Validating the usage of household food acquisition surveys to assess the consumption of ultra-processed foods: Evidence from Brazil

Our ability to research dietary changes over time and their effects on health is limited by challenges in accurately measuring food consumption. In countries where dietary surveys are scarce and rarely nationally representative, household budget surveys may serve as a useful alternative for assessing food consumption. The objective of this study was to evaluate how well household acquisition data reflects the actual intake of ultra-processed foods, using data from the 2008 to 2009 Brazilian Household Budget Survey. The food acquisition module was conducted for all households selected for the survey (n = 55,970) and a subsample corresponding to 25% of the households (n = 13,569) was randomly selected for the individual food intake module, which was conducted for all individuals aged 10 years or older (n = 34,003). Ultra-processed foods were defined as formulations made by the food industry mostly or entirely from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, chips, sugar-sweetened beverages, and ready-to-eat dishes. Our results showed an important agreement between the estimates of ultra-processed food consumption obtained from household acquisition data and individual intake inside-the-home data, particularly for the relative (% of total energy) consumption of these foods. Our study thus indicates that household budget surveys are quite promising for tracking population-level changes in the consumption of ultra-processed foods. The trend toward increased consumption of food away from home in other low- and middle-income countries indicates that future household budget surveys should include the collection of these data.     

Household history,SNAP participation,and food insecurity

Food security in an important public policy issue. In 2015, approximately 1 in 8 U.S. households experienced food insecurity at some point in the year. Low-income families are at higher risk for food insecurity than other families, and these families may also face higher levels of disruption (e.g., moves, loss of income, or individuals entering or leaving the household) than other families. I use data from the Survey of Income and Program Participation to explore the relationship between food insecurity, the household’s history during the previous year, and SNAP participation. The results indicate that a number of aspects of the household’s recent experience including negative income shocks, moves, and both increases and decreases in household size increase the probability of being food insecure while SNAP participation is estimated to reduce the probability of being food insecure.     

First of the month effect: Does it apply across food retail channels?

In this study we use detailed daily scanner data on household food purchases to examine monthly food expenditure patterns across food retail channels. We compare food expenditure patterns in high and low-income households comparing those where Supplementary Nutrition Assistance (SNAP) is received in the first 10 days of the month versus households which receive SNAP over the first 15 days of the month. We find that food expenditure patterns vary systematically across the month within different retail channels by income and SNAP payment schedules. Low-income households in early SNAP distribution areas decrease their grocery and mass/club/superstore expenditures at the end of the calendar month and supplement this decrease with increased food expenditures in convenience stores and food away from home. Households in staggered SNAP payment areas show far fewer systematic patterns given the more distributed payment system.     

Social media as a useful tool in food risk and benefit communication? A strategic orientation approach

Although considerable progress has been made in understanding the determinants of risk perception and in identifying the necessary components of effective food risk and benefit communication, this has not been matched with the development of efficient and appropriate communication tools. Little work has been done examining the implications of the explosion of new media and web technologies, which may offer potential for improving food risk and benefit communication. First, this study examines the views of stakeholders (n = 38) and experts (n = 33) in the food domain on the potential use of these emerging media for food risk/benefit communication. Based on in-depth interviews in six European countries (Belgium, Ireland, Italy, Latvia, Spain and The Netherlands), strengths, weaknesses, opportunities and threats (SWOT) of social media in food risk and benefit communication were identified. Second, a Strategic Orientation Round (SOR) was used to evaluate the relative importance of the SWOT components according to stakeholders (n = 10) and experts (n = 13). Results show that both stakeholders and experts confirm a future role of social media in food risk and benefit communication. Strengths as speed, accessibility and interaction make social media an interesting tool in crisis communication or issue awareness raising. Weaknesses as the lack of a filter, low trust, the risk of information overload and a communication preference for traditional media are acknowledged.     

