A Fortified Street Food to Prevent Nutritional Deficiencies in Homeless Men in France

Objective: To develop a food policy approach to prevent nutritional deficiencies and malnutrition in homeless men in France.

Study Population and Methods: A dietary survey was conducted among homeless men visiting an emergency shelter in Paris to assess their nutritional status and the quality of food aid provided. The use of a fortified food easy to eat in the street was identified as the best strategy to improve nutrient intake in this population. A fortified street food was therefore designed and its acceptability was tested in eight emergency centers.

Results: The dietary survey showed that there is a high frequency of malnutrition and inadequate intake of vitamins and minerals in homeless men in France although they are receiving food aid. A chocolate-flavored spread, naturally rich in potassium and n-3 fatty acids and fortified with nutritional doses of calcium, zinc, vitamins C, D, E, B₁₂, thiamin, niacin and folic acid was designed. It presents multiple advantages in the context of homeless nutrition: good resistance to bacterial contamination, a suitable viscosity for people with limited chewing capacity and high energy density. The acceptability study showed that approximately two thirds of the homeless men visiting emergency centers in Paris would consume the fortified food often, or daily, if available. Another advantage of this fortified street food is its high quality/price ratio, demonstrated by linear programming analysis in the present study.

Conclusions: Encouraging the use of fortified street foods in food aid programs is a practical and economic way to prevent nutritional deficiencies in homeless individuals.     

Food Marketing Practices of Major Online Grocery Retailers in the United States, 2019-2020

BackgroundFood marketing influences consumers’ preferences for and selection of marketed products. Although a substantial body of research has described food-marketing practices in brick-and-mortar stores, no research has examined food marketing in online grocery retail despite its growing importance as a source of food-at-home purchases.ObjectiveTo develop and apply a coding instrument to describe food marketing and the nutritional quality of marketed products in online grocery stores.DesignQuantitative content analysis and review of product Nutrition Facts labels and ingredients lists to calculate nutrient density and level of processing using the NOVA classification system.Participants/settingFoods and beverages (n = 3,473) marketed in the top revenue-generating online grocery retailers and those participating in the US Department of Agriculture Supplemental Nutrition Assistance Program Online Purchasing Pilot (n = 21) in 2019-2020.Main outcome measuresUse of marketing mix strategies (ie, product, placement, promotion, and pricing) across retailers and nutritional quality of marketed products. Products were considered of poor nutritional quality in the case that they were ultraprocessed (NOVA category 4) and excessive in sodium, saturated fat, free sugars, and/or other sweeteners. Products were also classified into 13 mutually exclusive food groups.Statistical tests performedThe proportion of retailers using each marketing strategy, proportion of products of poor nutritional quality, and proportion of products in each food group were calculated.ResultsRetailers commonly used product recommendations, search result ordering, branded website content, user-generated content, and social media engagement to market products online. Candy, sweets, and snacks made up the largest percentage of marketed products (17.3%), followed by fruit, vegetables, and legumes (16.7%). Most (62%) marketed products were of poor nutritional quality. Staple food categories such as fruits, vegetables, and grains were frequently marketed, particularly through price reductions and product recommendations.ConclusionsOnline grocery retailers use a variety of customizable food marketing strategies on their websites. Although most marketed products are of poor nutritional quality, there is potential for marketing of staple food categories online that is not feasible in a brick-and-mortar store.     

Poor Nutritional Status among Low-Income Older Adults: Examining the Interconnection between Self-Care Capacity,Food Insecurity,and Depression

