Article

Food Purchase Patterns at the Supermarket and their Relationship to Family Characteristics

Article

Food Purchase Patterns at the Supermarket and their Relationship to Family Characteristics

If you want to read the PDF, try requesting it from the authors.

Abstract

The purpose of this study was to develop a system for characterizing food purchases by families using supermarket receipt data. One hundred and five shoppers contributed data that represented 363 people (138 children and 225 adults). Participants provided food purchase receipt data for at least 6 weeks, which included an average of at least 20 food items/week. Receipt information was entered by trained technicians for analysis using a database of over 2600 distinct foods containing nutritional information. Eighty-five percent of the items on the store receipts were identifiable by item and quantity from the information printed on the receipt; the data on the remaining items was determined by shopper annotation or by use of a default value. The average percent of energy purchased as fat by this convenience sample was 38.4%, total fiber purchased was 6.61 g/1000 kcal, and number of servings of fruits and vegetables was 1.44/1000 kcal. All foods were divided among 11 categories to evaluate the contributions of particular food groups to energy, fat, and fiber purchase.The three major contributors to fat purchase were, in order, “add-on and cooking fats;” “meats, poultry, and fish;” and “dairy.” Purchased fiber came primarily from “produce,” with “breads” and “cereals” next in proportion. The families at highest risk for poor nutrition quality of purchases were those with lower socioeconomic status, more children, and younger age of the primary shopper. This receipt collection system was successful in providing specific nutrition data on purchases of over 100 families. The assessment system is unique in that tracking of shopping patterns of individual families can be accomplished.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Disadvantaged groups were more likely to buy fewer types of fruit and vegetables and less regularly than their higher status counterparts (14). In Virginia, lower family socioeconomic status (SES), computed using family income, was associated with higher levels of fat in food purchases and at the highest risk for poor nutrition quality (27). The most deprived Scottish households consume lower fruit and vegetables, brown/wholemeal bread, breakfast cereals, and oil-rich, and white fish, and higher total bread highest compared with the least deprived households for the period 2007-2009 (28). ...
... As Australian household size increased, grocery purchasing behavior was observed to be less compatible with dietary guideline recommendations (29). In Virginia, larger families purchased lower fruit and vegetable purchase and were at the highest risk for poor nutrition quality (27). The effect of socioeconomic class was positive for total calorie intake, "Vegetables", "Fruits", "Dairy", "Meat, Poultry, Fish, Eggs, Legumes, and Nuts" and "Fats, Oils, Sugars, and Sweets", and negative for "Bread, Cereal, Rice, and Pasta". ...
... In Australia, disadvantaged groups were more likely to buy fewer types of fruit and vegetables and less regularly than their higher status counterparts (14). In Virginia, lower family socioeconomic status (SES), computed using family income, was associated with higher levels of fat in food purchases and at the highest risk for poor nutrition quality (27). The most deprived Scottish households consume lower fruit and vegetables, brown/wholemeal bread, breakfast cereals, and oil-rich, and white fish, and higher total bread highest compared with the least deprived households for the period 2007-2009 (28). ...
Article
Full-text available
Background: Socioeconomic factors are major determinants of health and food consumption. The aim of the present study was assessing the changes in energy and different food groups consumption related to the socioeconomic status of Iranian households. Methods: In this repeated cross-sectional study, 717432 households data from the Households Income and Expenditure Survey (HIES) conducted yearly by the Statistical Centre of Iran (SCI) from 1991 to 2017 was used. The food consumption outcome was modeled as a function of household head age, household head age-squared, socioeconomic variables, household size, place of residence, and household`s head sex. Principle Component Analysis (PCA) was used to extract a socioeconomic status variable based on the educational, occupational, and income status of households. A cross-classified random effects modeling (CCREM) specifications of Hierarchical Age-Period-Cohort (HAPC) models was used in the present study. Results: In the present study, by moving to the higher quartiles of SES had higher calorie intake increased. There was a positive relationship between “Vegetables”, “Fruits”, “Dairy”, “Meat, Poultry, Fish, Eggs, Legumes, and Nuts” and “Fats, Oils, Sugars, and Sweets” with socioeconomic statues category. In the case of “Bread, Cereal, Rice, and Pasta”, there was a reverse relationship, and lower SES quartile consumed a higher amount of this food group. Conclusion: Lower income, education, and occupational status in lower SES quartile groups lead to lower calorie consumption and higher consumption of “Bread, Cereal, Rice, and Pasta" food group, which had lower energy cost compared to the other food groups.
... Plus, fruit and vegetable consumption and meat purchases typically display seasonal and/or holiday variations (Demark-Wahnefried et al., 1999;USDA, 2003). To avoid problems of seasonality, studies have used a 12 month span of data collection (Den Hond, Lesaffre, & Kesteloot, 1995), but if time is limited, other methods ranged between 2-10 weeks, with 8 weeks being appropriate (Cieslak, 2006;Rankin et al., 1998). Regardless, of the period chosen, there typically are substantial weekly variations in purchases, which make data analysis difficult. ...
... One estimate finds that 85 percent of items could be clearly labeled, while the remaining items either needed to be annotated by the shopper or received default nutritional or size information based on mean values of the food item. Lastly, bias is also possible if the selected individuals providing the receipts change shopping habits because they know they are being studied (Rankin et al., 1998). ...
... Even with these limitations, receipt data have been demonstrated as a feasible and flexible methodology (Rankin et al., 1998). For example, one study recruited participants from five large supermarkets to submit food receipts over a 10 week period (Anderson et al., 2000). ...
... Data collection differences include: receipt collection time frames, types of receipts collected, documentation of food item details, and missing receipts. While our protocol collected 30 days of receipts, other studies stipulated time periods that range from a single receipt (Martin, Howell, Duan, & Walters, 2006) to 10 weeks of data (Rankin et al., 1998). A single receipt does not capture daily or weekly variation in food availability, however as the timeframe extends, subject burden increases. ...
... Protocols also differ in techniques to document purchases without receipts and record details about foods. Several studies trained participants to document additional details directly on the receipts (Rankin et al., 1998; Winett et al., 1997) or make detailed annotations of all purchases (French, Wall, Mitchell, Shimotsu, & Welsh, 2009) during the data collection period. These annotation techniques may produce more accurate results since information is recorded closer to the purchase occasion; although extensive annotation may decrease accuracy by increasing subject burden and awareness of healthful qualities of food (i.e. ...
... The level of nutritional analysis and classification of food groups represent the main differences in data coding. Other studies utilized nutritional databases (Rankin et al., 1998; Ransley et al., 2001; Winett et al., 1997) to estimate energy, macronutrient, and fiber in food purchases. While analyzing foods by nutrients may provide more precise research outcomes, analyzing foods by categories produce results that can be applied more readily to individual dietary decisions and allow investigation of the association with intake of food groups. ...
Article
Rates of childhood obesity and comorbidities have been escalating steadily over the past three decades. Children’s food environment may promote excessive consumption of energy-dense food. This concurrent mixed-methods dissertation examined the relationship between physical home food environment (availability and accessibility) and body mass index (BMI) of middle school children within the contextual process of their food choices. Sixty-five children from a U.S. public middle school were enrolled. BMI z-scores were calculated based on measured weight and height, and derived against national reference data for standardization. Food store receipt and purchase log data were collected as a measure of home food availability. Home food accessibility, dietary intake, and other BMI covariates were measured via questionnaires and recalls. Hierarchical multiple regression analyses were conducted (n=58 participants). Semi-structured interviews were conducted with a sub-sample of children (n=47 participants) to explore factors that affect their food choices in the home. A data-driven content analysis was performed. Quantitative and qualitative data were integrated in analysis by exploring the differences in qualitative data by overweight status and in the interpretation of the results. Home food availability and accessibility were not significantly associated with BMI z-scores. However, dietary intake of fruits, low-fat dairy, and sugar-sweetened beverages were correlated with their availability in the home. Qualitative data revealed that children’s food choice in the home was a dynamic process involving three main interacting components – the child, parent, and food – embedded in the context of time. Overweight children emphasized weight concerns and nutritional aspects of foods, such as calories, in describing their food choices. Compared to healthy weight children, overweight children also expressed greater emotion in their preferences for and awareness of higher-energy foods in their homes. The inconsistency between the desire to lose weight and preferences for and awareness of higher-energy foods along with the significant associations between availability and intake support a focus on physical home environment within family-based obesity interventions. Future research should test the relationship between the home food environment, dietary intake, and BMI with larger cross-sectional or prospective studies and explore children’s process of food choice in other settings.
... There is a growing literature on the usefulness of receipt data to dietary intake assessment. [3][4][5][6][7][8][9][10][11] Receipt data have been used to estimate the energy and fat content of food 7,8 and to capture household food purchases from a wide range of sources. 3,4 Some studies have examined household food purchases by family characteristics 9,10 and socioeconomic status (SES). ...
... The 2-week food expenditures by sociodemographic variables are presented in Table 2. On average, 16 receipts (s.d. = 10) were (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Almost half of these receipts were for food stores (mean ± s.d. ...
... = 8 ± 5), with median (interquartile range) of 7 (5-10). For eating-out receipts, the mean (s.d.) number of receipts were 8 (7), with a median (interquartile range) of 5 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). The average 2-week food expenditure per person per household, based on receipts, was $138, with $96 for food stores and $45 for eating out. ...
Article
Full-text available
Background/objectives: To compare objective food store and eating-out receipts with self-reported household food expenditures. Subjects/methods: The Seattle Obesity Study II was based on a representative sample of King County adults, Washington, USA. Self-reported household food expenditures were modeled on the Flexible Consumer Behavior Survey (FCBS) Module from 2007 to 2009 National Health and Nutrition Examination Survey (NHANES). Objective food expenditure data were collected using receipts. Self-reported food expenditures for 447 participants were compared with receipts using paired t-tests, Bland-Altman plots and κ-statistics. Bias by sociodemographics was also examined. Results: Self-reported expenditures closely matched with objective receipt data. Paired t-tests showed no significant differences between receipts and self-reported data on total food expenditures, expenditures at food stores or eating out. However, the highest-income strata showed weaker agreement. Bland-Altman plots confirmed no significant bias across both methods-mean difference: 6.4; agreement limits: -123.5 to 143.4 for total food expenditures, mean difference 5.7 for food stores and mean difference 1.7 for eating out. The κ-statistics showed good agreement for each (κ 0.51, 0.41 and 0.49 respectively. Households with higher education and income had significantly more number of receipts and higher food expenditures. Conclusions: Self-reported food expenditures using NHANES questions, both for food stores and eating out, serve as a decent proxy for objective household food expenditures from receipts. This method should be used with caution among high-income populations, or with high food expenditures. This is the first validation of the FCBS food expenditures question using food store and eating-out receipts.European Journal of Clinical Nutrition advance online publication, 21 October 2015; doi:10.1038/ejcn.2015.166.
