3rd International Symposium on Nutrition: Urban Food Policies for Sustainable Nutrition and Health Conference, Online, 27-28 January 2022

This proceedings contains 7 articles that focus on the various issues related to nutrition and health concerning urban food policies. The symposium includes s on several topics, such as the regulation of food advertising, the relationship between the urban foodscape, diet, and health outcomes, the interpretation of observational studies, and the impact of obesity and diet on brain structure and function. Additionally, the issue features meeting reports on plant-rich dietary patterns and their impact on health. Two errata address food insecurity among third-level students in Ireland during the COVID-19 pandemic and a meeting report on plant-rich dietary patterns and health.

From multiple streams to a torrent: A case study of food policymaking and innovations in New York during the COVID-19 emergency.

The COVID-19 pandemic has had significant effects on urban and regional food systems. Local administrations worldwide have been challenged to design and implement policies to mitigate immediate food system disruptions while planning for longer-term equity and resilience. The fast pace and high degree of uncertainty of the pandemic have made systematic tracking and assessment of food system change and related policy responses arduous. To address this gap, this paper applies the multilevel perspective on sociotechnical transitions and the multiple streams framework on policy change to 16 months of food policy (March 2020 through June 2021) during the New York State-issued COVID-19 state of emergency, comprising more than 300 food policies advanced by New York City and State legislators and administrators. Content analysis of these policies revealed the most salient policy areas during this period, the status of legislation, and key programs and budget allocations, as well as local food governance and the organizational spaces within which food policy operates. The paper shows that food policy domains that gained prominence focused on support for food businesses and food workers and on ensuring and expanding food access through food security and nutrition policies. Most COVID-19 food policies were incremental and were limited to the duration of the emergency, yet the crisis allowed for enactment of novel policies that deviated from the common policy issues or the typical scale of changes proposed pre-pandemic. Taken together, and viewed through a multilevel and policy streams framework, the findings provide insight into the trajectory of food policymaking in New York during the pandemic and the areas that food justice activists, researchers, and policy makers should focus on as the COVID-19 pandemic is abated.

Food Oppression in a Pandemic.

COVID-related racial disparities represent a spectrum of injustices and inequalities. Focusing on food oppression, this essay argues that racism infuses food law and policy in ways that contribute to racially disparate COVID deaths and severe illnesses. USDA nutrition program participants were at a nutritional disadvantage when COVID hit. Yet, government responses focused on food insecurity, not nutritional quality. Racism against a predominantly Black and brown labor force of essential food workers - from fields to meat plants to grocery stores - created tolerance for the administration's failure to protect or compensate some of the country's most vulnerable workers. When COVID-driven supply issues threatened to narrow white people's activities and choices, the favored response was to keep their options open by sacrificing Black and brown workers. A food oppression lens - understanding how corporate interests drive food policy - is necessary to achieve food equality in this pandemic and beyond.

Food trade among Pacific Island countries and territories: implications for food security and nutrition.

BACKGROUND: There is growing attention to intra-regional trade in food. However, the relationship between such trade and food and nutrition is understudied. In this paper, we present an analysis of intra-regional food trade in the Pacific region, where there are major concerns regarding the nutritional implications of international food trade. Using a new regional database, we examine trends in food trade among Pacific Island Counties and Territories (PICTs) relative to extra-regional trade. RESULTS: Intra-regional trade represents a small, but increasing proportion of total imports. The major food group traded within the Pacific is cereal grains and flour, which represented 51% of total intra-regional food trade in 2018. Processed and prepared foods, sweetened or flavoured beverages, processed fish, and sugar and confectionary are also traded in large quantities among PICTs. Trade in root crops is negligible, and overall intra-regional trade of healthy foods is limited, both in terms of tonnage and relative to imports from outside the region. Fiji remains the main source of intra-regional imports into PICTs, particularly for non-traditional staple foods. CONCLUSIONS: This study highlights the growth in trade of staple foods intra-regionally, indicating a role for Fiji (in particular) in regional food security. Within this overall pattern, there is considerable opportunity to enhance intra-regional trade in traditional staple foods, namely root crops. Looking forward, the current food system disruption arising from the COVID-19 pandemic and associated policy measures has highlighted the long-term lack of investment in agriculture, and suggests an increased role for regional approaches in fostering trade in healthy foods.

Towards the high-quality development of City Region Food Systems: Emerging approaches in China.

