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Environmental Influences on Food Behaviour

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2019) | Viewed by 55240

Special Issue Editor


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Guest Editor
Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide SA 5001, Australia
Interests: food behaviour; food environment; social environment; food marketing; individual susceptibility; chronic disease epidemiology

Special Issue Information

Dear Colleagues,

We are organising a Special Issue on the impact of the environment on food behaviour in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph. 

The ubiquitous presence of food cues in our modern environment is believed to contribute to the rising trends in overconsumption and associated obesity observed over the last few decades. This has led to the rapid development of literature aiming to assess how the food or nutrition environment (the places where we purchase or consume food) promote healthy or unhealthy eating. Despite these developments, much remains to be done to better measure our food environments, how they influence specific purchasing and eating patterns across the life course, and who is more likely to be influenced by environmental food cues. From a methodological perspective, more experimental and prospective evidence for these relationships are needed to better inform the development of future interventions and policies.

This Special Issue is open to any subject area related to the impacts of environmental food cue exposure on food behaviour. The listed keywords suggest just a few of the many possibilities.

Dr. Catherine Paquet
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Keywords

  • Neighbourhood
  • Food Environment
  • Nutrition environment
  • Food outlets
  • Dietary behaviour
  • Nutrition
  • Food consumption
  • Foodscape
  • Restaurants
  • Food stores
  • Food cues

Published Papers (12 papers)

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Editorial

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4 pages, 251 KiB  
Editorial
Environmental Influences on Food Behaviour
by Catherine Paquet
Int. J. Environ. Res. Public Health 2019, 16(15), 2763; https://doi.org/10.3390/ijerph16152763 - 02 Aug 2019
Cited by 5 | Viewed by 2342
Abstract
The ubiquitous presence of food cues in our modern environment is believed to contribute to the rising trends in overconsumption and associated obesity observed over the last few decades [...] Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)

