Search Results (446)

This paper examines the essential role of urban green spaces in fostering healthy living from a landscape architecture perspective. Health goes beyond the mere absence of disease to include physical, mental, and social wellbeing, all of which are greatly enhanced by accessible green spaces. By synthesising existing literature, this paper shows that urban green spaces have strong positive associations with health outcomes, especially in urban settings where environmental stressors are pronounced. The paper stresses the importance of designing attractive and accessible green spaces that encourage physical activity, mental wellbeing, and social interaction, addressing public health issues such as obesity and mental health disorders. In addition to physical and mental health benefits, the paper explores the potential of local food production through edible green infrastructure, such as community gardens, which can significantly improve diet and nutrition. Additionally, the study discusses disparities in the access to quality green spaces, particularly between the Global North and South, and advocates for equitable design strategies that serve diverse populations. Integrating evidence-based approaches into landscape architecture, the paper argues for the establishment of urban green spaces as essential elements of public health infrastructure. Finally, the paper calls for future research and policy efforts to maximise the health benefits of urban green spaces and improve the quality of life in urban environments. Full article

Diet is one modifiable risk factor for hypertension. The low-sodium DASH (Dietary Approaches to Stop Hypertension) eating plan has been shown to significantly reduce the risk of hypertension and cardiovascular disease. However, there is a lack of available health information on the economic feasibility and cultural acceptability of DASH for low-income African American (AA) populations who are at the most risk for hypertension. An integrative review was conducted to summarize empirical literature on the economic feasibility and cultural acceptability of the DASH plan for low-income AAs using these databases: PubMed, EMBASE, CINAHL Complete, AGRICOLA, Web of Science Core Collection, ProQuest’s Dissertations, Theses Citation Index, and Google Scholar. Study elements from articles in the final analysis were extracted. Eleven (11) published works met the study’s inclusion criteria. Major themes were the availability and access of healthy foods, economic impact of obtaining healthy foods, material resources for cooking, food literacy, and the cultural acceptability of the DASH plan. These findings suggest that cost and cultural familiarity inhibit low-income AAs from benefiting from the DASH plan. Additional research is needed to develop and pilot test low-cost, culturally sensitive DASH eating plans for low-income AAs. Full article

Individuals with spinal cord injury (SCI) experience an increased risk for obesity and cardiometabolic disease. Recommendations to prevent and treat obesity for those with SCI follow those of the US Department of Agriculture to adopt a healthy eating pattern that includes eating a variety of fruits, vegetables, grains, dairy, and protein, plus limiting added sugars, saturated fats, and sodium. Yet, people with SCI eat too many calories, fat, and carbohydrates and too few fruits, vegetables, and whole grains. The study is based on secondary analyses of SCI participants (n = 122) who enrolled in a weight loss study to determine how SCI may impact their ability to prepare food at home. We hypothesize those with higher-level spinal injuries (specifically, those with cervical versus those with thoracic or lumbar/sacral injuries) experience significantly greater difficulty and are more likely to rely on others’ assistance to perform meal preparation tasks. Physiologic (weight, BMI, blood pressure, hemoglobin A1c) and self-reported data (demographic plus responses to the Life Habits Short Survey and meal prep items) were collected at baseline and qualitative data were obtained from a subsample after the intervention during phone interviews. Participants’ average age was 50 ± 14.7 years old, they lived with SCI for an average of 13.0 ± 13.1 years, and their average BMI was 32.0 ± 6.5. Participants were predominantly white (76.1%) men (54.1%) who had some college education (76.3%), though only 28.8% worked. A substantial proportion of respondents (30% to 68%) reported difficulty across the 13 tasks related to purchasing and preparing meals, with a proxy reported as the most common assistance type used across all tasks (17% to 42%). Forty-nine percent reported difficulty preparing simple meals, with 29% reporting a proxy does the task. More than half reported difficulty using the oven and stove, though between 60% to 70% reported no difficulty using other kitchen appliances (e.g., coffee machine, food processor, can opener), the refrigerator, or microwave. There was a significant difference in kitchen function by injury level. Those living with cervical-level injuries had significantly greater limitations than those with thoracic-level injuries. Spouses, other family members, and caregivers were most likely to serve as proxies and these individuals exerted both positive and negative influences on respondents’ dietary intake, based on qualitative data obtained during interviews. The results suggest that many people living with SCI experience functional and environmental barriers that impact their ability to prepare food and use kitchen appliances. Future research should examine how SCI-related functional limitations, transportation access, accessibility of the kitchen, ability to use appliances, availability of financial resources, and assistance by others to prepare foods impact people’s ability to follow a healthy eating pattern. Full article

