scholarly journals Cultural Adaptation and Evaluation of the Perceived Nutrition Environment Measures Survey to the Mediterranean Spanish Context (NEMS-P-MED)

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3257
Author(s):  
Alba Martínez-García ◽  
Eva María Trescastro-López ◽  
María Eugenia Galiana-Sánchez ◽  
Cristóbal Llorens-Ivorra ◽  
Pamela Pereyra-Zamora
Keyword(s):  
Internal Consistency ◽  
Food Environment ◽  
Internal Consistency Reliability ◽  
Food Environments ◽  
Food Stores ◽  
Nutrition Environment ◽  
Policy Interventions ◽  
Measurement Tools ◽  
Effective Policy ◽  
Standardized Measurement

Individuals’ perceptions of their food environments are a mediator between exposure to the environment and people’s interaction with it. The Nutrition Environment Measures Surveys (NEMS) are valid and reliable measures to assess food environments. In Spain, there is no adapted instrument to measure the perceived obesogenic environment. This article aims to adapt and evaluate the Perceived Nutrition Environment Measures Survey for a Spanish context (NEMS-P-MED). The Spanish version has 32 questions to measure the perception about availability, accessibility and marketing of 3 types of environment: home, shops and restaurants. We assess feasibility, construct validity and internal consistency reliability through a sample of 95 individuals. The internal consistency was acceptable for most items (Cronbach’s alpha coefficients range from 0.6 to 0.9), similar to that of the original scale. The NEMS-P-MED has been shown to be valid and, on certain items reliable, and was useful to assess the population’s perceptions of the food environment in the home, restaurants and food stores in a Spanish context. Adapting standardized measurement tools to specific contexts to assess the perceived and observed characteristics of food environments may facilitate the development of effective policy interventions to reduce excess weight.

scholarly journals Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED)

2020 ◽  
Vol 17 (19) ◽  
pp. 7031 ◽  
Author(s):  
Alba Martínez-García ◽  
Julia Díez ◽  
Carlos Fernández-Escobar ◽  
Eva María Trescastro-López ◽  
Pamela Pereyra-Zamora ◽  
...  
Keyword(s):  
Economic Status ◽  
Kappa Statistics ◽  
Food Environments ◽  
Food Stores ◽  
Census Tracts ◽  
Nutrition Environment ◽  
Policy Interventions ◽  
Measurement Tools ◽  
Urban Contexts ◽  
Access And Affordability

The Nutrition Environment Measures Surveys are valid and reliable measures of community and consumer food environments. This article describes the adaptation and evaluation of the Nutrition Environment Measures Survey in Stores (NEMS-S) for Mediterranean urban contexts (NEMS-S-MED). Trained raters used the adapted NEMS-S-MED tool to observe and rate food outlets in 21 census tracts and 43 food stores across the city of Madrid, Spain. We evaluated inter-rater and intra-rater reliabilities, construct validity, and the tool’s ability to discriminate between store types and between stores by area-level Socio-Economic Status (SES). Overall, the mean NEMS-S-MED score was 20.7 (SD = 9.8), which ranged from 7 to 43. Most food items displayed substantial or almost perfect inter-rater and intra-rater agreements; the percentage agreement across availability items was almost perfect and kappa statistics were also very high (median κ = 1.00 for inter-rater; κ = 0.92 for intra-rater). Furthermore, the NEMS-S-MED tool was able to discriminate between store types and census tracts of different SES. The adapted NEMS-S-MED instrument is a reliable and valid audit tool to assess the consumer food environment in Mediterranean urban contexts. Well-constructed measurement tools, such as the NEMS-S-MED, may facilitate the development of effective policy interventions to increase healthy food access and affordability.

