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PURPOSE AND OBJECTIVES: Although considered a promising model of practice, integrating healthy nutrition standards and practices into a large county governments contracting process with food vendors has not been widely described in empirical literature. We conducted an implementation evaluation project to address this gap. INTERVENTION APPROACH: County of Los Angeles food vendors provide food or meals annually to more than 100,000 employees and millions of clients and visitors. In 2011, the County of Los Angeles Board of Supervisors adopted a policy to integrate healthy nutrition standards and practices into its requests for proposals (RFPs) and contracting process with food vendors. The policy required all contracts awarded to adhere to these new standards. EVALUATION METHODS: In 2011, the Los Angeles County Department of Public Health (DPH) began reviewing RFPs for food services for county departments that procured, served, or sold food. From 2011 through 2021, DPH applied a 4-pronged formative-evaluative approach to help county departments implement the Board of Supervisors policy and ensure that nutritional requirements were appropriately integrated into all RFPs for new and renewing contracts with food vendors. We focused our evaluation on understanding the process and tracking the progress of this policy intervention. Our evaluation included 13 key informant interviews, a 2-part survey, reviews of contract data, and synthesis of lessons learned. RESULTS: Based on reviews and subsequent actions taken on more than 20 RFPs, DPH successfully assisted 7 county departments to incorporate healthy nutrition standards and practices into their food vendor contracts. Implementation of the food policy encountered several challenges, including staffing and training constraints and a limited infrastructure. An iterative approach to program improvement facilitated the process. IMPLICATIONS FOR PUBLIC HEALTH: Although the model for integrating healthy nutrition standards and practices into a government contracting process is promising, more work is needed to make it less resource-intensive and to increase user buy-in.

PURPOSE: Californias failed attempts to enact a statewide sugary beverage tax presents an opportunity to advance understanding of advocacy coalition behavior. We investigate the participation of advocacy coalitions in Californias statewide sugar-sweetened beverage (SSB) tax policy debate. DESIGN: Document analysis of legislative bills and newspaper articles collected in 2019. SETTING: California. METHOD: A total of 11 SSB tax-related bills were introduced in Californias legislature between 2001-2018 according to the states legislative website. Data sources include legislative bill documents (n = 94) and newspaper articles (n = 138). Guided by the Advocacy Coalition Framework (ACF), we identify advocacy coalitions involved in Californias SSB tax debate and explore strategies and arguments used to advance each coalitions position. RESULTS: Two coalitions (public health, food/beverage industry) were involved in Californias statewide SSB tax policy debate. The public health coalition had higher member participation and referred to scientific research evidence while the industry coalition used preemption and financial resources as primary advocacy strategies. The public health coalition frequently presented messaging on the health consequences and financial benefits of SSB taxes. The industry coalition responded by focusing on the potential negative economic impact of a tax. CONCLUSION: Multiple attempts to enact a statewide SSB tax in California have failed. Our findings add insight into the challenges of enacting an SSB tax considering industry interference. Results can inform future efforts to pass evidence-based nutrition policies.

Urban Agriculture in Indonesia is seen as a multidimensional approach to overcome urban challenges and offers several potential social, economic, and environmental benefits. This commentary article is dedicated to presenting the current state of the implementation of urban agriculture in large cities, the initiatives undertaken, and the mechanisms for implementing the set goals. However, major challenges arise from land scarcities, poor urban agricultural infrastructure, financial constraints, and regulatory and administrative issues. Urban agriculture significantly improves the quality of urban life by providing fresh and healthy food and fostering community engagement. Lessons from Singapore, New York, and Ghana highlight the importance of policy support, innovation, and community involvement in achieving sustainable urban agriculture. These elements support a more sustainable, resilient, and inclusive urban environment and promote the inclusion of urban agriculture in urban plans and resilience strategies. Indonesia can learn from global best practices to address local challenges and create healthier, sustainable urban dwellings through expanded urban agriculture. [ABSTRACT FROM AUTHOR]

The change in policy that allowed Supplemental Nutrition Assistance Program recipients to redeem their benefits online during the coronavirus disease 2019 pandemic highlighted the potential role of nutrition education programs in facilitating the purchase of healthy, economical food online. The objective of this exploratory qualitative study was to understand the education provided by nutrition educators on online grocery shopping and educators' perspectives on education needs and ways that healthy purchases can be encouraged online. Interviews revealed topics that can be included in in-person education on online shopping, insights for online nutrition education, and promotion strategies for encouraging healthy purchases by low-income shoppers online. [ABSTRACT FROM AUTHOR]

Researchers and community organizations are increasingly operationalizing food sovereignty, and argue that participatory, community-engaged food sovereignty metrics can enhance insights about local contexts, and opportunities for food sovereignty. In Haiti, one of the most food-insecure countries in the world, peasant and civil society organizations have been calling for food sovereignty for over a decade, and the state recently published a food sovereignty policy document, marking an important paradigm shift. In this paper, we share a case study of a food sovereignty tool that was designed through a participatory, community-based process in Northern Haiti, offering a blueprint and lessons learned that we hope will be useful to others working to operationalize food sovereignty. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY CONCLUSIONS We sought to determine the impact of school gardens and nutrition education on student fruit and vegetable consumption from limited‐income communities in Alabama.Third grade students at 99 Alabama schools with and without gardens on‐site were randomized to receive either nutrition education or to a wait‐list control group. Multi‐level models were used to assess the effects of treatment and control with and without school gardens.Students attending schools with gardens demonstrated highest consumption of fruits and vegetables prior to treatment. Nutrition education alone translated into significant dietary improvements. Both gardens and education translated into greatest dietary improvements.Devising financially accessible, practical, and culturally relevant ways to improve student health through garden and nutrition education may help improve student diet. Forming comprehensive Extension, SNAP‐Ed, and school collaboration to support gardens, nutrition education, and healthy school policies and systems can be a way to support and sustain healthy student learning environments.Combined gardening and nutrition education is associated with increases in fruit and vegetable consumption among majority rural, Southern students from limited‐resource communities. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) represent a global health challenge, accounting for 74% of deaths worldwide. One of the recommended interventions to reduce the risk of NCDs is the implementation of warning labels (WLs) on food products to alert consumers about high levels of undesirable nutrients, such as sugar or saturated fats. We aimed to conduct a bibliometric analysis of scientific literature related to WL policies in food and beverages to evaluate global trends and collaborations. Methods: A bibliometric analysis was performed using the Web of Science Core Collection (WoSCC). Articles published between 1998 and 2023 were retrieved using the search terms "warning labels" AND "food" OR "beverage". Bibliometric indicators, including publication counts, citations, collaborations, and thematic trends, were analyzed using the Bibliometrix package in R and VOSviewer. Results: We included 255 articles on WLs. Scientific production increased markedly from 2018 onwards, with over 30 articles published annually from 2018 to 2023. The most cited article, by Taillie et al., focused on the impact of Chile's WL policies. The United States had the largest scientific production, followed by Brazil and Chile. Nutrients was the journal with the most publications on this topic. Conclusions: The growth in WL-related research, particularly in Latin America, reflects the increasing implementation of these policies. These results underscore key collaborations and evolving research themes, from food labeling to broader public health impacts, emphasizing the need for continued evaluation of WL effectiveness. [ABSTRACT FROM AUTHOR]

