Digital Food Retail: Public Health Opportunities.

For over two decades, digital food retail services have been emerging alongside advances in mobile technology and improved access to wi-fi. Digitalization has driven changes within the food environment, complicating an already complex system that influences food-related behaviors and eating practices. Digital food retail services support an infrastructure that enhances commercial food systems by extending access to and availability of highly processed foods, further escalating poor dietary intakes. However, digital food retail services are heterogeneous-food delivery apps, online groceries, and meal kits-and can be feasibly adapted to nutrition interventions and personalized to individual needs. Although sparse, new evidence indicates great potential for digital food retail services to address food insecurity in urban areas and to support healthy eating by making it easier to select, plan, and prepare meals. Digital food retail services are a product of the digital transformation that reflect consumers' constant need for convenience, which must be addressed in future research and interventions. This paper will discuss public health opportunities that are emerging from the global uptake of digital food retail services, with a focus on online groceries, food delivery apps, and meal kits.

Influence of Cooking Workshops on Cooking Skills and Knowledge among Children Attending Summer Day Camps.

This study aimed to measure the influence of the Chefs in Action program (3 cooking workshops) on cooking skills, nutrition knowledge, and attitudes towards healthy eating in children attending summer day camps and compare it with a single cooking workshop. Groups of children (8-12 years) were randomly assigned to the intervention group (n = 25) or to 1 of 3 comparison groups performing a single workshop (group 1, n = 16; group 2, n = 36; group 3, n = 24). Two dietitians evaluated cooking skills during the workshops. Nutrition knowledge and attitudes towards healthy eating were assessed before and after the intervention. No improvement in cooking skills was observed in the intervention group (P = 0.25). The intervention group's cooking skills score was significantly higher than comparison group 1 (P < 0.001). Nutrition knowledge was significantly improved in the intervention group and the comparison group 3 (P < 0.0001) but no effect on attitudes towards healthy eating was observed (Pgroup × time = 0.36). In conclusion, the Chefs in Action program positively impacted nutrition knowledge in children. The results also suggest that the type of recipe may influence nutrition knowledge and cooking skills. Further studies are needed to better assess the degree of difficulty required in cooking workshop recipes to improve cooking skills in children.

Promoting meal planning through mass media: awareness of a nutrition campaign among Canadian parents.

OBJECTIVE: To evaluate awareness of the Eat Well Campaign (EWC) among parents and assess perceptions about its effectiveness. DESIGN: Post-campaign evaluation study with a cross-section of parents recruited through random digit dialling. Participants completed an online survey about EWC awareness, its perceived effectiveness among parents and their meal planning practices (attitudes, behaviours and self-efficacy). SETTING: A federal mass-media campaign disseminated by Health Canada (2013-2014) to promote meal planning to Canadian parents. PARTICIPANTS: Parents (n 964) of children aged 2-12 years from all Provinces and Territories. RESULTS: Of respondents, 41 % (390/964) were aware of the campaign; Quebec City and rural Quebec had the highest rates of awareness, whereas Vancouver, Winnipeg and Toronto had the lowest. Awareness was greater among parents with lower income, basic education and French-speakers. Campaign intensity was significantly associated with greater odds of reporting positive attitudes towards the EWC and meal planning (P < 0·05). Campaign awareness was significantly associated with greater odds of believing that meal planning helps maintain a healthy diet (OR = 1·68, 95 % CI 1·03, 2·74) and planning meals (OR = 1·66, 95 % CI 1·03, 2·54), but not self-efficacy, in adjusted models. CONCLUSIONS: The present study is the first to evaluate an initiative that promoted meal planning with mass media. The EWC demonstrated evidence of success in terms of equitable access to a nutrition initiative by reaching lower-income and less-educated parents. Understanding behavioural factors among different segments of the population will be important to target appropriate audiences and develop tailored interventions that support healthy eating practices.

Full-Time Employment, Diet Quality, and Food Skills of Canadian Parents.

Purpose: To explore the associations between full-time employment status, food skills, and diet quality of Canadian parents. Methods: A sample of Canadian parents (n = 767) were invited to complete a web-based survey that included sociodemographic variables, questions about food skills, and a validated food frequency questionnaire. Results were analyzed with linear and logistic regression models, controlling for sociodemographic variables and multiple testing. Results: After controlling for covariates and multiple testing, there were no statistically significant differences in foods skills between parents' employment status. Time was the most reported barrier for meal preparation, regardless of work status, but was significantly greater for full-time compared with other employment status (P < 0.0001). Additionally, parents who worked full-time had lower odds of reporting food preferences or dietary restrictions (P = 0.0001) and health issues or allergies (P = 0.0003) as barriers to food preparation, compared with parents with other employment status. These results remained statistically significant even after controlling for covariates and multiple testing. Conclusions: Overall, food skills did not differ significantly between parents' employment status. Time, however, was an important barrier for most parents, especially those working full time. To promote home-based food preparation among parents, strategies to manage time scarcity are needed.

