Search

In this case study, a formative evaluation was conducted for "Promoting Food Security and Healthy Lifestyles" pilot intervention at a Community-Based Organization in a marginalized neighborhood in Bedford-Stuyvesant in New York City. Utilizing a rigorous, theoretically grounded, and mixed methods approach, a survey was designed to encompass the social, environmental, and behavioral determinants of food insecurity and health promotion for Emergency Food Assistance System users. The final survey tested well for face and content validity and meets the criteria for internal reliability. This will aid to develop culturally tailored programs and policies for low-income, food insecure populations facing social and health disparities in this large urban neighborhood.

A daily intake of 5 portions of fruit and vegetables (FV) is recommended for protection against non-communicable diseases (NCDs). Inadequate FV intake is a global problem but resource-poor countries like Tanzania are most deprived and constitute settings where little is known for informing public health interventions. This study aimed to describe the prevalence of inadequate FV intake, frequency of FV intake, portions of FV intake and their associations with socio-demographic/lifestyle factors in South-Eastern Tanzania. Data on FV dietary indicators, socio-demographic factors, smoking, alcohol and healthcare use were collected from 7953 participants (≥15 years) of the population-based MZIMA open community cohort (2012-2013). Multivariable logistic regression was used to examine associations between FV intake outcomes and their socio-demographic/lifestyle determinants. Most (82%) of the participants did not meet the recommended daily FV intake While only a fraction consumed fruits daily (15.5%), almost half consumed vegetables daily (44.2%). However, the median (IQR) number of vegetable portions consumed was lower (2(1)/person/day) than that for fruits (2(2)/person/day) People with higher education were more likely to consume fruits daily. Independent correlates of inadequate FV intake included young age, being male, low education, low-income occupations, low alcohol, high tobacco and low healthcare use. Public health interventions should target the socio-economically deprived and culturally-rooted preferences while prioritizing promotion of vegetable for most immediate gain in overall FV intake.

Women of reproductive age are at nutritional risk due to their need for nutrient-dense diets. Risk is further elevated in resource-poor environments. In one such environment, we evaluated feasibility of meeting micronutrient needs of women of reproductive age using local foods alone or using local foods and supplements, while minimizing cost. Based on dietary recall data from Ouagadougou, we used linear programming to identify the lowest cost options for meeting 10 micronutrient intake recommendations, while also meeting energy needs and following an acceptable macronutrient intake pattern. We modeled scenarios with maximum intake per food item constrained at the 75th percentile of reported intake and also with more liberal maxima based on recommended portions per day, with and without the addition of supplements. Some scenarios allowed only commonly consumed foods (reported on at least 10% of recall days). We modeled separately for pregnant, lactating, and nonpregnant, nonlactating women. With maxima constrained to the 75th percentile, all micronutrient needs could be met with local foods but only when several nutrient-dense but rarely consumed items were included in daily diets. When only commonly consumed foods were allowed, micronutrient needs could not be met without supplements. When larger amounts of common animal-source foods were allowed, all needs could be met for nonpregnant, nonlactating women but not for pregnant or lactating women, without supplements. We conclude that locally available foods could meet micronutrient needs but that to achieve this, strategies would be needed to increase consistent availability in markets, consistent economic access, and demand., (© 2017 John Wiley & Sons Ltd.)

Objective: Convenience and cost impact on people's meal decisions. Takeaway and pre-prepared foods save preparation time but may contribute to poorer-quality diets. Analysing the impact of time on relative cost differences between meals of varying convenience contributes to understanding the barrier of time to selecting healthy meals., Design: Six popular New Zealand takeaway meals were identified from two large national surveys and compared with similar, but healthier, home-made and home-assembled meals that met nutrition targets consistent with New Zealand Eating and Activity Guidelines. The cost of each complete meal, cost per kilogram, and confidence intervals of the cost of each meal type were calculated. The time-inclusive cost was calculated by adding waiting or preparation time cost at the minimum wage., Setting: A large urban area in New Zealand., Results: For five of six popular meals, the mean cost of the home-made and home-assembled meals was cheaper than the takeaway meals. When the cost of time was added, all home-assembled meal options were the cheapest and half of the home-made meals were at least as expensive as the takeaway meals. The home-prepared meals were designed to provide less saturated fat and Na and more vegetables than their takeaway counterparts; however, the home-assembled meals provided more Na than the home-made meals., Conclusions: Healthier home-made and home-assembled meals were, except one, cheaper options than takeaways. When the cost of time was added, either the home-made or the takeaway meal was the most expensive. This research questions whether takeaways are better value than home-prepared meals.