... Household food environments have been measured in previous research using home food inventories, food purchase records, grocery store receipts, and bar code scanners (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Despite the important role that eating out plays in individual-level food choices and dietary quality, no household-level measure is available to determine the proportion of home food purchases or to gather information about the types of foods and beverages purchased from eating-out sources (1,2,25). ...
... Some have included comparison with individual dietary intake surveys collected contemporaneously with the household food purchase receipts. These studies are described below (20)(21)(22). ...
... Rankin enrolled 105 shoppers who purchased at least 20 items per week from a regional grocery store chain (20). Shoppers collected and annotated receipts from all grocery store food and beverage purchases (not including restaurants) for an average of 8 weeks and were paid $5 per week for the receipt collection. ...
Article
The household setting may be the most important level at which to understand the food choices of individuals and how healthful food choices can be promoted. However, there are few available measures of the food purchase behaviors of households and little consensus on the best way to measure it. This review explores the currently available measures of household food purchasing behavior. Three main measures are described, evaluated, and compared: home food inventories, food and beverage purchase records and receipts, and Universal Product Code bar code scanning. The development of coding, aggregation, and analytical methods for these measures of household food purchasing behavior is described. Currently, annotated receipts and records are the most comprehensive, detailed measure of household food purchasing behavior, and are feasible for population-based samples. Universal Product Code scanning is not recommended due to its cost and complexity. Research directions to improve household food purchasing behavior measures are discussed.
... Previous research has found that annotated food-shopping receipt data, collected over a period of time, can provide an objective, sensitive measure of dietary behavior of individual food shoppers Winett et al., 1991Winett et al., ,1997. Using a database of supermarket foods (Rankin et al., 1998;Winett et al., 1997), supermarket receipts can provide rich data regarding the nutritional status of individuals whose diets consist largely of foods purchased at food stores. For individuals who purchase a smaller proportion of foods at food stores, foodshopping receipts are less sensitive to intervention-related dietary change (Winett etal., 1991(Winett etal., ,1997. ...
... Supermarket receipt data. Food items purchased at the grocery store were analyzed for fat, fiber, fruit, and vegetable content using the Supermarket Foods Database (Rankin et al., 1998. These analyses yielded values for percentage of calories from fat, grams of fiber/1,000 kilocalories (kcals) purchased, and servings of fruits and vegetables/1,000 kcals purchased. ...
Article
Full-text available
A social-cognitive model of nutrition behavior (A. Bandura, 1997) was tested using structural equation modeling of data from 307 food shoppers recruited from 5 supermarkets in Southwest Virginia. The shoppers were participating in the baseline phase of an ongoing nutrition promotion program. As part of the evaluation, data were collected on the self-efficacy and outcome-expectations components of social-cognitive theory as well as on food purchases and intake. The structural analyses presented here support the social-cognitive model. Self-efficacy, physical outcome expectations, age, socioeconomic status, and number of children were important predictors of nutrition behavior among shoppers. Implications for interventions using social-cognitive variables to improve the nutritional content of food purchases and intake are discussed.
... The household food purchase receipt or record is a method that has been used to examine household food purchases (for a review, see French et al. [4,[18][19][20][21][22][23][24][25][26][27]). Household food purchase receipt and record studies have focused on grocery store food purchases in relation to individual dietary intake. ...
... No studies have examined household food purchase receipts from eating out sources, despite the fact that eating out sources comprise about half of the US household food expenditures [13][14][15][16]. Most of these studies find modest agreement between household grocery store purchases and individual dietary intake [4,[18][19][20][21][22][23][24][25][26][27]. ...
Article
Full-text available
The present study examined income-related household food purchases among a sample of 90 households from the community. Annotated food purchase receipts were collected for a four-week period by the primary household shopper. Receipt food source and foods items were classified into specific categories, and food quantities in ounces were recorded by research staff. For home sources, a limited number of food/beverage categories were recorded. For eating out sources, all food/beverage items were recorded. Median monthly per person dollars spent and per person ounces purchased were computed. Food sources and food categories were examined by household income tertile. A community-based sample of 90 households. Higher income households spent significantly more dollars per person per month from both home and eating out sources compared with lower income households ($163 versus $100, p < .001). Compared with lower income households, higher income households spent significantly more home source dollars on both fruits/vegetables (21.5 versus 10.2, p < .001) and sweets/snacks (17.3 versus 8.3, p < .001), but did not differ on home dollars spent on sugar sweetened beverages (2.0 versus 1.7, p < .46). The proportion of home beverages that were sugar sweetened beverages was significantly higher among lower income households (45% versus 26%, p < .01). Within eating out sources, lower income households spent a significantly greater percent of dollars per person at carry out places (54% versus 37%, p < .01). No income differences were observed for dollars spent at discount grocery stores, small grocery stores or convenience stores. Higher income households spent more money on both healthy and less healthy foods from a wide range of sources. Lower income households spent a larger proportion of their eating out dollars at carry out places, and a larger proportion of their home beverage purchases were sugar sweetened beverages.
... Household till receipts provide unique in-depth information on food sources and food items as well as accurate information on expenditures and quantities purchased (11,12) . Till receipts have been used in observational studies to characterize household food consumption patterns, especially in relation to different socio-economic characteristics (11,(13)(14)(15) , as they can provide a good estimate of dietary quality and nutrient intakes (12,16,17) . Collecting supermarket and grocery receipts was found to provide relevant information on energy and fat intakes (12) . ...
... However, nutritional analysis of food purchases can prove tedious and time-consuming, typically restricting studies to a few hundred households (5,(11)(12)(13)(14)(15)(16)(17)(18) . Participants are asked to collect and annotate receipts from all family members, and to record all food expenditures made without receipts. ...
Article
Objective To develop an index to assess the nutritional quality of household food purchases based on food expenditures only. Design A database of monthly food purchases of a convenience sample of low-income households was used to develop the Healthy Purchase Index (HPI). The HPI is the sum of two sub-scores based on expenditure shares of food categories in total household food expenditure: the purchase diversity sub-score and the purchase quality sub-score. The first was adapted from an existing diversity score. The second integrated those food categories identified as the best predictors of the nutritional quality of purchases based on associations between expenditure shares of food categories and two nutritional quality indicators: the mean adequacy ratio (MAR) and the mean excess ratio (MER). Correlation between the HPI and a score assessing adherence to French dietary guidelines (PNNS-GS mod ) was performed as a first validation. Setting/Particpants Food purchases of 112 households from deprived neighbourhoods of Marseille (France), participating in the Opticourses and Jassur projects (2012–2015). Results The purchase diversity sub-score reflects the presence in food purchases of five food categories: fruits, vegetables, starches, dairy products, and meat, fish & eggs. The purchase quality sub-score is based on expenditure shares for fruit & vegetables, added fats & seasonings, sweet snacks, cheese, sugary drinks, refined grains and fish, as these were identified as predictors of the nutritional quality of purchases. The HPI was positively associated with the PNNS-GS mod ( rs =0·378; P <0·001). Conclusions The HPI helps assess the healthiness of household food purchases.
... The remaining 18 studies used sales data to assess: the impact of policy changes on population food purchases 29,30 ; the effect of food pricing on healthier food choices 31 ; daily variations in food sales 32 ; ethnic differences 33-35 , regional differences 36,37 or income differences in dietary habits 38 ; validity of self-reported intake 39 ; and factors related to food purchasing behaviors [40][41][42][43][44][45][46] . Full details of the 18 studies are described in Table 2. ...
... Around 67% of the studies (12/18) [41][42][43][44][45][46] . ...
Article
Population food and nutrition monitoring plays a critical role in understanding suboptimal nutrition at the population level, yet current monitoring methods such as national surveys are not practical to undertake on a continuous basis. Supermarket sales data potentially address this gap by providing detailed, timely, and inexpensive monitoring data for informing policies and anticipating trends. This paper reviews 22 studies that used supermarket sales data to examine food purchasing patterns. Despite some methodological limitations, feasibility studies showed promising results. The potential and limitations of using supermarket sales data to supplement food and nutrition monitoring methods are discussed
... Similar linear gradients were found in adolescents for consumption of breakfast, fruits and vegetables . Interestingly, positive gradients for total fat and saturated fat were found in adults in the Quebec Nutrition Survey (QNC; Rankin et al., 1998), whereas negative gradients for total fat and saturated fat were found for NHANES III (Krebs-Smith & Kantor, 2001). This discrepancy could have occurred because the number of high-SES participants in the QNC was small (Dubois & Girard, 2001). ...
... The second approach to examining relationships between SES and diet involves food purchasing patterns. Compared with more advantaged individuals, socio-economically disadvantaged individuals have reported purchasing fewer fruits and vegetables and more foods low in fi bre and high in fat (Kirkpatrick & Tarasuk, 2003;Rankin et al., 1998;Turrell, Hewitt, Patterson, & Oldenburg, 2003). The lower availability of healthy products in grocery stores in low-SES areas partly explains this discrepancy (Williams & Collins, 2001). ...
Article
Full-text available
Adolescents from families with low socio-economic status (SES) experience more stress and have poorer diets than adolescents from families with high SES. This study investigated whether change in dietary quality among urban, black adolescents related to changes in the Perceived Stress Scale (PSS) and the Daily Hassles Microsystem Scale (DHMS) while controlling for household income. At two times 1 month apart, 25 adolescents completed a modified Adolescent Food Habits Checklist (AFHC), the PSS and the DHMS. Change scores from time 1 to time 2 for each measure were computed. AFHC change and PSS change had a significant, negative correlation (r = −0.458, p < 0.05), even when controlling for income (r = −0.585, p < 0.05). For girls, AFHC change and PSS change had a significant, negative correlation (r = −0.599, p < 0.05), even when controlling for income (r = −0.697, p < 0.05). No significant correlation was observed for boys (r = 0.003, p = 0.993), and when controlling for income (r = −0.346, p = 0.448). The correlation between AFHC change and DHMS change was not significant. Black adolescent girls, but not boys, tended to make more unhealthy dietary choices when under increased stress. Copyright © 2008 John Wiley & Sons, Ltd.
