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Bascuñán KA, Rodríguez JM, Osben C, Fernández A, Sepúlveda C, Araya M. Pandemic Effects and Gluten-Free Diet: An Adherence and Mental Health Problem. Nutrients 2021; 13:nu13061822. [PMID: 34071870 PMCID: PMC8229361 DOI: 10.3390/nu13061822] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/28/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has been present for many months, influencing diets such as the gluten-free diet (GFD), which implies daily challenges even in non-pandemic conditions. Persons following the GFD were invited to answer online ad hoc and validated questionnaires characterizing self-perceptions of the pandemic, current clinical condition, dietary characteristics, adherence to GFD, anxiety, and depression. Of 331 participants, 87% experienced shortage and higher cost of food and 14.8% lost their jobs. Symptoms increased in 29% and 36.6% failed to obtain medical help. Although 52.3% increased food preparation at home and purchased alternative foodstuffs, 53.8% had consumed gluten-containing foods. The Health Eating Index was intermediate/"needs improvement" (mean 65.6 ± 13.3 points); in 49.9% (perception) and 44.4% (questionnaire), adherence was "bad". Anxiety and depression scores were above the cutoff in 28% and 40.4%, respectively. Adherence and mental health were strongly related. The likelihood of poor adherence was 2.3 times higher (p < 0.004) in participants declaring that pandemic altered GFD. Those suffering depressive symptoms were 1.3 times more likely to have poor adherence (p < 0.000). Depression and faulty GFD (mandatory for treatment) appear, affecting a high proportion of participants, suggesting that support measures aimed at these aspects would help improve the health condition of people that maintain GFD. Comparisons of data currently appearing in the literature available should be cautious because not only cultural aspects but conditions and timing of data collection are most variable.
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Affiliation(s)
- Karla A. Bascuñán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile; (K.A.B.); (J.M.R.); (C.O.); (A.F.); (C.S.)
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago 8380453, Chile
| | - Juan Manuel Rodríguez
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile; (K.A.B.); (J.M.R.); (C.O.); (A.F.); (C.S.)
| | - Carla Osben
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile; (K.A.B.); (J.M.R.); (C.O.); (A.F.); (C.S.)
| | - Alan Fernández
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile; (K.A.B.); (J.M.R.); (C.O.); (A.F.); (C.S.)
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago 8380453, Chile
| | - Carlos Sepúlveda
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile; (K.A.B.); (J.M.R.); (C.O.); (A.F.); (C.S.)
- Laboratorio de Ciencias del Ejercicio, Clínica Meds, Santiago 7500000, Chile
| | - Magdalena Araya
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago 7810000, Chile; (K.A.B.); (J.M.R.); (C.O.); (A.F.); (C.S.)
- Corporación de Apoyo al Celíaco (COACEL), Santiago 7810000, Chile
- Correspondence: ; Tel.: +56-9-95395667
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Clemens KK, Le B, Anderson KK, Shariff SZ. Childhood food insecurity and incident diabetes: A longitudinal cohort study of 34 042 children in Ontario, Canada. Diabet Med 2021; 38:e14396. [PMID: 32876966 DOI: 10.1111/dme.14396] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/12/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022]
Abstract
AIM To examine the association between childhood food insecurity and incident diabetes. METHODS Using health administrative databases linked to the Canadian Community Health Survey, we conducted a population-based cohort study of children aged <18 years from Ontario, Canada. Children without diabetes who had a household response to the Canadian Community Health Survey Household Food Security Survey Module were followed for a median of 9.5 years for incident diabetes. Multivariable Cox proportional hazards models were used to examine the association between childhood food insecurity and incident diabetes, adjusted sequentially for important clinical and socio-economic risk factors. RESULTS We included 34 042 children, of whom 5.3% lived in food-insecure households. There were 184 new cases of diabetes, diagnosed at a median age of 16 and 18.5 years in food-secure and food-insecure children, respectively. In unadjusted analysis, childhood food insecurity was associated with an increased risk of incident diabetes (hazard ratio 1.69, 95% CI 1.01 to 2.81). When adjusted for clinical and socio-economic confounders, the relationship was no longer statistically significant (hazard ratio 1.55, 95% CI 0.91 to 2.66, adjusted for clinical confounders; hazard ratio 1.30, 95% CI 0.72 to 2.37, adjusted for clinical/socio-economic confounders). Our results remained robust in sensitivity analyses. CONCLUSIONS Although food-insecure children are a medically and socially vulnerable population, they do not appear to be at increased risk of incident diabetes over a median of 9.5 years.
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Affiliation(s)
- K K Clemens
- Department of Medicine, Division of Endocrinology and Metabolism, London, ON, Canada
- Department of Epidemiology and Biostatistics, London, ON, Canada
- ICES, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Centre for Diabetes, Endocrinology and Metabolism, St Joseph's Hospital, London, ON, Canada
| | | | - K K Anderson
- Department of Epidemiology and Biostatistics, London, ON, Canada
- ICES, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - S Z Shariff
- ICES, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
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Li J, Verteramo Chiu LJ, Gómez MI, Bills NL. Strategies to reduce risk perception among grocery shoppers in the US: A survey study. PLoS One 2021; 16:e0251060. [PMID: 33909663 PMCID: PMC8081199 DOI: 10.1371/journal.pone.0251060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 04/19/2021] [Indexed: 02/04/2023] Open
Abstract
During the COVID-19 lockdown in the US, many businesses were shut down temporarily. Essential businesses, most prominently grocery stores, remained open to ensure access to food and household essentials. Grocery shopping presents increased potential for COVID-19 infection because customers and store employees are in proximity to each other. This study investigated shoppers' perceptions of COVID-19 infection risks and put them in context by comparing grocery shopping to other activities outside home, and examined whether a proactive preventive action by grocery stores influence shoppers' perceived risk of COVID-19 infection. Our data were obtained via an anonymous online survey distributed between April 2 and 10, 2020 to grocery shoppers in New York State (the most affected by the pandemic at the time of the study) and Washington State (the first affected by the pandemic). We found significant factors associated with high levels of risk perception on grocery shoppers. We identified some effective preventive actions that grocery stores implement to alleviate anxiety and risk perception. We found that people are generally more concerned about in-store grocery shopping relative to other out-of-home activities. Findings suggest that a strict policy requiring grocery store employees to use facemasks and gloves greatly reduced shoppers' perceived risk rating of infection of themselves by 37.5% and store employees by 51.2%. Preventive actions by customers and businesses are critical to reducing the unwitting transmission of COVID-19 as state governments prepare to reopen the economy and relax restrictions on activities outside home.
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Affiliation(s)
- Jie Li
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, United States of America
| | - Leslie J. Verteramo Chiu
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, United States of America
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, United States of America
| | - Miguel I. Gómez
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, United States of America
| | - Nelson L. Bills
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, United States of America
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Abstract
There is no agreement regarding the role of fresh fruit and vegetables’ affordability, accessibility and availability, or access in general, on obesity rates. In this article we investigated whether access to fresh fruit and vegetables is related to better biometric indicators such as weight and body mass index. Using mediation and matching methods and assuming that farmers and traditional market sellers have easy access to fruit and vegetables, we found that having better access is not associated to a reduction in weight or body mass index. Potential explanations for this result are that better access was not associated with fresh fruit and vegetables’ consumption and fruit and vegetables’ consumption was not associated with weight and body mass index. Also, fresh fruit and vegetables’ sellers had a higher weight and body mass index compared to the rest of the population but, a similar weight and body mass index compared to people with their same educational level. Therefore, variations on weight and body mass index were more associated with educational level rather than with access. Access may not be the single story to explain fruit and vegetable consumption.
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Affiliation(s)
- Andres Silva
- Department of Economics, Government and Communication, Universidad Central de Chile, Santiago, Chile
- * E-mail:
| | - Pilar Jano
- Business School and Center of Economics and Regional Policy (CEPR), Universidad Adolfo Ibáñez, Viña del Mar, Chile
| | - Nicolás Von Hausen
- Analysis Unit, Servicio Nacional de Capacitación y Empleo, Ministerio del Trabajo, Santiago, Chile
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Nieman CM, Rudman AN, Chory ML, Murray GD, Fairbanks L, Campbell LM. Fishing for food: Values and benefits associated with coastal infrastructure. PLoS One 2021; 16:e0249725. [PMID: 33857188 PMCID: PMC8049240 DOI: 10.1371/journal.pone.0249725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/23/2021] [Indexed: 11/19/2022] Open
Abstract
While there is substantial literature about the socio-cultural characteristics and values associated with recreational and commercial fisheries in the U.S., studies directed at those who ‘fish for food’—those who depend on consuming their catch to various degrees—are relatively sparse. Using qualitative data collected through 80 semi-structured interviews with fishers in the summer and fall of 2018 in Carteret County, North Carolina, this study aims to better understand the group of recreational fishers who consume their catch by describing social and cultural dimensions and values associated with fishing for food, examining the role of infrastructure in facilitating access to benefits associated with this activity, and considering how knowledge of existing licensing regulations surrounding subsistence license waivers affect this fishing community. Interviews conducted at free public fishing structures in the region revealed that fishers derive a variety of values and benefits from fishing at these sites, including access to recreation, nutrition, a social community, and mental health benefits, which were found to be negatively impacted by Hurricane Florence in September 2018. We also found an informal economy of sharing catch on- and off-site that extends the reach and benefits facilitated by public infrastructure to people beyond those using it directly. Overall, we call for conceptualizations of ‘fishing for food’ that include aspects that go beyond traditional definitions of ‘subsistence’ or ‘recreational’ fishing such as food security, access, and less obvious social and cultural motivations behind the activity. These findings are a compelling rationalization for the creation and maintenance of formal and informal fishing places locally and, by extension, in other coastal areas, given the array of benefits provided by access to these types of locations.
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Affiliation(s)
- Cassandra M. Nieman
- Duke University Marine Lab, Nicholas School of the Environment, Duke University, Beaufort, North Carolina, United States of America
- Oak Ridge Institute for Science and Education, Environmental Protection Agency, Washington, DC, United States of America
| | - Alexie N. Rudman
- Duke University Marine Lab, Nicholas School of the Environment, Duke University, Beaufort, North Carolina, United States of America
- * E-mail:
| | - Margaret L. Chory
- Duke University Marine Lab, Nicholas School of the Environment, Duke University, Beaufort, North Carolina, United States of America
| | - Grant D. Murray
- Duke University Marine Lab, Nicholas School of the Environment, Duke University, Beaufort, North Carolina, United States of America
| | - Luke Fairbanks
- Division of Coastal Sciences, School of Ocean Science and Engineering, The University of Southern Mississippi, Ocean Springs, Mississippi, United States of America
| | - Lisa M. Campbell
- Duke University Marine Lab, Nicholas School of the Environment, Duke University, Beaufort, North Carolina, United States of America
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Sharma A, Abbas H, Siddiqui MQ. Modelling the inhibitors of cold supply chain using fuzzy interpretive structural modeling and fuzzy MICMAC analysis. PLoS One 2021; 16:e0249046. [PMID: 33848286 PMCID: PMC8043388 DOI: 10.1371/journal.pone.0249046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/09/2021] [Indexed: 11/19/2022] Open
Abstract
The Cold Supply Chain (CSC) is an integral part of the supply chain of perishable products. The aim of this research is to examine the inhibitors that have a major impact on the performance of CSC operations in the United Arab Emirates (UAE). This study provides a synthesis and suggests a hierarchical model among CSC inhibitors and their respective relevance. The hierarchical synthesis of twelve (12) primary CSC inhibitors is achieved through a comprehensive literature review and consultation with academics and CSC professionals. This study used semi-structured interviews, a fuzzy interpretive structural modeling (FISM) and a Fuzzy-MICMAC (FMICMAC) analysis to explore and establish the relationship between and among identified inhibitors. FISM is used to examine the interaction between inhibitors, while FMICMAC analysis is used to examine the nature of inhibitors on the basis of their dependence and driving power. The results of the FISM and FMICMAC analysis show the inter-relationships and relative dominance of identified inhibitors. The results show that some inhibitors are of high strategic importance due to their high driving power and low dependence. These inhibitors seek more management attention in order to improve their effectiveness. The result of a hierarchical model helps to understand the influence of a particular inhibitor on others. 'Higher capital and operating costs' occupy the highest level in the FISM model. The 'fragmented cold supply chains', 'lack of skilled labor', 'inadequate information system infrastructure' and 'lack of commitment by top level management' had strong driving power but weak dependence, which characterizes them as independent inhibitors. Management should be extra careful when dealing with these inhibitors as they influence the effects of other variables at the top of the FISM hierarchy in the overall management of the cold supply chain. The study also suggests a number of recommendations for addressing these inhibitors in cold supply chains operating in the UAE. With due attention and care for these inhibitors, the operation of the cold supply chains is likely to be even more successful.
