A Typology of Food Environments in the Pacific Region and Their Relationship to Diet Quality in Solomon Islands

Food purchasing places classification system based on the Dietary Guidelines for the Brazilian Population: Locais-Nova

OBJECTIVE

To propose a new classification system for food purchasing places (Locais-Nova) based on the Dietary Guidelines for the Brazilian Population.

METHODS

We used 2017-2018 Brazilian Household Budgets Survey data on household food purchasing. Foods were categorized, according to the Nova classification, into unprocessed or minimally processed food, processed culinary ingredients, processed foods and ultra-processed foods. We estimated the average share of each Nova classification group in the total of grams acquired in Brazil. This estimate was compared with the average share of each Nova classification group in each of the 16 purchasing places assessed. Places were classified as "purchasing sources" for a specific Nova classification group whenever that group's share a given place was equal to or greater than the national average.

RESULTS

Locais-Nova identified three categories of purchasing places: sources of unprocessed or minimally processed food and processed culinary ingredients, sources of processed foods and sources of ultra-processed foods. Fruits, vegetables, and farm products and butcher shops stood out as the main sources of unprocessed or minimally processed food; minimarkets and grocery stores were the main sources of ultra-processed foods; and bakeries and confectionaries, stood out as sources of processed and ultra-processed foods. Supermarkets were classified as sources of unprocessed or minimally processed food and ultra-processed foods.

CONCLUSION

This study presented an innovative classification of food purchasing places. This reflected the recommendations of the Dietary Guidelines for the Brazilian Population and made it possible to understand food purchasing patterns in different types of purchasing places.

A socio-ecological lens to segmenting adult's eating behaviour

Background: The increasing levels of overweight and obesity are negatively impacting the health and wellbeing of individuals and communities. Whilst individual factors are important, the prevalence of overweight and obesity is partly caused by several social and environmental factors that can potentially be modified. A limited number of studies apply a broader theoretical lens to expand the focus beyond individual factors targeted for change. Furthermore, many interventions take a one-size-fits-all approach, which overlooks the differences between subgroups of the population, such as gender, which has a significant impact on eating habits. Aim: This study aims to identify avenues to increase healthy eating by accommodating a wider theory-based socio-ecological viewpoint for change. Additionally, the theory-based socio-ecological lens was applied to identify if segments can be revealed, enabling tailored strategies to be developed to better meet the needs of segments. Methods: A male-dominated sample of n = 3044 Australians was sourced through CINT an online consumer panel provider. Participation was anonymous and voluntary, and consent to participate was indicated by the completion of the survey. Results: Three segments were identified with Socio-Economic Index For Individuals, being the most influential variable differentiating the segments. The most socio-economically advantaged segment (M = 3.7, SD = 0.7) had the highest diet quality score (79.7) while the least advantaged (M = 0.3, SD = 1.4) scored the lowest (67.1). Conclusion: This study confirms the suitability and usefulness of theory-driven segmentation in the development of eating behaviour programs for Australian adults. More effective interventions are required given overweight and obesity levels among this population are increasing.

Piloting Market Food Environment Assessments in LMICs: A Feasibility Assessment and Lessons Learned

BACKGROUND

Food environments are rapidly changing in low- and middle-income countries (LMICs), leading to dietary shifts. Many gaps exist in the measurement of food environments in LMICs making it difficult to characterize the linkages between food environments and diets.

OBJECTIVE

The objective of this study was to examine the feasibility of implementing USAID Advancing Nutrition's Market Food Environment Assessment (MFEA)-a suite of 7 non-resource intensive food environment assessments.

METHODS

We implemented the MFEA package in 4 countries (Liberia, Honduras, Nigeria, and Timor-Leste) and assessed the feasibility of implementing the package by conducting a descriptive analysis, using both qualitative and quantitative data of enumerators' feedback collected through training evaluations, feedback forms, detailed notes from meetings, and final reports from in-country partners.

RESULTS

Overall, we found it feasible to implement the MFEA, some assessments being easier to implement and more practical than others. Several key themes related to the MFEA implementation were identified across the countries, including: the potential for vendors to be hesitant to engage in assessments; the importance of ascertaining buy-in from local officials; the need to shift toward electronic, rather than paper-based, data collection; difficulties in selecting markets; the time constraints of conducting some of the assessments; and the need for better alignment between the instructions, data collection, and data analysis sheets.