Background/Objectives: Low quality diets are a risk factor for non-communicable diseases; therefore, improving diet quality is a public health and policy priority in the UK and elsewhere. Reformulating food/beverage products to make them healthier may be an effective approach. Evidence suggests that fiscal interventions, notably taxes/levies on soft drinks, can lead to reformulation but the evidence for voluntary or mandated non-fiscal interventions is less clear. We aimed to review and synthesise contemporary evidence to determine whether non-fiscal policies/interventions result in the reformulation of food/beverage products Methods: In April 2023, we systematically searched ten international academic and nine grey literature databases. We included real-world study designs, all nutrients, in- and out-of-home sectors, and studies published from 2013, to ensure policy relevancy. We excluded modelling studies. Using the Synthesis Without Meta-Analysis method we conducted vote counting of studies based on the direction of effect and narrative synthesis by intervention type. Risk of bias was assessed using a tool developed by the EPPI-Centre and quality was assessed using GRADE. Results: We included 77 real-world studies from 19 countries, reporting 100 non-fiscal policies/interventions. Most commonly, these were reduction targets (n = 44), front-of-pack labels (n = 23), and advertising standards (n = 9). Most interventions were voluntary (n = 67), compared to mandatory (n = 33), and focused on the in-home sector (n = 63). The vote counting results showed non-fiscal policies/interventions overall led to improvements in reformulation in 60/63 studies with a valid direction of effect (95%, 95% CI 0.869, 0.984, p < 0.001). Mandatory implementations were more successful than voluntary implementations with 15/15 showing an improvement (100%, 95% CI 0.796, 1], p < 0.001), compared 40/43 showing an improvement (93%, 95% CI 0.814, 0.976, p < 0.001). Most of the studies were of low quality, due to the observational nature of the studies. Sodium was the most commonly targeted nutrient (n = 56) and was found to be reformulated in most studies. Causation is difficult to establish from real-world studies, but evidence suggests that regulatory and multi-component strategies may be effective at driving reformulation. Conclusions: Non-fiscal policies/interventions can play an important role in driving reformulation, alongside fiscal measures. This work was funded by the National Institute for Health and Care Research PRP-PRU-02-15-Healthy Weight and registered on Open Science Framework. [ABSTRACT FROM AUTHOR]

Background: Children's exposure to sugary beverage advertising may have changed during the COVID-19 pandemic due to shifts in media habits, which could subsequently have influenced intake. This study aimed to examine: 1) children's frequency and setting of exposure to advertisements of sugary beverages in six countries before and during the COVID-19 pandemic; 2) the association between exposure to sugary beverage advertisements and intake. Methods: Children aged 10–17 years (n = 28,908) in Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States (US) completed online surveys in 2019, 2020 and 2021 as part of the International Food Policy Study using a repeat cross-sectional study design. Respondents self-reported frequency and setting of exposure to sugary beverage advertisements, location of school classes (in-person/online, 2020–2021 only), screen time, and sugary beverage intake. Adjusted weighted logistic and negative binomial regression models stratified by country examined associations between year and reported sugary beverage advertising exposure, and associations between sugary beverage advertising exposure and intake. Differences in reported advertising exposure between students taking online or in-person school classes were explored. Results: Self-reported exposure to advertisements for sugary beverages at least weekly was relatively stable across years within countries, with differences in settings of exposure. Exposure to sugary beverage advertisements increased on digital media independently of screen time from 2019 to 2021 in Australia, Canada, the UK and US, with a concomitant decrease in exposure in retail settings in all countries except the UK. In Australia and the UK, children attending all classes online were more likely to report at least weekly (vs less than once a week) exposure to sugary beverage advertisements, and children attending all classes online were more likely to report exposure to advertisements on digital media and in other settings (e.g., billboard, magazines) compared to children attending in-person classes in Australia, Canada and the UK. Exposure to sugary beverage advertisements at least weekly (IRR = 1.12,99%CI:1.09–1.15) and in each of the settings was associated with sugary beverage intake. Conclusions: Exposure to digital advertisements for sugary beverages increased from 2019 to 2021 in most countries, and exposure was associated with sugary beverage intake. Reducing children's exposure to advertising of less healthy foods, including on digital media, may reduce sugary beverage intake. [ABSTRACT FROM AUTHOR]

Background: A voluntary National Healthy Food and Drink Policy (the Policy) was introduced in public hospitals in New Zealand in 2016. This study assessed the changes in implementation of the Policy and its impact on providing healthier food and drinks for staff and visitors in four district health boards between 1 and 5 years after the initial Policy introduction. Methods: Repeat, cross-sectional audits were undertaken at the same eight sites in four district health boards between April and August 2017 and again between January and September 2021. In 2017, there were 74 retail settings audited (and 99 in 2021), comprising 27 (34 in 2021) serviced food outlets and 47 (65 in 2021) vending machines. The Policy's traffic light criteria were used to classify 2652 items in 2017 and 3928 items in 2021. The primary outcome was alignment with the Policy guidance on the proportions of red, amber and green foods and drinks (≥ 55% green 'healthy' items and 0% red 'unhealthy' items). Results: The distribution of the classification of items as red, amber and green changed from 2017 to 2021 (p < 0.001) overall and in serviced food outlets (p < 0.001) and vending machines (p < 0.001). In 2021, green items were a higher proportion of available items (20.7%, n = 815) compared to 2017 (14.0%, n = 371), as were amber items (49.8%, n = 1957) compared to 2017 (29.2%, n = 775). Fewer items were classified as red in 2021 (29.4%, n = 1156) than in 2017 (56.8%, n = 1506). Mixed dishes were the most prevalent green items in both years, representing 11.4% (n = 446) of all items in 2021 and 5.5% (n = 145) in 2017. Fewer red packaged snacks (11.6%, n = 457 vs 22.5%, n = 598) and red cold drinks (5.2%, n = 205 vs 12.5%, n = 331) were available in 2021 compared to 2017. However, at either time, no organisation or setting met the criteria for alignment with the Policy (≥ 55% green items, 0% red items). Conclusions: Introduction of the Policy improved the relative healthiness of food and drinks available, but the proportion of red items remained high. More dedicated support is required to fully implement the Policy. [ABSTRACT FROM AUTHOR]

Issue Addressed: Food environments in early childhood, such as early childhood education and care services, influence the development of dietary patterns and behaviours that traverse into adulthood, where they affect health and longevity. Nutrition policies are mandatory in early childhood education and care services in Australia and can positively or negatively shape the food environment. However, the quality of such nutrition policies is unknown. This study aimed to evaluate the comprehensiveness and strength of nutrition policies of early childhood education and care services among services participating in a university‐community alliance in South East Queensland. Methods: Early childhood education and care services (n = 12) in Nerang, Queensland, Australia, participated in a cross‐sectional study evaluating the comprehensiveness and strength of nutrition policies across four domains (Nutrition Education, Nutrition Standards, Promoting Healthy Eating and Communication and Evaluation) of the Wellness in Child Care Assessment Tool. Results: Nutrition policies evaluated in this study had median total comprehensiveness scores of 55 (out of 100) and median total strength scores of 19 (out of 100). 'Nutrition Education' had the highest median scores for comprehensiveness (67 out of 100) and strength (33 out of 100), while 'Nutrition Standards' had the lowest comprehensiveness score (41 out of 100), and 'Communication and Evaluation' had the lowest strength score (0 out of 100). Conclusions: All services have a nutrition policy, but there are opportunities to enhance both the content and linguistic strength of statements within policies related to nutrition domains. So What?: There is a clear need to improve the comprehensiveness and strength of written statements in nutrition policies across all four domains, particularly 'Nutrition Standards' and 'Communication and Evaluation'. [ABSTRACT FROM AUTHOR]