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Affiliation(s)
- Anshuman Sharma
- College of Business Administration, Ajman University, Ajman, United Arab Emirates
| | - Haidar Abbas
- Salalah College of Applied Sciences, University of Technology and Applied Sciences, Salalah, Oman
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Leung CW, Wolfson JA. Food Insecurity Among Older Adults: 10-Year National Trends and Associations with Diet Quality. J Am Geriatr Soc 2021; 69:964-971. [PMID: 33403662 PMCID: PMC8341441 DOI: 10.1111/jgs.16971] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/28/2020] [Accepted: 11/11/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND/OBJECTIVES Food insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of the present study were to: (1) examine national trends in food insecurity across a 10-year period, and (2) evaluate the associations between food insecurity and multiple diet quality indices in a recent and nationally representative sample of adults aged 60 or older. DESIGN Cross-sectional analysis of the 2007-2016 National Health and Nutrition Examination Surveys. SETTING Nationally representative sample of the United States. PARTICIPANTS The analytic sample was comprised of 5,097 adults aged 60 or older, with household incomes at or below 300% of the federal poverty level. MEASUREMENTS Household food security was measured using the 18-item US Household Food Security Survey Module. Diet was assessed using two 24-hour dietary recalls. Multivariate linear and logistic regression models examined the associations between household food security and three evidence-based diet quality indices, adjusting for sociodemographic and health characteristics. RESULTS Across the 10-year period, food insecurity increased significantly from 5.5% to 12.4% among older adults; this increase was more pronounced among lower-income older adults. From the linear regression models, food insecurity was associated with lower scores on the Healthy Eating Index (β = -1.90, 95% confidence interval (CI) = -3.70, -0.09), the Alternate Healthy Eating Index-2010 (β = -1.47, 95% CI = -2.51, -0.44), and the Mediterranean Diet Score (β = -0.54, 95% CI = -1.06, -0.01) after multivariate adjustment. Further adjustment for the presence of chronic medical conditions did not attenuate these results. CONCLUSION Food insecurity is associated with lower overall diet quality among older adults, supporting the need for clinical efforts to identify those at risk of food insecurity and public health efforts to alleviate food insecurity and promote healthy eating behaviors among older adults.
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Affiliation(s)
- Cindy W Leung
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Julia A Wolfson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Nasaruddin N, Jinap S, Samsudin NI, Kamarulzaman NH, Sanny M. Prevalence of mycotoxigenic fungi and assessment of aflatoxin contamination: a multiple case study along the integrated corn-based poultry feed supply chain in Malaysia. J Sci Food Agric 2021; 101:1812-1821. [PMID: 32893877 DOI: 10.1002/jsfa.10795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/19/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Corn, a main feed ingredient in the livestock industry, is one of the most susceptible crops to fungal infection and aflatoxin contamination. Livestock feeding on aflatoxin (AF)-contaminated feed have been shown to experience feed refusal, and decreased growth rate, milk production, and feed efficiency. In poultry, AF poisoning causes weight loss, poor feed efficiency, and reduced egg production and egg weight. The present work therefore aimed to determine the prevalence of mycotoxigenic fungi and the occurrence of AF contamination along the integrated corn-based poultry feed supply chain in Malaysia. A total of 51 samples were collected from different points along the feed supply chain from integrated poultry feed companies. The samples were subjected to mycological analyses (fungal isolation, enumeration, identification), and AFs were quantified by high-performance liquid chromatography equipped with a fluorescence detector (HPLC-FLD). RESULTS Samples collected from sampling point 1 (company A) and sampling point 9 (company B) yielded the highest total fungal load (>log 4 CFU g-1 ). The prevalent fungal genera isolated were Aspergillus, Fusarium, and Penicillium spp. Aflatoxin B1 was detected in 8.3% of corn samples, and 7.4% of corn-based poultry feed samples along the feed supply chain, whereas AFs B2 , G1 , and G2 were not detected. CONCLUSION The incidence of mycotoxigenic fungi along the integrated poultry feed supply chain warrant continuous monitoring of mycotoxin contamination to reduce the exposure risk of mycotoxin intake in poultry. © 2020 Society of Chemical Industry.
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Affiliation(s)
- Norafidah Nasaruddin
- Laboratory of Food Safety and Food Integrity, Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Malaysia
| | - Selamat Jinap
- Laboratory of Food Safety and Food Integrity, Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nik Ip Samsudin
- Laboratory of Food Safety and Food Integrity, Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nitty H Kamarulzaman
- Laboratory of Halal Policy and Management, Halal Products Research Institute, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Agribusiness and Bioresource Economics, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Malaysia
| | - Maimunah Sanny
- Laboratory of Food Safety and Food Integrity, Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia
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Jilcott Pitts SB, Wu Q, Truesdale KP, Rafferty AP, Haynes-Maslow L, Boys KA, McGuirt JT, Fleischhacker S, Johnson N, Kaur AP, Bell RA, Ammerman AS, Laska MN. A four-year observational study to examine the dietary impact of the North Carolina Healthy Food Small Retailer Program, 2017-2020. Int J Behav Nutr Phys Act 2021; 18:44. [PMID: 33761952 PMCID: PMC7990380 DOI: 10.1186/s12966-021-01109-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The North Carolina (NC) Healthy Food Small Retailer Program (HFSRP) was passed into law with a $250,000 appropriation (2016-2018) providing up to $25,000 in funding to small food stores for equipment to stock healthier foods and beverages. This paper describes an observational natural experiment documenting the impact of the HFSRP on store food environments, customers' purchases and diets. METHODS Using store observations and intercept surveys from cross-sectional, convenience customer samples (1261 customers in 22 stores, 2017-2020; 499 customers in 7 HFSRP stores, and 762 customers in 15 Comparison stores), we examined differences between HFSRP and comparison stores regarding: (1) change in store-level availability, quality, and price of healthy foods/beverages; (2) change in healthfulness of observed food and beverage purchases ("bag checks"); and, (3) change in self-reported and objectively-measured (Veggie Meter®-assessed skin carotenoids) customer dietary behaviors. Differences (HFSRP vs. comparison stores) in store-level Healthy Food Supply (HFS) and Healthy Eating Index-2010 scores were assessed using repeated measure ANOVA. Intervention effects on diet were assessed using difference-in-difference models including propensity scores. RESULTS There were improvements in store-level supply of healthier foods/beverages within 1 year of program implementation (0 vs. 1-12 month HFS scores; p = 0.055) among HFSRP stores only. Comparing 2019 to 2017 (baseline), HFSRP stores' HFS increased, but decreased in comparison stores (p = 0.031). Findings indicated a borderline significant effect of the intervention on self-reported fruit and vegetable intake (servings/day), though in the opposite direction expected, such that fruit and vegetable intake increased more among comparison store than HFSRP store customers (p = 0.05). There was no significant change in Veggie Meter®-assessed fruit and vegetable intake by customers shopping at the intervention versus comparison stores. CONCLUSIONS Despite improvement in healthy food availability, there was a lack of apparent impact on dietary behaviors related to the HFSRP, which could be due to intervention dose or inadequate statistical power due to the serial cross-sectional study design. It may also be that individuals buy most of their food at larger stores; thus, small store interventions may have limited impact on overall eating patterns. Future healthy retail policies should consider how to increase intervention dose to include more product marketing, consumer messaging, and technical assistance for store owners.
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Affiliation(s)
- Stephanie B. Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834 USA
| | - Qiang Wu
- Department of Biostatistics, East Carolina University, Greenville, NC 27834 USA
| | - Kimberly P. Truesdale
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Healthy Weight Research Center, University of Minnesota School of Public Health, Minneapolis, MN 55454 USA
| | - Ann P. Rafferty
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834 USA
| | - Lindsey Haynes-Maslow
- Department of Agricultural & Human Sciences, North Carolina State University, Raleigh, 27695 USA
| | - Kathryn A. Boys
- Department of Agricultural & Resource Economics, North Carolina State University, Raleigh, 27695 USA
| | - Jared T. McGuirt
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, 27412 NC USA
| | | | - Nevin Johnson
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834 USA
| | - Archana P. Kaur
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834 USA
| | - Ronny A. Bell
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, 27157 USA
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC 27157 USA
| | - Alice S. Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Melissa N. Laska
- Healthy Weight Research Center, University of Minnesota School of Public Health, Minneapolis, MN 55454 USA
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Pradhan A, S. R, D. J. N, Panda AK, Wagh RD, Maske MR, R. V. B. Farming System for Nutrition-a pathway to dietary diversity: Evidence from India. PLoS One 2021; 16:e0248698. [PMID: 33735281 PMCID: PMC7971902 DOI: 10.1371/journal.pone.0248698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/03/2021] [Indexed: 11/18/2022] Open
Abstract
Farming is the main livelihood of a majority of people in India. The country is also home to a large population of undernourished people. This indicates potential for mainstreaming the nutrition dimension in the farming system to impact on nutrition outcomes. A Farming System for Nutrition (FSN) study was conducted in two agro-ecologically different locations from 2013-2018, to explore the feasibility of nutrition-sensitive agricultural interventions. The baseline survey in 2013-2014 revealed that the population in the study area was largely undernourished and that household diets were cereal-dominated. The FSN model was designed in consultation with community members, to increase availability of nutrient-dense cereals and pulses, by enhancing production and crop diversification at the farm level, promoting cultivation of nutrient-rich fruits and vegetables in nutrition gardens and supporting interventions to promote access to animal foods. Nutrition awareness initiatives were undertaken to build capacity at the local level and translate production diversity to consumption diversity. An endline survey was conducted in 2017 (July-October), following three years of intervention. Crop, vegetable and animal food production and food consumption was compared with the baseline data. There was evidence of higher production and consumption of nutrient rich foods, improved household dietary diversity; and understanding and acceptance of nutrition-sensitive agriculture. The number of items consumed under each food group, frequency of consumption of food and average per capita intake of nutrient-rich foods were found to have improved. The results provide evidence regarding feasibility of location-specific FSN models to promote sustainable and healthy diets, using locally available plant and animal food resources, to address nutrition deficiencies in farm families.
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Affiliation(s)
- Aliza Pradhan
- ICAR-National Institute of Abiotic Stress Management, Baramati, Pune, India
| | - Raju S.
- M. S. Swaminathan Research Foundation (MSSRF), Taramani, Chennai, India
| | - Nithya D. J.
- M. S. Swaminathan Research Foundation (MSSRF), Taramani, Chennai, India
| | | | | | | | - Bhavani R. V.
- M. S. Swaminathan Research Foundation (MSSRF), Taramani, Chennai, India
- * E-mail:
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Kang MG, Yook SM, Hwang JY. Is It What They Eat or How Much They Eat That Matters More in Adults with Food Insecurity in a Wealthy-Country Context? Nutrients 2021; 13:851. [PMID: 33807652 PMCID: PMC7999059 DOI: 10.3390/nu13030851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022] Open
Abstract
This study aimed to investigate whether dietary quantity and/or quality differ according to food security levels in the Korean adult population. Dietary adequacy and quality were evaluated by the Korean Dietary Reference Intake and the Korean Healthy Eating Index (KHEI) for adults, respectively, according to three food security levels, i.e., food security, low food security, and very low food security. A total of 7144 Korean adults (aged 19 to 64 years) were selected from cross-sectional data from the 2013-2015 Korean National Health and Nutrition Examination Surveys. The risk of inadequate nutrient intakes of protein (p trend = 0.021) and phosphorus (p trend = 0.002) increased according to food insecurity levels after adjustment for putative risk factors. The total KHEI scores (p < 0.001) as well as scores of having breakfast (p < 0.001) were lowest in the very low food security group. Among KHEI components, adults with food insecurity were less likely to get full scores from intakes of mixed grains (p trend = 0.016), total fruit (p trend = 0.039), fresh fruit (p trend = 0.043), and breakfast (p trend < 0.001). In addition, food-insecure adults were more likely to get zero score from intakes of fresh fruit (p trend = 0.020), milk and dairy products (p trend = 0.049), breakfast (p trend < 0.001), % of energy from sweets and beverages (p trend = 0.002), and total energy (p trend = 0.033). In conclusion, food security levels were associated with how much they ate, as well what they ate, in adults in South Korea. These results implied that the diet adequacy as well as moderation and balance could be carefully treated with food assistance or nutrition intervention once nutritional adequacy has mostly been met. In addition, targeted intervention programs tailored to diverse contexts for improving food insecurity may prevent unintended consequences due to easy access to inexpensive obesogenic foods in adults with food insecurity.
