies analyzed the Food Environment at national, community, school, and household scales. Twenty-three articles (55%) assessed associations between Food Environment exposures and outcomes of interest, including diets (n = 14), nutrition status (n = 13), and health (n = 1). Food availability was associated with dietary outcomes at the community and school scales across multiple LMICs, although associations varied by vendor type. Evidence regarding associations between the Food Environment and nutrition and health outcomes was inconclusive. The paucity of evidence from high-quality studies is a severe limitation, highlighting the critical need for improved study designs and standardized methods and metrics. Future Food Environment research must address low-income and lower-middle-income countries, and include the full spectrum of dietary, nutrition, and health outcomes. Improving the quality of Food Environment research will be critical to the design of feasible, appropriate, and effective interventions to improve public health nutrition in LMICs.
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concepts and critical perspectives for Food Environment research a global framework with implications for action in low and middle income countries
Global Food Security, 2018Co-Authors: Christopher Turner, Sofia Kalamatianou, Helen Walls, Jennifer Coates, Anju Aggarwal, Anna Herforth, Adam Drewnowski, Suneetha KadiyalaAbstract:Abstract Malnutrition in all its forms currently affects one in three people globally and is considered one of the greatest public health challenges of our time. Low- and middle-income countries (LMICs) are increasingly facing a double burden of malnutrition that includes undernutrition, as well as increasing overweight, obesity and diet related non-communicable diseases. The role of Food Environments in shaping transitioning diets and the double burden of malnutrition in LMICs is increasingly gaining policy attention. However, Food Environment research to date has predominantly been undertaken in response to obesity and associated diet-related non-communicable diseases in high-income countries (HICs). Empirical research in LMICs is in its infancy. There is a need to create a cohesive research agenda to facilitate Food Environment research and inform action across the globe, particularly with regard to LMICs. In this paper, we address three fundamental questions: First, how can the Food Environment be defined and conceptualised in a way that captures the key dimensions that shape Food acquisition and consumption globally? Second, how can existing knowledge and evidence from HICs be leveraged to accelerate Food Environment research in LMICs? Third, what are the main challenges and opportunities in doing so? We conduct a brief synthesis of the Food Environment literature in order to frame our critical perspectives, and introduce a new definition and conceptual framework that includes external and personal domains and dimensions within the wider Food Environment construct. We conclude with a discussion on the implications for future research in LMICs.
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Food Environment and socioeconomic status influence obesity rates in Seattle and in Paris
International Journal of Obesity, 2014Co-Authors: Adam Drewnowski, Hélène Charreire, A. V. Moudon, J. Jiao, A. Aggarwal, B. ChaixAbstract:OBJECTIVE: To compare the associations between Food Environment at the individual level, socioeconomic status (SES) and obesity rates in two cities: Seattle and Paris. METHODS: Analyses of the SOS (Seattle Obesity Study) were based on a representative sample of 1340 adults in metropolitan Seattle and King County. The RECORD (Residential Environment and Coronary Heart Disease) cohort analyses were based on 7131 adults in central Paris and suburbs. Data on sociodemographics, health and weight were obtained from a telephone survey (SOS) and from in-person interviews (RECORD). Both studies collected data on and geocoded home addresses and Food shopping locations. Both studies calculated GIS (Geographic Information System) network distances between home and the supermarket that study respondents listed as their primary Food source. Supermarkets were further stratified into three categories by price. Modified Poisson regression models were used to test the associations among Food Environment variables, SES and obesity. RESULTS: Physical distance to supermarkets was unrelated to obesity risk. By contrast, lower education and incomes, lower surrounding property values and shopping at lower-cost stores were consistently associated with higher obesity risk. CONCLUSION: Lower SES was linked to higher obesity risk in both Paris and Seattle, despite differences in urban form, the Food Environments and in the respective systems of health care. Cross-country comparisons can provide new insights into the social determinants of weight and health.
