1
|
Nomura S, Eguchi A, Maruyama-Sakurai K, Higashino R, Yoneoka D, Kawashima T, Tanoue Y, Kawamura Y, Kumar RS, Fujita T, Miyata H. Characterizing Healthy Dietary Practices in Japan: Insights from a 2024 Nationwide Survey and Cluster Analysis. Nutrients 2024; 16:1412. [PMID: 38794650 PMCID: PMC11124242 DOI: 10.3390/nu16101412] [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: 04/11/2024] [Revised: 04/24/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
The increasing burden of lifestyle-related diseases highlights the need to address unhealthy dietary habits. This study aims to explore the latest dietary patterns in Japan following the COVID-19 pandemic, focusing on trends in health-promoting food choices. A web-based survey was conducted among 27,154 Japanese adults, selected via quota sampling to mirror national demographics. The study evaluated dietary diversity, measured through the Dietary Variety Score (Outcome 1), and the prioritization of nutritional and health considerations in food selection, assessed via a Likert scale (Outcome 2). Uniform Manifold Approximation and Projection (UMAP) and Ordering Points To Identify the Clustering Structure (OPTICS) algorithms were used to delineate patterns in health-centric food selections. OPTICS clustering revealed four distinct clusters for each outcome. Cluster 3, with a diverse diet, comprised older, predominantly female individuals with higher well-being and lower social isolation compared to Cluster 4, which lacked distinct dietary patterns. Cluster 3 also engaged more in snacking, treat foods, home cooking, and frozen meals. Similarly, a divide emerged between those prioritizing dietary considerations (Cluster C) and those indifferent to such aspects (Cluster D). The findings underscore the need for holistic post-COVID-19 public health initiatives addressing socioeconomic and cultural barriers to healthier dietary practices.
Collapse
Affiliation(s)
- Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Data for Social Transformation, 1-11-2 Osaki, Shinagawa-ku, Tokyo 141-0032, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akifumi Eguchi
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Data for Social Transformation, 1-11-2 Osaki, Shinagawa-ku, Tokyo 141-0032, Japan
- Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba 263-8522, Japan
| | - Keiko Maruyama-Sakurai
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Data for Social Transformation, 1-11-2 Osaki, Shinagawa-ku, Tokyo 141-0032, Japan
- Tokyo Foundation for Policy Research, 3-2-1 Roppongi, Minato-ku, Tokyo 106-6234, Japan
| | - Ruka Higashino
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Data for Social Transformation, 1-11-2 Osaki, Shinagawa-ku, Tokyo 141-0032, Japan
| | - Daisuke Yoneoka
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Disease, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-0052, Japan;
| | - Takayuki Kawashima
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Data for Social Transformation, 1-11-2 Osaki, Shinagawa-ku, Tokyo 141-0032, Japan
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo 152-8552, Japan
| | - Yuta Tanoue
- Faculty of Marine Technology, Tokyo University of Marine Science and Technology, 2-1-6, Etchujima, Koto-ku, Tokyo 135-8533, Japan;
| | - Yumi Kawamura
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
| | - Rauniyar Santosh Kumar
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Ocean Policy Research Institute, Sasakawa Peace Foundation, 1-15-16 Toranomon, Minato-ku, Tokyo 105-8524, Japan
| | - Takanori Fujita
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Data for Social Transformation, 1-11-2 Osaki, Shinagawa-ku, Tokyo 141-0032, Japan
- Tokyo Foundation for Policy Research, 3-2-1 Roppongi, Minato-ku, Tokyo 106-6234, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (A.E.); (K.M.-S.); (R.H.); (T.K.); (Y.K.); (R.S.K.); (T.F.); (H.M.)
