There are four main types of nutrition environments: the community, consumer, organizational and information.2 The community nutrition environment includes the type, location, and accessibility of food outlets such as stores and restaurants. The consumer nutrition environment includes the availability of healthy options, price, promotion, placement and nutrition information. The organizational nutrition environment encompasses the home, school, work, and other affiliations. The information environment covers the media and advertising of food items.2 These environments are not mutually exclusive and often overlap one another. Conceptualizing these different environments and their variables is useful in establishing the type of food people are exposed and have access to, and allow for targeted interventions to address their specific needs.
Nutrition plays an important role in the prevention of chronic diseases, and changing the food people eat has been defined as “one of the major modifiable determinants of chronic diseases.” However, our current food system and environment do not encourage people to eat healthy. California Center for Public Health Advocacy’s 2007 study found that California has more than four times as many fast-food restaurants and convenience stores as grocery stores and produce vendors. It has been demonstrated that access to high-calorie, low nutrition foods and convenience stores increases the risk of being overweight and obese.9 Obesity prevalence is highest for California adults who have high Retail Food Environment Indexes (RFEIs), which is the ratio of fast food-restaurants and convenience stores relative to grocery stores and produce vendors near their homes. Here are some ideas for interventions to change the food environments and make it easier for people to make healthier eating choices.
Farmer’s Markets and WIC
The WIC Program supports the consumption of fresh, locally grown fruits and vegetables, and encourages shopping at farmers’ markets. Since May 2010, farmer’s markets in California have been able to apply for authorization to accept the Women Infants and Children (WIC) Fruit and Vegetable Check (FVC). Since 2010, over 450 farmer’s markets have been authorized to accept the WIC benefit. Learn more about participating farms and farmer’s markets. Maternal, Child and Adolescent programs can promote local use Farmers' Markets
Research has shown that access to farmers' markets increases fruit and vegetable consumption among participants and that access to neighborhood supermarkets and farmers' markets reduces the risk of overweight and obesity. This is especially effective in low income communities where fresh produce is less accessible and more expensive. Farmers' markets can increase the availability of healthy foods and lower the overall food costs for the neighborhood. Since locally-grown produce is sold by local farmers, the cost of a middleman and transportation can be avoided making the sale prices competitive compared to grocery stores. Ultimately, farmers' markets can alter the community nutrition environment by making fresh fruits and vegetables more available and affordable, ensuring that more people have the opportunity to make healthier nutrition decisions.
Research supports the use of community gardens to improve a population's nutritional status. One study reported that adults with a household member that participated in a community garden consumed fruits and vegetables 1.4 times more per day and were 3.5 times more likely to consume fruits and vegetables five times a day than those who did not participate. Another study reported that community gardeners consumed fruits and vegetables 5.7 times per day compared with 4.6 times per day for home gardeners and 3.9 times per day for non-gardeners, suggesting that community gardens may benefit the health of its participants more so than private home gardens. Community gardens can also increase one's willingness to try the fruits and vegetables grown in a garden, which could prove useful for younger picky eaters. By improving the community nutrition environment with these gardens, participants may increase their consumption of fruits and vegetables and thus improve their health outcomes.
Programs such as Farm-to-School change the food environment in a school setting and help to increase the intake of fruits and vegetables in children. It has been reported that, by changing the organizational nutrition environment through school lunches, children consume an increase of one serving of fruits a vegetables per day. In working with various stakeholders involved with farming, institutions such as schools can improve the nutrition, and therefore the health outcomes children as well as their families.
Access to free and safe drinking water is essential to the health and well-being of communities. Work that supports creating access to free, safe drinking water (can includes working with partners to include water refilling stations, free water available in food service environments) and increasing the safety, taste, and appeal of water as a beverage choice. This work encourages consumption of water, especially in places of sugar-sweetened beverages (SSBs), and can help increase hydration and decrease risk for dental cavities, obesity and diabetes among community members.
Rethink Your Drink materials:
Water Works: A Guide to Improving Water Access and Consumption in Schools to Improve Health and Support Learning
Change Labs Drinking Water Access in Schools
CDC Increasing Access to Drinking Water in Schools
Water First Toolkit
Toolkits, all on NDWA website:
· Managing Lead in Schools and Childcare (Horsley Witten)
· Is My Water Safe? (Community Water Center)
· Waterworks School Toolkit (CFPA)
· Water Works (Howard)
· 4h20 for UC CalFresh Parents Making Waves (CFPA)
· Public water utilities for tap water safety and promotion