Research

Jump to: Editorial, Review, Other

14 pages, 15843 KiB  
Article
Me’akai in Tonga: Exploring the Nature and Context of the Food Tongan Children Eat in Ha’apai Using Wearable Cameras
by Loma Veatupu, Viliami Puloka, Moira Smith, Christina McKerchar and Louise Signal
Int. J. Environ. Res. Public Health 2019, 16(10), 1681; https://doi.org/10.3390/ijerph16101681 - 14 May 2019
Cited by 14 | Viewed by 4946
Abstract
Unhealthy food consumption is a key driver of the global pandemic in non-communicable diseases (NCDs). The Government of Tonga has prioritised NCD prevention due to the very high rates of NCDs in the Kingdom. This research examines the nature and context of the [...] Read more.
Unhealthy food consumption is a key driver of the global pandemic in non-communicable diseases (NCDs). The Government of Tonga has prioritised NCD prevention due to the very high rates of NCDs in the Kingdom. This research examines the nature and context of the me’akai (food) consumed by Tongan children in Ha’apai using wearable cameras. Thirty-six randomly selected 11-year-old children used wearable cameras to record their lives for three days, as part of the wider Kids’Cam Tonga project. Images were analysed to assess the participants’ food consumption according to a new data analysis protocol for Tonga. Core foods were defined as including breads and cereals, fresh fruit, vegetables, meat and alternatives, and staple vegetables. Non-core food types included confectionery, unhealthy snack foods, edible ices, and processed meat. Tongan researchers led the research in partnership with the Government of Tonga. Overall, children were observed to have consumed a mean of 4.5 (95% CI 3.3, 6.7) non-core and 2.3 (95% CI 1.8, 2.9) core foods per 10 h day, excluding mixed meals. Unhealthy snack foods, confectionary, and cookies, cakes, and desserts were the most commonly consumed non-core foods, and fresh fruit was the most frequently consumed core food. Snacking was the most frequent eating episode observed, with children snacking on non-core foods four times a day (95% confidence interval (CI) 2.5 to 6.2) compared to 1.8 (95% CI 1.3 to 2.6) core food snacks per day. Most commonly, children were observed eating at home, at school, and on the road while out walking. The most common sources of food were the home, other children, and the supermarket. On average, children consumed one purchased product per day, almost all (90%) of which were non-core. Children were also observed eating an average of just less than one mixed meal per day. Less than half (45.2%) of all mixed meals observed were traditional foods. This research illustrates the presence, and likely dominance, of energy-dense nutrient-poor (EDNP) foods in the diet of these Tongan children. It highlights a transition from a traditional diet and suggests that these children live in an obesogenic environment, one that promotes obesity as a normal response to an abnormal environment. The findings support efforts by the Government of Tonga for the implementation of a healthy School Food Policy, junk food taxes, and initiatives to ban the importation of EDNP foods. This study has relevance for other Pacific Island nations and all nations concerned with addressing obesity and other diet-related NCDs. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
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19 pages, 1213 KiB  
Article
Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors
by Sarah Gerritsen, Sophia Harré, Boyd Swinburn, David Rees, Ana Renker-Darby, Ann E. Bartos and Wilma E. Waterlander
Int. J. Environ. Res. Public Health 2019, 16(8), 1387; https://doi.org/10.3390/ijerph16081387 - 17 Apr 2019
Cited by 18 | Viewed by 7002
Abstract
Fruit and vegetable (FV) intake is declining in New Zealand, and over half of New Zealand’s children do not meet the recommendation of two serves of fruit and three serves of vegetables daily (with even lower adherence among children in high-deprivation neighbourhoods). The [...] Read more.
Fruit and vegetable (FV) intake is declining in New Zealand, and over half of New Zealand’s children do not meet the recommendation of two serves of fruit and three serves of vegetables daily (with even lower adherence among children in high-deprivation neighbourhoods). The aim of this study was to map the potential causal pathways explaining this decline and possible actions to reverse it. Semi-structured interviews were held in April–May 2018 with 22 national actors from the produce industry, food distribution and retail sector, government, and NGO health organisations. The qualitative systems dynamics method of cognitive mapping was used to explore causal relationships within the food system that result in low FV intake among children. Barriers and solutions identified by participants were analysed using thematic analysis and according to a public health intervention framework. Participants were in agreement with the goal of improving FV intake for health and economic outcomes, and that health promotion strategies had been ineffectual to date due to multiple systemic barriers. Common barriers discussed were poverty, high food prices, low skills/knowledge, unhealthy food environments, climate change, and urbanization. Solutions with the strongest evidence of efficacy identified by the participants were subsidizing FVs and early childhood interventions to improve FV exposure. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
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11 pages, 306 KiB  
Article