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Food Environment and socioeconomic status influence obesity rates in seattle and in paris
International Journal of Obesity, 2014Co-Authors: Adam Drewnowski, Anju Aggarwal, Hélène Charreire, A. V. Moudon, J. Jiao, Basile ChaixAbstract:To compare the associations between Food Environment at the individual level, socioeconomic status (SES) and obesity rates in two cities: Seattle and Paris. Analyses of the SOS (Seattle Obesity Study) were based on a representative sample of 1340 adults in metropolitan Seattle and King County. The RECORD (Residential Environment and Coronary Heart Disease) cohort analyses were based on 7131 adults in central Paris and suburbs. Data on sociodemographics, health and weight were obtained from a telephone survey (SOS) and from in-person interviews (RECORD). Both studies collected data on and geocoded home addresses and Food shopping locations. Both studies calculated GIS (Geographic Information System) network distances between home and the supermarket that study respondents listed as their primary Food source. Supermarkets were further stratified into three categories by price. Modified Poisson regression models were used to test the associations among Food Environment variables, SES and obesity. Physical distance to supermarkets was unrelated to obesity risk. By contrast, lower education and incomes, lower surrounding property values and shopping at lower-cost stores were consistently associated with higher obesity risk. Lower SES was linked to higher obesity risk in both Paris and Seattle, despite differences in urban form, the Food Environments and in the respective systems of health care. Cross-country comparisons can provide new insights into the social determinants of weight and health.
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obesity and the Food Environment dietary energy density and diet costs
American Journal of Preventive Medicine, 2004Co-Authors: Adam DrewnowskiAbstract:The highest rates of obesity in the United States occur among population groups with the highest poverty rates and the least education. The impact of socioeconomic variables on obesity may be mediated, in part, by the low cost of energy-dense Foods. The observed inverse relationship between energy density of Foods, defined as available energy per unit weight (kilocalories per gram or megajoules per kilogram), and energy cost (dollars per kilocalorie or dollars per megajoule) means that diets based on refined grains, added sugars, and added fats are more affordable than the recommended diets based on lean meats, fish, fresh vegetables, and fruit. Taste and convenience of added sugars and added fats can also skew Food choices in the direction of prepared and prepackaged Foods. Paradoxically, attempting to reduce diet costs may lead to the selection of energy-dense Foods, increased energy intakes, and overweight. The present energy-cost framework provides an economic explanation for the observed links between obesity and the Food Environment, with diet cost as the principal intervening variable. If higher Food costs represent both a real and perceived barrier to dietary change, especially for lower-income families, then the ability to adopt healthier diets may have less to do with psychosocial factors, self-efficacy, or readiness to change than with household economic resources and the Food Environment. Continuing to recommend costly diets to low-income families as a public health measure can only generate frustration and culpability among the poor and less-well educated. Obesity in America is, to a large extent, an economic issue.
Mary Story - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of school Food Environment policies on children s dietary behaviors a systematic review and meta analysis
PLOS ONE, 2018Co-Authors: Renata Micha, Mary Story, Dimitra Karageorgou, Ioanna Bakogianni, Eirini Trichia, Laurie P Whitsel, Jose L Penalvo, Dariush MozaffarianAbstract:Background School Food Environment policies may be a critical tool to promote healthy diets in children, yet their effectiveness remains unclear. Objective To systematically review and quantify the impact of school Food Environment policies on dietary habits, adiposity, and metabolic risk in children. Methods We systematically searched online databases for randomized or quasi-experimental interventions assessing effects of school Food Environment policies on children’s dietary habits, adiposity, or metabolic risk factors. Data were extracted independently and in duplicate, and pooled using inverse-variance random-effects meta-analysis. Habitual (within+outside school) dietary intakes were the primary outcome. Heterogeneity was explored using meta-regression and subgroup analysis. Funnel plots, Begg’s and Egger’s test evaluated potential publication bias. Results From 6,636 abstracts, 91 interventions (55 in US/Canada, 36 in Europe/New Zealand) were included, on direct provision of healthful Foods/beverages (N = 39 studies), competitive Food/beverage standards (N = 29), and school meal standards (N = 39) (some interventions assessed multiple policies). Direct provision