Objectives
Sustainable nutrition is increasingly important, as the food system contributes one third of greenhouse gas emissions. Sustainable nutrition, or sustainable diet, refers to diets with low ...environmental impacts that contribute to food security and health. This systematic review aimed to identify factors that influence whether professionals in health-related institutions integrate sustainable nutrition into their practice.
Methods
A mixed-methods systematic review was conducted using the MEDLINE, Embase, PsycINFO, and CINAHL databases. To be included, the studies had to document perspectives on sustainable nutrition from health professionals, including dietitians, students and educators in health sciences, public health officers, and hospital food service managers. Data extraction focused on perceived barriers, facilitating factors, and top recommendations for promoting sustainable nutrition.
Synthesis
Twenty studies were included, most of which focused on dietitians. Data analysis revealed that 25 factors influenced the integration of sustainable nutrition into professional practice. The factors most reported in the included studies were perceived knowledge of sustainable nutrition, self-efficacy, awareness of environmental issues, and perceiving the promotion of sustainable nutrition to be part of one’s professional role. Increasing societal support through awareness campaigns and increasing institutional support through guidelines, information tools, and financial support were also frequently mentioned.
Conclusion
Sustainable nutrition is a multifaceted concept; integrating it into already complex professional practices is therefore challenging. At the present time, dietitians seem to be the health professionals predominantly researched regarding their views on sustainable nutrition. Many concrete avenues to promote sustainable nutrition were identified through this review.
Food shopping behaviors may help determine how local food environments influence fruit and vegetable (F/V) intake, especially among food insecure households.
To examine whether household food ...security, food access, and food shopping behaviors are associated with F/V intake among residents of a low-income neighborhood.
Study design is cross-sectional.
A simple random sample of 451 adults from a low-income neighborhood in Montreal (Canada) were recruited through telephone interviews in 2014. Final analyses included 417 participants.
Validated assessment tools were applied to measure F/V intake and to distinguish food secure (FS) from food insecure (FI) participants. Neighborhood food access was calculated according to number of food stores within 0.5 miles of road network buffer of participants’ homes. Self-reported food shopping behaviors included trip frequency, store types, and transport used to reach the 3 most frequented stores. Participants also reported on mobility constraints, use of F/V markets, gardening, and perceived access to healthy food.
F/V intake was modeled using multivariable linear regression.
A sample of adults, of whom 21.3% were living in FI households, reported consuming F/V an average of 4.1 times daily. FI participants had a lower intake of F/V (b = −0.69, P = .04), independent of sociodemographics, food access, resource constraints, perceived access to healthy food, and food shopping behaviors. Participants with mobility constraints had lower F/V intake (b = −0.68, P = .02), while gardening was associated with higher F/V intake (b = 0.59, P = .01). Number of supermarkets (b = −0.06, P = .03) and specialty stores (b = 0.10, P = .04) were associated with F/V intake, although the strength of the association was weak.
For FI households, barriers to food access linked to financial challenges are associated with lower intake of F/V. Studies on food environment should include people’s experience of food access to better understand the numerous barriers to F/V consumption faced by FI households.
Abstract
Background
While considerable research has been conducted on household food insecurity (HFI), little research has examined the effects of food donation programs on users’ living conditions. ...The Pathways study was established to investigate the long-term effects of food donation programs on food insecurity as well as other critical outcomes, such as diet, health, and social support. Herein, we describe the design of the Pathways Study and the participants’ characteristics at baseline.
Methods
The Pathways study is a prospective cohort study of 1001 food-aid users in Quebec (Canada). We recruited newly registered users of food donation programs from 106 community-based food-aid organizations that partnered with the study. Baseline data were collected through face-to-face interviews from September 2018 to January 2020, with planned follow-up interviews at 12 and 24 months after enrollment. Household food insecurity, diet, food competencies, food shopping behaviors, perceived food environment, health status, social support and isolation, sociodemographic characteristics, housing conditions, negative life events, and the impacts of COVID-19 were assessed with validated questionnaires.