Objective: To examine use, knowledge, and perceptions of caffeinated energy drinks (CEDs) among youth., Design: Qualitative research using focus group discussions (n = 4)., Setting: Two Canadian cities (Toronto and Montreal)., Participants: Youth aged 12-18 years (n = 41)., Phenomenon of Interest: Perceived definitions of CEDs, reasons for use, knowledge of health effects, use with alcohol, marketing perceptions, and use and understanding of cautionary statements on packaging., Analysis: Data were analyzed using a modified grounded-theory approach., Results: Youth identified CEDs as products that provide energy and contain caffeine and sugar. Compared with mainstream CED brands and energy shots, youth were less likely to perceive Gatorade, Coca-Cola, and a Starbucks beverage as energy drinks, despite some ambiguity. The majority of participants believed that CEDs, including mixed with alcohol, were not necessarily harmful in moderation and that marketing was targeted toward older youth and young adults. Awareness of cautionary statements on CEDs was low; cautionary statements were perceived as difficult to find and read owing to the design and small font., Conclusions and Implications: Findings suggest a need to increase public education regarding the potential risks of CED consumption, including enhancements to the mandated cautionary statements, with greater attention to the impact of CED marketing on youth., (Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To examine the influence of front-of-pack nutrition information on the perception of healthfulness of ultra-processed products across 2 income levels., Design: A between-participants design was used to compare healthfulness perception of ultra-processed products featuring different front-of-pack nutrition information schemes (guideline daily amount system, traffic light system, and monochromatic traffic light system)., Participants: A total of 300 people (aged 18-70 years, 75% female) from Montevideo, Uruguay, participated in the study; half were middle- or high-income people and the other half were low-income people., Main Outcome Measures: Participants were shown the labels of each product and asked to rate their perceived healthfulness and the frequency with which each product should be consumed., Analysis: Results were analyzed using analysis of variance for statistical significance (P < .05)., Results: Low-income participants perceived ultra-processed products to be significantly (P < .05) more healthful than did middle- and high-income participants. The lowest perceived healthfulness scores for low-income participants were obtained for products featuring the colored and monochromatic traffic light system whereas no significant differences (P > .05) among schemes were found for middle- and high-income participants., Conclusions and Implications: Nutrition education programs aimed at increasing low-income people's knowledge of the nutritional composition of these products and their potential negative effects on health seem to be necessary. Although the inclusion of semidirective front-of-pack nutrition information decreased the perceived healthfulness of low-income people, it seemed unlikely to influence how they perceive these products., (Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to assess the level and predictors of dietary diversity (DD) in predominantly food-insecure area of South Wollo, Ethiopia among children ages 6 to 23 mo., Methods: The study was conducted in October 2014. We selected 2080 children using a multistage sampling technique. DD in the preceding day of the survey was assessed with the standard seven-food group score. Predictors of DD were identified via Poisson regression model and the outputs are presented using adjusted incidence rate ratio (IRR) with 95% confidence interval (CI)., Results: Only 7% (95% CI, 5.9%-8.1%) of the children met the recommended minimum DD. Child age and maternal knowledge of infant and young child feeding (IYCF) were significant predictors of DD with IRR of 1.027 (95% CI, 1.022-1.032) and 1.026 (95% CI, 1.010-1.043). Households with moderate and severe food insecurity had 9% (95% CI, 3.8-13.9%) and 24.9% (95% CI, 14.6-44%) reduced chance of providing diversified food. Husbands' direct involvement in IYCF increased DD by 13.7% (95% CI, 7.4-20.4). Caregivers who discussed IYCF with health extension workers, participated in cooking demonstrations, and heard radio spots about IYCF in the preceding 3 mo had 11.7% (95% CI, 3.4-20.7%), 18.9% (95% CI, 0.3-40.9%), and 11.4% (95% CI, 4.8-18.4) higher chance of providing diversified food, respectively. Backyard gardening (IRR, 1.088; 95% CI, 1.031-1.148) and number of chickens owned (IRR, 1.011; 95% CI, 1.001-1.021) also were significant predictors., Conclusions: In predominately food-insecure areas, nutrition education, implementation of nutrition-sensitive agriculture, and husband involvement in IYCF can improve children's DD., (Copyright © 2016 Elsevier Inc. All rights reserved.)