- Data for Social Transformation, 1-11-2 Osaki, Shinagawa-ku, Tokyo 141-0032, Japan
| |
Collapse
|
2
|
Minaker LM, Menko P, Olona D. Development and testing of two tools to assess point-of-sale food and beverage marketing to children in restaurants. Public Health Nutr 2024; 27:e128. [PMID: 38705591 PMCID: PMC11112432 DOI: 10.1017/s1368980024000983] [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: 04/24/2023] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE To describe the development and testing of two assessment tools designed to assess exterior (including drive-thru) and interior food and beverage marketing in restaurants with a focus on marketing to children and teens. DESIGN A scoping review on restaurant marketing to children was undertaken, followed by expert and government consultations to produce a draft assessment tool. The draft tool was mounted online and further refined into two separate tools: the Canadian Marketing Assessment Tool for Restaurants (CMAT-R) and the CMAT-Photo Coding Tool (CMAT-PCT). The tools were tested to assess inter-rater reliability using Cohen's Kappa and per cent agreement for dichotomous variables, and intra-class correlation coefficients (ICCs) for continuous or rank-order variables. SETTING Waterloo, Ontario, Canada. PARTICIPANTS Restaurants of all types were assessed using the CMAT-R (n 57), and thirty randomly selected photos were coded using the CMAT-PCT. RESULTS The CMAT-R collected data on general promotions and restaurant features, drive-thru features, the children's menu and the dollar/value menu. The CMAT-PCT collected data on advertisement features, features considered appealing to children and teens, and characters. The inter-rater reliability of the CMAT-R tool was strong (mean per cent agreement was 92·4 %, mean Cohen's κ = 0·82 for all dichotomous variables and mean ICC = 0·961 for continuous/count variables). The mean per cent agreement for the CMAT-PCT across items was 97·3 %, and mean Cohen's κ across items was 0·91, indicating very strong inter-rater reliability. CONCLUSIONS The tools assess restaurant food and beverage marketing. Both showed high inter-rater reliability and can be adapted to better suit other contexts.
Collapse
Affiliation(s)
- Leia M Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Patrycia Menko
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - David Olona
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| |
Collapse
|
3
|
Tarro L, Mandracchia F, Queral J, Besora-Moreno M, Vilanova N, Valls RM, Pedret A, Solà R, Llauradó E. Impact of an Intervention on Healthy Offerings and Allergenic Food Management in Restaurants: A Parallel Randomized Controlled Study. Nutrients 2023; 15:4869. [PMID: 38068728 PMCID: PMC10708017 DOI: 10.3390/nu15234869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023] Open
Abstract
The consumption of out-of-home meals is increasing. This study is aimed at assessing the effect of an intervention on healthy offerings and the management of food allergies and intolerances. Ten (control group) and eight restaurants (intervention group) were randomized in a 12-month parallel controlled trial. The outcomes were changes regarding adherence to the Mediterranean diet (AMed) and gluten management (SMAP) criteria, the traffic light rating category, nutrients, and gluten- and allergen-free content of dishes. After 12 months, and compared with baseline, there was an improvement of ≥25% in four items of the AMed criteria in the intervention group, whereas an increase in the offer of dairy desserts without added sugar, and a decrease in the first course offerings of vegetables and/or legumes were observed in the control group (p < 0.05). Also, after 12 months, there was an improvement of ≥50% in four SMAP criteria (p < 0.05) and in the mean average of all SMAP criteria (p = 0.021) compared with baseline in the intervention group, in which intra- and inter-group improvements for desserts in traffic light ratings, nutrients, and allergens were observed (p < 0.05). Therefore, the intervention showed beneficial effects, improving the quality of menus toward the Mediterranean diet pattern and gluten and food allergy/intolerance management.
Collapse
Affiliation(s)
- Lucia Tarro
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
| | - Floriana Mandracchia
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
| | - Judit Queral
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
- Institut Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus-Tarragona, Spain
| | - Maria Besora-Moreno
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
| | - Nerea Vilanova
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
- Institut Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus-Tarragona, Spain
| | - Rosa Maria Valls
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
| | - Anna Pedret
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
- Institut Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus-Tarragona, Spain
| | - Rosa Solà
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
- Institut Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus-Tarragona, Spain
- Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
| | - Elisabet Llauradó
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain; (L.T.); (F.M.); (J.Q.); (M.B.-M.); (N.V.); (R.M.V.); (A.P.)