Impact of metal silos on households’ maize storage,storage losses and food security: An application of a propensity score matching

Maize is the most important food staple in Eastern and Southern Africa, with a highly seasonal production but relatively constant consumption over the year. Farmers have to store maize to bridge seasons, for food security and to protect against price fluctuations. However, the traditional storage methods do not protect grain well, resulting in large postharvest losses. Hermetically sealed metal silos kill storage pests by oxygen deprivation without pesticides. Popular in Central America, they are now being promoted in Africa, but their impact here has not yet been studied. This study used propensity score matching to evaluate the impact of metal silos on duration of maize storage, loss abatement, cost of storage, and household food security. Metal silo adopters (N = 116) were matched with non-adopting farmers from a representative sample of 1340 households covering the major maize-growing zones in Kenya. The major effect of the metal silos was an almost complete elimination of losses due to insect pests, saving farmers an average of 150–200 kg of grain, worth KSh9750 (US$130). Metal silo adopters also spent about KSh340 less on storage insecticides. Adopters were able to store their maize for 1.8–2.4 months longer, and to sell their surplus after five months at good prices, instead of having to sell right after the harvest. The period of inadequate food provision among adopters was reduced by more than one month. We conclude that metal silos are effective in reducing grain losses due to maize-storage insects, and that they have a large impact on the welfare and food security of farm households. The initial cost of metal silos is high (KSh20,000/1.8 ton) and therefore policies to increase access to credit, to reduce the cost of sheet metal, and to promote collective action can improve their uptake by smallholder farmers.     

Food environments in Malta: Associations with store size and area-level deprivation

Food environments are potential targets for interventions to reduce obesity prevalence, particularly in island settings that are typically dependent on food imports. This observational study aimed to characterise the availability, quality and price of foods and beverages in a nationally representative sample of grocery stores in Malta using the Nutrition Environment Measures Survey for Stores (NEMS-S) instrument, and to examine the association between area-level density of different types of food stores and the likelihood of children living in these areas being overweight or obese. Fieldwork was carried out between March and May 2014. There was a strong positive correlation between store size and NEMS-S score (p = <0.001), suggesting that smaller grocery stores generally offered a smaller range of products and fewer healthy food/beverage options than larger supermarkets. Across all stores, median prices of certain ‘healthier’ versions of foods were more expensive than their less healthy alternatives. A significant association between risk of childhood overweight, and density of confectionery stores in children’s locality of residence, was found (OR 1.19; 95% CI: 1.04, 1.37). These baseline findings highlight opportunities to improve the food environment in Malta to support more healthful eating, and may be of particular interest to public health practitioners in island settings.     

Got milk? The impact of Heifer International’s livestock donation programs in Rwanda on nutritional outcomes

International animal donation programs have become an increasingly popular way for people living in developed countries to transfer resources to families living in developing countries. We evaluate the impact of Heifer International’s dairy cow and meat goat donation programs in Rwanda. We find that the program substantially increases dairy and meat consumption among Rwandan households who were given a dairy cow or a meat goat, respectively. We also find marginally statistically significant increases in weight-for-height z-scores and weight-for-age z-scores of about 0.4 standard deviations among children aged 0–5 years in households that were recipients of meat goats, and increases in height-for-age z-scores of about 0.5 standard deviations among children in households that received dairy cows. Our results suggest that increasing livestock ownership in developing countries may significantly increase consumption of nutrient dense animal-source foods and improve nutrition outcomes.     

Lessons learned from the national household food acquisition and purchase survey in the United States

The National Household Food Acquisition and Purchase Survey conducted in 2012 (FoodAPS-1) was an ambitious survey of Americans’ food acquisitions sponsored by the U.S. Department of Agriculture (USDA). The survey was challenging due to its goals of collecting comprehensive acquisition information and including data from extant sources to broaden the survey’s research capabilities. Some challenges were foreseen, and efforts were taken to overcome them through survey design features. Other challenges came as a surprise. This paper shares the experiences of the authors and others at USDA with survey design, survey implementation, and post-survey processing of data to ensure the availability of high-quality data to the research community. Lessons from FoodAPS-1 can inform similar future data collections both in the U.S. and abroad.     

Child dietary quality in rural Nepal: Effectiveness of a community-level development intervention

