Lay people's views of the school food supply

Purpose – This article aims to examine lay-persons' views of school food services in Victoria, Australia.

Design/methodology/approach – A cross-sectional postal questionnaire survey of a random sample of electors on the Electoral Roll in Victoria, Australia. Out of 1,000 potential respondents, 377 completed the questionnaire. Main outcome measures included responses to closed questions about foods supplied to children at school using five-point scales. Data analyses included frequency and cross-tabulation analyses, and multivariate analyses of principal component scores by demographic and personal values variables.

Findings – Many respondents were critical of children's school food services but they were generally supportive of food and health education, whilst holding ambivalent attitudes towards snacks and marketing practices.

Research limitations/implications – This was a cross-sectional survey with a relatively low response rate.

Practical implications – Understanding of laypersons' views of children's food services is likely to facilitate nutrition communication and promotion of healthy children's foods.

Originality/value – Lay views of children's food provision have rarely been reported, despite their importance for the support of public nutrition policies. The study identifies likely antecedents of lay people's views.

Social ideological influences on reported food consumption and BMI

Background : The purpose of this study was to investigate relationships between ideological beliefs, perceptions of the importance of health behaviours, health attitudes, food consumption, and Body Mass Index (BMI). A behavioural model was hypothesized based on the Theory of Reasoned Action (Fishbein & Ajzen, 1975).

Methods : A survey was conducted among shoppers aged between 40 and 70 years at Eastland Shopping Centre, Melbourne, Australia. The hypothesized model was tested with this empirical data (n = 410) for younger (n = 151) and older (n = 259) age groups using structural equation modelling.

Results : The findings generally support the study hypotheses. For both groups, egalitarianism had a direct and positive influence on perceptions of the importance of health behaviours. Materialism and masculinity impacted negatively on health attitudes, which positively influenced importance of health behaviours. Perceptions of importance of health behaviours impacted positively on the consumption of healthy foods such as vegetables and fruits, but negatively on consumption of unhealthy foods including sweets and fats. However, BMI was significantly influenced by the consumption of unhealthy foods (e.g., sugar and fats) only for the younger age group. Hence, the associations between beliefs, attitudes, consumption behaviours, and BMI outcomes differed between younger and older age populations.

Conclusion : Social ideological beliefs appear to influence health attitudes and thereafter, the consumption of healthy and unhealthy foods and BMI via different pathways.

Australian farmers' and food processors' values

Purpose – The aim of this exploratory study was to examine and compare a range of business values held by farmers and food processors.

Design/methodology/approach – Questionnaires with a section on business values were posted to 200 farmers and 200 food processing businesses in Victoria, Australia, with response rates of 44 per cent (n=69) and 31 per cent (n=48), respectively, achieved.

Findings – The most important of the 28 value items for farmers were high quality produce, honesty, and caring for employees. For processors, the most important values were quality products, customer value, and caring for employees. Between group differences reached statistical significance for one-third of the items. In particular, processor businesses valued innovation and convenience products more highly and had a stronger process orientation than did farming businesses. Environmental sustainability, caring for the community, and providing healthy products were more integral to farming than processing businesses.

Research limitations/implications – The main limitation was the small sample sizes, although it is likely that response bias was not high. Future research could survey a larger sample of food industry representatives and examine the values held by other food industry sectors.

Practical implications – This information could increase the effectiveness of communications with industry groups on a range of issues and in the formulation of appropriate health and environmental policies.

Originality/value – To the authors' knowledge, this is the first study to compare the values of farmers and food processors. This information is particularly important for those in the food industry and health and environmental policy makers.

Building an economic case for food interventions in the pacific

Diet-related health problems are a major issue throughout the Pacific region. Micronutrient deficiencies are widespread and rates of non-communicable diseases are increasing. There is a need for food-related policy interventions to improve the quality of the food supply and to enhance access to a healthy diet. To support the promotion and eventual implementation of these interventions, it is vital that the costs and impacts of the interventions are known. This paper outlines a project being undertaken in the region to develop cost-effectiveness models for food interventions in order to help build the case for action.

