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Food Policies and Diet
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Food Policies and Diet

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 91209

Special Issue Editor

Dr. Sara E. Benjamin-Neelon

E-Mail Website
Guest Editor
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Interests: policy and environmental approaches to promoting healthy eating in young children and their families; evaluation of natural experiments to create healthier food environments; early-life feeding; food insecurity and health

Special Issue Information

Dear Colleagues,

Policy-based approaches to promote healthy eating and improve dietary intake are becoming more common in a number of countries, populations, and settings. For this Special Issue, we seek papers examining food policies and dietary behaviors from the perspective of preventing chronic diseases across the lifespan.

We will interpret food policies and dietary behaviors broadly. These may include foods and beverages (including alcohol), specific aspects or areas of diet, nutrients, packaging and labels, food systems, food equity, food environments, supplemental foods, emergency foods, feeding programs, and food fortification, among others. Policies may include laws, regulations, statutes, rules, and even formally adopted guidelines. Policies may be implemented at the federal, state, local, or organizational level.

We welcome original research that fits broadly into the food policy and dietary behavior area. We will give preference to papers that describe prospective evaluations of new policies. However, we welcome papers presenting data from all study designs, including post-policy-only evaluations, cross-sectional studies, modeling studies, or descriptive studies. We also welcome review articles and letters to the editor.

Dr. Sara E. Benjamin-Neelon
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.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 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.

Keywords

  • Diet
  • Evaluation
  • Healthy eating
  • Food
  • Law
  • Natural experiment
  • Nutrition
  • Policy
  • Regulation
  • Food systems

Published Papers (18 papers)