Nutrition-sensitive agricultural interventions have the potential to improve child dietary quality in rural households, as evidenced by a growing body of work which concurrently measures agricultural and nutrition indicators. Our objective was to investigate whether children in rural farming communities of Nepal participating in a community-level, nutrition-sensitive development intervention had improved dietary quality compared with children living in non-participating matched rural communities. Six rural communities of Nepal where livelihoods were predominantly agricultural were selected to participate in the phased implementation of a community-level development intervention by Heifer International. Households and children in each community were surveyed at baseline, and follow-up surveys were implemented every six months for twenty-four months. Detailed data on food consumption for children older than 6 months of age were collected using a 24 h recall for 17 foods and food groups; parents responded for children. A difference-in-differences model with household fixed-effects and an analysis of covariance model were used to analyze the resulting panel data. Results indicated that the impacts of the intervention varied by agro-ecological region and by season. In the Hills region, which is poorer on average and more conducive to livestock production, children who had received the intervention for two years were 2.2 times as likely to have consumed food from an additional food group, 1.27 times as likely to have achieved minimum dietary diversity and 1.38 times as likely to have consumed animal source foods as children who received the intervention for only one year. In the Terai region, which is more conducive to crop production, there was no significant change in dietary quality attributable to the intervention. These results provide evidence that particularly vulnerable families can take advantage of community-level development activities. Given that the effects of community-level development activities were disparate across communities within the same country, we conclude that tailoring development activities for particular locations is necessary for success.     

European dietary patterns and their associated land use: Variation between and within countries

This paper determines the cropland use associated with the dietary patterns of 16 European countries and investigates sources of variation in land use between and within these countries. The analysis combines food availability data at the household level with country-specific land use data for food items. The household food availability data is obtained from a standardized and post-harmonized databank, developed in the Data Food Networking Project (DAFNE). The results show large differences between the land use of the 16 European countries, ranging from ±1500 m² (Ireland) to ±3000 m² (Malta) to supply an average person’s food demand. Major reasons for this divergence include disparities in total caloric food availability and in national yields. The composition of the diet is only a minor source of variation. Using food consumption data at the household level makes it also possible to look for sources of variation within countries. This paper investigates sources of variation within countries by examining the influence of education of the household head on land use associated with food consumption. The analysis shows that diets of people with only elementary education need on average 20% more land than diets of people with a higher education (2302 m² and 1948 m², respectively). The basis of this difference is the higher caloric availability for people with only an elementary education; the influence of differences in the composition of the diet is negligible. Variation in land use between countries is thus caused by the different agricultural productivities and caloric availabilities, and the major source of variation within countries is the caloric availability. The composition of the diet is only a minor source of variation, both between and within countries. The results implicate that highly educated people have a lower demand for land.     

Farm production diversity is associated with greater household dietary diversity in Malawi: Findings from nationally representative data

Farm production diversity has the potential to influence the diversity of household diets, an important nutrition outcome associated with the nutrient adequacy of diets and the nutritional status of individuals. Yet, little empirical research has assessed the relationship between farm diversity and diet diversity or the plausible causal mechanisms that may operate between these two constructs. This research examines cross-sectional data from the Malawi Third Integrated Household Survey (IHS3), a nationally representative sample of farming households in Malawi, implemented from March 2010–March 2011 as part of the World Bank Living Standards Measurement Study – Integrated Surveys on Agriculture (LSMS-ISA). These data were used to determine the relationship between farm production diversity and household dietary diversity, and to identify determinants of this relationship. Two indicators of dietary diversity, a modified Household Dietary Diversity Score (HDDS), and the Food Consumption Score (FCS), were calculated along with three indicators of farm production diversity including the Simpson’s Index, a metric accounting for both species richness and evenness. In multiple regression analyses, adjusting standard errors for the complex survey design of the IHS3 and controlling for the effects of several covariates on household dietary diversity, farm production diversity was consistently positively associated with dietary diversity (P < 0.0001). The association of increased farm diversity as measured by a combined crop and livestock measure on dietary diversity was significantly greater in woman-headed households compared to those headed by men (HDDS: P = 0.008; FCS: P = 0.076). The positive association of farm diversity with dietary diversity was also greater in wealthier households (P < 0.05). Consumption of legumes, vegetables and fruits was especially strongly associated with greater farm diversity. More diverse production systems may contribute to more diverse household diets. However, this relationship is complex; it may be influenced by gender, wealth, control of household decisions, the relative market-orientation of a household’s agricultural production, and the specific nature of farm diversity.     

The Thrifty Food Plan and low-income households in the United States: What food groups are being neglected?

Food assistance programs in the United States provide low-income households with the resources to purchase a healthy, nutritious, and palatable diet, if they buy the market baskets of food outlined in the Thrifty Food Plan. This study compares the cost of these baskets with actual spending on food at home by low-income households. Simulations reveal at-home food spending by low-income households to represent only 86% of what is needed to follow the Thrifty Food Plan. Married couples with children and female-headed households with children spend only 73% and 82%, respectively, and just 43% and 50% for at-home fruits and vegetables.     

