Availability and Accessibility of Healthy and Unhealthy Foods in Neighborhood and their Association with Noncommunicable Diseases: A Scoping Review (2024)

Sachdeva B, Puri S, Aeri BT. Availability and accessibility of healthy and unhealthy foods in neighborhood and their association with noncommunicable diseases: A scoping review. Indian J Public Health 2024;68:95-105. DOI: 10.4103/ijph.ijph_436_23

Abstract

Worldwide, 7 million mortalities and 187.7 million morbidities have been associated with dietary risks. Poor diets emerge because of an obesogenic environment. However, clear evidence indicating an association between food environment and noncommunicable diseases (NCDs) is inconclusive.

The present review was conducted to study the associations between the availability/accessibility of healthy/unhealthy foods and the risk of NCDs among adults of the age group above 18. Studies published between 2012 and 2022 were retrieved using three databases – PubMed, Google Scholar, and Science Direct.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), (2018) guidelines and based on the selection criteria, 3034 studies were retrieved, of which 64 were included in this review. Maximum studies were conducted in high-income countries and adopted a cross-sectional study design.

Overall, the results of the review illustrate mixed findings.

  • Compared to healthy food, direct associations between obesity and the availability/accessibility of unhealthy foods were reported (n = 12).
  • In the case of diabetes, supermarket availability was more likely to be protective (4 positive) compared to a negative association with unhealthy food stores (3 associations in 11 studies).
  • For cardiovascular diseases, an increased number of cases with fast-food outlets (n = 6) outnumbered positive associations with healthy food (n = 3).
  • Studies concerning multiple NCDs reported direct associations with unhealthy food outlets (n = 5) while inconclusive associations with healthy food.

Despite a large number of studies, a weak, inconclusive relationship between food environment and NCDs was found. The use of standardized tools and longitudinal and interventional studies are warranted to rationalize the execution of the policies related to the food environment.

Communicating about healthy & sustainable eating to consumers with low socioeconomic status: Evidence-based recommendations (2024)

European Food Information Council (EUFIC) and Caritas Trieste in Italy conducted joint research and developed evidence-based recommendations for “Facilitating the Healthy and Sustainable Diet Shift through Effective Communication in Communities with Low Socioeconomic Status”.

Consumers with low socioeconomic status (SES) face unique challenges that limit their uptake of healthy & sustainable eating (e.g., reduced affordability, accessibility, and availability of healthy & sustainable foods). The reduced exposure to, seeking of, and trust in health information that has been observed in consumers with low SES further reinforce these challenges.

This toolkit presents evidence-based recommendations on how to tailor your communication to consumers with low SES to empower them to shift towards healthier & more sustainable diets. The recommendations were developed based on a combination of qualitative and quantitative research findings.

Focus groups with social supermarket beneficiaries and professionals of the Caritas Trieste charitable foundation in Italy provided insights into the barriers and communication preferences of consumers with low SES with regard to healthy & sustainable eating. Based on these insights, tailored communication material (i.e., infographics) was developed and tested in a larger pool of consumers with low SES via an online survey.

This toolkit of recommendations is particularly relevant for science communicators, researchers, health professionals, journalists, NGOs, and policymakers who work with communities with low SES.

Sustain: the alliance for better food and farming (website)

Sustain is a powerful alliance of organisations and communities working together for a better system of food, farming and fishing, and cultivating the movement for change. Together, they advocate food and agriculture policies and practices that enhance the health and welfare of people and animals, improve the working and living environment, enrich society and culture, and promote equity.

The Sustain alliance works to influence government, local authorities, businesses, organisations and decision-makers in a position to influence or achieve change. We advocate for transparency, legal responsibilities, good governance and accountability. We work with sister alliances and organisations in the UK Nations and support experts and groups working on specialist issues where we can lend our weight. We also work with leaders, food partnerships and communities in places across the UK – and internationally – to improve health and sustainability through the mobilisation and celebration of local action on food.

The main sister alliances that Sustain works with include:

