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To determine the prevalence and sociodemographic factors associated with food insecurity in the state of New South Wales (NSW), Australia.
Design:
Cross-sectional analysis of food insecurity data collected by the NSW Population Health Survey between 2003 and 2014. Multiple logistic regression was used to examine associations with key sociodemographic variables.
Setting:
NSW, Australia.
Participants:
212 608 survey participants responded to the food insecurity survey question between 2003 and 2014. 150 767 of them were aged ≥16 years. The survey sample was randomly selected and weighted to be representative of the NSW population.
Results:
On average 6 % of adults aged ≥16 years experienced food insecurity in NSW. The odds of food insecurity appeared to increase from one survey year to the next by a factor of 1·05. Food insecurity was found to be independently associated with age, sex, marital status, household size, education, employment status, household income, smoking status, alcohol intake and self-rated health. The association with income, smoking status and self-rated health appeared to be the strongest among all covariates and showed a gradient effect. Food insecurity appeared to increase significantly between the age of 16 and 19 years.
Conclusions:
The prevalence of food insecurity appears to be rising over time. Given the negative health consequences of food insecurity, more rigorous measurement and monitoring of food insecurity in NSW and nationally is strongly recommended. The findings provide support for interventions targeting low-income and younger population groups.
To assess the frequency, healthfulness and promotional techniques of television food advertising to children and adolescents in the Russian Federation.
Design:
A cross-sectional study was conducted to monitor food and beverage television advertising. For the five most popular TV channels among children and adolescents, TV broadcasts were recorded for two weekdays and two weekends (320 h) during March–May 2017. Recordings were screened for advertisements. Food advertisements were categorised by food categories and as either ‘permitted’ or ‘not permitted’ for advertising to children in accordance with World Health Organization Regional Office for Europe Nutrient Profile Model (NPM), and promotional techniques in advertisements were recorded.
Results:
Overall, 11 678 advertisements were coded. Across all channels, food and drink (19·2 %) were the most frequently advertised product type. The most common food categories advertised were beverages (except juices, milk drinks and energy drinks) (24·1 %); yoghurts and other dairy foods (15 %); and chocolate and confectionery (12·3 %). A majority (64·2 %) of food and drink products advertised should not be permitted for advertising to children according to the NPM. The most frequently used persuasive appeals in the food advertisements were low price (15·4 %), product novelty (11·8 %) and enjoyment (10·0 %).
Conclusions:
Children and adolescents in the Russian Federation are likely exposed to a substantial number of unhealthy food advertisements. There is a need to consider policies to restrict children’s exposure to unhealthy food advertising on television in the Russian Federation.
To investigate the possible associations between the food environment and dietary intake in the Mexican population.
Design:
Four databases (PubMed, PsychInfo, Web of Science and SCIelo) were used to retrieve relevant articles using an open timeframe. Articles were reviewed if they contained a systematic measure (i.e. food checklist) of the food environment (e.g. food availability) and dietary intake.
Setting:
Urban and rural communities in Mexico.
Participants:
Population-based studies of Mexican communities.
Results:
Twenty studies that assessed at least one food environment level, and at least one dietary outcome, were reviewed. Findings from these studies showed that changes in the Mexican food environment seem to be associated with higher availability of energy-dense foods. Energy-dense foods can be linked to a high consumption in household, environment and community food environments. When both nutrient-dense and energy-dense foods were present, individuals were more likely to consume foods with added sugars, fats and salt options than nutrient-dense items.
Conclusions:
The various levels of the food environment (i.e. household, school, community) exposed participants to energy-dense foods. Although nutrient-dense foods were present in all three levels, individuals were more likely to consume energy-dense food items. Not all three levels of the food environment are well represented in the urban and rural settings. Most studies on the community food environment were done in rural areas, whereas most studies on the school food environment were done in urban settings. Additional rigorously designed studies are needed to document the relationship between the food environment and dietary intake in the Mexican population.