Making personalised nutrition the easy choice: Creating policies to break down the barriers and reap the benefits

Personalised diets based on people’s existing food choices, and/or phenotypic, and/or genetic information hold potential to improve public dietary-related health. The aim of this analysis, therefore, has been to examine the degree to which factors which determine uptake of personalised nutrition vary between EU countries to better target policies to encourage uptake, and optimise the health benefits of personalised nutrition technology. A questionnaire developed from previous qualitative research was used to survey nationally representative samples from 9 EU countries (N = 9381). Perceived barriers to the uptake of personalised nutrition comprised three factors (data protection; the eating context; and, societal acceptance). Trust in sources of information comprised four factors (commerce and media; practitioners; government; family and, friends). Benefits comprised a single factor. Analysis of Variance (ANOVA) was employed to compare differences in responses between the United Kingdom; Ireland; Portugal; Poland; Norway; the Netherlands; Germany; and, Spain. The results indicated that respondents in Greece, Poland, Ireland, Portugal and Spain, rated the benefits of personalised nutrition highest, suggesting a particular readiness in these countries to adopt personalised nutrition interventions. Greek participants were more likely to perceive the social context of eating as a barrier to adoption of personalised nutrition, implying a need for support in negotiating social situations while on a prescribed diet. Those in Spain, Germany, Portugal and Poland scored highest on perceived barriers related to data protection. Government was more trusted than commerce to deliver and provide information on personalised nutrition overall. This was particularly the case in Ireland, Portugal and Greece, indicating an imperative to build trust, particularly in the ability of commercial service providers to deliver personalised dietary regimes effectively in these countries. These findings, obtained from a nationally representative sample of EU citizens, imply that a parallel, integrated, public-private delivery system would capture the needs of most potential consumers.     

Targeting population nutrition through municipal health and food policy: Implications of New York City’s experiences in regulatory obesity prevention

Obesity remains a major public health challenge across OECD countries and policy-makers globally require successful policy precedents. This paper analyzes New York City’s innovative experiences in regulatory approaches to nutrition. We combined a systematic documentary review and key informant interviews (n = 9) with individuals directly involved in nutrition policy development and decision-making. Thematic analysis was guided by Kingdon’s three-streams-model and the International Obesity Task Force’s evidence-based decision-making framework. Our findings indicate that decisive mayoral leadership spearheaded initial agenda-change and built executive capacity to support evidence-driven policy. Policy-makers in the executive branch recognized the dearth of evidence for concrete policy interventions, and made contributing to the evidence base an explicit goal. Their approach preferred decision-making through executive action and rules passed by the Board of Health that successfully banned trans-fats from food outlets, set institutional food standards, introduced menu labeling requirements for chain restaurants, and improved access to healthy foods for disadvantaged populations. Although the Health Department collaborated with the legislature on legal and programmatic food access measures, there was limited engagement with elected representatives and the community on regulatory obesity prevention. Our analysis suggests that this hurt the administration’s ability to successfully communicate the public health messages motivating these contentious proposals; contributing to unexpected opposition from food access and minority advocates, and fueling charges of executive overreach. Overall, NYC presents a case of expert-driven policy change, underpinned by evidence-based environmental approaches. The city’s experience demonstrates that there is scope to redefine municipal responsibilities for public health and that incremental change and contentious public discussion can impact social norms around nutrition.     

Sequestering carbon in soils of agro-ecosystems

Soils of the world’s agroecosystems (croplands, grazing lands, rangelands) are depleted of their soil organic carbon (SOC) pool by 25–75% depending on climate, soil type, and historic management. The magnitude of loss may be 10 to 50 tons C/ha. Soils with severe depletion of their SOC pool have low agronomic yield and low use efficiency of added input. Conversion to a restorative land use and adoption of recommended management practices, can enhance the SOC pool, improve soil quality, increase agronomic productivity, advance global food security, enhance soil resilience to adapt to extreme climatic events, and mitigate climate change by off-setting fossil fuel emissions. The technical potential of carbon (C) sequestration in soils of the agroecosystems is 1.2–3.1 billion tons C/yr. Improvement in soil quality, by increase in the SOC pool of 1 ton C/ha/yr in the root zone, can increase annual food production in developing countries by 24–32 million tons of food grains and 6–10 million tons of roots and tubers. The strategy is to create positive soil C and nutrient budgets through adoption of no-till farming with mulch, use of cover crops, integrated nutrient management including biofertilizers, water conservation, and harvesting, and improving soil structure and tilth.     

