Geospatial models can facilitate the delineation of food access patterns, which is particularly relevant for urban planning and health policymaking. Because community food environmental studies use different analysis units or study scales, the rigor and consistency of their evaluations cannot be ensured. This issue is known as the modifiable areal unit problem (MAUP). The paper provides a systematic review of past literature on place-based community food environmental research using different analysis units or geospatial models as they pertain to the MAUP. We identify these key findings: (1) the ZIP code zone is not recommended as an appropriate analysis unit for modeling community food access, as it did not have significant correlations with health indicators; (2) using a circular buffer of less than 0.5 km around household locations is most likely to reveal health correlations, compared with network buffers or container-based measures; (3) to reveal health effects of the community food environment, it is recommended to focus in selected regions or partitions of a study area with similar socioeconomic statuses, such as the central city or low socioeconomic status areas; (4) for studies utilizing a single statistical unit or distance measure, it is suggested to discuss the existence of the MAUP, such as evaluating the sensitivity of the model to the change of the unit or the distance measure. By highlighting the MAUP, this paper has policy implications—given that geospatial modeling of food accessibility provides support for health policy intervention, using different metrics may lead to different interpretations of health disparities and could thus misinform policy decisions. Therefore, any assessment of community food environments that may potentially lead to a policy change should consider the effects of the MAUP.

The availability, promotion, and price of healthy foods within the university food environment may impact students’ dietary choices. This systematic review summarizes the tools and methods used to assess the healthfulness of university food environments where many students spend a significant portion of their emerging adulthood. Thirty-six global studies published between 2012 and 2022 were sourced from PubMed (NNLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycInfo (EBSCO), CINHAL Complete (EBSCO), ProQuest Nursing, and Allied Health, following PRISMA 2020 guidelines. Of the included studies, 58% were institutional-level audits, 17% examined individual-level perceptions, and 25% combined both. Most institutional-level audits focused on one aspect of the food environment (e.g., eateries, vending machines). For studies examining multiple spaces within the campus environment (38%), comprehensive assessments were limited, and most studies had to employ a combination of assessment tools. Surveys were most often used to gather individual perceptions about the food environment. The Nutrition Environment Measures Survey (NEMS) was the most commonly used tool across all studies. This review highlights the need for a standardized tool, method, or a “healthy” benchmark for specific use at universities to improve methodological rigor and comparability of findings across institutions.

Universities typically offer residential students a variety of fast-food dining options as part of the student meal plan. When residential students make fast-food purchases on campus there is a digital record of the transaction which can be used to study food purchasing behavior. This study examines the association between student demographic, economic, and behavioral factors and the healthfulness of student fast-food purchases. The 3781 fast-food items sold at the University of North Carolina at Charlotte from fall 2016 to spring 2019 were given a Fast-Food Health Score. Each student participating in the university meal plan was given a Student Average Fast-Food Health Score; calculated by averaging the Fast-Food Health Scores associated with each food and beverage item the student purchased at a fast-food vendor, concession stand, or convenience store over a semester. This analysis included 14,367 students who generated 1,593,235 transactions valued at $10,757,110. Multivariate analyses were used to examine demographic, economic, and behavioral factors associated with Student Average Fast-Food Health Scores. Being of a low income, spending more money on fast-food items, and having a lower GPA were associated with lower Student Average Fast-Food Health Scores. Future research utilizing institutional food transaction data to study healthy food choices is warranted.

In the United States, there is an opportunity to improve the nutritional health of university students through the campus food environment. This project used a content analysis approach to investigate whether healthy food standards and policies were incorporated into the contract agreements between North Carolina (NC) public universities and their food service management companies. Food service contracts were collected from 14 NC public universities using food service management companies on campus. Each contract was evaluated using the 35-item North Carolina Food Service Policy Guidelines Assessment to examine four elements of the campus food environment: Beverages, Packaged Snacks, Prepared Foods, and Other (e.g., strategic placement of healthier food). Five university food service contracts incorporated no North Carolina Food Service Policy Guidelines, three university contracts included one to five guidelines, and six university contracts included six to nine guidelines. Altogether, 13 of the 35 guidelines were incorporated into at least one university food service contract. This project presents a cost and time-effective assessment method for determining if evidence-based nutrition guidelines have been included in university food service contracts. This approach and findings may lead to contract revisions to improve the campus food environment and, subsequently, the nutritional health of college populations.

Background: High intake of food away from home is associated with poor diet quality. This study examines how the COVID-19 pandemic period and Food Away from Home (FAFH) inflation rate fluctuations influenced dining out behaviors. Methods: Approximately 2800 individuals in Texas reported household weekly dining out frequency and spending. Responses completed prior to the COVID-19 pandemic (2019 to early 2020) were compared to the post-COVID-19 period (2021 through mid-2022). Multivariate analysis with interaction terms was used to test study hypotheses. Results and Conclusion: From the COVID-19 period (before vs. after), the unadjusted frequency of dining out increased from 3.4 times per week to 3.5 times per week, while the amount spent on dining out increased from $63.90 to $82.20. Once the relationship between dining out (frequency and spending) was adjusted for FAFH interest rate and sociodemographic factors, an increase in dining out frequency post-COVID-19 remained significant. However, the unadjusted increase in dining out spending did not remain significant. Further research to understand the demand for dining out post-pandemic is warranted.

Increasing numbers of children and adolescents have unhealthy cardiometabolic risk factors and show signs of developing metabolic syndrome (MetS). Low-income populations tend to have higher levels of risk factors associated with MetS. The Supplemental Nutrition Assistance Program (SNAP) has the potential to reduce poverty and food insecurity, but little is known about how the program affects MetS. We examine the relationship between SNAP and the cardiometabolic risk factors in children and adolescents using regression discontinuity to control for unobserved differences between participants and nonparticipants. We find that SNAP-eligible youth who experience food insecurity have significantly healthier outcomes compared to food-insecure youth just over the income-eligibility threshold. Our findings suggest that SNAP may be most beneficial to the most disadvantaged households. Policy makers should consider the broad range of potential health benefits of SNAP.