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1.
OBJECTIVES: To develop an objective, nutrient-based, healthy eating indicator shopping basket (HEISB) tool for use in studies of access to healthy food. DESIGN: Tool development used a literature search to identify previous practice, web information on current definition of healthy foods by the UK Food Standards Agency, and population-based dietary surveys to identify culturally acceptable foods. These findings were then appraised with respect to practical fieldwork considerations. SETTING: The review took account of surveys undertaken in a range of geographical areas. RESULTS: Previous tools have varied in the foods selected and the rationale for inclusion. Most have considered nutritional composition but no systematic definition has been used and foods have been subjectively classified as 'less healthy' or 'more healthy'. Recent UK work on nutrient profiling enabled individual food items to be objectively assessed for inclusion. Data from national food surveys enabled commonly consumed and culturally acceptable foods to be identified. Practical considerations included item use in meals, convenience, price, and fieldwork constraints. Other issues including health and price discriminators as well as regional preferences were considered. The final HEISB tool comprised 35 items within the following categories - 17 from fruit and vegetables, nine from potatoes, bread and cereal, five from fish/meats, three from dairy, and one from fatty and sugary foods. CONCLUSIONS: The tool provides a rational basis for examining access and availability of healthy foods in cross-sectional and longitudinal retail and consumer studies.  相似文献   

2.
OBJECTIVE: This study assessed the impact of changes in school food policy on student lunch consumption in middle schools. METHODS: Two years of lunch food records were collected from students at three middle schools in the Houston, Texas area. During the first year, no changes occurred in the school food environment. After that school year was completed, chips and dessert foods were removed from the snack bars of all schools by the Food Service Director. Students recorded the amount and source of food and beverage items consumed. Point-of-service purchase machines provided a day-by-day electronic data file with food and beverage purchases from the snack bars during the 2-year period. Independent t-tests and time series analyses were used to document the impact of the policy change on consumption and sales data between the two years. RESULTS: In general, student consumption of sweetened beverages declined and milk, calcium, vitamin A, saturated fat and sodium increased after the policy change. Snack chips consumption from the snack bar declined in year 2; however, consumption of snack chips and candy from vending increased and the number of vending machines in study schools doubled during the study period. Ice cream sales increased significantly in year 2. CONCLUSIONS: Policy changes on foods sold in schools can result in changes in student consumption from the targeted environments. However, if all environments do not make similar changes, compensation may occur.  相似文献   

3.
AIM: The aim of the present study was to determine the impact of food advertising in primary and secondary schools on the food purchasing habits of children. METHODS: All forty-four primary and secondary schools in Rzeszow, Poland were included in the investigation; 15000 children attend primary and secondary schools in the region. Schools were visited by members of the research team, who filled in a questionnaire regarding the type of food products displayed or advertised in the school shop window and recorded the presence of direct corporate advertising in the proximity of the school shop. Shop owners were asked to fill in a form describing food purchases by students within the week preceding the visit. The school principal (or one of teachers) completed a form describing the school's policy regarding food advertising and the sponsorship of school activities by food companies. RESULTS: Recommended foods like milk, yogurts and fruit were offered by only 40.9 % of shops. There was a correlation between foods offered in the shop and foods purchased by students. In schools, 40.9% (95% CI 25.8, 56.0%) of shop windows displayed or advertised 'healthy' foods while 9.1% (95% CI 0.0, 17.9%) of shops displayed advertisements of food companies. The difference between display of 'healthy' food in shop windows and display of food on company advertisements was significant (likelihood ratio chi2 test, P < 0.04). Type of school (primary v. secondary) was not significant factor in advertising or purchasing pattern. CONCLUSIONS: Educational programmes should be introduced in schools with the aim of improving the understanding of nutritional principles among pupils, teachers and parents.  相似文献   

