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Zorbas C, Blake MR, Brown AD, Peeters A, Allender S, Brimblecombe J, Cameron AJ, Whelan J, Ferguson M, Alston L, Boelsen-Robinson T. A systems framework for implementing healthy food retail in grocery settings. BMC Public Health 2024; 24:137. [PMID: 38195419 PMCID: PMC10777568 DOI: 10.1186/s12889-023-17075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/26/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Food retailers can be reluctant to initiate healthy food retail activities in the face of a complex set of interrelated drivers that impact the retail environment. The Systems Thinking Approach for Retail Transformation (START) is a determinants framework created using qualitative systems modelling to guide healthy food retail interventions in community-based, health-promoting settings. We aimed to test the applicability of the START map to a suite of distinct healthy food marketing and promotion activities that formed an intervention in a grocery setting in regional Victoria, Australia. METHODS A secondary analysis was undertaken of 16 previously completed semi-structured interviews with independent grocery retailers and stakeholders. Interviews were deductively coded against the existing START framework, whilst allowing for new grocery-setting specific factors to be identified. New factors and relationships were used to build causal loop diagrams and extend the original START systems map using Vensim. RESULTS A version of the START map including aspects relevant to the grocery setting was developed ("START-G"). In both health-promoting and grocery settings, it was important for retailers to 'Get Started' with healthy food retail interventions that were supported by a proof-of-concept and 'Focus on the customer' response (with grocery-settings focused on monitoring sales data). New factors and relationships described perceived difficulties associated with disrupting a grocery-setting 'Supply-side status quo' that promotes less healthy food and beverage options. Yet, most grocery retailers discussed relationships that highlighted the potential for 'Healthy food as innovation' and 'Supporting cultural change through corporate social responsibility and leadership'. CONCLUSIONS Several differences were found when implementing healthy food retail in grocery compared to health promotion settings. The START-G map offers preliminary guidance for identifying and addressing commercial interests in grocery settings that currently promote less healthy foods and beverages, including by starting to address business outcomes and supplier relationships.
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Affiliation(s)
- Christina Zorbas
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia.
| | - Miranda R Blake
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Andrew D Brown
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Anna Peeters
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Steve Allender
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Julie Brimblecombe
- Department of Nutrition and Dietetics, Monash University, 264 Ferntree Gully Rd, Notting Hill, VIC, Australia
| | - Adrian J Cameron
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Jill Whelan
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Megan Ferguson
- School of Public Health, The University of Queensland, St Lucia, QLD, Australia
| | - Laura Alston
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
- Deakin Rural Health, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
| | - Tara Boelsen-Robinson
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, Australia
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2
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Evans CEL, Worth S, White R, Strachan EK. Evaluation of an experiment to increase availability of healthier snack foods in vending machines situated within English sports facilities. Public Health Nutr 2023; 26:3088-3099. [PMID: 37727877 PMCID: PMC10755406 DOI: 10.1017/s1368980023002069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 06/14/2023] [Accepted: 09/13/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To evaluate the impact of increased availability of healthier options on purchasing of different types of vending snack products sold in English leisure (sports) centres. DESIGN An evaluation of an intervention using pre-post methods and interrupted time series analysis. Products within the vending machines were altered over three phases to increase the availability of healthier options, using agreed nutrition criteria - Government Buying Standards for Food and Catering Services (GBSF) for England - as a guide, as well as product availability. The primary outcome was the change in mean weekly purchased energy between the first and third phase. Secondary outcomes included changes by phase and by week in weekly number of purchases, fats, sugars and salt for all products combined and by individual product categories. SETTING Fifteen sports centres in the city of Leeds, West Yorkshire, UK. PARTICIPANTS Snack products sold in eighteen vending machines. RESULTS Energy purchased reduced from baseline to phase 2, for all product categories combined, by 47·25 MJ (95 % CI (-61·22, -33·27)) per machine and by 279 kJ, (95 % CI (-325, -266)) per product unit. There were reductions in most nutrients purchased in all individual product categories except chocolate confectionery. Nutrients per product unit decreased for all product categories except saturated fat in chocolate confectionery. Minimal underlying trends in the baseline phase were identified, indicating changes in outcomes were likely to be due to the intervention. CONCLUSIONS Introducing standards to increase availability of healthier snack products in vending machines is feasible without substantially affecting sales.
