The impact of community-based food access strategies in high-income countries: a systematic review of randomised controlled trials.

OBJECTIVES: Some geographic regions in high-income countries (HIC), including Australia, have poor healthy food access and a high burden of diet-related chronic disease. Scalable and sustainable strategies to strengthen community food systems have the potential to address these inequities. To inform future interventions in regions with poor healthy food access in Sydney, Australia, and beyond, we systematically reviewed randomised controlled trials of community-based food access interventions in HIC, to identify effects on dietary behaviours and health outcomes. METHODS: Four electronic databases were searched. Studies involving community-based healthy food access strategies (solely or combined with education/behaviour change) and measuring effects on dietary behaviours and/or health outcomes were identified. Data on dietary behaviours, health outcomes and intervention descriptions were extracted, and the risk of bias was assessed. RESULTS: Seven studies met inclusion criteria, with most conducted in the US (n = 6). Intervention strategies included food pantry-based interventions (n = 2), mobile produce markets (n = 2) and community farms (n = 3). Most interventions (n = 6, 85%) incorporated educational and/or behavioural change aspects. All studies measured fruit and vegetable (F&V) intake, with nearly all (n =6, 85%) reporting significant beneficial effects. CONCLUSION: Preliminary evidence in our synthesis demonstrates that multicomponent community-based food system interventions promise to improve F&V intake in regions of HICs. Recommendations for improving future evaluations are identified to build evidence for policymakers and urban planners to enact upstream and downstream strategies to strengthen community healthy food, particularly in geographic regions with the greatest health inequities.

The Impact of Physical Distancing Policies During the COVID-19 Pandemic on Health and Well-Being Among Australian Adolescents.

PURPOSE: Physical distancing policies in the state of New South Wales (Australia) were implemented on March 23, 2020, because of the COVID-19 pandemic. This study investigated changes in physical activity, dietary behaviors, and well-being during the early period of this policy. METHODS: A cohort of young people aged 13-19 years from Sydney (N = 582) were prospectively followed for 22 weeks (November 18, 2019, to April 19, 2020). Daily, weekly, and monthly trajectories of diet, physical activity, sedentary behavior, well-being, and psychological distress were collected via smartphone, using a series of ecological momentary assessments and smartphone sensors. Differences in health and well-being outcomes were compared pre- and post-implementation of physical distancing guidelines. RESULTS: After the implementation of physical distancing measures in NSW, there were significant decreases in physical activity (odds ratio [OR] = .53, 95% confidence interval [CI] = .34-.83), increases in social media and Internet use (OR = 1.86, 95% CI = 1.15-3.00), and increased screen time based on participants' smartphone screen state. Physical distancing measures were also associated with being alone in the previous hour (OR = 2.09, 95% CI: 1.33-3.28), decreases in happiness (OR = .38, 95% CI = .18-.82), and fast food consumption (OR = .46, 95% CI = .29-.73). CONCLUSIONS: Physical distancing and social restrictions had a contemporaneous impact on health and well-being outcomes associated with chronic disease among young people. As the pandemic evolves, it will be important to consider how to mitigate against any longer term health impacts of physical distancing restrictions.