Are campus food environments healthy? A novel perspective for qualitatively evaluating the nutritional quality of food sold at foodservice facilities at a Brazilian university

2016 ◽  
Vol 137 (2) ◽  
pp. 122-135 ◽  
Author(s):  
Isadora Santos Pulz ◽  
Paula Andréa Martins ◽  
Charles Feldman ◽  
Marcela Boro Veiros
Keyword(s):  
Food Environment ◽  
Nutritional Quality ◽  
Food Choices ◽  
Healthy Food ◽  
Food Environments ◽  
Cross Sectional ◽  
Food Ingredients ◽  
Nutrition Environment ◽  
Food And Beverage

Aims: The purpose of this novel study was to evaluate the food environment at a Brazilian university, encompassing 6 restaurants and 13 snack bars. The investigation uniquely analyses the food environment (barriers, facilitators, type of foods and prices). This was a food-based analysis of the nutritional quality of the products sold on campus. Methods: A cross-sectional descriptive design was used, applying the classic Nutrition Environment Measures Survey–Restaurants (NEMS-R) adapted for Brazil and an original methodology to evaluate and classify qualitatively the nutritional quality and characteristics of the food. A census of all campus food environments was applied. Results: The main results show most food and beverage products were made with processed ingredients and had a lower nutritional quality and price when compared with similar products made on premises, that is, processed iced tea compared with fresh tea ( p < .001), fried refined flour salgados compared with baked wholegrain flour salgados ( p < .001) and refined flour biscuits compared with those made with whole grains ( p = .028). Only 16% of the outlets provided food ingredients or nutritional information of products available. Conclusion: The overall options for healthy food choices and good nutritional quality on campus were mostly limited by the availability and higher prices of products. These findings could be used to develop new policy perspectives for the offering of healthy food items and to facilitate better food choices among students in a healthier food environment.

scholarly journals A Systematic Review on Socioeconomic Differences in the Association between the Food Environment and Dietary Behaviors

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2215 ◽  
Author(s):  
Joreintje D. Mackenbach ◽  
Kyra G. M. Nelissen ◽  
S. Coosje Dijkstra ◽  
Maartje P. Poelman ◽  
Joost G. Daams ◽  
...  
Keyword(s):  
Food Environment ◽  
Dietary Behavior ◽  
Food Prices ◽  
Food Environments ◽  
Socioeconomic Differences ◽  
School Food ◽  
Food Stores ◽  
Adolescents And Adults ◽  
School Food Environment ◽  
Objectively Measured

Little is known about socioeconomic differences in the association between the food environment and dietary behavior. We systematically reviewed four databases for original studies conducted in adolescents and adults. Food environments were defined as all objective and perceived aspects of the physical and economic food environment outside the home. The 43 included studies were diverse in the measures used to define the food environment, socioeconomic position (SEP) and dietary behavior, as well as in their results. Based on studies investigating the economic (n = 6) and school food environment (n = 4), somewhat consistent evidence suggests that low SEP individuals are more responsive to changes in food prices and benefit more from healthy options in the school food environment. Evidence for different effects of availability of foods and objectively measured access, proximity and quality of food stores on dietary behavior across SEP groups was inconsistent. In conclusion, there was no clear evidence for socioeconomic differences in the association between food environments and dietary behavior, although a limited number of studies focusing on economic and school food environments generally observed stronger associations in low SEP populations. (Prospero registration: CRD42017073587)

scholarly journals Field validation of food outlet databases: the Latino food environment in North Carolina, USA

2014 ◽  
Vol 18 (6) ◽  
pp. 977-982 ◽  
Author(s):  
Pasquale E Rummo ◽  
Penny Gordon-Larsen ◽  
Sandra S Albrecht
Keyword(s):  
North Carolina ◽  
Food Environment ◽  
Spanish Language ◽  
Food Environments ◽  
Hispanic Population ◽  
Food Outlet ◽  
Field Validation ◽  
Food Stores ◽  
Total Food ◽  
Retail Food