4.
OBJECTIVES: To examine the association between education level and food purchasing behaviour and the contribution of dietary knowledge to this relationship; and the association between household income and purchasing behaviour and the contribution made by subjective perceptions about the cost of healthy food.DESIGN AND SETTING: The study was conducted in Brisbane City (Australia) in 2000. The sample was selected using a stratified two-stage cluster design. Data were collected by face-to-face interview from residents of private dwellings (n=1003), and the response rate was 66.4%. Dietary knowledge was measured using a 20-item index that assessed general knowledge about food, nutrition, health and their interrelationships. Food-cost concern was measured using a three-item scale derived from principal components analysis (alpha=0.647). Food purchasing was measured using a 16-item index that reflected a household's purchase of grocery items that were consistent (or otherwise) with dietary guideline recommendations. Associations among the variables were analysed using linear regression with adjustment for age and sex.RESULTS: Significant associations were found between education, household income and food purchasing behaviour. Food shoppers with low levels of education, and those residing in low-income households, were least likely to purchase foods that were comparatively high in fibre and low in fat, salt and sugar. Socio-economic differences in dietary knowledge represented part of the pathway through which educational attainment exerts an influence on diet; and food purchasing differences by household income were related to diet in part via food-cost concern.CONCLUSIONS: Our findings suggest that socio-economic differences in food purchasing behaviour may contribute to the relationship between socio-economic position and food and nutrient intakes, and, by extension, to socio-economic health inequalities for diet-related disease. Further, socio-economic differences in dietary knowledge and concerns about the cost of healthy food play an important role in these relationships and hence should form the focus of future health promotion efforts directed at reducing health inequalities and encouraging the general population to improve their diets.  相似文献   

5.
OBJECTIVE: To determine the extent to which identified nutrient inadequacies in the dietary intakes of a sample of food-insecure women could be ameliorated by increasing their access to the 'healthy' foods they typically eat. DESIGN: Merged datasets of 226 food-insecure women who provided at least three 24-hour dietary intake recalls over the course of a month. Dietary modelling, with energy adjustment for severe food insecurity, explored the effect of adding a serving of the woman's own, and the group's typically chosen, nutrient-rich foods on the estimated prevalence of nutrient inadequacy. SETTING AND SUBJECTS: One study included participants residing in 22 diverse community clusters from the Atlantic Provinces of Canada, and the second study included food bank attendees in Toronto, Ontario, Canada. Of the 226 participants, 78% lived alone with their children. RESULTS: While nutritional vulnerability remained after modelling, adding a single serving of either typically chosen 'healthy' foods from women's own diets or healthy food choices normative to the population reduced the prevalence of inadequacy by at least half for most nutrients. Correction for energy deficits resulting from severe food insecurity contributed a mean additional 20% improvement in nutrient intakes. CONCLUSIONS: Food-insecure women would sustain substantive nutritional gains if they had greater access to their personal healthy food preferences and if the dietary compromises associated with severe food insecurity were abated. Increased resources to access such choices should be a priority.  相似文献   

6.
OBJECTIVE: This paper examines trends in the neighbourhood food store environment (defined by the number and geographic density of food stores of each type in a neighbourhood), and in food consumption behaviour and overweight risk of 5779 men and women. DESIGN: The study used data gathered by the Stanford Heart Disease Prevention Program in four cross-sectional surveys conducted from 1981 to 1990. SETTING: Four mid-sized cities in agricultural regions of California. SUBJECTS: In total, 3154 women and 2625 men, aged 25-74 years. RESULTS: From 1981 to 1990, there were large increases in the number and density of neighbourhood stores selling sweets, pizza stores, small grocery stores and fast-food restaurants. During this period, the percentage of women and men who adopted healthy food behaviours increased but so did the percentage who adopted less healthy food behaviours. The percentage who were obese increased by 28% in women and 24% in men.ConclusionFindings point to increases in neighbourhood food stores that generally offer mostly unhealthy foods, and also to the importance of examining other food pattern changes that may have a substantial impact on obesity, such as large increases in portion sizes during the 1980s.  相似文献   

7.
OBJECTIVES: (1) To describe promotional activities, particularly student-led, targeting lower-fat à la carte foods that were conducted in secondary schools; and (2) to describe the relationships between the number and duration of total promotional activities for lower-fat à la carte foods and cafeteria sales of such foods over two years. DESIGN: Promotional activities were implemented in schools that were randomised to the intervention condition of a larger, two-year, school-based, randomised, controlled nutrition intervention trial. SETTING: Ten Minnesota secondary schools. SUBJECTS: Students and school faculty, school food-service and research staff (measured at the school level). RESULTS: Over two years, 181 promotions were implemented (n=49 in Year 1 and n=132 in Year 2). In Year 1, the number of promotions conducted in schools was significantly associated with percentage lower-fat food sales. In Year 2, the duration of promotions was significantly associated with percentage lower-fat food sales. CONCLUSIONS: Collaborative efforts among students, school food-service staff and research staff can be successful in implementing a large number of nutrition-related, school-wide promotional activities. These efforts can increase the sales of lower-fat foods in à la carte areas of school cafeterias.  相似文献   