Correlates of Discordance between Perceived and Objective Distances to Local Fruit and Vegetable Retailers
by Katherine L. Baldock, Catherine Paquet, Natasha J. Howard, Neil T. Coffee, Anne W. Taylor and Mark Daniel
Int. J. Environ. Res. Public Health 2019, 16(7), 1262; https://doi.org/10.3390/ijerph16071262 - 09 Apr 2019
Cited by 4 | Viewed by 2635
Abstract
Background: Perceptions of neighbourhood attributes such as proximity of food retailers that are discordant with objective measures of the same are associated with poor health behaviours and weight gain. Factors associated with discordant perceptions are likely relevant to planning more effective interventions [...] Read more.
Background: Perceptions of neighbourhood attributes such as proximity of food retailers that are discordant with objective measures of the same are associated with poor health behaviours and weight gain. Factors associated with discordant perceptions are likely relevant to planning more effective interventions to improve health. Purpose: Analysis of cross-sectional relationships between individual and neighbourhood factors and overestimations of walking distances to local fruit/vegetable retailers (FVR). Methods: Perceived walking times, converted to distances, between participant residences and FVR were compared with objectively-assessed road network distances calculated with a Geographic Information System for n = 1305 adults residing in Adelaide, South Australia. Differences between perceived and objective distances were expressed as ‘overestimated’ distances and were analysed relative to perceptions consistent with objective distances. Cross-sectional associations were evaluated between individual socio-demographic, health, and area-level characteristics and overestimated distances to FVR using multilevel logistic regression. Results: Agreement between objective and perceived distances between participants’ residence and the nearest FVR was only fair (weighted kappa = 0.22). Overestimated distances to FVR were positively associated with mental well-being, and were negatively associated with household income, physical functioning, sense of community, and objective distances to greengrocers. Conclusions: Individual characteristics and features of neighbourhoods were related to overestimated distances to FVR. Sense of connectivity and shared identity may shape more accurate understandings of local resource access, and offer a focal point for tailored public health initiatives that bring people together to achieve improved health behaviour. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
12 pages, 382 KiB  
Article
Parental Perceived Travel Time to and Reported Use of Food Retailers in Association with School Children’s Dietary Patterns
by Mariane de Almeida Alves, Maria Gabriela M. Pinho, Elizabeth Nappi Corrêa, Janaina das Neves and Francisco de Assis Guedes de Vasconcelos
Int. J. Environ. Res. Public Health 2019, 16(5), 824; https://doi.org/10.3390/ijerph16050824 - 07 Mar 2019
Cited by 5 | Viewed by 2786
Abstract
Considering the association between the neighborhood food environment and individual eating behaviors, this study aimed to assess the association between parents’ reported use of food facilities by their children, and parental perceived travel time to food facilities, with their children’s dietary patterns. Parents [...] Read more.
Considering the association between the neighborhood food environment and individual eating behaviors, this study aimed to assess the association between parents’ reported use of food facilities by their children, and parental perceived travel time to food facilities, with their children’s dietary patterns. Parents reported the use of supermarkets, full-service and fast-food restaurants, and perceived travel time to these food retailers. To assess school children’s food consumption, a previous day dietary recall was applied. Factor analysis was conducted to identify dietary patterns. To test the association between reported use and perceived travel time to food retailers and school children’s dietary patterns, we performed multilevel linear regression analyses. Parents’ reported use of supermarkets was associated with children’s higher score in the “Morning/Evening Meal” pattern. The use of full-service and fast-food restaurants was associated with children’s higher score in the “Fast Food” pattern. Higher parental perceived travel time to full-service and fast-food restaurants was associated with children’s lower score in the “Fast Food” pattern. Although the use of full-service and fast-food restaurants was associated with a less healthy dietary pattern, the perception of living further away from these food retailers may pose a barrier for the use of these facilities. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
12 pages, 315 KiB  
Article
The Moderating Role of Self-Control and Financial Strain in the Relation between Exposure to the Food Environment and Obesity: The GLOBE Study
by Joreintje D. Mackenbach, Marielle A. Beenackers, J. Mark Noordzij, Joost Oude Groeniger, Jeroen Lakerveld and Frank J. van Lenthe
Int. J. Environ. Res. Public Health 2019, 16(4), 674; https://doi.org/10.3390/ijerph16040674 - 25 Feb 2019
Cited by 18 | Viewed by 4921
Abstract
Low self-control and financial strain may limit individuals’ capacity to resist temptations in the local food environment. We investigated the moderating role of self-control and financial strain in the relation between the food environment and higher body weight. We used data from 2812 [...] Read more.