AbstractObjectiveObtaining valid, reliable measures of food environments that serve Latino communities is important for understanding barriers to healthy eating in this at-risk population.DesignThe primary aim of the study was to examine agreement between retail food outlet data from two commercial databases, Nielsen TDLinx (TDLinx) for food stores and Dun & Bradstreet (D&B) for food stores and restaurants, relative to field observations of food stores and restaurants in thirty-one census tracts in Durham County, NC, USA. We also examined differences by proportion of Hispanic population (</≥23·4 % Hispanic population) in the census tract and for outlets classified in the field as ‘Latino’ on the basis of signage and use of Spanish language.SettingOne hundred and seventy-four food stores and 337 restaurants in Durham County, NC, USA.ResultsWe found that overall sensitivity of food store listings in TDLinx was higher (64 %) than listings in D&B (55 %). Twenty-five food stores were characterized by auditors as Latino food stores, with 20 % identified in TDLinx, 52 % in D&B and 56 % in both sources. Overall sensitivity of restaurants (68 %) was higher than sensitivity of Latino restaurants (38 %) listed in D&B. Sensitivity did not differ substantially by Hispanic composition of neighbourhoods.ConclusionsOur findings suggest that while TDLinx and D&B commercial data sources perform well for total food stores, they perform less well in identifying small and independent food outlets, including many Latino food stores and restaurants.

scholarly journals Individual and food environmental factors: association with diet

2018 ◽  
Vol 21 (15) ◽  
pp. 2782-2792 ◽  
Author(s):  
Mariana Carvalho de Menezes ◽  
Ana Victoria Diez Roux ◽  
Bruna Vieira de Lima Costa ◽  
Aline Cristine Souza Lopes
Keyword(s):  
Environmental Factors ◽  
Food Environment ◽  
Care Service ◽  
Decisional Balance ◽  
Food Store ◽  
Cross Sectional ◽  
Food Stores ◽  
Individual Level ◽  
Nutrition Environment ◽  
Consumer Nutrition Environment

AbstractObjectiveTo examine the associations of individual and food environmental factors with fruit and vegetable (F&V) intake in a city in a low-to-middle-income country (LMIC).DesignCross-sectional.SettingRepresentative sample of the Brazilian Primary Care service known as the Health Academy Program (HAP) in Belo Horizonte, a Brazilian city.SubjectsUsing a conceptual model as a guide, individual and food environment data were obtained through: (i) face-to-face interviews with participants aged 20 years or older; and (ii) F&V food store audits. A broad set of individual, household, and community and consumer nutrition environment variables was investigated. Multilevel linear regression was used to quantify area-level variations in F&V intake and to estimate associations with the factors.ResultsEighteen HAP centres were selected and 2944 participants and 336 food stores were included. F&V intake varied between contexts, being higher in areas with better socio-economic conditions and food store quality, such as specialised F&V markets. Individual-level factors, including age, income, food insecurity, stage of change, self-efficacy and decisional balance, were significantly associated with F&V intake. After controlling for individual-level characteristics, greater F&V intake was also associated with higher quality of food stores.ConclusionsIn one of the first studies to comprehensively assess the food environment in an LMIC, individual-level factors accounted for the largest variation in F&V intake; however, the food environment was also important, because area-level variables explained 10·5 % of the F&V intake variation. The consumer nutrition environment was more predictive of healthy eating than was the community nutrition environment. The findings suggest new possibilities for interventions.

Assessing the Consumer Food Environment in Restaurants by Neighbourhood Distress Level across Saskatoon, Saskatchewan

2016 ◽  
Vol 77 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Jin Wang ◽  
Rachel Engler-Stringer ◽  
Nazeem Muhajarine
Keyword(s):  
Food Environment ◽  
Material Deprivation ◽  
Deprivation Index ◽  
Food Environments ◽  
Socioeconomic Indicators ◽  
Nutrition Environment ◽  
Distress Level ◽  
High Distress ◽  
Facilitators And Barriers ◽  
Coffee Shops