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Research

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13 pages, 266 KiB  
Article
Food Bank Donations in the United States: A Landscape Review of Federal Policies
by Katelin M. Hudak, Emily Friedman, Joelle Johnson and Sara E. Benjamin-Neelon
Nutrients 2020, 12(12), 3764; https://doi.org/10.3390/nu12123764 - 08 Dec 2020
Cited by 9 | Viewed by 5143
Abstract
Rates of food insecurity have increased substantially in the United States (US), and more families are turning to the charitable food system to help meet their needs. Prior studies have examined the nutritional quality of foods offered through food banks, but little is [...] Read more.
Rates of food insecurity have increased substantially in the United States (US), and more families are turning to the charitable food system to help meet their needs. Prior studies have examined the nutritional quality of foods offered through food banks, but little is known about what government policies may shape the healthy food donation landscape. The purpose of this study was to review US federal policies that impact food and beverage donations to food banks and assess whether policies encourage healthy food donations. In spring 2020, two researchers independently reviewed federal food and beverage donation policies using predefined search terms in two legal databases. We identified six categories of policies based on the existing food donation literature and themes that emerged in the policy review. We identified 42 federal policies spanning six categories that addressed food and beverage donations to food banks. The largest category was “government programs,” with 19 (45%) policies. The next largest category was “donation via schools,” with 12 (29%) policies. However, no policies specifically addressed the nutritional quality of food donations. There is an opportunity for the federal government to strengthen food bank donation policies and improve the nutritional quality of donated foods and beverages. Full article
(This article belongs to the Special Issue Food Policies and Diet)
22 pages, 1121 KiB  
Article
Food Sources and Dietary Quality in Small Island Developing States: Development of Methods and Policy Relevant Novel Survey Data from the Pacific and Caribbean
by Emily Haynes, Divya Bhagtani, Viliamu Iese, Catherine R. Brown, Jioje Fesaitu, Ian Hambleton, Neela Badrie, Florian Kroll, Cornelia Guell, Anna Brugulat-Panes, Arlette Saint Ville, Sara E. Benjamin-Neelon, Louise Foley, Thelma Alafia Samuels, Morgan Wairiu, Nita G. Forouhi, Nigel Unwin and on behalf of the Community Food and Health (CFaH) Team
Nutrients 2020, 12(11), 3350; https://doi.org/10.3390/nu12113350 - 30 Oct 2020
Cited by 18 | Viewed by 5121
Abstract
Small Island Developing States (SIDS) have high and increasing rates of diet-related diseases. This situation is associated with a loss of food sovereignty and an increasing reliance on nutritionally poor food imports. A policy goal, therefore, is to improve local diets through improved [...] Read more.
Small Island Developing States (SIDS) have high and increasing rates of diet-related diseases. This situation is associated with a loss of food sovereignty and an increasing reliance on nutritionally poor food imports. A policy goal, therefore, is to improve local diets through improved local production of nutritious foods. Our aim in this study was to develop methods and collect preliminary data on the relationships between where people source their food, their socio-demographic characteristics and dietary quality in Fiji and Saint Vincent and the Grenadines (SVG) in order to inform further work towards this policy goal. We developed a toolkit of methods to collect individual-level data, including measures of dietary intake, food sources, socio-demographic and health indicators. Individuals aged ≥15 years were eligible to participate. From purposively sampled urban and rural areas, we recruited 186 individuals from 95 households in Fiji, and 147 individuals from 86 households in SVG. Descriptive statistics and multiple linear regression were used to investigate associations. The mean dietary diversity score, out of 10, was 3.7 (SD1.4) in Fiji and 3.8 (SD1.5) in SVG. In both settings, purchasing was the most common way of sourcing food. However, 68% (Fiji) and 45% (SVG) of participants regularly (>weekly) consumed their own produce, and 5% (Fiji) and 33% (SVG) regularly consumed borrowed/exchanged/bartered food. In regression models, independent positive associations with dietary diversity (DD) were: borrowing/exchanging/bartering food (β = 0.73 (0.21, 1.25)); age (0.01 (0.00, 0.03)); and greater than primary education (0.44 (0.06, 0.82)). DD was negatively associated with small shop purchasing (−0.52 (95% CIs −0.91, −0.12)) and rural residence (−0.46 (−0.92, 0.00)). The findings highlight associations between dietary diversity and food sources and indicate avenues for further research to inform policy actions aimed at improving local food production and diet. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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18 pages, 347 KiB  
Article
Understanding Vietnamese Urban Consumers’ Nutrition Label Use, Health Concerns, and Consumption of Food and Beverages with Added Sugars
by Duc Nguyen-Anh, Wendy J. Umberger and Di Zeng
Nutrients 2020, 12(11), 3335; https://doi.org/10.3390/nu12113335 - 29 Oct 2020
Cited by 6 | Viewed by 4941
Abstract
Vietnam is experiencing a diet and nutrition transition. Increasing consumption of food and beverages with added sugars is a significant public health concern. Policies and interventions, such as mandatory nutrition labelling, are being considered to improve consumers’ awareness and understanding of diet and [...] Read more.