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Affiliation(s)
- Min Gyeong Kang
- Nutrition Education Major, Graduate School of Education, Sangmyung University, Seoul 03016, Korea;
| | - Sung-Min Yook
- Department of Foodservice Management and Nutrition, Graduate School, Sangmyung University, Seoul 03016, Korea;
| | - Ji-Yun Hwang
- Major of Foodservice Management and Nutrition, Sangmyung University, Seoul 03016, Korea
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Tuthill EL, Maltby A, Conteh J, Sheira LA, Miller JD, Onono M, Weiser SD, Young SL. Persistent Food Insecurity, but not HIV, is Associated with Depressive Symptoms Among Perinatal Women in Kenya: A Longitudinal Perspective. AIDS Behav 2021; 25:847-855. [PMID: 32989575 PMCID: PMC7886965 DOI: 10.1007/s10461-020-03047-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 02/06/2023]
Abstract
Food insecurity (FI) is an understudied risk factor for depression among perinatal women in sub-Saharan Africa. We therefore explored the longitudinal relationship between FI and depressive symptoms among a cohort of perinatal women of mixed HIV status (n = 371) in Kenya (NCT02974972, NCT02979418). Using longitudinal linear and logistic regressions with random effects, we assessed bivariate and adjusted associations between maternal FI and depressive symptoms. HIV status was also assessed as a potential effect modifier. At baseline, 58% of pregnant women had probable depression (CES-D score > 16) and 84% were severely food insecure. In adjusted analyses, severely food-insecure women had 5.90 greater odds (95% CI 2.32, 15.02, p < 0.001) of having probable depression and scored 4.58 points higher on the CES-D scale (SE: 1.04, p < 0.001) relative to food-secure women. HIV status did not modify the association between FI and depressive symptoms. Interventions to reduce FI may reduce perinatal depression, benefiting mothers and their infants.
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Affiliation(s)
- Emily L Tuthill
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Ann Maltby
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Jalang Conteh
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Lila A Sheira
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Joshua D Miller
- Department of Anthropology, Northwestern University, 1819 Hinman Ave., Evanston, IL, 60208, USA
| | - Maricianah Onono
- Kenya Medical Research Institute- Center for Microbiology Research, Nairobi, Kenya
| | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sera L Young
- Department of Anthropology, Northwestern University, 1819 Hinman Ave., Evanston, IL, 60208, USA.
- Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL, 60208-4100, USA.
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Ohri-Vachaspati P, Acciai F, Lloyd K, Tulloch D, DeWeese RS, DeLia D, Todd M, Yedidia MJ. Evidence That Changes in Community Food Environments Lead to Changes in Children's Weight: Results from a Longitudinal Prospective Cohort Study. J Acad Nutr Diet 2021; 121:419-434.e9. [PMID: 33309589 PMCID: PMC8742245 DOI: 10.1016/j.jand.2020.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/22/2020] [Accepted: 10/14/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Strategies to improve the community food environment have been recommended for addressing childhood obesity, but evidence substantiating their effectiveness is limited. OBJECTIVE Our aim was to examine the impact of changes in availability of key features of the community food environment, such as supermarkets, small grocery stores, convenience stores, upgraded convenience stores, pharmacies, and limited service restaurants, on changes in children's body mass index z scores (zBMIs). DESIGN We conducted a longitudinal cohort study. PARTICIPANTS/SETTING Two cohorts of 3- to 15-year-old children living in 4 low-income New Jersey cities were followed during 2- to 5-year periods from 2009 through 2017. Data on weight status were collected at 2 time points (T1 and T2) from each cohort; data on food outlets in the 4 cities and within a 1-mile buffer around each city were collected multiple times between T1 and T2. MAIN OUTCOME MEASURES We measured change in children's zBMIs between T1 and T2. STATISTICAL ANALYSIS Changes in the food environment were conceptualized as exposure to changes in counts of food outlets across varying proximities (0.25 mile, 0.5 mile, and 1.0 mile) around a child's home, over different lengths of time a child was exposed to these changes before T2 (12 months, 18 months, and 24 months). Multivariate models examined patterns in relationships between changes in zBMI and changes in the food environment. RESULTS Increased zBMIs were observed in children with greater exposure to convenience stores over time, with a consistent pattern of significant associations across varying proximities and lengths of exposure. For example, exposure to an additional convenience store over 24 months within 1 mile of a child's home resulted in 11.7% higher odds (P = 0.007) of a child being in a higher zBMI change category at T2. Lower zBMIs were observed in children with increased exposure to small grocery stores selling an array of healthy items, with exposure to an additional small grocery store within 1 mile over 24 months, resulting in 37.3% lower odds (P < 0.05) of being in a higher zBMI change category at T2. No consistent patterns were observed for changes in exposure to supermarkets, limited service restaurants, or pharmacies. CONCLUSIONS Increased availability of small grocery stores near children's homes may improve children's weight status, whereas increased availability of convenience stores is likely to be detrimental.
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Affiliation(s)
| | - Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Kristen Lloyd
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ
| | - David Tulloch
- Center for Remote Sensing and Spatial Analysis, Department of Landscape Architecture, Rutgers University, New Brunswick, NJ
| | - Robin S DeWeese
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Derek DeLia
- MedStar Health Research Institute, Hyattsville, MD; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix
| | - Michael J Yedidia
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ
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Lange SJ, Calancie L, Onufrak SJ, Reddy KT, Palmer A, Lowry Warnock A. Associations between Food Policy Councils and Policies That Support Healthy Food Access: A National Survey of Community Policy Supports. Nutrients 2021; 13:nu13020683. [PMID: 33672716 PMCID: PMC7924387 DOI: 10.3390/nu13020683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/08/2021] [Accepted: 02/13/2021] [Indexed: 11/20/2022] Open
Abstract
Food policy councils (FPCs) are one form of community coalition that aims to address challenges to local food systems and enhance availability, accessibility, and affordability of healthy foods for local residents. We used data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living, a nationally representative survey of US municipalities (n = 2029), to examine the prevalence of FPCs and cross-sectional associations between FPCs and four types of supports for healthy food access (approaches to help food stores, practices to support farmers markets, transportation-related supports, and community planning documents). Overall, 7.7% of municipalities reported having a local or regional FPC. FPCs were more commonly reported among larger municipalities with ≥50,000 people (29.2%, 95% Confidence Interval (CI): 21.6, 36.8) and western region municipalities (13.2%, 95% CI: 9.6, 16.8). After multivariable adjustment, municipalities with FPCs had significantly higher odds of having all four types of supports, compared to those without FPCs (adjusted odds ratio (aOR) range: 2.4–3.4). Among municipalities with FPCs (n = 156), 41% reported having a local government employee or elected official as a member, and 46% had a designated health or public health representative. Although FPCs were uncommon, municipalities that reported having a local or regional FPC were more likely to report having supports for healthy food access for their residents.
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Affiliation(s)
- Samantha J. Lange
- Oak Ridge Institute for Science and Education (ORISE) Research Participation Program, Oak Ridge, TN 37870, USA
- Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity, Atlanta, GA 30341, USA; (S.J.O.); (A.L.W.)
- Correspondence:
| | - Larissa Calancie
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA;
| | - Stephen J. Onufrak
- Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity, Atlanta, GA 30341, USA; (S.J.O.); (A.L.W.)
| | | | - Anne Palmer
- Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21202, USA;
| | - Amy Lowry Warnock
- Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity, Atlanta, GA 30341, USA; (S.J.O.); (A.L.W.)
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Larson N, Slaughter-Acey J, Alexander T, Berge J, Harnack L, Neumark-Sztainer D. Emerging adults' intersecting experiences of food insecurity, unsafe neighbourhoods and discrimination during the coronavirus disease 2019 (COVID-19) outbreak. Public Health Nutr 2021; 24:519-530. [PMID: 33092665 PMCID: PMC7683815 DOI: 10.1017/s136898002000422x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine how food insecurity is related to emerging adults' food behaviours and experiences of neighbourhood safety and discrimination and to identify resources needed to support their health during the COVID-19 outbreak. DESIGN Rapid response online survey. Participants completed the six-item US Household Food Security Survey Module, a brief measure of food insufficiency, and measures of food behaviours, neighbourhood safety and discrimination. Open-ended questions were used to assess changes in eating behaviours during COVID-19 and needed resources. SETTING C-EAT (COVID-19 Eating and Activity over Time) study invitations were sent by email and text message to a longitudinal cohort. PARTICIPANTS A total of 218 emerging adults (mean age = 24·6 (sd 2·0) years, 70·2 % female) completed a survey in April-May 2020 during a stay-at-home order in Minnesota. RESULTS The past year prevalence of food insecurity was 28·4 %. Among food-insecure respondents, 41·0 % reported both eating less and experiencing hunger due to lack of money in the past month. Food-insecure respondents were less likely than those who were food secure to have fruits/vegetables at home and more likely to have frequent fast-food restaurant meals, feel unsafe in their neighbourhood and experience discrimination during the stay-at-home order. Food-insecure adults reported changes including eating more food prepared at home, eating more take-out restaurant meals and purchasing more energy-dense snacks as a result of events related to COVID-19. Resources most needed to support their health included eligibility for more food assistance and relief funds. CONCLUSIONS Food-insecure emerging adults experience many barriers to maintaining healthful eating patterns during COVID-19.
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Jaime Slaughter-Acey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Tricia Alexander
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Jerica Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
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Siddique KHM, Li X, Gruber K. Rediscovering Asia's forgotten crops to fight chronic and hidden hunger. Nat Plants 2021; 7:116-122. [PMID: 33594263 DOI: 10.1038/s41477-021-00850-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
Asia has a rich variety of nutritious 'neglected crops', domesticated since ancient times but mostly forgotten or underutilized today. These crops, including cereals, roots, nuts, pulses, fruits and vegetables, are adapted to their land, resilient to environmental challenges and rich in micronutrients. Changing current agricultural practices from a near monoculture to a diverse cropping portfolio that uses these forgotten crops is a viable and promising approach to closing the current gaps in production and nutrition in Asia. Such an approach was proposed by the Food and Agriculture Organization's Zero Hunger initiative in Asia, which aims to end hunger by 2030. The Zero Hunger initiative is a promising approach to help increase access to nutritious food; however, it faces substantial challenges, such as the lack of farmer willingness to switch crops and adequate governmental support for implementation. Countries such as Nepal have started using these neglected crops, implementing various approaches to overcome challenges and start a new agricultural pathway.
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Affiliation(s)
- Kadambot H M Siddique
- The UWA Institute of Agriculture, The University of Western Australia (UWA), Perth, Western Australia, Australia.
| | - Xuan Li
- Food and Agriculture Organization of the United Nations (FAO), Bangkok, Thailand
| | - Karl Gruber
- The UWA Institute of Agriculture, The University of Western Australia (UWA), Perth, Western Australia, Australia
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Mackay S, Eyles H, Gontijo de Castro T, Young L, Ni Mhurchu C, Swinburn B. Which companies dominate the packaged food supply of New Zealand and how healthy are their products? PLoS One 2021; 16:e0245225. [PMID: 33497402 PMCID: PMC7837499 DOI: 10.1371/journal.pone.0245225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/27/2020] [Indexed: 02/03/2023] Open
Abstract
Improvement of national food supplies are an opportunity to improve a country's health. Our aim was to identify the major food companies manufacturing packaged foods and non-alcoholic beverages available in New Zealand supermarkets in 2018; to assess the healthiness of products using (1) the Health Star Rating (HSR) system, (2) Australian Dietary Guidelines classification (core/discretionary), and (3) by level of processing; to compare the healthiness of products displaying and not displaying the HSR and; to assess potential for food reformulation within selected food sub-categories. Information on packaged foods was obtained from the Nutritrack supermarket database. Companies that manufactured each food and brand were identified using company websites and the New Zealand companies register. In total, 13,506 packaged products were mapped to 1,767 brands and 1,214 companies. Based on market share of products available for sale (Euromonitor data), there were 22 dominating companies producing 31% of products and 17% of brands. Fifty-nine percent of products were classified as unhealthy (HSR <3.5/5 stars), 53% as discretionary, and 69% as ultra-processed. Products displaying the HSR on the package had a higher mean HSR ±SD than if the HSR was not displayed (3.2±1.3 versus 2.5±1.4, p = 0.000). Efforts to improve the healthiness of products should be directed to the 22 food companies dominating this market share, particularly in the core foods groups which are currently less likely to meet Heart Foundation reformulation targets (bread, breakfast cereals, cheese, canned baked beans, yoghurt). The New Zealand supermarket packaged food supply included in the Nutritrack database is dominated by a small number of companies and is mostly unhealthy. Government leadership is required to improve the healthiness of the packaged food supply and provide adequate information to consumers. This includes interventions setting reformulation targets for core food groups, setting population nutrient intake targets and mandating that the HSR is displayed on all products.