Background/Objectives: Food insecurity (FI) is defined as the lack of consistent access to enough food for an active and healthy life. FI affects over 30 million Americans and is associated with poor clinical outcomes and impaired quality of life and drives significant health inequities. Despite the rising prevalence of FI and the federal focus on improving access to healthy food, there is a paucity of research on FI in patients with inflammatory bowel disease (IBD). Therefore, the goal of this study was to define FI in a cohort of IBD patients and determine whether FI was associated with changes in dietary patterns, including specifically an increase in ultra-processed food (UPF) consumption in this high-risk patient population. Methods: This was a single-center, retrospective cohort study of patients with a diagnosis of IBD who were 18 years of age or older and who were seen in a nutrition focused clinic. Patients were screened for FI using the Hunger Vital Sign™, a 2-question validated FI screening tool and underwent a 24-h dietary recall. The degree of food processing was assessed using the NOVA Food Classification System. Results: Among 128 patients with IBD, we observed that FI is increasingly prevalent, with 45% of patients reporting difficulty with sufficient grocery access at least “sometimes” in the last 12 months and 10% reporting decreased food access “often” in the prior year. In addition, the patients at high-risk for FI were significantly more likely to eat NOVA 4 UPFs (54% vs. 27%, p = 0.001) and were significantly less likely to eat NOVA 1 unprocessed foods (32% vs. 61%, p = 0.001) as compared to those not at risk for FI. Finally, only a small percentage of those at highest risk for FI were enrolled in a federal food assistance program for grocery support. Conclusions: The prevalence of FI is increasing in patients with IBD and is associated with reduced dietary quality. Full article

Food insecurity in peri-urban areas is exacerbated by high living costs, limited access to healthy food, and economic inequality. Despite its growing prevalence due to factors like land loss from urban expansion, food insecurity has received limited attention. In Ethiopia, drastic urbanization creates competition for land between agriculture and urban development, which is becoming extreme in peri-urban areas., This study aims to assess the impact of urban expansion on food security among expropriated peri-urban households in Ethiopia. Using a calorie intake-based food security line, we categorize respondents as food-secure or -insecure. The research analyzed data from 350 expropriated peri-urban households through a structured questionnaire, employing descriptive statistics and binary logistic regression. About 67% of the respondents were classified as food-insecure. The binary logit model identified several significant determinants of food security, including compensation amount and type, household head demographics, agricultural land rent participation, irrigation and credit access, off-farm income, and organic fertilizer use. To address food insecurity among expropriated households, policymakers must prioritize these factors. Government attention and policy consideration are crucial to ensure the well-being of these vulnerable populations. Full article

The inequalities of Brazilian society are amplified in favelas, affecting access to basic sanitation, health, education services, and food. More research is needed to better understand the favela food environment and propose appropriate public food and nutrition policies to increase the availability of and access to healthy food. In this context, this study aimed to develop a conceptual model of the relationship between access to food and the favela food environment and its determinants. In developing the conceptual model, this study undertook a bibliographical survey of the food environment, and a preliminary version was submitted to an expert panel. The model represents a set of dimensions (individual, micro-environment, macro-environment, and decision-making) and elements that interact in a complex manner and help understand access to food in areas subject to multiple social vulnerabilities. This model can guide future research and aid policymakers in designing effective strategies to improve the food security and health of populations in areas of high socio-spatial vulnerability. Full article

