Do 20-minute neighbourhoods moderate associations between work and commute hours with food consumption?

OBJECTIVE: To examine associations between work and commute hours with food consumption and test whether neighbourhood type (20-minute neighbourhood (20MN)/non-20MN) moderate associations. DESIGN: Cross-sectional analysis of the Places and Locations for Activity and Nutrition study (ProjectPLAN). Exposures were work hours (not working (0 h), working up to full-time (1-38 h/week), working overtime (> 38 h/week)), and among those employed, combined weekly work and commute hours (continuous). Outcomes were usual consumption of fruit, vegetables, takeaway food, snacks and soft drinks, and number of discretionary food types (takeaway, snacks and soft drinks) consumed weekly. Generalised linear models were fitted to examine associations between each exposure and outcome. The moderating role of neighbourhood type was examined through interaction terms between each exposure and neighbourhood type (20MN/non-20MN). SETTING: Melbourne and Adelaide, Australia, 2018-2019. PARTICIPANTS: Adults ≥ 18 years old (n 769). RESULTS: Although all confidence intervals contained the null, overall, patterns suggested non-workers and overtime workers have less healthy food behaviours than up-to-full-time workers. Among those employed, analysis of continuous work and commute hours data suggested longer work and commute hours were positively associated with takeaway consumption (OR = 1·014, 95 % CI 0·999, 1·030, P-value = 0·066). Patterns of better behaviours were observed across most outcomes for those in 20MN than non-20MN. However, differences in associations between work and commute hours with food consumption across neighbourhood type were negligible. CONCLUSIONS: Longer work and commute hours may induce poorer food behaviours. There was weak evidence to suggest 20MN moderate associations between work and commute hours with food consumption, although behaviours appeared healthier for those in 20MN.

Consumption Frequency and Purchase Locations of Foods Prepared Outside the Home in Australia: 2018 International Food Policy Study.

BACKGROUND: Foods prepared outside the home (e.g., fast-food chains, restaurants) represent increasing proportions of diets worldwide, and have been associated with higher energy intakes and BMIs. To improve the healthiness of population diets, it is important to understand patterns of consumption of these foods, and whether related policy measures are effective. OBJECTIVES: This study aimed to identify the frequency and sources of consumption of foods prepared outside the home in Australia, and to understand the impact of nutrition information in restaurants on related food choices. METHODS: Data were from a web-based survey (the International Food Policy Study) completed in 2018 by Australian adults aged ≥18 years (n = 4103). The number of meals prepared outside the home, their purchase locations, and the extent to which nutrition information was noticed and influenced purchasing decisions were each analyzed by sociodemographic characteristics and BMI, with linear models also adjusted for sex, age group, education, ethnicity, and BMI. RESULTS: An average of 2.73 (95% CI, 2.61-2.86) meals per week were prepared outside the home, with higher frequencies among men, younger ages, and more highly educated participants. A wide variety of sources for these foods was observed, with fast-food outlets being most common. Around one-quarter of all foods prepared outside the home were delivered. A small percentage (14.9%; 95% CI, 13.3%-16.7%) of participants reported noticing nutrition information, but among those who did, around half reported that it influenced their behavior. CONCLUSIONS: Foods prepared outside the home are commonly purchased in Australia, particularly by young adults, from a variety of outlet types. While current menu energy labeling regulations may provide some population health benefit, a broader policy focus on foods prepared outside the home is needed as part of efforts to improve population diets.

Operationalising the 20-minute neighbourhood.

BACKGROUND: Recent rapid growth in urban areas and the desire to create liveable neighbourhoods has brought about a renewed interest in planning for compact cities, with concepts like the 20-minute neighbourhood (20MN) becoming more popular. A 20MN broadly reflects a neighbourhood that allows residents to meet their daily (non-work) needs within a short, non-motorised, trip from home. The 20MN concept underpins the key planning strategy of Australia's second largest city, Melbourne, however the 20MN definition has not been operationalised. This study aimed to develop and operationalise a practical definition of the 20MN and apply this to two Australian state capital cities: Melbourne (Victoria) and Adelaide (South Australia). METHODS: Using the metropolitan boundaries for Melbourne and Adelaide, data were sourced for several layers related to five domains: 1) healthy food; 2) recreational resources; 3) community resources; 4) public open space; and 5) public transport. The number of layers and the access measures required for each domain differed. For example, the recreational resources domain only required a sport and fitness centre (gym) within a 1.5-km network path distance, whereas the public open space domain required a public open space within a 400-m distance along a pedestrian network and 8 ha of public open space area within a 1-km radius. Locations that met the access requirements for each of the five domains were defined as 20MNs. RESULTS: In Melbourne 5.5% and in Adelaide 7.6% of the population were considered to reside in a 20MN. Within areas classified as residential, the median number of people per square kilometre with a 20MN in Melbourne was 6429 and the median number of dwellings per square kilometre was 3211. In Adelaide's 20MNs, both population density (3062) and dwelling density (1440) were lower than in Melbourne. CONCLUSIONS: The challenge of operationalising a practical definition of the 20MN has been addressed by this study and applied to two Australian cities. The approach can be adapted to other contexts as a first step to assessing the presence of existing 20MNs and monitoring further implementation of this concept.