Commercially available business (CAB) datasets for food environments have been investigated for error in large urban contexts and some rural areas, but there is a relative dearth of literature that reports error across regions of variable rurality. The objective of the current study was to assess the validity of a CAB dataset using a government dataset at the provincial scale.
Design:
A ground-truthed dataset provided by the government of Newfoundland and Labrador (NL) was used to assess a popular commercial dataset. Concordance, sensitivity, positive-predictive value (PPV) and geocoding errors were calculated. Measures were stratified by store types and rurality to investigate any association between these variables and database accuracy.
Setting:
NL, Canada.
Participants:
The current analysis used store-level (ecological) data.
Results:
Of 1125 stores, there were 380 stores that existed in both datasets and were considered true-positive stores. The mean positional error between a ground-truthed and test point was 17·72 km. When compared with the provincial dataset of businesses, grocery stores had the greatest agreement, sensitivity = 0·64, PPV = 0·60 and concordance = 0·45. Gas stations had the least agreement, sensitivity = 0·26, PPV = 0·32 and concordance = 0·17. Only 4 % of commercial data points in rural areas matched every criterion examined.
Conclusions:
The commercial dataset exhibits a low level of agreement with the ground-truthed provincial data. Particularly retailers in rural areas or belonging to the gas station category suffered from misclassification and/or geocoding errors. Taken together, the commercial dataset is differentially representative of the ground-truthed reality based on store-type and rurality/urbanity.
Early childhood factors can have persisting effects on development and cognition in children. We propose to explore the trends of Fe deficiency and Pb toxicity in early childhood and their association with child development at 2 years of age and cognition at 5 years.
Design:
Longitudinal birth cohort study.
Setting:
Urban slum, Vellore, India.
Participants:
Children enrolled at birth were followed up regularly in the first 2 years with developmental and cognitive assessments at 2 and 5 years of age, respectively.
Results:
The birth cohort enrolled 251 children with 228 children followed up at 2 years and 212 at 5 years of age. Fe deficiency (ID) was highest at 15 months of age and improved subsequently at 24 months. Blood Pb levels (BLL) remained high at all age groups with an increasing trend with age; 97 % at 36 months having high BLL. Persistent high mean BLL at 15 and 24 months had negative association with both cognition and expressive language raw scores of 24 months, while high mean BLL at 15, 24 and 36 months had no significant association with any of the domains of cognition at 5 years of age. Early childhood cumulative body Fe status at 7, 15 and 24 months did not show any association with child development at 2 years, but was associated with verbal, performance and processing speed components of cognition at 5 years.
Conclusions:
Optimising body Fe status and limiting Pb exposure in early childhood can augment child development and school entry cognition.
To examine 44-year trends in height, weight and BMI, and the prevalence of overweight/obesity and underweight in the elderly Japanese population because Japan, the country with the longest life expectancy, has the highest ageing population.
Design:
Using the nationally representative cumulative data from the Japan National Health and Nutrition Survey 1973–2016, sex-specific and age-adjusted mean height, weight and BMI, and the prevalence of overweight/obesity and underweight were calculated for each year. Trend analyses were performed using the Joinpoint Regression Program. Next, changes in height, weight and BMI, and the prevalence of overweight/obesity and underweight were estimated for each age group (65–69, 70–79 and >80 years) according to the birth year groups.
Setting:
Japan.
Participants:
Individuals aged ≥65 years with complete data on height and body weight measurements (N 94 508).
Results:
Trends in average height and weight increased over the four decades in both men and women. The prevalence of overweight/obesity dramatically increased and nearly tripled in men, accompanied with significantly decreased underweight prevalence. Furthermore, the increasing trend in average BMI and overweight/obesity prevalence in women reached a peak in 2002 and showed a decreasing trend thereafter, while a downward trend in underweight prevalence showed a gradual increase in women since 2003.
Conclusions:
Trends in height, weight and BMI among the elderly population should continue to be closely monitored in parallel with the effects of dietary changes, energy intake and physical activity (step counts).