... Unfortunately, the studies on the link between diet costs and nutritional quality did not use actual food expenditures but instead used standard food price databases, computed from prices paid by a national panel (1,2,4) or from local supermarket retail prices (6,8). Yet, a number of studies have shown the feasibility and accuracy of using cash register receipts to assess actual expenditure and food patterns of households (16)(17)(18)(19)(20). ...
... Thus, in previous studies, the relation between diet costs and the nutritional quality of diets was always explored by using standard food prices (1)(2)(3)(4)(5)(6)(7), and when food expenditure was recorded, its association with indicators of diet quality was never explored (16)(17)(18)(19). In the present study, we used food-purchase cash register receipts for a 1-mo period, collected as part of the baseline assessment of a nutrition intervention conducted in a low-income population, to test whether the positive relation observed between diet cost and nutritional quality is confirmed when diet cost is estimated from actual expenditure. ...
Article
Full-text available
It is unknown whether diet quality is correlated with actual food expenditure. According to the positive deviance theory, the study of actual food expenditure by people with limited economic resources could help identify beneficial food-purchasing behavior. The aims were to investigate the relation between actual expenditure on food and nutritional quality and to identify "positive deviants" among low-income households. Individuals in deprived social situations (n = 91) were recruited as part of the "Opticourses" nutrition intervention conducted in 2012-2014 in poor districts of Marseille, France. Opticourses participants collected food-purchase receipts for their household over a 1-mo period. "Actual diet costs" and "estimated diet costs" were calculated per 2000 kcal of food purchases by using actual expenditures and a standard food price database of food consumed by a representative sample of French adults, respectively. Mean adequacy ratio (MAR), mean excess ratio (MER), and energy density (ED) were used as nutritional quality indicators. "Positive deviants" were defined as having a higher MAR and a lower MER than the respective median values. Opticourses participants selected less-expensive food options than the average French population, both within a food group and for a given food item. Higher diet costs were associated with higher nutritional quality (higher MAR, lower ED), regardless of whether costs were calculated from actual expenditure or on the basis of standard food prices. Twenty-one positive deviants were identified. They made significantly healthier purchases than did other participants (MAR: +13%; MER: -90%. ED: -22%) at higher estimated diet costs. Yet, they did not spend more on food (having the same actual diet costs), which showed that they purchased food with a higher nutritional quality for their price. In this low-income population, actual diet cost was positively correlated with nutritional quality, yet the results showed that higher diet quality is not necessarily more costly when foods with higher nutritional quality for their price are selected. The Opticourses intervention was registered at clinicaltrials.gov as NCT02383875. © 2015 American Society for Nutrition.
... In conjunction with a database of supermarket foods developed specifically to evaluate nutritional content of food purchases (21), supermarket receipts can provide rich data regarding the nutritional status of individuals and families whose diets consist largely of foods purchased at food stores. For individuals who purchase a smaller proportion of foods at food stores, food shopping receipts are less sensitive to intervention-related dietary change (21,22,29). In light of the cost and response burden of annotating, collecting, and analyzing comprehensive samples of receipt data, food shopping receipts may be most useful as an objective measure used to corroborate self-report food frequency or diet-recall data. ...
Article
Full-text available
This study examined the direct and mediated impact of a self-administered, computer-based intervention on nutrition behavior self-efficacy, and outcome expectations among supermarket food shoppers. The intervention, housed in kiosks in supermarkets and based on social cognitive theory, used tailored information and self-regulation strategies delivered in 15 brief weekly segments. The study sample (N = 277), stratified and randomly assigned to treatment or control, was 96% female, was 92% White, had a median annual income of about $35,000, and had a mean education of 14. 78 +/- 2.11 years. About 12% of the sample reported incomes of $20,000 or less, and about 20% reported 12 years or fewer of education. Analysis of covariance immediately after intervention and at a 4- to 6-month follow-up found that treatment led to improved levels of fat, fiber, and fruits and vegetables. Treatment also led to higher levels of nutrition-related self-efficacy, physical outcome expectations, and social outcome expectations. Logistic regression analysis determined that the treatment group was more likely than the control group to attain goals for fat, fiber, and fruits and vegetables at posttest and to attain goals for fat at follow-up. Latent variable structural equation analysis revealed self-efficacy and physical outcome expectations mediated treatment effects on nutrition. In addition, physical outcome expectations mediated the effect of self-efficacy on nutrition outcomes. Implications for future computer-based health promotion interventions are discussed.
... Sampling in retail outlets for the purpose of this research, however, resulted in low compliance and a predominantly female sample. The level of compliance was nevertheless no lower than that previously reported using other survey approaches (McDonald & Dunbar, 1995) and the proportion of females was likely to be representative of those who shop in major food retail outlets (Rankin et al., 1998). ...
Article
This research has sought to identify factors determining consumer uptake and rejection of reduced fat foods. Initial qualitative research implied that use of reduced fat products could be dependent upon which dietary health strategies people adopt. This analysis therefore explores the degree to which various dietary strategies predict uptake of reduced fat products. Items were derived from prior qualitative findings and responses to relevant issues surveyed by interview (n = 1004) within selected retail outlets throughout Northern Ireland and England. Logistic regression analysis indicated that concern over health, drive to reduce calorie consumption, to increase intake of fish and poultry and fruit and vegetables consistently predicted consumption across a range of reduced fat products. These dietary strategies appeared to predict uptake of reduced fat foods to a greater degree than perceived taste or price. The findings imply that for reduced fat foods to achieve universal acceptance promotional messages need to be translated into commonly adopted dietary health strategies.
... In addition to these well-established systems, the neighborhood environment provides resources that can enhance or detract from parent efforts to support optimal child growth [22][23][24][25][26]. Without access to these resources, parents face significant barriers to adopting eating and activity-related behavioral intervention messages. ...
... The NLS programs focused on small, targeted changes within a food group to meet nutritional guidelines. A series of randomized control field studies with NLS demonstrated that NLS users decreased fat and increased fiber, fruits, and vegetables in their supermarket food purchases [104] [105] [106] [107] and could maintain some of these changes after contact with the program ended as assessed by a system using participants' food shopping receipts [108]. Program acceptability and nutrition effects held across study participants from a range of socioeconomic groups [105] [106] [107]. ...
Article
A major focus of Healthy People 2010 is promoting weight management and physical activity because overweight, obesity, and a sedentary lifestyle are strongly associated with risk for heart disease and stroke, diabetes, cancers, and premature death. Prevalence data and a focused review of weight management and physical activity studies point to the long-term weight gain prevention in normal weight (21-25 BMI), overweight (25-29 BMI), and even moderate obese (30-34 BMI) people as one alternative to prioritizing weight loss in health behavior interventions. This is because on a population basis annual weight gain is small (approximately 0.8 kg/year) and preventing weight gain appears to require only an energy shift of about 100 cal/day either through a modest increase in physical activity and/or consuming slightly less calories to maintain an energy balance. A more dynamic use of social cognitive theory (SCT) for developing programs to maintain health behavior changes is emerging with some evidence of long-term maintenance. The high use of the Internet provides a vehicle to reach different population segments with readily accessible, SCT-tailored long-term programs. Research studies using the Internet with tailored SCT interventions have shown changes in nutrition practices, physical activity, and weight loss for up to a year. One promising approach to weight gain prevention in population segments is the development and wide spread use of longer-term Internet programs using specific principles and procedures from SCT.
... 17 Drewnowski et al. argued energy dense foods are less expensive than more healthy foods and provide low-income consumers with a cheap form of energy. 17 The relation between household food purchasing behaviour and socioeconomic status has been examined in Canada, 18,19 the USA, 20 the UK 21 and Australia. 22 These studies highlight the disparity between low and high socioeconomic groups with respect to the absolute amount of money that is spent on food. ...
Conference Paper
Food purchasing practices of families by socio-economic and food security status C Smith, WR Parnell, R Brown Department of Human Nutrition, University of Otago, Dunedin, New Zealand Background Food insecurity is associated with poorer nutritional outcomes. In the 2002 NZ Children’s Nutrition Survey half of households reported food insecurity. Both physical and economic access to food are important influences on food purchasing practices and food security status. Objective To describe access to food and food purchasing practices of New Zealand families living within Dunedin and Wellington and to examine how they differ by socio-economic status and food security status. Design The Family Food Environment Survey was a cross- sectional survey (October 2007- October 2008) among 136 New Zealand families with children living in Dunedin and Wellington. The household food preparer was interviewed regarding access to food, food purchasing and meal planning and preparation. Food security was measured using validated statements from the 1997 National Nutrition Survey and income was used as a proxy measure of socio- economic status. Outcomes Eighty seven percent of low income households reported food insecurity. More households in the low income group agreed that “buying more fruit than we already do would be difficult on our budget”. (68%) compared to the medium and high income groups (41 & 25%). Households in the low income group purchased a lower number of types of fresh vegetables (6.0 per week) and canned vegetables compared to the high and medium income groups. The types of food shops used and the frequency of food shopping was similar by income and by food security status. All households reported favourable physical access to food shops. Overall use of ready to eat food was similar between groups but high income households were more likely to use restaurants (mean 1.2 occasions per month) and cafes (3.5) compared to low income households (cafes; 1.6 & restaurants; 0.3). Conclusion Physical access to food shops was not a barrier to food security for households in this survey however lack of money was. With the economic recession and the monetary constraints on many families being unlikely to ease the ability of some families to eat a healthy diet may be compromised.
... But do individuals settle back into preholiday shopping patterns, or did the holiday frenzy establish a new status quo of food purchasing that may undermine New Year's resolutions to eat healthier? While several studies have recorded general household food purchasing patterns, seasonal shifts in purchasing have not been documented [15][16][17]. Although food purchasing does not directly measure food consumption, previous research has shown a strong correlation between receipts recording food purchases and dietary recalls reflecting consumption in terms of total fat, total calories, and percent calories from fat [18,19]. ...