CONCLUSIONS

The package of food environment assessments, with minimal additional refinement, can be used to characterize market food environments in LMIC settings to inform context-specific interventions.

Testing the feasibility of implementing a package of 7 assessments to measure factors influencing food access in low-resource settings.

Food environments in the Pacific region and efforts to improve them: a scoping review

OBJECTIVE

To understand the characteristics of food environments in the Pacific region, and the broader economic, policy and sociocultural surroundings that influence food choices and interventions to improve food environments for Pacific communities.

DESIGN

Systematic searches were conducted for articles related to food environments or factors influencing food choices from 1993 to 2024 in five academic databases, Google, Google Scholar and relevant organisations' websites. Studies were included if they meet the eligibility criteria. Two authors independently reviewed the title and abstract of identified articles. Full-text screening was conducted before data were extracted from eligible studies. A narrative analysis was informed by an existing food environments framework.

SETTING

Pacific Island countries or territories that are a member of the Pacific Community (SPC).

PARTICIPANTS

Not applicable.

RESULTS

From the sixty-six included studies (of 2520 records screened), it was clear that food environments in the Pacific region are characterised by high availability and promotion of ultra-processed unhealthy foods. These foods were reported to be cheaper than healthier alternatives and have poor nutritional labelling. Food trade and investment, together with sociocultural and political factors, were found to contribute to unhealthy food choices. Policy interventions have been implemented to address food environments; however, the development and implementation of food environment policies could be strengthened through stronger leadership, effective multisectoral collaboration and clear lines of responsibility.

CONCLUSIONS

Interventions focused on improving physical, economic, policy and sociocultural influences on food choices should be prioritised in the Pacific region to improve the food environment and mitigate barriers to healthy eating.

Measuring characteristics of wild and cultivated food environments: a scoping review

BACKGROUND

Global food systems are essential to sustain life; however, unhealthy diets are the leading cause of poor health and death worldwide. Natural food environments are a critical source of healthful food such as fresh fruit and vegetables, lean meat and aquatic foods, particularly in low- and middle-income countries (LMICs) and Indigenous food systems. Understanding and monitoring natural food environments is critical to protecting the supply of healthy food, and the land and water it comes from, for current and future generations.

METHODS

A scoping review was applied to classify and summarise empirical methods and measures used for characterising natural food environments. The ways in which food environment characteristics are conceptualised and measured for natural (wild and cultivated) food environments were explored. Data were extracted from the included studies using the following fields: study country, aim/objective(s), type of natural food environment (wild vs. cultivated), method or measure used to measure the food environment, key food environment characteristic/s (up to four) measured and key findings in relation to the food environment measurement.

RESULTS

One hundred forty seven studies were found to be relevant in this review. Most studies investigated food environments in LMICs, with almost two-thirds of all studies focussing on middle-income countries (n = 89, 61%). There was a strong focus on food security and home-based agriculture from studies that measured the cultivated food environment in LMICs, while the majority of studies on the cultivated food environment from high-income countries focussed on urban and community gardening. In addition to the most common survey-based methodological approaches, our review yielded a broad range of both qualitative and quantitative methods for measuring natural food environments, such as geospatial analysis; biochemical analysis of food, soil and water; citizen science; photovoice and food availability calendars.

CONCLUSIONS

Our review demonstrated that the concept and characteristics of the food environment are a promising conceptualization for measuring natural food environments, particularly in relation to food availability, healthiness and food security. Mapping the currently used methods and measures to assess natural food environments is important to help identify critical leverage points for strengthening policy interventions, and monitoring and evaluation of progress.

Can digitalization improve the equality and equity of food environment? Evidence from greengrocers in central Shanghai

Introduction

Online food shopping has a profound impact on people's food acquisition behavior, the current study aims to understand how online food shopping may affect the accessibility of the local food environment and further influence the health equity among different populations.

Methods

Taking 8512 traditional and online greengrocers in central Shanghai as an example, this paper uses Gini coefficient, location quotient and spatial clustering method to compare the equality and equity of food environment between physical and digital food outlets.