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Affiliation(s)
- Charlotte EL Evans
- School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | | | - Rachel White
- Health Improvement and Disparities, Department of Health and Social Care, London, UK
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3
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Prowse R, Lawlor N, Powell R, Neumann EM. Creating healthy food environments in recreation and sport settings using choice architecture: a scoping review. Health Promot Int 2023; 38:daad098. [PMID: 37705493 PMCID: PMC10500220 DOI: 10.1093/heapro/daad098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Recreation and sport settings (RSS) are ideal for health promotion, however, they often promote unhealthy eating. Choice architecture, a strategy to nudge consumers towards healthier options, has not been comprehensively reviewed in RSS and indicators for setting-based multi-level, multi-component healthy eating interventions in RSS are lacking. This scoping review aimed to generate healthy food environment indicators for RSS by reviewing peer-reviewed and grey literature evidence mapped onto an adapted choice architecture framework. One hundred thirty-two documents were included in a systematic search after screening. Data were extracted and coded, first, according to Canada's dietary guideline key messages, and were, second, mapped onto a choice architecture framework with eight nudging strategies (profile, portion, pricing, promotion, picks, priming, place and proximity) plus two multi-level factors (policy and people). We collated data to identify overarching guiding principles. We identified numerous indicators related to foods, water, sugary beverages, food marketing and sponsorship. There were four cross-cutting guiding principles: (i) healthy food and beverages are available, (ii) the pricing and placement of food and beverages favours healthy options, (iii) promotional messages related to food and beverages supports healthy eating and (iv) RSS are committed to supporting healthy eating and healthy food environments. The findings can be used to design nested, multipronged healthy food environment interventions. Future research is needed to test and systematically review the effectiveness of healthy eating interventions to identify the most promising indicators for setting-based health promotion in RSS.
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Affiliation(s)
- Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's NL A1B 3V6, Canada
| | - Natasha Lawlor
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's NL A1B 3V6, Canada
| | - Rachael Powell
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's NL A1B 3V6, Canada
| | - Eva-Marie Neumann
- Library Services Division, Health Canada, Jeanne Mance Building, 200 Eglantine Driveway, Tunney’s Pasture, Ottawa, ON K1A 0K9, Canada
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4
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Blake MR, Romaniuk H, Riesenberg D, Boelsen-Robinson T, Cameron AJ, Orellana L, Peeters A. Implementation and sales impact of a capacity building intervention in Australian sporting facility food outlets: a longitudinal observational study. BMJ Nutr Prev Health 2022; 5:171-181. [PMID: 36619339 PMCID: PMC9813625 DOI: 10.1136/bmjnph-2022-000445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/25/2022] [Indexed: 01/11/2023] Open
Abstract
Background Few studies have explored behavioural and financial impacts of retail initiatives after 2 years to address the unhealthy food environments common in local government sporting settings. Aims To evaluate the impact of a 2-year local government capacity building intervention in sporting facility food outlets on (1) the healthiness of refrigerated drink choices available and visible to customers, (2) healthiness of refrigerated drinks sold and (3) refrigerated drink revenue. Methods 52 sporting facilities within 8 local governments from Victoria, Australia, participated in an intervention between March 2018 and February 2020 by limiting 'red' (least healthy) drinks to ≤20% of refrigerator display and increasing 'green' (healthiest) drinks to ≥50% of display. Mixed models assessed changes in mean percentage of 'red', 'amber' and 'green' drinks displayed over time, compared with baseline.Facilities provided electronic weekly itemised sales data (December 2015 to February 2020). Weekly volume of 'red' or 'green' drinks sold as a proportion of total drinks sold, and total refrigerated drinks revenue were compared preimplementation and postimplementation using mixed models (seasonal facilities), and mixed-effect interrupted time series models (non-seasonal facilities). Results Display of 'red' drinks decreased by mean -17.1 percentage points (pp) (95% CI -23.9 to -10.3) and 'green' drinks increased 16.1 pp (95% CI 9.30, 22.9) between baseline and 18-month audits.At nine seasonal facilities, compared with the summer preimplementation, the mean volume of 'red' drinks sold decreased by -19.0 pp (95% CI -28.6, to -9.51) and refrigerated drink revenue decreased by-AU$81.8 (95% CI -AU$123 to -AU$40.8) per week. At 15 non-seasonal facilities, by February 2020, the volume of 'red' drinks sold decreased on average by -11.0 pp (95% CI -21.6 to -0.41) with no change in drink revenue. Conclusion Reducing the display of unhealthy drinks can be an effective public health policy to improve the healthiness of customer purchases, provided there is consideration of potential impacts on revenue.