Article
Full-text available
Objective: How do the holidays--and the possible New Year's resolutions that follow--influence a household's purchase patterns of healthier foods versus less healthy foods? This has important implications for both holiday food shopping and post-holiday shopping. Methods: 207 households were recruited to participate in a randomized-controlled trial conducted at two regional-grocery chain locations in upstate New York. Item-level transaction records were tracked over a seven-month period (July 2010 to March 2011). The cooperating grocer's proprietary nutrient-rating system was used to designate "healthy," and "less healthy" items. Calorie data were extracted from online nutritional databases. Expenditures and calories purchased for the holiday period (Thanksgiving-New Year's), and the post-holiday period (New Year's-March), were compared to baseline (July-Thanksgiving) amounts. Results: During the holiday season, household food expenditures increased 15% compared to baseline ($105.74 to $121.83; p<0.001), with 75% of additional expenditures accounted for by less-healthy items. Consistent with what one would expect from New Year's resolutions, sales of healthy foods increased 29.4% ($13.24/week) after the holiday season compared to baseline, and 18.9% ($9.26/week) compared to the holiday period. Unfortunately, sales of less-healthy foods remained at holiday levels ($72.85/week holiday period vs. $72.52/week post-holiday). Calories purchased each week increased 9.3% (450 calories per serving/week) after the New Year compared to the holiday period, and increased 20.2% (890 calories per serving/week) compared to baseline. Conclusions: Despite resolutions to eat more healthfully after New Year's, consumers may adjust to a new "status quo" of increased less-healthy food purchasing during the holidays, and dubiously fulfill their New Year's resolutions by spending more on healthy foods. Encouraging consumers to substitute healthy items for less-healthy items may be one way for practitioners and public health officials to help consumers fulfill New Year's resolutions, and reverse holiday weight gain.
... In general, a range of studies noted that socioeconomic status can pose a critical barrier to healthy food access. Lower socioeconomic status, often assessed using a combination of multiple variables including income, education and occupation, has been found to be highly correlated with purchases or consumption of less healthy food (Darmon and Drewnowski 2008;Galobardes, Morabia, & Bernstein, 2001;Hulshof et al. 1991;Mishra, Ball, Arbuckle, & Crawford, 2002;Rankin et al. 1998). Research also reported food access disparities among different racial/ethnic groups. ...
Article
This research presents a study of visits to farmers' markets, a rapidly growing urban phenomenon in the U.S., from a geographic perspective. Although the social and economic impacts of farmers' markets have received considerable attention recently, examining farmers' market access in space-time is still lacking in the existing analytical frameworks. This study challenges conventional food access measures that have been primarily focused on the spatial separation between markets and consumers' homes and proposes a more realistic space-time based strategy. A survey was conducted on twelve markets in Tucson, Arizona. Analysis results show that majority of market patrons went to a market that was different from the one nearest to their homes, and the market choice, including the geographic location and the associated market operating time, was highly affected by patrons' other daily activities. The particular types of activities combined with farmers' market trips were found to vary temporally and fluctuate based on patron's employment characteristics. Our study suggests that conventional food access measures should be used in caution to assess farmers' market access as these measures can lead to an overestimate of the travel consumers are willing or even able to incur.
... Considera esencial y valiosa, aunque compleja, una correcta planificación de las comidas para poder equilibrar las necesidades de nutrición, las preferencias alimentarias y los horarios de los miembros de la familia, así como las limitaciones de tiempo y de presupuesto disponible para la compra de alimentos. Rankin et al (1998) hallaron que la edad del comprador principal influía en la calidad de las compras familiares de alimentos. El mayor riesgo en realizar compras de alimentos de mala calidad nutricional se daba si el comprador principal era joven, junto con un menor nivel socioeconómico y un mayor número de niños en la familia. ...
Article
This paper describes the application of the methodology developed in research on learning progressions to a health-related topic. More specifically, we present a human nutrition learning progression as a hypothesis that now requires empirical validation. The study involved three phases. In the first phase, we analysed the existing literature in the domain of human nutrition. Based on this analysis, phase 2 then involved drawing up a learning progression for this domain and identifying the learning targets and progress variables, as well as the upper and lower anchors. The analysis led us to identify five progress variables, associated with the development of the concepts of food, nutrient, energy and diet, as well as with the ability to classify foods according to their nutrients. Finally, in phase 3, we identified and described the pathways that students may follow in relation to each progress variable. Given its focus on a topic closely linked to personal health, the learning progression may be useful not only as a component of teaching modules that aim to improve scientific literacy but also as a platform for future health education campaigns that seek to promote healthy eating habits among different sectors of the population. http://rdcu.be/uxHX
... The reason for looking at these variables is that health studies show associations between some sociodemographic variables and dietary patterns. Most commonly, households of lower socioeconomic status (often described through social class, household size, employment and geographical location) tend to have poorer diets (Appelhans et al., 2012;Brennan and Singh, 2011;Giskes et al., 2007;Rankin et al., 1998). However, these studies often describe discrepancies in purchases of different product categories (which lead to different diet quality outcomes). ...
Article
Purpose Increasing and maintaining the population’s consumption of healthful food may hinder the global obesity pandemic. The purpose of this paper is to empirically test whether it is possible for healthful sub-brands to achieve higher consumer behavioural loyalty than their less healthful counterparts. Design/methodology/approach The study analysed three years of consumer panel data detailing all purchases from five consumer goods categories for 15,000 UK households. The analysis uses best-practice techniques for measuring behavioural loyalty: double jeopardy, polarisation index, duplication of purchase and user profile comparisons. Each sub-brand’s healthfulness was objectively coded. Findings Despite the level of healthfulness, all sub-brands have predictable repeat purchase patterns, share customers as expected and have similar user profiles as each other. The size of the customer base, not nutrition content, is, by far, the biggest determinant of loyalty levels. Research limitations/implications Consumers do not show higher levels of loyalty to healthful sub-brands, or groups of healthful sub-brands. Nor do they buy less healthful sub-brands less often (as a “treat”). There are also no sub-groups of (health conscious) consumers who would only purchase healthful options. Practical implications Sub-brands do not have extraordinarily loyal or disloyal customers because of their healthfulness. Marketers need to focus on growing sub-brands by increasing their customer base, which will then naturally grow consumer loyalty towards them. Originality/value This research brings novel evidence-based knowledge to an emerging cross-disciplinary area of health marketing. This is the first study comparing behavioural loyalty and user profiles towards objectively defined healthful/less healthful sub-brands.
... Many studies have already focused on measuring household food environments by making use of home food inventories, bar code scanners, food purchase records and supermarket receipts. These studies are mostly executed over a short period of time, i.e. 2-10 weeks, and tend to focus only on supermarket purchases and the food that is present in the household and have been conducted by Cullen et al. 3 ; deWalt et al. 4 ; Martin et al. 5 ; Rankin et al. 6 and Ransley et al. 7 . In this study, we make use of crowdsourced data on food purchases. ...
Conference Paper
Full-text available
Diet-related diseases are putting an increasing pressure on society and the national health budget. It is important to find a way to respond adequately to these health challenges. Increasing our insight into consumer purchase behavior, especially in supermarkets, is an important start in counteracting the current upward trend of diet-related diseases1 . On average, 85% of the food that enters the household is purchased in the supermarket2 . Therefore, investigating supermarket purchase behavior could provide valuable insight into household food consumption patterns. Many studies have already focused on measuring household food environments by making use of home food inventories, bar code scanners, food purchase records and supermarket receipts. These studies are mostly executed over a short period of time, i.e. 2-10 weeks, and tend to focus only on supermarket purchases and the food that is present in the household and have been conducted by Cullen et al.3 ; deWalt et al.4 ; Martin et al.5 ; Rankin et al.6 and Ransley et al.7 . In this study, we make use of crowdsourced data on food purchases. Crowdsourcing builds on the idea that consumers and citizens are willing to donate and share information that can be used in research and for the interest of the common good (e.g. solving societal issues) as pointed to by Cohn8 ; Wiggens & Crowston9 . It further assumes that these consumers are willing to share data with researchers that they would not have shared otherwise. This case study is an exploratory study on the crowdsourcing of supermarket purchase data, directly obtained from the consumer in the form of receipts. It aims to explore the potentials of using this data for the assessment of long term trends in consumer food purchase behavior. Furthermore, this study aims to investigate the possibilities of this kind of data for future scientific research. In accordance with the background information and the objective of this study the following research question is addressed: To what extent is it possible to use data, coming from supermarket receipts and obtained via crowdsourcing, for assessing human food purchase behavior over time? For this, we apply a traditional two-point analysis to a dataset of crowdsourced supermarket receipts from the years 2007 and 2015. Instead of trying to interpret observed differences in supermarket purchases between these years, we are mainly interested in the statistical possibilities of the crowdsourced data in case larger datasets would become available. These data may help in further development of consumer behavioral research.
... Until recently, the main academic research application of receipt scanning seems to have been smallscale, paper-and-post based studies which used receipts to analyse foods and beverages purchased and consumed by household members over a defined period as a method of supplementing or replacing dietary surveys (Becker 2001;DeWalt et al. 1990;French et al. 2008;Rankin et al. 1998;Ransley et al. 2001;Sekula et al. 2005). For these applications, receipts may require annotation and may need to be collected alongside other data activities such as individual dietary intake surveys (French et al. 2008) and manual records of visitors attending household meals, meals taken away from home, and foods purchased from shops not providing itemized bills (Greenwood et al. 2006). ...
Technical Report
Full-text available
We review process generated data sources and new technologies that could be used to improve the measurement of household finances. For each of thesewe review what is known about (i) the content of what can be measured, (ii) examples of research for which these data have been used, (iii) whether the data have been used asfree-standing data sources or linked to probability sample surveys, and(iv) the quality of the data regarding representativeness and measurement quality. The review is structured around an adapted version of the Total Survey Error framework and concludeswith a discussion of implications for survey practice and research needs.
... The method may be less feasible with less motivated samples or without the financial incentive. However, when considering the use of the receipt methodology with population-based samples, it should be noted that other national consumer expenditure surveys conducted with general population have achieved acceptable compliance using modest financial incentives [27][28][29][30]. Second, a more representative sample will provide more generalizable information about the proportion of spending from home and eating out sources and for specific food categories. ...
Article
Full-text available
Accurate measurement of household food purchase behavior (HFPB) is important for understanding its association with household characteristics, individual dietary intake and neighborhood food retail outlets. However, little research has been done to develop measures of HFPB. The main objective of this paper is to describe the development of a measure of HFPB using annotated food purchase receipts. Households collected and annotated food purchase receipts for a four-week period as part of the baseline assessment of a household nutrition intervention. Receipts were collected from all food sources, including grocery stores and restaurants. Households (n = 90) were recruited from the community as part of an obesity prevention intervention conducted in 2007-2008 in Minneapolis, Minnesota, USA. Household primary shoppers were trained to follow a standardized receipt collection and annotation protocol. Annotated receipts were mailed weekly to research staff. Staff coded the receipt data and entered it into a database. Total food dollars, proportion of food dollars, and ounces of food purchased were examined for different food sources and food categories. Descriptive statistics and correlations are presented. A total of 2,483 receipts were returned by 90 households. Home sources comprised 45% of receipts and eating-out sources 55%. Eating-out entrees were proportionally the largest single food category based on counts (16.6%) and dollars ($106 per month). Two-week expenditures were highly correlated (r = 0.83) with four-week expenditures. Receipt data provided important quantitative information about HFPB from a wide range of sources and food categories. Two weeks may be adequate to reliably characterize HFPB using annotated receipts.