  • Eating Better, is a movement for change of sixty organisations working to accelerate the transition from producing and eating too much meat and dairy to a fairer, healthier and more sustainable food system that is better for animal welfare and for nature.
  • Food Sense Wales is built on the foundations of Food Cardiff, a multi-award-winning food partnership and founding member of the Sustainable Food Places Network managed in partnership with the Soil Association, Food Matters and Sustain. Food Sense Wales delivers pioneering programmes such as Sustainable Food Places, Peas Please, and Food Power – bringing people together through food.
  • Green Alliance is an independent think tank and charity focused on ambitious leadership for the environment. It works with influential leaders in business, NGOs and politics to accelerate political action and create transformative policy for a green and prosperous UK. Sustain has worked extensively with Green Alliance members, and during the Brexit process with the Greener UK coalition hosted by the Green Alliance, to integrate food and farming into key environmental, fisheries and agriculture policy initiatives.
  • Green Care Coalition, was established in 2016 to promote the commissioning and use of Green Care services, and to give voice to the many organisations in the UK that are committed to delivering or supporting the delivery of high-quality and cost-effective Green Care services. Green Care refers to structured therapy or treatment programmes that take place in natural surroundings and recognise the instinctive connection between nature and health.
  • Nourish Scotland works across Scotland for a fair, healthy and sustainable food system that truly values nature and people. Nourish takes a systems approach to food. This means they work across a wide range of issues and levels: from production to consumption, from practice to policy, and from grassroots to national. They champion integrated approaches to solving the big challenges of the current food system: hunger and malnutrition, diet-related disease, exploitation, loss of biodiversity, and climate change.
  • The Obesity Health Alliance is a coalition of over 40 organisations working together to reduce obesity by influencing government policy. The goal of the Obesity Health Alliance is to prevent obesity-related ill-health by supporting evidence-based population-level policies to help address the wider environmental factors that lead to excess body weight.
  • The Sustainable Soils Alliance is a partnership of farming organisations, businesses, NGOs, applied science and academia working together to restore our soils to health within one generation. The alliance pursues this aim by bringing together the community of stakeholders interested in soil management to debate the scale and nature of the problem, agree on the appropriate indicators and determining factors and identify the relevant policy mechanisms and levers for reform. They engage media and stakeholders, educate the general public and lobby government for a policy framework that will bring about the transformational step change needed to support the development of healthy soil for generations to come.
  • The Trade Justice Movement is a UK coalition of nearly sixty civil society organisations, with millions of individual members, calling for trade rules that work for people and the planet. Trade Justice Movement members include trade unions, aid agencies, environment and human rights campaigns, Fair Trade organisations and consumer groups. 
  • Wildlife and Countryside Link is the largest environment and wildlife coalition in England, bringing together 57 organisations to use their strong joint voice for the protection of nature. Link’s members campaign to conserve, enhance and access our landscapes, animals, plants, habitats, rivers and seas.

Exploring the barriers and facilitators for following a sustainable diet: A holistic and contextual scoping review (2024)

Abstract: Changing current dietary patterns to more sustainable ones is paramount to decrease the pressure food systems are putting onto the planet and people’s health and wellbeing. However, modifying consumers’ behaviour is extremely challenging since multiple factors of variable nature (i.e., personal, socioeconomic, cultural, external…) influence food choices.

Fig. 2. Number of mentions from the literature review concerning internal and external factors influencing individuals following a sustainable and healthy diet. The dark blue bar (internal factors) are the sum of factors in light blue bars.

For this reason, we aim to identify consumers’ barriers and facilitators for following a sustainable and healthy diet, and explore how these are perceived among people from different socioeconomic backgrounds. To do so, we conducted a scoping review of the literature with a consultation phase with citizens from Barcelona with different socioeconomic backgrounds.

Results revealed one hundred intricate factors that influence people food behaviour, which were grouped into internal, and external factors. Although the literature generally agreed on the direction of influence from the identified factors, the consultation phase generated substantial disagreements given the participants’ diverse perspectives and motivations.

Fig. 3. Number of mentions from the consultation phase concerning internal and external factors influencing individuals following a sustainable and healthy diet. The dark blue bar (internal factors) are the sum of factors in light blue bars.

However, some limiting factors were commonly mentioned across groups which corresponded to feelings of distrust towards the food industry, lack of time, disgust towards specific foods, and the high cost of foods. Differences across socioeconomic groups were not observed except for the latter. All participants agreed that cost acted as a barrier, although participants from higher socioeconomic backgrounds were more capable to find arguments to overcome the price barrier. Results are necessary to acknowledge the particularities embedded in each person and the need to design context-based interventions to effectively overcome people’s barriers and enhance their facilitators.

Citation: Muñoz-Martínez, J., Cussó-Parcerisas, I., & Carrillo-Álvarez, E. (2024). Exploring the barriers and facilitators for following a sustainable diet: A holistic and contextual scoping review. Sustainable Production and Consumption, 46, 476-490. https://doi.org/10.1016/j.spc.2024.03.002

Food Systems Transformation WhatsApp Community (2024)

The Food Systems Transformation WhatsApp Community grew out of Food Systems at COP28. It is now a year-round meeting place for food systems folks who will bring information from and back to our homes and communities. There are different channels within it to suit your interests and to limit notifications to only what you really want to see.

💼 Job Opportunities
📖 Recommended Reading
🗣 General Chitchat
🆘 Requests for Support
📅 Event Promotion
👋 Introduce Yourself

Join at: https://chat.whatsapp.com/Cx88Tny19mG8dP7tLNDF14

See you there!