BackgroundUnderstanding of the mechanisms of how food insecurity and poor physical and mental health status are interrelated with nutritional status among older adults is needed due to their unique health and social needs.ObjectiveTo examine the complex relationships between self-care capacity, depressive symptoms, food insecurity, and nutritional status among low-income older adults.DesignThe cross-sectional study was conducted from February 2017 to May 2017.Participants/settingA total of 372 low-income older adults, 60 years of age and older, living in the state of Alabama participated.Main outcome measuresParticipants completed a validated survey measuring food insecurity (six-item US Food Security Survey Module), self-care capacity (Self-Care Capacity Scale), depressive symptoms (10-item Geriatric Depression Scale), and nutritional status (Mini Nutritional Assessment Short-Form).Statistical analyses performedGeneralized structural equation modeling was used to include the simultaneous equations and multiple mediators in one model. The Akaike Information Criterion, Bayesian Information Criterion, and likelihood ratio tests were conducted to compare the fit of competing model specifications.ResultsLower self-care capacity was associated with greater food insecurity (beta [b]=.11, odds ratio [OR]=1.11, P=0.03) and higher depressive symptoms (b=.08, P=0.005). Poorer self-care capacity and higher depressive symptoms were associated with poorer nutritional status (b=.24, OR=1.27, P<0.001; b=.13, OR=1.43, P=0.001, respectively). Higher food insecurity was associated with increased depressive symptoms (b=.40, P<0.001). Self-care capacity was associated with nutritional status directly and indirectly through depressive symptoms (b=.04, P=0.048). Although food insecurity was not significantly associated with nutritional status, a significant indirect association between food insecurity and nutritional status through depressive symptoms was observed (b=.02, P=0.04).ConclusionsStudy results indicate functionally impaired low-income older adults encounter greater food insecurity. Inability to afford food combined with limited ability to take care of oneself contributes to an increased self-report of depressive symptoms, resulting in less favorable nutritional status.     

The Use of Charitable Food Assistance Among Low-Income Households in the United States

BackgroundAbout 11% of US households are food insecure, and many of those households seek charitable food assistance (CFA). However, little is understood about the nutritional composition of the diets of households receiving CFA, or the relationship between CFA and Supplemental Nutrition Assistance Program (SNAP) usage among low-income households.ObjectiveThe aim of the study was to compare the nutritional quality of foods obtained by CFA clients to those of similar nonclients. Furthermore, the study examined the timing of CFA use relative to the timing of SNAP use among CFA clients during the week.Design/participantsAnalyses were conducted using 2012 US Department of Agriculture National Household Food Acquisition and Purchase Survey (FoodAPS), which collected data for 4826 households’ food acquisitions during a 7-day survey week. Sixty-seven households reported using CFAs during the survey week.Main outcomes measureThe nutritional quality of food was measured by the ratios between food acquisition quantities and the US Department of Agriculture Thrifty Food Plan consumption recommendations. The date of SNAP use was compared with that of CFA use for CFA clients who were also SNAP recipients.Statistical analyses performedPropensity score matching was utilized to construct a matching sample of CFA clients and nonclients. T tests were used to compare the means of variables.ResultsCFA clients were more likely to be food insecure (48% vs 28%, P < .001) and less likely to have access to a car (61.2% vs 84.8%, P < .001) than CFA nonclients. CFAs represent an important source of foods for CFA clients, taking up 28% of their total food at home acquisitions. CFA clients obtained more nonstarchy vegetables than matched nonclients. Furthermore, among the 45% of CFA clients who also participated in SNAP, the majority (52.4%) of them used SNAP benefits within 10 days of SNAP benefits distribution while most (67.9%) of those households used CFAs starting on day 11 or later after SNAP benefits were allocated.ConclusionsCFAs provide a substantial portion of the diets of their clients and, in particular, for foods that constitute components of healthy diets. For the proportion of CFA clients who received SNAP, this study finds evidence that CFA clients relied more on CFAs when their SNAP benefits were likely to run low.     

Healthy Characters? An Investigation of Marketing Practices in Children's Food Advertising

ObjectiveTo determine the nutritional quality of foods advertised with familiar children's characters and health-related messages.DesignChildren's programming aired on the most popular broadcast and cable channels during 2011 was sampled to form a composite weekday and weekend day. All food advertisements (ads) included in this programming were content analyzed.ParticipantsFive hundred seventy-seven food ads.Variables MeasuredFamiliar characters promoting products were either trade or licensed characters. A product's nutritional quality was determined using the United States Department of Health and Human Services' categorizations, based on the frequency foods should be consumed. Health cues were present when a food was claimed to be healthy, physical activity was depicted, or the product was associated with fruit.AnalysisFrequencies and chi square analyses were conducted; P < .05.ResultsNearly three quarters (73%) of food ads targeting children use a familiar character. The majority of these ads (72%) promote foods of low nutritional quality, yet 53% employ a health-related message.Conclusions and ImplicationsFamiliar characters proliferate in food advertising to children, yet marketers do not adhere to recommendations that characters promote strictly healthy foods. Future research is needed to investigate effects and inform policy decisions in this realm.     