Article
To examine the association between socio-economic position (SEP) and diet, by assessing the unadjusted and simultaneously adjusted (independent) contributions of education, occupation and household income to food purchasing behaviour. The sample was randomly selected using a stratified two-stage cluster design, and the response rate was 66.4%. Data were collected by face-to-face interview. Food purchasing was examined on the basis of three composite indices that reflected a household's choice of grocery items (including meat and chicken), fruit and vegetables. Brisbane City, Australia, 2000. : Non-institutionalised residents of private dwellings located in 50 small areas (Census Collectors Districts). When shopping, respondents in lower socio-economic groups were less likely to purchase grocery foods that were high in fibre and low in fat, salt and sugar. Disadvantaged groups purchased fewer types of fresh fruits and vegetables, and less often, than their counterparts from more advantaged backgrounds. When the relationship between SEP and food purchasing was examined using each indicator separately, education and household income made an unadjusted contribution to purchasing behaviour for all three food indices; however, occupation was significantly related only with the purchase of grocery foods. When education and occupation were simultaneously adjusted for each other, the socio-economic patterning with food purchase remained largely unchanged, although the strength of the associations was attenuated. When household income was introduced into the analysis, the association between education, occupation and food purchasing behaviour was diminished or became non-significant; income, however, showed a strong, graded association with food choice. The food purchasing behaviours of socio-economically disadvantaged groups were least in accord with dietary guideline recommendations, and hence are more consistent with greater risk for the development of diet-related disease. The use of separate indicators for education, occupation and household income each adds something unique to our understanding of how socio-economic position is related to diet: each indicator reflects a different underlying social process and hence they are not interchangeable, and do not serve as adequate proxies for one another.
Article
Understanding the particularly low intake of fruits and vegetables among socioeconomically disadvantaged groups is an important issue for public health. This study investigated whether access to retail outlets is similar across areas of varying socioeconomic disadvantage in an Australian urban setting, in terms of distance, the numbers of local shops, and their opening hours. This ecological cross-sectional study used 50 randomly sampled census collection districts and their nearby shopping environment (i.e. within 2.5 km), and generally found minimal or no socioeconomic differences in shopping infrastructure. Important methodological and social/economic issues may explain this contrast with overseas findings.
Article
To identify the most common frequency of food-purchasing patterns and relate this pattern to characteristics of individuals and families. A customer-intercept survey was conducted in the greater Houston area, Texas, USA, in 2002. The frequency of food shopping at supermarkets, convenience stores and restaurants to buy food for eating at home was assessed. A total of 823 adults (78.5% female; mean age 37.4 years) who went to any of several grocery or convenience stores, including European, Hispanic and African Americans, and Asian/Pacific Islanders. Major food-shopping patterns were a weekly big trip with a few small trips (34.9%), biweekly big trips with a few small trips (21.9%), no big shopping trips (15.4%), a weekly big trip without small trips (13.9%), a monthly big trip (8.3%), and biweekly big trips without small trips (6.4%). While 61.1% of participants never went to convenience stores to buy fruit and vegetables (F&V) for eating at home, 67% went to restaurants for F&V. African American families shopped for food least frequently, while Asian American families shopped for food most frequently. Educational level was negatively associated with the use of convenience stores and positively associated with take-away from restaurants. There is substantial variability in the frequency of food shopping. Future research on food shopping should incorporate this variable.
Article
To assess the psychometric characteristics of new scales of shopping practices and social support for purchasing fruits and vegetables. Participants were recruited in front of diverse grocery stores. Telephone data collection was done on 2 occasions, separated by 6 weeks. 166 food shoppers with children at home participated. New scales of food shopping practices and social support for purchasing fruits and vegetables were psychometrically analyzed and related to a measure of home fruit or vegetable availability as a test of construct validity. Both classical test and item response theory procedures were used. Correlations related the new measures to home fruit and vegetable availability. Single dimension scales were specified for fruit and vegetable shopping practices (35% of the variance), fruit purchase social support (53% of the variance), and vegetable purchase social support (52% of the variance). Item response theory difficulty estimates varied from -0.64 to 0.73 for fruit and vegetable shopping practices, from -0.55 to 0.33 for fruit purchase social support, and from -0.55 to 0.34 for vegetable social support. Each scale significantly correlated with home fruit and vegetable availability (construct validity), even after controlling for social desirability of response (0.19 for shopping practices, 0.37 for fruit purchasing social support, and 0.28 for vegetable purchasing social support). Person separation reliability was 0.80 for food shopping practices, 0.74 for fruit purchasing social support, and 0.73 for vegetable purchasing social support. The scales performed well. These scales are now available to help better understand fruit and vegetable shopping practices, fruit purchase social support, and vegetable purchase social support.
Article
Full-text available
To pilot the design and methodology for a large randomised controlled trial (RCT) of two interventions to promote healthier food purchasing: culturally appropriate nutrition education and price discounts. A 12-week, single-blind, pilot RCT. Effects on food purchases were measured using individualised electronic shopping data ('Shop 'N Go' system). Partial data were also collected on food expenditure at other (non-supermarket) retail outlets. A supermarket in Wellington, New Zealand. Eligible customers were those who were the main household shoppers, shopped mainly at the participating store, and were registered to use the Shop 'N Go system. Ninety-seven supermarket customers (72% women; age 40 +/- 9.6 years, mean +/- standard deviation) were randomised to one of four intervention groups: price discounts, nutrition education, a combination of price discounts and nutrition education, or control (no intervention). There was a 98% follow-up rate of participants, with 85% of all reported supermarket purchases being captured via the electronic data collection system. The pilot did, however, demonstrate difficulty recruiting Maori, Pacific and low-income shoppers using the electronic register and mail-out. This pilot study showed that electronic sales data capture is a viable way to measure effects of study interventions on food purchases in supermarkets, and points to the feasibility of conducting a large-scale RCT to evaluate the effectiveness of price discounts and nutrition education. Recruitment strategies will, however, need to be modified for the main trial in order to ensure inclusion of all ethnic and socio-economic groups.
Article
The relationship between socioeconomic position (SEP) and diet has been examined mainly on the basis of food and nutrient intake. As a complement to this work, we focused on the socioeconomic patterning of food purchasing, as many educational dietary messages emphasize behaviours such as food choice when shopping. Also, the type of food people buy influences the quality of their nutrient intake. A probability sample of households in Brisbane City, Australia (n = 1003, 66.4% response rate). Data were collected using face-to-face interviews. SEP was measured using education, occupation and household income. Food purchasing was examined on the basis of grocery items (including meat and chicken) and fruit and vegetables. Significant associations were found between each socioeconomic indicator and food purchasing. Persons from socioeconomically disadvantaged backgrounds were less likely to purchase grocery foods that were comparatively high in fibre and low in fat, salt and sugar. The least educated, those employed in blue-collar (manual) occupations and residents of low income households purchased fewer types of fruit and vegetables, and less regularly, than their higher status counterparts. Health promotion efforts aimed at narrowing socioeconomic differences in food purchasing need to be designed and implemented with an understanding of, and a sensitivity to, the barriers to nutritional improvement that difficult life circumstances can impose.
Article
Full-text available
To examine the association between area and individual level socioeconomic status (SES) and food purchasing behaviour. The sample comprised 1000 households and 50 small areas. Data were collected by face to face interview (66.4% response rate). SES was measured using a composite area index of disadvantage (mean 1026.8, SD = 95.2) and household income. Purchasing behaviour was scored as continuous indices ranging from 0 to 100 for three food types: fruits (mean 50.5, SD = 17.8), vegetables (61.8, 15.2), and grocery items (51.4, 17.6), with higher scores indicating purchasing patterns more consistent with dietary guideline recommendations. Brisbane, Australia, 2000. Persons responsible for their household's food purchasing. Controlling for age, gender, and household income, a two standard deviation increase on the area SES measure was associated with a 2.01 unit increase on the fruit purchasing index (95% CI -0.49 to 4.50). The corresponding associations for vegetables and grocery foods were 0.60 (-1.36 to 2.56) and 0.94 (-1.35 to 3.23). Before controlling for household income, significant area level differences were found for each food, suggesting that clustering of household income within areas (a composition effect) accounted for the purchasing variability between them. Living in a socioeconomically advantaged area was associated with a tendency to purchase healthier food, however, the association was small in magnitude and the 95% CI for area SES included the null. Although urban areas in Brisbane are differentiated on the basis of their socioeconomic characteristics, it seems unlikely that where you live shapes your procurement of food over and above your personal characteristics.