- Institut Investigació Sanitària Pere i Virgili (IISPV), 43204 Reus-Tarragona, Spain
| |
Collapse
|
4
|
Graça J, Campos L, Guedes D, Roque L, Brazão V, Truninger M, Godinho C. How to enable healthier and more sustainable food practices in collective meal contexts: A scoping review. Appetite 2023; 187:106597. [PMID: 37178929 DOI: 10.1016/j.appet.2023.106597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
Collective meal contexts such as restaurants, cafeterias and canteens can help accelerate transitions to healthier and more sustainable diets. However, evidence from intervention studies on these contexts lacks integration. This scoping review aimed to map determinants of dietary change in collective meal contexts across multiple settings, interventions, target groups, and target behaviors. The review provided two main outcomes: (i) identifying intervention components to promote dietary change in collective meal contexts, based on the existing body of evidence; and (ii) classifying and integrating these intervention components into an overarching framework of behavior change (i.e., COM-B system). The review encompassed twenty-eight databases via two indexing services and extracted information from 232 primary sources (27,458 records selected for title and abstract screening, 574 articles selected for full-text screening). We identified a total of 653 intervention activities, which were classified into intervention components and grouped under three broad themes, namely contextual and environmental changes, social influence, and knowledge and behavioral regulation. Multi-component interventions tended to report overall positive outcomes. The review proposes several directions for future research, including: (i) moving toward more theory-based interventions in collective meal contexts; (ii) providing more detailed information about intervention settings, implementation, target groups, activities, and materials; and (iii) improving the use of open science practices in the field. Furthermore, the review offers a free, original, open-access list and synthesis of 277 intervention studies in collective meal contexts, which can help intervention planners and evaluators optimize their efforts to promote healthier and more sustainable food practices in these contexts.
Collapse
Affiliation(s)
- João Graça
- University of Groningen, Groningen, the Netherlands; Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal.
| | - Lúcia Campos
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal; Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | - David Guedes
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal; Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | - Lisa Roque
- Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | | | - Monica Truninger
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal
| | - Cristina Godinho
- NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| |
Collapse
|
5
|
Bianchi F, Luick M, Bandy L, Bone J, Kelly S, Farrington J, Leung J, Mottershow A, Murar F, Jebb SA, Harper H, Pechey R. The impact of altering restaurant and menu option position on food selected from an experimental food delivery platform: a randomised controlled trial. Int J Behav Nutr Phys Act 2023; 20:60. [PMID: 37208720 PMCID: PMC10197857 DOI: 10.1186/s12966-023-01456-8] [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: 11/28/2022] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Overconsumption is one of the most serious public health challenges in the UK and has been linked to increased consumption of food ordered through delivery platforms. This study tested whether repositioning foods and/or restaurant options in a simulated food delivery platform could help to reduce the energy content of users' shopping basket. METHODS UK adult food delivery platform users (N = 9,003) selected a meal in a simulated platform. Participants were randomly allocated to a control condition (choices listed randomly) or to one of four intervention groups, (1) food options listed in ascending order of energy content, (2) restaurant options listed in ascending order of average energy content per main meal, (3) interventions 1 and 2 combined (4) interventions 1 and 2 combined, but food and restaurant options repositioned based on a kcal/price index to display options lower in energy but higher in price at the top. Gamma regressions assessed the impact of interventions on total energy content of baskets at checkout. RESULTS The energy content of participants' baskets in the control condition was 1382 kcals. All interventions significantly reduced energy content of baskets: Compared to control, repositioning both foods and restaurants purely based on energy content of options resulted in the greatest effect (-209kcal; 95%CIs: -248,-168), followed by repositioning restaurants (-161kcal; 95%CIs: -201,-121), repositioning restaurants and foods based on a kcal/price index (-117kcals; 95%CI: -158,-74) and repositioning foods based on energy content (-88kcals; 95%CI: -130,-45). All interventions reduced the basket price compared to the control, except for the intervention repositioning restaurants and foods based on a kcal/price index, which increased the basket price. CONCLUSIONS This proof-of-concept study suggests repositioning lower-energy options more prominently may encourage lower energy food choices in online delivery platforms and can be implemented in a sustainable business model.