Vietnam is experiencing a diet and nutrition transition. Increasing consumption of food and beverages with added sugars is a significant public health concern. Policies and interventions, such as mandatory nutrition labelling, are being considered to improve consumers’ awareness and understanding of diet and health implications of added sugars in food and beverages. The effectiveness of various policy approaches relies on an improved understanding of the interrelationships between urban Vietnamese consumers’ health concerns, nutrition label use, and intake of sugars. We empirically disentangle these relationships for urban Vietnamese households using novel intra-household data covering 4047 adults and 737 adolescents from 1590 households in Hanoi and Ho Chi Minh City. The data are from comprehensive household surveys and 24-hour food diaries. Simultaneous equation regression models are estimated using three-stage least squares (3SLS) to account for possible endogeneity. Nutrition label use is significantly associated with a lower share of calories from foods and beverages with added sugars. These findings suggest that nutrition labelling programs may be an effective policy mechanism to reduce the negative health implications of increasing availability and consumption of food and beverages with added sugars in urban Vietnam. Full article
(This article belongs to the Special Issue Food Policies and Diet)
16 pages, 938 KiB  
Article
How Is Functional Food Advertising Understood? An Approximation in University Students
by Cristina González-Díaz, Maria J. Vilaplana-Aparicio and Mar Iglesias-García
Nutrients 2020, 12(11), 3312; https://doi.org/10.3390/nu12113312 - 29 Oct 2020
Cited by 8 | Viewed by 3302
Abstract
In functional food advertising, messages are not always easily understandable for the target audience. Current European legislation, enforced through Regulation 1924/2006, specifies that such messages should be clear and precise so as not to mislead the consumer. The objective of this study was [...] Read more.
In functional food advertising, messages are not always easily understandable for the target audience. Current European legislation, enforced through Regulation 1924/2006, specifies that such messages should be clear and precise so as not to mislead the consumer. The objective of this study was to observe consumers’ understanding of messages in functional food advertisements. The methodology used was a self-administered survey filled out by 191 students enrolled in a Degree in Advertising and Public Relations at the University of Alicante (Spain). The results suggest that a large number of students do not know what functional food is and obtain information about these products mainly from labelling/packaging. The major means of communication through which they learn about health benefits via advertising is the internet, followed by television. Most respondents indicated that they understood related advertisements and found it helpful to be given additional information on health benefits. Worthy of note, the greater their level of understanding of the messages, the higher their level of distrust of advertising messages, which they considered to be deceptive or misleading. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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12 pages, 267 KiB  
Article
Changes in Population-Level Consumption of Taxed and Non-Taxed Sugar-Sweetened Beverages (SSB) after Implementation of SSB Excise Tax in Thailand: A Prospective Cohort Study
by Sirinya Phulkerd, Natjera Thongcharoenchupong, Aphichat Chamratrithirong, Rossarin Soottipong Gray and Piyada Prasertsom
Nutrients 2020, 12(11), 3294; https://doi.org/10.3390/nu12113294 - 27 Oct 2020
Cited by 17 | Viewed by 4702
Abstract
Background: Thailand has implemented a sugar-sweetened beverage (SSB) excise tax since September 2017, but questions remain about changes in individual-level SSB consumption after tax implementation. This study aimed to analyze the change in taxed and non-taxed SSB consumption in the Thai population. Method: [...] Read more.
Background: Thailand has implemented a sugar-sweetened beverage (SSB) excise tax since September 2017, but questions remain about changes in individual-level SSB consumption after tax implementation. This study aimed to analyze the change in taxed and non-taxed SSB consumption in the Thai population. Method: This cohort study was carried out in 2018 and 2019. A total of 5594 persons who participated in both years were included in the analysis. Descriptive and t-test analyses were carried out in order to identify the significance of the difference between taxed and non-taxed SSB consumption in 2018 and 2019. Results: A lower mean ratio of average taxed SSBs consumed to average non-taxed SSBs consumed was found to be statistically significant (p = 0.001). That is, the decline in taxed SSB consumption is significantly greater than that of the non-taxed consumption. The greater reduction in taxed SSB consumption than the non-taxed SSB consumption was found to be significant among males, older persons, the lower-income population, and the unemployed. Conclusions: Overall, the current SSB tax has the capacity to successfully discourage consumption of SSBs with high sugar level. The decline in SSB consumption is, however, not found across all socioeconomic groups. Thresholds for SSB-tiered tax structure may have to be reviewed. Full article
(This article belongs to the Special Issue Food Policies and Diet)
14 pages, 1218 KiB  
Article
Consumption of Foods Derived from Subsidized Crops Remains Associated with Cardiometabolic Risk: An Update on the Evidence Using the National Health and Nutrition Examination Survey 2009–2014
by Whitney L. Do, Kai M. Bullard, Aryeh D. Stein, Mohammed K. Ali, K. M. Venkat Narayan and Karen R. Siegel
Nutrients 2020, 12(11), 3244; https://doi.org/10.3390/nu12113244 - 23 Oct 2020
Cited by 7 | Viewed by 3018
Abstract
In this study, we examined the associations between the consumption of foods derived from crops subsidized under the 2008 United States (US) Farm Bill and cardiometabolic risk factors and whether the magnitude of these associations has changed since the 2002 US Farm Bill. [...] Read more.