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Affiliation(s)
- Miranda R Blake
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Helena Romaniuk
- Deakin University, Biostatistics Unit, Faculty of Health, Geelong, Victoria, Australia
| | - Devorah Riesenberg
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Tara Boelsen-Robinson
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Adrian J Cameron
- Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria, Australia
| | - Liliana Orellana
- Deakin University, Biostatistics Unit, Faculty of Health, Geelong, Victoria, Australia
| | - Anna Peeters
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia
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5
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Dwyer KM, Robson B, Muecke J. Too much sugar does not just make us fat; it can also make us sick. Intern Med J 2022; 52:1089-1092. [PMID: 35599454 PMCID: PMC9324956 DOI: 10.1111/imj.15812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/02/2022] [Accepted: 02/21/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Karen M. Dwyer
- Kidney Health Australia Melbourne Victoria
- School of Medicine Deakin University Geelong Victoria
- Epworth Healthcare Geelong Victoria
| | | | - James Muecke
- Sight For All Adelaide South Australia Australia
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6
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Forsyth A, Nicholson M, Skiadopoulos A, Trakman G, Devlin B, Belski R, Randle E, O'Halloran P, Cameron M, Staley K. Interventions to reduce sugar-sweetened beverage consumption using a nudge approach in Victorian community sports settings. Aust N Z J Public Health 2021; 45:592-598. [PMID: 34762340 DOI: 10.1111/1753-6405.13182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/01/2021] [Accepted: 10/01/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To assess the effectiveness of interventions using a nudge approach to reduce sugar-sweetened beverage purchases in community sports settings. METHODS A total of 155 community sporting organisations participating in VicHealth funded programs were invited to nominate a nudge based on a traffic light approach to drinks classification. These included limit red drinks, red drinks off display, water the cheapest option, and meal deals. Sales data was collected for a predetermined period prior to and following the introduction of the nudge. Nudges were classified initially on whether they were implemented to VicHealth standards. Appropriately implemented nudges were classified as successful if they achieved a relative decrease in sales from drinks classified as red. RESULTS In all, 148 organisations trialled 195 nudges; 15 (7.7%) were successful and 20 (10.3%) were appropriately implemented but unsuccessful. Limit red drinks was the most frequently attempted nudge (30.8%). Red drinks off display had the greatest rate of success (20.0%). CONCLUSIONS Red drinks off display was the simplest and most successful nudge. Implications for public health: Guidelines limiting the display of sugar-sweetened beverages may be an effective means of altering consumer behaviour.