Results
The cohort included 1001 participants living in rural (
n
= 181), semi-urban (
n
= 250), and urban areas (
n
= 570). Overall, household food insecurity was reported as severe among 46.2% and moderate in 36.9% of participants. Severe household food insecurity was more prevalent in rural (51.4%) and urban (47.8%) areas compared to semi-urban (39%) areas. Overall, 76.1% of participants reported an annual income below C$20,000. Half (52%) had low education levels (high school or lower), 22.0% lived in single-parent households, and 52.1% lived alone. Most (62.9%) experienced at least one major financial crisis in the preceding year.
Conclusions
Results show that newly registered users of food donation programs often have low-income and severe food insecurity, with major differences across geographical locations. The Pathways study is the first study designed to follow, over a 2-year period, a cohort of newly registered users of food donation programs and to quantify their trajectories of service use. Findings from the Pathways study might help adapt the community response to the strategies used by food-insecure households to feed themselves.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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•Agroecological farmers have more nutritious and balanced diets.•Agroecology may improve nutrient adequacy through higher production diversity.•Agroecology may improve dietary ...moderation through non-market food consumption.•Social and human capital, but not income, may mediate agroecology's diet effects.•Agroecological farmers have healthier diets despite spending less money on food.
Agroecology has received much attention as a sustainable production strategy that may leverage agriculture-nutrition linkages to positively impact farmer nutritional health, but its potential has not been thoroughly established through empirical assessment. This mixed methods study uses survey data from Ecuador to assess how farmers' participation in agroecological associations may impact their diets. Our results suggest that agroecological farmers outperform reference farming neighbors on both nutrient adequacy (i.e. meeting key nutrient needs) and dietary moderation (i.e. avoiding dangerous excesses). Stronger nutrient adequacy is likely related to agroecological farmers' higher production diversity as well as the social and human capital developed within their networks, while stronger dietary moderation is likely related to their greater consumption of foods obtained through own-production and the social economy (e.g. barter). Dietary differences between agroecological and reference farmers occur despite similar incomes and other socioeconomic characteristics, and in fact, agroecological farmers achieve healthier diets while spending less money to purchase foods. Agroecology-based famers' networks may thus hold promise for integrating nutritional health priorities into sustainable food systems.
Alternative food sources (AFS) such as local markets in disadvantaged areas are promising strategies for preventing chronic disease and reducing health inequalities. The present study assessed how ...sociodemographic characteristics, physical access and fruit and vegetable (F&V) consumption are associated with market use in a newly opened F&V market next to a subway station in a disadvantaged neighbourhood.
Two cross-sectional surveys were conducted among adults: (i) on-site, among shoppers who had just bought F&V and (ii) a telephone-based population survey among residents living within 1 km distance from the market.
One neighbourhood in Montreal (Canada) with previously limited F&V offerings.
Respectively, 218 shoppers and 335 residents completed the on-site and telephone-based population surveys.
Among shoppers, 23 % were low-income, 56 % did not consume enough F&V and 54 % did not have access to a car. Among all participants living 1 km from the market (n 472), market usage was associated (OR; 95 % CI) with adequate F&V consumption (1·86; 1·10, 3·16), living closer to the market (for distance: 0·86; 0·76, 0·97), having the market on the commute route (2·77; 1·61, 4·75) and not having access to a car (2·96; 1·67, 5·26).
When implemented in strategic locations such as transport hubs, AFS like F&V markets offer a promising strategy to improve F&V access among populations that may be constrained in their food acquisition practices, including low-income populations and those relying on public transportation.
