Formative Research for a Healthy Diet Intervention Among Inner-City Adolescents : The Importance of Family, School and Neighborhood Environment

Objectives: To understand influences on diet among low-income African-American adolescents in East Baltimore. Methods: Formative research was conducted for a food store-centered healthy diet intervention targeted to inner-city youth. Family, school and neighborhood influences on eating habits and health concepts were explored. Results: Family structure, economic resources and past experiences influence what food means to adolescents. Healthy food in school and local stores is limited. Terminology to categorize foods was identified, including the term home foods. Conclusions: Suggested adolescent nutritional interventions include promotion of home-based eating, improving availability of healthy foods in school and neighborhood stores, and targeted educational materials.

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https://hdl.handle.net/10986/5218

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Cited 29 times in Scopus (view citations)

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Healthy and Sustainable Diets in Bangladesh
(World Bank, Washington, DC, 2022-09) Divya, Mehra; Tong, Junying; Dizon, Felipe; De Pee, Saskia
An ideal food system is envisioned to provide healthy diets for people and be sustainable for the environment. Such a food system is required to deliver on these goals even as diets are increasingly and disproportionately comprised of high-fat and/or high-sugar foods vis-à-vis nutritious diets. The ideal “planetary health diet,” as defined in the EAT Lancet report for several countries, presents trade-offs when contextualized at the local level. Using Bangladesh as the case study, this paper examined the change in diets (between 2000 and 2016) and their greenhouse gas emissions over time and compared the nutritional value and environmental impact to two modeled diets: national food-based dietary guidelines and the planetary health diet/EAT Lancet diet. The analysis finds that despite a change of the diet toward the recommended diet, significant gaps remain from a nutritional perspective. Moreover, meeting the dietary guidelines would increase greenhouse gas emissions by at least 10 percent. Compared to the food-based dietary guidelines, the EAT Lancet diet requires dietary patterns to change even more significantly and would increase greenhouse gas emissions by 23 percent. The policy implications and options from the production and demand sides are complex and require assessing multiple trade-offs.
Safe, Healthy, and Sustainable Diets
(World Bank, Washington, DC, 2022-06) Kathuria, Ashi Kohli; Anand, Deepika
The paper discusses in brief India’s food regulatory system in the context of modernized frameworks and examples of well-developed and mature regulatory systems from five selected developed countries (Australia, New Zealand, Canada, the United States, and the European Union). India’s food regulator, the Food Safety and Standards Authority of India (FSSAI), established in 2008, has developed a modernized regulatory system that aligns well with the most recent food safety regulatory systems model of the World Health Organization (WHO) (2018). As it continues to strengthen the regulatory system to enhance food safety, FSSAI is applying innovative approaches to address the country’s unique challenges of food safety, public health, and sustainable diets. The paper discusses two of FSSAI’s innovations: (i) approaches to enhance the safety of food businesses operating in India’s huge informal food sector; and (ii) proactive direct engagement with consumers at scale to promote safe, nutritious, healthy, and sustainable diets by influencing behavior change, thus contributing to improvements in public health, nutrition, and environmental sustainability. The paper also describes FSSAI’s regulatory leadership during the COVID-19 pandemic to promote food safety. The paper concludes that the approaches and innovations adopted by FSSAI appear promising and there are lessons that could be adopted and adapted by other low- and middle-income countries (LMICs). These approaches have not yet been evaluated but do merit a deeper study and discussion that may well lead to expanding the roles food regulatory bodies could play in promoting food safety, public health and nutrition, and sustainability. Whether food regulators are well-placed to take on wider roles may vary by country and the system of public administration, but it is not inappropriate per se for regulators to have that expanded role.
Literature Review : Family Formation and Fertility as Risk-Coping Mechanisms
(World Bank, Washington, DC, 2013-11-12) Cáceres-Delpiano, Julio
This report reviews the role of family as an institution that helps individuals manage risk, specifically, how family formation and fertility impact risk management, by (1) presenting the literature on family formation and risk management, (2) reviewing the role of fertility, and (3) reviewing policy implications. Both family formation and fertility determine the size of the family network and, therefore, the gains from pooling risk within this network, while changes in the risk environment alter the gains from network size, which in turn influences family arrangements and fertility. The mechanisms available to cope with risk, along with the magnitude and the consequences of risk, vary widely with level of development, and as more individuals become involved in managing risk, the cost of these strategies should fall. Understanding the determinants of family formation and fertility thus remains critical to understanding how effectively households in the developing world are able to cope with risk.
Consulting with Caregivers : Using Formative Research to Improve Maternal and Newborn Care and Infant and Young Child Feeding in the Lao People's Democratic Republic
(World Bank, Washington, DC, 2004-10) Gillespie, Anna; Creed-Kanashiro, Hilary; Sirivongsa, Deuanesay; Sayakoummane, Deuan; Galloway, Rae
Improving maternal and newborn care and young child feeding will decrease under five mortality and malnutrition in developing countries. To help design interventions in these areas, a study was conducted in the Lao PDR. The study found that washing newborns after delivery and delaying breastfeeding for 1-3 days are common practices that may expose newborns to hypothermia. Few caregivers practice clean cord care and exclusive breastfeeding for the first six months, increasing the risk of infection. Most women deliver at home without assistance from a trained provider. They also restrict what they eat based on traditional beliefs about foods thought to affect mothers' health or breastmilk. Traditional beliefs also determine how young children are fed. Most caregivers, when asked to try four feeding recommendations for young children (add or give more animal food, increase the amount of food, number of feedings, and vegetables and fruits), were willing to try and continue them. Many caregivers were surprised about how much and what types of foods children can consume, if they are encouraged to, and valued receiving new information about how to improve young child feeding. The study conclusions are that newborn care can be improved using low-cost technologies such as keeping newborns warm by deferring washing for 24 hours, and wiping, wrapping and breastfeeding newborns immediately after delivery. Risk of infection can be reduced by proper care of the umbilical cord and by exclusively breastfeeding infants for six months. What women eat can be improved by promoting the consumption of certain foods that improve the quality and quantity of breastmilk. To improve the feeding of young children, messages are needed about how much and what types of foods they require and how to encourage them to eat those foods.
Beginning a Family and Adopting a Healthy Lifestyle
(World Bank, Washington, DC, 2015-11-25) Moucheraud, Corrina; Hasan, Rifat
Decisions during youth have great long-term impacts on human development, which is key to poverty alleviation and economic development. During adolescence, two of the primary transitions are beginning a family and adopting a healthy lifestyle. Youth face many choices and challenges around these key decisions, such as when to initiate sex, when to marry, when to have children, and whether to engage in risky behaviors – all of which affect their future health and future opportunities. Consequences of these early decisions can have long-lasting effects on adolescents and their communities, potentially increasing public health costs and depleting human capital. This note briefly presents program and policy approaches that have been implemented in different contexts for addressing these two key transition periods of youth: beginning a family and adopting a healthy lifestyle. It concludes by presenting a set of programmatic lessons and investment recommendations based on the global evidence.

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