Out-of-home food outlets and area deprivation: case study in Glasgow, UK

Background
There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas.

Methods
We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways), and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles.

Results
The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2) and lowest in the second most deprived quintile (Q4). Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32–0.84) in Q1, 0.50 (CI 0.31 – 0.80) in Q4 and 0.61 (CI 0.38 – 0.98) in Q5. Outlets were located in the City Centre, West End, and along arterial roads.

Conclusion
In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

Food and activity in out of school hours care in Victoria

Objective: To describe characteristics of the Victorian out of school hours care (OSHC) sector to assess its potential role in promoting healthy lifestyles to children and their families.

Design: Written questionnaires were sent to 1100 Victorian OSHC programs to collect information about the services, foods and activities offered to children, the training and resources utilised by staff and the type of information sent home to parents/guardians.

Subjects: A total of 426 Victorian OSHC coordinators completed questionnaires in the present descriptive study (39% response rate).

Setting: Out of school hours care provides care for 5–12 years olds before school, after school and/or during school holidays.

Results: Over 80% of coordinators reported offering fruit, breads, cereals, and milk and dairy products. One-third offer vegetables as part of meals or snacks. One-third reported offering cakes, biscuits and/or slices, and chips and/or pastries. About 17% reported offering water, whereas 24% reported offering cordial/soft drinks and fruit juice. Cooking was offered as an after-school activity by about half of those surveyed. Active games were common (62%) as were indoor active games and sports (36%). Sedentary activities were also commonplace (37–51%). Only about 30% of OSHC coordinators had participated in nutrition and/or physical activity training in the previous two years. Few OSHC programs sent home health information to parents/guardians.

Conclusion and application: Opportunities exist to help Victorian OSHC programs with nutrition and physical activity information, resources and training. Although the findings of the present study are specific to Victoria, they highlight the potential role of the growing OSHC sector to help improve the health of Australian children.

Effect of feeding systems on omega-3 fatty acids, conjugated linoleic acid and trans fatty acids in Australian beef cuts: potential impact on humnan health

The influence of feeding systems on the levels of functional lipids and other fatty acid concentrations in Australian beef was examined. Rump, strip loin and blade cuts obtained from grass feeding, short-term grain feeding (80 days; STGF) and long-term grain feedlot rations (150-200 days; LTFL) were used in the present study. The typical Australian feedlot ration contains more than 50% barley and/or sorghum and balanced with whole cottonseed and protein meals were used as feed for STGF and LTFL regimens. Meat cuts from 18 cattle for each feeding regimen were trimmed of visible fat and  connective tissue and then minced (300 g lean beef); replicate samples of 7g were used for fatty acid (FA) analysis. There was a significantly higher level of total omega-3 (n-3) and long chain n-3 FA in grass-fed beef (P <0.0001) than the grain-fed groups regardless of cut types. Cuts from STGF beef had significantly reduced levels of n-3 FA and conjugated linoleic acid (CLA) and similar levels of saturated, monounsaturated and n-6 FA compared with grass feeding (P <0.001). Cuts from LTFL beef had higher levels of saturated, monounsaturated, n-6 FA and trans 18:1 than similar  cuts from the other two groups (P <0.01), indicating that increased length of grain feeding was associated with more fat deposited in the carcass. There was a step-wise increase in trans 18:1 content from grass to STGF to LTGF, suggesting grain feeding elevates trans FA in beef, probably because of increased intake of 18:2n-6. Only grass-fed beef reached the target of more than 30mg of long chain n-3 FA/100 g muscle as recommended by Food Standard Australia and New Zealand for a food to be considered a source of omega- 3 fatty acids. The proportions of trans 18:1 and n-6 FA were higher (P<0.001) for both grain-fed beef groups than grass-fed beef. Data from the present study show that grain feeding decreases functional lipid  components (long chain n-3 FA and CLA) in Australian beef regardless of meat cuts, while increasing total trans 18:1 and saturated FA levels.

