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To examine associations between geographic information systems (GIS)-assessed accessibility to small food stores, shopping patterns and dietary behaviours among small food store customers.
Design:
Residential addresses and customer shopping patterns (frequency of shopping, and previous purchase of fruits and vegetables) were gathered through customer intercept surveys. Addresses were geocoded, and GIS-assessed distance and driving time from the participants’ residence to the store were calculated. Dietary status and behaviours were assessed using an objective non-invasive measure of skin carotenoids, the National Cancer Institute Fruit and Vegetable Screener, and items to assess sugary beverage intake. Associations between distance and driving time, demographics, shopping frequency, prior reported purchase of fruits and vegetables at the store and dietary behaviours were examined.
Setting:
Small food stores (n 22) across North Carolina.
Participants:
Cross-sectional convenience samples of English-speaking customers aged 18 years or older (n 692).
Results:
Participants living closer to the small store had lower income and formal education, were more likely to be Black, more likely to have previously bought fruits and vegetables at the store and more frequently shopped at the store. In adjusted models, skin carotenoids (n 644) were positively associated with distance to the store from home in miles (P = 0·01).
Conclusions:
Customers who lived closer to the stores were more frequent shoppers and more likely to have previously purchased fruits and vegetables at the store yet had lower skin carotenoids. These results support continued efforts to examine how to increase the availability and promotion of healthful foods at small food retail stores.
Our objectives were to explore attitudes regarding food retail policy and government regulation among managers of small food stores and examine whether manager views changed due to the 2014 Minneapolis Staple Foods Ordinance, a city policy requiring retailers to stock specific healthy products.
Design:
Manager interviewer-administered surveys were used to assess views on food retail policy four times from 2014 to 2017. We examined baseline views across manager and store and neighbourhood characteristics using cross-sectional regression analyses and examined changes over time using mixed regression models. In 2017, open-ended survey questions asked about manager insights on the Minneapolis Staple Foods Ordinance.
Setting:
Minneapolis, MN, where the ordinance was enacted, and St. Paul, MN, a control community, USA.
Participants:
Managers from 147 small food retail stores.
Results:
At baseline, 48 % of managers were likely to support a policy requiring stores to stock healthy foods/beverages, 67·5 % of managers were likely to support voluntary programmes to help retailers stock healthy foods and 23·7 % agreed government regulation of business is good/necessary. There was a significant increase in overall support for food retail policies and voluntary programmes from 2014 to 2017 (P < 0·01); however, neither increase differed by city, suggesting no differential impact from the ordinance. Minneapolis store managers reported some challenges with ordinance compliance and offered suggestions for how local government could provide support.
Conclusions:
Findings suggest that managers of small food retail stores are becoming increasingly amenable to healthy food policies; yet, challenges need to be addressed to ensure healthy food is available to all customers.
To describe continuity over time in reports of valuing sustainable diet practices and investigate relationships between values, household meal behaviours and dietary intake.
Design:
Observational study. Participant ratings of how important it is for food to be produced as organic, not processed, locally grown and not GM were categorized to represent whether they valued (very/somewhat important) or did not value (a little/not at all important) each practice. Diet quality markers (e.g. fruit servings) were based on an FFQ.
Setting:
Mailed and online surveys.
Participants:
Young adults (n 1620; 58 % female, mean age 31 (sd 1·6) years) who were participating in Project EAT (Eating and Activity among Teens and Young Adults) and responded to follow-up surveys in 2003–2004 and 2015–2016.
Results:
One-third (36·1 %) of participants reported valuing <2 practices at both assessments; 11·1 and 34·5 % respectively reported valuing ≥2 practices in 2003–2004 only and in 2015–2016 only; 18·3 % reported valuing ≥2 practices at both assessments. Regression models including demographics, parental status and vegetarian status showed that valuing ≥2 practices was associated with preparation of meals with vegetables at least a few times/week, less frequent purchase of family meals from fast-food restaurants, and higher diet quality in 2015–2016. For example, those who valued ≥2 practices consumed nearly one full vegetable serving more than other young adults on an average day and part of this difference was specifically associated with intake of dark green and red/orange vegetables.
Conclusions:
Addressing the sustainability of food choices as part of public health messaging may be relevant for many young adults.