Issue Addressed: Little is known about the executional techniques that are most likely to make healthy eating messages memorable over the longer term. The aim of this exploratory study was to identify factors contributing to the ongoing salience of the Go for 2&5 social marketing campaign among older audience members. Methods: Interviews were conducted with 75 Western Australians aged 60+ years. A peer‐interviewing method was used whereby eight older people recruited and interviewed members of their extended peer groups. The interview guide included questions about interviewees' recollections of healthy eating messages across their lifespans. Results: Around one in five interviewees discussed the Go for 2&5 campaign that was on air in Western Australia between 2002 and 2011. These discussions focused on either specific advertisement features that were considered to be especially memorable (in particular, humour and the use of anthropomorphised depictions of produce) and/or their recollection of the number of daily servings of fruits and vegetables recommended in the campaign. Few were able to recall other healthy eating campaigns, and in some cases it was assumed that advertisements for specific food stores or products constituted health advice. Conclusions: Different campaign attributes may influence shorter‐term attitudinal and behavioural responses versus longer‐term recall. The characteristics of the Go for 2&5 campaign appear to have enabled it to achieve relatively high levels of recall among older people. So What?: The study results suggest that some advertising approaches that activate the peripheral route to persuasion may achieve recall over a longer period of time. [ABSTRACT FROM AUTHOR]

Summary: Implementing proactive and effective policy tools is essential for governments to manage food safety risks. Existing studies have overlooked the synergistic effects among policy tools for governing food safety risks in China. This study uses policy tool synergy to develop a quantitative model to evaluate the degree of synergy among policy tools for food safety risk governance by considering its vertical, horizontal, and temporal dimensions. Using the Top2Vec topic model and text mining techniques, we examined 558 policy documents implemented by the central and six provincial governments. The findings reveal that China's food safety risk governance system has established a collaborative mechanism, with the Administration for Market Regulation, the Department of Agriculture and Rural Affairs, and the Health Commission playing crucial roles in policy implementation. Vertical and horizontal synergies between the upper and lower levels of government and among departments at the same level are crucial for enhancing comprehensive synergy. [ABSTRACT FROM AUTHOR]

Gather perspectives on healthy retail policies and strategies from a national sample of Supplemental Nutrition Assistance Program (SNAP) participants. Anonymous web-based survey fielded in English and Spanish. The survey measured support for healthy retail policies and strategies. National Qualtrics panel fielded on September 30 and October 19, 2022. A total of 1,559 adult SNAP participants (in the last 12 months) participated in the Qualtrics SNAP survey panel. Overall support for retail policies and strategies was calculated using response frequencies and proportions. Cross-tabulations and chi-square tests of independence assessed differences in policy support by online shopping behavior and nutrition security status. Significance was determined at P < 0.05. Most SNAP participants were broadly supportive of policies and strategies to improve the healthy food retail environment. More restrictive policies were less popular than policies that expanded consumer choice. Support also varied by online shopping status and nutrition security status. Policies and strategies that improve the healthy food retail environment are popular among a national sample of SNAP participants. Policy discussions must understand SNAP participants' perspectives regarding changes to the retail environment that may impact their ability to access healthy foods. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this systematic literature review is to examine policy and practice recommendations, along with calls for future research, aimed at addressing food insecurity for community colleges across the U.S. Argument/Proposed Model: This article will provide a detailed methodology for the systematic literature review, as well as the findings gathered from a range of peer-reviewed articles on this topic. The authors analyzed six significant themes that surfaced from the current literature related to policy and practice at the federal, state, local, and institutional levels. Conclusions/Contributions: Six chief themes are discussed in-depth, including but not limited to: important tools and approaches for marketing and communications, data-driven decision-making, and the augmentation of food support with other public benefits and institutional resources. These thematic findings address the issue of food insecurity on community college campuses, and also offer a range of techniques and areas for consideration. This systematic literature review offers a compilation of policy and practice recommendations steeped in actionable strategies for researchers, policymakers, campus leaders, and practitioners alike. The strategies can be implemented and/or tailored to meet the needs and nuances of any community college population. [ABSTRACT FROM AUTHOR]

Nutrition-related health disparities plague prisons in the United States. Unregulated and inadequate prison menus may contribute to noncommunicable chronic health conditions in this vulnerable population. The purpose of this research was to assess nutrition offerings provided by prison menus. Researchers requested the most current version of all master menus and associated nutrition analyses for gendered and age-centric (pediatric vs geriatric) menus. Menu and nutrient data were extracted and entered into a spreadsheet for analysis. Prisons serve gendered or nongendered menus to the general population, and 52.9% of prisons offer nongendered menus where males and females receive the same meals. This approach provides excess calories and saturated fat to females. Sodium was served in excess to both males and females. Fruit and vegetable servings on all gendered menus fell short of recommendations. The average prison menu inappropriately offers calories, sodium, and fruit and vegetable servings in a one-size-fits-all menu development method without considering gender, age, and physical activity. Interpretation and application of Dietary Guidelines for Americans are inconsistent. Nutrition guidelines recommending appropriate nutrients and food groups should be developed and available to corrections systems and dietitians. Current prison menu development practices yield inappropriate nutrition for prison populations. [ABSTRACT FROM AUTHOR]

Background/Objectives: Nutrition incentive programs can increase access to fresh fruits and vegetables and improve food security among Supplemental Nutrition Assistance Program (SNAP) participants and others in the United States. This qualitative study explored SNAP participants' and farmers' market staff's perceptions of and experiences with a pilot supplemental benefit program offered at seven farmers' markets in 2023 as part of the California Fruit and Vegetable Electronic Benefit Transfer Pilot Project. The pilot introduced specific characteristics that differ from more traditional nutrition incentive program dollar-for-dollar match incentive models, particularly the traditional model operating in California. Specific differences included the following: (1) offering a monthly USD 60 supplemental benefit that could be redeemed in a single shopping trip; (2) providing the supplemental benefit as a match that could be spent on any SNAP-eligible item in any retail location (rather than solely on fruits and vegetables at the farmers' market). Methods: We conducted a qualitative, cross-sectional study including seven focus groups with 40 SNAP shoppers and six focus groups with 14 farmers' market staff at six pilot-participating farmers' markets in California. All focus groups were conducted by trained research staff and were recorded, transcribed, and analyzed using the immersion crystallization method. Results: Our findings include that shoppers appreciated several features of the pilot, particularly the ability to obtain an entire month's supplemental benefit during one shopping trip and the ability to spend the benefit earned on any SNAP-eligible item at any SNAP retailer. Farmers' market staff appreciated that the pilot benefited shoppers but found it difficult to manage due to staff and shopper confusion about the program, increased program utilization, subsequent long lines, and the spending of the earned incentives at other SNAP retailers. Both shoppers and staff reported that the program was difficult to understand. Conclusions: These findings can inform future nutrition incentive program designs to benefit SNAP participants while offering sustainable models for farmers' markets. [ABSTRACT FROM AUTHOR]

Introduction: The U.S. Child and Adult Care Food Program (CACFP) provides tiered reimbursements for healthy foods for children at participating family childcare homes (FCCH). Higher tier 1 reimbursements are for providers who operate in low-income communities or who are themselves living on a low income. All FCCHs received a higher rate to address food insecurity during the COVID-19 pandemic. Methods: A survey was administered in the spring of 2023 to a randomly selected sample of licensed California FCCHs to assess the perceived impacts of the increased reimbursement on CACFP participation and anticipated challenges with reinstated tiered rates. A total of 518 surveys (261 tier 1, 257 tier 2) were analyzed using linear or logistic regression, adjusting for confounders. Results: Among tier 1 and tier 2 providers combined, over half reported lowering out-of-pocket spending for food (59%) and serving greater variety (55%) and quality (54%) of foods. Tier 2 providers reported experiencing more benefits (p < 0.05) and tended to be more likely to implement optional CACFP best practices (although not significantly different between tiers). Most FCCH providers found reimbursement rates were inadequate before (83%) the pandemic; this amount decreased to 54% post-pandemic for tier 1 and tier 2 providers combined. Conclusions: The temporary CACFP reimbursement positively impacted the perceived quality and variety of foods served to children, especially among tier 2 providers. Increased reimbursements for all FCCHs may ensure children have access to the healthy meals and snacks provided by the CACFP. [ABSTRACT FROM AUTHOR]

