Policy Solutions To The ‘Grocery Gap’

Primary objective: Understanding the aspects of the home food environment of children and adolescents such as the availability, accessibility, and visibility of home healthy and unhealthy foods and the frequency and quality of family meals is necessary for developing direct interventions for weight management. This review examined the literature on associations of home food environment including availability, accessibility, and visibility of home healthy and unhealthy foods and frequency and quality of family meals with children’s eating behaviors and weight status and methods to assess the availability and accessibility of foods in the home. Main outcomes and results: Research suggests:1) the availability and/or accessibility of home healthy or unhealthy foods were associated with children or adolescents’ dietary intakes; 2) the link between home food availability and accessibility with weight status is weak; 3) the evidence on associations of frequency or nutritional quality of family meals with weight status is inconsistent; 4) the in-home assessments for food availability, accessibility and visibility appear to be necessary; however the assessment tools may need to be further improved to capture the quantity of the healthy and unhealthy foods in the home; and 5) repeated in-home assessments are needed to help determine the stability of foods routinely purchased at home. Conclusions: The obesogenic home environment is complex. This review aims to provide valuable insights for designing direct interventions for weight management in children and adolescents by improving their home food environment.

Social public policies are fundamental to enable access to certain rights and needs for marginalized citizens, without which this would not be possible. In Brazil, social policies were instituted as consequences of class struggles, a path to the conquest of rights and the reduction of inequalities. As the effectiveness and maintenance of public policies are dependent on the release of public resources, one of the problems is their fragmentation and discontinuity due to changes in government over the years. Faced with the scenario of food and nutritional insecurity experienced by the Brazilian population and aware of the State's responsibility to respect, protect and promote people's right to have access to adequate and healthy food, the government has created several strategies to guarantee this right established by the Federal Constitution of Brazil. Among the strategies, programs to provide healthy and nutritious food to socially vulnerable people stand out. Narrowing it down a little further, there is the Popular Restaurant program, which was designed with the objective of providing complete and healthy meals at affordable prices for the low-income population. In this context, this research aimed to identify whether the Federal Government and the State Governments have programs for access to free or subsidized food in all Brazilian states. For this, the research was developed with a quantitative and exploratory approach, and the data collection was done through the websites of the Federal and State governments to identify the policies/programs of access to free or subsidized food, analyzing the following elements: if there are programs, what is the number of units, the amounts charged for lunch and the date of implementation of the program. It was concluded that, despite the difficulty of finding information regarding the programs in some states, in quantitative terms, there is a relevant number of establishments, but there is a need for a better geographical distribution of them so that access to free or low-cost food is achieved by the population of the various Brazilian regions and not just some.

This systematic review and meta-analysis assessed the socioeconomic, psychological, and environmental factors influencing healthy food consumption in the USA. A total of 90 studies were included, following a comprehensive screening process, and the findings were synthesized using qualitative thematic analysis and quantitative meta-analysis. The results show that socioeconomic factors, particularly income and education, significantly impact dietary choices. Individuals from lower-income groups were 28% less likely to consume healthy foods (pooled OR = 0.72; 95% CI: 0.65–0.80). The high cost of nutritious food and time constraints were identified as significant barriers. Psychological factors, including health consciousness and self-efficacy, were also important, with individuals with low health awareness being 38% less likely to consume healthy foods (pooled OR = 0.62; 95% CI: 0.55–0.70). Environmental factors, particularly food accessibility, were critical, as individuals in food deserts were 43% less likely to consume healthy foods (pooled OR = 0.57; 95% CI: 0.50–0.65). The findings underscore the need for multi-faceted policy interventions, such as subsidies for healthy foods, expanded nutrition education, and improved access to affordable, nutritious food in underserved areas. Addressing these barriers holistically could improve the dietary habits of diverse populations across the USA.