The development of user-friendly nutrition resources for pregnant women seldom involves end-users. This qualitative study used a citizens’ jury approach to determine if our modification of a longstanding, frequently used dietitian-informed diet and diabetes booklet was deemed to be a good healthy eating resource for pregnant women.
Design:
Midwives recruited thirteen first-time pregnant women not requiring specialist obstetric care or specialist dietetic advice for any reason. Participants were sent a copy of the modified healthy eating in pregnancy booklet prior to ‘jury day’. Five women were unable to attend the citizens’ jury citing reasons such as early labour. At the jury, five experts presented evidence. Participants adjourned, with an independent facilitator, to ‘deliberate’ as to whether the resource was suitable or not. The verdict was presented, and subsequent discussion was audio-recorded, transcribed and inductively content analysed.
Setting:
Southland, New Zealand.
Participants:
Pregnant women aged 19–35 years (n 8), of whom half had a household income <$NZ30 000.
Results:
The verdict was ‘Yes’; the resource was good. Three themes were derived: communication of health information, resource content and harm reduction in pregnancy. Based on these data, ways to enhance the quality and usability of the booklet were evident.
Conclusions:
Citizens’ juries can be used to obtain an independent assessment by end-users of health resources. Our modified diet and diabetes booklet was considered suitable for providing healthy eating advice to pregnant women. Inclusion of end-users’ perspectives is critical for end-user relevant content, comprehension and resource credibility.
To examine the impact of Nutrition for Life (NFL), a goal-setting nutrition education program, on the knowledge, self-efficacy and behaviour of adults eligible for Supplemental Nutrition Assistance Program-Education.
Design:
NFL was developed using a 4-week goal-setting behavioural strategy focused on nutrition, physical activity and meal planning techniques. A quantitative repeated-measures design using self-reported data was collected at pre- and post-interventions and at 1-week and 1-month follow-ups.
Setting:
Two Federally Qualified Health Centers in Philadelphia, PA, USA.
Participants:
A total of ninety-eight participants enrolled in the intervention; the majority were women (80·2 %), Black/Non-Hispanic (75·0 %) and 45–54 year old (39·6 %).
Results:
Participants showed significant improvement in knowledge, self-efficacy and behaviour. Specifically, mean daily intake for vegetables increased by 0·31 cup (P < 0·05) and for fruits by 0·39 cup (P < 0·01) at 1-week follow-up. Participants also showed healthier behaviour at 1-month follow-up. Planning at least seven meals per week increased from 14·8 to 50 % (P < 0·01), completing at least 30 min of physical activity every day in the last week increased from 16·7 to 36 % (P < 0·01) and consuming water with all meals increased from 39 to 70·6 % (P < 0·01).
Conclusions:
The implementation of a goal-oriented nutrition education program offers a promising approach at achieving positive behaviour change among SNAP-eligible adults.
The Child Eating Behaviour Questionnaire (CEBQ), a widely used instrument that has been validated mostly in high-income countries, has limitations in its factorial validity when used among different cultures. This study examines whether the CEBQ instrument is culturally appropriate and valid to be used in a low- and middle-income country (LMIC) in a setting where child undernutrition remains prevalent.
Design:
The study employed a qualitative process to validate the content of items relative to the culture and setting, which was followed by a survey to test the psychometric properties of the instrument. Tests of factorial validity, convergent validity and reliability were performed.
Setting:
Three different socio-economic settings of Yogyakarta, Indonesia.
Participants:
The participants of this study were mothers of children aged 25–60 months. In-depth interviews were conducted with twenty-four mothers and the questionnaire validation process involved 238 mothers in the survey.
Results:
A Confirmatory Factor Analysis model with eight subscales provided the best fit (root-mean-square error of approximation = 0·048 (90 % CI 0·040, 0·057); Comparative Fit Index = 0·95 and Tucker Lewis Index = 0·95) after three new items and eight items from the original CEBQ were removed. Convergent validity with child’s weight was found for two subscales, slowness in eating and satiety responsiveness. Reliability measured using Cronbach’s alpha provided values between 0·62 and 0·78.