The outbreak of COVID-19 has underscored the vulnerability of our current food systems. In China, following a series of strategies in guaranteeing food security in the past decades, the pandemic has further highlighted the necessity to strengthen urban-rural linkages and facilitate the sustainable development of local agri-food systems. The study for the first time introduced the City Region Food Systems (CRFS) approach to Chinese cities and attempted to holistically structure, analyze and promote the sustainability of local food systems in China. Taking Chengdu as an example, the study first took stock of existing concepts and policies in China and the city, and defined the high-quality development goals of CRFS for Chengdu. An indicator framework was then developed to serve as a CRFS assessment tool for identifying existing challenges and potentials of local food systems. Further, a rapid CRFS scan using the framework was conducted in Chengdu Metropolitan Area, providing concrete evidence for potential policy interventions and practice improvement in the area. The study has explored new paradigm of analysis for food related issues in China and provided supporting tools for evidence-based food planning in cities, which collectively contribute to the food system transformation in a post-pandemic scenario.

Shifting the social determinants of food insecurity during the COVID-19 pandemic: the Australian experience.

We aimed to explore experiences of government-led actions on the social determinants of food insecurity during Australia's COVID-19 pandemic response (which included novel, yet temporary, social protection measures to support Australians facing hardship during state-wide lockdowns). During November-December 2020, we conducted in-depth interviews with 24 Victorians who received government income support (prior to COVID-19) and the temporary COVID-19 specific payments. Interviews were guided by a theoretical understanding of the social determinants of health and health inequities, which we aligned to the social policy context. Data were audio-recorded, transcribed, inductively coded, categorised and thematically analysed. Our sample included mostly women (n = 19) and single parents (n = 13). Interviews reflected four key themes. Firstly, participants described 'battles all around them' (i.e., competing financial, health and social stressors) that were not alleviated by temporary social policy changes and made healthy eating difficult to prioritise during the pandemic. Secondly, housing, income, job, and education priorities rendered food a lower and more flexible financial priority - even with 18 participants receiving temporary income increases from COVID-19 Supplements. Thirdly, given that food remained a lower and more flexible financial priority, families continued to purchase the cheapest and most affordable options (typically less healthful, more markedly price discounted). Finally, participants perceived the dominant public and policy rhetoric around income support policies and healthy eating to be inaccurate and shaming - often misrepresenting their lived experiences, both prior to and during COVID-19. Participants reported entrenched struggles with being able to afford basic living costs in a dignified manner during COVID-19, despite temporary social protection policy changes. To reduce inequities in population diets, a pre-requisite to health, all stakeholders must recognise an ongoing responsibility for adopting long-term food and social policies that genuinely improve lived experiences of food insecurity and poverty. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-022-01318-4.

A hybrid method to quantify household urban agriculture gardening: Implications for sustainable and equitable food action planning

Urban food action plans seek quantitative data on household agriculture gardening, traditionally difficult to quantify rapidly, as welt as data on inequality to explore the potential to improve equitable access to fresh vegetables through household agriculture. This article presents a novel hybrid field survey (HFS) method, combining ground surveys with satellite imagery to quantify the prevalence and area of household agriculture gardens, as well as inequality by neighborhood income. We test the method in Minneapolis and St. Paul, Minnesota, (Twin Cities), USA, analyzing the presence/absence (prevalence) and size of agriculture gardens across a total of similar to 17,500 households in 2017 and repeated in 2020 (during COVID-19). In 2017, the overall mean frequency of household agricultural gardening was 5.0%, with significant differences (2.7 vs. 7.0%) across low- vs. high-income neighborhoods. The city-wide median area per agriculture garden size was 14.6 m(2) with greater size (19.8 vs. 11.6 m(2)) in low- vs. high-income neighborhoods, respectively. Across all income groups, the gardening area was a small fraction of the yard area, suggesting little land availability constraints. Measurements in the summer of 2020 during COVID-19 found the method sensitive over time, showing an overall 60% increase in the prevalence of household agriculture with low-income neighborhoods increasing rates from 3 to 5%. Overall, the method can inform aggregate production potential and inequality in household agriculture.

Meeting Older Adults' Food Needs During the COVID-19 Pandemic: Lessons And Challenges from Washington State.