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Affiliation(s)
- Adrienne Forsyth
- Department of Dietetics, Nutrition and Sport, La Trobe University, Victoria.,Centre for Sport and Social Impact, La Trobe University, Victoria
| | | | - Anne Skiadopoulos
- Centre for Sport and Social Impact, La Trobe University, Victoria.,RMIT University, Victoria
| | - Gina Trakman
- Department of Dietetics, Nutrition and Sport, La Trobe University, Victoria.,Centre for Sport and Social Impact, La Trobe University, Victoria
| | - Brooke Devlin
- Department of Dietetics, Nutrition and Sport, La Trobe University, Victoria.,Centre for Sport and Social Impact, La Trobe University, Victoria
| | - Regina Belski
- Centre for Sport and Social Impact, La Trobe University, Victoria.,School of Health Sciences, Swinburne University of Technology, Victoria
| | - Erica Randle
- Centre for Sport and Social Impact, La Trobe University, Victoria
| | - Paul O'Halloran
- Centre for Sport and Social Impact, La Trobe University, Victoria.,Department of Public Health, La Trobe University, Victoria
| | | | - Kiera Staley
- Centre for Sport and Social Impact, La Trobe University, Victoria
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7
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Boelsen-Robinson T, Jerebine A, Kurzeme A, Gilham B, Huse OT, Blake MR, Backholer K, Chung A, Peeters A. Evaluating the implementation and customer acceptability of a sugar-sweetened beverage reduction initiative in thirty Australian aquatic and recreation centres. Public Health Nutr 2021; 24:5166-5175. [PMID: 34085621 PMCID: PMC11082803 DOI: 10.1017/s1368980021002421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/05/2021] [Accepted: 05/21/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the feasibility of implementation and customer perspectives of a sugar-sweetened beverage (SSB) reduction initiative across YMCA Victoria aquatic and recreation centres. DESIGN Two data sources were used to assess implementation and customer acceptability. Photo audits were used to assess the type of drinks available for purchase 6 months prior to initiative implementation and 6 months after, in thirty centres. Change in the range of SSB targeted for removal, non-targeted SSB, as well as drinks classified as 'red' (limit), 'amber' (choose carefully) and 'green' (best choice), was reported. Customer surveys were conducted in three centres to assess acceptability and awareness of the initiative. Inductive and deductive thematic analysis was used to analyse customers' perspectives of the initiative. SETTING 30 aquatic and recreation centres in Victoria, Australia. PARTICIPANTS 806 customers. RESULTS At post-implementation, 87 % of centres had removed targeted SSB. 'Red' drinks reduced by an average of 4·4 drink varieties compared to pre-implementation (11·9 varieties) and 'green' drinks increased by 1·4 varieties (3·2 varieties pre-implementation). Customers were largely unaware of the SSB-reduction initiative (90 %) but supported YMCA Victoria in continuing the initiative (89 %), with many believing it would support children in making healthier choices. CONCLUSIONS Implementation of an initiative that limited SSB availability across a large number of aquatic and recreation centres was feasible and considered acceptable by customers. Customers frequently mentioned the importance of protecting children from consuming SSB.
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Affiliation(s)
- Tara Boelsen-Robinson
- School of Public Health and Preventive Medicine,
Monash University, Melbourne,
Australia
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | | | | | - Beth Gilham
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Oliver T Huse
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Miranda R Blake
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Kathryn Backholer
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Alexandra Chung
- School of Public Health and Preventive Medicine,
Monash University, Melbourne,
Australia
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Anna Peeters
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
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8
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Trakman G, Staley K, Forsyth A, Devlin B, Skiadopoulos A, Pearce K, Nicholson M, Belski R. Healthy-Canteen Displays: A Tactic to Encourage Community Sport Canteens to Provide Healthier Food and Beverage Options. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910194. [PMID: 34639496 PMCID: PMC8507705 DOI: 10.3390/ijerph181910194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Community sport settings present a range of conflicting health behaviours, including the tension between being physically active and consuming discretionary foods. Therefore, community sport settings are considered a promising location for health promotion. The aim of this project was to evaluate perceptions, knowledge and the impact (e.g., barriers and outcomes) of a healthy-canteen (cafeteria) display, based on traffic light labeling (TLL), which was set up at an Australian Basketball Association Managers’ Convention and Trade Show. (2) Methods: We set up a healthy ‘canteen display and surveyed Basketball managers on their perceptions of the display before (Survey 1) and after (Survey 2) visiting the display. Three months later they were surveyed (Survey 3) on changes made to their community sport canteens. (3) Results: Eighty-eight, 76 and 22 participants completed Surveys 1, 2 and 3, respectively. Participants believed stocking healthy foods and beverages was important (mean 8.5/10). Food waste, lack of consumer interest and price were identified barriers to stocking healthy foods. After visiting the display, 75% were inspired to make changes and 50% were surprised by the differences between their perceptions of the healthfulness of foods and the TLL ratings. Post-convention, 41% and 70% made or had planned healthy changes to their community sport canteen. (4) Conclusions: A healthy-canteen display is a low-cost, easy-to-implement strategy that may be able to direct self-driven improvement in the healthfulness of foods stocked at community canteens and lead to improved nutritional intakes at these venues.