Low self-control and financial strain may limit individuals’ capacity to resist temptations in the local food environment. We investigated the moderating role of self-control and financial strain in the relation between the food environment and higher body weight. We used data from 2812 Dutch adults who participated in the population-based GLOBE study in 2014. Participants’ home addresses and the location of food retailers in 2013 were mapped using GIS. The density of fast food retailers and the totality of food retailers in Euclidean buffers of 250, 400 and 800 m around the home were linked to body mass index and overweight status. A higher density of fast food outlets (B (95% confidence interval (CI)) = −0.04 (−0.07; −0.01)) and the totality of food outlets (B (95% CI) = −0.01 (−0.01; −0.00)) were associated with a lower body mass index. Stratification showed that associations were strongest for those experiencing low self-control or great financial strain. For example, every additional fast food outlet was associated with a 0.17 point lower BMI in those with great financial strain, while not significantly associated with BMI in those with no financial strain. In conclusion, we did find support for a moderating role of self-control and financial strain, but associations between the food environment and weight status were not in the expected direction. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
13 pages, 344 KiB  
Article
Social Norms Influencing the Local Food Environment as Perceived by Residents and Food Traders: The Heart Healthy Hoods Project
by María Sandín Vázquez, Jesús Rivera, Paloma Conde, Marta Gutiérrez, Julia Díez, Joel Gittelsohn and Manuel Franco
Int. J. Environ. Res. Public Health 2019, 16(3), 502; https://doi.org/10.3390/ijerph16030502 - 11 Feb 2019
Cited by 8 | Viewed by 3844
Abstract
Exploring subjective elements of the food environment remains key to understand why and how residents purchase food. Our aim was to explore and describe the social norms relating to the local food environment and food purchasing behaviors, as perceived by residents and food [...] Read more.
Exploring subjective elements of the food environment remains key to understand why and how residents purchase food. Our aim was to explore and describe the social norms relating to the local food environment and food purchasing behaviors, as perceived by residents and food traders in Madrid, Spain. This qualitative study took place in a middle socioeconomic status neighborhood of Madrid between January 2015 and May 2016. We conducted 35 semi-structured interviews. We used stratified purposive sampling to recruit residents, neighborhood workers (N = 20) and food traders (N = 15) representing different levels of involvement with food purchasing behaviors. We analyzed these data using an interpretative phenomenological analysis approach. Participants highlighted social aspects of the food environment in relation to food purchasing behaviors. First, interpersonal and relational food environment elements were emphasized, including trust and tradition. Participants also identified generational demographic trends in relation to changes in the way residents purchased food: the new pace of life and the lack of time to buy fresh food and to cook at home. All these elements were influenced by the economic crisis. Food environment interventions aiming to improve food purchasing behaviors and residents’ diets should consider intermediate social aspects of the food environment like trust and tradition and the fast pace of life of younger generations. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
14 pages, 5891 KiB  
Article
More than Fast Food: Development of a Story Map to Compare Adolescent Perceptions and Observations of Their Food Environments and Related Food Behaviors
by Kristin A. Riggsbee, Jonathon Riggsbee, Melissa J. Vilaro, Lauren Moret, Marsha Spence, Elizabeth Anderson Steeves, Wenjun Zhou, Melissa D. Olfert, Lisa Franzen-Castle, Tanya Horacek, Elizabeth Hall and Sarah Colby
Int. J. Environ. Res. Public Health 2019, 16(1), 76; https://doi.org/10.3390/ijerph16010076 - 28 Dec 2018
Cited by 9 | Viewed by 4674
Abstract
The purpose of this convergent, multiphase, mixed methods study was to better understand the perceptions of adolescents’ food environments and related food behaviors using grounded visualization and story mapping. Adolescents from one high school (13–16 years) in the southeastern United States were evaluated [...] Read more.
The purpose of this convergent, multiphase, mixed methods study was to better understand the perceptions of adolescents’ food environments and related food behaviors using grounded visualization and story mapping. Adolescents from one high school (13–16 years) in the southeastern United States were evaluated via data from health behavior surveys (n = 75), school environment maps, focus groups (n = 5 groups), and Photovoice (n = 6) from October 2016 to April 2017. Data from each phase were integrated using grounded visualization and new themes were identified (n = 7). A story map using ArcGIS Online was developed from data integration, depicting the newly identified themes. Participants failed to meet national recommendations for fruit and vegetable intake (2.71 cups). Focus group and Photovoice findings indicated the need for convenience food items in all environments. The story map is an online, interactive dissemination of information, with five maps, embedded quotes from focus groups, narrative passages with data interpretation, pictures to highlight themes, and a comparison of the participants’ food environments. Story mapping and qualitative geographic information systems (GIS) approaches may be useful when depicting adolescent food environments and related food behaviors. Further research is needed when evaluating story maps and how individuals can be trained to create their own maps. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