The COVID-19 pandemic threatened the ability of nutrition providers to address food insufficiency among older adults. Findings from Household Pulse Survey data and interviews with 23 service leaders in Washington state during the summer of 2020 point to key organizational practices that should inform future emergency food assistance planning. Organizations deeply connected to and trusted by racially and ethnically diverse, unhoused, and low-income older adults are critical to addressing disparities in food insufficiency. Stable and flexible increases in funding would allow these organizations to maintain the effective and culturally-relevant service adaptations they implemented in the first months of the pandemic.

Effects of the revised WIC food package on women's and children's health: a quasi-experimental study.

BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was revised in 2009 to be more congruent with national dietary guidelines. There is limited research examining effects of the revision on women's and children's health. The objective of this study was to evaluate whether the revised WIC food package was associated with various indicators of physical and mental health for women and children. METHODS: We used 1998-2017 waves of the National Health Interview Survey (N = 81,771 women and 27,780 children) to estimate effects of the revised WIC food package on indicators of health for both women (self-reported health and body mass index) and children (anemia, mental health, and parent-reported health). We used difference-in-differences analysis, a quasi-experimental technique that assessed pre-post differences in outcomes among WIC-recipients while "differencing out" the secular underlying trends among a control group of non-recipients. RESULTS: For all outcomes evaluated for women and children, we were unable to rule out the null hypothesis that there was no effect of receiving the revised WIC food package. These findings were confirmed across several secondary analyses conducted to assess heterogeneity of effects and robustness of results. CONCLUSION: While we did not find effects of the revised WIC food package on downstream health indicators, studies using similarly robust methods in other datasets have found shorter-term effects on more proximal outcomes related to diet and nutrition. Effects of the modest WIC revisions may be less impactful on longer-term indicators of health, and future studies should examine the larger COVID-19-era expansion.

The Role of Local Authorities in Shaping Local Food Systems

Given the importance that current food-related challenges pose to our society, the potential of local food initiatives to address sustainability has gained increased attention. Nevertheless, research has increasingly demonstrated that local food initiatives are limited in fulfilling their sustainability potential. This realisation has led many scholars to argue that the path towards food system transformation needs to be based on interconnected networks of these ‘alternative’ practices—what this paper terms local food systems. Nevertheless, as many local food initiatives rely on funding and volunteer work, their capacity to create infrastructures for integrated approaches is limited. In this context, influential players—those who can provide resources, such as local authorities—become key in the assemblage of local food systems. However, there is limited understanding of how the role of local authorities affects the internal dynamics of local food systems and potential outcomes. This study addresses this research gap by analysing two case studies (Preston, England and Vitoria-Gasteiz, Basque Country). Using urban political ecology (UPE) as a theoretical framework, this study offers original insight into the key governance elements affecting the direction of local food systems and thus the alignment of diverse local food initiatives, limiting their sustainability potential.

Society for Social Medicine Annual Scientific Meeting Abstracts, Virtual, 15-17 September 2021

These proceedings contain 90 articles that discuss COVID-19 epidemiology, prevention and control;cardiovascular disease modelling;paediatrics;obesity;diabetes & global health;dementia, cognition, and ageing;food policies;women's health;physical activity;mental health;tobacco smoking;health inequalities;and primary health care.

Food security in the community of West African States: a study on policy decisions in the COVID-19 pandemic

The aim of this study is to analyze the policy decisions taken by countries in the Economic Community of West African States (ECOWAS) region to mitigate the impacts of the COVID-19 pandemic on the food supply. Information was drawn from the Food and Agriculture Policy Decision Analysis (FAPDA), which depicts policy decisions implemented to mitigate impacts with respect to food security. After analyzing these data in relation to the indicators of the Global Food Security Index (GFSI), it was found that policy decisions were centered on the dimensions "access to food" and "availability of food". In terms of access to food, we highlight food transfer policies in kind and social protection measures policies. In terms of food availability, macroeconomic policies and policies to support food production stand out. The effects of the pandemic have heightened the risk of food insecurity, particularly in sub-Saharan Africa.