Raised personal health awareness and social environmental responsibility put pressure on the agri-food industry to adopt more sustainable ways of production, including the use of more natural ingredients, reducing waste, conservation and the regeneration of resources and energy. Plant-based colorants are ecologically friendly alternatives to artificial food dyes, especially with regards to the current reports on the adverse effects of some of the latter on human health. Various plants are traditionally used by many cultures to obtain vivid food coloration; however, the knowledge and means to produce them becomes less and less accessible to urbanized societies, and affordable organic alternatives are not always available on the market. An online questionnaire was performed to explore the awareness on plant-based dyes and pro-environmental attitudes of Bulgarian customers through the lens of Orthodox Easter eggs dyeing and the obtaining of plant dyes. From a total of 294 adult participants, only 5% reported a strict preference for natural dyes, while more than half of them (54%) were found to use natural and artificial ones concomitantly or switching between both. Of 45 plant taxa used for egg coloration, 12 were most frequently cited with many new additions of imported plants. Most of the used plant-based dyes were common fruits, spices, herbal infusions and even food waste like onion peels and avocado pits that were readily available from home gardens, markets and food shops. Additionally, we made a review of the scientific literature regarding their antioxidant and antimicrobial activity against food spoilage bacteria and foodborne pathogens isolated from eggs. All frequently used taxa were reported to exhibit antibacterial activities against Gram-positive and Gram-negative bacteria and possess antioxidant activity due to the presence of various polyphenols, essential oils and other compounds. Grape and red wine, roselle and stinging nettle are the species with the most diverse antibacterial activity, effective against 15 out of the 16 bacterial species of spoilage and foodbourn microorganisms included in our focus. The antimicrobial activities, however, were found mostly tested against bacterial strains in vitro, and further studies are needed to confirm their potential antibacterial activity when applied to Easter/boiled eggs or other food products. Our findings suggest that traditional cultural practices, as a multifaceted and engaging phenomenon, have the potential to promote environmental responsibility and a healthy lifestyle using both contemporary and traditional knowledge. Full article

Leveraging learner-driven insights to enhance the SFE can significantly influence food choices by decreasing the consumption of unhealthy foods and increasing access to healthier options. Using learners’ voices as important stakeholders in the school food environment (SFE), this qualitative research study aimed to gain a deeper understanding of their perspectives, identify barriers and enablers to fostering a healthy SFE in South African public schools, and explore the link between the SFE and learners’ food choices. Six focus group discussions (FGDs) with 4–6 participants were held in six schools, including three primary and three secondary schools in the KwaZulu-Natal Department of Education’s iLembe district, SA, with learners aged 12–14 and 15–18 years, respectively. Learners were asked how schools could help them eat healthier and how their SFE benefitted them. The data were analysed using thematic data analysis methods. The FGDs generated 14 themes and subthemes. Emerging information suggests a lack of control over the sale of unhealthy food despite the existence of guidelines. This is further exacerbated by the marketing of unhealthy foods, which prevents learners from selecting healthier options. Furthermore, they stated that promoting the school food programme (SFP) and changing attitudes towards healthy food intake through comprehensive nutrition education are useful ways to enhance the SFE. The findings of this study underscore the critical role of learner insights in shaping effective strategies to improve the SFE. Full article

In recent decades, meat consumption has faced growing scrutiny from an environmental, health, and animal welfare perspective. As a result, reducing meat consumption has emerged as an important strategy to mitigate its negative effects. Flexitarians, a growing group of meat reducers, have attracted attention for potentially shaping future dietary trends. This study uses a qualitative approach and draws on 15 in-depth interviews with young flexitarians in Slovenia (YFS) to identify the main facilitators and barriers to meat reduction by exploring their motivations, capabilities, and opportunities as described in the COM-B behavioral model. This study fills the gap in studies on flexitarians using the COM-B model by looking at capabilities and opportunities, not solely motives. In addition, it fills the gap in qualitative in-depth studies on all three COM-B categories, as well as a gap in studies conducted outside northwest Europe and other primarily western geographical contexts. This study highlights important findings for the central and eastern European context that industry and governments should consider when developing behavior change strategies for healthy, sustainable diets. This study shows that strong rural family ties and limited access to meat alternatives are the major barriers to meat reduction in Slovenia. The YFS preferred whole, unprocessed foods (legumes, vegetables, grains) over processed meat alternatives and reduced their meat consumption primarily for health and environmental reasons, relying on social support from peers and information from popular documentaries and social media influencers. Full article