Collapse
Affiliation(s)
| | - Madison Luick
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Lauren Bandy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Stefan Kelly
- Behavioural Insights Team, London, UK
- Nesta, London, UK
| | | | | | | | | | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hugo Harper
- Behavioural Insights Team, London, UK
- Nesta, London, UK
| | - Rachel Pechey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
6
|
Level of Fruit and Vegetable Intake and Its Relationship with Risk for Malnutrition in China’s Adult Labor Force: China Nutrition and Health Surveillance, 2015–2017. Nutrients 2023; 15:nu15061431. [PMID: 36986161 PMCID: PMC10053820 DOI: 10.3390/nu15061431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
The purpose of this study was to analyze the fruit and vegetable intake status and examine both potential risk and protective action factors in the Chinese labor force population, while investigating the association between fruit and vegetable intake and malnutrition in this population. Data were derived from a population-based cross-sectional survey, the China Nutrition and Health Surveillance, 2015–2017. Sociodemographic information, physical measurements, and dietary intake data were collected. A total of 45,459 survey respondents aged 18–64 years old were included in the analysis. Fruit and vegetable consumption data were assessed by a food frequency questionnaire (FFQ), and the average daily intake was calculated. In 2015, the daily intake of fresh fruits, fresh vegetables, and combined fruits and vegetables among the Chinese labor force was 64.3 g, 210.0 g, and 330.0 g (median), respectively. Compared with the Dietary Guidelines for Chinese Residents (2022), 79.9% and 53.0% were at risk of inadequate fruit and vegetable intake, while 55.2% were at risk of inadequate intake of combined fruits and vegetables compared with the WHO recommendation. Multivariate logistic regression analysis showed that female gender, higher educational level, and higher income were protective factors for adequate fruit intake, while increasing age and living in the southern region were protective factors for adequate vegetable intake. The results confirmed that increasing vegetable intake helped urban labor force maintain normal BMI and control overweight. Increased fruit consumption may reduce the risk of underweight, but no clear negative association with overweight and obesity was observed. In conclusion, the consumption of fresh fruits and vegetables by the Chinese labor force was inadequate, especially for fruits. Interventions are needed to promote the daily intake of fruits and vegetables in this population. In addition, further in-depth studies in this area are recommended in populations with different health status.
Collapse
|
7
|
Caballero S, Moënne-Loccoz C, Delgado M, Luarte L, Jimenez Y, Galgani JE, Perez-Leighton CE. Eating contexts determine the efficacy of nutrient warning labels to promote healthy food choices. Front Nutr 2023; 9:1026623. [PMID: 36687700 PMCID: PMC9852898 DOI: 10.3389/fnut.2022.1026623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Unhealthy food choices increase the risk of obesity and its co-morbidities. Nutrition labels are a public health policy that aims to drive individuals toward healthier food choices. Chile has been an example of this policy, where mandatory nutrient warning labels (NWL) identify processed foods high in calories and critical nutrients. Eating contexts influence individual food choices, but whether eating contexts also influence how NWL alter the decision process and selection during food choice is unknown. Methods In an online mouse-tracking study, participants prompted to health, typical, or unrestricted eating contexts were instructed to choose between pairs of foods in the presence or absence of NWL. Conflict during choices was analyzed using mouse paths and reaction times. Results NWL increased conflict during unhealthy food choices and reduced conflict during healthy choices in all contexts. However, the probability that NWL reversed an unhealthy choice was 80% in a healthy, 37% in a typical, and 19% in an unrestricted context. A drift-diffusion model analysis showed the effects of NWL on choice were associated with an increased bias toward healthier foods in the healthy and typical but not in the unrestricted context. Discussion These data suggest that the efficacy of NWL to drive healthy food choices increases in a healthy eating context, whereas NWL are less effective in typical or unrestricted eating contexts.