Agroecology is increasingly recognized as a sustainable production strategy that is appropriate for the rural poor. Meanwhile, agricultural initiatives have received much attention for their role in ...improving farmer nutrition, and three key pathways between agriculture and nutrition include consumption of own production, income and women's empowerment. In this study based in Ecuador's Imbabura province, we used qualitative methods to explore the practices of agroecological farmers with respect to these three key pathways. Results demonstrate the heterogeneity of lived experiences through which agroecology increases agricultural diversity and builds social and human capital to improve nutrition. We further identify barter as an under-explored means to nutrition outcomes, and we discuss the role of the complex rationales that mediate farmers' performance on agriculture-for-nutrition pathways. Finally, our results illustrate agroecology's potential to spread nutrition-promoting practices through endogenous farmers' networks.
Neighbourhood community life has been widely recognized as an important determinant of population health. This systematic review of reviews provides an overview of the evidence for the ecological ...correlation between neighbourhood community life and population health. Nine databases were searched from 2008 to 2018 in order to identify systematic reviews of studies examining the association between neighbourhood community life and population health in urban neighbourhoods within the Organisation for Economic Co-operation and Development countries. Two reviewers completed selection and data extraction, then assessed the methodological quality of reviews using the Measurement Tool to Assess Systematic Reviews. We identified three high quality reviews and five of moderate quality. The reviews vary in quality of methodology, concepts, and measures. Most of the reviews examined the influence of social cohesion, social capital, and social interactions on health. Reviews found evidence supporting a consistently favourable correlation between social cohesion and physical activity, as well as a favourable trend in the relationship between social cohesion and healthy weight. They also found evidence of a favourable trend in the correlation between social capital and healthy weight. Reviews identified studies supporting a consistently favourable correlation between social interaction and depression. We identify evidence of a positive association between neighbourhood community life and several population health outcomes. Future research should define and conceptualize neighbourhood community life factors and health indicators to improve the comparison between studies and the process of evidence synthesis. This will also enable policy makers to take appropriate decisions.
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To characterize 12-month trends in the use of food donations and other food-related community-based social assistance programs (CB-SAPs) during the first year following the enrollment of new food ...bank (FB) users in Quebec, Canada.
A cohort of 1,001 newly registered FB-users in Quebec from the Pathways Study were followed-up during 12-month following baseline assessment. Outcomes were monthly use of food donations and other food-related CB-SAPs. Main predictors were alternative food source utilization (AFSU) profiles: 1) exclusive-FB-users; 2) FB+fruit/vegetable-market-users; and 3) Multiple/diverse-AFS-users. Covariates included sociodemographic characteristics, health status, and major life events. We fit Bayesian hierarchical mixed-effect models, accounting for spatial clustering, temporal correlation, and censoring.
We observed an overall downward trend of food donation use among study completers (
= 745). Each AFSU profile had a distinctive monthly trend of food donation use, but probabilities of use across the three profiles overlapped, between 44% and 55%. The use of other food-related CB-SAPs was low and not correlated with AFSU profiles.
FB-users use food donations in different ways over time according to specific contextual AFSU profiles.
Farmers' market implementation holds promise for increasing access to healthy foods. Although rarely measured, purchase data constitute an intermediate outcome between food environment and actual ...consumption. In a study conducted with two seasonal Fruits and Vegetables (FV) stands in a disadvantaged area of Montréal (Canada), we analysed how accessibility, perception, and mobility-related factors were associated with FV purchase. This analysis uses a novel measure of FV purchasing practices based on sales data obtained from a mobile application. A 2016 survey collected information on markets' physical access, perceived access to FV in the neighbourhood, usual FV consumption and purchases. Multivariate models were used to analyse three purchasing practice indicators: number of FV portions, FV variety and expenditures. Average shoppers purchased 12 FV portions of three distinct varieties and spent 5$. Shoppers stopping at the market on their usual travel route spent less (
= 0.11), bought fewer portions (
= 0.03) and a lesser FV variety (
< 0.01). FV stands may complement FV dietary intake. Individuals for whom the market is on their usual travel route might make more frequent visits and, therefore, smaller purchases. The novel data collection method allowed analysis of multiple purchase variables, is precise and easy to apply at unconventional points of sales and could be transposed elsewhere.
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