Background: Emerging evidence suggests that low socioeconomic status (SES) home environments may play a role by promoting excess energy intake through a lack of access to non-food reinforcers. Because of the deleterious effects of SES-related disparities on child health and development, feasible and culturally acceptable interventions are urgently needed. Community-based music enrichment programs may be an ideal intervention strategy. Methods: In collaboration with a local non-profit organization and music studio, we conducted a pilot randomized controlled trial to assess the effects of a music enrichment program versus a play date control in a group of 9–24-month-old healthy infants (N = 16). The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Children’s Mercy Hospital Kansas City. This study is registered with clinicaltrials.gov (NCT05868811). Results: Overall, we found some intervention effects on the relative reinforcing value of food (RRV_food) and the home environmental enrichment measures (i.e., increased music use at home and the home language environment). Our intervention demonstrated large effects on the increased use of music at home. We did not find significant group differences in the RRV_food and home language environment, but some of the effect sizes were medium-to-large. Results also suggest that our intervention is feasible and acceptable. Parent feedback indicated that the intervention was well-liked and that the steps we took to help reduce barriers worked. Conclusions: Music enrichment programs may be a high-impact, low-cost strategy to address socioeconomic disparities. Full article

The modern work environment is constantly evolving, and with it, the emphasis on employee health and well-being is increasing. Background: Nutritional education has become a key component of health promotion strategies in many companies that recognize the benefits of healthy eating habits for enhancing efficiency and job satisfaction. Objectives: The aim of this study was to understand employees’ nutritional needs at work, and to assess the support provided by employers. The analysis focused on employees’ eating habits and their attitudes towards eating at work, motives and barriers to healthy eating. Methods: The study was conducted using an anonymous survey completed by 1.056 individuals from across Poland. A discriminant function was selected for data analysis, which examined the differences between groups. Results/Conclusions: The larger enterprises are more inclined to establish meal consumption spaces, which contributes to a more organised work culture. The larger the business, the more time employees spend eating meals, it being influenced by better-developed eating facilities, which undoubtedly encourages the workers to take longer breaks. The people with obesity were found to place the highest value on healthy food options and the people with a normal BMI are more responsive to healthy food subsidies, nutritional advice provided by a dietitian, and access to fitness facilities. Full article

Nowadays, there is a general concern regarding the increasing global talk about functional foods that respond to our demands and needs as consumers in order to maintain health and body weight through a correctly balanced diet. Cereals are key elements of nutrition and a healthy diet, and they also play a significant role in health promotion due to the useful nutrient content. Therefore, this work aims to identify barley and oat genotypes suitable for human nutrition and to achieve practical results for their widespread use in preventing or treating certain chronic diseases by analyzing the nutritional and physical properties of 52 genotypes of oat and barley conserved in Suceava Gene Bank, Romania. The first part of this manuscript is the presentation of these accessions and the evaluation of their most important properties. For oat and barley cultivars, detailed processing was carried out, involving the computation of variation amplitude, coefficients of correlation and cluster analyses, both for biochemical (protein, lysine and tryptophan contents) and physical (test weight and seed weight) properties. The results indicated high variability between oat and barley varieties. Thus, according to the results, the 26 varieties of oat exhibited almost double the content of lysine compared to barley seeds, while tryptophan had higher values in barley than in oat seeds. Overall, both species play an essential role in human nutrition, barley being important because of its high protein content and higher productivity compared to oats, which, although not as productive, have better quality seeds due to their higher lysine content. The results presented are not only of scientific interest but also have practical implications for agriculture, food safety, nutrition and human health. The documented information will facilitate new studies needed to contribute to improving human nutrition and health. Full article