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Affiliation(s)
- Gina Trakman
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia; (A.F.); (B.D.)
- Centre for Sport and Social Impact, La Trobe University, Melbourne 3086, Australia; (K.S.); (M.N.); (R.B.)
- Correspondence: ; Tel.: +61-3-9479-5655
| | - Kiera Staley
- Centre for Sport and Social Impact, La Trobe University, Melbourne 3086, Australia; (K.S.); (M.N.); (R.B.)
| | - Adrienne Forsyth
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia; (A.F.); (B.D.)
- Centre for Sport and Social Impact, La Trobe University, Melbourne 3086, Australia; (K.S.); (M.N.); (R.B.)
| | - Brooke Devlin
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia; (A.F.); (B.D.)
- Centre for Sport and Social Impact, La Trobe University, Melbourne 3086, Australia; (K.S.); (M.N.); (R.B.)
| | | | - Karen Pearce
- Basketball Victoria, Melbourne 3152, Australia;
- Football Victoria, Melbourne 3004, Australia
| | - Matthew Nicholson
- Centre for Sport and Social Impact, La Trobe University, Melbourne 3086, Australia; (K.S.); (M.N.); (R.B.)
- Research and Development, Monash University Malaysia, Subang Jaya 47500, Malaysia
| | - Regina Belski
- Centre for Sport and Social Impact, La Trobe University, Melbourne 3086, Australia; (K.S.); (M.N.); (R.B.)
- School of Health Sciences, Swinburne University of Technology, Melbourne 3122, Australia
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9
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Nuss T, Morley B, Scully M, Wakefield M. Energy drink consumption among Australian adolescents associated with a cluster of unhealthy dietary behaviours and short sleep duration. Nutr J 2021; 20:64. [PMID: 34225738 PMCID: PMC8259213 DOI: 10.1186/s12937-021-00719-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-alcoholic energy drinks ('energy drinks') are high in sugar, as well as caffeine, leading to concerns regarding their suitability for children and adolescents. Despite this, marketing of energy drinks is often directed at adolescents, and there are no age restrictions on the sale of these products in Australia. The current study aimed to examine patterns in consumption of energy drinks among Australian secondary school students and identify sociodemographic and behavioural correlates associated with regular consumption. METHODS Participants were 8942 students in Years 8 to 11 (aged 12 to 17 years) who participated in the 2018 National Secondary Students' Diet and Activity (NaSSDA) cross-sectional survey. A multistage stratified random sampling procedure was used. Within the school setting, students self-completed an online questionnaire assessing their dietary, physical activity and sedentary behaviours. A multilevel logistic regression model was used to examine associations between energy drink consumption and sociodemographic and behavioural factors. RESULTS Overall, 8% of students reported consuming energy drinks on a weekly basis ('regular consumers'). A further 16% indicated they consume less than one cup per week of these types of drinks, while around three-quarters (76%) reported they do not consume energy drinks. Regular consumption of energy drinks was independently associated with being male, having greater weekly spending money, high intakes of snack foods, fast food, other sugar-sweetened beverages and fruit juice, as well as short sleep duration. There was no independent association with other sociodemographic characteristics (i.e., year level, level of disadvantage, geographic location), consumption of vegetables and fruit, physical activity level, or sedentary recreational screen time. CONCLUSIONS While most Australian adolescents do not consume energy drinks, regular consumption is more prevalent among males, and consumption appears to cluster with other unhealthy dietary behaviours and short sleep duration. Findings support the need for policies that will reach identified at-risk groups (e.g., increased regulation of the marketing and sale of energy drinks), as well as suggest opportunities for interventions targeting energy drink consumption alongside other unhealthy dietary behaviours.