policies, which largely targeted fruits and vegetables, increased consumption of fruits by 0.27 servings/d (n = 15 estimates (95%CI: 0.17, 0.36)) and combined fruits and vegetables by 0.28 servings/d (n = 16 (0.17, 0.40)); with a slight impact on vegetables (n = 11; 0.04 (0.01, 0.08)), and no effects on total calories (n = 6; -56 kcal/d (-174, 62)). In interventions targeting water, habitual intake was unchanged (n = 3; 0.33 glasses/d (-0.27, 0.93)). Competitive Food/beverage standards reduced sugar-sweetened beverage intake by 0.18 servings/d (n = 3 (-0.31, -0.05)); and unhealthy snacks by 0.17 servings/d (n = 2 (-0.22, -0.13)), without effects on total calories (n = 5; -79 kcal/d (-179, 21)). School meal standards (mainly lunch) increased fruit intake (n = 2; 0.76 servings/d (0.37, 1.16)) and reduced total fat (-1.49%energy; n = 6 (-2.42, -0.57)), saturated fat (n = 4; -0.93%energy (-1.15, -0.70)) and sodium (n = 4; -170 mg/d (-242, -98)); but not total calories (n = 8; -38 kcal/d (-137, 62)). In 17 studies evaluating adiposity, significant decreases were generally not identified; few studies assessed metabolic factors (blood lipids/glucose/pressure), with mixed findings. Significant sources of heterogeneity or publication bias were not identified. Conclusions Specific school Food Environment policies can improve targeted dietary behaviors; effects on adiposity and metabolic risk require further investigation. These findings inform ongoing policy discussions and debates on best practices to improve childhood dietary habits and health.
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The School Food Environment and Obesity Prevention: Progress Over the Last Decade
Current Obesity Reports, 2016Co-Authors: Emily Welker, Megan Lott, Mary StoryAbstract:The school Food Environment—including when and where children obtain Food and the types of options available during the school day—plays an important role in children’s consumption patterns. Thus, childhood obesity prevention efforts often focus on altering the school Food Environment as a mechanism for improving student dietary intake. This review examines the role school Food programs and policies play in improving children’s diet, weight, and health. Overall, research suggests that significant improvements have been made in school nutrition policies and programs. Due to the recent program changes made as a result of the 2010 Healthy, Hunger-Free Kids Act, an emphasis was placed on research conducted over the past decade and especially on the evaluation of Foods and beverages served and sold since implementation of this national law. This review also examines remaining gaps in the literature and opportunities for further improvements in school Food programs and policies.
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school lunch and snacking patterns among high school students associations with school Food Environment and policies
International Journal of Behavioral Nutrition and Physical Activity, 2005Co-Authors: Dianne Neumarksztainer, Mary Story, Simone A French, Peter J Hannan, Jayne A FulkersonAbstract:Objectives This study examined associations between high school students' lunch patterns and vending machine purchases and the school Food Environment and policies.
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soft drinks candy and fast Food what parents and teachers think about the middle school Food Environment
Journal of The American Dietetic Association, 2005Co-Authors: Martha Y Kubik, Leslie A Lytle, Mary StoryAbstract:Abstract Objective To assess the opinions and beliefs of parents and teachers of middle school students regarding the school Food Environment. Design Surveys mailed to parents and placed in teachers' school mailboxes included questions about adolescents' eating practices, Food choice at school, and school-related Food policies and practices. Subjects/settings A convenience sample of parents (n=350; response rate: 350/526=66%) and teachers (n=490; response rate: 490/701=70%) of middle school students from 16 schools in the St Paul-Minneapolis metropolitan area who participated in the Teens Eating for Energy and Nutrition at School study. Statistical analysis Descriptive statistics examined the prevalence of parents' and teachers' opinions and beliefs about adolescents' eating practices, Food choice at school, and school-related Food policies and practices. Results Most parents and teachers agreed that the nutritional health of students should be a school priority. However, only 18% of parents and 31% of teachers believed schools give adequate attention to student nutrition. Among both parents and teachers, 90% agreed that more healthy snacks and beverages should be available in school vending machines and on school a la carte lines. Conclusions Findings suggest that parents and teachers are concerned about the nutritional health of students and the "state of health" of the school Food Environment. Dietetic and other health professionals who work in school settings should actively engage parents and teachers in the process of affecting and monitoring policies and practices that foster a healthy school Food Environment.