We examined differences in consumer-level characteristics and structural resources and capabilities of small and non-traditional food retailers (i.e. corner stores, gas-marts, pharmacies, dollar stores) by racial segregation of store neighbourhood and corporate status (corporate/franchise- v. independently owned).
Design
Observational store assessments and manager surveys were used to examine availability-, affordability- and marketing-related characteristics experienced by consumers as well as store resources (e.g. access to distributors) and perceived capabilities for healthful changes (e.g. reduce pricing on healthy foods). Cross-sectional regression analyses of store and manager data based on neighbourhood segregation and store corporate status were conducted.
Setting
Small and non-traditional food stores in Minneapolis and St. Paul, MN, USA.
Participants
One hundred and thirty-nine stores; seventy-eight managers.
Results
Several consumer- and structural-level differences occurred by corporate status, independent of residential segregation. Compared with independently owned stores, corporate/franchise-owned stores were more likely to: not offer fresh produce; when offered, receive produce via direct delivery and charge higher prices; promote unhealthier consumer purchases; and have managers that perceived greater difficulty in making healthful changes (P≤0·05). Only two significant differences were identified by residential racial segregation. Stores in predominantly people of colour communities (<30 % non-Hispanic White) had less availability of fresh fruit and less promotion of unhealthy impulse buys relative to stores in predominantly White communities (P≤0·05).
Conclusions
Corporate status appears to be a relevant determinant of the consumer-level food environment of small and non-traditional stores. Policies and interventions aimed at making these settings healthier may need to consider multiple social determinants to enable successful implementation.
To assess the feasibility, reliability and validity of reflection spectroscopy (RS) to assess skin carotenoids in a racially diverse sample.
Design
Study 1 was a cross-sectional study of corner store customers (n 479) who completed the National Cancer Institute Fruit and Vegetable Screener as well as RS measures. Feasibility was assessed by examining the time it took to complete three RS measures, reliability was assessed by examining the variation between three RS measures, and validity was examined by correlation with self-reported fruit and vegetable consumption. In Study 2, validity was assessed in a smaller sample (n 30) by examining associations between RS measures and dietary carotenoids, fruits and vegetables as calculated from a validated FFQ and plasma carotenoids.
Setting
Eastern North Carolina, USA.
Results
It took on average 94·0 s to complete three RS readings per person. The average variation between three readings for each participant was 6·8 %. In Study 2, in models adjusted for age, race and sex, there were statistically significant associations between RS measures and (i) FFQ-estimated carotenoid intake (P<0·0001); (ii) FFQ-estimated fruit and vegetable consumption (P<0·010); and (iii) plasma carotenoids (P<0·0001).
Conclusions
RS is a potentially improved method to approximate fruit and vegetable consumption among diverse participants. RS is portable and easy to use in field-based public health nutrition settings. More research is needed to investigate validity and sensitivity in diverse populations.
To test the associations between sleep indices and eating behaviours in young adults, a group vulnerable to suboptimal sleep.
Design
Cross-sectional analysis of survey measures of sleep (i.e. time in bed, variability, timing and quality) and dietary patterns (i.e. breakfast skipping, eating at fast-food restaurants, consumption of sports and energy drinks, and sugar-free, sugar-sweetened and caffeinated beverages).
Setting
Minneapolis/St. Paul metropolitan area of Minnesota (USA).
Subjects
A total of 1854 respondents (20–30 years, 55·6 % female) from the 2008–2009 survey conducted for the third wave of the population-based Project EAT (Eating and Activity in Teens and Young Adults) study.
Results
After adjustment for demographic and behavioural covariates in linear regression models, those who went to bed after 00.30 hours consumed 0·3 more servings of sugar-sweetened beverages per day, consumed 1·7 times more energy drinks, skipped breakfast 1·8 more times per week and consumed fast food 0·3 more times per week compared with those who went to bed before 22.30 hours. Reported sleep quality in the lowest (Q1) v. highest (Q3) tertile was associated with more intake of energy drinks (Q3 v. Q1, prevalence ratio, 95 % CI: 1·79, 1·24, 2·34), sports drinks (1·28, 1·00, 1·55) and breakfast skipping (adjusted mean, 95 % CI: Q1: 4·03, 3·81, 4·26; Q3: 3·43, 3·17, 3·69). Time in bed and sleep variability were associated with few eating behaviours.
