Snapshots of urban and rural food environments: EPOCH-based mapping in a high-, middle-, and low-income country from a non-communicable disease perspective

Mark Spires, Aravinda Berggreen-Clausen, Francis Xavier Kasujja, Peter Delobelle, Thandi Puoane, David Sanders, Meena Daivadanam

Onderzoeksoutput: Articlepeer review

20 Citaten (Scopus)
133 Downloads (Pure)

Samenvatting

A changing food environment is implicated as a primary contributor to the increasing levels of non-communicable diseases (NCDs). This study aimed to generate snapshots of selected external food environments to inform intervention strategies for NCD prevention in three countries: Uganda (low income), South Africa (middle income) and Sweden (high income), with one matched pair of urban–rural sites per country. Fifty formal and informal food retail outlets were assessed, and descriptive and comparative statistical analyses were performed. We found that formal food retail outlets in these countries had both positive and negative traits, as they were the main source of basic food items but also made unhealthy food items readily available. The Ugandan setting had predominantly informal outlets, while the Swedish setting had primarily formal outlets and South Africa had both, which fits broadly into the traditional (Uganda), mixed (South Africa) and modern (Sweden) conceptualized food systems. The promotion of unhealthy food products was high in all settings. Uganda had the highest in-community advertising, followed by South Africa and Sweden with the lowest, perhaps related to differences in regulation and implementation. The findings speak to the need to address contextual differences in NCD-related health interventions by incorporating strategies that address the food environment, and for a critical look at regulations that tackle key environment-related factors of food on a larger scale.

Originele taal-2English
Artikelnummer484
TijdschriftNutrients
Volume12
Nummer van het tijdschrift2
DOI's
StatusPublished - 14 feb 2020

Bibliografische nota

Funding Information:
Funding: This study is part of the SMART2D project funded by the European Commission’s Horizon 2020 Health Coordination Activities (Grant Agreement No 643692) under call “HCO-05-2014: Global Alliance for Chronic Diseases: Prevention and treatment of type 2 diabetes” as well as through Crown Princess Margareta’s Memorial Foundation (A.B.-C.).

Funding Information:
This study is part of the SMART2D project funded by the European Commission’s Horizon 2020 Health Coordination Activities (Grant Agreement No 643692) under call “HCO-05-2014: Global Alliance for Chronic Diseases: Prevention and treatment of type 2 diabetes” as well as through Crown Princess Margareta’s Memorial Foundation (A.B.-C.). Acknowledgments: We would like to thank the following people: Gloria Naggayi for data collection in Uganda; Jhon Álvarez Ahlgren for technical help and ongoing support with RedCap; Filipa Sampaio for guidance in calculating International Dollars. Agneta Andersson and Helle Mölsted Alvesson, thank you for all your constructive comments while critically reviewing the manuscript. We would also like to acknowledge Clara Chow and her team for access to the original EPOCH tool, with the permission to adapt the same; as well as her input in helping us understand the rationale behind the original methodology in order to facilitate the adaptation. Last but not least, this study would not have been possible without the cooperation of shop owners and employees that allowed us to collect data from their food retail outlets.

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

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