Justice in sustainability transitions requires states to design transition policies that 'leave no‐one behind'. Emphasising fairness, however, may entail slowing or scaling down the impetus of sustainability transition. To examine this risk empirically, we analysed how stakeholders frame justice in deliberating policy measures needed to support just transition in agricultural land use and dietary changes, the cornerstones of building healthier and climate friendlier food systems in Finland. The results show that justice frames focus on the potential impacts of transition, largely ignore global scale, and prioritise social justice claims at the cost of environmental ambition. To create just and environmentally effective policies, policymakers need to consider justice at the level of policy‐mixes combining environmental and social policies. Furthermore, they need to acknowledge systemic injustices present in existing systems while striving towards just transition. [ABSTRACT FROM AUTHOR]

Experience and credence characteristics are hard to assess when consumers select food products. Therefore, consumers who are unfamiliar with specific products typically use search characteristics as a proxy for product quality. As search characteristics are pivotal in consumers' decisions, we expect them to be reflected in the resulting product prices in the beer market. Besides traditional search characteristics such as beer color or fermentation type, new search characteristics such as online consumer ratings are emerging in beer markets all over the world. Thus, we use a hedonic price estimation to learn about the relative importance of traditional versus new search characteristics in the Belgian beer market. Specifically, the beer prices for 1517 different beer products of two large beer retailers are investigated to compare the role of traditional beer characteristics—color, fermentation type, beer style, origin, brewery type, and alcohol percentage—with the role of online beer ratings from the platform RateBeer.com. We find that while traditional characteristics still play a key role in the beer market, the role of online ratings seems dependent on the retail context [EconLit Citations: C36 Instrumental Variables Estimation, D83 Search—Communication, Q11 Agriculture—Prices, Q18 Food Policy]. [ABSTRACT FROM AUTHOR]

Background: Anemia in pregnancy has been associated with a number of adverse birth outcomes, such as low birth weight (LBW) or preterm birth (PTB). However, the evidence from primary studies on anemia in pregnancy with LBW and PTB is contentious. Moreover, a systematic review and meta-analysis to summarize these findings have not been conducted for Ethiopia. This study aimed to synthesize the best available evidence and quantify the strength and direction of the association of anemia in Ethiopia. Methods: This review examined women with singleton pregnancies with low birth weight (LBW) and preterm birth (PTB). We retrieved studies from PubMed, Wiley, Cochrane databases, and Google Scholar from inception to February 2, 2024. The World Health Organization (WHO) defines anemia in pregnancy as a low blood haemoglobin (Hgb) concentration below 11 g/dl or a hematocrit level of < 33%. When the newborn's weight was below 2500 g, LBW was considered. Preterm birth refers to the birth of a baby before 37 completed weeks of gestation. Meta-analysis was conducted using fixed and random effects models. The degree of heterogeneity, publication bias, and quality of the evidence of studies was assessed. Results: There were 35 and 8 studies, with 14,319 and 3,265 respondents included in the meta-analysis for LBW and PTB, respectively. Neonates born to women who had normal Hgb levels were less likely to be LBW [pooled odds ratio (POR) = 0.22, 95% CI: (0.17, 0.28); I2 = 80%] (low-quality evidence). Neonates born to women with normal Hgb levels had a lower risk of PTB [POR = 0.22, 95% CI: 0.18, 0.28; I2 = 19%] (very low-quality evidence). The effect size estimate remained significant after sub-group analysis based on study design and province, except in two retrospective cohort studies for LBW. Conclusion: The findings suggest major implications for strengthening the implementation of nutrition policies to prevent anemia during pregnancy in Ethiopia. Further research is warranted to assess interventions that are effective in combating maternal anemia to reduce rates of LBW and PTB. [ABSTRACT FROM AUTHOR]

Summary Increasing the healthiness of food retail environments is an identified mechanism to help halt rising rates of diet‐related non‐communicable diseases. Previous studies on healthy food environment adoption report that retailers' perceptions of loss of profitability and higher food costs are often barriers to change. Despite this, actual changes to profitability and food costs have not been fully explored. This study aimed to systematically scope the evidence relating to changes to food costs or profitability when changes are made to increase the healthiness of food and drinks sold by food service retailers. Nine databases were searched, with studies included from settings that sold ready‐to‐consume items, with interventions to increase the healthiness of menus, and reporting food environment/nutrition outcomes, and cost/profit outcomes. Of the 12 studies included, the majority were conducted in the United States and in school settings. Most studies indicated that increasing the healthiness of food service retail environments resulted in neutral or favorable financial outcomes. Food costs and/or profit changes were most often monitored via simple accounting measures. While further research is needed to strengthen the evidence on financial outcomes of healthier food provision, this review indicates that some perceived barriers to change may not be warranted. [ABSTRACT FROM AUTHOR]

Background: The Lao People's Democratic Republic (Lao PDR), a lower-middle income country, has a higher malnutrition rate than other Southeast Asian countries. The decentralization of healthcare is a determinant of the effectiveness of programs to reduce malnutrition, but no study has focused on this factor in this country. This organizational study explores the state of decentralization of the healthcare system in Lao PDR that underlies the nutrition programs in the country. Methods: A qualitative study, which is based on a neo-institutional theory conceptual framework, explored factors related to dominant structure (laws, regulations, resources) and interpretative schemes (dominant ideas and beliefs) that characterize the nutrition services provided in the Lao healthcare system. Twenty-four semistructured interviews were performed with representatives of healthcare institutions involved in nutrition programs at different government levels, external donors and civil society organizations. The interviews were completed with relevant documents. The analysis focused on the convergence of interpretative schemes of the organizations concerned and the coherence between the structure underpinning the nutrition programs and the interpretative schemes. Results: Services deployed to reduce malnutrition in the Lao PDR remain largely centralized, despite factors specific to the country that led it to promote decentralization of its services. The convergence of interpretive schemes and the coherence between the observed structure and the interpretative schemes of actors at all governance levels ensure the stability of this state of decentralization, which has persisted for almost 50 years. Conclusion: Nutrition programs in the Laos PDR are largely under the responsibility of the central government. The transformations in the healthcare system, notably with the use of new information technologies and the fact that the provinces are populated by a growing number of professionals trained in nutrition in addition to factors that push the system to be decentralized, such as ethnic diversity, the increasing availability of human resources in provinces, and the use of communication technologies, are not strong enough to change the balance of power between governance levels. The deconcentration that characterizes decentralization is therefore likely to continue for the foreseeable future. [ABSTRACT FROM AUTHOR]

Background: Food and beverage companies play a central role in shaping the healthfulness of food environments. Methods: The BIA-Obesity tool was used to evaluate and benchmark the specificity, comprehensiveness and transparency of the food environment-related policies and commitments of leading food and beverage manufacturing and retailing companies in Canada. Policies and commitments related to the healthfulness of food environments within 6 action areas were assessed: 1) corporate nutrition strategy; 2) product (re)formulation; 3) nutrition information and labelling; 4) product and brand promotion; 5) product accessibility; and 6) disclosure of relationships with external organizations. Data were collected from publicly available sources, and companies were invited to supplement and validate information collected by the research team. Each company was then assigned a score out of 100 for each action area, and an overall BIA-Obesity score out of 100. Results: Overall BIA-Obesity scores for manufacturers ranged from 18 to 75 out of 100 (median = 49), while scores for retailers ranged from 21 to 25 (median = 22). Scores were highest within the product (re)formulation (median = 60) followed by the corporate nutrition strategy (median = 59) domain for manufacturers, while retailers performed best within the corporate nutrition strategy (median = 53), followed by the disclosure of relationships with external organizations (median = 47) domain. Companies within both sectors performed worst within the product accessibility domain (medians = 8 and 0 for manufacturers and retailers, respectively). Conclusions: This study highlights important limitations to self-regulatory approaches of the food and beverage industry to improve the healthfulness of food environments. Although some companies had specific, comprehensive, and transparent policies and commitments to address the healthfulness of food environments in Canada, most fell short of recommended best-practice. Additional mandatory government policies and regulations may be warranted to effectively transform Canadian food environments to promote healthier diets and prevent related non-communicable diseases. [ABSTRACT FROM AUTHOR]