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Affiliation(s)
- Sally Mackay
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Helen Eyles
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
| | - Teresa Gontijo de Castro
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Leanne Young
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
| | - Boyd Swinburn
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
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Dinku AM, Mekonnen TC, Adilu GS. Child dietary diversity and food (in)security as a potential correlate of child anthropometric indices in the context of urban food system in the cases of north-central Ethiopia. J Health Popul Nutr 2020; 39:11. [PMID: 33298197 PMCID: PMC7771062 DOI: 10.1186/s41043-020-00219-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/16/2020] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To investigate the relation of child dietary diversity and household food insecurity along with other socio-demographic with child anthropometric indices in north-central Ethiopia, an area with a high level of food insecurity and inadequate diet quality. DESIGN A community-based cross-sectional study was used. SETTINGS The study was conducted in Dessie and Combolcha towns of north-central Ethiopia from April to May 2018. PARTICIPANTS Randomly selected 512 mother-child pairs with child's age range of 6-59 months. RESULTS The mean (± SD) scores of weight-for-height/length, height/length-for-age, weight-for-age, and BMI-for-age Z-scores were 1.35 (± 2.03), - 1.89 (± 1.79), 0.05 (± 1.54), and 1.39 (± 2.06), respectively. From all anthropometric indicators, stunting and overweight/obesity remained the severe public issues hitting 43% and 42% of the children, respectively. In the model, mothers' age and education and child's age, sex, and dietary diversity were significantly related with child height-for-age Z-score while place of residence, sex of household head, child's age, and dietary diversity score were the predictors of child BMI-for-age Z-score in the urban contexts of the study area. Nevertheless, food insecurity was not related to any of the child anthropometric indices. CONCLUSION The double burden of malnutrition epidemics (stunting and obesity) coexisted as severe public health concerns in urban settings. Anthropometric statuses of children were affected by multidimensional factors and seek strong integration and immediate intervention of multiple sectors.
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Affiliation(s)
- Amare Molla Dinku
- Researcher at the Department of Rural Development and Agricultural Extension, College of Agriculture, Wollo University, Dessie, Ethiopia
| | - Tefera Chane Mekonnen
- Researcher at the School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getachew Shumye Adilu
- Researchr at the Department of Plant Science, College of Agriculture, Wollo University, Dessie, Ethiopia
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Serra-Majem L, Tomaino L, Dernini S, Berry EM, Lairon D, Ngo de la Cruz J, Bach-Faig A, Donini LM, Medina FX, Belahsen R, Piscopo S, Capone R, Aranceta-Bartrina J, La Vecchia C, Trichopoulou A. Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns. Int J Environ Res Public Health 2020; 17:E8758. [PMID: 33255721 PMCID: PMC7728084 DOI: 10.3390/ijerph17238758] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited historical approach, mainly focused on nutrients and health, to a new one considering the environmental, socio-economic and cultural impact-and thus the sustainability-of diets. OBJECTIVE To present an updated version of the Mediterranean Diet Pyramid (MDP) to reflect multiple environmental concerns. METHODS We performed a revision and restructuring of the MDP to incorporate more recent findings on the sustainability and environmental impact of the Mediterranean Diet pattern, as well as its associations with nutrition and health. For each level of the MDP we provided a third dimension featuring the corresponding environmental aspects related to it. CONCLUSIONS The new environmental dimension of the MDP enhances food intake recommendations addressing both health and environmental issues. Compared to the previous 2011 version, it emphasizes more strongly a lower consumption of red meat and bovine dairy products, and a higher consumption of legumes and locally grown eco-friendly plant foods as much as possible.
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Affiliation(s)
- Lluís Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, and Complejo Hospitalario Universitario Insular—Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas de Gran Canaria, Spain; (L.T.); (J.A.-B.)
- International Foundation of Mediterranean Diet, Nutrition Research Foundation, Barcelona Science Park, 08028 Barcelona, Spain; (S.D.); (E.M.B.); (J.N.d.l.C.)
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Laura Tomaino
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, and Complejo Hospitalario Universitario Insular—Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas de Gran Canaria, Spain; (L.T.); (J.A.-B.)
- Department of Clinical Medicine and Community Health (DISCCO), Università degli Studi di Milano, 20122 Milan, Italy;
| | - Sandro Dernini
- International Foundation of Mediterranean Diet, Nutrition Research Foundation, Barcelona Science Park, 08028 Barcelona, Spain; (S.D.); (E.M.B.); (J.N.d.l.C.)
- Forum on Mediterranean Food Cultures, 00148 Rome, Italy
| | - Elliot M. Berry
- International Foundation of Mediterranean Diet, Nutrition Research Foundation, Barcelona Science Park, 08028 Barcelona, Spain; (S.D.); (E.M.B.); (J.N.d.l.C.)
- Braun School of Public Health, Hebrew University Hadassah Medical School, 91120 Jerusalem, Israel
| | - Denis Lairon
- Human Nutrition, Aix Marseille University, INSERM, INRA, C2VN, 13005 Marseille, France;
| | - Joy Ngo de la Cruz
- International Foundation of Mediterranean Diet, Nutrition Research Foundation, Barcelona Science Park, 08028 Barcelona, Spain; (S.D.); (E.M.B.); (J.N.d.l.C.)
| | - Anna Bach-Faig
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018 Barcelona, Spain; (A.B.-F.); (F.-X.M.)
- Food and Nutrition Area, Barcelona Official College of Pharmacists, 08009 Barcelona, Spain
| | - Lorenzo M. Donini
- Department of Experimental Medicine, Sapienza University, 00136 Rome, Italy;
| | - Francesc-Xavier Medina
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018 Barcelona, Spain; (A.B.-F.); (F.-X.M.)
| | - Rekia Belahsen
- Training and Research Unit on Nutrition & Food Sciences, Biotechnology, Biochemistry & Nutrition Laboratory, Chouaib Doukkali University, El Jadida 24000, Morocco;
| | - Suzanne Piscopo
- Department of Health, Physical Education and Consumer Studies, Faculty of Education, University of Malta, MSD2080 Msida, Malta;
| | - Roberto Capone
- International Center for Advanced Mediterranean Agronomic Studies (CIHEAM), 70010 Valenzano (Bari), Italy;
| | - Javier Aranceta-Bartrina
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, and Complejo Hospitalario Universitario Insular—Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas de Gran Canaria, Spain; (L.T.); (J.A.-B.)
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Food Sciences and Physiology, University of Navarra, 31008 Pamplona, Spain
| | - Carlo La Vecchia
- Department of Clinical Medicine and Community Health (DISCCO), Università degli Studi di Milano, 20122 Milan, Italy;
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Fitzpatrick KM, Willis DE, Spialek ML, English E. Food Insecurity in the Post-Hurricane Harvey Setting: Risks and Resources in the Midst of Uncertainty. Int J Environ Res Public Health 2020; 17:ijerph17228424. [PMID: 33203035 PMCID: PMC7696393 DOI: 10.3390/ijerph17228424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
Food insecurity is of heightened concern during and after natural disasters; higher prevalence is typically reported in post-disaster settings. The current study examines food insecurity prevalence and specific risk/resource variables that may act as barriers or advantages in accessing food in such a setting. Using a modified quota sample (n = 316), Hurricane Harvey survivors participated in face-to-face interviews and/or online surveys that assessed health, social and household factors, and sociodemographic characteristics. Using logistic regression analyses we find that social vulnerabilities, circumstantial risk, and social and psychological resources are important in determining the odds of food insecurity. Hispanic and/or Nonwhite survivors, renters, and those persons displaced during the natural disaster have higher food insecurity odds. Survivors with stronger social ties, higher levels of mastery, and a greater sense of connectedness to their community are found to have lower food insecurity odds. A more nuanced analysis of circumstantial risk finds that while the independent effects of displacement and home ownership are important, so too is the intersection of these two factors, with displaced-renters experiencing significantly higher odds than any other residence and displacement combinations, and particularly those who are homeowners not displaced during the disaster. Strategies for addressing differential risks, as well as practical approaches for implementation and education programming related to disaster recovery, are discussed.
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Affiliation(s)
- Kevin M. Fitzpatrick
- Department of Sociology and Criminology, University of Arkansas, Fayetteville, AR 72701, USA
- Correspondence: ; Tel.: +1-479-856-8820
| | - Don E. Willis
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR 72701, USA;
| | - Matthew L. Spialek
- Department of Communications, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Emily English
- Department of Pediatrics, University of Arkansas for Medical Sciences, Fayetteville, AR 72701, USA;
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Bin Zarah A, Enriquez-Marulanda J, Andrade JM. Relationship between Dietary Habits, Food Attitudes and Food Security Status among Adults Living within the United States Three Months Post-Mandated Quarantine: A Cross-Sectional Study. Nutrients 2020; 12:E3468. [PMID: 33198215 PMCID: PMC7697798 DOI: 10.3390/nu12113468] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/25/2020] [Accepted: 11/05/2020] [Indexed: 12/14/2022] Open
Abstract
COVID-19 has disrupted the lives of many and may have influenced dietary habits through factors such as food security status and attitudes. The purpose of this study was to identify dietary habits and their associations with food insecurity and attitudes among adults living in the United States within three months post-mandated quarantine. An online cross-sectional study was conducted from April to June 2020. Participants (n = 3133) responded to a 71-item questionnaire regarding demographics (n = 7), health information (n = 5), lifestyle habits (n = 8), dietary habits (n = 37), food attitudes (n = 8), and food security status (n = 6). Frequency counts and percentages were tabulated, and multivariate linear regression was conducted to examine associations using STATA v14 at a statistical significance level of p < 0.05. Results showed that most participants indicated no change in dietary habits (43.6-87.4%), yet participants reported increased consumption of sweets (43.8%) and salty snacks (37.4%). A significant positive association for food attitude scores (1.59, 95% CI 1.48 to 1.70; p < 0.001) and food security scores (1.19, 95% CI 0.93 to 1.45; p < 0.001) on total dietary habit scores was found. Future extensive population studies are recommended to help public health authorities frame actions to alleviate the impact that mandated quarantine has on dietary habits.
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Affiliation(s)
| | | | - Jeanette Mary Andrade
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA; (A.B.Z.); (J.E.-M.)
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Kubo A, Ohara N, Enshouiwa M, Sekiguchi J, Sudo N, Tsuboyama-Kasaoka N, Okuda H, Shibuya I. [A nationwide survey on nutritional assistance and preparation measures adopted by municipal registered dietitians during large-scale disasters]. Nihon Koshu Eisei Zasshi 2020; 67:344-355. [PMID: 32493894 DOI: 10.11236/jph.67.5_344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Hamadani JD, Hasan MI, Baldi AJ, Hossain SJ, Shiraji S, Bhuiyan MSA, Mehrin SF, Fisher J, Tofail F, Tipu SMMU, Grantham-McGregor S, Biggs BA, Braat S, Pasricha SR. Immediate impact of stay-at-home orders to control COVID-19 transmission on socioeconomic conditions, food insecurity, mental health, and intimate partner violence in Bangladeshi women and their families: an interrupted time series. Lancet Glob Health 2020; 8:e1380-e1389. [PMID: 32857955 PMCID: PMC7447230 DOI: 10.1016/s2214-109x(20)30366-1] [Citation(s) in RCA: 224] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Stay-at-home orders (lockdowns) have been deployed globally to control COVID-19 transmission, and might impair economic conditions and mental health, and exacerbate risk of food insecurity and intimate partner violence. The effect of lockdowns in low-income and middle-income countries must be understood to ensure safe deployment of these interventions in less affluent settings. We aimed to determine the immediate impact of COVID-19 lockdown orders on women and their families in rural Bangladesh. METHODS An interrupted time series was used to compare data collected from families in Rupganj upazila, rural Bangladesh (randomly selected from participants in a randomised controlled trial), on income, food security, and mental health a median of 1 year and 2 years before the COVID-19 pandemic to data collected during the lockdown. We also assessed women's experiences of intimate partner violence during the pandemic. RESULTS Between May 19 and June 18, 2020, we randomly selected and invited the mothers of 3016 children to participate in the study, 2424 of whom provided consent. 2414 (99·9%, 95% CI 99·6-99·9) of 2417 mothers were aware of, and adhering to, the stay-at-home advice. 2321 (96·0%, 95·2-96·7) of 2417 mothers reported a reduction in paid work for the family. Median monthly family income fell from US$212 at baseline to $59 during lockdown, and the proportion of families earning less than $1·90 per day rose from five (0·2%, 0·0-0·5) of 2422 to 992 (47·3%, 45·2-49·5) of 2096 (p<0·0001 comparing baseline with lockdown period). Before the pandemic, 136 (5·6%, 4·7-6·6) of 2420 and 65 (2·7%, 2·1-3·4) of 2420 families experienced moderate and severe food insecurity, respectively. This increased to 881 (36·5%, 34·5-38·4) of 2417 and 371 (15·3%, 13·9-16·8) of 2417 during the lockdown; the number of families experiencing any level of food insecurity increased by 51·7% (48·1-55·4; p<0·0001). Mothers' depression and anxiety symptoms increased during the lockdown. Among women experiencing emotional or moderate physical violence, over half reported it had increased since the lockdown. INTERPRETATION COVID-19 lockdowns present significant economic, psychosocial, and physical risks to the wellbeing of women and their families across economic strata in rural Bangladesh. Beyond supporting only the most socioeconomically deprived, support is needed for all affected families. FUNDING National Health and Medical Research Council, Australia.
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Affiliation(s)
| | | | - Andrew J Baldi
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | | | - Shamima Shiraji
- International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | | | - Jane Fisher
- Department of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Fahmida Tofail
- International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | | | - Beverley-Ann Biggs
- Department of Medicine, Peter Doherty Institute, The University of Melbourne, Parkville, VIC, Australia; Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Sabine Braat
- Department of Medicine, Peter Doherty Institute, The University of Melbourne, Parkville, VIC, Australia; School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sant-Rayn Pasricha
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia; Diagnostic Haematology, Royal Melbourne Hospital, Parkville, VIC, Australia; Clinical Haematology at the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC Australia.