Agriculture and fisheries support policies in Algeria - a strategic prospective towards sustainable food security 2035

Covid-19 and the Ukrainian crisis have put the question of the "food emergency" back on everyone's agenda. If the need to ensure food security is unanimous in Algeria, this is however not the case for the future orientation of public policies in this area. This work attempts to contribute to this debate through a strategic prospective analysis to 2035 identifying new orientations for policies to support agricultural and fisheries production systems. It demonstrates that it is necessary, in order to better prepare for these "long and short time" challenges, to act now and to go further "than instead of" marginal adjustments. Also, these new policies must accompany "a double paradigm shift" that of the food model and the agricultural and fisheries production systems. The establishment of a cross-cutting food security policy in Algeria therefore appears to be essential to promote and succeed in this new dynamic.

Framing of policy responses to migrant horticultural labour shortages during Covid-19 in the Italian print media.

The Covid-19 pandemic led to a global food crisis. Like previous food crises how the debate is framed by food policy actors can have a bearing on policy outcomes. This study researches how the policy responses to migrant horticultural labour shortages, due to the pandemic, were framed in the Italian print media and how this relates to longer-term food policy making. Data were gathered from the six highest-circulation Italian daily newspapers. The coverage was dominated by left-leaning outlets and peaked in relation to Covid-19 recovery policies and political processes. Farmer industry bodies were the most quoted group, and the legalisation of undocumented migrant workers was the most frequently discussed policy response. A frames analysis was conducted and identified three principal frames: food security, worker exploitation and immigration. The worker exploitation and immigration frames were most frequently used by left-leaning newspapers, while centre-right papers used the food security frame the most often. The results suggest that media framing could contribute to both policy change, helping to open policy windows, as well as policy lock-ins, side-lining certain debates, actors and policy solutions. The research aims to contribute to growing empirical work which seeks to understand the impact of Covid-19 on migrant agricultural workers and food policy.

Low-income parents' perceptions of a sweetened beverage tax in Philadelphia.

Objective: To characterise perceptions of the Philadelphia Beverage Tax among low-income parents. Design: We conducted semi-structured interviews and administered demographic questions via telephone. We based the interview guide and initial codebook on a conceptual model illustrating perceived fairness and effectiveness as essential for successfully adopting food policies. We performed thematic analysis using NVivo 12. Setting: We recruited from a primary care paediatrics clinic in Philadelphia, Pennsylvania from July to August 2020. Participants: Philadelphia parents/caregivers of 2- to 11-year-old children with Medicaid insurance. Results: Participants were predominantly African American (97 %), female (100 %), and had annual household incomes <$50 000 (80 %). Participants were 26- to 72-years old, with an average aged child of 5 years (range 7 months to 20 years). Themes emerged regarding tax perceptions, revenue use and behaviour change due to the tax. Using revenue for highly valued programmes and accountability of city government to use revenue as promised were critical elements in perceptions of tax fairness. Some parents avoided the tax through cross-border shopping and buying drink powders or concentrates, influencing perceptions of tax effectiveness. The tax signalled the health dangers of sweetened beverage consumption to most parents. Conclusion: Our findings bring to light four key takeaways for policymakers designing sweetened beverage taxes. (1) Dedication of tax revenue to programmes highly valued by parents and (2) transparency in revenue spending may improve acceptability. (3) State or national taxes may be more effective at decreasing consumption due to cross-border shopping. (4) Pairing taxes with health promotion campaigns may enhance behaviour change.

England's food policy coordination and the Covid-19 response.

The impact of the first wave of the Covid-19 pandemic and the response of government and non-government actors, from February-September 2020, offers critical insights into the current state of England's food policy processes and operations, and in particular the coordination of national food policy approaches. This study aims to clarify and solidify the discourse around food policy coordination by differentiating between routine coordination of the activities of government, and strategic coordination of such policy activities with higher-level strategic goals, such as those associated with a healthy and sustainable food system. This framework is applied to the case study based on documentary analysis. In detailing the evidence of coordination in the response, including examples of cross-government working, and collaboration across the public, private and third sectors, the findings illustrate the breadth of actors which constituted the policy and governance response. These included public policymakers in national and local governments, and from a range of different government departments; private sector food businesses; and third sector organisations. There was a high level of routine coordination, but also instances of disconnection and delay. A lack of strategic coordination provides an explanatory device for several instances of disconnection and incoherence, including interventions which failed to prioritise nutrition-related health, and the working conditions of those employed in the food sector. The routine-strategic distinction can be deployed to inform discussions on the types of policy coordination mechanisms, such as cross-cutting taskforces or bodies, which might be instituted to support connected working on food.