Results

It finds that spatial equality is more significantly improved as a result of online food stores than are population equality and social equity of the food environment; older populations are not disadvantaged in terms of healthy food access but lower-income people are; the impact of online stores varies for different regions and different types of stores; depot-based stores have the most positive impact on health equity.

Discussion

Policy implications are discussed to promote the environmental justice of healthy food accessibility.

Environmental Sustainability of Food Environments: Development and Application of a Framework in 4 cities in South Asia

Background

Food environments, where people directly engage with broader food systems, may be an important contributor to the environmental sustainability of food systems.

Objectives

The primary objectives of this study were to establish a new food environment framework that considers environmental indicators and to assess data availability and gaps using data previously collected as part of a food systems survey in 4 South Asian cities.

Methods

The framework was developed by conducting a structured literature review of previous food environment frameworks and in-depth interviews with content experts (n = 6). The framework and indicators were then mapped to data collected by consumer and vendor surveys using the Urban Food Systems Assessment Tool (UFSAT) in Ahmedabad (India), Pune (India), Kathmandu (Nepal), and Pokhara (Nepal).

Results

We have expanded the sustainability domain within food environments to include consumer travel to food vendors, the presence of food delivery services, policies related to sustainability, vendor food waste, vendor plastic use, vendor utility usage, vendor recycling and waste management practices, and food packaging. Mapping the framework to existing data from 4 cities in South Asia, we found variations in food environment sustainability indicators, particularly regarding consumer transportation to food vendors, the presence of delivery services, and food waste.

Conclusions

Although the majority of food environment research focuses on the availability and affordability of healthy foods, there is an urgent need to understand better how aspects of food environments contribute to environmental goals. When mapping the framework to existing food systems data, we found gaps in data on environmental sustainability in food environments and variation in indicators across settings.

Adapting food environment frameworks to recognize a wild-cultivated continuum

Food environments, or interfaces between consumers and their food systems, are a useful lens for assessing global dietary change. Growing inclusivity of nature-dependent societies in lower-and middle-income countries is driving recent developments in food environment frameworks. Downs et al. (2020) propose a food environment typology that includes: wild, cultivated, informal and formal market environments, where wild and cultivated are "natural food environments." Drawing from transdisciplinary perspectives, this paper argues that wild and cultivated food environments are not dichotomous, but rather exist across diverse landscapes under varying levels of human management and alteration. The adapted typology is applied to a case study of Indigenous Pgaz K'Nyau food environments in San Din Daeng village, Thailand, using the Gallup Poll's Thailand-adapted Diet Quality Questionnaire with additional food source questions. Wild-cultivated food environments, as classified by local participants, were the source of more food items than any other type of food environment (37% of reported food items). The case of Indigenous Pgaz K'Nyau food environments demonstrates the importance of understanding natural food environments along a continuum from wild to cultivated.

Convenience as a dimension of food environments: A systematic scoping review of its definition and measurement

Convenience is a major driver of food choice throughout the world, yet it is often inconsistently conceptualised, defined and measured. This limits the scope for food systems policy and interventions to leverage convenience to improve diet and nutrition outcomes. We conducted a systematic literature review to determine how convenience is both defined and measured in food environment and nutrition research. Six databases were systematically searched and studies were screened by two independent reviewers based on pre-defined eligibility criteria, yielding 243 studies for inclusion in the final review. 77% of studies did not explicitly define convenience. Among those that did, the dimensions and components within definitions varied. 83% of studies used perceived measures of convenience rather than objective measures. Convenience was most commonly measured in high income countries (64%) and in relation to the home food environment (53%), followed by formal retail (40%). Very few studies measured convenience in relation to the informal retail or cultivated food environments, and no studies considered convenience in relation to wild food environments. The vast majority of studies did not consider the validity or reliability of the measures of convenience. Based on our findings we propose a definition of convenience as a characteristic that results in reduced requirement for resources including time, physical effort, mental effort and skills by the consumer in relation to the planning, acquisition, preparation, storage, transport, consumption or clean-up of food. This definition can be used to help guide the development of measurement tools that can be used to assess convenience across different dimensions and contexts in a more comprehensive way. We also propose a framework for considering convenience as an entry point in food systems to improve diets and nutrition outcomes.