Food and move project, promoting healthy eating & physical activity in a secondary school setting, pat 1: baseline data, interventions and future recommendations

The Food and Move project was a collaborative project with the students, staff and parents from four Warrnambool secondary colleges which focussed on promoting healthy eating and physical activity in secondary schools and built capacity for ongoing health promotion to address overweight/obesity.

The project aimed to:

1. Increase awareness amongst students, parents and staff of the links between regular physical activity and good nutrition to achieve optimal health.
2. Increase awareness amongst students, parents and staff of childhood/adolescent obesity and its implications for future health.
3. Improve the opportunities for students to access healthy food at their school canteen.
4. Improve the opportunities for students to access physical activity at recess and lunchtime.
5. Prepare a resource package of initiatives for use in secondary colleges to support the provision of opportunities for healthy eating and physical activity at Warrnambool secondary colleges.
6. Support the development of appropriate physical activity and nutrition curricula.

Ecosystems and human well-being : health synthesis

This report synthesizes the findings from the Millennium Ecosystem Assessment's (MA) global and sub-global assessments of how ecosystem changes do, or could, affect human health and well-being. Main topics covered are: Food, fresh water, timber, fibre, and fuel, nutrient and waste management, pollution, processing and detoxification, cultural, spiritual and recreational services, climate regulation, and extreme weather events.

Nutrition, health and related claims

The article deals with food regulations controlling the use of nutrition, health and related claims in Australia and New Zealand. It relates how such regulation of claims are managed in several ways. Examples are the Code of Practice on Nutrient Claims, vitamin and mineral claims, claims about electrolyte drinks and sports food and the Australia New Zealand Food Standards Code.

Supermarkets as a setting to promote health eating : some lessons learnt in Victoria

Issue addressed: Supermarkets are a potential setting in which to deliver nutrition promotion to the community. A pilot project was able to examine the requirements for health authorities to form partnerships with other sectors and opportunities and limitations of using industry- based communication strategies to promote healthy eating messages. Methods: Pre-intervention interviews helped determine communication strategies. Post-intervention interviews were used to assess content and appropriateness of nutrition resources, collaboration between key participants, satisfaction with training and barriers/promoters to implementation. An intercept survey with consumers measured the impact of the intervention. Results: The survey of more than 1,120 women indicated only limited success. 12% of respondents from the intervention supermarkets had watched demonstrations and 20% had noticed the recipe leaflets, with only 5% able to name the promotion. Supermarket owners, representatives from participating food companies and demonstrators were supportive of the concept and content used in the promotion and qualitative analysis provides indicators for similar promotions. Conclusions: Health authorities considering 'partnerships' with the food/supermarket industry should recognise the diversity of roles and responsibilities of the organisations involved in the supply of food through the retail market and allow for long term planning when working with them. Head office of the supermarket group has a key coordinating role, however, individual supermarkets will be driven by financial returns. So what?: The recognition and trust in the name of health authorities by consumers means that organisations value an association with them.

Identifying the barriers to implementing the Victorian Department of Education and Training guidelines regarding the provisions of nutrient dense food options in school canteens

Aims & rationale/Objectives : To identify barriers to the full implementation of new guidelines regarding school canteen menus launched by The Victorian Education Department in May 2004.
Methods : A self-administered questionnaire was sent to principals, business mangers and canteen managers of 13 secondary schools in South West Victoria covered by The Greater Green Triangle area (response rate 59%). The questions explored the canteen's role, operation, staffing and profits; existence and content of canteen policy; enablers and barriers to the sale of healthier foods; introduction and promotion of healthier foods; and perceived implications of banning less healthy foods.
Principal findings : The study identified several barriers to implementing healthy menus in school canteens, these being largely consistent with those found in other studies. The majority of schools reported they were making attempts to follow the guidelines for school food services, but were experiencing difficulty in proceeding to full implementation. The barriers identified through the study were student preference for less healthy options, concerns about profitability, lack of policy or its active communication and promotion at the school level and competition from other food outlets.
Discussion : There was evidence that healthy foods had not been actively promoted, suggesting that identification of student preferences as a barrier was based on perception rather than observation. The Victorian guidelines are effectively voluntary, with no accountability measures in place.
Implications : Research needs to be conducted to provide reliable and tested information about factors which impact on student choice. Schools would benefit from specialised assistance to formulate business plans for contemporary canteens selling healthy food and a clarification of government policy.
Presentation type : Poster

