Can a community of practice equip public health nutritionists to work with remote retail to improve the food supply?

INTRODUCTION: This study aimed to determine the influence on practice of a community of practice designed for public health nutritionists who work with retail stores in remote Indigenous communities in Australia. METHODS: A descriptive evaluation of the community of practice participants' perspectives using the most significant change technique and individual in-depth interviews was conducted. Data were analysed using thematic and content analysis with a focus on answering the evaluation questions. RESULTS: Twelve public health nutritionists employed to work with remote Indigenous community stores were involved. The community of practice was reported to develop competence through problem solving, knowledge sharing and building confidence for innovative work. Building competence was achieved through accessible and timely professional support. Sharing stories and being encouraged to reflect on practice was valued and supported the participant's practice. Working to improve the food supply is challenging but there is value in being supported by like-minded colleagues to stay focused on this work. CONCLUSIONS: Most participants perceived the community of practice intervention to be an effective strategy to improve their work. These findings provide evidence of a promising intervention for building the public health nutrition workforce in remote Indigenous community store retail settings.

Colorectal cancer and nonfermented milk, solid cheese, and fermented milk consumption: a systematic review and meta-analysis of prospective studies.

Colorectal cancer is the second most prevalent cancer worldwide. A systematic review and meta-analysis of prospective studies was conducted to examine the association between intake of different types of dairy foods during adulthood and the development of colorectal cancer, specifically comparing nonfermented milk, solid cheese, and fermented milk. Seven databases were systematically searched and 15 cohort studies selected for inclusion, involving over 900,000 subjects and over 5200 colorectal cancer cases. Meta-analysis resulted in an overall relative risk of colon cancer of 0.74 (95% confidence interval 0.60-0.91) in men consuming nonfermented milk (highest intake category averaging 525 g/day). No association was found between consumption of nonfermented milk and rectal cancer in men or nonfermented milk and colon or rectal cancer in women. No protective association was found between consumption of solid cheese or fermented milk and colorectal cancer. Reasons for the differences in the impact of nonfermented milk, solid cheese, and fermented milk in the colon are discussed. This meta-analysis supports the inverse association between nonfermented milk consumption and risk of colon cancer in men, and provides an evidence base to assist in the formulation of dietary guidelines involving dairy foods.

The cost of healthy food in rural Victoria.

INTRODUCTION: The cost of healthy food has been associated previously with the degree of remoteness and socioeconomic status. This study aimed to investigate the factors that influence the cost of food in rural Victoria, Australia. It also aimed to compare the cost of nutritious foods with less healthy foods, and to identify the population sub-groups most vulnerable to economic food insecurity. METHODS: A cross-sectional survey of the cost of food was undertaken in 2007 in a convenience sample of 34 supermarkets in rural areas across Victoria using the Victorian Healthy Food Basket (VHFB). The VHFB was designed to meet the nutritional needs of four different family types for a fortnight. RESULTS: The cost of the VHFB for a 'typical family' (2 adults, 2 children) was (mean [interquartile range]) AU $402.81 ($26.36). No association was evident between food cost and remoteness as indicated by the Accessibility/Remoteness Index for Australia (ARIA) score, socioeconomic status as indicated by the Socio-Economic Indices for Areas (SEIFA), population size or density, or distance of the town from the state capital, Melbourne. It was more expensive to purchase the VHFB at an independent store (median cost $406.66 [$29.39]) than at a supermarket chain (median cost $394.93 [$26.64]), p<0.05. Vegetables and legumes were the most expensive component of the VHFB to purchase and this food group showed significantly greater variation in food price than cereals (p<0.05), non-core foods (p<0.05) and unhealthy foods (p<0.001). The median cost of the VHFB was most expensive for a typical family and 'single parent family' (40% and 37% of welfare income) and least expensive for a single man (29% of income) and elderly pensioner (19% income). CONCLUSIONS: The VHFB is an effective tool for assessing economic food security for different population groups. The cost of food in rural Victoria varies in a manner that appears unrelated to remoteness, population, socioeconomic status or distance from the metropolitan centre. Purchase of healthy food requires a considerable proportion of welfare income and may thus be unaffordable for some groups. Food cost must be monitored at a national level to provide a knowledge base to inform development of food and nutrition policies for improved population health.