Health beliefs - what role do they play in outcomes research?

Lay beliefs about health and illness are individual and social, influenced by prevailing social and medical ideologies. Health beliefs clearly influence self-care motivation and have an effect on health-promoting behaviour (e.g. attendance at a screening program, food choices, adherence to prescribed medication). Further, the beliefs and attributions that people hold can directly affect physiological systems (e.g. the immune system). Health beliefs have been shown to influence a variety of patient-reported outcomes, including medication adherence, satisfaction and health-related quality of life. It is widely acknowledged that when the patient's beliefs are acknowledged and incorporated, rather than ignored, optimal biomedical patient-reported outcomes are more likely to be achieved. Several psychological models have been developed to predict health behaviours and may be utilised to identify the beliefs that inform such behaviours. These models consider the social milieu, personality, demographic, political and economic predictors of health beliefs. They demonstrate the impact of beliefs such as the causes of illness, effectiveness of healthcare and acceptability of health services, and how manipulating these can result in actual or intended behaviour change. This workshop will introduce health beliefs and discuss the psychological models that underpin the translation of belief into behaviour. The session is interactive, with participants defining health beliefs and their impact on behaviour. Participants will be invited to critique the models and apply their chosen model to a health indication of their choice.

Integrating agriculture and food policy to achieve sustainable peri-urban fruit and vegetable production in Victoria, Australia

Efforts to increase fruit and vegetable consump­tion are a significant aspect of national approaches to preventive health. However, policy frameworks for increasing fruit and vegetable consumption rarely take an integrated food-systems approach that includes a focus on production. In this policy analysis and commentary we examine fruit and vegetable production in peri-urban areas of Melbourne in Victoria, Australia, and highlight the significance of emerging environmental and eco­nomic pressures on fruit and vegetable production. This examination will be of interest to other locations around the world also experiencing pressure on their peri-urban agriculture. These pressures suggest that the availability and afforda­bility of fruit and vegetable supplies cannot be taken for granted, and that future initiatives to increase fruit and vegetable consumption should include a focus on sustainable production. Threats to production that include environmental pressures, together with the loss and cost of peri-urban agri­cultural land and a cost-price squeeze due to rising input costs and low farm-gate prices, act in combi­nation to threaten the viability of the Victorian fruit and vegetable industries. We pro­pose that policy initiatives to increase fruit and vegetable consumption should include measures to address the pressures facing production, and that the most effective policy responses are likely to be integrated approaches that aim to increase fruit and vegetable availability and affordability through innovative solutions to problems of production and distribu­tion. Some brief examples of potential integrated policy solutions are identified to illu­strate the possibilities and stimulate discussion.

Core health promotion competencies in Australia : are they compatible with climate change action?

Issues addressed: Health promotion principles for practice are closely aligned with that of environmental sustainability. Health promotion practitioners are well positioned to take action on climate change. However, there has been scant discussion about practice synergies and subsequently the type and nature of professional competencies that underpin such action.

Methods: This commentary uses the Australian Health Promotion Association (AHPA) national core competencies for Health Promotion Practitioners as a basis to examine the synergies between climate change and health promotion action.

Results: We demonstrate that AHPA core competencies, such as program planning, evaluation and partnership building, are highly compatible for implementing climate change mitigation and adaptation strategies. We use food security examples to illustrate this case.

Conclusions: There appears to be considerable synergy between climate change and health promotion action. This should be a key focus of future health promotion competency development in Australia.

It's here! Are we ready? Five case studies of health promotion practices that address climate change from within Victorian health care settings

Issue addressed: Climate changes and environmental degradation caused by anthropogenic activities are having an irrefutable impact on human health. The critical role played by health promotion in addressing environmental challenges has a history in seminal charters − such as the Ottawa Charter for Health Promotion − that explicitly link human well-being with the natural environment. The lack of documented practice in this field prompted an investigation of health promotion practice that addresses climate change issues within health care settings.