Collapse
Affiliation(s)
- Sara Caballero
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile,Programa de Magister en Nutrición, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristóbal Moënne-Loccoz
- Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Delgado
- Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis Luarte
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile,Programa Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yanireth Jimenez
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José E. Galgani
- Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudio E. Perez-Leighton
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile,Programa Interdisciplinario de Neurociencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,*Correspondence: Claudio E. Perez-Leighton,
| |
Collapse
|
8
|
AVACARD – Menu evaluation index: Construction and validation. Int J Gastron Food Sci 2023. [DOI: 10.1016/j.ijgfs.2023.100671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
9
|
Pineda E, Barbosa Cunha D, Taghavi Azar Sharabiani M, Millett C. Association of the retail food environment, BMI, dietary patterns, and socioeconomic position in urban areas of Mexico. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001069. [PMID: 36962971 PMCID: PMC10022358 DOI: 10.1371/journal.pgph.0001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023]
Abstract
The retail food environment is a key modifiable driver of food choice and the risk of non-communicable diseases (NCDs). This study aimed to assess the relationship between the density of food retailers, body mass index (BMI), dietary patterns, and socioeconomic position in Mexico. Cross-sectional dietary data, BMI and socioeconomic characteristics of adult participants came from the nationally representative 2012 National Health and Nutrition Survey in Mexico. Geographical and food outlet data were obtained from official statistics. Densities of food outlets per census tract area (CTA) were calculated. Dietary patterns were determined using exploratory factor analysis and principal component analysis. The association of food environment variables, socioeconomic position, BMI, and dietary patterns was assessed using two-level multilevel linear regression models. Three dietary patterns were identified-the healthy, the unhealthy and the carbohydrates-and-drinks dietary pattern. Lower availability of fruit and vegetable stores was associated with an unhealthier dietary pattern whilst a higher restaurant density was associated with a carbohydrates-and-drinks pattern. A graded and inverse association was observed for fruit and vegetable store density and socioeconomic position (SEP)-lower-income populations had a reduced availability of fruit and vegetable stores, compared with higher-income populations. A higher density of convenience stores was associated with a higher BMI when adjusting for unhealthy dietary patterns. Upper-income households were more likely to consume healthy dietary patterns and middle-upper-income households were less likely to consume unhealthy dietary patterns when exposed to high densities of fruit and vegetable stores. When exposed to a high concentration of convenience stores, lower and upper-lower-income households were more likely to consume unhealthy dietary patterns. Food environment and sociodemographic conditions within neighbourhoods may affect dietary behaviours. Food environment interventions and policies which improve access to healthy foods and restrict access to unhealthy foods may facilitate healthier diets and contribute to the prevention of NCDs.
Collapse
Affiliation(s)
- Elisa Pineda
- Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, South Kensington Campus, London, United Kingdom
- Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Diana Barbosa Cunha
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Christopher Millett
- Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| |
Collapse
|
10
|
Rosi A, Biasini B, Monica E, Rapetti V, Deon V, Scazzina F. Nutritional Composition and Environmental Impact of Meals Selected in Workplace Canteens before and after an Intervention Promoting the Adherence to the Mediterranean Diet. Nutrients 2022; 14:nu14214456. [PMID: 36364719 PMCID: PMC9656980 DOI: 10.3390/nu14214456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 11/28/2022] Open
Abstract
Enhancing healthy and sustainable food systems is one of the key goals of the current European Commission policy. In this light, the creation of a food environment where people are properly informed about the healthiness and sustainability of food choices is essential. This study aimed to evaluate the nutritional profile and the environmental impact of meals consumed in a workplace canteen in Italy in the presence of a nudge (i.e., the Double Pyramid logo) combined with a web-based application promoting the Mediterranean Diet. Energy and nutrient contents and the carbon, water, and ecological footprints of 29,776 meals were compared across three subsequent periods (from June to April) through one-way ANOVA. Although the choice of dishes labelled with the Double Pyramid logo was comparable across periods, the selection of fish- and plant-based dishes increased from +2% (fish, vegetables) up to +17% (whole-grain cereals), with a concurrent reduction of meat-based options (−2%). Although the consumption of healthy items increased (p < 0.001), they were not added as a replacement for alternative options, leading to a higher content in energy (p < 0.001) and nutrients (p < 0.001) and worse environmental footprints, contrarily to what was observed when data were adjusted for energy. The intervention significantly improved food choices; however, as the higher selection of desired dishes was not adequately compensated for, it was not fully effective.