A pathway to personal, population and planetary health for dietitians and nutrition professionals (2023 Nov)

MacKenzie-Shalders, K. L., Barbour, L., Charlton, K., Cox, G. R., Lawrence, M., Murray, S., Newberry, K., Senior, N. M., Stanton, R., & Tagtow, A. M. (2023). A pathway to personal, population and planetary health for dietitians and nutrition professionals. Public Health Nutrition, Advance online publication. https://doi.org/10.1002/puh2.137

Abstract

Background

Earth and all its inhabitants are threatened by a planetary crisis; including climate change, deforestation, biodiversity loss and pollution. Dietitians and nutrition professionals have a responsibility to lead transformational change in contemporary food and health systems to help mitigate this crisis. The study aims to develop a conceptual framework to support dietitians towards personal, population and planetary health.

Methods

Non-empirical methods were used by the co-researchers to explore and explain the application of an international framework ‘Next-Generation Solutions to Address Adaptive Challenges in Dietetics Practice: The I + PSE Conceptual Framework for Action’. (I+PSE = Individual plus Policy, System, and Environmental)

Results

A non-sequential pathway guide to personal, population and planetary health for nutrition professionals was developed including several key guiding principles of Agency, Action, Ascension, Alignment, Alliance and Allyship, and Advocacy and Activism. Each guiding principle features descriptors and descriptions to enhance dietitian and nutrition professional

  • Agency (i.e. vision, self-belief, confidence, strength and responsibility),
  • Action (i.e. start, shift, translate, achieve and commit),
  • Ascension (i.e. build, overcome, manage, challenge and progress),
  • Alignment (i.e. leadership, transparency, diplomacy, values and systems),
  • Alliance and Allyship (i.e. support, collaborate, represent, community and citizenship) and
  • Advocacy and Activism (i.e. disrupt, co-design, transform, empower and urgency).

The framework and its descriptors support enhanced understanding and are modifiable and flexible in their application to guide the participation of dietitians and nutrition professionals in transformational change in personal, population and planetary health. This guide acknowledges that First Nations knowledge and customs are important to current and future work within this field.

Conclusions

Alongside the international body of work progressing in this field, this framework and visual guide will support dietitians and nutrition professionals to achieve urgent, transformational change in personal, population and planetary health.

Food environment framework in low- and middle-income countries – An integrative review (2023 Dec)

Neha Gupta, Vaishali Deshmukh, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora. Food environment framework in low- and middle-income countries – An integrative review. Global Food Security. Volume 39. 2023. 100716. ISSN 2211-9124. https://doi.org/10.1016/j.gfs.2023.100716. (pay wall)

Relevant to: 

Researchers from multidisciplinary domains, policy makers, program managers

Question: 

The integrative review addressed the following objectives: (1) to develop a multi-level framework of Food Environments (FE) for low- and middle-income countries (LMICs) based on McLeroy socio ecological theory and Penchansky and Thomas’s theory of access; (2) to identify the factors operating at different levels of the FE framework; and (3) to understand the relationship between factors operating at different levels of FE framework and dietary behaviors in LMICs.

Bottom line for nutrition practice: 

  • Food environment embedded in the food systems is a key consideration in sustainability. This study finds that the food environments in LMICs are in a dynamic state and have context specific mix of traditional systems and emerging modern supply chain-based markets.
  • The proposed socio-ecological model of the food environment in the context of LMICs should lay the foundation for an operational and analytical tool for surveillance, capturing dynamicity and its determinants.

Abstract: 

  • There are major gaps in our understanding of food environments (FE) in low-and middle-income countries (LMICs) witnessing differential and complex social and economic transition. The present integrative review was conducted to develop a conceptual framework of FE for LMICs using socio-ecological and access theory. The FE framework has four layers: public policy, community/neighborhood (including organizational e.g., markets, schools), household, and individual. Availability, accessibility, and affordability with built-in socio-cultural and contextual factors were the major domains in every layer. The following additional domains emerged: global influences, marketing and regulation, nutrition programs, time-constrained family members, and food behavior. Wet and informal markets are important components of FE. The next step is determining the model’s resilience to accommodate and capture nuances across LMICs.

Details of results: 

  • The integrative review included evidence from 28 studies about food environment in low and middle-income countries in the last two decades.
  • The review used McLeroy’s socio-ecological model and Penchansky’s access theory as the basis for identifying the socio-economic and ecological factors operating at multiple levels in the LMIC food environment that influence dietary outcomes.
  • The factors were operating at (i) policy, (ii) community, (iii) household, and (iv) individual levels under the availability, affordability, and accessibility domains at each level are interwoven among themselves
  • The review identified that context and neighborhood characteristics characterise the food environment. In addition, the unorganized markets comprise of the major component of food environment
  • The evidence synthesis identified the following additional domains at multiple levels: Nutrition programs and global influences (Policy level); marketing and regulations (policy and neighborhood level); and time constraint and food behavior (household level).