Is having a 20-minute neighbourhood associated with eating out behaviours and takeaway home delivery? A cross-sectional analysis of ProjectPLAN.

BACKGROUND: Through improved service provision and accessibility, 20-min neighbourhoods (20MNs) aim to enable people to meet most of their daily (non-work) needs within 20 min from home. Associations between 20MNs and food practices remain unknown. This study examines links with the frequency and location of eating out behaviours as well as the frequency of home food delivery. METHODS: This cross-sectional study used data from 769 adults from the Places and Locations for Activity and Nutrition study (ProjectPLAN) conducted in Melbourne and Adelaide, Australia, between 2018 and 2019. Outcomes were 1) visit frequency to i) cafés, ii) restaurants, bars or bistros, iii) major chain fast food outlets and iv) takeaway outlets to purchase food; 2) total number of different types of out-of-home food outlets visited; 3) use frequency of home food delivery services; 4) distance from home to the most frequented out-of-home food outlets. Exposure was whether participants had a 20MN (areas with high service/amenity provision) or a non-20MN (areas with low service/amenity provision). Ordinal regression models were fitted for the frequency outcomes. Poisson regression models were fitted for the number of different outlet types. Linear and spatial regression models were fitted for the distance outcomes. RESULTS: Results suggested no differences in frequency of visitations to out-of-home food outlets and use of food delivery services between those with a 20MN and those with a non-20MN. Yet, those with a 20MN were more likely to use a greater number of different types of outlets on a weekly basis. Where a regular eating out location was reported, it was nearer to home for those with a 20MN. CONCLUSIONS: This study provides evidence supportive of 20MNs potentially facilitating more localised food practices, however, 20MNs may also encourage greater cumulative frequency of meals out across a variety of out-of-home food providers.

The role of dwelling type on food expenditure: a cross-sectional analysis of the 2015-2016 Australian Household Expenditure Survey.

OBJECTIVE: To explore differences in proportion of food budget and total food expenditure by dwelling type. DESIGN: A cross-sectional study using data from the Australian Bureau of Statistics 2015-2016 Household Expenditure Survey. Food expenditure was examined on multiple categories: fresh fruits, fresh vegetables, pre-prepared meals, meals in restaurants, hotels and clubs, and fast food and takeaway meals, using two-part models and zero-one inflated beta regression models. Dwelling types were categorised as separate house, semi-detached house, low-rise apartment and high-rise apartment. SETTING: Australia, 2015-2016. PARTICIPANTS: Seven thousand three hundred and fifty-eight households from greater capital city areas. RESULTS: Households living in high-rise apartments were estimated to allocate a greater proportion of their food budget to meals in restaurants, hotels and clubs, and to spend more (actual dollars) on that category, compared with other dwelling types. No substantial differences were estimated in the proportion of food budget allocated to the other food categories across dwelling types. CONCLUSIONS: The dwelling type households live in may play a role in their food budget. Households living in a high-rise apartment may potentially spend more on meals in restaurants, hotels and clubs than those living in other dwelling types. Given the growth in urban population and the changes in living arrangements, findings point to the critical need for a better understanding of the influence of dwelling types on food expenditure and call for research investigating the relationship between the two.

Systematic review of the impact of nutrition claims related to fat, sugar and energy content on food choices and energy intake.

BACKGROUND: As part of efforts to address high levels of overweight and obesity, the provision of nutrition information (e.g., through nutrition labels and nutrition claims) on food packages has increasingly become an important policy option. This study aimed to assess the influence of nutrition claims relating to fat, sugar, and energy content on product packaging on several aspects of food choices to understand how they contribute to the prevention of overweight and obesity. METHODS: A systematic literature review was conducted using the online databases EBSCOhost Global Health, EBSCOhost Medline, ScienceDirect, Scopus, PsycINFO and Embase. Studies were included if they measured the influence of nutrition claims relating to fat, sugar, and energy content on outcomes related to body weight, and were published between January 2003 and April 2018. RESULTS: Eleven studies were included in the review. Results showed that nutrition claims can influence the knowledge of consumers with respect to perceived healthfulness of products, as well as expected and experienced tastiness of food products - making food products with nutrition claims seem healthier and less tasty. Nutrition claims can make the appropriate portion size appear to be larger and lead to an underestimation of the energy content of food products. Nutrition claims can also influence food purchase intentions, moderated by the perceived healthfulness of the relevant food products and the health consciousness of individuals. Nutrition claims were also found to have an impact on food purchases, to influence 'consumption guilt' (i.e., feeling of guilt associated with eating), and to increase consumption, moderated by the weight status of individuals. These influences were shown to vary depending on the type of claim and food carrying the claim. CONCLUSIONS: There is evidence that, while nutrition claims may lead some consumers to improve their nutrition knowledge and select healthier options, it may also lead consumers to increase food consumption and overall energy intake. This may run counter to efforts to address overweight and obesity.