Collapse
Affiliation(s)
- Alice Rosi
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, 43125 Parma, Italy
- Correspondence: ; Tel.: +39-0521-903913
| | - Beatrice Biasini
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, 43125 Parma, Italy
| | - Elisa Monica
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, 43125 Parma, Italy
| | - Valeria Rapetti
- Global Nutrition & Wellbeing Unit, Research, Development & Quality Group, Barilla G. e R. Fratelli, 43122 Parma, Italy
| | - Valeria Deon
- Global Nutrition & Wellbeing Unit, Research, Development & Quality Group, Barilla G. e R. Fratelli, 43122 Parma, Italy
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drugs, University of Parma, 43125 Parma, Italy
| |
Collapse
|
11
|
The Impact of Modifying Food Service Practices in Secondary Schools Providing a Routine Meal Service on Student's Food Behaviours, Health and Dining Experience: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14173640. [PMID: 36079897 PMCID: PMC9460342 DOI: 10.3390/nu14173640] [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: 08/12/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022] Open
Abstract
The education sector is recognised as an ideal platform to promote good nutrition and decision making around food and eating. Examining adolescents in this setting is important because of the unique features of adolescence compared to younger childhood. This systematic review and meta-analysis examine interventions in secondary schools that provide a routine meal service and the impact on adolescents’ food behaviours, health and dining experience in this setting. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist and Cochrane Handbook recommendations. Studies published in English searched in four databases and a hand search yielded 42 interventions in 35 studies. Risk of bias was assessed independently by two reviewers. Interventions were classified using the NOURISHING framework, and their impact analysed using meta-analysis, vote-counting synthesis or narrative summary. The meta-analysis showed an improvement in students selecting vegetables (odds ratio (OR): 1.39; 1.12 to 1.23; p = 0.002), fruit serves selected (mean difference (MD): 0.09; 0.09 to 0.09; p < 0.001) and consumed (MD: 0.10; 0.04 to 0.15; p < 0.001), and vegetable serves consumed (MD: 0.06; 0.01 to 0.10; p = 0.024). Vote-counting showed a positive impact for most interventions that measured selection (15 of 25; 41% to 77%; p = 0.002) and consumption (14 of 24; 39% to 76%; p = 0.013) of a meal component. Interventions that integrate improving menu quality, assess palatability, accessibility of healthier options, and student engagement can enhance success. These results should be interpreted with caution as most studies were not methodologically strong and at higher risk of bias. There is a need for higher quality pragmatic trials, strategies to build and measure sustained change, and evaluation of end-user attitudes and perceptions towards intervention components and implementation for greater insight into intervention success and future directions (PROSPERO registration: CRD42020167133).
Collapse
|
12
|
Perez PMP, Castro IRRD, Franco ADS. [Trajectory of changes in dietary habits of students from a Brazilian public university]. CIENCIA & SAUDE COLETIVA 2022; 27:2789-2803. [PMID: 35730847 DOI: 10.1590/1413-81232022277.17312021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to evaluate possible differences in dietary trajectories of students according to their attendance at a University Restaurant (UR) and the basis for their admission to the university. It was an experiment conducted with undergraduate students (n=1,131) from a Brazilian public university. In 2011 and 2013, questionnaires identified and completed in person were applied assessing the regular consumption of foods that were markers of healthy or unhealthy diet, partaking of lunch, dinner and replacement of lunch and/or dinner with a snack. Changes in regular food practices were examined by the individual trajectory of each student versus the studied practices obtained by combining the responses from the questionnaires. The analysis of the association between UR attendance and trajectory was carried out using multiple logistic regression models. An association was observed (95%CI non-overlapping) with greater UR attendance and a higher chance of a positive trajectory for dinner and lunch, and consumption of beans, vegetables, raw vegetables fruit, cookies, packaged salty snacks, hamburgers and candies, and a lower chance of a negative trajectory for beans, raw vegetables, and fried snacks. The implementation of the UR promoted a significant improvement in the diet of conscientious students.