Background: In 2016, a voluntary National Healthy Food and Drink Policy was released to improve the healthiness of food and drinks for sale in New Zealand health sector organisations. The Policy aims to role model healthy eating and demonstrate commitment to health and well-being of hospital staff and visitors and the general public. This study aimed to understand the experiences of hospital food providers and public health dietitians/staff in implementing the Policy, and identify tools and resources needed to assist with the implementation. Methods: A maximum variation purposive sampling strategy (based on a health district's population size and food outlet type) was used to recruit participants by email. Video conference or email semi-structured interviews included 15 open-ended questions that focused on awareness, understanding of, and attitudes towards the Policy; level of support received; perceived customer response; tools and resources needed to support implementation; and unintended or unforeseen consequences. Data was analysed using a reflexive thematic analysis approach. Results: Twelve participants (eight food providers and four public health dietitians/staff) were interviewed; three from small (< 100,000 people), four from medium (100,000-300,000 people) and five from large (> 300,000 people) health districts. There was agreement that hospitals should role model healthy eating for the wider community. Three themes were identified relating to the implementation of the Policy: (1) Complexities of operating food outlets under a healthy food and drink policy in public health sector settings; (2) Adoption, implementation, and monitoring of the Policy as a series of incoherent ad-hoc actions; and (3) Policy is (currently) not achieving the desired impact. Concerns about increased food waste, loss of profits and an uneven playing field between food providers were related to the voluntary nature of the unsupported Policy. Three tools could enable implementation: a digital monitoring tool, a web-based database of compliant products, and customer communication materials. Conclusions: Adopting a single, mandatory Policy, provision of funding for implementation actions and supportive tools, and good communication with customers could facilitate implementation. Despite the relatively small sample size and views from only two stakeholder groups, strategies identified are relevant to policy makers, healthcare providers and public health professionals. [ABSTRACT FROM AUTHOR]

As the development of modern food systems continues to reshape dietary habits, the need for effective food policies to counter the rise of ultra-processed foods (UPFs) becomes increasingly urgent. UPFs are industrial formulations of several highly refined ingredients and additives with little or no nutritional value but potentially harmful health effects. In this paper, we develop a simple model of duopolistic competition in which food manufacturers compete by choosing the degree of food sophistication of their products (i.e., the degree of food formulation and processing). We show that when firms compete for market shares, an unhealthy degree of food sophistication is a strategically stable Nash–Bertrand equilibrium outcome. Furthermore, we compare the effectiveness of alternative health-related food policies. Our model highlights the shortcomings of nutrient-to-limit regulations and suggests that policy interventions should prioritize whole-food reformulation-based approaches within an 'ecological' regulatory framework. [ABSTRACT FROM AUTHOR]

Faced with a significant devaluation of its currency and a surge in food prices, the Nigerian government prohibited the use of foreign currency for food imports. This essentially blocked the importation of numerous food items under the guise of stimulating the domestic output of these staples. Consequently, food prices in Nigeria increased despite a global decline in food prices, and the incidence and severity of food insecurity escalated. This study examines the changes in the types and severity of coping mechanisms for food insecurity resulting from the food price shock caused by the oil price crash, currency devaluation, and restrictions on foreign exchange. Nigeria's General Household Survey Panel data from 2012 and 2015, during periods of high oil prices, is compared with data from 2018 when oil prices had remained low, the currency had been devalued, and the treasury had been depleted. Alongside detailed descriptive statistics, logistic and hurdle regressions are employed for statistical analysis. Findings indicate a rise in the percentage of Nigerian households grappling with food insecurity from 2015 to 2018. During this period, 68.7% of households resorted to at least one coping mechanism, 31.8% adopted six or more coping strategies, and 43.2% resorted to severe coping strategies. The issue stems not primarily from natural disasters or conflicts but from a failure in macroeconomic and agricultural economic policies. Our findings confirm that these policies come at great cost, particularly to female‐headed households, single‐parent households, households headed by elderly people, and other vulnerable populations, pushing them deeper into food insecurity. [ABSTRACT FROM AUTHOR]

The existing literature addresses the importance of food system disruptions and the risk of the global food crisis. However, there is insufficient understanding of response strategies and their effectiveness evaluations. This study offers a comprehensive introduction to China's food security policies and evaluates their effectiveness in enhancing the nation's risk resistance capability. Utilizing the Entropy Weight Method (EWM) and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), we evaluated China's provincial food security resilience (FSR) from 2003 to 2020 and adopted the ArcGIS platform to map spatiotemporal trends. Our findings reveal significant improvements in FSR nationwide, with a notable average annual growth rate of 1%–5%. However, regional disparities persist, with higher resilience observed in eastern provinces compared to the west. The study emphasizes the effectiveness of China's food security policies, which have synergistically enhanced grain production, agricultural mechanization, and farmers' economic conditions. The article offers policy recommendations aimed at bolstering China's FSR and challenges with global implications. Our study contributes to the broader discourse on global food security by offering a nuanced understanding of the effectiveness of policy interventions in a major agricultural economy. [ABSTRACT FROM AUTHOR]

• Higher intake of green and white vegetables/fruits is linked to reduced breast cancer (BrCa) risk. • The role of diet in reducing BrCa is emphasized, highlighting the importance of the color of vegetables/fruits. • Our study provides information supporting dietary guidelines to lower BrCa risk. Breast cancer (BrCa) remains a significant health concern globally, influenced by both nonmodifiable and modifiable risk factors. Limited studies have explored the role of color-specific vegetables and fruits, which are rich in specific phytonutrients, on BrCa risk. We hypothesized that consuming color-specific vegetables and fruits may decrease BrCa risk in Korean women. This case-control study examined the relationship between the intake of different-colored vegetables and fruits and the risk of BrCa, considering menopausal, hormone receptor status, tumor subtypes. We matched 395 patients and 395 controls by age and recruited from the National Cancer Center in Korea. Dietary data was collected via food frequency questionnaire, categorizing by colors: green, orange/yellow, red/purple, and white. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated by logistic regression models, with subgroup analyses for menopausal, hormone receptor status, and tumor subtypes. Results shown BrCa patients consumed less vegetables and fruits than control group. Higher consumption of green, other orange/yellow, and white vegetables and fruits was negatively associated with BrCa risk [OR (95% CIs) of Q4 vs Q1 = 0.59 (0.36-0.94); 0.55 (0.33-0.89); and 0.60 (0.37-0.96), respectively]. Particularly, a greater intake of dark green leafy vegetables was significantly associated with reduced BrCa risk (OR of Q4 vs Q1 = 0.55, 95% CI = 0.34-0.89). Subgroup analysis consistently demonstrated inverse associations between higher intake of green-color vegetables and fruits and BrCa risk. Our findings suggest that a diet rich in green and white-color vegetables and fruits may lower BrCa risk among Korean women. [Display omitted] This case-control study examined the link between color-type vegetables and fruits and BrCa risk among Korean women, categorizing by colors: green, orange/yellow, red/purple, and white. Subgroup analyses considered menopausal status, hormone receptor status, tumor subtypes, and cancer stages. Findings indicate higher intake of green-, orange/yellow-, and white vegetables and fruits is linked to lower BrCa risk, especially in postmenopausal women with triple-negative BrCa and stage III. These data may support nutritional guidelines based on BrCa types. Abbreviations: BrCa, breast cancer [ABSTRACT FROM AUTHOR]