8.
OBJECTIVES: To develop a concise, simple tool for use by non-specialists to assess diet in children aged 3-7 years attending primary schools. DESIGN: A 24-hour food tick list covering all aspects of the diet and with a focus on fruit and vegetable consumption was developed. This was compared against a 24-hour semi-weighed food diary obtained for the same day as the tick list. SETTING: Six primary schools with a range of socio-economic and ethnic backgrounds from a large city in the north of England (Leeds). PARTICIPANTS: One hundred and eighty children returned completed packs of information; a response rate of 77% of those who were willing to take part, 48% of those approached. RESULTS: On average, 2.4 items of fruit including juice (2.1 items as 5-a-day count) were eaten and 1.6 items of vegetables (excluding potato). Twenty-seven per cent and 36% of boys and 23% and 24% of girls reported not eating any fruit or vegetables, respectively, on the recording day. Correlations comparing the diary and tick list were high for both foods (range r=0.44 to 0.89) and nutrients (range r=0.41 to 0.68). The level of misclassification was much less than would be expected by chance. Parent and teacher evaluation of the tick list was very positive. Parents felt the tick list was easy and quick to complete. CONCLUSION: The Child and Diet Evaluation Tool (CADET) tick list has been used successfully for rapid collection of food and nutrient information from children aged 3-7 years from diverse social and ethnic backgrounds. The tool has performed better than many food-frequency questionnaires in comparison to a food diary.  相似文献   

9.
OBJECTIVE: Food-based dietary guidelines (FBDGs) are globally promoted as an important part of national food and nutrition policies. They are presented within policy as key features of the strategy to educate the public and guide policy-makers and other stakeholders about a healthy diet. This paper examines the implementation of FBDGs in four countries: Chile, Germany, New Zealand and South Africa - diverse countries chosen to explore the realities of the FBDG within policy on public health nutrition. DESIGN: A literature review was carried out, followed by interviews with representatives from the governmental, academic and private sector in all four countries. RESULTS: In all four countries the FBDG is mainly implemented via written/electronic information provided to the public through the health and/or education sector. Data about the impact of FBDGs on policy and consumers' food choice or dietary habits are incomplete; nutrition surveys do not enable assessment of how effective FBDGs are as a factor in dietary or behavioural change. Despite limitations, FBDGs are seen as being valuable by key stakeholders. CONCLUSION: FBDGs are being implemented and there is experience which should be built upon. The policy focus needs to move beyond merely disseminating FBDGs. They should be part of a wider public health nutrition strategy involving multiple sectors and policy levels. Improvements in the implementation of FBDGs are crucial given the present epidemic of chronic, non-communicable diseases.  相似文献   

10.
OBJECTIVE: To assess socio-economic indicators, nutritional status and living conditions of farm workers and their families, with the purpose to develop research and intervention programmes aimed at enhancing nutritional status and quality of life. DESIGN AND SETTING: Three farm schools in two districts of the North-West Province and farming communities were selected. Anthropometrical measurements, structured face-to-face questionnaires and focus group discussions were carried out in 2002 and 2003 by a multidisciplinary research team. RESULTS: Access to electricity, water and sanitation, as well as monthly food rations or subsidies, vary and depend on farm owners. The majority of adults have education below or up to grade four, farm schools provide only up to grade seven. Distance to farm schools and intra-household issues hamper children's attendance and performance at school. Household food security is compromised due to a lack of financial resources, infrastructure and also household resource allocation. This impacts negatively especially on children, with half of them being underweight, stunted or wasted. Employment is usually linked to men, while most women have access to casual jobs only. Insecurity of residence and the perceived disempowered position towards farm owners add to feelings of hopelessness and stress. CONCLUSIONS AND RECOMMENDATIONS: This study highlights destitute living conditions of farm worker families. Apart from structural and financial constraints, paternalistic structures of the past might also hamper development. Based on these findings, follow-up research projects and in-depth investigations into underlying social issues with regard to nutrition insecurity and livelihoods of farm workers were initiated.  相似文献   