In this study, we examined the associations between the consumption of foods derived from crops subsidized under the 2008 United States (US) Farm Bill and cardiometabolic risk factors and whether the magnitude of these associations has changed since the 2002 US Farm Bill. Four federal databases were used to estimate daily consumption of the top seven subsidized commodities (corn, soybeans, wheat, rice, sorghum, dairy, and livestock) and to calculate a subsidy score (0–1 scale) for Americans’ daily dietary intake during 2009–2014, with a higher score indicative of a higher proportion of the diet derived from subsidized commodities. The cardiometabolic risk factors included obesity, abdominal adiposity, hypertension, dyslipidemia, and dysglycemia. Linear and logistic regression models were adjusted for age, sex, race/ethnicity, the poverty–income ratio, the smoking status, educational attainment, physical activity, and daily calorie intake. During 2009–2014, adults with the highest subsidy score had higher probabilities of obesity, abdominal adiposity, and dysglycemia compared to the lowest subsidy score. After the 2002 Farm Bill (measured using data from 2001–2006), the subsidy score decreased from 56% to 50% and associations between consuming a highly-subsidized diet and dysglycemia did not change (p = 0.54), whereas associations with obesity (p = 0.004) and abdominal adiposity (p = 0.002) significantly attenuated by more than half. The proportion of calories derived from subsidized food commodities continues to be associated with adverse cardiometabolic risk factors, though the relationship with obesity and abdominal adiposity has weakened in recent years. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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18 pages, 1145 KiB  
Article
Elderly Perception of Distance to the Grocery Store as a Reason for Feeling Food Insecurity—Can Food Policy Limit This?
by Robert Gajda and Marzena Jeżewska-Zychowicz
Nutrients 2020, 12(10), 3191; https://doi.org/10.3390/nu12103191 - 19 Oct 2020
Cited by 13 | Viewed by 3001
Abstract
The sense of food insecurity in a group of elderly people may be determined by the perception of distance to food outlets. The aim of the study was to assess the relationship between the perception of food insecurity by the elderly and their [...] Read more.
The sense of food insecurity in a group of elderly people may be determined by the perception of distance to food outlets. The aim of the study was to assess the relationship between the perception of food insecurity by the elderly and their perception of the distance between the places of residence and food purchase. A cross-sectional quantitative survey was carried out in 2019–2020 amongst 762 Polish elderly living in Świętokrzyskie and Śląskie Voivodeship. The assessment of the relationships between the perceived food insecurity due to living too far away from the grocery shops and socio-demographic features was performed using multiple correspondence analysis (MCA), chi-square tests, and Phi and Cramér’s V coefficients. Too great a distance to the place of food purchase was the cause of a lack of a sense of food security in 20.5% of the study sample, especially in men, people aged 75 and more, people living in a rural environment and people living alone. People reporting a lack of food due to the distance to the place of purchase showed socio-demographic characteristics similar to those of people declaring a lack of a sense of food security. Reduced food consumption due to the distance from the place of sale, including of fish (24.8%), some fruits (18.9%) and vegetables (15.4%) and beef (17.3%), may contribute to the deterioration of the diet and, as a result, health conditions. Including access to places of the sale of food in food policy as a factor contributing to ensuring the food security of older people can help to maintain a better quality of life and avoid exclusion. Especially in a situation of limited independence, food insecurity in elders due to causes other than financial limitations should be a focus of food policy. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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10 pages, 879 KiB  
Article
Preschool Healthy Food Policy Did Not Increase Percent of Food Wasted: Evidence from the Carolinas
by Roni A. Neff, Daniel A. Zaltz, Amelie A. Hecht, Russell R. Pate, Brian Neelon, Jennifer R. O’Neill and Sara E. Benjamin-Neelon
Nutrients 2020, 12(10), 3024; https://doi.org/10.3390/nu12103024 - 02 Oct 2020
Cited by 4 | Viewed by 2880
Abstract
This research evaluates the effects of a South Carolina (SC) policy, which changed the nutrition standards for foods served in early care and education (ECE) settings, on wasted food. A two-group pre-test/post-test evaluation was performed in ECE centers serving children age 3–5 from [...] Read more.
This research evaluates the effects of a South Carolina (SC) policy, which changed the nutrition standards for foods served in early care and education (ECE) settings, on wasted food. A two-group pre-test/post-test evaluation was performed in ECE centers serving children age 3–5 from households with lower incomes in SC (n = 102 children from 34 centers, intervention) and North Carolina (NC; n = 99 children from 30 centers, comparison). Direct observation was performed to assess the quantity and kcal of food served and quantity and percent of food discarded, by food group and nutrient, enabling assessment of waste in the absence of intervention. Mixed-effects linear models were fit to estimate, by state, differences in change from baseline to post-implementation at the center level. Covariates were selected a priori, including center enrollment, racial composition, director educational attainment, years in operation, for-profit status, and Child and Adult Care Food Program (CACFP) participation. Waste of food was high across states and time points. The policy was not associated with a change in percent of food discarded in SC compared to NC in adjusted analyses. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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12 pages, 292 KiB  
Article
What Dimensions of Risk Perception are Associated with Avoidance of Buying Processed Foods with Warning Labels?
by Cristian Adasme-Berríos, Luis Aliaga-Ortega, Berta Schnettler, Mercedes Sánchez, Consuelo Pinochet and Germán Lobos
Nutrients 2020, 12(10), 2987; https://doi.org/10.3390/nu12102987 - 29 Sep 2020
Cited by 5 | Viewed by 3461
Abstract
Nutritional Warning Labels (NWLs) inform consumers about processed foods that exceed critical nutrient levels activating the risk perception in consumers. However, this information is limited. The objective was to identify the dimensions of risk perception and to study their associations with avoidance of [...] Read more.