Methods: This qualitative study involved five case studies of Victorian health care agencies that explicitly identified climate change as a priority. Individual and group interviews with ten health promotion funded practitioners as well as document analysis techniques were used to explore diverse practices across these rural, regional and urban health care agencies.

Results: Health promotion practice in these agencies was oriented toward: active and sustainable transport; healthy and sustainable food supply; mental health and community resilience; engaging vulnerable population groups such as women; and organisational development.

Conclusion: Despite differences in approach, target population and context, the core finding was that health promotion strategies, competencies and frameworks were transferable to action on climate change in these health care settings.

Is proximity to a food retail store associated with diet and BMI in Glasgow, Scotland?

Background: Access to healthy food is often seen as a potentially important contributor to diet. Policy documents in many countries suggest that variations in access contribute to inequalities in diet and in health. Some studies, mostly in the USA, have found that proximity to food stores is associated with dietary patterns, body weight and socio-economic differences in diet and obesity, whilst others have found no such relationships. We aim to investigate whether proximity to food retail stores is associated with dietary patterns or Body Mass Index in Glasgow, a large city in the UK.
Methods: We mapped data from a ‘Health and Well-Being Survey’ (n = 991), and a list of food stores (n = 741) in Glasgow City, using ArcGIS, and undertook network analysis to find the distance from respondents’ home addresses to the nearest fruit and vegetable store, small general store, and supermarket.
Results: We found few statistically significant associations between proximity to food retail outlets and diet or obesity, for unadjusted or adjusted models, or when stratifying by gender, car ownership or employment.
Conclusions: The findings suggest that in urban settings in the UK the distribution of retail food stores may not be a major influence on diet and weight, possibly because most urban residents have reasonable access to food stores

Baby boomers' reasons for choosing specific food shops

Purpose – Baby boomers (people born between 1946 and 1964) are approaching retirement and there is concern about their preparation for their future health and wellbeing. Food shopping is likely to play a major role in their future lives. The purpose of this paper is to examine their reasons for choosing to buy food from particular shops and whether demographic characteristics and health status were associated with them.

Design/methodology/approach – A questionnaire survey was conducted among a random sample of 1,037 people aged between 40 and 71 years in Victoria, Australia. Respondents were asked to indicate, from a list, their reasons for choosing to shop at particular food outlets. Regression analysis was used to examine the relationships between respondents' demographics and health status and their reasons for shopping at the food stores.

Findings – Multivariate analysis showed that the reasons the respondents reported in choosing shops fell into four groups: saving, convenience, quality and healthy foods, and user-friendly environment. Saving was negatively related to income, age, level of education and also linked with country of birth, religious affiliation, and marital status. Convenience was negatively associated with age and also related to health status and religious affiliation. Quality/healthy food products were positively related to age but negatively associated with body mass index, and also linked to country of birth. User-friendly environment was negatively associated with income and education and related to gender and religious affiliation.

Originality/value – The paper's results show that stores could provide more information, perhaps as signage, to their recycling and health information facilities, particularly in low socio-economic status areas. Furthermore, the social status and religious associations confirm the view that shopping reflects broad societal affiliations among baby boomers. Shopping centres can be used to provide support for health and environmental sustainability promotions.

The association between habitual diet quality and the common mental disorders in community-dwelling adults : The Hordaland health study

Objective Recent evidence suggests a role for diet quality in the common mental disorders depression and anxiety. We aimed to investigate the association between diet quality, dietary patterns, and the common mental disorders in Norwegian adults.

Methods This cross-sectional study included 5731 population-based men and women aged 46 to 49 and 70 to 74 years. Habitual diet was assessed using a validated food frequency questionnaire, and mental health was measured using the Hospital Anxiety and Depression Scale.