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16 pages, 343 KiB  
Article
Development and Validation of a Simple Convenience Store SHELF Audit
by Tanya M. Horacek, Elif Dede Yildirim, Erin Kelly, Adrienne A. White, Karla P. Shelnutt, Kristin Riggsbee, Melissa D. Olfert, Jesse Stabile Morrell, Anne E. Mathews, Terezie T. Mosby, Tandalayo Kidd, Kendra Kattelmann, Geoffrey Greene, Lisa Franzen-Castle, Sarah Colby, Carol Byrd-Bredbenner and Onikia Brown
Int. J. Environ. Res. Public Health 2018, 15(12), 2676; https://doi.org/10.3390/ijerph15122676 - 28 Nov 2018
Cited by 7 | Viewed by 4429
Abstract
Background This paper describes the development, reliability, and convergent validity of a practical tool—the Convenience Store Supportive Healthy Environment for Life-Promoting Food (SHELF) Audit. Methods Audit items included: a variety of fresh, processed, and frozen fruits and vegetables; low-fat dairy products; healthy staples [...] Read more.
Background This paper describes the development, reliability, and convergent validity of a practical tool—the Convenience Store Supportive Healthy Environment for Life-Promoting Food (SHELF) Audit. Methods Audit items included: a variety of fresh, processed, and frozen fruits and vegetables; low-fat dairy products; healthy staples and frozen meals; healthy food incentive programs; items sold in check-out areas; portion/cup sizes; and pricing. Each audit item was scored using a five-point semantic-differential scale (1 = provides little or no support for healthful foods to 5 = provides high support for healthful foods). Convergent validity was examined by comparing the SHELF audit to Ghirardelli et al. and Laska et al. store audits. Statistical analysis included: Factor analysis, ANOVA, and Spearman correlations. Results SHELF included three factors: a Fruits/Vegetables scale (eight items, α = 0.79; total potential points = 34); a Healthy Foods scale (four items, α = 0.72; total potential points = 16); and a Supports scale (four items, α = 0.685; total potential points = 16). Only 6% of the 124 convenience stores assessed scored in the most healthful range (46–66). The assessed drug stores (n = 15) scored higher than convenience stores (n = 81) on the Healthy Foods and Supports scales but not the Fruits/Vegetables scale. The SHELF sub-scores were highly correlated with other audit tools indicating convergent validity. Conclusion The SHELF convenience store audit is a valid, reliable tool for assessing the degree to which convenience stores support healthfulness regarding Fruits/Vegetables, Healthy Foods, and Supports for choosing healthy. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
15 pages, 647 KiB  
Article
Local Retail Food Environment and Consumption of Fruit and Vegetable among Adults in Hong Kong
by Ting Zhang and Bo Huang
Int. J. Environ. Res. Public Health 2018, 15(10), 2247; https://doi.org/10.3390/ijerph15102247 - 14 Oct 2018
Cited by 29 | Viewed by 5393
Abstract
Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables [...] Read more.
Outside of western countries, the study of the local food environment and evidence for its association with dietary behavior is limited. The aim of this paper was to examine the association between the local retail food environment and consumption of fruit and vegetables (FV) among adults in Hong Kong. Local retail food environment was measured by density of different types of retail food outlets (grocery stores, convenience stores, and fast food restaurants) within a 1000 m Euclidean buffer around individual’s homes using a geographic information system (GIS). The Retail Food Environment Index (RFEI) was calculated based on the relative density of fast-food restaurants and convenience stores to grocery stores. Logistic regressions were performed to examine associations using cross-sectional data of 1977 adults (18 years or older). Overall, people living in an area with the highest RFEI (Q4, >5.76) had significantly greater odds of infrequent FV consumption (<7 days/week) after covariates adjustment (infrequent fruit consumption: OR = 1.36, 95% CI 1.04–1.78; infrequent vegetable consumption: OR = 1.72, 95% CI 1.11–2.68) in comparison to the lowest RFEI (Q1, <2.25). Highest density of fast food restaurants (Q4, >53) was also significantly associated with greater odds of infrequent fruit consumption (<7 days/week) (unadjusted model: OR = 1.34, 95% CI 1.04–1.73), relative to lowest density of fast food restaurants (Q1, <13). No significant association of density of grocery stores or convenience stores was observed with infrequent FV consumption regardless of the covariates included in the model. Our results suggest that the ratio of fast-food restaurants and convenience stores to grocery stores near people’s home is an important environmental factor in meeting fruit and vegetable consumption guidelines. “Food swamps” (areas with an abundance of unhealthy foods) rather than “food deserts” (areas where there is limited access to healthy foods) seems to be more of a problem in Hong Kong’s urban areas. We advanced international literature by providing evidence in a non-western setting. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
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Review