Purpose: Front-of-pack labelling systems, such as the Health Star Rating (HSR), aim to aid healthy consumer dietary choices and complement national dietary guidelines. Dietary guidelines aim to be holistic by extending beyond the individual nutrients of food, including other food components that indicate diet quality, including whole grains. We aimed to test the feasibility of including whole grains in the HSR algorithm, to better inform dietary guidance in Australia coherent with existing dietary guidelines. Methods: We assigned whole-grain points as a favourable component of the HSR based on the whole-grain content of foods. We compared the original, and three modified HSR algorithms (including altered thresholds for star ratings) using independent-samples median tests. Finally, we used Spearman's correlation to measure the strength of association between an item's nutritional composition (all components of the HSR algorithm including all favourable and unfavourable components) and their HSR using each algorithm. Results: Up to 10 points were added for products with ≥ 50% whole-grain content, with no points for products with < 25%. Adjusting the HSR score cut-off by 3 points for grain products created the greatest difference in median HSR between refined and whole-grain items (up to 2 stars difference), compared to the original algorithm (a maximum of 1 star). Conclusions: The addition of whole grains to the HSR algorithm improved the differentiation of refined and whole-grain items, and therefore better aligned with dietary guidelines. Holistic approaches to food guidance systems are required to provide consistent messaging and inform positive food choices. [ABSTRACT FROM AUTHOR]

To reveal students' experiences and perspectives related to Universal School Meals (USM) under the federal coronavirus disease 2019 waivers during school years 2021–22. Qualitative; 17 focus groups in June–July 2022. Virtual; students from 9 California regions in public and charter schools. 67 students (n = 31 in high school, n = 36 in middle school) from a racially and economically diverse sample. Students' perceived benefits and drawbacks of USM. Thematic analysis using an immersion-crystallization approach. Students appreciated USM for increasing school meals' accessibility, promoting food security by financially supporting families, reducing the stigma associated with school meals, simplifying the payment system, and enhancing school meals convenience. An increase in school meal participation was observed. However, concerns emerged regarding a perceived decline in food quality and quantity and increased food waste. Universal School Meals showed promise in increasing access to meals, reducing food insecurity, stigma, and increasing participation. Addressing food quality, quantity, and waste concerns is critical for its sustained success. Policymakers need to advocate for the expansion and continuous refinement of USM, prioritizing stakeholder feedback. Ensuring adequate funding to balance meal quality and quantity while minimizing waste is essential for an adequate school meal policy. [ABSTRACT FROM AUTHOR]

Co‐production is a collaborative way of working which emphasises the exchange of diverse forms of knowledge in an equal partnership for equal benefits. Co‐produced research is a key strategic aim of the UK Research and Innovation (UKRI) Transforming UK Food Systems (TUKFS) Strategic Priorities Fund; this research programme brings together researchers, policymakers, industry and communities to create positive change in the way food is produced, accessed and consumed. However, more generally, there are diverse understandings of co‐production and a lack of consensus on what 'good practice' looks like. Therefore, this study aimed to identify and map examples of co‐production methods employed across the TUKFS programme. Two creative workshops (n = 15 participants), conversations with TUKFS researchers and stakeholders (n = 15), and systematic analysis of project documents were used to critically explore co‐production activities within six TUKFS projects. A range of co‐production activities were identified. Findings highlighted areas of 'messiness' and complexity, challenges associated with applying co‐production approaches and practical solutions. Four key shared principles for co‐production were identified: (1) Relationships: developing and maintaining reciprocity‐based partnerships; (2) Knowledge: recognising the contribution of diverse forms of expertise; (3) Power: considering power dynamics and addressing imbalances; and (4) Inclusivity: ensuring research is accessible to all who wish to participate. Opportunities for reflection and reflexivity were considered crucial across all these areas. Findings contribute important insights towards a shared conceptual understanding of co‐production for food system transformation research. This paper makes recommendations for researchers, practitioners, academic institutions and funders working in this area of research and practice. [ABSTRACT FROM AUTHOR]

An editorial is presented the Scientific Advisory Committee on Nutrition's (SACN) 2016 report, which determined that blood vitamin D levels below 25nmol/L increase the risk of poor musculoskeletal health. Topics include the recommended daily intake of vitamin D, historical changes in UK fortification practices, and current government advice on vitamin D supplementation.

MyPlate is a tool designed to educate the general US population on how to eat in alignment with the Dietary Guidelines for Americans; yet, there is a lack of data on who has heard of MyPlate over time. The objective of this analysis was to examine the prevalence of awareness of MyPlate within the US population and if awareness changes differentially over time. This study was a serial, cross-sectional survey. Three survey waves of data (2013-2018) were used from the National Health and Nutrition Examination Survey of adults aged 20 years or older (n = 17,023). Percentage of the US adult population who had heard of MyPlate was measured and stratified by sex, age, citizenship status, education, household food security status, income, receipt of Supplemental Nutrition Assistance Program (SNAP) benefits, and receipt of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits. Global Wald tests were used to assess whether prevalence of awareness of MyPlate differed by sociodemographic characteristics. Tests of homogeneity using likelihood ratio tests of nested logistic regression models were used to assess whether differences in awareness of MyPlate by various sociodemographic characteristics changed over time from 2013 to 2018. Twenty percent (19.5%) (n = 875) of the analytic sample of participants aged 20 years and older had heard of MyPlate in 2013-2014, 24.5% (n = 1,020) in 2015-2016, and 24.6% (n = 1,086) in 2017-2018. Awareness of MyPlate changed differentially over time (P value <.1) from 2013 to 2018 by income, household food security status, and receipt of SNAP benefits, with slower increases in awareness for households with lowest income over time, narrowing of differences in awareness by household food security status over time, and persistent differences in awareness by receipt of SNAP benefits over time. These results highlight the current low awareness of MyPlate, disparities in awareness of MyPlate immediately after implementation by sociodemographic characteristics, and increases in awareness over time at differential rates within levels of income, food security status, and ever receipt of SNAP benefits. Given that the Dietary Guidelines for Americans 2025-2030 are currently in development, new strategies should be considered to disseminate tools that translate the updated Dietary Guidelines in such a way that reach the general population equitably upon implementation within the United States. [ABSTRACT FROM AUTHOR]

Background: Parents commonly seek online sources of information on the important complementary feeding period, but the accuracy of these sources varies. The 21st Century Integrated Digital Experience Act (IDEA) states federal government resources should be accurate and user-friendly; however, the quantity, quality, and accuracy of federal resources on complementary feeding is unknown. Methods: An environmental scan of online federal, parent-facing resources about complementary feeding was conducted. The authors reviewed federal resources for concordance of information with the Dietary Guidelines for Americans (DGA). Quality was evaluated using the Patient Education Materials Assessment Tool. Results: A total of 112 resources across 2 federal government departments. Overall quality was high as was concordance with recommendations from the DGA for age of complementary food introduction, foods to introduce, and foods to avoid. Allergenic food introduction and textured food progression recommendations were less consistent. Recommendations for improvements to federal resources are made. Clinical Implications: This environmental scan only included federal resources for CF. Parents may be accessing other, non-federal resources online. However, given the enactment of IDEA, it is expected that these federal resources will be up-to-date and user-friendly, which was not always the case. Nurses should review the DGA guidelines for complementary feeding and provide evidence-based anticipatory guidance to families, focusing especially on allergenic food introduction and textured food progression. Future complementary feeding interventions may benefit from directing families to online exemplars from federal sources. [ABSTRACT FROM AUTHOR]