Conclusions
Some, but not all, sleep indices were related to problematic eating behaviours. Sleep habits may be important to address in interventions and policies that target improvements in eating patterns and health outcomes.
The present study examined food and beverage distributors’ sourcing, placement and promotion of obesogenic (energy-dense, nutrient-poor) product categories from the perspective of small food store owners/managers. The obesogenic product categories of interest were savoury snacks, sugary beverages, sweet snacks, confectionery and frozen treats. Specifically, we examined how frequently distributors sourced these products, and the types of agreements and expectations they had for their placement and promotion. Differences were explored by store size and ethnicity. Fresh produce was used as a comparison when examining differences in frequency of sourcing only, with implications for healthy food access.
Design
Survey research involving in-person interviews.
Setting
Four urban areas in the USA: Baltimore, MD; Durham, NC; Minneapolis/St. Paul, MN; and San Diego, CA.
Subjects
Seventy-two small food store owners/managers, 65 % consent rate.
Results
Most distributors sourced obesogenic products weekly. Agreements to place products were predominantly informal (e.g. handshake) with sweet snack, confectionery and frozen treat distributors, and formal (e.g. contract) with savoury snack and sugary beverage distributors. Free-standing displays were the most common incentive provided by distributors and they expected some control over their placement and pricing. Free/discounted products and signage were also common incentives but slotting fees were not. Smaller stores and ethnic stores were less likely to receive various incentives, but among sweet snack distributors, they were more likely to control the price in ethnic v. non-ethnic stores.
Conclusions
Obesogenic products are ubiquitous. Influencing what is made available to consumers in the retail food environment needs to consider the distributor.
Little is known about customer purchases of foods and beverages from small and non-traditional food retailers (i.e. corner stores, gas-marts, dollar stores and pharmacies). The present study aimed to: (i) describe customer characteristics, shopping frequency and reasons for shopping at small and non-traditional food retailers; and (ii) describe food/beverage purchases and their nutritional quality, including differences across store type.
Design
Data were collected through customer intercept interviews. Nutritional quality of food/beverage purchases was analysed; a Healthy Eating Index-2010 (HEI-2010) score for purchases was created by aggregating participant purchases at each store.
Setting
Small and non-traditional food stores that were not WIC-authorized in Minneapolis and St. Paul, MN, USA.
Subjects
Customers (n 661) from 105 food retailers.
Results
Among participants, 29 % shopped at the store at least once daily; an additional 44 % shopped there at least once weekly. Most participants (74 %) cited convenient location as the primary draw to the store. Customers purchased a median of 2262 kJ (540 kcal), which varied by store type (P=0·04). The amount of added sugar far surpassed national dietary recommendations. At dollar stores, participants purchased a median of 5302 kJ (1266 kcal) for a median value of $US 2·89. Sugar-sweetened beverages were the most common purchase. The mean HEI-2010 score across all stores was 36·4.
Conclusions
Small and non-traditional food stores contribute to the urban food environment. Given the poor nutritional quality of purchases, findings support the need for interventions that address customer decision making in these stores.
Little is known about the practices for stocking and procuring healthy food in non-traditional food retailers (e.g. gas-marts, pharmacies). The present study aimed to: (i) compare availability of healthy food items across small food store types; and (ii) examine owner/manager perceptions and stocking practices for healthy food across store types.
Design
Descriptive analyses were conducted among corner/small grocery stores, gas-marts, pharmacies and dollar stores. Data from store inventories were used to examine availability of twelve healthy food types and an overall healthy food supply score. Interviews with managers assessed stocking practices and profitability.
Setting
Small stores in Minneapolis and St. Paul, MN, USA, not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children.
Subjects
One hundred and nineteen small food retailers and seventy-one store managers.
Results
Availability of specific items varied across store type. Only corner/small grocery stores commonly sold fresh vegetables (63 % v. 8 % of gas-marts, 0 % of dollar stores and 23 % of pharmacies). More than half of managers stocking produce relied on cash-and-carry practices to stock fresh fruit (53 %) and vegetables (55 %), instead of direct store delivery. Most healthy foods were perceived by managers to have at least average profitability.
Conclusions
Interventions to improve healthy food offerings in small stores should consider the diverse environments, stocking practices and supply mechanisms of small stores, particularly non-traditional food retailers. Improvements may require technical support, customer engagement and innovative distribution practices.
