BACKGROUND: Healthy food store interventions (HFIs) are an important health-promotion tool, but face implementation and sustainment barriers. This paper aims to explore the underlying factors that produce these barriers using an innovative systems innovation perspective, through the case study of a multi-component HFI. The HFI was implemented in a minor, national, cooperative supermarket chain, in the Netherlands, a competitive market where price-based competition is the norm.
METHODS: The HFI was implemented for 6-12 months, in six stores. It was implemented by the researchers, and maintained by store employees. The study applied a Reflexive Monitoring in Action (RMA) approach, meaning that the researchers monitored stores\' adherence to the HFI, via store visits, to identify potential issues. Subsequently, the researchers interviewed the store managers responsible for the intervention, to have them reflect upon the barriers leading to these adherence issues, underlying systemic factors, and potential solutions. The stores implemented these solutions, and during the next monitoring visit the researchers evaluated whether the barrier had been resolved.
RESULTS: We found that the HFI often clashed with regular activities of the stores (eg, competing over the same spaces) and that store managers generally prioritized these regular activities. This prioritization was based on the greater commercial value of those regular activities (eg, selling unhealthy products) according to store managers, based on their beliefs and assumptions about commerce, health, and consumer preferences. Due to the limited resources of supermarkets (eg, people, time, space), and the HFI often not fitting within the existing structures of the stores as easily as traditional practices, store managers often neglected the HFI components in favor of regular store activities.
CONCLUSIONS: Our findings illustrate the systemic factors that produce implementation barriers for HFIs, and the dynamics by which this production occurs. These insights help future researchers to anticipate and respond to such barriers.

OBJECTIVE: Diet-related disease is rising, disproportionately affecting minority communities in which small food retail stores swamp supermarkets. Barriers to healthy food access were exacerbated by the pandemic. We examined the following: (1) individual- and household-level factors in a sample of Baltimore community members who regularly shop at corner stores and (2) how these factors are associated with indicators of dietary quality.
METHODS: Cross-sectional data were collected using an online survey to capture sociodemographics, anthropometrics, and food sourcing, spending, and consumption patterns. Concurrent quantitative and qualitative analyses were conducted in Stata 18 and ATLAS.ti.
METHODS: This study was set in Baltimore, Maryland, USA.
METHODS: The participants included adults (n = 127) living or working in Baltimore who identified as regular customers of their neighborhood corner store.
RESULTS: The respondents were majority Black and low-income, with a high prevalence of food insecurity (62.2%) and overweight/obesity (66.9%). Most (82.76%) shopped in their neighborhood corner store weekly. One-third (33.4%) of beverage calories were attributed to sugar-sweetened beverages, and few met the recommended servings for fruits and vegetables or fiber (27.2% and 10.4%, respectively). Being Black and not owning a home were associated with lower beverage and fiber intake, and not owning a home was also associated with lower fruit and vegetable intake. Food insecurity was associated with higher beverage intake, while WIC enrollment was associated with higher fruit and vegetable and fiber intakes. Open-ended responses contextualized post-pandemic food sourcing and consumption in this setting.
CONCLUSIONS: This paper helps characterize the consumers of a complex urban food system. The findings will inform future strategies for consumer-engaged improvement of local food environments.

Food insecurity is pervasive in Allegheny County, as one in five residents experiences food insecurity. Food insecurity is linked to chronic health conditions like heart disease and hypertension and disproportionately affects women in the United States, particularly women who are head of household. There are multiple dimensions used to measure regional disparities in food accessibility. Prior research has examined the linkages between food access and food insecurity, and this study aims to explore further the relationship between equitable access to sustainable and affordable food sources. This study examines food outlets in Allegheny County to determine if there is a significant relationship between food outlet availability and food insecurity. Both the presence and accessibility of these food outlets were examined. To measure accessibility, the walking distance to the nearest public transportation stop was calculated for each public transportation stop. The minimum distance to each food outlet was compared to food insecurity rates on a census tract level. Results showed that communities without grocery stores had lower access to healthy and affordable food sources. Also, communities with a higher proportion of female-headed households experienced greater food insecurity, regardless of access to food outlets. There was no statistically significant relationship between the distance from public transportation stops to grocery stores and rates of food insecurity overall and in low-income communities. However, communities with inaccessible grocery stores, either absent in the census tract or without close public transport stops, did have even greater average rates of food insecurity if there was an above-average proportion of female-headed households. Based on these findings, it is evident there exist structural elements of the built environment that correspond with disproportionate rates of food insecurity experienced by communities with households that are predominately female headed. In addition to resource support for these marginalized groups, we suggest that sole reliance on distance as an indicator of food insecurity can be misleading. There should be a greater focus on walkability aggregated on a household or individual level within the community instead of physical distance alone at a general scale.