Article
The objective of this study was to evaluate the effectiveness of a health promotion action that consisted in delivering nutritional information to consumers of 10 supermarkets in Santiago. The delivery process of the educational material was evaluated through a survey to 898 consumers that received them, a structured questionnaire to describe the place of delivery and the people involved. To evaluate the degree of nutritional information retained by consumers and the possible changes of attitudes in the consumers nutritional behaviour, an additional follow-up telephone survey was done in 495 persons. Part of the educational materials delivered were validated in focus groups («Nutritional guidelines for a healthier life» and «Nutritional guidelines for pre-schoolers, school children and adolescents»). There was a favourable acceptance of the survey from consumers (n=898); some reasons to obtain the educational materials were: to improve family nutrition (42%) and self-care (20%), among others. Only 30% answered that they knew the nutritional guidelines and 60% knew the food pyramid. In a telephone follow-up, 407 people were contacted, of whom 80% answered that they had read the materials and 97% had intention to apply this contents. The guideline that most people wanted to apply was the one to improve the consumption of fruits and vegetables. This predisposition to change is a first step to improve nutritional habits. In general there was a good understanding of the validated brochures. Conclusions: The supermarket is apt as a place to deliver nutritional information and the consumers studied were interested to be informed about nutrition. We suggest to continue with this type of educational intervention in the supermarke
Article
Across Australia and other developed nations, morbidity and mortality follows a socioeconomic gradient whereby the lowest socioeconomic groups experience the poorest health. The dietary practices of low socioeconomic groups, which are comparatively less consistent with dietary recommendations, have been thought to contribute to the excess morbidity and mortality observed among low socioeconomic groups, although this phenomenon is not well understood. Using a socioecological framework, this thesis examines whether the local food retail environment and confidence to cook contribute to socioeconomic differences in fruit and vegetable purchasing. To achieve this, four quantitative analyses of data from two main sources were conducted. The food retail environment was examined via secondary analysis of the Brisbane Food Study (BFS) and confidence to cook was examined in a cross-sectional study designed and carried out by the author. The first three manuscripts were based on findings from the BFS. Briefly, the BFS was a multilevel cross-sectional study, designed to examine determinants of inequalities, that was conducted in Brisbane in the year 2000. A stratified random sample was taken of 50 small areas (census collection districts, CCDs) and 1003 residents who usually shopped for their households were interviewed face-to-face using a schedule that included a measure of fruit and vegetable purchasing and three socioeconomic markers: education, occupation and gross household income. The purchasing measure was based on how often (never, rarely, sometimes nearly always or always) participants bought common fruits and vegetables for their households in fresh or frozen form, when in season. Food shops within a 2.5 km radius of the CCDs in which survey respondents lived were identified and audited to determine their location, type, their opening hours, and their price and availability of a list of food items. The first publication demonstrated there was minimal to no difference in the availability of supermarkets, greengrocers and convenience stores between areas that were most and least disadvantaged, in terms of the number of shops, distance to the nearest shop, or opening hours. Similarly, the second publication showed the most disadvantaged and least disadvantaged areas had no large or significant difference in the price and availability of fruits and vegetables within supermarkets, greengrocers and convenience stores, but small differences were consistently apparent, such that on average, low socioeconomic areas had lower prices but also lesser availability than more advantaged areas. The third submitted manuscript presents results of multilevel logistic regression analyses of the BFS data. While there were some associations between environmental characteristics and fruit and vegetable purchasing, environmental characteristics did not mediate socioeconomic differences in purchasing the fruit and vegetable items since there was no substantial socioeconomic patterning of the price or availability of fruits and vegetables. The fourth submitted manuscript was based on the cross-sectional study of cooking skills. A stratified random sample of six CCDs in Brisbane was taken and 990 household members ‘mostly responsible’ for preparing food were invited to participate. A final response rate of 43% was achieved. Data were collected via a self-completed questionnaire, which covered household demographics, vegetable purchasing (using the same measure employed in the BFS for continuity), confidence to prepare these same vegetables, and confidence to cook vegetables using ten cooking techniques. Respondents were asked to indicate how confident they felt (ranging from not at all- to very- confident) to prepare each vegetable, and to use each technique. This fourth study found respondents with low education and low household income had significantly lower confidence to cook than their higher socioeconomic counterparts, and lower confidence to cook was in turn associated with less household vegetable purchasing. Collectively, the four manuscripts comprising this thesis provide an understanding of the contribution of food accessibility, affordability and cooking skills to socioeconomic differences in fruit and vegetable purchasing, within a socioecological framework. The evidence provided by this thesis is consistent with a contributory role of confidence to cook in socioeconomic differences in fruit and vegetable purchasing, but is not definitive. Additional research is necessary before promoting cooking skills to improve population nutrition or reduce nutritional inequalities. An area potentially useful to examine would be how cooking skills integrate with psychosocial correlates of food and nutrition, and socioeconomic position. For example, whether improvement of cooking skills can generate interest and knowledge, and improve dietary behaviours, and whether a lack of interest in food and nutrition contributes to a lack of both fruit and vegetable consumption and cooking skills. This thesis has demonstrated that an inequitably distributed food retail environment probably does not contribute to socioeconomic variation in fruit and vegetable purchasing, at least in contemporary Brisbane, Australia. Findings are unlikely to apply to other time periods, rural and regional settings, and perhaps other Australian cities as residential and retail development, and the supply and pricing of produce vary substantially across these dimensions. Overall, the main implication for public health is that interventions targeting the food supply in terms of ensuring greater provision of shops, or altering the available food and prices in shops may not necessarily carry a great benefit, at least in major cities similar to Brisbane. Future studies of equitable food access may need to look beyond mapping the distribution of shops and prices, perhaps to more personal and subjective facets of accessibility and affordability that incorporate individuals’ perceptions and ability to access and pay for foods.
Article
In an evaluation of the theoretical foundations of behavior change, the current study examined whether social cognitive (SCT) variables mediated treatment effects on physical activity and nutrition in the recently reported Guide-to-Health trial (GTH). Adults (N = 661) were assessed at baseline, seven months and 16 months to examine whether treatment-related changes in SCT variables at seven months mediated change in nutrition and physical activity at 16 months. GTH treatment effects were mediated by self-efficacy, self-regulation and social support; self-regulation mediated self-efficacy. Social-cognitive variables explained only part of the treatment effects suggesting future investigations evaluate the environmental-selection and affective processes of behavior change.
Article
Full-text available
People with a mental illness can have deficits in a range of areas, including food skills. Mothers who have a mental illness and have residential care of their children are particularly vulnerable to experiencing food insecurity. The food skills programme known as Food Cent$ is a new way of spending money on food using the 10-plan, so that people can learn to balance their diet and their food budget. Occupational therapists in a mental health rehabilitation service incorporated the use of Food Cent$ into a parenting programme for mothers with a mental illness. A pilot study was conducted to identify whether the Food Cent$ programme influenced behaviours and attitudes towards food and food selection and preparation and reduced grocery expenditure. The participants were six mothers with a mental illness who had children under 5 years of age in their care. A focus group was conducted to gain insight into the experiences of mothers who had attended the programme. Supermarket receipts were collected before and after the project to determine changes in dietary practices. The results indicated that attending Food Cent$ contributed to an improvement in dietary intake, food selection and preparation, and grocery expenditure. Further research is required into the effectiveness of this programme with other target groups likely to experience food insecurity.
Chapter
This chapter reviews different process‐generated data sources and new technologies that could be used to enhance the measurement of household finances in longitudinal surveys. It examines financial aggregators, loyalty cards, credit and debit cards, credit ratings, barcode scanning, receipt scanning, and mobile apps. The chapter aims to contribute to a greater understanding of errors that may arise at different stages of the data generating mechanism (with process generated data), or data collection (with new technologies), and how resulting errors may affect data quality. This will inform research and development into methods to reduce the likelihood and impact of errors. An expanded version of the total survey error framework is proposed for evaluating these new data sources. The chapter concludes with a discussion of implications for survey practice and research needs.
Article
AimThe aims of this study were to examine total food expenditure and the types of food purchased in food-insecure households with children, to compare these by severity of food insecurity (moderate or low food security) and furthermore to estimate food expenditure as a percentage of net household income. Methods The study was conducted in Dunedin, New Zealand (NZ) (from June 2009 to May 2010), and included low-income (≤NZ$45 000/year), food-insecure households with children (n = 165). The main food preparer was interviewed to determine the food security status of the household. Households collected food shopping receipts and recorded all food that was purchased for four weeks. ResultsHouseholds reported spending NZ$132/week on food. The greatest percentage of food dollars was allocated to the food group meat, fish and poultry (14.5%), followed by fruit and vegetables (13.7%). Households with low food security reported spending less money compared to households with moderate food security on total food and the food groups fruit and vegetables and cereals but not on the food groups meat, fish and poultry or dairy and eggs (excluding milk). Food expenditure was estimated to be more than 30% of net income for households with an annual income of less than NZ$35 000. Conclusions For the core foods fruit, vegetables and cereals, reported food spending was less for households with low food security compared to households with moderate food security. This is likely to contribute to poor health in addition to being an undesirable and stressful condition for a household.
Article
Full-text available
Objectives. We assessed the impact of a rewards-based incentive program on fruit and vegetable purchases by low-income families. Methods. We conducted a 4-phase prospective cohort study with randomized intervention and wait-listed control groups in Philadelphia, Pennsylvania, in December 2010 through October 2011. The intervention provided a rebate of 50% of the dollar amount spent on fresh or frozen fruit and vegetables, reduced to 25% during a tapering phase, then eliminated. Primary outcome measures were number of servings of fruit and of vegetables purchased per week. Results. Households assigned to the intervention purchased an average of 8 (95% confidence interval [CI] = 1.5, 16.9) more servings of vegetables and 2.5 (95% CI = 0.3, 9.5) more servings of fruit per week than did control households. In longitudinal price-adjusted analyses, when the incentive was reduced and then discontinued, the amounts purchased were similar to baseline. Conclusions. Investigation of the financial costs and potential benefits of incentive programs to supermarkets, government agencies, and other stakeholders is needed to identify sustainable interventions. (Am J Public Health. Published online ahead of print March 13, 2014: e1-e7. doi:10.2105/AJPH.2013.301752).
Article
Objective: To compare food purchasing behaviors and diet quality of foods purchased between men and women who were the primary food purchaser for their households. Methods: Food purchasing was measured via itemized receipts. The dietary composition of purchased foods was derived using the Nutrition Data System for Research and quality was assessed using the Healthy Eating Index-2010. Results: Men comprised 17.2% of the household primary food purchasers in the sample (n = 204). There were no differences by gender in the number of items purchased or the number of receipts. Men made fewer purchases at stores (74.0%) than did women (81.4%; P < .001). There were no gender differences in the quality of foods purchased overall or by source of purchase. Conclusions and implications: In primary purchasers, purchasing behaviors varied by gender but not purchases did not. Food purchasing interventions should include both genders for greatest impact.
Article
Recent studies on agritourism share a common voice in that the economic benefit of agritourism to farms is significant but rather small. However, the majority of studies examine only the short-term economic impact of agritourism. This suggests that the potential long-run economic impacts of agritourism may not have been empirically investigated yet, leading to underestimation of its net impact. Meanwhile, theories on mere exposure and product familiarity suggest that agritourism may lead tourists to change their agriproduct purchasing patterns after the experience. Thus, this study examines the effect of agritourism experience on consumers' future grocery purchase patterns. Household-level consumer panel data on grocery expenditure is estimated through the Almost Ideal Demand System (AIDS) approach. The results indicate that agritourism experience significantly alters consumers' expenditure patterns in the food categories of grain, vegetable, fruit, meat, and fish. Implications for research and practice are discussed along with the findings of the study.