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74
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Beavis AL, Sanneh A, Stone RL, Vitale M, Levinson K, Rositch AF, Fader AN, Topel K, Abing A, Wethington SL. Basic social resource needs screening in the gynecologic oncology clinic: a quality improvement initiative. Am J Obstet Gynecol 2020; 223:735.e1-735.e14. [PMID: 32433998 PMCID: PMC8340269 DOI: 10.1016/j.ajog.2020.05.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Social determinants of health are known to contribute to disparities in health outcomes. Routine screening for basic social needs is not a part of standard care; however, the association of those needs with increased healthcare utilization and poor compliance with guideline-directed care is well established. OBJECTIVE In this study, we aimed to assess the prevalence of basic social resource needs identified through a quality improvement initiative in a gynecologic oncology outpatient clinic. In addition, we aimed to identify clinical and demographic factors associated with having basic social resource needs. STUDY DESIGN We performed a prospective cohort study of women presenting to a gynecologic oncology clinic at an urban academic institution who were screened for basic social resource needs as part of a quality improvement initiative from July 2017 to May 2018. The following 8 domains of resource needs were assessed: food insecurity, housing insecurity, utility needs, financial strain, transportation, childcare, household items, and difficulty reading hospital materials. Women with needs were referred to resources to address those needs. Demographic and clinical information were collected for each patient. The prevalence of needs and successful follow-up interventions were calculated. Patient factors independently associated with having at least 1 basic social resource need were identified using multivariable Poisson regression. RESULTS A total of 752 women were screened in the study period, of whom 274 (36%) reported 1 or more basic social resource need, with a median of 1 (range, 1-7) need. Financial strain was the most commonly reported need (171 of 752, 23%), followed by transportation (119 of 752, 16%), difficulty reading hospital materials (54 of 752, 7%), housing insecurity (31 of 752, 4%), food insecurity (28 of 752, 4%), household items (22 of 752, 3%), childcare (15 of 752, 2%), and utility needs (13 of 752, 2%). On multivariable analysis, independent factors associated with having at least 1 basic social resource need were being single, divorced or widowed, nonwhite race, current smoker, nonprivate insurance, and a history of anxiety or depression. A total of 36 of 274 (13%) women who screened positive requested assistance and were referred to resources to address those needs. Of the 36 women, 25 (69%) successfully accessed a resource or felt equipped to address their needs, 9 (25%) could not be reached despite repeated attempts, and 2 (6%) declined assistance. CONCLUSION Basic social resource needs are prevalent in women presenting to an urban academic gynecologic oncology clinic and can be identified and addressed through routine screening. To help mitigate ongoing disparities in this population, screening for and addressing basic social resource needs should be incorporated into routine comprehensive care in gynecologic oncology clinics.
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Affiliation(s)
- Anna Louise Beavis
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Awa Sanneh
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rebecca L Stone
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Kimberly Levinson
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Anne F Rositch
- Department of Cancer Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Amanda Nickles Fader
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Kristin Topel
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University, Baltimore, MD
| | | | - Stephanie L Wethington
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD.
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Adams EL, Caccavale LJ, Smith D, Bean MK. Food Insecurity, the Home Food Environment, and Parent Feeding Practices in the Era of COVID-19. Obesity (Silver Spring) 2020; 28:2056-2063. [PMID: 32762129 PMCID: PMC7436743 DOI: 10.1002/oby.22996] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/13/2020] [Accepted: 07/30/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed to describe changes in families' home food environment and parent feeding practices, from before to during the coronavirus disease 2019 (COVID-19) pandemic, and examine whether changes differed by food security status. METHODS Parents (N = 584) in the US completed a single online survey, reporting on food security, home food availability, and feeding practices both retrospectively (considering before COVID-19) and currently (during COVID-19). χ2 and univariate regressions examined associations by food security status. RESULTS The percent of families reporting very low food security increased by 20% from before to during COVID-19 (P < 0.01). About one-third of families increased the amount of high-calorie snack foods, desserts/sweets, and fresh foods in their home; 47% increased nonperishable processed foods. Concern about child overweight increased during COVID-19, with a greater increase for food-insecure versus food-secure parents (P < 0.01). Use of restriction, pressure to eat, and monitoring increased, with a greater increase in pressure to eat for parents with food insecurity compared with food-secure parents (P < 0.05). CONCLUSIONS During COVID-19, increases in very low food security and changes in the home food environment and parent feeding practices were observed. Results highlight the need to address negative impacts of COVID-19 on children's obesity risk, particularly among those facing health disparities.
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Affiliation(s)
- Elizabeth L. Adams
- Department of PediatricsChildren’s Hospital of Richmond at Virginia Commonwealth UniversityRichmondVirginiaUSA
| | - Laura J. Caccavale
- Department of PediatricsChildren’s Hospital of Richmond at Virginia Commonwealth UniversityRichmondVirginiaUSA
| | - Danyel Smith
- Department of PediatricsChildren’s Hospital of Richmond at Virginia Commonwealth UniversityRichmondVirginiaUSA
| | - Melanie K. Bean
- Department of PediatricsChildren’s Hospital of Richmond at Virginia Commonwealth UniversityRichmondVirginiaUSA
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Kim S, Lee KI, Heo SY, Noh SC. Identifying Food Deserts and People with Low Food Access, and Disparities in Dietary Habits and Health in Korea. Int J Environ Res Public Health 2020; 17:ijerph17217936. [PMID: 33138016 PMCID: PMC7663763 DOI: 10.3390/ijerph17217936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022]
Abstract
This study aims to identify the regions and people with low food access (LFA) for Korea at the national level and to examine disparities in food consumption, dietary behavior, and health outcome for those regions and people. Based on the distance to the nearest grocery store from residence, the regions and people with LFA are identified through geographical information system (GIS) analysis. To examine disparities between the regions and people with LFA and without LFA, a consumer survey is conducted and data from National Health and Nutrition Examination Survey and Community Health Survey are analyzed. This study found that there exists a serious access to food issue in Korea, especially for the aged. Moreover, there also exist significant disparities between the regions and people with and without LFA in the distance and one-way travel time to the grocery store that is mainly visited, frequency of offline/online grocery shopping, availability of various foods, dietary habits such as eating regularly, eating nutritionally balanced foods, and eating sufficient fruit/vegetable/whole grains, the acquisition and utilization of food-related information, and health outcomes. This study suggests that, to resolve such a serious food access problem, assistance policies, such as mobile grocery stores and lunch-box delivery, need to be activated in countries similar to Korea since this problem could potentially deteriorate the national medical finances as well as the regional and individual disparities.
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Affiliation(s)
- Sanghyo Kim
- Korea Rural Economic Institute, Naju 58321, Korea; (K.-I.L.); (S.-Y.H.)
- Correspondence: ; Tel.: +82-61-820-2218
| | - Kyei-Im Lee
- Korea Rural Economic Institute, Naju 58321, Korea; (K.-I.L.); (S.-Y.H.)
| | - Seong-Yoon Heo
- Korea Rural Economic Institute, Naju 58321, Korea; (K.-I.L.); (S.-Y.H.)
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Martínez-García A, Trescastro-López EM, Galiana-Sánchez ME, Llorens-Ivorra C, Pereyra-Zamora P. Cultural Adaptation and Evaluation of the Perceived Nutrition Environment Measures Survey to the Mediterranean Spanish Context (NEMS-P-MED). Nutrients 2020; 12:nu12113257. [PMID: 33114384 PMCID: PMC7693738 DOI: 10.3390/nu12113257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 12/04/2022] Open
Abstract
Individuals’ perceptions of their food environments are a mediator between exposure to the environment and people’s interaction with it. The Nutrition Environment Measures Surveys (NEMS) are valid and reliable measures to assess food environments. In Spain, there is no adapted instrument to measure the perceived obesogenic environment. This article aims to adapt and evaluate the Perceived Nutrition Environment Measures Survey for a Spanish context (NEMS-P-MED). The Spanish version has 32 questions to measure the perception about availability, accessibility and marketing of 3 types of environment: home, shops and restaurants. We assess feasibility, construct validity and internal consistency reliability through a sample of 95 individuals. The internal consistency was acceptable for most items (Cronbach’s alpha coefficients range from 0.6 to 0.9), similar to that of the original scale. The NEMS-P-MED has been shown to be valid and, on certain items reliable, and was useful to assess the population’s perceptions of the food environment in the home, restaurants and food stores in a Spanish context. Adapting standardized measurement tools to specific contexts to assess the perceived and observed characteristics of food environments may facilitate the development of effective policy interventions to reduce excess weight.
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Affiliation(s)
- Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
| | - Eva María Trescastro-López
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
- Correspondence: ; Tel.: +34-96-590-34-00 (ext. 3834)
| | - María Eugenia Galiana-Sánchez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
| | - Cristóbal Llorens-Ivorra
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
- Public Health Center of Dénia (Alicante), Valencian Community, 03700 Alicante, Spain
| | - Pamela Pereyra-Zamora
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain; (A.M.-G.); (M.E.G.-S.); (C.L.-I.); (P.P.-Z.)
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Laurenzi C, Field S, Honikman S. Food Insecurity, Maternal Mental Health, and Domestic Violence: A Call for a Syndemic Approach to Research and Interventions. Matern Child Health J 2020; 24:401-404. [PMID: 32009230 DOI: 10.1007/s10995-019-02872-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Food security is a prerequisite for achieving optimal health, and mothers and children living in food insecure households face barriers to physical and mental health and healthy development. Mothers in food insecure households often also experience poor mental health and domestic violence. Although associations between these domains have been explored, little research exists about the intersection of these three phenomena. METHODS In this commentary, we briefly identify existing, relevant research that investigates the relationships between and among food insecurity, maternal mental health, and domestic violence. RESULTS A substantial body of evidence from cross-sectional and longitudinal studies has demonstrated significant relationships and pathways between these co-morbidities, with bi-directional associations between food insecurity and poor mental health, domestic violence and poor mental health, and cumulative risks attributed to more severe symptoms and exposures. However, there is limited evidence about interventions that target these three areas concurrently. More specifically, there are few sustained, multi-disciplinary efforts that tackle these issues in a broad, cross-cutting way. DISCUSSION In line with the Sustainable Development Goals, we suggest the adoption of an interdisciplinary approach to address more effectively the needs of the most vulnerable mothers who rest at the intersection of these issues. We identify three avenues for further research efforts.
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Affiliation(s)
- Christina Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, 7505, South Africa.
| | - Sally Field
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, 7700, South Africa
| | - Simone Honikman
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, 7700, South Africa
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Mansour R, Liamputtong P, Arora A. Prevalence, Determinants, and Effects of Food Insecurity among Middle Eastern and North African Migrants and Refugees in High-Income Countries: A Systematic Review. Int J Environ Res Public Health 2020; 17:ijerph17197262. [PMID: 33020437 PMCID: PMC7579266 DOI: 10.3390/ijerph17197262] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/20/2020] [Accepted: 09/29/2020] [Indexed: 12/13/2022]
Abstract
Issues related to poverty and income inequality in high-income countries have led to food insecurity among some population groups, such as migrants and refugees. While there are some studies on the experience of some migrant groups (and other subpopulations), little is known about food security among Middle Eastern and African migrants and refugees. This systematic review identified the prevalence of food insecurity and its effects among Middle Eastern and North African (MENA) migrants and refugees in high-income countries. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in this systematic review. Four databases, namely MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), and PubMed were searched. Three studies met the inclusion criteria, all of which were conducted in USA: two among Sudanese migrant families, and one among Somali refugee women. The rates of reported food insecurity ranged from 40% to 71% and were significantly higher than for the general population. Food insecurity was associated with acculturation and socio-economic factors. Food insecurity adversely impacts the health of MENA migrants and refugees, creating economic implications for individuals, families, the broader community in which they now live, and for governments.
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Affiliation(s)
- Reima Mansour
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, NSW 2751, Australia; (P.L.); (A.A.)
- Correspondence: ; Tel.: +61-4-2682-8215
| | - Pranee Liamputtong
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, NSW 2751, Australia; (P.L.); (A.A.)
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, NSW 2751, Australia; (P.L.); (A.A.)
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
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Neff RA, Zaltz DA, Hecht AA, Pate RR, Neelon B, O’Neill JR, Benjamin-Neelon SE. Preschool Healthy Food Policy Did Not Increase Percent of Food Wasted: Evidence from the Carolinas. Nutrients 2020; 12:E3024. [PMID: 33023143 PMCID: PMC7600022 DOI: 10.3390/nu12103024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/10/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022] Open
Abstract
This research evaluates the effects of a South Carolina (SC) policy, which changed the nutrition standards for foods served in early care and education (ECE) settings, on wasted food. A two-group pre-test/post-test evaluation was performed in ECE centers serving children age 3-5 from households with lower incomes in SC (n = 102 children from 34 centers, intervention) and North Carolina (NC; n = 99 children from 30 centers, comparison). Direct observation was performed to assess the quantity and kcal of food served and quantity and percent of food discarded, by food group and nutrient, enabling assessment of waste in the absence of intervention. Mixed-effects linear models were fit to estimate, by state, differences in change from baseline to post-implementation at the center level. Covariates were selected a priori, including center enrollment, racial composition, director educational attainment, years in operation, for-profit status, and Child and Adult Care Food Program (CACFP) participation. Waste of food was high across states and time points. The policy was not associated with a change in percent of food discarded in SC compared to NC in adjusted analyses.