Fundamental transformations of trust and its drivers: A multi-stage approach of business-to-business relationships

This research tests a multistage model of trust in business-to-business (B2B) relationships. The model contains three forms of trust, each with unique drivers and consequences for buyer–supplier relationships. An exploratory qualitative study (N = 38) and four quantitative studies (N_Total = 616) validate the distinct stages (N1 = 140, N2 = 144, N3 = 152) and provide an overall test of the model (N4 = 180), using structural equation modeling techniques. The results support the proposed modeling of the stages and highlight a positive effect of reputation on calculative trust. Conflict resolution, communication, and sympathy positively affect cognitive trust. However, shared values do not significantly drive affective trust. Interdependence also exists among the three trust forms, both directly and indirectly. That is, calculative trust does not affect investments in relationship or confidential communication, but cognitive trust influences these constructs indirectly, through the mediation of affective trust. Affective trust also leads directly to greater investments in relationship and generates additional confidential communication.     

Potential impacts of increasing average yields and reducing maize yield variability in Africa

This study evaluates the potential impacts of investing in Drought Tolerant Maize (DTM) in 13 countries of East, South and West Africa. The analysis utilizes geo-referenced production data at the regional and household levels and employs a model that estimates both the conventional mean yield gains and the additional benefits from yield stability gains of DTM varieties as well as impacts on poverty. The results indicate that by 2016, adoption of DTM can generate between US$ 362 million and US$ 590 million in cumulative benefits to both producers and consumers. Yield variance reductions stand to generate considerable benefits, especially in high drought risk areas. These benefits translate into poverty reductions in the range of 0.01–4.29% by 2016. Significant benefits are also found among different types of households living in drought risk areas of Kenya, Ethiopia and Nigeria.     

Integrating climate change,food prices and population health

The inter-related nature of food, health and climate change requires a better understanding of the linkages and a greater alignment of policy across these issues to be able to adequately meet the pressing social and health challenges arising from climate change. Food price is one way through which climate change may affect health. The aim of this study of the global and Australian food systems is to provide a whole-of-system analysis of food price vulnerabilities, highlighting the key pressure points across the food system through which climate change could potentially have the greatest impact on consumer food prices and the implications for population health. We outline areas where there are particular vulnerabilities for food systems and food prices arising from climate change, particularly global commodity prices; agricultural productivity; short term supply shocks; and less direct factors such as input costs and government policies. We use Australia as a high-income country case study to consider these issues in more detail. The complex and dynamic nature of pricing mechanisms makes it difficult to predict precisely how prices will be impacted. Should prices rise disproportionately among healthy foodstuffs compared to less healthy foods there may be adverse health outcomes if less expensive and less healthy foods are substituted. Higher prices will also have equity implications with lower socio-economic groups most impacted given these households currently spend proportionately more of their weekly income on food. The ultimate objective of this research is to identify the pathways through the food system via which climate change may affect food prices and ultimately population health, thereby providing evidence for food policy which takes into account environmental and health considerations.     

Gender differences in the influence of food safety and health concerns on dietary and physical activity habits

The purpose of the study was to examine middle aged Australians’ dietary and physical activity habits and to investigate their relationships with their food safety concerns, body weight, demographics, and personal values (guiding principles in people’s lives). A mail survey was conducted among a random sample of men and women aged between 38 and 79 years; 1095 usable questionnaires were obtained. Multi-group structural equation modelling was used to examine the relationships between the variables among men and women. Findings suggest that food safety concerns played central roles in the relationships between demographics, body weight, personal values and dietary and physical activity habits for both men and women. However, there were significant differences between the genders in the ways the food safety concerns impacted these relationships. For example, body weight was negatively related to women’s physical activity behaviours but not men’s; the concerns were associated with dining out habits among women but not men; age influenced women’s concerns and physical activity but not those of men. Therefore, men and women’s dietary and physical activity habits were impacted directly by personal background characteristics, body weight, and personal values, and indirectly through food safety concerns. The implications of the study are that for food policy makers, a gendered focus on food safety concerns, and other relatively malleable variables such as personal values, may be more likely to change dietary and physical activity habits in the short term than a focus on more stable socio-demographic characteristics.