Jump to: Editorial, Research, Other

19 pages, 871 KiB  
Review
Customer Purchase Intentions and Choice in Food Retail Environments: A Scoping Review
by Iana A. Castro, Anuja Majmundar, Christine B. Williams and Barbara Baquero
Int. J. Environ. Res. Public Health 2018, 15(11), 2493; https://doi.org/10.3390/ijerph15112493 - 08 Nov 2018
Cited by 44 | Viewed by 8751
Abstract
Food purchasing and consumption behaviors have implications for nutrition and obesity. Food retail environments, in particular, shape customer food choices and energy intake. The marketing literature offers insights about how public health practitioners can work within food retail environments to encourage healthy food [...] Read more.
Food purchasing and consumption behaviors have implications for nutrition and obesity. Food retail environments, in particular, shape customer food choices and energy intake. The marketing literature offers insights about how public health practitioners can work within food retail environments to encourage healthy food choices. We reviewed experimental studies in the marketing literature to examine factors influencing customer purchase intentions and choice for food products in retail stores. Database searches were conducted in February 2016 for original, empirical articles published in English from 2000–2015 in marketing journals. Each research article included at least one experimental design study conducted in a real or simulated retail environment with purchase intentions or choice of food products as an outcome variable. Backward and forward reference searches were conducted for articles meeting inclusion criteria. Narrative synthesis methods were used to thematically group and summarize the findings of forty-one articles that met inclusion criteria into three categories: shelf display and product factors, pricing and price promotion factors, and in-store and customer decision-making factors. This research contributes to the literature by providing specific and actionable approaches that can increase/decrease customer purchase intentions and choice for food products in retail environments. Translating marketing strategies into public health applications can provide recommendations for future intervention research and policy related to customer food purchasing behavior. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
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Other

8 pages, 287 KiB  
Brief Report
Associations between Community Environmental-Level Factors and Diet Quality in Geographically Isolated Australian Communities
by Thomas P. Wycherley, Jolieke C. van der Pols, Mark Daniel, Natasha J. Howard, Kerin O’Dea and Julie K. Brimblecombe
Int. J. Environ. Res. Public Health 2019, 16(11), 1943; https://doi.org/10.3390/ijerph16111943 - 31 May 2019
Cited by 5 | Viewed by 2886
Abstract
Remote Indigenous Australians experience disproportionately poor cardio-metabolic health, which is largely underpinned by adverse dietary intake related to social determinants. Little evidence exists about the community environmental-level factors that shape diet quality in this geographically isolated population group. This study aimed to explore [...] Read more.
Remote Indigenous Australians experience disproportionately poor cardio-metabolic health, which is largely underpinned by adverse dietary intake related to social determinants. Little evidence exists about the community environmental-level factors that shape diet quality in this geographically isolated population group. This study aimed to explore the modifiable environmental-level factors associated with the features of dietary intake that underpin cardio-metabolic disease risk in this population group. Community-level dietary intake data were estimated from weekly store sales data collected throughout 2012 and linked with concurrent social, built, and physical environmental dimension data for 13 remote Indigenous Australian communities in the Northern Territory. Statistical analyses were performed to investigate associations. At the community level, store sales of discretionary foods were lower in communities with greater distance to a neighbouring store (r = −0.45 (p < 0.05)). Sales of sugar-sweetened beverages were lower in communities with higher levels of household crowding (r = −0.55 (p < 0.05)), higher levels of Indigenous unemployment (r = −0.62 (p = 0.02)), and greater distance to neighbouring stores (r = −0.61 (p = 0.004)). Modifiable environmental-level factors may be associated with adverse diet quality in remote Indigenous Australian communities and further investigations of these factors should be considered when developing policies to improve dietary intake quality in geographically isolated populations. Full article
(This article belongs to the Special Issue Environmental Influences on Food Behaviour)
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