National data for the USA show increases in sports and energy drink consumption over the past decade with the largest increases among young adults aged 20–34 years. The present study aimed to identify sociodemographic factors and health-risk behaviours associated with sports and energy drink consumption among young adults.
Design
Cross-sectional analysis of survey data from the third wave of a cohort study (Project EAT-III: Eating and Activity in Teens and Young Adults). Regression models stratified on gender and adjusted for sociodemographic characteristics were used to examine associations of sports and energy drink consumption with eating behaviours, physical activity, media use, weight-control behaviours, sleep patterns and substance use.
Setting
Participants completed baseline surveys in 1998–1999 as students at public secondary schools in Minneapolis/St. Paul, Minnesota, USA and the EAT-III surveys online or by mail in 2008–2009.
Subjects
The sample consisted of 2287 participants (55 % female, mean age 25·3 years).
Results
Results showed 31·0 % of young adults consumed sports drinks and 18·8 % consumed energy drinks at least weekly. Among men and women, sports drink consumption was associated with higher sugar-sweetened soda and fruit juice intake, video game use and use of muscle-enhancing substances like creatine (P≤0·01). Energy drink consumption was associated with lower breakfast frequency and higher sugar-sweetened soda intake, video game use, use of unhealthy weight-control behaviours, trouble sleeping and substance use among men and women (P<0·05).
Conclusions
Health professionals should consider the clustering of sports and energy drink consumption with other unhealthy behaviours in the design of programmes and services for young adults.
(i) To examine associations between young adults’ meal routines and practices (e.g. food preparation, meal skipping, eating on the run) and key dietary indicators (fruit/vegetable, fast-food and sugar-sweetened beverage intakes) and (ii) to develop indices of protective and risky meal practices most strongly associated with diet.
Design
Cross-sectional survey.
Setting
Minneapolis/St. Paul metropolitan area, Minnesota (USA).
Subjects
A diverse sample of community college and public university students (n 1013).
Results
Meal routines and practices most strongly associated with healthy dietary patterns were related to home food preparation (i.e. preparing meals at home, preparing meals with vegetables) and meal regularity (i.e. routine consumption of evening meals and breakfast). In contrast, factors most strongly associated with poor dietary patterns included eating on the run, using media while eating and purchasing foods/beverages on campus. A Protective Factors Index, summing selected protective meal routines and practices, was positively associated with fruit/vegetable consumption and negatively associated with fast-food and sugar-sweetened beverage consumption (P<0·001). A Risky Factors Index yielded significant, positive associations with fast-food and sugar-sweetened beverage consumption (P<0·001). The probability test for the association between the Risky Factors Index and fruit/vegetable intake was P=0·05.
Conclusions
Meal routines and practices were significantly associated with young adults’ dietary patterns, suggesting that ways in which individuals structure mealtimes and contextual characteristics of eating likely influence food choice. Thus, in addition to considering specific food choices, it also may be important to consider the context of mealtimes in developing dietary messaging and guidelines.
The present study assessed the impact of the 2009 food packages mandated by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on perceived sales, product selection and stocking habits of small, WIC-authorized food stores.
Design
A cross-sectional study involving in-depth interviews with store managers/owners.
Setting
Small, WIC-authorized food stores in eight major cities in the USA.
Subjects
Fifty-two store managers/owners who had at least 1 year of experience in the store prior to study participation.
Results
The WIC-approved food products (fresh, canned and frozen fruits; fresh, canned and frozen vegetables; wholegrain/whole-wheat bread; white corn/whole-wheat tortillas; brown rice; lower-fat milk (<2 %)) were acquired in multiple ways, although acquisition generally occurred 1–2 times/week. Factors such as customer requests (87 %), refrigerator/freezer availability (65 %) and profitability (71 %) were rated as very important when making stocking decisions. Most managers/owners perceived increases in sales of new WIC-approved foods including those considered most profitable (wholegrain/whole-wheat bread (89 %), lower-fat milk (89 %), white corn/whole wheat tortillas (54 %)), but perceived no changes in sales of processed fruits and vegetables. Supply mechanisms and frequency of supply acquisition were only moderately associated with perceived sales increases.
Conclusions
Regardless of type or frequency of supply acquisition, perceived increases in sales provided some evidence for the potential sustainability of these WIC policy efforts and translation of this policy-based strategy to other health promotion efforts aimed at improving healthy food access in underserved communities.