Leslie A Lytle - One of the best experts on this subject based on the ideXlab platform.
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Measures of the Food Environment: A systematic review of the field, 2007-2015.
Health & place, 2017Co-Authors: Leslie A Lytle, Rebeccah L. SokolAbstract:Abstract Background Many studies have examined the relationship between the Food Environment and health-related outcomes, but fewer consider the integrity of measures used to assess the Food Environment. The present review builds on and makes comparisons with a previous review examining Food Environment measures and expands the previous review to include a more in depth examination of reliability and validity of measures and study designs employed. Methods We conducted a systematic review of studies measuring the Food Environment published between 2007 and 2015. We identified these articles through: PubMed, Embase, Web of Science, PsycINFO, and Global Health databases; tables of contents of relevant journals; and the National Cancer Institute’s Measures of the Food Environment website. This search yielded 11,928 citations. We retained and abstracted data from 432 studies. Results The most common methodology used to study the Food Environment was geographic analysis (65% of articles) and the domination of this methodology has persisted since the last review. Only 25.9% of studies in this review reported the reliability of measures and 28.2% reported validity, but this was an improvement as compared to the earlier review. Very few of the studies reported construct validity. Studies reporting measures of the school or worksite Environment have decreased since the previous review. Only 13.9% of the studies used a longitudinal design. Conclusions To strengthen research examining the relationship between the Food Environment and population health, there is a need for robust and psychometrically-sound measures and more sophisticated study designs.
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measures of the Food Environment a compilation of the literature 1990 2007
American Journal of Preventive Medicine, 2009Co-Authors: Robin A Mckinnon, Jill Reedy, Meredith A Morrissette, Leslie A Lytle, Amy L YarochAbstract:A structured literature search was conducted to identify peer-reviewed articles published between January 1990 and August 2007 that measured the community-level Food Environment. These articles were categorized into the following Environments: Food stores, restaurants, schools, and worksites. The measurement strategies in these studies were categorized as instruments or methodologies .Valid and reliable measures are required to assess any effect of the Food Environment on individual dietary behavior, and form the foundation of research that may inform obesity-related policy. Although many methods of measuring the Food Environment exist, this area of research is still relatively new and there has been no systematic attempt to gather these measures, to compare and contrast them, or to report on their psychometric properties. In this study, a total of 137 articles were identified that included measures of the Food Environment. Researchers focused on assessing the accessibility, availability, affordability, and quality of the Food Environment. The most frequently used measure overall was some form of geographic analysis. Eighteen of the 137 articles (13.1%) tested for any psychometric properties, including inter-rater reliability, testﾖretest reliability, and/or validity.The study concluded that a greater focus on testing for reliability and validity of measures of the Food Environment may increase rigor in research in this area. Robust measures of the Food Environment may strengthen research on the effects of the community-level Food Environment on individual dietary behavior, assist in the development and evaluation of interventions, and inform policymaking targeted at reducing the prevalence of obesity and improving diet.
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Measures of the Food Environment: a compilation of the literature, 1990-2007.
American journal of preventive medicine, 2009Co-Authors: Robin A Mckinnon, Jill Reedy, Meredith A Morrissette, Leslie A Lytle, Amy L YarochAbstract:Valid and reliable measures are required to assess any effect of the Food Environment on individual dietary behavior, and form the foundation of research that may inform obesity-related policy. Although many methods of measuring the Food Environment exist, this area of research is still relatively new and there has been no systematic attempt to gather these measures, to compare and contrast them, or to report on their psychometric properties. A structured literature search was conducted to identify peer-reviewed articles published between January 1990 and August 2007 that measured the community-level Food Environment. These articles were categorized into the following Environments: Food stores, restaurants, schools, and worksites. The measurement strategies in these studies were categorized as instruments (checklists, market baskets, inventories, or interviews/questionnaires) or methodologies (geographic, sales, menu, or nutrient analyses). A total of 137 articles were identified that included measures of the Food Environment. Researchers focused on assessing the accessibility, availability, affordability, and quality of the Food Environment. The most frequently used measure overall was some form of geographic analysis. Eighteen of the 137 articles (13.1%) tested for any psychometric properties, including inter-rater reliability, test-retest reliability, and/or validity. A greater focus on testing for reliability and validity of measures of the Food Environment may increase rigor in research in this area. Robust measures of the Food Environment may strengthen research on the effects of the community-level Food Environment on individual dietary behavior, assist in the development and evaluation of interventions, and inform policymaking targeted at reducing the prevalence of obesity and improving diet.