Purpose: To assess the consumer food environment in restaurants in Saskatoon, using the Nutrition Environment Measures Survey for Restaurants (NEMS-R), to examine differences by neighbourhood distress level and to reflect on the need for further refinement of the assessment of restaurant consumer food environments. Methods: Neighbourhoods were classified as low, middle, or high distress level based on the socioeconomic indicators (income, employment, and education) in the Material Deprivation Index. Differences in restaurant consumer food environments, indicated by mean NEMS-R total and sub-scores, were examined by various restaurant categories and by varying neighbourhood distress levels. Results: Chain coffee shops and pita and sandwich restaurants had higher NEMS-R totals and “Healthy Entrées” sub-scores; however, burger and chicken restaurants and pizza restaurants had more barriers to healthful eating. Although restaurants in lower distress level neighbourhoods generally rated healthier (higher NEMS-R scores), only a few measures (such as “Facilitators” and “Barriers”) significantly differed by neighbourhood distress level. Conclusions: The findings highlight the importance of developing interventions to improve restaurant consumer food environments, especially in neighbourhoods with higher distress levels. The results suggest that reliable measures of the consumer food environment could be developed beginning with what can be measured by NEMS-R.

Food store environment examination – FoodSee: a new method to study the food store environment using wearable cameras

2019 ◽  
Vol 27 (3) ◽  
pp. 73-81 ◽  
Author(s):  
Christina McKerchar ◽  
Moira Smith ◽  
James Stanley ◽  
Michelle Barr ◽  
Tim Chambers ◽  
...  
Keyword(s):  
Food Environment ◽  
Food Product ◽  
New Method ◽  
Food Environments ◽  
Food Store ◽  
Food Stores ◽  
Product Availability ◽  
Convenience Stores ◽  
Wearable Cameras ◽  
Store Environment

Introduction: Food environments shape food behaviours and are implicated in rising rates of obesity worldwide. Measurement of people’s interactions with food stores is important to advance understanding of the associations between the food environment and in-store behaviour. This paper describes a new method, Food Store Environment Examination (FoodSee) to measure people’s interaction with the food store environment in a feasibility study focused on convenience stores and children. Methods: One hundred and sixty-eight randomly selected children (aged 11–13 years) recruited from 16 randomly selected schools in Wellington, New Zealand, used wearable cameras for 4 days that recorded images every 7 s. The study was conducted from July 2014 to June 2015. All images of convenience stores and service stations, and a sample of images from supermarkets, were evaluated to determine the feasibility of assessing food availability and marketing. The outcomes of interest assessed were: food product availability, placement, packaging, branding, price promotion, purchases and consumption. Results: Thirty-seven children (22%) visited a convenience store or service station at least once during the study period. In total, there were 65 visits to 34 different stores. Seven hundred and nineteen images revealed the in-store environment. Of those, 86.1% were usable and able to be analysed for the outcomes of interest. Conclusions: The FoodSee methodology provides a promising new method to study people’s interaction with the in-store food environment. The evidence generated will be valuable in understanding and improving the food store environment within which people shop, and will contribute to efforts to address obesity globally.

scholarly journals The food environment in school’s vicinities of Sao Paulo, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M F Barata ◽  
M A Leite ◽  
R B Levy
Keyword(s):  
Children And Adolescents ◽  
Human Development ◽  
Food Environment ◽  
Sao Paulo ◽  
Food Environments ◽  
São Paulo ◽  
Food Stores ◽  
Study Results ◽  
Processed Products ◽  
The City

Abstract The school environment plays an important role in the eating patterns of students. The quality of food available in the school vicinities can influence the health and diet outcomes of this population. The study aims to analyze the food environment in the school vicinity of the city of Sao Paulo, focusing on stores selling ultra-processed products. The association between presence and characteristics of schools and density of stores will be investigated. Schools information was obtained from the 2016 School Census, provided by the National Institute of Educational Studies and Research Anísio Teixeira (INEP). The 2016 Annual Social Information List (RAIS) database was used to characterize the school vicinity. Eleven types of stores selling ultra-processed products were identified through the National Classification of Economic Activities (CNAE). Initially, schools and stores were georeferenced by the Postal Address Code in the city street map; this information was attached to the Human Development Units (UDH). Descriptive analyzes (absolute numbers and density per 10.000 inhabitants) were carried out to investigate the distribution of food stores by each category of Municipal Human Development Index (IDHM) present in the city. The influence of the schools on the presence of stores was verified by comparing stores densities in areas with and without schools, considering IDHM categories. The results show that food stores densities are smaller in areas with lower IDHM (8.79/10.000 inhabitants) and bigger in areas with higher IDHM (79.19/10.000 inhabitants). Comparing areas with and without schools, areas with schools present higher food stores densities in every category of IDHM. Furthermore, the study results are relevant and necessary to fill gaps in current literature and may support the formulation of recommendations and intervention proposals for promoting healthy food environments for children and adolescents. Key messages The results assist in the understanding of how different determinants can modulate food choices and practices of children and adolescents. Food environments investigations and monitoring provide important subsidies for designing and directing accurate public policies that promote healthier food environments and choices.