11.
Evidence for substantial environmental influences on health and food safety comes from work with environmental health indicators which show that agroenvironmental practices have direct and indirect effects on human health, concluding that "the quality of the environment influences the quality and safety of foods" [Fennema, O. Environ. Health Perspect. 1990, 86, 229-232). In the field of genetically modified organisms (GMOs), Codex principles have been established for the assessment of GM food safety and the Cartagena Protocol on Biosafety outlines international principles for an environmental assessment of living modified organisms. Both concepts also contain starting points for an assessment of health/food safety effects of GMOs in cases when the environment is involved in the chain of events that could lead to hazards. The environment can act as a route of unintentional entry of GMOs into the food supply, such as in the case of gene flow via pollen or seeds from GM crops, but the environment can also be involved in changes of GMO-induced agricultural practices with relevance for health/food safety. Examples for this include potential regional changes of pesticide uses and reduction in pesticide poisonings resulting from the use of Bt crops or influences on immune responses via cross-reactivity. Clearly, modern methods of biotechnology in breeding are involved in the reasons behind the rapid reduction of local varieties in agrodiversity, which constitute an identified hazard for food safety and food security. The health/food safety assessment of GM foods in cases when the environment is involved needs to be informed by data from environmental assessment. Such data might be especially important for hazard identification and exposure assessment. International organizations working in these areas will very likely be needed to initiate and enable cooperation between those institutions responsible for the different assessments, as well as for exchange and analysis of information. An integrated assessment might help to focus and save capacities in highly technical areas such as molecular characterization or profiling, which are often necessary for both assessments. In the area of establishing international standards for traded foods, such as for the newly created Standards in Trade and Development Facility (STDF), an integrated assessment might help in the consideration of important environmental aspects involved in health and food safety. Furthermore, an established integrated view on GMOs may create greater consumer confidence in the technology.  相似文献   

12.
OBJECTIVE: To measure factors affecting food choice in a sample of Greek schoolchildren attending 5th and 6th grade. DESIGN: Three self-administered questionnaires were distributed to the participants - one on nutritional knowledge, one on self-efficacy and social support for dietary change and a food-frequency questionnaire. SETTING: One hundred Greek primary schools from Attica and Thessaloniki regions. SUBJECTS: In total, 2439 students in 5th and 6th grades. RESULTS: Principal components analysis was applied to extract the main factors affecting food choice of our subjects. Six components were derived explaining 66% of the total variation in factors affecting food choice. The first component was characterised by readiness to make the healthier choice when competitive foods are considered (explained variation 29%); the second was characterised by the impact of parents, friends and advertisements on students' choices and also the impact of taste, smell and cooking method on the consumption of vegetables (explained variation 11%); the third component was characterised by readiness to choose fresh foods instead of ready-to-eat, pre-packaged choices as a main meal and awareness of the health value of fruits and vegetables (explained variation 8%); the other components mainly expressed the interdependence of the main factors. CONCLUSIONS: Nutrition education and health promotion programs in Greece must include family members and activities regarding food preparation, as well as education and environmental changes in schools. Public health measures must include regulation of advertising. Moreover, the categorisation of foods as 'healthier but less tasty' and 'appealing but unhealthy' needs to be challenged in the future, since balanced nutrition is founded in variety and norm.  相似文献   

13.
OBJECTIVES: To determine if participants would be interested in consuming soy foods to lower cholesterol in primary and secondary prevention of heart disease, and to identify the role physicians and registered dietitians have in providing dietary advice, about soy foods or other foods, for participants with elevated cholesterol. METHODOLOGY: Qualitative data from 12 focus groups were gathered from a convenience sample of 74 adults, aged 18-91 years, with and without high cholesterol (total cholesterol >200 mg dl(-1)). Participants were recruited from Minneapolis/St. Paul mainstream and natural foods grocery stores. Focus group interviews were taped and transcribed verbatim. Common themes were identified, coded and compared using NVivo computer software. RESULTS: Participants believed diet, lifestyle and genetics were the cause of high cholesterol and cardiovascular disease (CVD). Few participants were aware of the Food and Drug Administration health claim for soy protein, yet many were willing to consume soy as part of lifestyle modification to prevent CVD. They reported preferring food and exercise over medication to treat high cholesterol. Few participants had ever received dietary advice from physicians on treating high cholesterol or CVD, and most doubted the accuracy of such advice. They believed registered dietitians were the most credible source of nutrition counselling and expressed an interest in physician referrals to dietitians. CONCLUSIONS: A collaboration and referral system between physicians and registered dietitians could increase CVD patients' consumption of soy foods as a means potentially leading to a reduced risk of heart disease in participants.  相似文献   