Nutritional Warning Labels (NWLs) inform consumers about processed foods that exceed critical nutrient levels activating the risk perception in consumers. However, this information is limited. The objective was to identify the dimensions of risk perception and to study their associations with avoidance of buying processed foods with warning labels. A survey was applied to 807 decision-makers who choose what to eat at home. The four dimensions of risk perception (performance, financial, physical, and psychological) were identified through exploratory factor analysis. Through a multiple regression model, we determined the dimensions of risk perception and sociodemographic variables that affect the intention to avoid buying processed foods with NWLs. The results show that the performance risk, physical risk, and psychological risk positively affect the intention of avoiding processed foods with NWLs. In addition, the female gender considers NWLs to purchase foods. Nevertheless, the high frequency of consumption and belonging to a lower-income socioeconomic group are barriers to the use of NWLs. In conclusion, NWLs help people to choose processed food that does not impact negatively their food expectations, as well as their mental and physical health. However, health authorities must invest in nutrition education. Specifically, in groups who pay less attention to NWLs. Such groups include people with high daily consumption of processed foods, males, and low-income socioeconomic groups. Full article
(This article belongs to the Special Issue Food Policies and Diet)
17 pages, 600 KiB  
Article
Changes in Child and Adult Care Food Program (CACFP) Practices at Participating Childcare and Education Centers in the United States Following Updated National Standards, 2017–2019
by Jamie F. Chriqui, Julien Leider, Rebecca M. Schermbeck, Anmol Sanghera and Oksana Pugach
Nutrients 2020, 12(9), 2818; https://doi.org/10.3390/nu12092818 - 15 Sep 2020
Cited by 20 | Viewed by 2744
Abstract
The U.S. Department of Agriculture’s (USDA) Child and Adult Care Food Program (CACFP) updated meal pattern standards took effect in October 2017. The aim of this quasi-experimental, pre-post study is to identify changes in food and beverage practices of CACFP-participating centers due to [...] Read more.
The U.S. Department of Agriculture’s (USDA) Child and Adult Care Food Program (CACFP) updated meal pattern standards took effect in October 2017. The aim of this quasi-experimental, pre-post study is to identify changes in food and beverage practices of CACFP-participating centers due to implementation of updated CACFP meal patterns over a 21-month period. Eight hundred and fifty-eight centers located in 47 states and the District of Columbia completed a survey (primarily electronic) at both time points (67.6% follow-up response rate). Multivariable logistic regressions with robust standard errors assessed changes over time, accounting for repeated observations within each site. From baseline to follow-up, centers reported the increased familiarity and implementation, albeit with time, money, and staffing-related challenges. Significant improvements were seen in not serving sugary cereals or flavored milk, in serving 100% whole grains, and serving processed meats less than once a week. While CACFP-participating centers reported making significant progress in meeting the updated meal pattern standards and suggested best practices within 15–19 months of their effective date, reported compliance and adherence to the standards and best practices was not universal. USDA, state agencies, and technical assistance providers should work to provide centers with additional guidance to help them with implementation. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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11 pages, 543 KiB  
Article
Changes in Foods Served and Meal Costs in Boston Family Child Care Homes after One Year of Implementing the New Child and Adult Care Food Program Nutrition Standards
by Mary Kathryn Poole, Angie L. Cradock and Erica L. Kenney
Nutrients 2020, 12(9), 2817; https://doi.org/10.3390/nu12092817 - 15 Sep 2020
Cited by 7 | Viewed by 2233
Abstract
This study aimed to determine the impact of 2017 revisions to the Child and Adult Care Food Program (CACFP) nutrition standards on foods and beverages served and meal costs in family child care homes (FCCHs). Our pre–post study utilized four weeks of menus [...] Read more.
This study aimed to determine the impact of 2017 revisions to the Child and Adult Care Food Program (CACFP) nutrition standards on foods and beverages served and meal costs in family child care homes (FCCHs). Our pre–post study utilized four weeks of menus and food receipts from 13 FCCH providers in Boston, MA prior to CACFP nutrition standards changes in 2017 and again one year later, resulting in n = 476 menu observation days. We compared daily servings of food and beverage items to the updated standards. Generalized estimating equation models tested for changes in adherence to the standards and meal costs. FCCHs offered more whole grains and less juice and refined grains from baseline to follow-up. FCCHs were more likely to meet the revised whole grain standard at follow-up (OR = 2.7, 95% CI: 1.4, 5.2, p = 0.002), but rarely met all selected standards together. Inflation-adjusted meal costs increased for lunch (+$0.27, p = 0.001) and afternoon snack (+$0.25, p = 0.048). FCCH providers may need assistance with meeting CACFP standards while ensuring that meal costs do not exceed reimbursement rates. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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24 pages, 3269 KiB  
Article
Towards Win–Win Policies for Healthy and Sustainable Diets in Switzerland
by Alexi Ernstoff, Katerina S. Stylianou, Marlyne Sahakian, Laurence Godin, Arnaud Dauriat, Sebastien Humbert, Suren Erkman and Olivier Jolliet
Nutrients 2020, 12(9), 2745; https://doi.org/10.3390/nu12092745 - 09 Sep 2020
Cited by 13 | Viewed by 12109
Abstract
The first Swiss national dietary survey (MenuCH) was used to screen disease burdens and greenhouse gas emissions (GHG) of Swiss diets (vegan, vegetarian, gluten-free, slimming), with a focus on gender and education level. The Health Nutritional Index (HENI), a novel disease burden-based nutritional [...] Read more.