Food Acquisition Strategies of Homeless Youth in the Greater Seattle Area: A Cross- Sectional Study

ObjectivesThe aims of this study were to describe how homeless youths access food in the Seattle area, and to describe the nutritional adequacy and quality of food obtained.MethodsThis cross-sectional study was conducted between February 2018 and May 2019. Data collection took place at seven organizations in the greater Seattle area at which homeless youths typically access food. Trained research assistants verbally administered an ∼50-item survey to homeless youths aged 14 to 24 years on their general demographic characteristics, current housing situation, ability to access food, and quantity and quality of foods acquired. Each participant was given $10 at the completion of the survey.ResultsParticipants were 122 homeless youths with an average age of 21.6±1.94 years. During the previous week, 79.3% obtained meals from drop-in centers and 69.8% from a shelter. Most (75.2%) had not utilized a food bank during the previous month. The majority (73.6%) reported having enough food to eat, but not always the kind they wanted, and 75.4% rated the overall nutritional quality of their diet as average or below. Not having enough food or money for food contributed to skipping meals (50.4%), eating less than desired (47.1%), being hungry (45.5%), and losing weight (20.5%).ConclusionsInformation from this study can be used to identify barriers that homeless youths experience in acquiring adequate nutrition; to make suggestions for future research and program development; and to help social service organizations improve the network of nutrition services and the quality of food available to this vulnerable population through policy, community partnership, and public health action.     

The Role of Food Advertising in Adolescents‘ Nutritional Health Socialization

ABSTRACT

Adolescents are heavily exposed to food advertising in their daily lives. Food ads tend to juxtapose unhealthy food products with overly thin models who promote these foods. This paradoxical presentation of food and body raises important questions about adolescents’ perceptions of food ads and the body, as part of the larger realm of nutritional health. The study sheds light on adolescents’ nutritional health socialization by exploring the role of food advertising as it intersects with other socialization agents, namely parents and peers. Adolescent’s perceptions of and reactions to food ads, and the food products and models in these ads, are examined using the media practice model as the theoretical framework. In-depth interviews were conducted with 82 adolescents in middle- and high-school, taking into consideration their development, heightened vulnerability to messages about the body and appearances, and their lived experiences. The study’s findings suggest that adolescents, though skeptical of ads, internalize the mediated thin ideal and expect models in ads to be thin, beautiful, and famous. Parents emerged as positive role models for nutritional health whereas peers are more paradoxical, emphasizing the importance of exercising along with a socially-oriented consumption of junk food. Socialization messages from parents, peers, and the media interact in shaping adolescents’ reactions to food ads. Only minimal gender differences were found in adolescents’ reactions to food ads and their approach to nutritional health. Mostly, female models are expected to meet more stringent standards of thinness and beauty than male models, especially among female adolescents.     

Exploring Vegan Mothers’ Experiences of Making Food Choices for Infants and Young Children

ObjectiveOur study aimed to explore vegan mothers’ experiences and decision-making processes when feeding their children (up to 3 years old).MethodsWe conducted a qualitative photo-elicitation interview study in the United Kingdom. Eight vegan mothers provided 5 photographs of food choices they had made for their children and completed online photo-elicitation interviews to discuss these images. Data were transcribed verbatim and analyzed using reflexive thematic analysis.ResultsFive themes were developed: role modeling eating behavior, shared decision-making, nutritional guidance for vegan parents, fear of judgment for being vegan, and desire for convenience.Conclusions and ImplicationsFindings illustrate the complexity of the decision-making process and highlight the need for targeted resources for vegan parents. There is a need for awareness raising and training for health care professionals and the development of vegan-specific child-feeding resources to facilitate the provision of evidence-based nutritional guidance for vegan parents.     

