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Food purchasing decisions of Malawian mothers with young children in households experiencing the nutrition transition.

ABSTRACT: As overweight/obesity prevalence increases in sub-Saharan Africa, information is needed about factors influencing food purchases in households with overweight members. This study assessed food purchasing decisions of Malawian mothers with young children (N = 54 dry season, N = 55 rainy season) among whom the mother, child, or both were overweight. Research assistants completed structured observations of mothers shopping for food during the dry season and of the types and quantities of foods in mothers' homes during the rainy season. After each observation, research assistants conducted an in-depth interview about factors that influenced food purchases, including asking mothers to sort 12 factors into piles that always, sometimes, or never influence their food purchases. Observations showed mothers most often shopped at outdoor markets to buy foods needed to prepare relish, such as tomatoes (71%), green leafy vegetables (58%), cooking oil (58%), and fish (40%). At home, maize flour (80%) and salt (66%) were the most common foods. Pile sorts and in-depth interviews revealed cost, taste preferences, freshness, and healthiness were the strongest factors influencing food purchases. Mothers described buying a smaller quantity or making substitutions (e.g., fish instead of meat) if a food is too expensive. Many mothers reported buying foods their family likes and prioritizing children's preferences. Freshness of foods, especially fruits and vegetables, and whether foods were perceived to be healthy also influenced food purchases, but mothers' knowledge of which foods were healthy was mixed. Mothers used some of their minimal funds to buy unhealthy foods (e.g., packaged or fried snacks) for their children, despite their overall emphasis on food cost and healthiness. These findings can be used by programs to reinforce healthy and decrease unhealthy food purchases by mothers with young children in Malawi.

SUBMITTER: Flax VL

PROVIDER: S-EPMC7677890 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Food purchasing decisions of Malawian mothers with young children in households experiencing the nutrition transition.

Flax Valerie L VL Thakwalakwa Chrissie C Schnefke Courtney H CH Phuka John C JC Jaacks Lindsay M LM

Appetite 20200830

As overweight/obesity prevalence increases in sub-Saharan Africa, information is needed about factors influencing food purchases in households with overweight members. This study assessed food purchasing decisions of Malawian mothers with young children (N = 54 dry season, N = 55 rainy season) among whom the mother, child, or both were overweight. Research assistants completed structured observations of mothers shopping for food during the dry season and of the types and quantities of foods in m ...[more]

PMID: 32877746

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Project description:IntroductionThe Special Supplemental Nutrition Program for Women, Infants and Children (WIC) required major revisions to food packages in 2009; effects on nationwide low-income household purchases remain unexamined.MethodsThis study examines associations between WIC revisions and nutritional profiles of packaged food purchases from 2008 to 2014 among 4,537 low-income households with preschoolers in the U.S. (WIC participating versus nonparticipating) utilizing Nielsen Homescan Consumer Panel data. Overall nutrients purchased (e.g., calories, sugar, fat), amounts of select food groups with nutritional attributes that are encouraged (e.g., whole grains, fruits and vegetables) or discouraged (e.g., sugar-sweetened beverages, candy) consistent with dietary guidance, composition of purchases by degree of processing (less, moderate, or high), and convenience (requires preparation, ready to heat, or ready to eat) were measured. Data analysis was performed in 2016. Longitudinal random-effects model adjusted outcomes controlling for household composition, education, race/ethnicity of the head of the household, county quarterly unemployment rates, and seasonality are presented.ResultsAmong WIC households, significant decreases in purchases of calories (-11%), sodium (-12%), total fat (-10%), and sugar (-15%) occurred, alongside decreases in purchases of refined grains, grain-based desserts, higher-fat milks, and sugar-sweetened beverages, and increases in purchases of fruits/vegetables with no added sugar/fats/salt. Income-eligible nonparticipating households had similar, but less pronounced, reductions. Changes were gradual and increased over time.ConclusionsWIC food package revisions appear associated with improved nutritional profiles of food purchases among WIC participating households compared with low-income nonparticipating households. These package revisions may encourage WIC families to make healthier choices among their overall packaged food purchases.