Conclusion:
The original eight-factor structure of the CEBQ showed adequate content validity and provided factorial, discriminant and convergent validity with mothers of preschool children living in a LMIC where child nutrition remains a significant public health issue.
Compared with standard wines, low-alcohol wines may have several social and health benefits. Innovative production processes have led to high-quality light wines. It is, however, unclear how consumers perceive and consume these alcohol-reduced wines. The current study aimed to investigate how people evaluate low-alcohol wine (Sauvignon Blanc) and if the reduction in alcohol and the information that a wine is low in alcohol influences consumption.
Design:
Randomised controlled trial (RCT).
Setting:
Participants were invited to a wine tasting and randomised into one of the three conditions: they either tasted a ‘new white wine’ (12·5 % alcohol content), a ‘new low-alcohol white wine’ (8·0 % alcohol content) or they tasted the low-alcohol wine but were not aware that the wine was reduced in alcohol (low-alcohol, blinded).
Participants:
Ninety participants (42 % male, mean age = 41 (sd 14) years).
Results:
Mean comparisons showed similar ratings for the low-alcohol conditions and the standard alcohol condition (mean > 5·6/7). The mean consumed amount across all conditions did not differ (162 (sd 71) ml, (F2,86 = 0·43, P > 0·05)), hence people who tasted the low-alcohol wine consumed approximately 30 % less alcohol. However, participants were willing to pay more for the normal wine compared with the low-alcohol wine, (F2,87 = 3·14, P < 0·05).
Conclusions:
Participants did not alter their drinking behaviour in response to the reduced alcohol content, and the low-alcohol wine was perceived positively. There might be an emerging market potential for wine of reduced alcohol content, but consumers may not be willing to pay the same price as for the standard wine.
To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, dietary diversity and dietary practices) in two African countries in relation to postulated changes in the context of nutrition transition.
Design:
Systematic review and meta-analyses, including six online databases and grey literature, 1971–2018 (Protocol CRD42017067718).
Setting:
Urban Ghana and Kenya.
Participants:
Population-based studies of healthy adolescents and adults.
Results:
The forty-seven included studies encompassed 20 726 individuals plus 6526 households. Macronutrients were within WHO-recommended ranges: mean energy intake was 1867 kcal/d (95 % CI 1764, 1969) and the proportions of macronutrients were carbohydrate 61·2 % (58·4, 64·0), fat 25·3 % (22·8, 28·0) and protein 13·7 % (12·3, 15·1). The proportion of population consuming fruit and vegetables was 51·6 %; unhealthy foods, 29·4 %; and sugar-sweetened beverages (SSBs), 39·9 %. Two-thirds (68·8 %) consumed animal-source proteins. Dietary diversity scores were within the mid-range. Meal patterns were structured (typically three meals per day), with evidence lacking on snacking or eating out.
Conclusions:
Population-level diets fell within WHO macronutrient recommendations, were relatively diverse with structured meal patterns, but some indications of nutrition transition were apparent. The proportion of population consuming fruit and vegetables was low compared to healthy-eating recommendations, and consumption of SSBs was widespread. A paucity of evidence from 1971 to 2010 precluded a longitudinal analysis of nutrition transition. Evidence from these two countries indicates which aspects of dietary behaviours may be contributing to increasing overweight/obesity, namely a low proportion of population consuming fruit and vegetables and widespread consumption of SSBs. These are potential targets for promoting healthier diets.
To investigate the hypothesis that folic acid supplementation and dietary folate intake before conception and during pregnancy reduce the risk of small for gestational age (SGA) and to examine the joint effect of folic acid supplementation and dietary folate intake on the risk of SGA.
Design:
Participants were interviewed by trained study interviewers using a standardized and structured questionnaire. Information on birth outcomes and maternal complications was abstracted from medical records and dietary information was collected via a semi-quantitative FFQ before conception and during pregnancy.
Setting:
A birth cohort data analysis using the 2010–2012 Gansu Provincial Maternity and Child Care Hospital.
Participants:
Women (n 8758) and their children enrolled in the study.