The first Swiss national dietary survey (MenuCH) was used to screen disease burdens and greenhouse gas emissions (GHG) of Swiss diets (vegan, vegetarian, gluten-free, slimming), with a focus on gender and education level. The Health Nutritional Index (HENI), a novel disease burden-based nutritional index built on the Global Burden of Disease studies, was used to indicate healthiness using comparable, relative disease burden scores. Low whole grain consumption and high processed meat consumption are priority risk factors. Non-processed red meat and dairy make a nearly negligible contribution to disease burden scores, yet are key drivers of diet-related GHGs. Swiss diets, including vegetarian, ranged between 1.1–2.6 tons of CO2e/person/year, above the Swiss federal recommendation 0.6 ton CO2e/person/year for all consumption categories. This suggests that only changing food consumption practices will not suffice towards achieving carbon reduction targets: Systemic changes to food provisioning processes are also necessary. Finally, men with higher education had the highest dietary GHG emissions per gram of food, and the highest disease burden scores. Win–win policies to improve health and sustainability of Swiss diets would increase whole grain consumption for all, and decrease alcohol and processed meat consumption especially for men of higher education levels. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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11 pages, 584 KiB  
Article
Addressing Challenges with the Categorization of Foods Processed at Home: A Pilot Methodology to Inform Consumer-Facing Guidance
by Rachel Bleiweiss-Sande, Caitlin P. Bailey, Jennifer Sacheck and Jeanne P. Goldberg
Nutrients 2020, 12(8), 2373; https://doi.org/10.3390/nu12082373 - 08 Aug 2020
Cited by 5 | Viewed by 3352
Abstract
The objective of this study was to inform consumer-facing dietary guidance by (1) adapting the current University of North Carolina at Chapel Hill (UNC) food processing framework to include a home processing (HP) component and (2) pilot testing the adapted version using a [...] Read more.
The objective of this study was to inform consumer-facing dietary guidance by (1) adapting the current University of North Carolina at Chapel Hill (UNC) food processing framework to include a home processing (HP) component and (2) pilot testing the adapted version using a nationally representative sample of foods consumed in the U.S. The UNC framework was adapted to include guidelines for categorizing home-prepared (HP) foods. The original UNC and adapted HP frameworks were used to code dietary recalls from a random sample of National Health and Nutrition Examination Survey (2015–2016 cycle) participants (n = 100; ages 2–80 years). Percent changes between the UNC and HP adapted frameworks for each processing category were calculated using Microsoft Excel, version 16.23. Participants were 56% female, 35% non-Hispanic white (mean age = 31.3 ± 23.8). There were 1,376 foods with 651 unique foods reported. Using the HP compared to the UNC framework, unprocessed/minimally processed foods declined by 11.7% (UNC: 31.0% vs. HP: 27.4%); basic processed foods increased by 116.8% (UNC: 8.2% vs. HP: 17.8%); moderately processed foods increased by 16.3% (UNC: 14.2% vs. HP: 16.6%); and highly processed foods decreased by 17.8% (UNC: 46.5% vs. HP: 38.2%). Home-prepared foods should be considered as distinct from industrially produced foods when coding dietary data by processing category. This has implications for consumer-facing dietary guidance that incorporates processing level as an indicator of diet quality. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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16 pages, 2560 KiB  
Article
Development of Criteria for a Positive Front-of-Package Food Labeling: The Israeli Case
by Michal Gillon-Keren, Vered Kaufman-Shriqui, Rebecca Goldsmith, Carmit Safra, Iris Shai, Gila Fayman, Elliot Berry, Amir Tirosh, Dror Dicker, Oren Froy, Eli Gordon, Anat Chavia Ben-Yosef, Lesley Nitsan, Hava Altman, Moran Blaychfeld-Magnazi and Ronit Endevelt
Nutrients 2020, 12(6), 1875; https://doi.org/10.3390/nu12061875 - 23 Jun 2020
Cited by 22 | Viewed by 7302
Abstract
Efforts to shape the food environment are aimed at reducing diet-related co-morbidities. Front-of-package labeling (FOPL) may support the consumers to make an informed decision at the point of purchase and encourage industry to reformulate food products. The Israeli Ministry of Health (MOH) implemented [...] Read more.
Efforts to shape the food environment are aimed at reducing diet-related co-morbidities. Front-of-package labeling (FOPL) may support the consumers to make an informed decision at the point of purchase and encourage industry to reformulate food products. The Israeli Ministry of Health (MOH) implemented a unique FOPL system, using two colors: A mandatory warning (red) label alongside a voluntary positive (green) label. An independent Scientific Committee, from academia, the healthcare system, and MOH was appointed to determine the core principles for the positive FOPL. The criteria were based on the Mediterranean diet principles, with adjustments to the Israeli dietary habits, focusing on the health advantages of the food and considering its processing level. The food products eligible for positive FOPL are foods in their natural form or with added spices or herbs, or those that underwent minimal processing, with no food additives. Based on population consumption data, 19.8% of food products were eligible for positive FOPL; of them, 54% were fruits and vegetables, 20% dairy, and 14% grains. An evaluation plan is needed to assess the degree of acceptance of the positive FOPL by the industry, retailers, and the public, and its impact on food consumption and on public health. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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21 pages, 280 KiB  
Article
Participants’ Experiences of the 2018–2019 Government Shutdown and Subsequent Supplemental Nutrition Assistance Program (SNAP) Benefit Disruption Can Inform Future Policy