Collapse
Affiliation(s)
- Patrícia Maria Périco Perez
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro. R. São Francisco Xavier 524, Bloco E, sala 12.007, Maracanã. 20559-900 Rio de Janeiro RJ Brasil.
| | - Inês Rugani Ribeiro de Castro
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro. R. São Francisco Xavier 524, Bloco E, sala 12.007, Maracanã. 20559-900 Rio de Janeiro RJ Brasil.
| | | |
Collapse
|
13
|
Nury E, Stadelmaier J, Morze J, Nagavci B, Grummich K, Schwarzer G, Hoffmann G, Angele CM, Steinacker JM, Wendt J, Conrad J, Schmid D, Meerpohl JJ, Schwingshackl L. Effects of nutritional intervention strategies in the primary prevention of overweight and obesity in school settings: systematic review and network meta-analysis. BMJ MEDICINE 2022; 1:e000346. [PMID: 36936562 PMCID: PMC9951385 DOI: 10.1136/bmjmed-2022-000346] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/04/2022] [Indexed: 12/25/2022]
Abstract
Objective To examine the effects of different nutritional intervention strategies in the school setting on anthropometric and quality of diet outcomes by comparing and ranking outcomes in a network meta-analysis. Design Systematic review and network meta-analysis. Data sources PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Education Resources Information Centre (ERIC), PsycInfo, CAB Abstracts, Campbell Library, Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) BiblioMap, Australian Education Index, Joanna Briggs Institute Evidence-Based Practice (JBI EBP) database, Practice-based Evidence in Nutrition (PEN) database, ClinicalTrials.gov, Current Controlled Trials, and World Health Organization International Clinical Trials Registry Platform. Eligibility criteria for selecting studies A systematic literature search was performed from inception to 2 May 2022. Cluster randomised controlled trials meeting these study criteria were included: generally healthy school students aged 4-18 years; intervention with ≥1 nutritional components in a school setting; and studies that assessed anthropometric measures (eg, body mass index, body fat) or measures related to the quality of diet (eg, intake of fruit and vegetables), or both. Random effects pairwise meta-analyses and network meta-analyses were performed with a frequentist approach. P scores, a frequentist analogue to surface under the cumulative ranking curve, ranging from 0 to 1 (indicating worst and best ranked interventions, respectively) were calculated. Risk of bias was assessed with Cochrane's RoB 2 tool. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to rate the certainty of evidence. Results 51 cluster randomised controlled trials involving 75 954 participants and seven intervention nodes were included. Inconsistency could not be assessed (except for intake of fruit and vegetables) because the network meta-analyses were based mainly on star shaped networks with no direct evidence for specific pairs of nutritional interventions. Overall, little or no evidence was found to support a difference in body mass index, body weight, body fat, or waist circumference and moderate improvements in intake of fruit and vegetables with nutritional interventions in a school setting. Low to moderate certainty of evidence further suggested that multicomponent nutritional interventions likely reduced the prevalence (odds ratio 0.66, 95% confidence interval 0.55 to 0.80) and incidence (0.67, 0.47 to 0.96) of overweight compared with a control group. Based on low certainty of evidence, nutrition education and multicomponent interventions may be more effective than a control group (ie, usual practice) for increasing intake of fruit and vegetables. Multicomponent nutritional interventions were ranked the most effective for reducing body mass index (P score 0.76) and intake of fat (0.82). Nutrition education was ranked as best for body mass index z score (0.99), intake of fruit and vegetables (0.82), intake of fruit (0.92), and intake of vegetables (0.88). Conclusions The findings suggest that nutritional interventions in school settings may improve anthropometric and quality of diet measures, potentially contributing to the prevention of overweight and obesity in childhood and adolescence. The findings should be interpreted with caution because the certainty of evidence was often rated as low. The results of the network meta-analysis could be used by policy makers in developing and implementing effective, evidence based nutritional intervention strategies in the school setting. Systematic review registration PROSPERO CRD42020220451.
Collapse
Affiliation(s)
- Edris Nury
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Stadelmaier
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakub Morze
- Department of Cardiology and Internal Diseases, University of Warmia and Mazury, Olsztyn, Poland
- Department of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland
| | - Blin Nagavci
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Grummich
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Guido Schwarzer
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Claudia M Angele
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- Centre for Teacher Education, University of Vienna, Vienna, Austria
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Janine Wendt
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Johanna Conrad
- Science Department, German Nutrition Society, Bonn, Germany
| | - Daniela Schmid
- Division for Quantitative Methods in Public Health and Health Services Research, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|