Of additional interest: 

n/a

Conflict of interest/ Funding:  

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

External relevant links:  

n/a

Corresponding author: 

Seema Puri, Department of Food and Nutrition, Institute of Home Economics, University of Delhi, New Delhi, India, dr.seemapuri@gmail.com

Sustainable Food Systems Network (EUFIC)

European Food Information Council (EUFIC)‘s Global Sustainable Food Systems Network facilitates communication and collaboration amongst stakeholders in sustainable food systems (SFS) across the globe. In this community, you will find policy makers, business professionals, civil society organizations, researchers, NGOs/non-profit organizations, funding agencies and interested citizens. The network allows members to:

  • Add to and use the resources section
  • Reach out to members through the chat in a field/topic you are interested in. Network, ask questions, build bridges. Chat conversations are private and confidential!
  • Publish about events you are organizing regarding SFS (on average, 30-120 members attend events shared in the feed!)
  • Peruse the calendar of events shared by other members.
  • Share calls, documents, reports, papers, etc. that you think are interesting for the whole community.
  • Ask the community for feedback and start a conversation, e.g. by creating a poll!
  • Share job openings as “opportunities”. The network currently spans 2000+ people, and their personal networks spread much further.

The SFSN Community leaders send a biweekly newsletter with featured shared events, opportunities, posts, and new members for further dissemination.

If you have any feedback, questions or would like to get more involved, email sfsn@eufic.org or contact us directly through the chat (search Community Managers).

JHND Special Issue: Sustainable Food Systems and Dietary Patterns in Nutrition and Dietetic Practice (2023 Dec)

The British Dietetic Association’s Journal of Human Nutrition and Dietetics (JHND) published a Special Issue on Sustainable Food Systems and Dietary Patterns in Nutrition and Dietetic Practice edited by: Liesel Carlsson, Angela Madden, and Kalliopi-Anna Poulia (Volume 36, Issue 6, Pages: 2121-2350, December 2023).

Twelve of the sixteen articles are open access and cover a wide range of practice settings.

  • Open Access – Conceptualising sustainability in Canadian dietetic practice: A scoping review – Dietitians are well-positioned to promote sustainable food systems and diets. This research identifies practice activities described in the Canadian published literature and compares these with dietetic competency standards. Increasing practitioners’ ability to analyse issues using systems thinking will help address complex challenges. Updates to competency standards and curricular supports are needed to support this area of practice.
  • Open Access – Local food procurement by hospitals: a scoping review – There is a paucity of peer-reviewed studies describing local food procurement by hospitals. Details of local food procurement models were generally lacking: categorisable as either purchases made ‘on-contract’ via conventional means or ‘off-contract’. If hospital foodservices are to increase their local food procurement, they require access to a suitable, reliable and traceable supply, that acknowledges their complexity and budgetary constraints.

How to Effectively Encourage Sustainable Food Choices: A Mini-Review of Available Evidence (2022 Nov)

This is open-access peer review mini-review from Frontiers (Psychology) by Wokje Abrahamse, School of Geography, Environment and Earth Sciences, Victoria University of Wellington, Wellington, New Zealand. He describes the review as the following:

“Food choices are difficult to change. People’s individual motivations (such as taste, cost, and food preferences) can be at odds with the negative environmental outcomes of their food choices (such as deforestation, water pollution, and climate change). How then can people be encouraged to adopt more sustainable food choices?

This rapid review uses a dual-processing framework of decision-making to structure an investigation of the effectiveness of interventions to encourage sustainable food choices (e.g., local and organic food consumption, reducing meat and dairy intake, reducing food waste) via voluntary behavior change. The review includes interventions that rely on fast, automatic decision-making processes (e.g., nudging) and interventions that rely on more deliberate decision-making (e.g., information provision). These interventions have varying degrees of success in terms of encouraging sustainable food choices.

This mini-review outlines some of the ways in which our understanding of sustainable food choices could be enhanced. This includes a call for the inclusion of possible moderators and mediators (past behavior, attitudes, beliefs, values) as part of effect measurements, because these elucidate the mechanisms by which behavior change occurs. In light of the climate change challenge, studies that include long-term effect measurements are essential as these can provide insight on how to foster sustained and durable changes.”

This article was shared with us through our ICDA SFS Toolkit Community of Practice forum titled: Behaviour Change Techniques In Sustainability. Join us on the forum to learn & GROW together!