by Wendi Gosliner, Wei-Ting Chen, Cathryn Johnson, Elsa Michelle Esparza, Natalie Price, Ken Hecht and Lorrene Ritchie
Nutrients 2020, 12(6), 1867; https://doi.org/10.3390/nu12061867 - 23 Jun 2020
Cited by 6 | Viewed by 4447
Abstract
The federal government shutdown from 22 December 2018 to 25 January 2019 created an unprecedented disruption in Supplemental Nutrition Assistance Program (SNAP) benefits. We conducted a cross-sectional qualitative study to begin to capture how the disruption affected food security and wellbeing among a [...] Read more.
The federal government shutdown from 22 December 2018 to 25 January 2019 created an unprecedented disruption in Supplemental Nutrition Assistance Program (SNAP) benefits. We conducted a cross-sectional qualitative study to begin to capture how the disruption affected food security and wellbeing among a small sample of California SNAP participants. We collected data from 26 low-income adults in four focus groups in four diverse California counties. We found that participants routinely struggle to secure an adequate and healthy diet in the context of high costs of living, the shutdown and benefit disruption added to participants’ stress and uncertainty and exacerbated food insecurity, and it diminished some participants’ faith in government. Participants reported that, while having additional benefits in January felt like a relief from typical end-of-month deprivation, the subsequent extended gap between benefit distributions and a lack of clarity about future benefits caused cascading effects as participants later had to divert money from other expenses to buy food and faced added uncertainty about future economic stability. Additionally, the shutdown highlighted challenges related to the availability, timing, and tone of communications between participants and SNAP agencies. Participants recommended that SNAP adjust benefit and eligibility levels to better address costs of living, improve customer service, and avoid future disruptions. Full article
(This article belongs to the Special Issue Food Policies and Diet)
13 pages, 314 KiB  
Article
Healthy Eating Policy Improves Children’s Diet Quality in Early Care and Education in South Carolina
by Daniel A. Zaltz, Amelie A. Hecht, Roni A. Neff, Russell R. Pate, Brian Neelon, Jennifer R. O’Neill and Sara E. Benjamin-Neelon
Nutrients 2020, 12(6), 1753; https://doi.org/10.3390/nu12061753 - 11 Jun 2020
Cited by 13 | Viewed by 3303
Abstract
Policies to promote healthy foods in early care and education (ECE) in the United States exist, but few have been prospectively evaluated. In South Carolina, a statewide program serving low-income children in ECE enacted new policies promoting healthy foods. We conducted an evaluation [...] Read more.
Policies to promote healthy foods in early care and education (ECE) in the United States exist, but few have been prospectively evaluated. In South Carolina, a statewide program serving low-income children in ECE enacted new policies promoting healthy foods. We conducted an evaluation to measure changes in dietary intake among children in ECE exposed and not exposed to the new policy. Using direct observation, we assessed dietary intake in 112 children from 34 ECE centers in South Carolina and 90 children from 30 ECE centers in North Carolina (a state with no policy). We calculated Healthy Eating Index-2015 (HEI) scores to measure diet quality consumed before and after the policy was enacted. We fit mixed-effects linear models to estimate differences in HEI scores by state from baseline to post-policy, adjusting for child race, number of children enrolled, director education, center years in operation, participation in the Child and Adult Care Food Program (CACFP), and center profit status. The policy increased HEI scores for whole fruits, total fruits, and lean proteins, but decreased scores for dairy. Thus, the policy was associated with some enhancements in dietary intake, but additional support may help improve other components of diet. Full article
(This article belongs to the Special Issue Food Policies and Diet)
13 pages, 597 KiB  
Article
Nutritional Quality of Food and Beverages Offered in Supermarkets of Lima According to the Peruvian Law of Healthy Eating
by Mayra Meza-Hernández, David Villarreal-Zegarra and Lorena Saavedra-Garcia
Nutrients 2020, 12(5), 1508; https://doi.org/10.3390/nu12051508 - 22 May 2020
Cited by 13 | Viewed by 4996
Abstract
The purpose of this paper was to determine the foods and beverages offered in the city of Lima, Peru, that would be subject to front-of-package warning labels (octagons) according to the thresholds for the two phases (6 and 39 months after the approval) [...] Read more.
The purpose of this paper was to determine the foods and beverages offered in the city of Lima, Peru, that would be subject to front-of-package warning labels (octagons) according to the thresholds for the two phases (6 and 39 months after the approval) for nutrients of concern (sugar, sodium, saturated fat, and trans-fat) included in the Peruvian Law of Healthy Eating. An observational, descriptive cross-sectional study was conducted that evaluated the nutritional composition of processed and ultra-processed foods that are sold in a supermarket chain in Lima. Of all the processed and ultra-processed foods captured, foods that report nutritional information and do not require reconstitution to be consumed were included. A descriptive analysis was carried out by food categories to report the nutrient content and the percentage of foods that would be subject to front-of-package warning labels. Results: A total of 1234 foods were evaluated, according to the initial thresholds that became effective 6 months after the law was implemented; 35.9% of foods had two octagons; 34.8% had one octagon; 15.8% had no octagons; 12% had three octagons; and no products had four octagons. At 39 months, when the final and more restrictive thresholds become effective, 4.8% did not have octagons. The majority of processed and ultra-processed foods that are sold in a Peruvian supermarket chain carry at least one octagon, and more than 10% of them carry octagons for three of the four nutrients of concern. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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Review