Residents of rural areas may have limited access to healthy foods, leading to higher incidence of diet related health issues. Smaller grocers in rural areas experience challenges in maintaining fresh produce and other healthy foods available for customers. This study assessed the rural food environment in northeast Lower Michigan in order to inform healthy food financing projects such as the Michigan Good Food Fund. The area's retail food businesses were categorized using secondary licensing, business, and nutrition program databases. Twenty of these stores were visited in person to verify the validity of the categories created, and to assess the availability of healthy foods in their aisles. In-depth interviews with key informants were carried out with store owners, economic development personnel, and other food system stakeholders having knowledge about food access, in order to learn more about the specific challenges that the area faces. Out-shopping, seasonality, and economic challenges were found to affect healthy food availability. Mid-sized independent stores were generally found to have a larger selection of healthy foods, but smaller rural groceries also have potential to provide fresh produce and increase food access. Potential healthy food financing projects are described and areas in need of further research are identified.

BackgroundFood insecurity concerns have featured prominently in the UK response to the COVID-19 pandemic. We assess changes in the prevalence of food-related hardships in the UK population from April to July 2020.MethodWe analysed longitudinal data on food-related hardships for 11,104 respondents from the April-July 2020 waves of the Understanding Society COVID-19 web survey with linked data from the 2017-9 wave of the annual Understanding Society survey. Outcome variables were reports of being hungry but not eating and of being unable to eat healthy and nutritious food in the last week, which were adapted from the Food Insecurity Experience Scale. We used unadjusted estimates to examine changes in population prevalence and logistic regression to assess the association between employment transitions and both outcomes at the individual level.FindingsThe prevalence of reporting an inability to eat healthy or nutritious food rose from 3•2% in April to 16•3% in July 2020. The largest increases in being unable to eat healthy or nutritious food were among Asian respondents, the self-employed, and 35-44-year-olds. The prevalence of being hungry but not eating rose from 3•3% in April to 5•1% in July, with the largest increases observed among unemployed individuals below age 65. Those moving from employment to unemployment had higher odds of being hungry but not eating in the last week relative to furloughed individuals (OR = 2•2; p < 0•05; 95% CI: 1•1 to 4•2) and to the persistently employed (OR = 3•5; p < 0•001; 95% CI: 1•8 to 6•9), adjusting for age, highest qualification in 2017-19, net household income in 2017-19 (equivalized), gender, race/ethnicity, number children at home (aged 0-4, 5-15, and 16-18), cohabitation status, and government office region. Respondents moving from employment to unemployment also had higher odds of reporting an inability to eat healthy and nutritious food relative to furloughed individuals (OR = 1•9; p < 0•05; 95% CI: 1•4 to 3•2) and to the persistently employed (OR = 2•0; p < 0•01; 95% CI: 1•2 to 3•4). No statistically significant differences were found between furloughed individuals and the persistently employed in their probability of reporting either outcome.InterpretationFood-related hardships increased substantially in the UK between April and July 2020, largely driven by reports of an inability to eat healthy and nutritious food. The Coronavirus Job Retention Scheme and Self-Employment Income Support Scheme appeared to have conferred some protection, but more could have been done to mitigate the problems we describe in obtaining affordable food.FundingDS is funded by the Wellcome Trust investigator award. JK and DS are funded by the European Research Council n. 313590 – HRES. VT is funded by the European Research Council n. 694145- IFAMID.

Food banks are providing crucial relief as food insecurity increases worldwide. While these services are essential for vulnerable populations, there is variability in foods available and users may experience poor nutritional quality, and an overabundance of discretionary foods, contributing to public health risks including overnutrition and obesity. Understanding how customers perceive food availability, variety, and quality is important to inform relief services and health interventions. This study reports the findings of a convergent parallel mixed-methods investigation of user experiences and perceptions of food availability, variety, and quality at a major food bank in Western Australia. Food bank customers (N = 207) at a food bank branch and mobile van locations completed a survey, with an option to complete a subsequent semi-structured interview (n = 15). Approximately 80% of the survey sample had low (48%) or very low (30%) food security, half of the sample had been using the food bank for longer than 6 months, and 77% reported the food bank as their first choice for food. Three-quarters (77%) reported financial barriers to a balanced diet in the past twelve months and described how limited availability and variety complicated shopping. Interviewees explained complex perceptions of these issues, including favouring healthy food while considering discretionary food as a "luxury" that enhanced their quality of life. Our findings suggest that food bank users experience barriers to maintaining a balanced diet, encounter variable supplies of healthy and nutritious foods, and have concerns about the impacts of frequent discretionary food consumption. These findings have implications for public health promotion.