Novel perspectives on fermented milks and cardiometabolic health with a focus on type 2 diabetes.

This review will explore the observational and mechanistic evidence supporting the hypothesis that fermented milk consumption has beneficial effects on metabolism. Live cultures in fermented dairy are thought to contribute to gut microbial balance, which is likely an instrumental mechanism that protects the host against gut dysbiosis and systemic inflammation associated with cardiometabolic diseases. Lactic acid bacteria (LAB) release bioactive metabolites, such as exopolysaccharides and peptides, that have the potential to exert a wide range of metabolic and regulatory functions. In particular, peptides derived from fermented dairy products are likely to exert greater cardiometabolic and anti-inflammatory effects than nonfermented dairy. It is hypothesized that LAB-derived bioactive peptides have the potential to protect the host against cardiometabolic diseases through antimicrobial actions and to effect changes in gene expression of glucose regulatory and anti-inflammatory signaling pathways. The peptides released through fermentation may explain some of the health effects of fermented dairy products on cardiometabolic disease risk observed in epidemiological studies, particularly type 2 diabetes; however, mechanisms have yet to be explored in detail.

Yogurt and Cardiometabolic Diseases: A Critical Review of Potential Mechanisms.

Associations between yogurt intake and risk of diet-related cardiometabolic diseases (CMDs) have been the subject of recent research in epidemiologic nutrition. A healthy dietary pattern has been identified as a pillar for the prevention of weight gain and CMDs. Epidemiologic studies suggest that yogurt consumption is linked to healthy dietary patterns, lifestyles, and reduced risk of CMDs, particularly type 2 diabetes. However, to our knowledge, few to no randomized controlled trials have investigated yogurt intake in relation to cardiometabolic clinical outcomes. Furthermore, there has been little attempt to clarify the mechanisms that underlie the potential beneficial effects of yogurt consumption on CMDs. Yogurt is a nutrient-dense dairy food and has been suggested to reduce weight gain and prevent CMDs by contributing to intakes of protein, calcium, bioactive lipids, and several other micronutrients. In addition, fermentation with bacterial strains generates bioactive peptides, resulting in a potentially greater beneficial effect of yogurt on metabolic health than nonfermented dairy products such as milk. To date, there is little concrete evidence that the mechanisms proposed in observational studies to explain positive results of yogurt on CMDs or parameters are valid. Many proposed mechanisms are based on assumptions that commercial yogurts contain strain-specific probiotics, that viable yogurt cultures are present in adequate quantities, and that yogurt provides a minimum threshold dose of nutrients or bioactive components capable of exerting a physiologic effect. Therefore, the primary objective of this review is to investigate the plausibility of potential mechanisms commonly cited in the literature in order to shed light on the inverse associations reported between yogurt intake and various cardiometabolic health parameters that are related to its nutrient profile, bacterial constituents, and food matrix. This article reviews current gaps and challenges in identifying such mechanisms and provides a perspective on the research agenda to validate the proposed role of yogurt in protecting against CMDs.

Facilitators and barriers experienced by federal cross-sector partners during the implementation of a healthy eating campaign.

OBJECTIVE: To identify facilitators and barriers that Health Canada's (HC) cross-sector partners experienced while implementing the Eat Well Campaign: Food Skills (EWC; 2013-2014) and describe how these experiences might differ according to distinct partner types. DESIGN: A qualitative study using hour-long semi-structured telephone interviews conducted with HC partners that were transcribed verbatim. Facilitators and barriers were identified inductively and analysed according partner types. SETTING: Implementation of a national mass-media health education campaign. SUBJECTS: Twenty-one of HC's cross-sector partners (food retailers, media and health organizations) engaged in the EWC. RESULTS: Facilitators and barriers were grouped into seven major themes: operational elements, intervention factors, resources, collaborator traits, developer traits, partnership factors and target population factors. Four of these themes had dual roles as both facilitators and barriers (intervention factors, resources, collaborator traits and developer traits). Sub-themes identified as both facilitators and barriers illustrate the extent to which a facilitator can easily become a barrier. Partnership factors were unique facilitators, while operational and target population factors were unique barriers. Time was a barrier that was common to almost all partners regardless of partnership type. There appeared to be a greater degree of uniformity among facilitators, whereas barriers were more diverse and unique to the realities of specific types of partner. CONCLUSIONS: Collaborative planning will help public health organizations anticipate barriers unique to the realities of specific types of organizations. It will also prevent facilitators from becoming barriers. Advanced planning will help organizations manage time constraints and integrate activities, facilitating implementation.