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Affiliation(s)
- Roni A. Neff
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Daniel A. Zaltz
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA; (D.A.Z.); (S.E.B.-N.)
| | - Amelie A. Hecht
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208, USA; (R.R.P.); (J.R.O.)
| | - Brian Neelon
- Division of Biostatistics, Department of Public Health Sciences, Medical University of South Carolina, 35 Cannon St, Charleston, SC 29415, USA;
| | - Jennifer R. O’Neill
- Department of Exercise Science, University of South Carolina Arnold School of Public Health, 921 Assembly St, Columbia, SC 29208, USA; (R.R.P.); (J.R.O.)
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA; (D.A.Z.); (S.E.B.-N.)
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Ashby NJS. Impact of the COVID-19 Pandemic on Unhealthy Eating in Populations with Obesity. Obesity (Silver Spring) 2020; 28:1802-1805. [PMID: 32589788 PMCID: PMC7361200 DOI: 10.1002/oby.22940] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study aimed to examine the impact of the coronavirus disease (COVID-19) pandemic on patronage to unhealthy eating establishments in populations with obesity. METHODS Anonymized movement data accounting for roughly 10% of devices in the United States at 138,989 unhealthy eating locations from December 1, 2019, through April 2020 and the percentage of adults with obesity, the poverty rate, and the food environment index in 65% of United States counties were collected and merged. A cluster corrected Poisson spline regression was performed predicting patronage by day, the percentage of adults with obesity in the establishment's county, the county's poverty rate, and its food environment index, as well as their interactions. RESULTS Patronage to unhealthy eating establishments was higher where there was a higher percentage of the adult population with obesity. A similar pattern was observed for counties with a lower food environment index. These disparities appear to have increased as the COVID-19 pandemic spread. CONCLUSIONS These results suggest unhealthy eating patterns during the COVID-19 pandemic are higher in already at-risk populations. Policy makers can use these findings to motivate interventions and programs aimed at increasing healthy food intake in at-risk communities during crises.
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Wang M, Miller JD, Collins SM, Santoso MV, Wekesa P, Okochi H, Onono M, Weiser S, Gandhi M, Young SL. Social Support Mitigates Negative Impact of Food Insecurity on Antiretroviral Adherence Among Postpartum Women in Western Kenya. AIDS Behav 2020; 24:2885-2894. [PMID: 32212069 PMCID: PMC7483232 DOI: 10.1007/s10461-020-02839-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Food insecurity (FI), low social support, and low health-related quality of life (HRQoL) are associated with self-reported nonadherence to antiretroviral therapy (ART) among postpartum women, but these relationships have not been evaluated using objective adherence indicators. Hair samples were therefore analyzed among 83 postpartum Kenyan women living with HIV on efavirenz and nevirapine ART drug regimens in an observational cohort (NCT02974972). FI (0-27), social support (0-40), and HRQoL (8-40) in the prior month were also assessed. In multivariable models, each point increase in FI and decrease in HRQoL were associated with a 45.1% (95% CI: -64.3%, -15.6%) and 10.5% decrease (95% CI: 1.0%, 22.1%) in hair ART drug concentrations respectively, when social support was held constant. A significant interaction between social support and FI (β = 0.02, p = 0.017) indicated that greater social support was predicted to mitigate the negative impacts of FI on ART adherence. Addressing these modifiable barriers could improve ART adherence during this critical period.
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Affiliation(s)
- Mira Wang
- Department Anthropology, Program in Global Health, Northwestern University, Evanston, IL, 60208, USA
| | - Joshua D Miller
- Department Anthropology, Program in Global Health, Northwestern University, Evanston, IL, 60208, USA
| | - Shalean M Collins
- Department Anthropology, Program in Global Health, Northwestern University, Evanston, IL, 60208, USA
| | - Marianne V Santoso
- Department Anthropology, Program in Global Health, Northwestern University, Evanston, IL, 60208, USA
| | - Pauline Wekesa
- Family Aids Care and Education Services (FACES), Kenya Medical Research Institute, Kisumu, Kenya
| | - Hideaki Okochi
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Maricianah Onono
- Family Aids Care and Education Services (FACES), Kenya Medical Research Institute, Kisumu, Kenya
| | - Sheri Weiser
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Monica Gandhi
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sera L Young
- Department Anthropology, Program in Global Health, Northwestern University, Evanston, IL, 60208, USA.
- Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA.
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83
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Weaver RR, Vaughn NA, Hendricks SP, McPherson-Myers PE, Jia Q, Willis SL, Rescigno KP. University student food insecurity and academic performance. J Am Coll Health 2020; 68:727-733. [PMID: 31063031 DOI: 10.1080/07448481.2019.1600522] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/08/2019] [Accepted: 03/24/2019] [Indexed: 06/09/2023]
Abstract
Objective: Characterize the prevalence and dimensions of student food insecurity and the associations with academic performance. Participants: An online survey was distributed (November 2017) to 13,897 undergraduates at a midsized, New Jersey Public University; 2,055 (15%) responded. Methods: Demographic, behavioral, and food security data from University IT services, and the survey were combined in a single dataset. The USDA food security index was adapted to assess food insecurity. Results: Forty-eight percent of students were food insecure. Odds were higher for: women, African Americans, Hispanics, students with partial or no meal plan, commuters, and students receiving financial assistance. Food insecurity increased the odds of being among the lower 10% GPA and reduced the odds of being among the upper 10% GPA. Conclusions: Food insecurity among university students is high and is associated with academic performance. Understanding the mechanisms underlying this relationship is essential to design programs to address this problem.
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Affiliation(s)
- Robert R Weaver
- Department of Health and Exercise Science, School of Health Professions, Rowan University, Glassboro, New Jersey, USA
| | - Nicole A Vaughn
- Department of Health and Exercise Science, School of Health Professions, Rowan University, Glassboro, New Jersey, USA
| | - Sean P Hendricks
- University Advising, Rowan University, Glassboro, New Jersey, USA
| | | | - Qian Jia
- Health, Nutrition and Exercise Sciences, Immaculata University, Immaculata, Pennsylvania, USA
| | - Shari L Willis
- Department of Health and Exercise Science, School of Health Professions, Rowan University, Glassboro, New Jersey, USA
| | - Kevin P Rescigno
- Department of Health and Exercise Science, School of Health Professions, Rowan University, Glassboro, New Jersey, USA
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85
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Abstract
PURPOSE OF THE REVIEW Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.
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Affiliation(s)
- Gabriella Luongo
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Kelly Skinner
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Breanna Phillipps
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Ziwa Yu
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS, B3H 4R2, Canada
| | - Debbie Martin
- School of Health and Human Performance, Dalhousie University, Stairs House, 6230 South Street, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada
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86
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Zavaleta-Cortijo C, Ford JD, Arotoma-Rojas I, Lwasa S, Lancha-Rucoba G, García PJ, Miranda JJ, Namanya DB, New M, Wright CJ, Berrang-Ford L, Harper SL. Climate change and COVID-19: reinforcing Indigenous food systems. Lancet Planet Health 2020; 4:e381-e382. [PMID: 32777205 PMCID: PMC7413660 DOI: 10.1016/s2542-5196(20)30173-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 05/18/2023]
Affiliation(s)
- Carol Zavaleta-Cortijo
- Universidad Peruana Cayetano Heredia, Urbanización Ingeniería, San Martín de Porres, Lima 31, Peru.
| | - James D Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | | | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | | | - Patricia J García
- Universidad Peruana Cayetano Heredia, Urbanización Ingeniería, San Martín de Porres, Lima 31, Peru
| | - J Jaime Miranda
- Universidad Peruana Cayetano Heredia, Urbanización Ingeniería, San Martín de Porres, Lima 31, Peru
| | | | - Mark New
- African Climate Development Initiative, University of Cape Town, Rondebosch, South Africa; School of International Development, University of East Anglia, Norwich, UK
| | - Carlee J Wright
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | - Sherilee L Harper
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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87
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Pirrie M, Harrison L, Angeles R, Marzanek F, Ziesmann A, Agarwal G. Poverty and food insecurity of older adults living in social housing in Ontario: a cross-sectional study. BMC Public Health 2020; 20:1320. [PMID: 32867736 PMCID: PMC7460754 DOI: 10.1186/s12889-020-09437-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poverty and food insecurity have been linked to poor health and morbidity, especially in older adults. Housing is recognized as a social determinant of health, and very little is known about subjective poverty and food insecurity in the marginalized population of older adults living in subsidized social housing. We sought to understand poverty and food insecurity, as well as the risk factors associated with both outcomes, in older adults living in social housing in Ontario. METHODS This was a cross-sectional study using data collected from the Community Paramedicine at Clinic (CP@clinic) program. A total of 806 adult participants residing in designated seniors' or mixed family-seniors' social housing buildings attended CP@clinic within 14 communities across Ontario, Canada. RESULTS The proportion of older adults reporting poverty and food insecurity were 14.9 and 5.1%, respectively. Statistically significant risk factors associated with poverty were being a smoker (AOR = 2.38, 95% CI: 1.23-4.62), self-reporting feeling extremely anxious and/or depressed (AOR = 3.39, 95% CI: 1.34-8.62), and being food insecure (AOR = 23.52, 95% CI: 8.75-63.22). Statistically significant risk factors associated with food insecurity were being underweight (AOR = 19.79, 95% CI: 1.91-204.80) and self-reporting experiencing poverty (AOR = 23.87, 95% CI: 8.78-64.90). In those who self-reported being food secure, the dietary habits reported were consistent with a poor diet. CONCLUSION The poverty rate was lower than expected which could be related to the surrounding environment and perceptions around wealth. Food insecurity was approximately twice that of the general population of older adults in Canada, which could be related to inaccessibility and increased barriers to healthy foods. For those who reported being food secure, dietary habits were considered poor. While social housing may function as a financial benefit and reduce perceived poverty, future interventions are needed to improve the quality of diet consumed by this vulnerable population.
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Affiliation(s)
- Melissa Pirrie
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, Hamilton, Canada
| | - Leila Harrison
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Canada
| | - Ricardo Angeles
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, Hamilton, Canada
| | - Francine Marzanek
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, Hamilton, Canada
| | - Andrea Ziesmann
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, Hamilton, Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, Hamilton, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Canada.
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88
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Riddle ES, Niles MT, Nickerson A. Prevalence and factors associated with food insecurity across an entire campus population. PLoS One 2020; 15:e0237637. [PMID: 32866157 PMCID: PMC7458338 DOI: 10.1371/journal.pone.0237637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/22/2020] [Indexed: 11/18/2022] Open
Abstract
Comprehensive assessment of food insecurity across all college community members is lacking. This research surveyed a random sample of an entire campus population at a Northeast University in two surveys (spring 2017, n = 1,037 and fall 2017, n = 1,123). Analysis of variance, t-tests, and multivariable logit models were used to understand food insecurity outcomes and comparisons among groups. The overall rate of food insecurity on campus was 19.6% (spring) and 15.0% (fall). Food insecurity rates were highest among undergraduates, graduate and medical students, and staff as compared to faculty. First generation students and off-campus students were also more likely to be food insecure in both surveys, while people of color were more likely to be food insecure in the spring survey. Findings suggest university members beyond undergraduates also face high rates of food insecurity, which has important implications for efforts to reduce food insecurity on college campuses.