Rising food insecurity and the impacts of the COVID-19 pandemic on emergency food assistance in Michigan

This study of eight types of emergency food assistance organizations in Michigan, USA, is the first statewide study of the COVID-19 pandemic's impacts on the operations of these organizations. It focuses on the following question: How did the pandemic affect the operations of emergency food assistance organizations? The paper examines how the race/ethnicity of the organization's director was related to program activities, the pandemic's impacts, and responses to the pandemic. It offers new insights into emergency food assistance organizations operated by Black and multicultural directors. The article examines how the sex of the emergency food assistance directors is related to programming, the pandemic's impacts, and responses to it. Most studies of emergency food assistance focus on urban areas. In addition to studying organizations in the state's metropolitan areas, we also study organizations in small towns and rural areas. The paper also analyzes two additional questions: How did the government support the state's emergency food assistance organizations during the pandemic? And how do organization leaders perceive government responses to the pandemic? The sample consists of 181 emergency food assistance organizations. Whites directed most organizations;82.9% had a primary director who was White, 11% had Black directors, and 6.1% had directors from other racial/ethnic groups. The organizations studied are long-lived;they have been operating for a mean of 20.8 years. The organizations serve meals to an average of 79 people per day. They also provide food items to roughly 185 people daily. The pandemic had profound effects on the operations of emergency food assistance organizations. About 28% of the organizations indicated that they cut back on their programming, and just over a fifth of the organizations limited their operating hours. Moreover, 23% of the organizations reported that the number of restaurants donating food declined, while 18% percent reported a decline in supermarket food donations. However, 58.9% of the organizations increased the amount of food they distributed, and 61.3% reported an increase in the number of people seeking food from the organization. During the pandemic, White-run organizations obtained government funding from 19 sources, multicultural-led organizations got government support from 10 sources, and Black-run organizations received support from three sources. Forty percent of directors in allBlack-run organizations, 23.5% of those in multiracial-led organizations, and 22.6% of the directors in all-White-led organizations criticized government responses to the pandemic.

Impacts of the COVID-19 pandemic and associated policy responses on food systems in sub-Saharan Africa

This policy brief summarizes a report which applies a systematic literature review methodology to survey the evidence on the impacts of the COVID-19 pandemic on sub-Saharan African food systems, particularly with respect to domestic food value chains, regional/international food trade, and food and nutrition security. This evidence synthesis gives rise to several recommendations for policy makers, some of which are immediately applicable while others would be relevant if a lockdown were reintroduced in a future crisis.

The Impact of COVID-19 on the Right to Food In Latin America: Insights From Uruguay

Although the right to food has been recognized as a basic human right, its full realization is far from being a reality. The measures implemented to contain the COVID-19 pandemic worldwide have led to an increase in poverty and food insecurity, posing additional challenges to the short- and long-term realization of this basic human right. The present chapter discusses the impact of the COVID-19 pandemic on food insecurity in Uruguay, a high-income country in Latin America, as well as the strategies implemented in the country to improve access to food among the most vulnerable sectors of the population. Using Uruguay as a case study, the chapter intends to contribute to the identification of food policies that could contribute to the full realization of the right to food in the context of COVID-19 and beyond. © 2021 by Nova Science Publishers, Inc.

Efforts in adopting the ultra-processed food and soft drinks labeling legislation in a COVID-19 environment: The cases of Colombia and Mexico

Diabetes contributes to COVID-19 deaths in Colombia and Mexico, where the latter having the highest prevalence of diabetes among OECD countries. Some reports consider that advertising influences diabetes by confusing labels on ultra-processed foods and soft drinks that lead to unhealthy food choices. Both countries are in the process of modifying their labeling legislation;however, governments and food industries have pushed to delay its implementation. Using a mixed research design, we interviewed 550 consumers in both countries during June?July 2020;a high number of respondents misunderstand today's food labeling and are unaware of the new labeling legislation. Respondents strongly agree that the food industry should be in charge of changing the labels;otherwise, they would consider not buying their products. Using cluster analysis, we identified three groups that would help design public policies, nutritional and educational campaigns. Although changes in food labeling alone are not enough to reduce obesity and diabetes rates, food labels constitute public health tools due they assist consumers to make food and nutritional choices (considering that nutrition can help prevent and overcome COVID-19). The costs of maintaining current labels could increase Colombians and Mexicans illnesss and poverty. These deceptive practices of the food industry would harm their brands.