Potential Health Benefits of Combining Yogurt and Fruits Based on Their Probiotic and Prebiotic Properties.

Fruit and yogurt have been identified individually as indicators of healthy dietary patterns. Fruits are relatively low in energy density and are an excellent source of antioxidants and prebiotic fibers and polyphenols, which can promote digestive health. Yogurt, on the other hand, is a nutrient-dense food that is a good source of dairy protein, calcium, magnesium, vitamin B-12, conjugated linoleic acid, and other key fatty acids. In addition, it contains beneficial bacterial cultures, making it a potential source of probiotics. Yogurt's unique fermented food matrix provides added health benefits by enhancing nutrient absorption and digestion. Combining the intake of yogurt and fruit could provide probiotics, prebiotics, high-quality protein, important fatty acids, and a mixture of vitamins and minerals that have the potential to exert synergistic effects on health. Yogurt consumption has been associated with reduced weight gain and a lower incidence of type 2 diabetes, whereas fruits have established effects on reducing the risk of cardiovascular disease. Yogurt and fruits can be eaten together and may exert combined health benefits through potential prebiotic and probiotic effects. Furthermore, substituting high-energy, nutrient-deficient snacks with fruit and yogurt could reduce the intake of high-calorie obesogenic foods. In light of the positive cardiometabolic impacts of fruit and yogurt and their association with healthy dietary patterns, there is sufficient evidence to warrant further exploration into the potential synergistic health benefits of a combined intake of fruit and yogurt.

Factors influencing the adoption of a healthy eating campaign by federal cross-sector partners: a qualitative study.

BACKGROUND: The Eat Well Campaign (EWC) was a social marketing campaign developed by Health Canada and disseminated to the public with the help of cross-sector partners. The purpose of this study was to describe factors that influenced cross-sector partners' decision to adopt the EWC. METHODS: Thematic content analysis, based primarily on an a priori codebook of constructs from Roger's diffusion of innovations decision process model, was conducted on hour-long semi-structured telephone interviews with Health Canada's cross-sector partners (n = 18). RESULTS: Dominant themes influencing cross-sector partners' decision to adopt the EWC were: high compatibility with the organization's values; being associated with Health Canada; and low perceived complexity of activities. Several adopters indicated that social norms (e.g., knowing that other organizations in their network were involved in the collaboration) played a strong role in their decision to participate, particularly for food retailers and small organizations. The opportunity itself to work in partnership with Health Canada and other organizations was seen as a prominent relative advantage by many organizations. Adopters were characterized as having high social participation and positive attitudes towards health, new ideas and Health Canada. The lack of exposure to the mass media channels used to diffuse the campaign and reserved attitudes towards Health Canada were prominent obstacles identified by a minority of health organizations, which challenged the decision to adopt the EWC. Most other barriers were considered as minor challenges and did not appear to impede the adoption process. CONCLUSIONS: Understanding factors that influence cross-sector adoption of nutrition initiatives can help decision makers target the most appropriate partners to advance public health objectives. Government health agencies are likely to find strong partners in organizations that share the same values as the initiative, have positive attitudes towards health, are extremely implicated in social causes and value the notion of partnership.

Drastic increases in overweight and obesity from 1981 to 2010 and related risk factors: results from the Barbados Children's Health and Nutrition Study.

OBJECTIVE: To examine overweight and obesity (OWOB), changes in prevalence and potential risk factors in Barbadian children. DESIGN: A cross-section of students were weighed and measured. The WHO BMI-for-age growth references (BAZ), the International Obesity Task Force cut-offs and the US Centers for Disease Control and Prevention growth percentiles were used to determine OWOB prevalence. Harvard weight-for-height-for-age growth standards were used to estimate differences in OWOB prevalence from 1981 to 2010. Samples of parents and students were interviewed to describe correlates of OWOB. SETTING: Barbados. SUBJECTS: Public-school students (n 580) in class 3. RESULTS: Based on WHO BAZ, the overall prevalence of OWOB was 34·8 % (95 % CI 30·9, 38·7 %). A trend of higher OWOB prevalence was seen for girls across cut-offs, with significant sex differences noted using the International Obesity Task Force cut-offs. According to Harvard growth standards, OWOB has increased dramatically, from 8·52 % to 32·5 %. Children were more likely to be OWOB when annual household income was below BBD 9000 (OR=2·69; 95 % CI 1·21, 5·99). Eating dinner with the family every night was associated with a lower prevalence of OWOB (OR=0·56; 95 % CI 0·36, 0·87). CONCLUSIONS: The sharp increase of OWOB rates in Barbados warrants attention. Sex disparities in OWOB prevalence may emerge at a young age. Promoting family meals may be a feasible option for OWOB prevention. Understanding familial and sociodemographic factors influencing OWOB will be useful in planning successful intervention or prevention programmes in Barbados.