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Affiliation(s)
- Tegan Nuss
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010 Australia
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10
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Hoenink JC, Stuber JM, Lakerveld J, Waterlander W, Beulens JWJ, Mackenbach JD. The effect of on-shelf sugar labeling on beverage sales in the supermarket: a comparative interrupted time series analysis of a natural experiment. Int J Behav Nutr Phys Act 2021; 18:49. [PMID: 33823851 PMCID: PMC8025575 DOI: 10.1186/s12966-021-01114-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 03/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutrition labels show potential in increasing healthy food and beverage purchases, but their effectiveness seems to depend on the type of label, the targeted food category and the setting, and evidence on their impact in real-world settings is limited. The aim of this study was to evaluate the effectiveness of an industry-designed on-shelf sugar label on the sales of beverages with no, low, medium and high sugar content implemented within a real-world supermarket. METHODS In week 17 of 2019, on-shelf sugar labels were implemented by a Dutch supermarket chain. Non-alcoholic beverages were classified using a traffic-light labeling system and included the beverage categories "green" for sugar free (< 1.25 g/250 ml), "blue" for low sugar (1.25-6.24 g/250 ml), "yellow" for medium sugar (6.25-13.5 g/250 ml) and "amber" for high sugar (> 13.5 g/250 ml). Store-level data on beverage sales and revenue from 41 randomly selected supermarkets for 13 weeks pre-implementation and 21 weeks post-implementation were used for analysis. In total, 30 stores implemented the on-shelf sugar labels by week 17, and the 11 stores that had not were used as comparisons. Outcome measures were differences in the number of beverages sold in the four label categories and the total revenue from beverage sales in implementation stores relative to comparison stores. Analyses were conducted using a multiple-group Interrupted Time Series Approach. Results of individual store data were combined using random effect meta-analyses. RESULTS At the end of the intervention period, the changes in sales of beverages with green (B 3.4, 95%CI -0.3; 7.0), blue (B 0.0, 95%CI -0.6; 0.7), yellow (B 1.3, 95%CI -0.9; 3.5), and amber (B 0.9, 95%CI -5.5; 7.3) labels were not significantly different between intervention and comparison stores. The changes in total revenues for beverages at the end of the intervention period were also not significantly different between intervention and comparison stores. CONCLUSION The implementation of an on-shelf sugar labeling system did not significantly decrease unhealthy beverage sales or significantly increase healthier beverage sales. Nutrition labeling initiatives combined with complementary strategies, such as pricing strategies or other healthy food nudging approaches, should be considered to promote healthier beverage purchases.
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Affiliation(s)
- J C Hoenink
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands. .,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - J M Stuber
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - W Waterlander
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - J W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Utrecht, the Netherlands
| | - J D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
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11
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Westberg K, Stavros C, Parker L, Powell A, Martin DM, Worsley A, Reid M, Fouvy D. Promoting healthy eating in the community sport setting: a scoping review. Health Promot Int 2021; 37:6153943. [PMID: 33647956 DOI: 10.1093/heapro/daab030] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Community sport organizations promote beneficial health outcomes such as social connection and physical activity, yet they can also facilitate the consumption of unhealthy food and beverages. To provide a foundation for future research and to inform intervention efforts in this context, this scoping review summarizes existing knowledge of the factors that contribute to unhealthy food and beverage consumption in the community sport setting and explores the interventions to promote healthier choices. Using a qualitative process aligned with the nature of our aims, 228 articles were initially identified and subjected to a systemized appraisal, resulting in 45 articles pertinent to the review. The findings identify that the two key factors contributing to unhealthy food choices are the limited availability of healthy options within the sport setting and the presence of unhealthy food and beverage sponsorship. These factors contribute to the normalization of unhealthy eating in this context and health promotion interventions have had limited success. Barriers to change primarily stem from the revenue implications of removing unhealthy food sponsors, lack of organizational capabilities and resources, and consumer preference for unhealthy options. Public health practitioners seeking to intervene in this setting should consider adopting practices used in other settings outside of the sport environment, including the use of technology, the role of peers and mentors and the co-production of impactful material. Community sport plays a vital role in delivering health benefits but must do more to stem its facilitation of a potentially unhealthy consumptive environment.