Article
Full-text available
Background: Demographic, socioeconomic, and environmental determinants are important to population health status in all countries and diet is the main way that these factors could affect health. We aimed to conduct a systematic review of recent research evidence about these determinants of household food basket composition. Methods: The PRISMA guideline was used to the reproducibility of this systematic review. Three databases including PubMed, Scopus and Google Scholar were systematically searched from 1991 to Dec 2017. Results: Thirty four studies were included. Most studies were done in the United States. Three categories of determinants including the demographic, socioeconomic, and environmental define the contribution of different food groups in the household food basket. These factors determine the healthiness of family diet. Conclusion: Many determinants affect household food basket. Comprehensive consideration of policymakers to these factors is essential to creating and maintaining a healthy society.
Article
Full-text available
Background: Theory-based interventions accessible to large groups of people are needed to induce favorable shifts in health behaviors and body weight. Purpose: The aim was to assess nutrition; physical activity; and, secondarily, body weight in the tailored, social cognitive Guide to Health (GTH) Internet intervention delivered in churches. Methods: Participants (N = 1,071; 33% male, 23% African American, 57% with body mass index > or = 25, 60% sedentary, Mdn age = 53 years) within 14 Baptist or United Methodist churches were randomized to the GTH intervention only (GTH-Only; 5 churches), with church-based supports (GTH-Plus; 5 churches), or to a waitlist (control; 4 churches). Verified pedometer step counts, measured body weight, fat, fiber, and fruit and vegetable (F&V) servings from food frequency and supermarket receipts were collected at pretest, posttest (7 months after pretest), and follow-up (16 months after pretest). Results: Participants in GTH-Only increased F&V at post (approximately 1.50 servings) compared to control (approximately 0.50 servings; p = .005) and at follow-up (approximately 1.20 vs. approximately 0.50 servings; p m = .038) and increased fiber at post (approximately 3.00 g) compared to control (approximately 1.5 g; p = .006) and follow-up (approximately 3.00 g vs. approximately 2.00 g; p = .040). GTH-Plus participants compared to control increased steps at post (approximately 1,500 steps/day vs. approximately 400 steps/day; p = .050) and follow-up (approximately 1,000 steps/day vs. approximately - 50 steps/day; p = .010), increased F&V at post (approximately 1.5 servings; p = .007) and follow-up (approximately 1.3 servings; p = .014), increased fiber at post (approximately 3.00A g; p = .013), and follow-up (approximately 3.00; p = .050) and decreased weight at post (approximately - 0.30 kg vs. approximately + 0.60 kg; p = .030). Conclusions: Compared to control, both GTH treatments improved nutrition at posttest, but church supports improved physical activity and nutrition at posttest and follow-up, suggesting environmental supports may improve Internet-based interventions.
Article
Full-text available
Lists of nutrition information posted in supermarkets were designed to reduce the information-processing costs of comparing alternative foods. In Experiment 1, lists of vitamins and minerals increased nutrition knowledge but had no influence on actual purchases. In Experiment 2, a list of added sugar—a negative component of food—increased the market share of low-sugar breakfast cereals at the expense of high-sugar brands. We conclude that effort-reducing displays are a successful technique for increasing information use, especially for the more highly valued negative nutrients.
Article
Full-text available
Many women are not meeting dietary recommendations for fiber and fat intakes. Health educators need to know which foods are major sources of these nutrients. This study analyzed the contributions of 27 food groups to fiber, fat, saturated fat, and cholesterol intakes of 2134 women aged 19 to 50 years in USDA's Continuing Survey of Food Intakes by Individuals, the 1985 and 1986 surveys (CSFII 85-86). Major determinants of fiber intake include frequency of use of certain food groups (vegetables, including potatoes, bread, fruit, soups, ready-to-eat cereal) and choice of particular foods within the larger food groups (e.g., whole grain bread, high fiber cereal). Major determinants of total fat, saturated fat, and cholesterol intakes included frequency of use of certain foods (sweet grains, beef, eggs, cheeses/cream, whole milks) and additions to foods (regular salad dressing and butter/margarine). Demographic characteristics were related to various food group consumption parameters. Information about the relationships between food group and nutrient intake and the effects of household income, race/ethnicity, and region of residence on food group intake indicate opportunities to refine nutritional education programs.
Article
Full-text available
Twenty-four hour dietary recall data from the Second National Health and Nutrition Examination Survey (1976-80) were used to estimate the numbers of servings of fruit and vegetables consumed by Black and White adults, to examine the types of servings (e.g., potatoes, garden vegetables, fruit, and juice), and to estimate the mean intake of calories, fat, dietary fiber, and vitamins A and C by number of servings. An estimated 45 percent of the population had no servings of fruit or juice and 22 percent had no servings of a vegetable on the recall day. Only 27 percent consumed the three or more servings of vegetables and 29 percent had the two or more servings of fruit recommended by the US Departments of Agriculture and of Health and Human Services; 9 percent had both. Consumption was lower among Blacks than Whites. The choice of vegetables lacked variety. Diets including at least three servings of vegetables and two servings of fruit contained about 17 grams of dietary fiber. Although caloric and fat intake increased with increasing servings of fruit and vegetables, the percent of calories from fat remained relatively constant. Although these data are 10 years old, more recent surveys have shown similar results. The discrepancy between dietary guidelines and the actual diet suggests a need for extensive public education.
Article
Full-text available
We use nationally representative samples of US women aged 19-50 y to examine comparable food-group consumption data collected in 1977 and 1985. We examine changes in the proportion of women consuming each specifically defined food group as well as the quantities users consume and the determinants of consumption changes over time. The food groupings are traditional ones, such as red meat, poultry, and milk, which are further divided by fat and dietary fiber content. Women have made major changes in their diets. The grams consumed within most food groups have decreased and the diversity of their diet and the number of lower-fat foods consumed have increased. The percentage consuming several higher-fat foods, such as higher-fat cheeses, desserts, and mixed grain dishes, has also increased. This analysis identifies important demographic and socioeconomic factors, particularly the education level of these women, associated with changes in food consumption.
Article
Full-text available
The National Cancer Institute (NCI) believes that the potential for dietary changes to reduce the risk of cancer is considerable and that the existing scientific data provide evidence that is sufficiently consistent to warrant prudent interim dietary guidelines that will promote good health and reduce the risk of some types of cancer. Six interim dietary guidelines and their scientific rationale are discussed herein. The evidence presented for the scientific rationale is based on the 1982 National Academy of Sciences Committee report Diet, Nutrition and Cancer and NCI's own scientific reviews that link long-term dietary patterns with cancer risk. These guidelines to the American public are consistent with other dietary recommendations from the US departments of Agriculture and Health and Human Services, the American Cancer Society, and the American Heart Association.
Article
Full-text available
Dietary data from 11,658 adult respondents in the second National Health and Nutrition Examination Survey were used to provide quantitative information regarding the contribution of specific foods to the total population intake of the following nutrients: calories, protein, carbohydrate, total fat, saturated fat, oleic acid, linoleic acid, and cholesterol. The percentage of total nutrient intake which each food provides is presented for the top 50 contributors of each of these nutrients, as well as the proportion of the population consuming them. These data may provide a basis for the selection of foods to be included in dietary assessment instruments. They may also be useful to health care planners or nutrition educators.
Article
Dietary data from 11,658 adult respondents in the second National Health and Nutrition Examination Survey were used to provide quantitative information regarding the contribution of specific foods to the total population intake of the following nutrients: calories, protein, carbohydrate, total fat, saturated fat, oleic acid, linoleic add, and cholesterol. The percentage of total nutrient intake which each food provides is presented for the top 50 contributors of each of these nutrients, as well as the proportion of the population consuming them. These data may provide a basis for the selection of foods to be included in dietary assessment instruments. They may also be useful to health care planners or nutrition educators.
Article
A quasi-experimental repeated measures design using a matched set of 20 test and comparison supermarkets in the Washington, D. C. and Baltimore, Md., metropolitan areas was used to evaluate a nutrition information program called “Special Diet Alert” (SDA) introduced by Giant Food, Inc. into Washington, D. C. stores in March 1981. The objective of the SDA program was to help supermarket shoppers find products for special diet needs by providing brand-specific (i.e., individual product level) shelf markers that identified products considered low or reduced in sodium, calories, cholesterol, and fat, supplemented by take-away information booklets available from a rack in the store which listed SDA brand names and specific nutrient values. Market shares of these products were tracked over the two-year evaluation period in Washington, D. C. and Baltimore stores. The pattern of differential sales trends across 16 individual food categories was complicated, but sales of shelf-marked products increased on the average 4 to 8 percent more over the two-year evaluation period in Washington, D. C. than in Baltimore, Md. stores. The average magnitude of effect attributable to SDA was modest in comparison with other factors influencing consumer purchases, highlighting the need for powerful evaluation designs to assess the effectiveness of information programs that operate in the context of many other more powerful influences. Further research is needed to determine which aspects of the SDA program were critical to its success, but one obvious difference between SDA and other in-store nutrition information programs that have been reported in the literature was the use of individual brand-specific shelf markers to deliver nutrition information to shoppers rather than prominently displayed sectional posters and detailed educational pamphlets.
Article
The corporate headquarters of 83 grocery store chains were contacted to determine whether these chains used in-store nutrition information programs. Thirty of the chains (36%) were using such programs, which focused primarily on using shelf labels to identify foods that were low or lower in calories, sodium, fat, cholesterol, or sugar, or that had favorable ratios of polyunsaturated to saturated fat. Most of the programs used color-coded shelf tags to identify the foods. The product labels and manufacturers' data were the primary sources of the programs' nutrient information. Although the programs used similar techniques, nutrients selected for tagging and the terminology and criteria for tagging were different.
