Objective
In response to recent national efforts to increase the availability of healthy food in small stores, we sought to understand the extent to which small food stores could implement the newly published Healthy Small Store Minimum Stocking Recommendations and reflect on the new US Department of Agriculture Food and Nutrition Service's final rule for stocking of staple foods for Supplemental Nutrition Assistance Program–approved retailers.
Design
We collected qualitative and quantitative data from 57 small stores in four states (Arizona, Delaware, Minnesota, and North Carolina) that accepted Supplemental Nutrition Assistance Program but not Special Supplemental Nutrition Assistance Program for Women, Infants, and Children benefits. Data from semistructured, in-depth interviews with managers/owners were transcribed, coded, and analyzed. We collected quantitative store inventory data onsite and later performed descriptive analyses.
Results
Store interviews revealed a reluctant willingness to stock healthy food and meet new recommendations. No stores met recommended fruit and vegetable stocking, although 79% carried at least one qualifying fruit and 74% carried at least one qualifying vegetable. Few stores met requirements for other food categories (ie, whole grains and low-fat dairy) with the exception of lean proteins, where stores carrying nuts or nut butter were more likely to meet the protein recommendation. Water and 100% juice were widely available and 68% met basic healthy beverage criteria.
Conclusions
In contrast to the inventory observed, most owners believed store stock met basic recommendations. Further, findings indicate that small stores are capable of stocking healthy products; however, technical and infrastructure support, as well as incentives, would facilitate shifts from staple to healthier staple foods. Retailers may need support to understand healthier product criteria and to drive consumer demand for new products.
Objective: To evaluate five popular fast-food chains' menus in relation to dietary guidance.
Design: Menus posted on chains' websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids' menus and sets of items promoted as healthy or nutritious were also assessed.
Setting: Five popular fast-food chains in the USA.
Subjects: Not applicable.
Results: Full menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids' menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points.
Conclusions: The poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus.
Many factors influence children’s health behaviors and health outcomes. The Social Ecological Model (SEM) groups these factors into interactive layers, creating a framework for understanding their influence and for designing interventions to achieve positive change. The layers of influence in the SEM include individual, interpersonal, organizational, community, and policy factors.
Results: No significant associations between WIC store counts near children’s homes and consumption were observed in the overall sample at any distance. A small, but significant inverse relationship was seen in total added sugar consumption among children residing in WIC households only, with each additional WIC store within a 0.5 mile roadway network associated with a 0.24-decile lower consumption (p = .047). In age-stratified exploratory analysis, higher vegetable (p = .024) and combined fruits and vegetables (p = .006) consumption were seen in the under 5 age group only.
Conclusions: Living close to more WIC-authorized stores was associated with healthier consumption, but only for a subset of children and only for a few food categories examined. Lack of a consistent pattern of healthier consumption among children suggests that access to WIC stores may have a positive, albeit limited impact on children’s diets.