Spatial and socioeconomic disparities in the availability of healthy food via online food delivery services in Nanjing, China: An analysis based on absolute and relative measures.

To investigate whether geographical location or type of store is associated with differences in healthy and unhealthy food availability in grocery stores. A cross-sectional study using the Victorian Healthy Food Basket to measure food availability (44 'healthy' and 10 'unhealthy' items) in a convenience sample of 112 stores in urban and regional Victoria, Australia. Logistic regression analyses assessed whether location (regional, urban), distance from capital city central business district (km) and type of store (chain supermarket, independent supermarket and general store) predicted the number of missing healthy and unhealthy food items. There were 54 chain supermarkets, 43 independent supermarkets and 15 general stores, with 56% of stores located in urban areas and 44% located regionally. The strongest significant predictor of missing items was being a general store, which had greater odds (odds ratio (OR) = 136, 95% confidence interval (CI) = 13-1399) of having missing 'healthy' items and missing 'unhealthy' items (OR = 63, 95% CI = 7-575), compared with chain supermarkets. Independent supermarkets had increased odds of having missing 'healthy' items (OR = 7, 95% CI = 2-22) compared with chain supermarkets. Regional store location was a significant predictor of missing 'healthy' and 'unhealthy' items, compared with urban location (OR = 6, 95% CI = 2-25) and (OR = 7, 95% CI = 2-29), respectively. Store type was a stronger predictor of stores having missing 'healthy' and 'unhealthy' food items than the store distance from a large urban centre. General stores and independent supermarkets may be important settings for interventions to improve availability of healthy food.

Vulnerable, single and living in poverty: Women’s challenges to accessing food in the Australian Capital Territory

Association of Home Food Availability with Prediabetes and Diabetes Among Adults in the United States

The people of West Jakarta City, particularly in South Meruya, faces various complex health and nutrition problems, similar to those found in other major urban areas. These include issues such as undernutrition and stunting, overnutrition (obesity), and unhealthy eating habits. Although South Meruya is known for its abundance of culinary options, unfortunately, many of these food and beverage choices are unhealthy, often containing high levels of sugar, salt, trans fats, and harmful food additives. On the other hand, healthy food options remain limited, leading people to prefer fast food or easily accessible snacks. Additionally, many business owners still lack an understanding of the principles of healthy and balanced food, resulting in a low availability and limited choices of healthy food circulating in South Meruya. One of the root causes of these nutritional problems is the lack of public knowledge about nutrition science and the principles of a balanced diet as outlined in the Balanced Nutrition Guidelines (Pedoman Gizi Seimbang or PGS). The purpose of this Community Service Program is to increase public understanding of the importance of PGS principles and their application in daily life as well as in starting a healthy food business. The main targets of this activity are PKK women, posyandu cadres, and small business owners (MSMEs). Through seminars, training, and mentoring, participants received education on PGS and how to create opportunities in the healthy food business and strategies for marketing them. The program was successfully held on April 24, 2025, at RPTA Menara, South Meruya, with over 30 participants. The attendees were attentive and enthusiastic throughout the event. MSME participants also expressed their intention to develop new or alternative healthy food products. Evaluation results showed that 90% of participants stated the material was highly relevant to their daily lives and easy to understand. Additionally, 78% felt motivated to start or improve their healthy culinary business, and 80% reported gaining new awareness about applying balanced nutrition in their households.