Centering context when characterizing food environments: the potential of participatory mapping to inform food environment research

Food environments are a critical place within the food system to implement interventions aimed at enabling sustainable diets. In this perspective article, we argue for the need for food environment research to more comprehensively examine the different types of food environments that people access within their communities to ensure that interventions and programs are better aligned with people's lived experiences. We highlight the potential ways in which participatory mapping (PM) can be leveraged to better design food environment research by: (1) identifying the different food environment types that are accessed within a given community; (2) providing insight into the timing for data collection; (3) informing the prioritization of where to conduct food environment assessments; and (4) highlighting the dynamism of food environments over time (e.g., across a given day or across seasons). We provide a case study example of the application of PM and the lessons learned from it in Cambodia. By conceptualizing food environments in a more comprehensive way, from the perspective of the people living within a given community, we will be able to measure food environments in a way that more closely aligns with people's lived experiences.

Characterizing pathways of seafood access in small island developing states

Ensuring healthy and sustainable food systems in increasing social, economic, and ecological change is a key global priority to protect human and environmental health. Seafood is an essential component of these food systems and a critical source of nutrients, especially in coastal communities. However, despite rapid transformations in aquatic food systems, and our urgent need to understand them, there is a dearth of data connecting harvested food production to actualized food consumption. Many analyses suggest institutional, legal, or technological innovations to improve food systems, but few have analyzed the pathways through which people already gain access to nutritious food. Here, using a random forest model and cluster analysis of a nationally representative data set from Kiribati, we operationalize access theory to trace the flows of consumptive benefit in a fisheries-based food system. We demonstrate that the market access mechanism is the key mechanism mediating seafood access in Kiribati, but importantly, the highest seafood consumption households showed lower market access, pointing to the importance of non-market acquisition (e.g., home production and gifting). We reveal six distinct household strategies that employ different sets of access mechanisms to ensure high levels of local seafood consumption in different contexts. We demonstrate the impacts of these strategies on the composition of household seafoods consumed, stressing the need to support these existing successful strategies. Finally, we point to key policy and management insights (e.g., improved infrastructure, shifts in species management) that may be more effective in reinforcing these existing pathways than commonly proposed food system interventions.

Food price and availability in Solomon Islands during COVID-19: A food environment survey

Background: In Solomon Islands, the retail food environment is an important food source, for instance, the dominant source of fresh fruit and vegetables for urban consumers is open markets. The effects of COVID-19 mitigation measures (such as restriction of human movement and border closures) in early 2020 placed food security at risk in many parts of the community. Of particular concern was the risk of price gouging in an already price-sensitive market. Aims: The study aimed to provide rapid and policy-relevant information on the pricing of foods in the urban food environment in Solomon Islands in the context of the unfolding COVID-19 pandemic. Methods: A vendor survey was conducted in July to August 2020 and repeated in July 2021 using a survey tool that collected information on type, quantity, and price of food on offer. Findings: We found price reductions among the majority of fresh fruit and non-starchy vegetables available. A trend of rising prices was reported for some other commodities, such as fresh locally caught fish. Conclusion: Our findings highlight the impact of 'schocks to the system' on food prices as a potential barrier or enabler to consumption of fresh foods purchased from urban areas - an important finding in a price sensitive market. The survey design was successful in collecting pricing data from the retail food environment during a time of external 'shock to the system'. Our approach is applicable to other settings needing a rapid survey of the external food environment.

Food Acquisition during the COVID-19 Lockdown and Its Associations with the Physical-Digital Integrated Community Food Environment: A Case Study of Nanjing, China

The COVID-19 pandemic and measures such as lockdowns affect food access, dietary choices, and food security. We conducted an online survey among 517 respondents during early 2020 in Nanjing, China to explore respondents' food acquisition behaviors before and during the pandemic and associations with the community food environment. Using geographic analysis and binary logistic models, we revealed that despite inconvenience regarding food acquisition, no food security issues occurred during lockdown in Nanjing. The pandemic changed the access and frequency of obtaining food; meanwhile, pre-pandemic habits had a strong impact on food acquisition behavior. Online and in-store food acquisition showed a substitution relationship, with online food access playing a crucial role in food acquisition. Physical and digit food outlets are highly integrated in Chinese urban communities, and both objectively measured and perceived accessibility of these food outlets had a significant association with the food acquisition methods and transportation mode chosen by people during this public health crisis.