Results:
Folic acid supplementation was associated with a reduced risk of SGA (OR = 0·72, 95 % CI 0·60, 0·86), with the reduced risk seen mainly for SGA at ≥37 weeks of gestational age (OR = 0·70, 95 % CI 0·58, 0·85) and nulliparous SGA (OR = 0·67, 95 % CI 0·54, 0·84). There was no significant association between dietary folate intake and SGA risk.
Conclusions:
Our study suggested that folic acid supplementation was associated with a reduced risk of SGA and the risk varied by preterm status and parity.
Maternal risk factors for pregnancy outcomes are known to vary by employment status. We evaluated whether pre-pregnancy diet quality varies by occupation in a population-based sample.
Design:
We analysed interview data from 7341 mothers in a national case–control study of pregnancy outcomes. Self-reported job(s) held during the 3 months before pregnancy were classified using Standard Occupational Classification (SOC) codes. Usual diet in the year before conception was assessed with a semi-quantitative FFQ and evaluated using the Diet Quality Index for Pregnancy (DQI-P). Using logistic regression, we calculated adjusted OR and 95 % CI to estimate associations between low diet quality (defined as the lowest quartile of DQI-P scores) and occupation types.
Setting:
The National Birth Defects Prevention Study: Arkansas, California, Georgia, Iowa, Massachusetts, North Carolina, New Jersey, New York, Texas, Utah.
Participants:
Employed mothers of infants born between 1997 and 2011.
Results:
No occupation was strongly associated with low diet quality. Moderate but relatively imprecise associations were observed for women employed in management (OR: 1·3; 95 % CI: 1·1, 1·7); arts, design, entertainment, sports and media (OR: 1·4; 95 % CI: 0·9, 2·1); protective service (OR 1·3; 95 % CI: 0·7, 2·5) and farming, fishing, and forestry occupations (OR: 0·5; 95 % CI: 0·2, 1·1).
Conclusions:
Our analyses suggest that women in certain occupations may have lower diet quality in the months before pregnancy. Further research is needed to determine whether certain occupations could benefit from interventions to improve diet quality in the workplace for women of reproductive age.
To cope with the pressure of modern life, consumer demand for convenience foods has increased in the last decades. The current study set out to compare the costs of buying industrially processed dishes and of preparing them at home.
Design:
Direct purchase costs of industrially processed dishes frequently consumed in France (n 19) and of the ingredients needed for their home-prepared counterparts (n 86) were collected from four major food retailers’ websites in Montpellier, France. Mean prices and energy density were calculated for four portions. Costs related to energy used by cooking appliances and time spent preparing dishes were further estimated.
Setting:
Montpellier, France.
Participants:
Not applicable.
Results:
Based on the costs of ingredients and energy used for cooking, dishes prepared at home cost less (–0·60 € per four portions, P < 0.001) than industrially processed dishes, but when the cost of time was taken into account, the industrially processed dishes were much cheaper (–5·34 € per four portions, P < 0.001) than their home-prepared counterparts. There was no difference in energy density between industrially processed and home-prepared dishes.
Conclusions:
Our findings suggest that industrially processed dishes are more profitable to consumers when the cost of time for preparing dishes at home is valued. Given the ever greater demands of everyday life, more account should be taken of the additional cost to consumers of the time they spend preparing meals at home.
To examine differences in eating and physical activity behaviours among ethnic groups in Queensland, Australia, and differences in those behaviours due to the duration of residency in Australia.
Design:
Cross-sectional study using baseline data collected for the Living Well Multicultural–Lifestyle Modification Program between October 2014 and June 2017.
Setting:
Culturally and linguistically diverse communities (CALD), including Afghani, Somali, Burmese, Pacific and South Sea Islander, Sri Lankan, Sudanese and Vietnamese, living in Queensland, Australia.
Participants:
People were recruited if they were ≥18 years old and living in the targeted CALD communities.
