Stephanie Chambers

Local, national and imported foods : A qualitative study

The UK government is currently attempting to encourage consumers to buy more locally produced food. It is hoped that this will provide economic, environmental and social benefits to local areas, leading to more sustainable patterns of consumption. This qualitative study looks at the views and behaviour of consumers towards local foods with a particular focus on the barriers that prevent greater uptake of local produce. In total, four focus groups (n=33) were conducted. Content analysis identified six relevant themes in relation to local, national and imported foods. These were cost, lifestyle, food quality, consumer ethnocentrism, choice and farmers. Overall, although participants reported buying few local products currently, there was widespread enthusiasm across socio-economic groups for local foods, with participants perceiving them as being of a higher quality than imported foods. They also generally endorsed the idea of supporting local farmers and their own national economy. The main barriers preventing participants from buying more local products were price and inconvenience. The results are discussed in relation to developing future strategies for encouraging people to buy more local food products.

Attitudinal and demographic determinants of diet quality and implications for policy targeting

BACKGROUND Poor diet quality is a major public health concern that has prompted governments to introduce a range of measures to promote healthy eating. For these measures to be effective, they should target segments of the population with messages relevant to their needs, aspirations and circumstances. The present study investigates the extent to which attitudes and constraints influence healthy eating, as well as how these vary by demographic characteristics of the UK population. It further considers how such information may be used in segmented diet and health policy messages. METHODS A survey of 250 UK adults elicited information on conformity to dietary guidelines, attitudes towards healthy eating, constraints to healthy eating and demographic characteristics. Ordered logit regressions were estimated to determine the importance of attitudes and constraints in determining how closely respondents follow healthy eating guidelines. Further regressions explored the demographic characteristics associated with the attitudinal and constraint variables. RESULTS People who attach high importance to their own health and appearance eat more healthily than those who do not. Risk-averse people and those able to resist temptation also eat more healthily. Shortage of time is considered an important barrier to healthy eating, although the cost of a healthy diet is not. These variables are associated with a number of demographic characteristics of the population; for example, young adults are more motivated to eat healthily by concerns over their appearance than their health. CONCLUSIONS The approach employed in the present study could be used to inform future healthy eating campaigns. For example, messages to encourage the young to eat more healthily could focus on the impact of diets on their appearance rather than health.

What the UK public believes causes obesity, and what they want to do about it: A cross-sectional study

Increases in the prevalence of obesity have led to calls for policy interventions in the United Kingdom. Little is known, however, about how the public explains overweight, or their support for interventions. Our research team recruited 500 adults (⩾18 years of age) across the United Kingdom to complete a cross-sectional survey asking about beliefs concerning the causes of excess weight, and support for particular policy interventions. Respondents completed questionnaires in their homes with the assistance of an interviewer. Results suggested that support for policy interventions was greatest when responsibility was attributed to factors beyond individual control, with support for child-focused interventions particularly high. The relationship is more complex than previous studies suggest, as believing in the over-availability of unhealthy foods predicted higher support for policy interventions, whereas beliefs in structural explanations, such as cost, had little influence on support. Recognition of this complexity may help to design more effective future policies to tackle obesity.

Reducing the volume, exposure and negative impacts of advertising for foods high in fat, sugar and salt to children: A systematic review of the evidence from statutory and self-regulatory actions and educational measures.

PURPOSE To identify and review evidence on 1) the effectiveness of statutory and self-regulatory actions to reduce the volume, exposure or wider impact of advertising for foods high in fat, sugar and salt (HFSS) to children, and 2) the role of educational measures. DESIGN/METHODOLOGY/APPROACH A systematic review of three databases (Medline, CINAHL and PsycINFO) and grey literature was carried out. Relevant evidence included studies evaluating advertising bans and restrictions, advertising literacy programmes and parental communication styles. Relevant media included TV, internet, radio, magazines and newspaper advertising. No studies were excluded based on language or publication date. FINDINGS Forty-seven publications were included: 19 provided evidence for the results of statutory regulation, 25 for self-regulation, and six for educational approaches. Outcome measures varied in approach, quality and results. Findings suggested statutory regulation could reduce the volume of and childrens exposure to advertising for foods HFSS, and had potential to impact more widely. Self-regulatory approaches showed varied results in reducing childrens exposure. There was some limited support for educational measures. DISCUSSION Consistency in measures from evaluations over time would assist the development and interpretation of the evidence base on successful actions and measures to reduce the volume, exposure and impact of advertising for foods HFSS to children.

A systematic review of grandparents' influence on grandchildren's cancer risk factors

Many lifestyle patterns are established when children are young. Research has focused on the potential role of parents as a risk factor for non communicable disease in children, but there is limited investigation of the role of other caregivers, such as grandparents. The aim of this review was to identify and synthesise evidence for any influence grandparents’ care practices may have on their grandchildren’s long term cancer risk factors. A systematic review was carried out with searches across four databases (MEDLINE, Embase, Web of Science, PsycINFO) as well as searches of reference lists and citing articles, and Google Scholar. Search terms were based on six areas of risk that family care could potentially influence–weight, diet, physical activity, tobacco, alcohol and sun exposure. All study designs were included, as were studies that provided an indication of the interaction of grandparents with their grandchildren. Studies were excluded if grandparents were primary caregivers and if children had serious health conditions. Study quality was assessed using National Institute for Health and Care Excellence checklists. Grandparent impact was categorised as beneficial, adverse, mixed or as having no impact. Due to study heterogeneity a meta-analysis was not possible. Qualitative studies underwent a thematic synthesis of their results. Results from all included studies indicated that there was a sufficient evidence base for weight, diet, physical activity and tobacco studies to draw conclusions about grandparents’ influence. One study examined alcohol and no studies examined sun exposure. Evidence indicated that, overall, grandparents had an adverse impact on their grandchildren’s cancer risk factors. The theoretical work in the included studies was limited. Theoretically underpinned interventions designed to reduce these risk factors must consider grandparents’ role, as well as parents’, and be evaluated robustly to inform the evidence base further.