scholarly journals Measuring Rural Food Environments for Local Action in Australia: A Systematic Critical Synthesis Review

2019 ◽  
Vol 16 (13) ◽  
pp. 2416 ◽  
Author(s):  
Penelope Love ◽  
Jillian Whelan ◽  
Colin Bell ◽  
Jane McCracken
Keyword(s):  
Food Environment ◽  
Objective Measure ◽  
Psychometric Testing ◽  
Food Environments ◽  
Urban Context ◽  
Cross Sectional ◽  
Community Or ◽  
Intervention Point ◽  
Measurement Tools ◽  
Quasi Experimental

Poor diet is a significant contributor to obesity and chronic disease. With all being more prevalent in rural than urban Australia, modifying the food environment is a potential intervention point to improve the health of rural populations. This review examined the applicability of measurement tools used in rural food environment research for rural Australia. Six electronic databases were searched for peer-reviewed literature, published in English between 2006 and 2018, including at least one objective measure of the Community or Consumer Food Environment in a rural or mixed rural/urban context. One-hundred and seventy-seven papers were returned after removal of duplicates, with a final review of 25. Most studies were cross-sectional, with one intervention study of quasi-experimental design. Nine studies employed a conceptual model; there was considerable variability in tools used; and few described psychometric testing. The most common attribute measured was price, followed by available healthy options. The findings of this review do not offer a suite of ‘gold standard’ measurement tools known to be reliable, valid and sensitive to change to assess the community or consumer food environments in rural Australian towns. However, recommendations are proposed to progress this important area of research within a rural context.

scholarly journals The use and misuse of ratio and proportion exposure measures in food environment research

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Lukar E. Thornton ◽  
Karen E. Lamb ◽  
Simon R. White
Keyword(s):  
Food Environment ◽  
Fast Food ◽  
Statistical Treatment ◽  
Food Environments ◽  
Main Body ◽  
Food Stores ◽  
Ratio And Proportion ◽  
Environment Research ◽  
Fast Food Restaurants ◽  
Study Designs

Abstract Background The food stores within residential environments are increasingly investigated as a possible mechanism driving food behaviours and health outcomes. Whilst increased emphasis is being placed on the type of study designs used and how we measure the outcomes, surprisingly little attention gets diverted to the measures of the food environment beyond calls for standardised approaches for food store coding and geographic scales of exposure. Food environments are a challenging concept to measure and model and the use of ratio and proportion measures are becoming more common in food environment research. Whilst these are seemingly an advance on single store type indicators, such as simply counting the number of supermarkets or fast food restaurants present, they have several limitations that do not appear to have been fully considered. Main body In this article we report on five issues related to the use of ratio and proportion food environment measures: 1) binary categorisation of food stores; 2) whether they truly reflect a more or less healthy food environment; 3) issues with these measures not reflecting the quantity of food stores; 4) difficulties when no stores are present; and 5) complications in statistical treatment and interpretation of ratio and proportion measures. Each of these issues are underappreciated in the literature to date and highlight that ratio and proportion measures need to be treated with caution. Conclusion Calls for the broader adoption of relative food environment measures may be misguided. Whilst we should continue to search for better ways to represent the complexity of food environments, ratio and proportion measures are unlikely to be the answer.

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