14.
While there appear to be very clear associations between food growers, the hospitality sector, and educational institutions offering hospitality management or related degrees, to date very few studies discuss those links. In particular, little is known of food growers’ perceptions of educational institutions, also in regard to how those institutions could assist farmers. This study seeks to add knowledge to those unresearched areas, learning from a group of 30 Alabama farmers. The findings clearly demonstrate that educational institutions offering hospitality degrees can play several positive roles in assisting farmers, such as in raising awareness about the “local” element of foods or even involving students in various constructive ways. Several implications are discussed concerning the findings and future research avenues are suggested.  相似文献   

15.
BACKGROUND: Many factors need to be considered in a food-based intervention. Vitamin A deficiency and chronic diseases, such as diabetes, heart disease and cancer, have become serious problems in the Federated States of Micronesia (FSM) following the decreased production and consumption of locally grown foods. However, agricultural and social conditions are still favourable for local food production. AIM: To identify key factors to consider in a Micronesian food-based intervention focusing on increased production and consumption of four major Micronesian staple foods: banana, breadfruit, giant swamp taro and pandanus. METHODS: Ethnographic methods including key informant interviews and a literature review. RESULTS: Pacific and Micronesian values, concepts of food and disease, and food classifications differ sharply from Western concepts. There are few FSM professionals with nutrition expertise. Traditional foods and food cultivars vary in nutrient content, consumption level, cost, availability, status, convenience in growing, storing and cooking, and organoleptic factors. CONCLUSIONS: A systematic consideration of the factors that relate to a food-based intervention is critical to its success. The evaluation of which food and cultivar of that food that might be most effectively promoted is also critical. Regional differences, for example FSM inter-island differences between the staple foods and cultivars, must be considered carefully. The evaluation framework presented here may be relevant to Pacific Island and other countries with similar foods where food-based interventions are being planned. An ethnographic approach was found to be essential in understanding the cultural context and in data collection and analysis.  相似文献   

16.
BACKGROUND: In New Zealand the burden of nutrition-related disease is greatest among Māori, Pacific and low-income peoples. Nutrition labels have the potential to promote healthy food choices and eating behaviours. To date, there has been a noticeable lack of research among indigenous peoples, ethnic minorities and low-income populations regarding their perceptions, use and understanding of nutrition labels. Our aim was to evaluate perceptions of New Zealand nutrition labels by Māori, Pacific and low-income peoples and to explore improvements or alternatives to current labelling systems. METHODS: Māori, Samoan and Tongan researchers recruited participants who were regular food shoppers. Six focus groups were conducted which involved 158 people in total: one Māori group, one Samoan, one Tongan, and three low-income groups. RESULTS: Māori, Pacific and low-income New Zealanders rarely use nutrition labels to assist them with their food purchases for a number of reasons, including lack of time to read labels, lack of understanding, shopping habits and relative absence of simple nutrition labels on the low-cost foods they purchase. CONCLUSIONS: Current New Zealand nutrition labels are not meeting the needs of those who need them most. Possible improvements include targeted social marketing and education campaigns, increasing the number of low-cost foods with voluntary nutrition labels, a reduction in the price of 'healthy' food, and consideration of an alternative mandatory nutrition labelling system that uses simple imagery like traffic lights.  相似文献   