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Measuring the Food Environment: State of the Science
American Journal of Preventive Medicine, 2009Co-Authors: Leslie A LytleAbstract:The past decades have seen an increased interest in understanding how the Environment affects population health. In particular, public health practitioners and researchers alike are eager to know how the Food Environments of neighborhoods, schools, and worksites affect Food choices and, ultimately, population risk for obesity and other diet-related chronic disease. However, the measurement tools for assessing the Environment and the employed study designs have limited our ability to gain important ground. The field has not yet fully considered the psychometric properties of the Environmental measurement tools, or how to deal with the copious amounts of data generated from many Environmental measures. The field is dominated by research using unsophisticated study designs and has frequently failed to see the role of social and individual factors and how they interrelate with the physical Environment. This paper examines some of the measurement issues to be considered as public health practitioners and researchers attempt to understand the impact of the Food Environment on the health of communities and takes a broad look at where the science currently is with regard to how the Food Environment is measured, thoughts on what issues may benefit from more deliberate inspection, and directions for future work.
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soft drinks candy and fast Food what parents and teachers think about the middle school Food Environment
Journal of The American Dietetic Association, 2005Co-Authors: Martha Y Kubik, Leslie A Lytle, Mary StoryAbstract:Abstract Objective To assess the opinions and beliefs of parents and teachers of middle school students regarding the school Food Environment. Design Surveys mailed to parents and placed in teachers' school mailboxes included questions about adolescents' eating practices, Food choice at school, and school-related Food policies and practices. Subjects/settings A convenience sample of parents (n=350; response rate: 350/526=66%) and teachers (n=490; response rate: 490/701=70%) of middle school students from 16 schools in the St Paul-Minneapolis metropolitan area who participated in the Teens Eating for Energy and Nutrition at School study. Statistical analysis Descriptive statistics examined the prevalence of parents' and teachers' opinions and beliefs about adolescents' eating practices, Food choice at school, and school-related Food policies and practices. Results Most parents and teachers agreed that the nutritional health of students should be a school priority. However, only 18% of parents and 31% of teachers believed schools give adequate attention to student nutrition. Among both parents and teachers, 90% agreed that more healthy snacks and beverages should be available in school vending machines and on school a la carte lines. Conclusions Findings suggest that parents and teachers are concerned about the nutritional health of students and the "state of health" of the school Food Environment. Dietetic and other health professionals who work in school settings should actively engage parents and teachers in the process of affecting and monitoring policies and practices that foster a healthy school Food Environment.
Deanna M Hoelscher - One of the best experts on this subject based on the ideXlab platform.
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Socioeconomic inequalities in children's diet: the role of the home Food Environment.
The international journal of behavioral nutrition and physical activity, 2015Co-Authors: Nalini Ranjit, Anna V Wilkinson, Leslie M Lytle, Alexandra E Evans, Debra Saxton, Deanna M HoelscherAbstract:It is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy Foods and that these differences in consumption patterns are influenced by neighborhood Food Environments. Less understood is the role that SES differences in physical and social aspects of the home Food Environment play in consumption patterns. Using data on 4th grade children from the 2009-2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home Food Environment, and measures of the neighborhood Environment accounted for these SES differences. Small but significant differences in children’s SHEI by SES strata exist (-1.33 between highest and lowest SES categories, p<0.01). However, incorporating home Food Environment and neighborhood Environment measures in this model eliminates these differences (-0.7, p=0.145). Home Food Environment explains a greater portion of the difference. Both social (mealtime structure) and physical aspects (Food availability) of the home Food Environment are strongly associated with consumption of healthy and unhealthy Foods. Our findings suggest that modifiable parent behaviors at home can improve children’s eating habits and that the neighborhood may impact diet in ways other than through access to healthy Food.