Food Insecurity,Poor Diet Quality,and Obesity among Food Pantry Participants in Hartford,CT

ObjectiveExamine relationships between food security, diet quality, and body mass index (BMI) among food pantry users.MethodsConvenience sample of 212 food pantry clients in Hartford, CT from June, 2010 to May, 2011. Main outcomes included food security (United States Department of Agriculture module), fruit and vegetable consumption (Block Screener), and BMI (stadiometer and digital medical scale). Chi-square tests, Spearman correlations, and logistic regression models were analyzed.ResultsOver half of the sample (50.5%) had very low food security. Mean BMI was 29.5 kg/m². Age was positively associated with food security (P < .01). Food-secure participants were twice as likely to eat fruit, vegetables, and fiber as food-insecure participants (P = .04). Women were 4 times as likely to be obese as men (P < .01), yet food insecurity was not associated with obesity in this sample.Conclusions and ImplicationsEnsuring the nutritional adequacy of donated food is an important consideration for food donors and pantry staff.     

Hunting-Based Food Donation Programs: Program Characteristics Across the US

ObjectiveHunting-based food donation (HBFD) programs are unique food assistance programs because they provide under-resourced food bank participants with a quality protein source. This study aimed to summarize the characteristics of US HBFD programs and discuss the potential barriers and considerations to use or access these programs.MethodsData were collected via a web search for HBFD programs within all 50 states and the District of Columbia.ResultsMost states were found to have an active program (n = 36), whereas 14 states and the District of Columbia do not have programs. Game donation amounts vary greatly between states, and funding for these programs typically comes from a government agency.Conclusions and ImplicationsHunting-based food donation can positively impact the food security and nutritional status of vulnerable populations. Nutrition professionals can aid in promoting awareness of these programs and provide nutrition education around wild game nutrition, safety, and food preparation.     

Food and Beverage Brands That Market to Children and Adolescents on the Internet: A Content Analysis of Branded Web Sites

ObjectiveTo identify food and beverage brand Web sites featuring designated children's areas, assess marketing techniques present on those industry Web sites, and determine nutritional quality of branded food items marketed to children.DesignSystematic content analysis of food and beverage brand Web sites and nutrient analysis of food and beverages advertised on these Web sites.SettingThe World Wide Web.ParticipantsOne-hundred thirty Internet Web sites of food and beverage brands with top media expenditures based on the America's Top 2000 Brands section of Brandweek magazine's annual “Superbrands” report.Main Outcome MeasuresA standardized content analysis rating form to determine marketing techniques used on the food and beverage brand Web sites. Nutritional analysis of food brands was conducted.ResultsOf 130 Web sites analyzed, 48% featured designated children's areas. These Web sites featured a variety of Internet marketing techniques, including advergaming on 85% of the Web sites and interactive programs on 92% of the Web sites. Branded spokescharacters and tie-ins to other products were featured on the majority of the Web sites, as well. Few food brands (13%) with Web sites that market to children met the nutrition criteria set by the National Alliance for Nutrition and Activity.Conclusions and ImplicationsNearly half of branded Web sites analyzed used designated children's areas to market food and beverages to children, 87% of which were of low nutritional quality. Nutrition professionals should advocate the use of advertising techniques to encourage healthful food choices for children.     

Differences in Food Environment Perceptions and Spatial Attributes of Food Shopping Between Residents of Low and High Food Access Areas

ObjectiveTo explore potential differences in food shopping behaviors and healthy food availability perceptions between residents living in areas with low and high food access.DesignA cross-sectional telephone survey to assess food shopping behaviors and perceptions. Data from an 8-county food environment field census used to define the Centers for Disease Control and Prevention (CDC) healthier food retail tract and US Department of Agriculture Economic Research Service food desert measure.ParticipantsA total of 968 residents in 8 South Carolina counties.Main Outcome MeasuresResidents' food shopping behaviors and healthy food availability perceptions.AnalysisLinear and logistic regression.ResultsCompared with residents in high food access areas, residents in low food access areas traveled farther to their primary food store (US Department of Agriculture Economic Research Service: 8.8 vs 7.1 miles, P = .03; CDC: 9.2 vs 6.1 miles, P < .001), accumulated more total shopping miles per week (CDC: 28.0 vs 15.4 miles; P < .001), and showed differences in perceived healthy food availability (P < .001) and shopping access (P < .001).Conclusions and ImplicationsThese findings lend support to ongoing community and policy interventions aimed at reducing food access disparities.     