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Affiliation(s)
- Emilie S. Riddle
- Department of Nutrition and Food Sciences, The University of Vermont, Burlington, VT, United States of America
| | - Meredith T. Niles
- Department of Nutrition and Food Sciences & Food Systems Program, University of Vermont, Burlington, VT, United States of America
- * E-mail:
| | - Amy Nickerson
- Department of Nutrition and Food Sciences, The University of Vermont, Burlington, VT, United States of America
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Melby CL, Orozco F, Averett J, Muñoz F, Romero MJ, Barahona A. Agricultural Food Production Diversity and Dietary Diversity among Female Small Holder Farmers in a Region of the Ecuadorian Andes Experiencing Nutrition Transition. Nutrients 2020; 12:nu12082454. [PMID: 32824150 PMCID: PMC7468725 DOI: 10.3390/nu12082454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 12/13/2022] Open
Abstract
Some rural areas of Ecuador, including the Imbabura Province of the Andes Highlands, are experiencing a double burden of malnutrition where micronutrient deficiencies persist at the same time obesity is increasing as many traditional home-grown foods are being replaced with more commercially prepared convenience foods. Thus, the relationships among agricultural food production diversity (FPD), dietary diversity (DD), and household food insecurity (HFI) of the rural small holder farmers need further study. Therefore, we examined these associations in small holder farmers residing in this Province in the Andes Highlands (elevation > 2500 m). Non-pregnant maternal home managers (n = 558, x age = 44.1, SD = 16.5 y) were interviewed regarding the number of different agricultural food crops cultivated and domestic animals raised in their family farm plots. DD was determined using the Minimum Dietary Diversity for Women Score (MDD-W) based on the number of 10 different food groups consumed, and household food insecurity (HFI) was determined using the 8-item Household Food Insecurity Experience Scale. The women reported consuming an average of 53% of their total food from what they cultivated or raised. Women with higher DD [MMD-W score ≥ 5 food groups (79% of total sample)] were on farms that cultivated a greater variety of crops (x = 8.7 vs. 6.7), raised more animals (x = 17.9 vs. 12.7, p < 0.05), and reported lower HFI and significantly higher intakes of energy, protein, iron, zinc, and vitamin A (all p < 0.05). Multiple regression analyses demonstrated that FPD was only modestly related to DD, which together with years of education, per capita family income, and HFI accounted for 26% of DD variance. In rural areas of the Imbabura Province, small holder farmers still rely heavily on consumption of self-cultivated foods, but greater diversity of crops grown in family farm plots is only weakly associated with greater DD and lower HFI among the female caretakers.
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Affiliation(s)
- Christopher L Melby
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA
- Colorado School of Public Health, MPH Program at Colorado State University, Fort Collins, CO 80523, USA;
- Correspondence: ; Tel.: +01-970-491-6736
| | - Fadya Orozco
- School of Public Health, Universidad San Francisco de Quito, Quito, Ecuador;
| | - Jenni Averett
- Colorado School of Public Health, MPH Program at Colorado State University, Fort Collins, CO 80523, USA;
| | | | - Maria José Romero
- Faculty of Engineering in Agricultural and Environmental Sciences, Universidad Técnica del Norte, Ibarra, Ecuador;
| | - Amparito Barahona
- Faculty of Health Sciences, Universidad Técnica del Norte, Ibarra, Ecuador;
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90
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Erokhin V, Gao T. Impacts of COVID-19 on Trade and Economic Aspects of Food Security: Evidence from 45 Developing Countries. Int J Environ Res Public Health 2020; 17:E5775. [PMID: 32785155 PMCID: PMC7459461 DOI: 10.3390/ijerph17165775] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/30/2020] [Accepted: 08/02/2020] [Indexed: 12/15/2022]
Abstract
The stability of food supply chains is crucial to the food security of people around the world. Since the beginning of 2020, this stability has been undergoing one of the most vigorous pressure tests ever due to the COVID-19 outbreak. From a mere health issue, the pandemic has turned into an economic threat to food security globally in the forms of lockdowns, economic decline, food trade restrictions, and rising food inflation. It is safe to assume that the novel health crisis has badly struck the least developed and developing economies, where people are particularly vulnerable to hunger and malnutrition. However, due to the recency of the COVID-19 problem, the impacts of macroeconomic fluctuations on food insecurity have remained scantily explored. In this study, the authors attempted to bridge this gap by revealing interactions between the food security status of people and the dynamics of COVID-19 cases, food trade, food inflation, and currency volatilities. The study was performed in the cases of 45 developing economies distributed to three groups by the level of income. The consecutive application of the autoregressive distributed lag method, Yamamoto's causality test, and variance decomposition analysis allowed the authors to find the food insecurity effects of COVID-19 to be more perceptible in upper-middle-income economies than in the least developed countries. In the latter, food security risks attributed to the emergence of the health crisis were mainly related to economic access to adequate food supply (food inflation), whereas in higher-income developing economies, availability-sided food security risks (food trade restrictions and currency depreciation) were more prevalent. The approach presented in this paper contributes to the establishment of a methodology framework that may equip decision-makers with up-to-date estimations of health crisis effects on economic parameters of food availability and access to staples in food-insecure communities.
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Affiliation(s)
| | - Tianming Gao
- School of Economics and Management, Harbin Engineering University, Harbin 150001, China;
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91
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Simmet A, Teut M, Schleicher R, Bschaden A, Stroebele-Benschop N. Impact of a smoking cessation program on smoking prevalence and food security among food pantry users - a study protocol for a pragmatic cluster randomised controlled trial. BMC Public Health 2020; 20:1124. [PMID: 32680475 PMCID: PMC7366453 DOI: 10.1186/s12889-020-09232-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Among food pantry users there is a high prevalence of both smoking and food insecurity, which may be related to one another. This study aims to evaluate the impact of a smoking cessation program carried out in food pantries on the smoking status and the food security status of food pantry users. METHODS / DESIGN Before starting the cluster randomised controlled trial, stakeholders will be engaged to adapt a behavioural group counselling program for smoking cessation to the needs of the food pantry users in a pre study. Food pantry users and workers as well as other experts, such as smoking cessation trainers, social workers, and psychologists, will be involved, using the world café technique and telephone interviews and a qualitative thematic analysis for data analysis to design the concept of the intervention program will be applied. In the second phase, the impact of the intervention on the smoking status and on food insecurity will be investigated by a cluster randomised controlled trial. A total of 416 food pantry users across 32 clusters (food pantries) in Berlin, Germany, should be recruited and randomly assigned to either the intervention group or the waiting list control group. The intervention will consist of a behavioural group counselling program for smoking cessation, specially tailored for food pantry users, as well as optional nicotine replacement therapy and the implementation of environmental smoking reduction measures in the food pantries. The primary outcomes 6 months after the treatment will be self-reported continuous smoking abstinence, validated by exhaled carbon monoxide (< 10 ppm of carbon monoxide), and increased food security level (the percentage of participants with an improved food security level). DISCUSSION This study will be the first long-term investigation into the effect of a smoking cessation program on smoking status and food insecurity. The results of this study will inform the implementation of smoking cessation programs in food pantries throughout Germany. TRIAL REGISTRATION Prospectively registered DRKS00020037 . Registered 29 April 2020.
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Affiliation(s)
- Anja Simmet
- Institute of Nutritional Medicine, Department of Nutritional Psychology, University of Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| | - Michael Teut
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Luisenstraße 57, 10117 Berlin, Germany
| | - Romy Schleicher
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Luisenstraße 57, 10117 Berlin, Germany
| | - Andreas Bschaden
- Institute of Nutritional Medicine, Department of Nutritional Psychology, University of Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| | - Nanette Stroebele-Benschop
- Institute of Nutritional Medicine, Department of Nutritional Psychology, University of Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
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Niles MT, Bertmann F, Belarmino EH, Wentworth T, Biehl E, Neff R. The Early Food Insecurity Impacts of COVID-19. Nutrients 2020; 12:nu12072096. [PMID: 32679788 PMCID: PMC7400862 DOI: 10.3390/nu12072096] [Citation(s) in RCA: 273] [Impact Index Per Article: 68.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/04/2020] [Accepted: 07/12/2020] [Indexed: 11/16/2022] Open
Abstract
COVID-19 has disrupted food access and impacted food insecurity, which is associated with numerous adverse individual and public health outcomes. To assess these challenges and understand their impact on food security, we conducted a statewide population-level survey using a convenience sample in Vermont from March 29 to April 12, 2020, during the beginning of a statewide stay-at-home order. We utilized the United States Department of Agriculture six-item validated food security module to measure food insecurity before COVID-19 and since COVID-19. We assessed food insecurity prevalence and reported food access challenges, coping strategies, and perceived helpful interventions among food secure, consistently food insecure (pre-and post-COVID-19), and newly food insecure (post COVID-19) respondents. Among 3219 respondents, there was nearly a one-third increase (32.3%) in household food insecurity since COVID-19 (p < 0.001), with 35.5% of food insecure households classified as newly food insecure. Respondents experiencing a job loss were at higher odds of experiencing food insecurity (OR 3.06; 95% CI, 2.114-0.46). We report multiple physical and economic barriers, as well as concerns related to food access during COVID-19. Respondents experiencing household food insecurity had higher odds of facing access challenges and utilizing coping strategies, including two-thirds of households eating less since COVID-19 (p < 0.001). Significant differences in coping strategies were documented between respondents in newly food insecure vs. consistently insecure households. These findings have important potential impacts on individual health, including mental health and malnutrition, as well as on future healthcare costs. We suggest proactive strategies to address food insecurity during this crisis.
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Affiliation(s)
- Meredith T. Niles
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405, USA; (F.B.); (E.H.B.); (T.W.)
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405, USA
- Gund Institute for Environment, University of Vermont, 210 Colchester Ave, Burlington, VT 05405, USA
- Correspondence:
| | - Farryl Bertmann
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405, USA; (F.B.); (E.H.B.); (T.W.)
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405, USA
| | - Emily H. Belarmino
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405, USA; (F.B.); (E.H.B.); (T.W.)
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405, USA
| | - Thomas Wentworth
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405, USA; (F.B.); (E.H.B.); (T.W.)
| | - Erin Biehl
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, W7010, Baltimore, MD 21205, USA; (E.B.); (R.N.)
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Roni Neff
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, W7010, Baltimore, MD 21205, USA; (E.B.); (R.N.)
- Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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93
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Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, Sawadogo-Lewis T, Walker N. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health 2020; 8:e901-e908. [PMID: 32405459 PMCID: PMC7217645 DOI: 10.1016/s2214-109x(20)30229-1] [Citation(s) in RCA: 743] [Impact Index Per Article: 185.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND While the COVID-19 pandemic will increase mortality due to the virus, it is also likely to increase mortality indirectly. In this study, we estimate the additional maternal and under-5 child deaths resulting from the potential disruption of health systems and decreased access to food. METHODS We modelled three scenarios in which the coverage of essential maternal and child health interventions is reduced by 9·8-51·9% and the prevalence of wasting is increased by 10-50%. Although our scenarios are hypothetical, we sought to reflect real-world possibilities, given emerging reports of the supply-side and demand-side effects of the pandemic. We used the Lives Saved Tool to estimate the additional maternal and under-5 child deaths under each scenario, in 118 low-income and middle-income countries. We estimated additional deaths for a single month and extrapolated for 3 months, 6 months, and 12 months. FINDINGS Our least severe scenario (coverage reductions of 9·8-18·5% and wasting increase of 10%) over 6 months would result in 253 500 additional child deaths and 12 200 additional maternal deaths. Our most severe scenario (coverage reductions of 39·3-51·9% and wasting increase of 50%) over 6 months would result in 1 157 000 additional child deaths and 56 700 additional maternal deaths. These additional deaths would represent an increase of 9·8-44·7% in under-5 child deaths per month, and an 8·3-38·6% increase in maternal deaths per month, across the 118 countries. Across our three scenarios, the reduced coverage of four childbirth interventions (parenteral administration of uterotonics, antibiotics, and anticonvulsants, and clean birth environments) would account for approximately 60% of additional maternal deaths. The increase in wasting prevalence would account for 18-23% of additional child deaths and reduced coverage of antibiotics for pneumonia and neonatal sepsis and of oral rehydration solution for diarrhoea would together account for around 41% of additional child deaths. INTERPRETATION Our estimates are based on tentative assumptions and represent a wide range of outcomes. Nonetheless, they show that, if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating. We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come. FUNDING Bill & Melinda Gates Foundation, Global Affairs Canada.
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Affiliation(s)
- Timothy Roberton
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Emily D Carter
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Victoria B Chou
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Angela R Stegmuller
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Bianca D Jackson
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Yvonne Tam
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Talata Sawadogo-Lewis
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Neff Walker
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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94
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Lee AJ, Kane S, Herron LM, Matsuyama M, Lewis M. A tale of two cities: the cost, price-differential and affordability of current and healthy diets in Sydney and Canberra, Australia. Int J Behav Nutr Phys Act 2020; 17:80. [PMID: 32571334 PMCID: PMC7309977 DOI: 10.1186/s12966-020-00981-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/08/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The perception that healthy foods are more expensive than unhealthy foods has been reported widely to be a key barrier to healthy eating. However, assessment of the relative cost of healthy and unhealthy foods and diets is fraught methodologically. Standardised approaches to produce reliable data on the cost of total diets and different dietary patterns, rather than selected foods, are lacking globally to inform policy and practice. METHODS This paper reports the first application, in randomly selected statistical areas stratified by socio-economic status in two Australian cities, of the Healthy Diets Australian Standardized Affordability and Pricing (ASAP) method protocols: diet pricing tools based on national nutrition survey data and dietary guidelines; store sampling and location; determination of household incomes; food price data collection; and analysis and reporting. The methods were developed by the International Network on Food and Obesity/NCD Research, Monitoring and Action Support (INFORMAS) as a prototype of an optimum approach to assess, compare and monitor the cost and affordability of diets across different geographical and socio-economic settings and times. RESULTS Under current tax policy in Australia, healthy diets would be 15-17% less expensive than current (unhealthy) diets in all locations assessed. Nevertheless, healthy diets are likely to be unaffordable for low income households, costing more than 30% of disposable income in both cities surveyed. Households spent around 58% of their food budget on unhealthy food and drinks. Food costs were on average 4% higher in Canberra than Sydney, and tended to be higher in high socioeconomic locations. CONCLUSIONS Health and fiscal policy actions to increase affordability of healthy diets for low income households are required urgently. Also, there is a need to counter perceptions that current, unhealthy diets must be less expensive than healthy diets. The Healthy Diets ASAP methods could be adapted to assess the cost and affordability of healthy and unhealthy diets elsewhere.