Introduction: The U.S. Child and Adult Care Food Program (CACFP) provides tiered reimbursements for healthy foods for children at participating family childcare homes (FCCH). Higher tier 1 reimbursements are for providers who operate in low-income communities or who are themselves living on a low income. All FCCHs received a higher rate to address food insecurity during the COVID-19 pandemic. Methods: A survey was administered in the spring of 2023 to a randomly selected sample of licensed California FCCHs to assess the perceived impacts of the increased reimbursement on CACFP participation and anticipated challenges with reinstated tiered rates. A total of 518 surveys (261 tier 1, 257 tier 2) were analyzed using linear or logistic regression, adjusting for confounders. Results: Among tier 1 and tier 2 providers combined, over half reported lowering out-of-pocket spending for food (59%) and serving greater variety (55%) and quality (54%) of foods. Tier 2 providers reported experiencing more benefits (p < 0.05) and tended to be more likely to implement optional CACFP best practices (although not significantly different between tiers). Most FCCH providers found reimbursement rates were inadequate before (83%) the pandemic; this amount decreased to 54% post-pandemic for tier 1 and tier 2 providers combined. Conclusions: The temporary CACFP reimbursement positively impacted the perceived quality and variety of foods served to children, especially among tier 2 providers. Increased reimbursements for all FCCHs may ensure children have access to the healthy meals and snacks provided by the CACFP. Full article

Background: Nutrition and adequate dietary intake during pregnancy strongly influence the health and well-being of the mother, as well as the physical and cognitive development of the unborn child. While previous studies have documented factors associated with the dietary behaviour of pregnant women in Ethiopia, a comprehensive overview is missing. Objective: The aim of this study was to close this research gap. Methodology: We conducted a mapping review, including 37 studies published between 2000 and 2022 in our analysis. Dietary behaviour refers to all phenomena related to food choice, eating behaviour and dietary intake. We used an innovative approach by integrating a socio-ecological framework with UNICEF’s conceptual framework on maternal and child nutrition, which specifies multidimensional individual, underlying and enabling determinants associated with the nutritional status of women. Importantly, we integrated a focus on care for women and healthy environments. Results: A total of 68 factors were identified as influencing the dietary behaviour of pregnant women, with a focus on the intra- (31/68) and interpersonal (21/68) levels, while factors at the community (11/68) and the institutional levels (5/68) were scarce. Few studies investigated socio-cultural aspects, such as gender roles, decision-making power and workload of women, psychological factors and eating practices related to food taboos. None of the studies explored the influence of resources at the institutional level. Conclusions: This attests that the focus in maternal nutrition is still placed on the individual responsibility of women, instead of addressing the structural conditions that would enable women to access resources such as land, education and nutrition information. Full article

Black neighborhoods in the U.S., historically subjected to redlining, face inequitable access to resources necessary for health, including healthy food options. This study aims to identify the enablers and barriers to promoting equitable healthy food access in small, independently owned carryout restaurants in under-resourced neighborhoods to address health disparities. Thirteen in-depth interviews were conducted with restaurant owners in purposively sampled neighborhoods within Healthy Food Priority Areas (HFPAs) from March to August 2023. The qualitative data were analyzed using inductive coding and thematic analysis with Taguette software (Version 1.4.1). Four key thematic domains emerged: interpersonal, sociocultural, business, and policy drivers. Owners expressed mixed perspectives on customers’ preferences for healthy food, with some perceiving a community desire for healthier options, while others did not. Owners’ care for the community and their multicultural backgrounds were identified as potential enablers for tailoring culturally diverse menus to meet the dietary needs and preferences of their clientele. Conversely, profit motives and cost-related considerations were identified as barriers to purchasing and promoting healthy food. Additionally, owners voiced concerns about taxation, policy and regulation, information access challenges, and investment disparities affecting small business operations in HFPAs. Small restaurant businesses in under-resourced neighborhoods face both opportunities and challenges in enhancing community health and well-being. Interventions and policies should be culturally sensitive, provide funding, and offer clearer guidance to help these businesses overcome barriers and access resources needed for an equitable, healthy food environment. Full article