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Socioeconomic inequalities in children’s diet: the role of the home Food Environment
International Journal of Behavioral Nutrition and Physical Activity, 2015Co-Authors: Nalini Ranjit, Anna V Wilkinson, Leslie M Lytle, Alexandra E Evans, Debra Saxton, Deanna M HoelscherAbstract:It is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy Foods and that these differences in consumption patterns are influenced by neighborhood Food Environments. Less understood is the role that SES differences in physical and social aspects of the home Food Environment play in consumption patterns. Using data on 4th grade children from the 2009–2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home Food Environment, and measures of the neighborhood Environment accounted for these SES differences. Small but significant differences in children’s SHEI by SES strata exist (-1.33 between highest and lowest SES categories, p
Lukar E Thornton - One of the best experts on this subject based on the ideXlab platform.
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The use and misuse of ratio and proportion exposure measures in Food Environment research.
The international journal of behavioral nutrition and physical activity, 2020Co-Authors: Lukar E Thornton, Karen E. Lamb, Simon R. WhiteAbstract:The Food stores within residential Environments are increasingly investigated as a possible mechanism driving Food behaviours and health outcomes. Whilst increased emphasis is being placed on the type of study designs used and how we measure the outcomes, surprisingly little attention gets diverted to the measures of the Food Environment beyond calls for standardised approaches for Food store coding and geographic scales of exposure. Food Environments are a challenging concept to measure and model and the use of ratio and proportion measures are becoming more common in Food Environment research. Whilst these are seemingly an advance on single store type indicators, such as simply counting the number of supermarkets or fast Food restaurants present, they have several limitations that do not appear to have been fully considered. In this article we report on five issues related to the use of ratio and proportion Food Environment measures: 1) binary categorisation of Food stores; 2) whether they truly reflect a more or less healthy Food Environment; 3) issues with these measures not reflecting the quantity of Food stores; 4) difficulties when no stores are present; and 5) complications in statistical treatment and interpretation of ratio and proportion measures. Each of these issues are underappreciated in the literature to date and highlight that ratio and proportion measures need to be treated with caution. Calls for the broader adoption of relative Food Environment measures may be misguided. Whilst we should continue to search for better ways to represent the complexity of Food Environments, ratio and proportion measures are unlikely to be the answer.
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effect of changes to the school Food Environment on eating behaviours and or body weight in children a systematic review
Obesity Reviews, 2014Co-Authors: C E Driessen, Lukar E Thornton, Adrian J Cameron, Samuel K Lai, Lisa M BarnettAbstract:Previous school obesity-prevention reviews have included multi-component interventions. Here, we aimed to review the evidence for the effect of isolated Food Environment interventions on both eating behaviours (including Food purchasing) and/or body weight. Five electronic databases were searched (last updated 30 November 2013). Of the 1,002 unique papers identified, 55 reported on school Food Environment changes, based on a review of titles and abstracts. Thirty-seven further papers were excluded, for not meeting the inclusion criteria. The final selection consisted of 18 papers (14 United States, 4 United Kingdom). Two studies had a body mass index (BMI) outcome, 14 assessed purchasing or eating behaviours and two studies assessed both weight and behaviour. Seventeen of 18 papers reported a positive outcome on either BMI (or change in BMI) or the healthfulness of Food sold or consumed. Two studies were rated as strong quality and 11 as weak. Only three studies included a control group. A school Environment supportive of healthy eating is essential to combat heavy marketing of unhealthy Food. Modification of the school Food Environment (including high-level policy changes at state or national level) can have a positive impact on eating behaviours. A need exists, however, for further high-quality studies.