There is little research on how affective reactions (e.g., stress) to perceptions of nutritious food accessibility contribute to dietary behaviors. This study explores whether stress associated with limited access to nutritious foods-termed nutrition resource stress (NRS)-contributes to diet outcomes, and whether these associations are mediated by health-related self-efficacy. Using data from the cross-sectional National Cancer Institute's Health Information National Trends Survey, analyses were conducted to examine whether reported NRS was associated with specific dietary behaviors (i.e., fewer servings of fruit/vegetables; more servings of sugar-sweetened soda; N = 3,112). Analyses revealed a main association such that NRS was negatively associated with fruit/vegetable consumption (β = -0.08, p = .016). There was a negative association between NRS and self-efficacy (β = -0.11, p < .001). There was no significant association between NRS and soda consumption. Mediation analyses revealed a significant indirect association between NRS and fruit/vegetable consumption, mediated by perceived health-related self-efficacy (β = -0.03, 95% confidence interval [-.04, -.01], p < .0001). Given that self-efficacy (the mediator) was not significantly associated with soda consumption (β = 0.01, p = .912), mediation analyses were not conducted for this outcome. This study suggests that stress associated with perceptions of inability to access nutritious foods may influence dietary behaviors, and points to a psychological mechanism (i.e., self-efficacy) that may explain the association. In addition to improving objective barriers of access to healthy foods, future interventions might address ways of improving nutritious food-related self-efficacy or perceived stress related to obtaining healthy foods.

Nutrition and Kidney Health: Processing Emerging Evidence About Foods

This concept paper proposes initiatives to promote healthy food access in urban areas of the USA, addressing food insecurity and improving nutritional health. By implementing strategies such as community gardens, farmers' markets, and incentives for grocery stores, this paper aims to create sustainable solutions to improve food access and health outcomes in urban communities. Access to healthy food is a critical determinant of health, yet many urban areas in the USA face challenges related to food insecurity and limited access to nutritious foods. This concept paper explores strategies to promote healthy food access initiatives in urban areas of the USA, with a focus on addressing food insecurity and improving nutritional health. The paper discusses the current state of food insecurity and its impact on health outcomes in urban areas, highlighting the need for targeted interventions to improve access to healthy foods. It then examines various strategies that have been successful in promoting healthy food access, including community gardens, farmers' markets, and mobile food markets. Key components of successful healthy food access initiatives, such as community engagement, policy advocacy, and partnerships with local organizations, are discussed. The paper also explores the role of technology, such as online grocery delivery services, in improving access to healthy foods in urban areas. Through a comprehensive analysis, this concept paper aims to provide insights into effective strategies for promoting healthy food access in urban areas of the USA. By implementing these strategies, policymakers, healthcare providers, and community organizations can work together to address food insecurity and improve nutritional health in urban communities. Keywords: Healthy Food, Insecurity, USA.

To enhance the impact of school nutrition programs on children's health, more information is needed on the associations between healthy and unhealthy food offerings during school lunch periods and children's eating behavior. The purpose of this study is to evaluate the contributions of food offerings and participation in school lunch programs on children's overall (both in- and out-of-school) eating behavior. A cross-sectional observational study was conducted in which 2039 students in 12 elementary and 10 middle schools reported their eating behavior and the frequencies with which they purchased meals and à la carte items in the school cafeteria. Food service managers from each school provided information on the availability of foods and beverages during school lunch periods. Multilevel regression analyses were conducted to identify school- and student-level predictors of children's eating behavior. The availability of nutritious foods during school lunch periods was associated with healthier eating behavior among students. However, this effect was observed only among children who infrequently purchased à la carte food items, and not among those who were frequent purchasers. Increased availability of fruits, vegetables, whole grains, and low-fat dairy products as components of school meals may be an effective strategy to promote healthy eating behaviors among children. Improving the nutrition standards for foods offered in competition with federally reimbursable school meals may enhance the positive effects of school meal programs on student eating behavior.