Deterministic versus stochastic quantitative microbial Risk Assessment models for wastewater irrigation of food crops

Reuse of wastewater to irrigate food crops is being practiced in many parts of the world and is becoming more commonplace as the competition for, and stresses on, freshwater resources intensify. But there are risks associated with wastewater irrigation, including the possibility of transmission of pathogens causing infectious disease, to both workers in the field and to consumers buying and eating produce irrigated with wastewater. To manage these risks appropriately we need objective and quantitative estimates of them. This is typically achieved through one of two modelling approaches: deterministic or stochastic. Each parameter in a deterministic model is represented by a single value, whereas in stochastic models probability functions are used. Stochastic models are theoretically superior because they account for variability and uncertainty, but they are computationally demanding and not readily accessible to water resource and public health managers. We constructed models to estimate risk of enteric virus infection arising from the consumption of wastewater-irrigated horticultural crops (broccoli, cucumber and lettuce), and compared the resultant levels of risk between the deterministic and stochastic approaches. Several scenarios were tested for each crop, accounting for different concentrations of enteric viruses and different lengths of environmental exposure (i.e. the time between the last irrigation event and harvest, when the viruses are liable to decay or inactivation). In most situations modelled the two approaches yielded similar estimates of risk (within 1 order-of-magnitude). The two methods diverged most markedly, up to around 2 orders-of-magnitude, when there was large uncertainty associated with the estimate of virus concentration and the exposure period was short (1 day). Therefore, in some circumstances deterministic modelling may offer water resource managers a pragmatic alternative to stochastic modelling, but its usefulness as a surrogate will depend upon the level of uncertainty in the model parameters.

A systematic policy approach to changing the food system and physical activity environments to prevent obesity

As obesity prevention becomes an increasing health priority in many countries, including Australia
and New Zealand, the challenge that governments are now facing is how to adopt a systematic
policy approach to increase healthy eating and regular physical activity. This article sets out a
structure for systematically identifying areas for obesity prevention policy action across the food
system and full range of physical activity environments. Areas amenable to policy intervention can
be systematically identified by considering policy opportunities for each level of governance (local,
state, national, international and organisational) in each sector of the food system (primary
production, food processing, distribution, marketing, retail, catering and food service) and each
sector that influences physical activity environments (infrastructure and planning, education,
employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured
fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of
governance and all relevant sectors. In the Australian context, potential regulatory policy
intervention areas are widespread throughout the food system, e.g., land-use zoning (primary
production within local government), food safety (food processing within state government), food
labelling (retail within national government). Policy areas for influencing physical activity are
predominantly local and state government responsibilities including, for example, walking and
cycling environments (infrastructure and planning sector) and physical activity education in schools
(education sector). The analysis structure presented in this article provides a tool to systematically
identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of
developing and implementing a comprehensive obesity prevention strategy. It also serves to
highlight the need for a coordinated approach to policy development and implementation across
all levels of government in order to ensure complementary policy action.

Understanding the older food consumer, present day behaviours and future expectations

The main aim of this study was to determine whether Baby boomers know how they would manage to maintain a healthy diet on lower incomes in retirement. A cross-sectional survey was conducted at two shopping centres in Melbourne, Australia with 352 respondents. Contingency table analyses (using chi-square tests) were used to examine differences in present and future cooking habits between gender, age and socio-economic groups as well as anticipated changes to food shopping if they had less money in the future. The findings suggest that the most common food preparation behaviours were making meals from scratch ingredients (80% of participants) or using a combination of fresh and convenience foods (55% of participants), with socio-economic and demographic factors significantly influencing specific behaviours. Nearly 50% responded that if they had reduced income they would make a change to their food shopping habits. The most common changes were to the types of food purchased and seeking out special offers or cheaper brands. The results suggest that when faced with a lower standard of living, people will make changes to their food consumption habits. The challenge facing health promotion practitioners, is to ensure that these changes are well informed, leading to healthy options.