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Affiliation(s)
- Kate Westberg
- School of Economics, Finance and Marketing, RMIT University, 124 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Constantino Stavros
- School of Economics, Finance and Marketing, RMIT University, 124 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Lukas Parker
- School of Media and Communication, RMIT University, 124 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Ashleigh Powell
- School of Economics, Finance and Marketing, RMIT University, 124 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Diane M Martin
- School of Economics, Finance and Marketing, RMIT University, 124 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Anthony Worsley
- School of Exercise and Nutrition Science, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
| | - Mike Reid
- School of Economics, Finance and Marketing, RMIT University, 124 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - David Fouvy
- School of Media and Communication, RMIT University, 124 La Trobe Street, Melbourne, Victoria 3000, Australia
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12
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Kirk SFL, Olstad DL, McIsaac JLD, Prowse RJL, Caswell S, Hanning R, Raine KD, Mâsse LC, Naylor PJ. Appetite for change? Facilitators and barriers to nutrition guideline implementation in Canadian recreational facilities. Health Promot Int 2021; 36:1672-1682. [PMID: 33615376 DOI: 10.1093/heapro/daab017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
As providers of community-based physical activity programs, recreation and sports facilities serve as an important resource for health promotion. Unfortunately, the food environments within these settings often do not reflect healthy eating guidelines. This study sought to describe facilitators and barriers to implementing provincial nutrition guidelines in recreation and sports facilities in three Canadian provinces with nutrition guidelines. Semi-structured interviews were analysed thematically to identify facilitators and barriers to implementing provincial nutrition guidelines. Facilitators and barriers were then categorised using a modified "inside out" socio-ecological model that places health-related and other social environments at the centre. A total of 32 semi-structured interviews were conducted at two time-points across the three guideline provinces. Interview participants included recreation staff managers, facility committee or board members and recreation volunteers. Eight facilitators and barriers were identified across five levels of the inside out socio-ecological model. Facilitators included provincial or municipal expectations of guideline implementation, clear communication to staff around guideline directives and the presence of a champion within the community or facility who supported guideline implementation. Barriers included unhealthy food culture within community, competition from other food providers and issues within food service contracts that undermined healthy food provision. Findings reinforce the importance of top down (clear expectations regarding guideline implementation at the time of approval) and bottom up (need for buy-in from multiple stakeholders) approaches to ensure successful implementation of nutrition guidelines. The application of a modified socio-ecological model allowed for a more nuanced understanding of leverage points to support successful guideline implementation. Lay summary Healthy eating is an important behaviour for preventing chronic diseases. Supporting people to access healthy foods in places where they live, learn, work or play is a public health priority. Recreation and sports facilities are a setting where people can be physically active. Unfortunately, the food environment in these settings may not reflect nutrition guidelines. In this study, we interviewed key stakeholders from recreation and sports facilities in three Canadian provinces who had put guidelines for healthy eating in place. We used a specific framework to do this called the inside out socio-ecological model. Eight facilitators and barriers were identified using this model. Facilitators included provincial or municipal expectations of guideline implementation, clear communication to staff around guideline directives and the presence of a champion within the community or facility who supported guideline implementation. Barriers included unhealthy food culture within community, competition from other food providers and issues within food service contracts that undermined healthy food provision. Our findings can help people working in recreation and sports facilities to identify issues that may help or hinder healthy food provision in these settings.
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Affiliation(s)
- Sara F L Kirk
- Healthy Populations Institute
- School of Health and Human Performance, Faculty of Health, Dalhousie University, PO Box 150000, Halifax, NS, Canada B3H 4R2
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6
| | - Jessie-Lee D McIsaac
- Healthy Populations Institute
- Faculty of Education and Department of Child and Youth Study, Mount Saint Vincent University, Halifax, NS, Canada B3M 2J6
| | - Rachel J L Prowse
- School of Public Health, University of Alberta, 11405 87 Avenue NW, Edmonton, AB, Canada T6G 1C9
| | - Susan Caswell
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave West, Waterloo, ON, Canada N2L 3G1
| | - Rhona Hanning
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave West, Waterloo, ON, Canada N2L 3G1
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405 87 Avenue NW, Edmonton, AB, Canada T6G 1C9
| | - Louise C Mâsse
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4
| | - P J Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, Stn CSC, Victoria, BC, Canada V8W 3P1
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