Relationship of Hunger and Food Insecurity to Food Availability and Consumption

Objective To describe the relationship of new measures of hunger and food insecurity to household food supplies and individual food and nutrient intake.Design and Setting A questionnaire containing the Radimer/Cornell hunger and food insecurity items and questions on eating patterns and the frequency of fruit and vegetable consumption was administered to subjects during a personal interview in their homes. A 24-hour diet recall and a household food inventory were conducted at the initial interview and at a follow-up visit.Subjects Participants were 193 women drawn from a random sample of 308 women who had completed a previous health census in a rural New York State county. Subjects’ ages ranged from 15 to 40 years. All had children living at home and less than 16 years of education.Statistical analyses Regression analysis was used to test for linear trends across food insecurity groups for the household food inventory scores and for the frequency of consumption of fruits and vegetables, t Tests were used to assess differences between the food secure and food insecure groups for nutrient and food group means. A χ² test for trend was used to examine differences in the distribution of nutrient and fruit and vegetable intake between the food secure and food insecure groups.Results A significant decrease in the frequency of consumption of fruits and vegetables and the amount of food in the household and a significant increase in scores indicative of disordered eating patterns were associated with a worsening of food insecurity status. Potassium and fiber intake and fruit consumption differed significantly between the food secure and food insecure groups. The percentage of respondents consuming less than the Recommended Dietary Allowance for vitamin C and fewer than five fruits and vegetables per day was significantly greater among food insecure respondents than food secure respondents.Applications/conclusions The quantity of food available in households and consumption of fruits and vegetables decreased with increasingly severe problems with food insecurity and hunger. In this rural population, the Radimer/Cornell measures were useful in identifying households experiencing food insecurity and providing information about the nature of the food supply and the dietary intake problems experienced by food insecure households and persons, suggesting that these measures may be useful on community surveys designed to examine food insecurity issues. J Am Diet Assoc. 1996; 96:1019-1024.     

Technological Developments and the Need for Technical Competencies in Food Services

Abstract

The growing scale of institutional and commercial food services requires the application of the industrial cuisine principles. The fundamentals of food service technology (food safety, sensory and nutritional changes, equipment engineering and packaging) underpin food service systems (cook-freeze, cook-chill and others). Food service operators have to minimise the impact of bulk production: the numerous steps in production process, the fundamental weaknesses in food safety design, the practical limitations in HACCP management, the potential unevenness of temperature distribution, and the product deterioration during storage. At present, the 'high tech' options, which can potentially improve a product's nutritional value, including natural preservation hurdles and functional meals, are not used in practice. The paper concludes that the culinary/food service education has to be complemented with the technological 'know how.'     

Food Consumption Patterns of Nigerian Adolescents and Effect on Body Weight

ObjectiveAssociation between nutritional status of adolescents and food consumption pattern.DesignData on number of meals and snacks consumed daily were collected using structured questionnaires. Nutritional status was assessed as weight-for-age body mass index score less than fifth percentile of the National Center for Health Statistics/World Health Organization International Growth Reference.SettingCross-sectional studies of adolescents using multistage random sampling procedure.Participants401 adolescents from 32 secondary schools in Osun State, Nigeria.AnalysisFrequency counts, percentages, and cross-tabulation analysis were used to analyze data, analysis of variance was used to test the differences, as well as chi-square analysis. Level of significance was taken at .05 and .01 levels.Results66.1% of adolescents ate 3 meals daily; this percentage was higher among rural (75.4%) than urban (61.4%) children (P < .001). About 33.0% consumed snacks daily but to a varying degree, which was higher among urban than rural adolescents (P = .002). Prevalence of underweight was 20.1%, more common in rural (22.1%) than urban adolescents (18.7%). Underweight prevalence was highest among those who ate 3 meals and no snacks daily (28.6%) and least among those who ate 3 meals and snacks twice daily (15.9%).ConclusionSnacks are important in food consumption among adolescents; when snacks are consumed in addition to 3 meals, they will improve the nutritional status of adolescents.