Article
Increased interest in health promotion and disease prevention has created new opportunities to explore novel approaches to providing nutrition-related in­ formation to the public. The supermarket has re­ cently been endorsed as an excellent place to provide nutrition information because this setting affords an opportunity to influence impulse-buying behavior (1). The Point-of-Purchase Advertising Institute re­ cently estimated that more than 50% of food pur­ chase decisions are made while individuals are in the supermarket (2). Therefore, consumers need useful in-store information to help guide their food-pur­ chasing decisions. The use of computerized super­ market nutrition education programs is one way to meet this need and to reach audiences not currently being reached by traditional nutrition education methods. Supermar.kets first introduced computers for au­ tomated check-out and inventory control; newer ap­ plications include coupon and recipe dispensing, di­ rectory assistance, and electronic marketing. Several supermarket chains that feature computerized sys­ tems designed to answer questions concerning prod­ uct location, weekly specials, and recipes (3-5) have reported consumer acceptance of computers in the supermarket. However, the use of computers as a nutrition education medium in the supermarket has not yet been demonstrated. Recent technological advances have made com­ puter use more practical and economically feasible. The benefits of using microcomputers in nutrition education include minimal cost, maximum teaching effectiveness, and flexibility to meet individual learn­ ing needs (6). A recent Food Marketing Institute survey (Note 1) indicated that the most appropriate nutrition programs for supermarket nutrition edu­ cation were those that used videocassettes, slides, and computer programs. The immediate feedback
Article
A nutrition information program, consisting of brand-specific nutrition shelf-tags and a supplementary explanatory booklet, was tested for two years in Baltimore stores of the Giant Food chain, replicating a previous successful trial of the program in Washington, DC. Over the two-year evaluation period, market shares of shelf-tagged products increased 12% on average in Baltimore stores in 8 of 16 product categories that had been included in the original program trial. The largest marketshare increases occurred for products with the most flagged nutrients. Products with fewer flagged nutrients actually lost marketshare, suggesting that shopper purchases tended to be influenced by the number of featured nutrients as well as by the nature of the nutrients themselves. Responses to a shopper survey as well as the sales data converged to indicate that shopper concerns about nutrition and health status of family members are more highly correlated with program use than are education, income, and age.
Article
As lifestyles become more complex, nutrition educators must explore alternative forms of delivery to reach and educate busy consumers. This impact study explored the ability of in-store videos to increase consumers' nutrition knowledge about dietary fat and cholesterol. A Solomon 4 group design was used to assess the impact of continuous replay videos that were placed in grocery stores in four communities. A random sample of households within these communities was administered the pretest. The treatment consisted of four video tapes that conveyed information about dietary fat and cholesterol. It was implemented for 3 months, followed by the post-test. Findings indicate that the in-store video tapes did increase nutrition knowledge for those consumers who viewed them while grocery shopping. In addition to their viewing the video tapes, the consumers' age, education level, and confidence in their nutrition knowledge were the factors most highly associated with the nutrition knowledge quiz scores on the post-test. Findings from this study suggest that nutrition educators should continue to explore innovative avenues of consumer education.
Article
A randomized-control test of a multimedia nutrition intervention-the Nutrition for a Lifetime System (NLS©)- utilized supermarket receipts to examine effects of NLS treatment on the daily per person nutritional content of participants' supermarket purchases. In regression analyses controlling for background variables, baseline purchases and trends toward increased purchasing, NLS treatment contributed to lower levels of total fat and to higher levels of total fiber and servings of fruits and vegetables at post-test. Redemption of NLS coupons contributed to greater decreases in fat and increases in servings of fruits and vegetables in users' purchases. Implications for future interventions promoting healthier food choices include tailoring program content and addressing broader lifestyle issues such as caloric intake and expenditure.
Article
Twenty-three fruits, 33 vegetables, 41 grain products, 7 legumes, 4 nuts, and 9 miscellaneous foods were analyzed by an accurate chemical method to determine their dietary fiber content and composition. The mean (+/- standard deviation) dietary fiber content of fruits was 1.4 +/- 0.7 g/100 g (fresh weight); of vegetables, 2.0 +/- 0.8 g; of 32 refined grains (less than 5% fiber), 2.3 +/- 1.0 g; of legumes, 4.0 +/- 0.7 g; and of nuts, 6.4 +/- 2.1 g; the dietary fiber content of nine higher-fiber grains (greater than 5%) was variable. The soluble fiber fraction averaged 23% of the total fiber in refined grains, 3% in nuts, and 13% to 20% in the other food groups. Dietary fiber composition of every food group was heterogenous. Pectin, which was negligible in grains, constituted approximately 15% to 30% of the fiber in fruits, vegetables, legumes, and nuts. Hemicelluloses composed about half of the total fiber in grains, and approximately 25% to 35% of total fiber in other foods. Cellulose was one third or less of the total fiber in most foods, except for legumes, in which it was about one half. Values for total dietary fiber content generally agree with those reported previously. The soluble fiber fraction was lower than what has been reported because the distribution of total fiber between the soluble and insoluble fractions is determined by the method of analysis. The analyses used in this study demonstrated that the concentration of dietary fiber in many frequently consumed foods is 1% to 3%. The generally similar fiber concentrations of food within a group--fruits, vegetables, refined grains, and legumes--suggest that an average value for the fiber concentration in that group can be used to rank food intakes and histories into low, medium, or high dietary fiber contents.
Article
Data for 5,884 adults (19 years of age and older) who participated in the 1987-88 Nationwide Food Consumption Survey (1987-88 NFCS) were used to investigate demographic and economic factors associated with dietary quality. Although the low response rate for the 1987-88 NFCS has raised concerns about possible bias, it is appropriate to use this extensive data set for analyses that do not attempt to generalize the results to the US population as a whole. Two aspects of quality were calculated for the mean of the 3-day reported intakes: number of nutrients below two thirds of the 1989 Recommended Dietary Allowance (RDA) (low-intake nutrients) and percent of energy from fat. Few adults reported mean intakes that met suggested guidelines: 22% of diets were above two thirds of the RDA for all 15 nutrients and 14% were below 30% fat, but only 2% met both criteria. Energy intake was a strong negative predictor of number of low-intake nutrients and a weak positive predictor of percent of energy from fat. Results of multivariate regression analyses identified few demographic or economic predictors of either the number of low-intake nutrients or percent of energy from fat. According to these data, diets of most adults do not conform to current dietary guidelines. Nutrition education efforts should be directed to all adults, and research should be undertaken to determine more effective ways to help adults improve their overall dietary quality.
Article
Two hundred sixty-six free-living human volunteers, 21-64 y old, were trained by dietitians to record daily their food intake for at least 7 d. Subsequently, they were fed diets of conventional foods adjusted in amounts to maintain their body weight for greater than or equal to 45 d. Comparing their estimated energy intake with the intake determined to maintain weight yielded mean differences of 2365 and 1792 kJ (565 and 428 kcal) in men and women, respectively, representing an underreporting of 18%. Twenty-two individuals (8%) overestimated and 29 (11%) were accurate to within 419 kJ (100 kcal) of their maintenance requirement. The remaining 215 individuals (81%) reported their habitual intake at 2930 +/- 1586 kJ (700 +/- 379 kcal) below that subsequently determined as their maintenance requirement. These findings suggest caution in the interpretation of food-consumption data.
Article
This review focuses on dietary guidelines regarding fruit and vegetable consumption; sources of the antioxidant micronutrients, beta-carotene and vitamin C; and survey data on the US population's actual consumption of these foods. The Dietary Guidelines for Americans recommended consumption of five or more servings of vegetables and fruits daily, as did the 1989 Diet and Health report, which also emphasized fruits and vegetables rich in vitamin C and carotenoids. In contrast with these recommendations and strong evidence for a beneficial effect, very few individuals in the United States even approach the recommended levels of intake. In the US NHANES II data, 41% of the population had no fruit on the survey day; only one fourth had a fruit or vegetable rich in vitamin A or in vitamin C. Only 10% consumed the recommended five servings. Efforts to increase consumption of these foods are needed to improve the diet and health of the population.
Article
The growing evidence linking dietary patterns to the incidence and prevention of chronic disease has prompted a number of prominent health and scientific agencies to publish dietary guidelines for the public. Some dietary guidelines address specific diseases, such as cancer or heart disease; others focus on overall health promotion. This situation has created a demand for nutrition education and information programs for the public. Increasingly, supermarkets are seen as potential sites for effective consumer education. Eat for Health is a joint research study by the National Cancer Institute (NCI) and Giant Food Inc., a regional supermarket chain in the Washington-Baltimore area. The study's goal was to test the feasibility of supermarkets as a site for consumer nutrition education. Eat for Health's educational focus was diet and cancer control issues in the context of dietary patterns that promote health. Particular attention was paid to reduction of fat intake and increases in consumption of dietary fiber from grains, vegetables, and fruits. Analysis of program results is currently underway; data should be available in early 1990.
Article
Intervention strategies aimed at reducing the prevalence of nutrition-related diseases, including designing nutrition policies and nutrition education and assistance programs, require effective monitoring of what Americans are eating. Nutrient reference data from the third National Health and Nutrition Examination Survey provide essential information to achieve these goals. Mean and median iron intakes were adequate in males of all race-ethnic groups but were generally low in females and young children. Mean and median calcium intakes were also higher in males than in females and were lower than recommendations in adolescents and in women of all ages. Mean sodium intakes for all age, sex, and race-ethnic groups exceeded the minimum requirements of healthy persons and were higher in non-Hispanic black children and adolescents than in non-Hispanic white and Mexican American children and adolescents. Mean fiber intakes also did not meet recommendations in most subgroups and were higher in Mexican American adults followed by non-Hispanic white adults and non-Hispanic black adults. Further research is planned to compare the food sources of energy and nutrients consumed by different population groups in NHANES III to similar results from earlier nation surveys. NHANES III, Phase 2 (1991-94) recalls were collected using the same dietary method as those collected in Phase 1 (1988-91), and other analyses will compare findings from both phases of NHANES III.
Provisional table on the dietary fiber content of selected foods
  • U S Department
U.S. Department ofAgriculture. Provisional table on the dietary fiber content of selected foods. (HNIS IPT-106).
Data tables: combined results from USDA's 1994 and 1995 Continuting Survey of Food Intakes by Individuals and 1994 and 1995 Diet and Health Knowledge Survey
  • Enns Cw Wllson Jw
  • Goldman
  • Jd
Wllson JW, Enns CW, Goldman JD, et al. Data tables: combined results from USDA's 1994 and 1995 Continuting Survey of Food Intakes by Individuals and 1994 and 1995 Diet and Health Knowledge Survey [online: http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm]. ARS Food Surveys Research Group.
The fiber counter. NewYork: Dell
  • C Netzer
Netzer C.The fiber counter. NewYork: Dell, 1994.
Energy and macronutrient intakes of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey
  • M A Mcdowell
  • R D Ronette
  • R Briefel
Data tables: combined results from USDA's 1994 and 1995 Continuting Survey of Food Intakes by Individuals and 1994 and 1995 Diet and Health Knowledge Survey
  • J W Wilson
  • C W Enns
  • J D Goldman