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Association between fast Food purchasing and the local Food Environment
Nutrition & diabetes, 2012Co-Authors: Lukar E Thornton, Anne M KavanaghAbstract:In this study, an instrument was created to measure the healthy and unhealthy characteristics of Food Environments and investigate associations between the whole of the Food Environment and fast Food consumption. In consultation with other academic researchers in this field, Food stores were categorised to either healthy or unhealthy and weighted (between +10 and −10) by their likely contribution to healthy/unhealthy eating practices. A healthy and unhealthy Food Environment score (FES) was created using these weightings. Using a cross-sectional study design, multilevel multinomial regression was used to estimate the effects of the whole Food Environment on the fast Food purchasing habits of 2547 individuals. Respondents in areas with the highest tertile of the healthy FES had a lower likelihood of purchasing fast Food both infrequently and frequently compared with respondents who never purchased, however only infrequent purchasing remained significant when simultaneously modelled with the unhealthy FES (odds ratio (OR) 0.52; 95% confidence interval (CI) 0.32–0.83). Although a lower likelihood of frequent fast Food purchasing was also associated with living in the highest tertile of the unhealthy FES, no association remained once the healthy FES was included in the models. In our binary models, respondents living in areas with a higher unhealthy FES than healthy FES were more likely to purchase fast Food infrequently (OR 1.35; 95% CI 1.00–1.82) however no association was found for frequent purchasing. Our study provides some evidence to suggest that healthier Food Environments may discourage fast Food purchasing.
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association between fast Food purchasing and the local Food Environment
Nutrition & Diabetes, 2012Co-Authors: Lukar E Thornton, Anne M KavanaghAbstract:OBJECTIVE: In this study, an instrument was created to measure the healthy and unhealthy characteristics of Food Environments and investigate associations between the whole of the Food Environment and fast Food consumption. DESIGN AND SUBJECTS: In consultation with other academic researchers in this field, Food stores were categorised to either healthy or unhealthy and weighted (between +10 and -10) by their likely contribution to healthy/unhealthy eating practices. A healthy and unhealthy Food Environment score (FES) was created using these weightings. Using a cross-sectional study design, multilevel multinomial regression was used to estimate the effects of the whole Food Environment on the fast Food purchasing habits of 2547 individuals. RESULTS: Respondents in areas with the highest tertile of the healthy FES had a lower likelihood of purchasing fast Food both infrequently and frequently compared with respondents who never purchased, however only infrequent purchasing remained significant when simultaneously modelled with the unhealthy FES (odds ratio (OR) 0.52; 95% confidence interval (CI) 0.32-0.83). Although a lower likelihood of frequent fast Food purchasing was also associated with living in the highest tertile of the unhealthy FES, no association remained once the healthy FES was included in the models. In our binary models, respondents living in areas with a higher unhealthy FES than healthy FES were more likely to purchase fast Food infrequently (OR 1.35; 95% CI 1.00-1.82) however no association was found for frequent purchasing. CONCLUSION: Our study provides some evidence to suggest that healthier Food Environments may discourage fast Food purchasing.
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Is the objective Food Environment associated with perceptions of the Food Environment
Public Health Nutrition, 2011Co-Authors: Lauren K. Williams, Lukar E Thornton, Kylie Ball, David CrawfordAbstract:Objective The present study examined whether objective measures of the Food Environment are associated with perceptions of the Food Environment and whether this relationship varies by socio-economic disadvantage. Design The study is a cross-sectional analysis of self-report surveys and objective Environment data. Women reported their perceptions on the nutrition Environment. Participants’ homes and Food stores were geocoded to measure the objective community nutrition Environment. Data on the average price and variety of fruit and vegetables were used to measure the objective consumer nutrition Environment. Setting The study was conducted in Melbourne, Australia, in 2003–2004. Subjects Data presented are from a sample of 1393 women aged 18–65 years. Results Overall the match between the perceived and objective Environment was poor, underscoring the limitations in using perceptions of the Environment as a proxy for the objective Environment. Socio-economic disadvantage had limited impact on the relationship between perceived and objective nutrition Environment. Conclusions Further research is needed to understand the determinants of perceptions of the nutrition Environment to enhance our understanding of the role of perceptions in nutrition choices and drivers of socio-economic inequalities in nutrition.