Identifying dietary differences between Scotland and England: a rapid review of the literature

OBJECTIVE Rates of premature mortality have been higher in Scotland than in England since the 1970s. Given the known association of diet with chronic disease, the study objective was to identify and synthesise evidence on current and historical differences in food and nutrient intakes in Scotland and England. DESIGN A rapid review of the peer-reviewed and grey literature was carried out. After an initial scoping search, Medline, CINAHL, Embase and Web of Science were searched. Relevant grey literature was also included. Inclusion criteria were: any date; measures of dietary intake; representative populations; cross-sectional or observational cohort studies; and English-language publications. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. A narrative synthesis of extracted information was conducted. RESULTS Fifty publications and reports were included in the review. Results indicated that children and adults in Scotland had lower intakes of vegetables and vitamins compared with those living in England. Higher intakes of salt in Scotland were also identified. Data were limited by small Scottish samples, difficulty in finding England-level data, lack of statistical testing and adjustment for key confounders. CONCLUSIONS Further investigation of adequately powered and analysed surveys is required to examine more fully dietary differences between Scotland and England. This would provide greater insight into potential causes of excess mortality in Scotland compared with England and suitable policy recommendations to address these inequalities.

Positive association between sugar consumption and dental decay prevalence independent of oral hygiene in pre-school children: a longitudinal prospective study

Abstract Background Few studies explore how the longitudinal cumulative and combined effects of dietary habits and oral hygiene habits relate to dental decay in very young children. Methods Using longitudinal survey data, logistic regression models were specified to predict dental decay by age 5. Predictor variables included questions on diet and oral hygiene from ages 2 to 5. Results Compared to mainly eating meals, children who snacked all day but had no real meals had a higher chance of dental decay (odds ratios (OR) = 2.32). There was an incremental association between a decreasing frequency of toothbrushing at age 2 and higher chances of dental decay at age 5 (OR range from 1.39 to 2.17). Among children eating sweets or chocolate more frequently (once/day or more), toothbrushing more often (once/day; twice/day or more) reduced the chance of decay (OR of 2.11–2.26 compared to OR 3.60 for the least frequent brushing group). Compared to mothers in managerial and professional occupations, those who had never worked had children with a much higher chance of decay (OR = 3.47). Conclusion This study has shown that toothbrushing can only in part attenuate the association between snacking and long term sugar consumption on dental decay outcomes in children under 5.

School and local authority characteristics associated with take-up of free school meals in Scottish secondary schools, 2014

School meals are an important state-delivered mechanism for improving children’s diets. Scottish local authorities have a statutory duty to provide free school meals (FSM) to families meeting means-testing criteria. Inevitably take-up of FSM does not reach 100%. Explanations put forward to explain this include social stigma, as well as a more general dissatisfaction amongst pupils about lack of modern facilities and meal quality, and a preference to eat where friends are eating. This study investigated characteristics associated with take-up across Scottish secondary schools in 2013–2014 using multilevel modelling techniques. Results suggest that stigma, food quality and the ability to eat with friends are associated with greater take-up. Levels of school modernisation appeared less important, as did differences between more urban or rural areas. Future studies should focus on additional school-level variables to identify characteristics associated with take-up, with the aim of reducing the number of registered pupils not taking-up FSM.

The Parental Dental Concerns Scale (PDCS): its development and initial psychometric properties

OBJECTIVES To assess the validity and reliability of a Parental Dental Concerns Scale (PDCS) to identify parents unable to access preventive dental care for their children. METHODS Two studies were conducted. In Study One, a purposive convenience sample of 399 Scottish parents answered questions on going to the dentist, family life and demographics. Parents were retested eight weeks later. In Study Two, 574 Scottish parents participating in a preventive oral health programme were posted the same questionnaire. Information on child dental attendance was gained from dental records. Data were analysed using exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency and test-retest correlations provided reliability estimates. Validity was assessed with confirmatory factor analysis, correlations and independent t-tests. RESULTS EFA indicated that the PDCS had a four factor structure, supported by a subsequent CFA. The PDCS and its four subscales had good internal consistency, concurrent validity and test-retest reliability. Further work is required to confirm the scales predictive validity in discriminating between children and parents who did and did not attend the dental practice. CONCLUSIONS The PDCS is a reliable scale, which demonstrates good construct validity. Further testing is required to confirm its predictive validity.

Shirt sponsorship by gambling companies in the English and Scottish Premier Leagues: global reach and public health concerns

Abstract While the nature of gambling practices is contested, a strong evidence base demonstrates that gambling can become a serious disorder and have a range of detrimental effects for individuals, communities and societies. Over the last decade, football in the UK has become visibly entwined with gambling marketing. To explore this apparent trend, we tracked shirt sponsors in both the English and Scottish Premier Leagues since 1992 and found a pronounced increase in the presence of sponsorship by gambling companies. This increase occurred at the same time the Gambling Act 2005, which liberalized rules, was introduced. We argue that current levels of gambling sponsorship in UK football, and the global visibility it provides to gambling brands, is a public health concern that needs to be debated and addressed. We recommend that legislators revisit the relationship between football in the UK and the sponsorship it receives from the gambling industry.