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Affiliation(s)
- Amanda J Lee
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia.
| | - Sarah Kane
- Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Lisa-Maree Herron
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Misa Matsuyama
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Meron Lewis
- School of Public Health, The University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
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95
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Tutunchi H, Ebrahimi-Mameghani M, Asghari-Jafarabadi M, Farrin N, Tabrizi S, Vaghef-Mehrabany E, Ostadrahimi A. Is the modified household food security survey (HFSS) questionnaire a practical tool for screening food insecurity? Evidence from northwest of Iran. BMC Public Health 2020; 20:883. [PMID: 32513137 PMCID: PMC7282109 DOI: 10.1186/s12889-020-09014-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/29/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Adequate supplies of food and food security (FS) are the fundamental aspects of human societies, and considered one of the pivotal factors of individual and social health. The aim of the present study was to assess the applicability of the short questionnaire for screening food insecurity (FI) and to evaluate the prevalence of FI in northwest of Iran. METHODS In this study, 550 subjects aged ≥16 years were studied. Three-day dietary records and a short questionnaire were applied to estimate the prevalence of FI in terms of hunger and hidden hunger. The sensitivity, specificity and accuracy of the short questionnaire were assessed. Moreover, the association between the results of the short questionnaire and the criteria that were theoretically related to FI were examined. Data were presented as mean (SD), median (min-max) for the numeric normal and non-normal variables, respectively, and frequency (percent) for categorical variables. The between-group comparisons of variables were done using independent samples t test. P values less than 0.05 were considered statistically significant. RESULTS The prevalence of hunger and hidden hunger was 30.8 and 46.0%, respectively. Overall, 23.2% of the subjects were classified as "food secure". The sensitivity, specificity and accuracy of the short questionnaire in determining hunger were 92.8% (95% CI: 87.3-95.9), 84.2% (95% CI: 79.3-89.3), and 87% (95% CI: 84-90.2), respectively. These values for hidden hunger were 21.6% (95% CI: 15.7-29.9), 92.3% (95% CI: 88.7-99.4), and 53.4% (95% CI: 47.9-59.8), respectively. Our study showed a statistically significant association between FI and socio-economic status. FI significantly enhanced the risk of underweight, while it markedly reduced the risk of overweight and obesity. The average frequency of monthly consumption of meat, dairy products, fruits, vegetables, and rice was significantly lower in food insecure group, while the median frequency of bread consumption was markedly higher in food insecure group. The participants of insecure group were less likely to consume fruits, vegetables, dairy products, rice and meat. CONCLUSIONS FI was frequent in North-west of Iran. The findings indicated that the short questionnaire was a simple, low-cost and practical tool for screening FI in terms of hunger. TRIAL REGISTRATION IR.TBZMED.REC.1397.400.
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Affiliation(s)
- Helda Tutunchi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, 5166614711 Iran
| | - Mehrangiz Ebrahimi-Mameghani
- Social Determinant of Health Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Nazila Farrin
- Nutrition Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sirous Tabrizi
- Faculty of Education, University of Windsor, Windsor, Canada
| | - Elnaz Vaghef-Mehrabany
- Nutrition Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, 5166614711 Iran
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Olfert MD, Hagedorn RL, Walker AE, Wattick RA. Rapid Dissemination of College Food Insecurity Findings in A Multi-Institutional Study Using the eB4CAST Approach. Nutrients 2020; 12:nu12061646. [PMID: 32498301 PMCID: PMC7352705 DOI: 10.3390/nu12061646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/21/2020] [Accepted: 05/29/2020] [Indexed: 11/16/2022] Open
Abstract
The sharing of college food insecurity data with higher education administrators and stakeholders is essential to increase awareness of campus-specific food insecurity outcomes. This study utilized the evidence-Based forecast C-capture, A-assemble, S-sustain, T-timelessness (eB4CAST) approach to develop campus-specific food insecurity reports for researchers involved in a multi-institutional food insecurity study. eB4CAST reports were developed for each higher education institution (n = 22). The reports were four pages of visual data that included details of the eB4CAST approach and the multi-institutional food insecurity study, campus demographics, an overview of college food insecurity, food insecurity prevalence estimates at all participating institutions, and student use and awareness of campus resources, as well as the campus-specific resources that are available. The interpretation and forecasted use of the reports were evaluated through a 17-item online survey. The survey was completed by 26 content experts and showed a favorable perception of the eB4CAST institutional report. A majority of participants strongly agreed that the eB4CAST food insecurity report was clear to understand (72%), it was easy to read (64%), the statistics were easy to interpret (80%), it shared valuable information (92%), and it was impactful to their work (80%). Further, 84% of participants found the overall information of the report to be relevant and sharable. Participants forecasted disseminating the reports primarily to administration (77%) and with other faculty and staff (85%). These findings highlight the projected usability of the visualized data eB4CAST report across many sectors of college food insecurity research, which may help disseminate rapid findings on this emerging issue and increase awareness.
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Abstract
The COVID-19 pandemic has dramatically increased food insecurity in the United States (US). The objective of this study was to understand the early effects of the COVID-19 pandemic among low-income adults in the US as social distancing measures began to be implemented. On 19-24 March 2020 we fielded a national, web-based survey (53% response rate) among adults with <250% of the federal poverty line in the US (N = 1478). Measures included household food security status and COVID-19-related basic needs challenges. Overall, 36% of low-income adults in the US were food secure, 20% had marginal food security, and 44% were food insecure. Less than one in five (18.8%) of adults with very low food security reported being able to comply with public health recommendations to purchase two weeks of food at a time. For every basic needs challenge, food-insecure adults were significantly more likely to report facing that challenge, with a clear gradient effect based on severity of food security. The short-term effects of the COVID-19 pandemic are magnifying existing disparities and disproportionately affecting low-income, food-insecure households that already struggle to meet basic needs. A robust, comprehensive policy response is needed to mitigate food insecurity as the pandemic progresses.
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Affiliation(s)
- Julia A Wolfson
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
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98
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Guo B, Huang J, Porterfield SL. Food security and health in transition to adulthood for individuals with disabilities. Disabil Health J 2020; 13:100937. [PMID: 32418807 DOI: 10.1016/j.dhjo.2020.100937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/11/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Due to a more stringent disability definition used for eligibility redetermination at age 18, individuals with disabilities may lose eligibility for the Supplement and Nutrition Assistance Program (SNAP). OBJECTIVE This study examines how the transition to adulthood may affect the association between food security and self-rated health and healthcare needs for individuals with disabilities. METHODS The study uses five years of data (2011-2015) from the National Health Interview Survey (NHIS). One health indicator, self-rated health status, and two indicators of unmet healthcare needs, delayed medical care and not receiving medical care due to cost, are analyzed as dependent variables. The effects of food security status on health and health-related outcomes are closely examined for the four groups: youth without disabilities, youth with disabilities, young adults without disabilities and young adults with disabilities. RESULTS Results indicate a statistically significant association between food security status and self-rated health and unmet healthcare needs in late childhood and young adulthood. Such association is stronger for young adults than for youth. The association between low food security and self-rated health and health-related outcomes does not significantly differ between the two youth groups or the two young adult groups by disability status. CONCLUSIONS Suggestions for improving accessibility of public food and nutrition programs are discussed. The study also suggests the importance of creating a healthcare system that benefits every member of the society.
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Affiliation(s)
- Baorong Guo
- University of Missouri-St. Louis, School of Social Work, 121 Bellerive Hall, One University Boulevard, St. Louis, MO, 63121, USA.
| | - Jin Huang
- School of Social Work, Saint Louis University, USA.
| | - Shirley L Porterfield
- School of Social Work, University of Missouri-St. Louis, 121 Bellerive Hall, St. Louis, USA.
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Shai N, Pradhan GD, Shrestha R, Adhikari A, Chirwa E, Kerr-Wilson A, Jewkes R. "I got courage from knowing that even a daughter-in-law can earn her living": Mixed methods evaluation of a family-centred intervention to prevent violence against women and girls in Nepal. PLoS One 2020; 15:e0232256. [PMID: 32427999 PMCID: PMC7237029 DOI: 10.1371/journal.pone.0232256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 04/10/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND We developed, and pilot tested a family focused intervention Sammanit Jeevan "Living with Dignity" to reduce gender-based violence by husbands, change harmful social and gender norms and improve the economic conditions of women through young married women-led income generating activities (IGAs). METHODS We conducted a modified interrupted time series study and qualitative research to evaluate the intervention in two migrant communities in Baglung district, Nepal. We enrolled young married women, their husbands and in-laws from 100 families. 200 women and 157 men completed questionnaires before the programme, and 6, 12 and 18 months afterwards. 18 in-depth interviews were conducted before the programme and 6 and 12 months later. We analysed the data for trends. RESULTS The intervention positively impacted young married women's economic conditions, exposure to violence and changed inequitable gender attitudes. Some positive outcomes were observed among older women and men. Young women's past month earnings (35.0% - 81.3%, β = 0.11, p-value<0.001) and savings (29.0% - 80.2%, β = 0.14, p-value<0.001) more than doubled over time. Young women experienced much less past year physical IPV over time (10% - 4.4%, β = -0.08, p-value = 0.077). They also perceived that their mothers-in-law were less cruel (mean 9.0-8.6, β = -0.03, p-value = 0.035). Improvements were observed in young women's individual (mean 44.4-43.3, β = -0.04, p-value = 0.297) and perceived community gender attitudes (mean 54.4-51.4, β = -0.19, p-value<0.001) and they reported that their husbands were less controlling (mean 17.5-16.1, β = -007, p-value<0.001). These changes were supported by qualitative findings. CONCLUSIONS Whilst caution is needed in attributing the effect due to lack of control arm, the results suggest that with adequate time and seed funding, Sammanit Jeevan enabled considerable income generation, a strengthened the position of young women in the households and it reduced their exposure to violence in this community. It warrants further research to optimise its impact.
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Affiliation(s)
- Nwabisa Shai
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Ratna Shrestha
- Voluntary Services Overseas (VSO) Nepal, Kathmandu, Nepal
| | | | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Vergeer L, Vanderlee L, Ahmed M, Franco-Arellano B, Mulligan C, Dickinson K, L'Abbé MR. A comparison of the nutritional quality of products offered by the top packaged food and beverage companies in Canada. BMC Public Health 2020; 20:650. [PMID: 32393206 PMCID: PMC7216504 DOI: 10.1186/s12889-020-08828-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 05/01/2020] [Indexed: 03/29/2024] Open
Abstract
BACKGROUND Canada's food supply is abundant in less healthy products, increasing Canadians' risk of obesity and non-communicable diseases. Food companies strongly influence the food supply; however, no studies have examined differences in the healthfulness of products offered by various companies in Canada. This study aimed to compare the nutritional quality of products offered by the top packaged food and beverage companies in Canada. METHODS Twenty-two top packaged food and beverage manufacturing companies were selected, representing > 50% of the Canadian market share in 2018. Nutritional information for products (n = 8277) was sourced from the University of Toronto Food Label Information Program 2017 database. Descriptive analyses examined the nutritional quality of products based on: 1) the Health Star Rating (HSR) system; 2) calories, sodium, saturated fat and total sugars per 100 g (or mL) and per reference amounts (RAs) defined by Health Canada; and 3) "high in" thresholds for sodium, saturated fat and total sugars proposed by Health Canada for pending front-of-package labelling regulations. Kruskal-Wallis tests compared HSRs of products between companies. RESULTS Mean HSRs of companies' total product offerings ranged from 1.9 to 3.6 (out of 5.0). Differences in HSRs of products between companies were significant overall and for 19 of 22 food categories (P < 0.05), particularly for fats/oils and beverages. Calories, sodium, saturated fat and total sugars contents varied widely between companies for several food categories, and depending on whether they were examined per 100 g (or mL) or RA. Additionally, 66.4% of all products exceeded ≥1 of Health Canada's "high in" thresholds for sodium (31.7%), saturated fat (28.3%) and/or sugars (28.4%). The proportion of products offered by a company that exceeded at least one of these thresholds ranged from 38.5 to 97.5%. CONCLUSIONS The nutritional quality of products offered by leading packaged food and beverage manufacturers in Canada differs significantly overall and by food category, with many products considered less healthy according to multiple nutrient profiling methods. Variation within food categories illustrates the need and potential for companies to improve the healthfulness of their products. Identifying companies that offer less healthy products compared with others in Canada may help prompt reformulation.
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Affiliation(s)
- Laura Vergeer
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Lana Vanderlee
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Kacie Dickinson
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, G.P.O, Box 2100, Adelaide, SA, 5001, Australia
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
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