Influence of work hours and commute time on food practices: a longitudinal analysis of the Household, Income and Labour Dynamics in Australia Survey.

OBJECTIVES: Work hours and commute time are key contributors to time scarcity, with potential detrimental implications for healthy eating. This study examined (1) associations between work and commute hours with food practices and (2) within-individual associations between changes in work and commute hours with changes in food practices. DESIGN: Longitudinal study SETTING: Australia PARTICIPANTS: Data were from 14 807 respondents in waves 7 (2007), 9 (2009), 13 (2013) and 17 (2017) of the Household, Income and Labour Dynamics in Australia Survey. The sample for this analysis included individuals who were in paid employment in at least one of the four waves. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes included frequency of out-of-home food purchasing for breakfast, lunch, dinner and all three summed eating occasions, and fruit and vegetables consumption. RESULTS: Results indicated the longer individuals spent working and commuting, the more likely they were to purchase out-of-home foods (frequency of total out-of-home food purchasing: incidence rate ratio (IRR)=1.007 (95% CI 1.007 to 1.008)), and the less they consumed fruit and vegetables, although reductions in fruit and vegetables servings were minimal (fruit: ß=-0.002 (95% CI -0.003 to -0.001), vegetables: ß=-0.002 (95% CI -0.003 to -0.001)). Similar results regarding associations with out-of-home food purchasing were observed when examining within-individual changes (IRR=1.006 (95% CI 1.005 to 1.007)). CONCLUSIONS: Results suggest employment-related time demands push towards more frequent out-of-home food purchasing. In the long term, this may have negative health consequences as out-of-home foods tend to be less healthy than home-prepared foods.

Do residents with a 20-min neighbourhood walk more? Findings from ProjectPLAN.

BACKGROUND: The 20-min neighbourhood (20 MN) concept aims to provide people the ability to meet their daily needs within a 20-min non-motorised trip from home. Evidence as to whether the 20 MN encourages more walking for transport or recreation is currently absent. METHODS: This cross-sectional study used self-reported data from the Places and Locations for Activity and Nutrition study (ProjectPLAN) targeting adults (n = 843) residing in Melbourne or Adelaide, Australia. Multiple services and amenities were used to represent access to five service domains (healthy food, community resources, recreational resources, public open space, public transport). Address points meeting the access criteria for each of the five domains were defined as having a 20 MN. Non-20 MNs were defined as having five or fewer individual services and amenities. This study examined if those residing in a 20 MN compared with a non-20MN undertook more walking for transport or for recreation. The analysis considered separately each of the cities to support the estimation of effects specific to each local context. RESULTS: Respondents residing in a 20 MN relative to a non-20MN had higher odds of walking for transport in Melbourne (OR = 4.24, 95% CI = 2.38, 7.56), whilst in Adelaide there was no evidence of a difference (OR = 1.31, 95% CI = 0.80, 2.13). In Melbourne, the mean time spent walking for transport was greater for 20 MNs (82.5 min/week, 95% CI = 65.3, 99.7) compared to non-20MNs (41.2 min/week, 95% CI = 32.7, 49.7). Whilst minutes spent walking for recreation was higher than minutes spent walking for transport, no differences were found between neighbourhood types and walking for recreation in either city. CONCLUSION: 20 MNs appeared to promote walking for transport in the higher density setting of Melbourne, but no association was observed in the lower density city of Adelaide. Further investigation is required to determine other factors beyond service provision that can promote walking for transport in Adelaide (e.g. pedestrian safety). Recreational walking did not differ across neighbourhood types highlighting that service provision and thus the 20 MN is not related to walking for exercise/recreation purposes.

Urban-regional patterns of food purchasing behaviour: a cross-sectional analysis of the 2015-2016 Australian Household Expenditure Survey.

BACKGROUND/OBJECTIVES: In many high-income countries people living in regional (rural) areas have higher rates of chronic disease compared to people living in urban areas. Food purchasing behaviour provides a potential pathway linking residential location with dietary intake and health outcomes. This study examined the relationship between geographic location and food expenditure on a range of foods. SUBJECTS/METHODS: Data from the 2015-2016 Australian Household Expenditure Survey (number of households = 9827) were used to examine weekly household food expenditure and proportion of total food expenditure on 14 categories of food items. Foods were classified using the Australian Guide to Healthy Eating. Two-part models and zero-one inflated beta regression models were used to assess the association between geographic area and food expenditure. RESULTS: Average proportion of total food expenditure on fruit was estimated to be more for households located in major cities compared to households located in inner and outer regional areas. Households located in inner and outer regional areas allocated less to fresh fruit, fish and meals out compared to households in major cities. Households located in inner regional areas allocated a greater proportion of their food budget to sweet cakes, biscuits, puddings, desserts, chocolate and ice-cream compared to households in major cities and outer regional areas. CONCLUSIONS: The geographic patterns in food purchasing suggest those in regional areas may be at risk of diets less aligned with healthy guidelines. Given the findings of this study suggesting geographic differences in food purchasing, further research is warranted to enhance contextual understanding of food purchasing behaviours in regional areas.