Project description:In energy systems' economic models, people's behaviour is often underestimated, and they are generally unaware of how habits impact energy efficiency. Improving efficiency is challenging, and recommendations alone may not be sufficient. Changing behaviour requires understanding the direct impact of needs and habits on energy efficiency. This research introduces a methodology that retrieves human expert knowledge from four key aspects of the current energy transition: everyday appliances, buildings, mobility, flexibility, and energy efficiency. The aim is to examine the causal relationship between energy consumption and human behaviour, gaining a deeper understanding of the links among the factors that drive final energy consumers to change habits through the adoption of energy-saving measures. Working in collaboration with expert panels, this study provides a methodology for extracting expert human knowledge based on a set of future energy transition scenarios aligned with the achievement of the Paris Agreement, a taxonomy of 32 factors that have a strong influence on households' investment decisions, and the results of a survey that characterises the European population through the 32-factor taxonomy and some socioeconomic conditions. In addition, the survey included a sample of the Latin American population to analyse how socioeconomic conditions (region, education, gender, etc.) influence the prioritisation of these factors. We discuss the high priority given to competence and autonomy over financial factors by inhabitants of the European Union residential sector. We provide an analysis of the factors through which other similar projects are focused and on which we converge. In addition, we contribute by presenting the hierarchy of priorities assigned by people. This highlights the importance for policymakers to take these aspects seriously when implementing energy policy interventions that go beyond purely financial measures and fiscal incentives.

Project description:BackgroundPoint-of-sale is a potentially important opportunity to promote healthy eating through nutrition education and environment modification. The aim of this review was to describe and review the evidence of effectiveness of various types of interventions that have been used at point-of-sale to encourage purchase and/or eating of healthier food and to improve health outcomes, and the extent to which effectiveness was related to intensity, duration and intervention setting.MethodsRecords from searches in databases were screened and assessed against inclusion criteria. Included studies had risk of bias assessed. Intervention effectiveness was assessed for two outcomes: i) purchase and/or intake of healthier food options and/or nutrient intake; and ii) mediating factors that might effect the primary outcome.ResultsThe search identified 5635 references. Thirty-two papers met the inclusion criteria. Twelve studies had low risk of bias and were classified as strong, nine were moderate and 11 were weak. Six intervention types and a range of different outcome measures were described in these papers: i) nutrition education and promotion alone through supermarkets/stores; ii) nutrition education plus enhanced availability of healthy food; iii) monetary incentive alone; iv) nutrition education plus monetary incentives; v) nutrition intervention through vending machines; and vi) nutrition intervention through shopping online. The evidence of this review indicates that monetary incentives offered to customers for a short-term look promising in increasing purchase of healthier food options when the intervention is applied by itself in stores or supermarkets. There was a lack of good quality studies addressing all other types of relevant point-of-sale interventions examining change in purchase and/or intake of healthier food options. There were few studies that examined mediating factors that might mediate the effect on the primary outcomes of relevant interventions.ConclusionsA range of intervention types have been used at point-of-sale to encourage healthy purchasing and/or intake of healthier food options and to improve health outcomes. There is a need for more well designed studies on the effectiveness of a range of point-of-sale interventions to encourage healthier eating and improve health outcomes, and of the mediating factors that might impact these interventions.

Project description:BackgroundDigital nutrition apps that monitor or provide recommendations on diet have been found to be effective in behavior change and weight reduction among individuals with obesity. However, there is less evidence on how integration of personalized nutrition recommendations and changing the food purchasing environment through online meal planning and grocery delivery, meal kits, and grocery incentives impacts weight loss among individuals with obesity.ObjectiveThe objective of this observational longitudinal study was to examine weight loss and predictors of weight loss among individuals with obesity who are users of a digital nutrition platform that integrates tools to provide nutrition recommendations and changes in the food purchasing environment grounded in behavioral theory.MethodsWe included 8977 adults with obesity who used the digital Foodsmart platform, created by Zipongo, Inc, DBA Foodsmart between January 2013 and April 2020. We retrospectively analyzed user characteristics and their associations with weight loss. Participants reported age, gender, height, at least 2 measures of weight, and usual dietary intake. Healthy Diet Score, a score to measure overall diet quality, was calculated based on responses to a food frequency questionnaire. We used paired t tests to compare differences in baseline and final weights and baseline and final Healthy Diet Scores. We used univariate and multivariate logistic regression models to estimate odds ratios and 95% CI of achieving 5% weight loss by gender, age, baseline BMI, Healthy Diet Score, change in Healthy Diet Score, and duration of enrollment. We conducted stratified analyses to examine mean percent weight change by enrollment duration and gender, age, baseline BMI, and change in Healthy Diet Score.ResultsOver a median (IQR) of 9.9 (0.03-54.7) months of enrollment, 59% of participants lost weight. Of the participants who used the Foodsmart platform for at least 24 months, 33.3% achieved 5% weight loss. In the fully adjusted logistic regression model, we found that baseline BMI (OR 1.02, 95% CI 1.02-1.03; P<.001), baseline Healthy Diet Score (OR 1.06, 95% CI 1.05-1.08; P<.001), greater change in Healthy Diet Score (OR 1.12, 95% CI 1.11-1.14; P<.001), and enrollment length (OR 1.28, 95% CI 1.23-1.32; P<.001) were all significantly associated with higher odds of achieving at least 5% weight loss.ConclusionsThis study found that a digital app that provides personalized nutrition recommendations and change in one's food purchasing environment appears to be successful in meaningfully reducing weight among individuals with obesity.