Results:
Burmese/Vietnamese, on average, had better eating scores in line with Australian dietary guidelines, compared with Afghani/Arabic-speaking (difference = 2·05 points, 95 % CI 1·39, 2·72), Somali/Sudanese (difference = 1·53 points, 95 % CI 0·79, 2·28) and Pacific Islander (difference = 1·46 points, 95 % CI 0·79, 2·13). Association between ethnicity and meeting the physical activity guideline was not significant. Those who stayed in Australia longer than a year were less likely to meet the physical activity guideline than those staying <1 year (OR = 0·51, 95 % CI 0·31, 0·84). There was no significant association between duration of residency in Australia and eating scores.
Conclusions:
Eating behaviours were significantly different among the ethnic groups in Queensland with Burmese/Vietnamese and Sri Lankan/Bhutanese having the healthiest diets. All ethnic groups were less likely to meet the physical activity guideline compared with the general Australian population. People with duration of residency of at least 1 year in Australia were less likely to meet the physical activity guideline compared with those who had shorter stays.
To examine the relationship between household food insecurity (FI) and children’s involvement in family meal choices and food preparation, used as proxies for children’s food skills, and to explore gender differences within these associations.
Design:
Households were classified as food-secure or food-insecure using the six-item, short-form Household Food Security Survey Module. Children’s involvement in family meal choices and food preparation were treated as proxies for children’s food skills. Mixed-effects multinomial logistic regression models were used.
Setting:
Public schools in Nova Scotia, Canada.
Participants:
5244 children in the fifth grade (10–11 years old) participating in the Children’s Lifestyle and School Performance Study (CLASS).
Results:
Most children reported being involved in family meal choices or food preparation at least weekly (74 and 68 %). The likelihood of helping choose family meals once a week was 33 % lower among girls from food-insecure households compared to girls from food-secure households. No differences in boys’ involvement in family meal choices were observed according to household FI status. Boys from food-insecure households were 65 % more likely than boys from food-secure households to assist with food preparation/cooking four times per week. No differences in girls’ involvement in food preparation were observed according to household FI status.
Conclusions:
Findings support that household FI is not due to a lack of food skills but most likely due to inadequate access to resources. This supports the call for upstream policies targeting the structural issues underpinning household FI such as low income.
To assess the feasibility and efficacy of in-restaurant interventions aiming to promote healthy choices via fundraising incentives benefiting school wellness programmes and point-of-purchase nutrition promotion.
Design:
Twelve schools were randomly assigned to one of the two intervention periods: Fundraising Incentive (FI) donated funds for visiting the study restaurant and Fundraising-Healthy Eating Incentive (F-HEI) included FI with additional funds given when selecting a healthier item. Both conditions included point-of-purchase nutrition promotions. Families were recruited to attend their designated intervention and complete a survey. Feasibility was assessed based on recruitment and participation, implementation fidelity and intervention acceptability. Efficacy was assessed by comparing participant receipts between intervention periods and by comparing overall restaurant sales during intervention v. two no-intervention time frames.
Setting:
Fast-casual restaurant in Southern California.
Participants:
Parents with children attending participating schools.
Results:
Eighty-one families visited the restaurant during the intervention, with sixty-six completing surveys. All study activities were implemented successfully, but school family participation in the intervention was low (0·95 %). Among participants completing surveys, all indicated satisfaction with the programme. The percentage of healthier items ordered was significantly greater during both FI (χ2 = 5·97, P = 0·01) and F-HEI (χ2 = 8·84, P = 0·003) v. Comparison 2. Results were similar but did not reach statistical significance when comparing the interventions to Comparison 1.
Conclusions:
Results support potential efficacy of this programme, but more research is needed to inform feasibility. Fidelity and acceptability data supported feasibility, but participation rates were low in this initial study. Methods evaluating this intervention with a greater proportion of parents should be considered.
To estimate the impact of recent changes to the Child and Adult Care Food Program (CACFP) meal pattern on young children’s diets in family child care homes (FCCHs) serving racially/ethnically diverse children.