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24 pages, 1199 KiB  
Review
Experimental Studies of Front-of-Package Nutrient Warning Labels on Sugar-Sweetened Beverages and Ultra-Processed Foods: A Scoping Review
by Lindsey Smith Taillie, Marissa G. Hall, Barry M. Popkin, Shu Wen Ng and Nandita Murukutla
Nutrients 2020, 12(2), 569; https://doi.org/10.3390/nu12020569 - 22 Feb 2020
Cited by 104 | Viewed by 14208
Abstract
Policies that require front-of-package (FoP) nutrient warnings are becoming increasingly common across the globe as a strategy to discourage excess consumption of sugary drinks and ultra-processed food. However, a better understanding of the pathway through which FoP nutrient warnings work, as well as [...] Read more.
Policies that require front-of-package (FoP) nutrient warnings are becoming increasingly common across the globe as a strategy to discourage excess consumption of sugary drinks and ultra-processed food. However, a better understanding of the pathway through which FoP nutrient warnings work, as well as a review of how outcomes being measured in recent studies map onto this pathway, are needed in order to inform policy on the most effective FoP label design for reducing purchases of ultra-processed foods. This scoping review describes a conceptual model for how FoP nutrient warnings affect consumer behavior, examines which of these outcomes are currently being measured, and summarizes evidence from randomized controlled experiments. Twenty-two studies which experimentally tested nutrient warnings against a control label or other labeling systems were included for full-text review. Our conceptual model includes attention; comprehension, cognitive elaboration, and message acceptance; negative affect and risk perception; behavioral intentions, and behavioral response, along with other elements such as external factors and interpersonal communications. We found that many studies focused on outcomes such as attention, comprehension, and behavioral intentions, but considerable gaps in the evidence remain, particularly for intermediary steps on the pathway to behavioral change, such as negative affect and social interactions. FoP nutrient warnings were visually attended to by consumers, easy to understand, helped consumers identify products high in nutrients of concern, and discouraged them from purchasing these products, although other labeling systems were perceived as containing more information and performed better at helping consumers rank the healthfulness of products. More research is needed to understand whether and how nutrient warnings work in the real world to discourage consumer purchases of sugary drinks and ultra-processed food. Full article
(This article belongs to the Special Issue Food Policies and Diet)
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