BACKGROUND: Staphylococcus aureus (S. aureus) is one of the most widespread bacterial pathogens in animals and humans, and its role as an important causative agent of food poisoning is well-documented. The aim of this study was to highlight and characterize the resistance patterns of methicillin-resistant S. aureus (MRSA) in charcuterie products sold in selected supermarkets (SM) in Bobo-Dioulasso, Burkina Faso.
METHODS: In this study, 72 samples including ham (n = 19), merguez (n = 22), sausage (n = 15) and minced meat (n = 16) were collected from 3 supermarkets. Standard microbiology methods were utilised to characterise S. aureus isolates. Phenotypic resistance patterns were investigated using the disk diffusion method on Mueller-Hinton agar. Genotypic testing using polymerase chain reaction (PCR) was performed on the isolates to detect the 16S-23S gene. Using specific primers, the following genes PVL, TSST-1, mecA, gyrA, gyrB, qnrA, intI1 and aac(6\')-Ib-cr were identified from purified DNA by PCR.
RESULTS: Among the 72 ready-to-eat food samples, S. aureus was present in 51, (70.83%). The yield was highest in both the ham and merguez food products, 15/51 (29.41%) each, followed by minced meat 12/51 (23.53%) and sausage 9/51 (17.65%). A total of 35 isolates (68.63%) were confirmed as S. aureus after molecular characterization using 16-23 S primers with 05 (14.29%) strains identified as MRSA. All of the MRSA and majority of the methicillin-sensitive S.aureus (MSSA) isolates were resistant to penicillin G, ampicillin, tetracycline and erythromycin, whereas one isolate from minced meat was found in SM3-harbouring PVL, TSST-1, mecA, gyrA, gyrB and Int1 genes.
CONCLUSIONS: Our study revealed a high prevalence of S. aureus in chacuterie products in Bobo-Dioulasso with antimicrobial profiles that show resistance to most antibiotics. These findings should inform and augment efforts to raise awareness among local supermarket owners on adequate food manufacturing practices as well as promoting food safety and hygiene.

BACKGROUND: Nudges offer a promising tool to reduce sugary drink intake among children who are most at risk for diet-related disease.
OBJECTIVE: To examine the impact of online store nudges on purchases of sugary drinks for children in lower-income households.
METHODS: Caregivers with lower-income were recruited to an online shopping experiment and instructed to spend $10-$30 on three beverages for their child aged 1-5 years. Participants were randomized to navigate an online supermarket in its standard version (n = 1106) or a version with nudges (n = 1135), including a product placement nudge (i.e. placing healthy beverages in prominent positions) and a swap nudge (i.e. offering a swap of water, plain milk and/or 100% fruit juice upon selection of sugary drinks).
RESULTS: On average, participants purchased 1887 (SD = 2113) and 620 (SD = 1528) calories from sugary drinks per basket in the control and experimental conditions, respectively. Model-based results indicate that those in the experimental condition purchased 1267 (95% CI: 1419, 1114) fewer calories from sugary drinks, and fewer grams of total sugar (β = -253.5 g (95% CI: -286.3, -220.6)) and added sugar (β = -287.8 g (95% CI: -323.1, -252.5)) purchased from sugary drinks.
CONCLUSIONS: Nudges may be an effective, acceptable, scalable strategy for leading caregivers in lower-income households to purchase fewer sugary drinks for their children.

UNASSIGNED: Growing evidence suggests that it is possible to change the retail food environment to enable healthier choices via in-store interventions. It has been difficult to draw clear conclusions as to which interventions are most effective in positively influencing consumer purchasing behaviour given the significant heterogeneity within the food retail research literature. The aim of this study was to (1) summarise current high-quality systematic, scoping, and/or narrative reviews (Part I: overview of reviews); and (2) synthesise high-quality original research, to understand the range, types and effectiveness of strategies implemented in food retail settings (Part II: evaluation of primary studies).
UNASSIGNED: To identify reviews describing the effects of intervention strategies aiming to improve the healthiness of consumer purchasing in supermarkets, a systematic search across seven electronic databases was completed in April 2023. The methodological quality of reviews was assessed using the risk of bias in systematic reviews for systematic and scoping reviews, and the Scale for the Assessment of Narrative Review Articles for narrative reviews. High-quality reviews were further inspected and synthesised narratively (Part I). Next, to understand strategies associated with improved healthiness of consumer purchasing high-quality, primary articles from high-quality reviews identified in Part I were retrieved, and the strategies implemented within these interventions were summarised (Part II).
UNASSIGNED: Thirty-eight reviews met the inclusion criteria for Part I; two-thirds (n = 25, 66%) were rated as high-quality (66%). These reviews indicated that pricing strategies had the greatest proportion of reported positive or promising effects on outcomes (n = 8 of 11 reviews, 73%). Twenty reviews met the inclusion criteria for Part II and the 771 primary articles from these reviews were screened with 23 high-quality primary articles included in analysis. Findings indicated that promotional strategies in combination with another strategy appeared to be most successful among regular shoppers (the general population), whereas pricing was most successful in low socio-economic status and rural sub-groups.
UNASSIGNED: Promotion, pricing and prompting were the most commonly tested strategies across the overview of reviews and review of primary articles. Promotion, in combination with other strategies, and pricing appear to be most promising, but the effectiveness of pricing strategies may vary by sub-groups of the population. How pricing and promotion in combination with other strategies can be implemented responsibly and sustainably to change purchase habits towards healthier items should be explored further.
UNASSIGNED: OSF, https://osf.io/jyg73/.