Results After adjustments for variables including age, education, income, physical activity, smoking, and alcohol consumption, an a priori healthy diet quality score was inversely related to depression (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.59–0.84) and anxiety (OR = 0.77, 95% CI = 0.68–0.87) in women and to depression (OR = 0.83, 95% CI = 0.70–0.99) in men. Women scoring higher on a healthy dietary pattern were less likely to be depressed (OR = 0.68, 95% CI = 0.57–0.82) or anxious (OR = 0.87, 95% CI = 0.77–0.98), whereas men were more likely to be anxious (OR = 1.19, 95% CI = 1.03–1.38). A traditional Norwegian dietary pattern was also associated with reduced depression in women (OR = 0.77, 95% CI = 0.64–0.92) and anxiety in men (OR = 0.77, 95% CI = 0.61–0.96). A western-type diet was associated with increased anxiety in men (OR = 1.27, 95% CI = 1.14–1.42) and women (OR = 1.29, 95% CI = 1.17–1.43) before final adjustment for energy intake.

Conclusions In this study, those with better quality diets were less likely to be depressed, whereas a higher intake of processed and unhealthy foods was associated with increased anxiety.

Modelling the health impact of environmentally sustainable dietary scenarios in the UK

BACKGROUND/OBJECTIVES:


Food is responsible for around one-fifth of all greenhouse gas (GHG) emissions from products consumed in the UK, the largest contributor of which is meat and dairy. The Committee on Climate Change have modelled the impact on GHG emissions of three dietary scenarios for food consumption in the UK. This paper models the impact of the three scenarios on mortality from cardiovascular disease and cancer.
SUBJECTS/METHODS:


A previously published model (DIETRON) was used. The three scenarios were parameterised by fruit and vegetables, fibre, total fat, saturated fat, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol and salt using the 2008 Family Food Survey. A Monte Carlo simulation generated 95% credible intervals.
RESULTS:


Scenario 1 (50% reduction in meat and dairy replaced by fruit, vegetables and cereals: 19% reduction in GHG emissions) resulted in 36 910 (30 192 to 43 592) deaths delayed or averted per year. Scenario 2 (75% reduction in cow and sheep meat replaced by pigs and poultry: 9% reduction in GHG emissions) resulted in 1999 (1739 to 2389) deaths delayed or averted. Scenario 3 (50% reduction in pigs and poultry replaced with fruit, vegetables and cereals: 3% reduction in GHG emissions) resulted in 9297 (7288 to 11 301) deaths delayed or averted.
CONCLUSION:


Modelled results suggest that public health and climate change dietary goals are in broad alignment with the largest results in both domains occurring when consumption of all meat and dairy products are reduced. Further work in real-life settings is needed to confirm these results.

Population-level changes to promote cardiovascular health

Background: Cardiovascular diseases (CVD) cause 1.8 million premature (<75 years) death annually in Europe. The majority of these deaths are preventable with the most efficient and cost-effective approach being on the population level. The aim of this position paper is to assist authorities in selecting the most adequate management strategies to prevent CVD.

Design and Methods: Experts reviewed and summarized the published evidence on the major modifiable CVD risk factors: food, physical inactivity, smoking, and alcohol. Population-based preventive strategies focus on fiscal measures (e.g. taxation), national and regional policies (e.g. smoke-free legislation), and environmental changes (e.g. availability of alcohol).

Results: Food is a complex area, but several strategies can be effective in increasing fruit and vegetables and lowering intake of salt, saturated fat, trans-fats, and free sugars. Tobacco and alcohol can be regulated mainly by fiscal measures and national policies, but local availability also plays a role. Changes in national policies and the built environment will integrate physical activity into daily life.

Conclusion: Societal changes and commercial influences have led to the present unhealthy environment, in which default option in life style increases CVD risk. A challenge for both central and local authorities is, therefore, to ensure healthier defaults. This position paper summarizes the evidence and recommends a number of structural strategies at international, national, and regional levels that in combination can substantially reduce CVD.