17.
OBJECTIVE: To assess the relationship between education and the intake of a variety of individual foods, as well as groups of foods, for Australian men and women in different age groups. DESIGN: Cross-sectional national survey of free-living men and women. SUBJECTS: A sample of 2501 men and 2739 women aged 18 years and over who completed the National Nutrition Survey (NNS) 1995. METHODS: Information about the frequency of consumption of 88 food items was obtained using a food-frequency questionnaire in a nation-wide nutrition survey. Irregular and regular consumers of foods were identified according to whether they consumed individual foods less than or more than once per month. The relationship between single foods and an index of education (no post-school qualifications, vocational, university) was analysed via contingency table chi-square statistics for men and women. Food group variety scores were derived by assigning individual foods to conventional food group taxonomies, and then summing the dichotomised intake scores for individual foods within each food group. Two-way analyses of variance (education by age groups) were performed on food variety scores for men and women, separately. RESULTS: While university-educated men and women consumed many individual foods more regularly than less-educated people, they were less likely to be regular consumers of several meat products. The relationship between education and food consumption was less apparent when individual food scores were aggregated into food group scores. University-educated men and women exhibited higher scores on total food group variety than the other educational groups. CONCLUSIONS: Higher education is associated with the regular consumption of a wider variety of foods. Aggregation of individual food consumption indices into food variety scores may mask the apparent effects of educational background on food consumption.  相似文献   

18.
OBJECTIVE: To examine the role of foreign direct investment (FDI) in the nutrition transition, focusing on highly processed foods. DESIGN: Data on FDI were identified from reports/databases and then compiled and analysed. A review of published literature on FDI into the food sector was conducted. SETTING: The nutrition transition is a public health concern owing to its connection with the rising burden of obesity and diet-related chronic diseases in developing countries. Global health leaders are calling for action to address the threat. Highly processed foods often have considerable fat, sugar and salt content, and warrant closer examination. RESULTS: FDI into food processing, service and retail has risen rapidly since the 1980s, mainly from transnational food companies (TFCs) in developed countries. As FDI has risen, so has the proportion invested in highly processed foods for sale in the host market. FDI has proved more effective than trade in generating sales of highly processed foods, and enables TFCs to cut costs, gain market power and obtain efficiencies in distribution and marketing. The amount of FDI targeted at developing countries is increasing; while a disproportionate share enters the larger developing economies, foreign affiliates of TFCs are among the largest companies in low- and low- to middle-income countries. The effect of FDI is to make more highly processed foods available to more people. FDI has made it possible to lower prices, open up new purchasing channels, optimise the effectiveness of marketing and advertising, and increase sales. CONCLUSION: FDI has been a key mechanism in shaping the global market for highly processed foods. Notwithstanding the role of demand-side factors, it has played a role in the nutrition transition by enabling and promoting the consumption of these foods in developing countries. Empirical data on consumption patterns of highly processed foods in developing countries are critically needed, but since FDI is a long-term investment vehicle, it is reasonable to assume that availability and consumption of highly processed foods will continue to increase. FDI can, however, bring considerable benefits as well as risks. Through its position 'upstream', FDI would therefore be an appropriate entry-point to implement a range of public health policies to 'redirect' the nutrition transition.  相似文献   

19.
OBJECTIVES: There has been surprisingly little research into the effects of food advertising on parents' perception of commonly consumed children's food items, although the available research suggests that parents may find nutritional claims in these advertisements confusing. The purpose of the present study was to investigate parents' perceptions of branded snack foods targeted at children, and the extent to which these perceptions are influenced by advertising messages. DESIGN: Using an intercept survey, participants were shown either adult-targeted or child-targeted advertisements for the same food products. SETTING: Central business district of a major Australian city. SUBJECTS: One hundred adults, mean age 40 years. RESULTS: The study results suggest that: (1) adults' perceptions of advertised food products and, most importantly, purchase intentions for those products differ according to the version of the advertisement seen (for three of the products, 42-54% would buy the product after seeing the child version compared with 82-84% after seeing the adult version); and (2) adults clearly perceive distinctly different messages in advertisements for the same products which are targeting parents vs. those targeting children (e.g. for three of the products, 74-92% perceived that the adult version of the advertisement suggested the food was nutritionally beneficial compared with 2-14% perceiving this for the child version). CONCLUSIONS: It is clear that the messages conveyed to children about specific foods are quite different to the messages conveyed to adults - and importantly parents - about the same foods.  相似文献   

20.
阐述了环境经济手段在我国农业非点源污染控制中应用的必要性和可行性。并结合福建省九龙江流域农业非点源污染的主要问题,提出“畜禽养殖税(费)、排污权交易,化肥和农药施用税(费)、补贴、促险,退耕补贴、水保押金,流域共同治理基金、排污配额交易”等环境经济手段及其应用形式,并分析论证了其实施后的费用效果和可行性。  相似文献   

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