UNASSIGNED: The basic product information, health, safety, and nutritional details, as well as food marketing, advertising, and promotion, are all provided on a packed food label. This study was carried out to assess the knowledge, attitude, and practices of the shoppers regarding food labels as there are few studies done in India and none in Pune.
UNASSIGNED: A cross-sectional study was carried out among 226 participants using a validated semi-structured questionnaire, which consisted of sociodemographic details and questions on their knowledge, attitude, and practice regarding food labels while purchasing a packed food item. Quantitative data are presented in the form of mean, standard deviation, 95% confidence interval (CI) of mean, median, and interquartile range (IQR). Qualitative data are in terms of number (N), percentages (%), and 95% CI of percentage.
UNASSIGNED: Of the 226 participants, 163 (72.12) were aware of the label on packaged foods. One hundred seventy-seven (78.32%) participants in all read the label on the packaged food. The maximum retail price (MRP) and expiration date were the most frequent labels sought. Although 17.7% of consumers did not consider nutrient composition when making a purchase, energy and protein were the most often considered nutrients. The majority (70.35%) falsely believed that juice was healthy. The packed food label\'s tiny font made it difficult to read for 30.38% of the customers.
UNASSIGNED: Despite the increased awareness about packed food labeling, a fraction of shoppers were not concerned about nutritional information. In contrast to the prevailing knowledge, the majority believes packed food has a positive effect on health.

The objective of this study was to assess purchasing, intake, and weight after discounting fruits and vegetables (F&V) and noncaloric beverages in New York City supermarkets.
A 16-week randomized controlled trial was conducted with a 4-week baseline, an 8-week intervention with 50% discounts on F&V and noncaloric beverages, and a 4-week follow-up. Purchasing was tracked via loyalty cards, and intake was tracked via 24-h dietary recalls. Weights were measured at five in-person visits.
Data from 67 participants were analyzed (38 in the experimental group; 29 in the control group). F&V and noncaloric beverage weekly purchasing was greater in the experimental than the control group (mean difference [SD], $4.64 [$1.44], p < 0.0001; $0.53 [$0.39], p = 0.008) during intervention, with F&V purchasing remaining greater in the experimental versus control group during follow-up (p = 0.005). F&V intake was greater for the experimental than the control group during intervention (142 [105] g/day; p = 0.009) and follow-up (p = 0.001). Although no difference in noncaloric beverage consumption was observed between groups, there was lower alcohol intake in the experimental than the control group during follow-up (-85.8 [60.2] g/day; p = 0.004). The experimental group lost weight compared with the control group (-1.33 [0.92] kg; p = 0.006 intervention and p = 0.106 follow-up). No differences in nutrient composition or high energy-dense product consumption were found.
A 50% discount on F&V and noncaloric beverages promoted increased purchasing and intake of F&V and induced weight loss.

BACKGROUND: The aims of this study were to develop and evaluate a high/low-emulsifier diet and compare emulsifier content with preclinical studies that have associated Crohn\'s disease with emulsifiers.
METHODS: Supermarkets were audited with a seven-day high- (HED) and low-emulsifier diet (LED) meal plan developed. The emulsifier content of food was sought from food manufacturers, compared to acceptable daily intake (ADI), and doses were provided in trials. Nutritional composition analysis was completed. Healthy adults ate these diets for seven days in a randomized single-blinded cross-over feeding study to assess palatability, tolerability, satiety, food variety, dietary adherence, blinding and the ease of following the meal plan via visual analogue scale.
RESULTS: A database of 1680 foods was created. There was no difference in nutritional content between the HED and LED, except HED had a higher ultra-processed food content (p < 0.001). The HED contained 41 emulsifiers, with 53% of the products able to be quantified for emulsifiers (2.8 g/d), which did not exceed the ADI, was similar to that in observational studies, and was exceeded by doses used in experimental studies. In ten participants, diets were rated similarly in palatability-HED mean 62 (5% CI 37-86) mm vs. LED 68 (54-82) mm-in tolerability-HED 41 (20-61) mm vs. LED 55 (37-73) mm-and in satiety HED 57 (32-81) mm vs. LED 49 (24-73) mm. The combined diets were easy to follow (82 (67-97) mm) with good variety (65 (47-81)) and excellent adherence.
CONCLUSIONS: Nutritionally well-matched HED and LED were successfully developed, palatable and well tolerated.

The use of mobile applications to assist with food decision making has increased significantly. Although food scanner applications provide nutritional information to consumers in the marketplace, little is known about their effects on users\' intentions and behavior. This research investigates whether a mobile food scanner app can influence consumers toward healthier food choices. Four studies tested whether information displayed through a food scanner app (as opposed to no information or front-of-packaging label information) influenced purchase intentions for food products (Studies 1-3) or led consumers to make healthier food choices (Study 4). Application-provided information enhanced hypothetical choice and purchase intentions of healthy products in comparison no information, but it did not influence real behavior when participants made choices in an experimental supermarket. Information provided through a food scanner app was systematically outperformed by front-of-packaging label information.