The study assesses the status quo of SDG 2 implementation in South Africa. The study further examines the obstacles to achieving SDG 2 within the nation's framework. The study also looks at and assesses several national programmes related to food security. A few interventions are discussed and considered to enhance and augment the extent of food security in South Africa. The study employed a qualitative approach and used the literature review to compile information related to SDG 2 and food security interventions, which was further analyzed through document and conceptual analysis. The findings show that there are issues with the implementation of policies pertaining to food security initiatives. The study aims to answer the following questions: What obstacles need to be overcome for SDG 2 to be implemented effectively, and what measures are necessary to ensure the success of food security interventions in South Africa? Thus, the study aims to evaluate South Africa's progress toward food security (focus). It also seeks to assess the accomplishments and shortcomings of food security initiatives implemented in South Africa (locus). The sustainable livelihoods approach (SLA) is considered a theoretical framework for the study. Suggestions for improving policy are made as a contribution to the public management and governance field. [ABSTRACT FROM AUTHOR]

Public procurement of food is crucial for ensuring proper nutrition and the provision of high-quality products in public institutions like schools and kindergartens. It should be seen as an investment in health promotion, particularly for young children. Notably, when no quality criteria are specified, the cheapest and often lowest-quality products are typically selected. This study analyzed 1126 public procurement orders processed by schools and kindergartens in Poland between November 2022 and March 2023, with a focus on cereal products and their derivatives. Of these orders, 197 met the inclusion criteria, yielding a total of 5084 cereal products for detailed analysis. The study assessed the quantities ordered and the quality characteristics specified in the procurement documents. The results revealed that the most commonly described criteria pertained to product composition, especially typical characteristics and the absence of additives. Sensorial characteristics such as consistency and color were also frequently specified, while sustainable public procurement criteria were mentioned the least, indicating their marginal importance in current procurement practices. This underscores the critical importance of establishing minimum standards for describing cereal products in terms of sensorial characteristics, composition, and sustainability. Such standards are essential for improving the quality of grain products supplied to public institutions and ensuring that these institutions actively contribute to promoting healthy eating habits among children. [ABSTRACT FROM AUTHOR]

Transitioning to food systems that are equitable, resilient, healthy and environmentally sustainable will require the cultivation and diffusion of transformational sociotechnical innovations—and grassroots movements are an essential source of such innovations. Within the literature on strategic niche management, government-provided 'protected spaces' where niche innovations can develop without facing the pressures of the market is an essential part of sustainability transitions. However, because of their desire to transform rather than transition food systems, grassroots movements often struggle to acquire such protected spaces and so must determine how and where to generate change whilst being marginalised and exposed to unprotected spaces. The aim of this research is to gain a precise view of the multiple touchpoints of marginalisation that exist across the grassroots-government interface and to apply a new framework for conceptual analysis of these touchpoints that can help to identify where and how grassroots movements might be able to push against this marginalisation. The study finds that, by applying a 'who, what, where' framework of analysis to policies across this interface, it is possible to find pathways forward for achieving small wins towards food systems transformation. [ABSTRACT FROM AUTHOR]

In the last 2 decades, the literature has documented the upsurge of community-driven processes of consumer-producer cooperation, which are alternative to the dominant food system. These organizational arrangements have been conceptualized differently, witnessing the growing importance of local communities in generating place-based solutions to the demand for organic, local, and sustainable food. Relying on a practice theory approach, this article delves into two key inquiries: first, what motivates individuals to become part of Civic Food Networks (CFNs) and how does this influence the variety of food entering their households? And second, how does participation in a CFN impact people's daily food practices, with a particular focus on diet diversification? We employ the term "civic food networks (CFN)" to underscore the significance of grassroots initiatives in the broader context of local food policies. This term also highlights the connections to other movements known for their potential for transformation, such as the solidarity economy, transition towns, and de-growth movements. Our analysis draws on a comprehensive qualitative approach, which includes participant observation, in-depth interviews, and a focus group involving members of the CSA Naturalmente in Trentino, situated in the North-Eastern part of Italy. The findings reveal that altering dietary habits poses various challenges both at the individual and institutional levels. This process involves the stabilization of ingrained habits, adjustments to daily routines, and the reinforcement of shared norms. Furthermore, it underscores the critical role of food policies in promoting sustainable eating practices. [ABSTRACT FROM AUTHOR]

The modern global food system is highly unsustainable, shaped by industrialisation and corporate consolidation, with negative repercussions on the environment and biodiversity as well as human health. This paper looks at the burgeoning economy in neglected and underutilised species (NUS) in the Western Cape, South Africa, as a potential innovation that could make the local food system more socially and ecologically resilient. Although, at present, NUS are only marginally included in the local food system and policy discussions, NUS increasingly appear in the high-end food industry, driven by international gastronomic trends. These species hold potential as climate resilient, nutritionally dense, and socially and culturally significant foods in the region, but they also carry ecological and social risks. We critically examine the fledgling NUS economy in the Cape Town area to unpack the motivations and challenges associated with the potentially transformative inclusion of these foods into the local food system. We demonstrate that the main risks associated with NUS are negative ecological repercussions, privatisation of the NUS economy, and the reproduction and further entrenchment of unequal power and race dynamics in the region. To mitigate these risks and actualise the related benefits associated with NUS, engagement with the ecological, social, and political context of NUS needs to be significantly deepened. This is particularly true for those working in the high-end food industry, who appear to be driving the NUS economy, and will require education around sustainability and Traditional Ecological Knowledge (TEK), as well as a foregrounding awareness of power dynamics. [ABSTRACT FROM AUTHOR]

Abstract Background In 2016, a voluntary National Healthy Food and Drink Policy was released to improve the healthiness of food and drinks for sale in New Zealand health sector organisations. The Policy aims to role model healthy eating and demonstrate commitment to health and well-being of hospital staff and visitors and the general public. This study aimed to understand the experiences of hospital food providers and public health dietitians/staff in implementing the Policy, and identify tools and resources needed to assist with the implementation. Methods A maximum variation purposive sampling strategy (based on a health district’s population size and food outlet type) was used to recruit participants by email. Video conference or email semi-structured interviews included 15 open-ended questions that focused on awareness, understanding of, and attitudes towards the Policy; level of support received; perceived customer response; tools and resources needed to support implementation; and unintended or unforeseen consequences. Data was analysed using a reflexive thematic analysis approach. Results Twelve participants (eight food providers and four public health dietitians/staff) were interviewed; three from small ( 300,000 people) health districts. There was agreement that hospitals should role model healthy eating for the wider community. Three themes were identified relating to the implementation of the Policy: (1) Complexities of operating food outlets under a healthy food and drink policy in public health sector settings; (2) Adoption, implementation, and monitoring of the Policy as a series of incoherent ad-hoc actions; and (3) Policy is (currently) not achieving the desired impact. Concerns about increased food waste, loss of profits and an uneven playing field between food providers were related to the voluntary nature of the unsupported Policy. Three tools could enable implementation: a digital monitoring tool, a web-based database of compliant products, and customer communication materials. Conclusions Adopting a single, mandatory Policy, provision of funding for implementation actions and supportive tools, and good communication with customers could facilitate implementation. Despite the relatively small sample size and views from only two stakeholder groups, strategies identified are relevant to policy makers, healthcare providers and public health professionals.