Project description:BackgroundTo limit the spread of COVID-19, a strict lockdown was imposed in France between March and May 2020. Mobility limitations and closure of non-essential public places (restaurants, open-air markets, etc.) affected peoples' food environment (FE) and thus their food purchasing practices (FPPs). This study aimed to explore changes in FPPs of French households during lockdown and associations with individual and environmental factors.MethodsIn April of 2020 households from the Mont'Panier cross-sectional study (n = 306), a quota sampling survey conducted in the south of France, were asked to complete an online questionnaire about their FPPs during lockdown and related factors, including perceived FE (distance to closest general food store, perception of increased food prices, etc.). Objective FE (presence, number, proximity, and density of food outlets) was assessed around participant's home using a geographical information system. Multiple correspondence analysis based on changes in frequency of use and quantity of food purchased by food outlet, followed by a hierarchical cluster analysis, resulted in the identification of clusters. Logistic regression models were performed to assess associations between identified clusters and household's sociodemographic characteristics, perceived, and objective FE.ResultsFive clusters were identified. Cluster "Supermarket" (38% of the total sample), in which households reduced frequency of trips, but increased quantity bought in supermarkets during lockdown, was associated with lower incomes and the perception of increased food prices. Cluster "E-supermarket" (12%), in which households increased online food shopping with pickup at supermarket, was associated with higher incomes. Cluster "Diversified" (22%), made up of households who reduced frequency of trips to diverse food outlet types, was associated with the perception of increased food prices. Cluster "Organic Food Store" (20%), in which households did not change frequency of trips, nor quantity purchased in organic food stores, was associated with being older (35-50 y vs. <35 y). Finally, cluster "Producer" (8%), which includes households who regularly purchased food from producers, but mostly reduced these purchases during lockdown, was associated with the presence of an organic food store within a 1-km walking distance around home.ConclusionThis study highlighted diverse changes in FPPs during lockdown and overall more significant associations with perceived than with objective FE indicators.

Project description:BackgroundThis is the first study on dietary intakes of infants and young children in the Eastern Mediterranean Region, a region that is currently witnessing the nutrition transition. It aims at characterizing food consumption patterns amongst 0-4 year old children in Lebanon, evaluating their macro- and micronutrient intakes and assessing adherence to dietary recommendations.MethodsBased on a national cross-sectional survey in 2012 (n = 866), the study collected data on sociodemographic and anthropometric characteristics, and one 24-hour dietary recall was administered. Nutrient intakes were compared with reference values: Estimated Average Requirement (EAR), Adequate Intake (AI) and Acceptable Macronutrient Distribution Range (AMDR).ResultsMilk was the highest contributor to energy intake (EI) in infants (95.8 and 56.5% in 0-5.9 months and 6-11.9 months old infants, respectively), while its intake was lower among toddlers and preschoolers (35.4 and 15.1%, respectively). In contrast, intakes of sweets and sweetened beverages were the highest in preschoolers compared to younger children, contributing 18.5% EI in preschoolers. Compared to dietary guidelines, the lowest dietary adherence was found for vegetables (17.8-20.7%) and fruits (14.4-34.3%). Protein intake was within the recommendations for the vast majority of children. Although total fat intake was lower in toddlers and preschoolers compared to infants, more than 40% of toddlers and preschoolers exceeded the AMDR for fat and 87.3% of preschoolers exceeded the upper limit for saturated fat. Only 3.6% of toddlers and 11.5% of preschoolers exceeded the AI level for dietary fiber. Micronutrient intake assessment showed that mean intakes in infants exceeded the AI for all micronutrients, except for vitamin D and magnesium. In toddlers, vitamin D and calcium were below the EAR among 84.7, and 44.6%, respectively. In preschoolers, most of the children (91.9%) had inadequate intakes of vitamin D, and a third had inadequate intakes of folate, calcium and vitamin A.ConclusionsThis study identified priority issues for nutrition intervention in infants and young children in Lebanon. Concerted multi-stakeholder efforts are needed to instill heathier food consumption and nutrient intake patterns early in life.

Dataset Information

Food purchasing decisions of Malawian mothers with young children in households experiencing the nutrition transition.

Publications

Food purchasing decisions of Malawian mothers with young children in households experiencing the nutrition transition.

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