Design:
In a natural experimental study of thirteen CACFP-participating FCCHs, we used digital photographs taken of children’s plates before and after meals matched with menus to measure children’s dietary intake both prior to implementation of the new meal patterns (summer/fall of 2017) and again 1 year later (summer/fall of 2018). Generalised estimating equations tested for change in intake of fruits, vegetables, whole grains, 100 % juice, grain-based desserts, meat/meat alternates and milk, adjusting for clustering of observations within providers.
Setting:
FCCHs in Boston, MA, USA.
Participants:
Three- to 5-year-old children attending FCCHs.
Results:
We observed 107 meals consumed by twenty-eight children at the thirteen FCCHs across an average of 2·5 (sd 1·3) d before the CACFP policy change, and 239 meals consumed by thirty-nine children across 3·8 d (sd 1·4) 1 year later. During lunch, fruit intake increased by about a third of a serving (+0·38 serving, 95 % CI 0·04, 0·73, P = 0·03), and whole grain intake increased by a half serving (+0·50 serving, 95 % CI 0·19, 0·82, P = 0·002). No changes were seen in other meal components.
Conclusion:
Young children’s dietary intake in CACFP-participating FCCHs improved following the CACFP meal pattern change, particularly for fruits and whole grains, which were targets of the new policy. Additional research should examine impacts of the changes in other child care settings, age groups and locales.
Children are surrounded by ubiquitous forms of unhealthy food marketing at home and in schools. The US Department of Agriculture now restricts food and beverage marketing that does not meet Smart Snacks in School standards. School superintendents, as districts’ top administrators, play a critical role in ensuring marketing policies are implemented and adhered to; however, there is limited research involving this stakeholder group. The current study examined superintendents’ perspectives on food marketing in schools and the marketing provision in wellness policies, as well as experiences with the implementation of such policies.
Design:
Qualitative focus groups and follow-up interviews (with focus group participants) were conducted by trained researchers.
Setting:
Focus groups occurred at The School Superintendents’ annual meeting; follow-up interviews were over the telephone.
Participants:
Superintendents and assistant superintendents (n 39) from twenty-three states participated. Interviews were recorded and professionally transcribed; transcripts were team-coded in Atlas.ti using an iteratively revised coding guide to facilitate theme generation.
Results:
Despite common concerns that marketing to children was ‘insidious’, superintendents reported a wide range of food and beverage marketing policies. In addition, the main issue is fundraising – such as ‘restaurant nights’ – that results in marketing that occurs on- and off-campus and afterschool.
Conclusions:
Discrepancies between perspectives and practices point to the challenges that superintendents face with budgetary constraints, as well as relationships with parent–teacher organisations. These findings provide important insights about superintendents’ perspectives and challenges, particularly for government and child health advocates supporting school districts, to implement these policies.
There are concerns that some non-profit organisations, financed by the food industry, promote industry positions in research and policy materials. Using Freedom of Information (FOI) requests, we test the proposition that the International Life Sciences Institute (ILSI), one prominent non-for profit in international health and nutrition research, promotes industry positions.
Design:
U.S. Right to Know filed five FOI from 2015 to 2018 covering communications with researchers at four US institutions: Texas A&M, University of Illinois, University of Colorado and North Carolina State University. It received 15 078 pages, which were uploaded to the University of California San Francisco’s Industry Documents Library. We searched the Library exploring it thematically for instances of: (1) funding research activity that supports industry interests; (2) publishing and promoting industry-sponsored positions or literature; (3) disseminating favourable material to decision makers and the public and (4) suppressing views that do not support industry.
Results:
Available emails confirmed that ILSI’s funding by corporate entities leads to industry influence over some of ILSI activities. Emails reveal a pattern of activity in which ILSI sought to exploit the credibility of scientists and academics to bolster industry positions and promote industry-devised content in its meetings, journal and other activities. ILSI also actively seeks to marginalise unfavourable positions.
Conclusions:
We conclude that undue influence of industry through third-party entities like ILSI requires enhanced management of conflicts of interest by researchers. We call for ILSI to be recognised as a private sector entity rather than an independent scientific non-profit, to allow for more appropriate appraisal of its outputs and those it funds.