Abstract Background Food and beverage companies play a central role in shaping the healthfulness of food environments. Methods The BIA-Obesity tool was used to evaluate and benchmark the specificity, comprehensiveness and transparency of the food environment-related policies and commitments of leading food and beverage manufacturing and retailing companies in Canada. Policies and commitments related to the healthfulness of food environments within 6 action areas were assessed: 1) corporate nutrition strategy; 2) product (re)formulation; 3) nutrition information and labelling; 4) product and brand promotion; 5) product accessibility; and 6) disclosure of relationships with external organizations. Data were collected from publicly available sources, and companies were invited to supplement and validate information collected by the research team. Each company was then assigned a score out of 100 for each action area, and an overall BIA-Obesity score out of 100. Results Overall BIA-Obesity scores for manufacturers ranged from 18 to 75 out of 100 (median = 49), while scores for retailers ranged from 21 to 25 (median = 22). Scores were highest within the product (re)formulation (median = 60) followed by the corporate nutrition strategy (median = 59) domain for manufacturers, while retailers performed best within the corporate nutrition strategy (median = 53), followed by the disclosure of relationships with external organizations (median = 47) domain. Companies within both sectors performed worst within the product accessibility domain (medians = 8 and 0 for manufacturers and retailers, respectively). Conclusions This study highlights important limitations to self-regulatory approaches of the food and beverage industry to improve the healthfulness of food environments. Although some companies had specific, comprehensive, and transparent policies and commitments to address the healthfulness of food environments in Canada, most fell short of recommended best-practice. Additional mandatory government policies and regulations may be warranted to effectively transform Canadian food environments to promote healthier diets and prevent related non-communicable diseases.

BACKGROUND: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages for children ages 1 to 4 y include a cash value benefit (CVB) redeemable for fruits and vegetables (FVs) with participating vendors. The CVB value was increased beginning in June 2021. OBJECTIVES: This study evaluated associations of the augmented CVB with the amount and diversity of redeemed FVs. METHODS: Price look-up codes (PLUs) in redemption data determined outcomes including any redemption (any, none), amount redeemed (United States dollars [USD]/mo), and percent of total CVB redemption (percent) in 54 FV commodity groups among a cohort of 1770 WIC-participating children in Southern California. Outcomes across all commodity groups for fresh fruits, fresh vegetables, and all FVs were evaluated including dollar amount redeemed, percentage of redemption, and diversity of produce redeemed (variety and balance among items redeemed). Comparisons were made between augmented CVB periods (35 USD/mo in June-September 2021, 24 USD/mo October 2021-June 2022) and the preaugment period (9 USD/mo in June 2020-May 2021). Associations were tested in multivariable generalized estimating equation Poisson (any redemption) and linear (amount, percent, diversity) regression models. RESULTS: The augmented CVB was associated with higher any redemption prevalence and amount redeemed for 53 of 54 commodity groups at both 35 USD/mo and 24 USD/mo compared with 9 USD/mo. Redemption diversity increased for both fruits, vegetables, and all produce during both augment periods, and modestly greater increases in redeemed fruits relative to vegetables were observed at 35 USD/mo. The most commonly redeemed vegetables were tomatoes, onions, cucumbers, peppers, and avocados and the most commonly redeemed fruits were bananas, apples, grapes, limes, and melons. CONCLUSIONS: The augmented CVB was associated with greater redeemed FV amount and greater redeemed FV diversity. Data on FV intake diversity among WIC-participating children are needed to understand dietary impacts of the CVB increase.

An overwhelming number of Canadians believe that a national school food program (SFP) would benefit children, but concerns around limited funding are frequently raised. SFPs across Canada are struggling to meet increasing demands due to rising food costs, meaning that food quality and quantity within existing SFPs are suffering. This paper discusses the urgency to implement a cost-shared and federally funded SFP amidst the current economic context and lack of clear direction from the federal government. The paper also explores ways in which federal funding for school meals can help to reduce the rate of chronic diseases and actualize many proven physical and mental health benefits for Canadians, all of which have positive and long-term downstream effects on the country’s economy.

Abstract Background National food environment policies can contribute to the reduction of diet-related non-communicable diseases. Yet, their implementation in the Netherlands remains low. It has been hypothesized that the media can play a pivotal role in inducing spikes in policy attention, thereby shaping political action. The aim of this study was to examine the discourse on food policies in Dutch newspaper articles between 2000–2022, by analyzing arguments used by various actors. Methods A systematic search in Nexis Uni was used to identify newspaper articles that covered national-level Dutch food environment policies published in seven Dutch national newspapers between 2000–2022. Covered policies were classified into six domains including food composition, labeling, promotion, prices, provision and retail and into the four stages of the policy cycle; policy formulation, decision-making, implementation, and evaluation. A grey literature search was used to identify food policies implemented during 2000–2022. Descriptive statistics were used to summarize coverage of policies over time, policy type and policy stage. An interpretive content analysis was performed on a random subsample of the newspaper articles to determine the actors, viewpoints and arguments of the food policies. Results We identified 896 relevant newspaper articles. The coverage of food policies in newspapers was initially low but peaked in 2018/2021/2022. Through grey literature search we identified 6 food policies which were implemented or adjusted between 2000–2022. The majority of the newspaper articles reported on food pricing policies and were discussed in the policy formulation stage. Academics (mainly supportive) were the most and food industry (mostly opposing) the least cited actors. Supportive arguments highlighted health consequences, health inequalities and collective responsibility, whereas opposing arguments focused on unwanted governmental interference and ineffectiveness of policies. Conclusions Dutch newspaper articles covering food policies represented a variety of actors and arguments, with individual versus collective responsibility for food choices playing a central role in the arguments. These insights may serve as a basis for further research into why certain arguments are used and their effect on policy attention and implementation.

Background: Food labels are typically significant to the costumers. It is crucial to ensure that labels are accurate as they provide essential information about products. Therefore, the major objective of this study was to assess the current printing information. Methods: In this descriptive analytical study, 120 food products were selected in January 2020 and divided into eight food categories. Ten requirements of the food labels and the levels of compliance with the criteria developed by the Food and Drug Administration were evaluated. The data were subsequently analyzed using chi-square test and SPSS Software. Results: The results revealed that 82.7% of the product labels contained food labeling requirements in line with the regulations developed in Iran. Among the non-compliant labels, the highest rate (62%) was associated with the use of deceptive words and the lowest rate (0.8%) was linked to inclusion of the company’s name. The highest non-compliance rate was observed in the groups of prepared and semi-prepared foods, snacks, cereals and flours, as well as confectioneries. Conclusions: In order to prevent consumer confusion and decrease non-communicable diseases, it is necessary to develop coherent plans and unify all food labels, regarding the acceptable compliance of labeling requirements with the country's regulations and the compatibility of the existing developed criteria with the regulations and standards of other Islamic and leading countries. DOI: 10.18502/jfqhc.11.2.15649

Background: In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, "the Policy") was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors' awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. Methods: Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. Results: Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that "Hospitals should be good role models." Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. Conclusions: The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces. [ABSTRACT FROM AUTHOR]

Industrially produced trans fat (iTFA) is a harmful compound created as a substitute for animal and saturated fats. Estimated to cause up to 500,000 deaths per year, it is replaceable. In 2018, Resolve to Save Lives, the World Health Organization (WHO), Global Health Advocacy Incubator, and NCD Alliance partnered to achieve global trans fat elimination. The WHO Director-General called for the elimination of trans fat by 2023 through best practice policies outlined in the WHO REPLACE package. Since the accelerated global efforts in 2018, 43 countries have adopted best practice regulations protecting an additional 3.2 billion people and building momentum toward global elimination. Current coverage will prevent 66% of deaths estimated to be caused each year by trans fat in foods. Despite producing and selling iTFA-free products in many countries, companies continue to sell iTFA-containing products in unregulated markets. Global incentives, accountability mechanisms, and regional policies will help achieve the elimination goal. • Policies can reduce known risk of coronary heart disease due to trans fat consumption. • A strategic partnership accelerated progress toward global elimination of trans fats by 2023. • Policies in place today will prevent 66% of the deaths estimated to be caused by trans fats each year. • Global trans fat elimination offers a model to tackle other nutrition policy priorities. [ABSTRACT FROM AUTHOR]