To examine whether involvement in food preparation tracks over time, between adolescence (15–18 years), emerging adulthood (19–23 years) and the mid-to-late twenties (24–28 years), as well as 10-year longitudinal associations between home food preparation, dietary quality and meal patterning.
Design
Population-based, longitudinal cohort study.
Setting
Participants were originally sampled from Minnesota public secondary schools (USA).
Subjects
Participants enrolled in Project EAT (Eating Among Teens and Young Adults)-I, EAT-II and EAT-III (n 1321).
Results
Most participants in their mid-to-late twenties reported an enjoyment of cooking (73 % of males, 80 % of females); however, few prepared meals including vegetables most days of the week (24 % of males, 41 % of females). Participants in their mid-to-late twenties who enjoyed cooking were more likely to have engaged in food preparation as adolescents and emerging adults (P < 0·01); those who frequently prepared meals including vegetables were more likely to have engaged in food preparation as emerging adults (P < 0·001), but not as adolescents. Emerging adult food preparation predicted better dietary quality five years later in the mid-to-late twenties, including higher intakes of fruit, vegetables and dark green/orange vegetables, and less sugar-sweetened beverage and fast-food consumption. Associations between adolescent food preparation and later dietary quality yielded few significant results.
Conclusions
Food preparation behaviours appeared to track over time and engagement in food preparation during emerging adulthood, but not adolescence, was associated with healthier dietary intake during the mid-to-late twenties. Intervention studies are needed to understand whether promoting healthy food preparation results in improvements in eating patterns during the transition to adulthood.
To assess the relationship between adolescent perception of time to walk to neighbourhood food retail outlets and purchasing of sugar-sweetened beverages (SSB), fast and convenience food items, and to test for differences by urban v. suburban environment.
Design
Cross-sectional observational study.
Setting
Twin Cities Metropolitan Area, Minnesota, USA.
Subjects
Adolescents from two studies completed survey-based measures on perceptions of time to walk to food retail outlets from home, purchasing patterns of SSB and fast and convenience store items, perceptions of personal safety and pedestrian infrastructure, and demographic characteristics. Descriptive analysis, Spearman correlations and multivariate linear regression, accounting for clustering, were conducted.
Results
There were 634 adolescents, approximately half male, predominantly white, with a middle-class background. Greater perceived time to food outlets was associated with less frequent purchasing of SSB, convenience store foods and fast-food items. Multivariate models showed that a perceived shorter walking time (i.e. 1−5 v. 31+ min) was significantly associated with more SSB purchasing. SSB purchases were also significantly associated with the number of food outlets within a 10 min walk (B = 0·05, P = 0·02).
Conclusions
A reduction in consumption of SSB and other energy-dense snacks is an important obesity prevention approach. An approach offering alternatives or reducing exposure in addition to education to alter purchasing habits may contribute to improving dietary habits and reducing the obesity epidemic.
To examine neighbourhood food environments, adolescent nutrition and weight status.
Design
Cross-sectional, observational study.
Setting
Minneapolis/St. Paul metropolitan region, Minnesota, USA.
Subjects
A total of 349 adolescents were recruited to the study. Participants completed 24 h dietary recalls and had their weight and height measured. They also reported demographic information and other diet-related behaviours. Geographic Information Systems were used to examine the availability and proximity of food outlets, particularly those captured within the 800, 1600 and/or 3000 m network buffers around participants’ homes and schools.
Results
Adjusting for gender, age and socio-economic status, adolescents’ sugar-sweetened beverage intake was associated with residential proximity to restaurants (including fast food), convenience stores, grocery stores and other retail facilities within the 800 and/or 1600 m residential buffers (P ≤ 0·01). BMI Z-score and percentage body fat were positively associated with the presence of a convenience store within a 1600 m buffer. Other individual-level factors, such as energy, fruit and vegetable intake, as well as convenience store and fast food purchasing, were not significantly associated with features of the residential neighbourhood food environment in adjusted models. In addition, school neighbourhood environments yielded few associations with adolescent outcomes.
Conclusions
Many factors are likely to have an important role in influencing adolescent dietary intake and weight status. Interventions aimed at increasing neighbourhood access to healthy foods, as well as other approaches, are needed.
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