While there is a growing body of research on food environments for children, there has not been a published comprehensive review to date evaluating food environments outside the home and school and their relationship with diet in children. The purpose of this paper is to review evidence on the influence of the community and consumer nutrition environments on the diet of children under the age of 18 years.

Childhood obesity is a growing concern for public health. Given a majority of children in many countries spend approximately 30 h per week in early childcare centers, this environment represents a promising setting for implementing strategies to foster healthy behaviours for preventing and controlling childhood obesity. Healthy Start-Départ Santé was designed to promote physical activity, physical literacy, and healthy eating among preschoolers. The objectives of this study are to assess the effectiveness of the Healthy Start-Départ Santé intervention in improving physical activity levels, physical literacy, and healthy eating among preschoolers attending early childcare centers. This study follows a cluster randomized controlled trial design in which the childcare centers are randomly assigned to receive the intervention or serve as usual care controls. The Healthy Start-Départ Santé intervention is comprised of interlinked components aiming to enable families and educators to integrate physical activity and healthy eating in the daily lives of young children by influencing factors at the intrapersonal, interpersonal, organizational, community, physical environment and policy levels. The intervention period, spanning 6-8 months, is preceded and followed by data collections. Participants are recruited from 61 childcare centers in two Canadian provinces, New Brunswick and Saskatchewan. Centers eligible for this study have to prepare and provide meals for lunch and have at least 20 children between the ages of 3 and 5. Centers are excluded if they have previously received a physical activity or nutrition promoting intervention. Eligible centers are stratified by province, geographical location (urban or rural) and language (English or French), then recruited and randomized using a one to one protocol for each stratum. Data collection is ongoing. The primary study outcomes are assessed using accelerometers (physical activity levels), the Test of Gross Motor Development-II (physical literacy), and digital photography-assisted weighted plate waste (food intake). The multifaceted approach of Healthy Start-Départ Santé positions it well to improve the physical literacy and both dietary and physical activity behaviors of children attending early childcare centers. The results of this study will be of relevance given the overwhelming prevalence of overweight and obesity in children worldwide. NCT02375490 (ClinicalTrials.gov registry).

Over the course of the past century, the quantity of prepackaged, pre-prepared foods available in the North American context has increased dramatically. This study examines the shifts in food practices that are taking place through an exploration of the day-to-day cooking practices of a group of young, low-income women in Montreal and considers how these contribute to health problems such as obesity and nutritional deficiencies in addition to health inequalities within populations. The participatory study uses data from five focus groups with a total of 22 participants to contribute to our understanding of how social and physical food environments (the “foodscape”) shape daily food and cooking practices. Aspects of these environments that were discussed include household roles and responsibilities that require complex management, personal food choice and skill, as well as health, learning, and access to food.

Objective: To assess the evidence of the impact of new food store (supermarket/grocery store) interventions on selected health-related outcomes.Design: A systematic review following the Effective Public Health Practice Project guidelines. All quantitative studies were assessed for their methodological quality. Results were synthesized narratively.Setting: Eight electronic databases – MEDLINE, EMBASE, CINAHL, ProQuest Public Health, Web of Science, Scopus, PsycINFO and Cochrane Library – were searched to identify relevant records.Subjects: Peer-reviewed scholarly journal articles on new grocery store/supermarket interventions with adult study populations, published in the English language after 1995.Results: Eleven records representing seven new grocery store interventions were identified. Six were assessed having ‘weak’ methodological quality, one as ‘moderate’ and two as ‘strong’. All studies reported fruit and vegetable consumption but results were not consistent, some studies reporting significantly more and others no increase in consumption. BMI and self-rated health did not show significant improvements. Perceptions of food access, neighbourhood satisfaction and psychological health showed significant improvements.Conclusions: Improved food access through establishment of a full-service food retailer, by itself, does not show strong evidence towards enhancing health-related outcomes over short durations. Presently the field is developing and the complex linking pathways/mechanisms are yet to be elucidated. Further evidence, in the form of high-quality research in different communities with longer follow-up periods, is needed to inform policy decisions.

We examined location-related accessibility to healthy and unhealthy food sources for school going children in Saskatoon, Saskatchewan. We compared proximity to food sources from school sites and from small clusters of homes (i.e., dissemination blocks) as a proxy for home location. We found that (1) unhealthy food sources are more prevalent near schools in lower income than higher income neighbourhoods; (2) unhealthy compared to healthy food sources are more accessible from schools as well as from places of residence; and (3) while some characteristics of neighbourhood low socio-economic status are associated with less accessibility to healthy food sources, there is no consistent pattern of access. Greater access to unhealthy food sources from schools in low-income neighbourhoods is likely a reflection of the greater degree of commercialization. Our spatial examination provides a more nuanced understanding of accessibility through our approach of comparing place of residence and school access to food sources.

Background: Since young children spend approximately 30 h per week in early childcare centres (ECC), this setting is ideal to foster healthy behaviours. This study aimed to assess the effectiveness of the Healthy Start-Départ Santé (HSDS) randomized controlled trial in increasing physical activity (PA) levels and improving healthy eating and fundamental movement skills in preschoolers attending ECC.Methods: Sixty-one ECC were randomly selected and allocated to either the usual practice (n = 30;n = 433 children) or intervention group (n = 31;n = 464 children). The HSDS intervention group was provided a 3-h on-site training for childcare educators which aimed to increase their knowledge and self-efficacy in promoting healthy eating, PA and development of fundamental movement skills in preschoolers. PA was measured during childcare hours for five consecutive days using the Actical accelerometer. Preschoolers’ fundamental movement skills were assessed using the standard TGMD-II protocol and POMP scores. Food intake was evaluated using digital photography-assisted weighted plate waste at lunch, over two consecutive days. All data were collected prior to the HSDS intervention and again 9 months later. Mixed-effect models were used to analyse the effectiveness of the HSDS intervention on all outcome measures.Results: Total number of children who provided valid data at baseline and endpoint for PA, food intake and fundamental movement skills were 259, 670 and 492, respectively. Children in the HSDS intervention group had, on average, a 3.33 greater point increase in their locomotor motor skills scores than children in the control group (β = 3.33,p = 0.009). No significant differences in effects were observed for object control, PA and food intake. However, results demonstrated a marginal increase in portions of fruits and vegetables served in the intervention group compared to control group (β = 0.06,p = 0.05).Conclusion: Of the 12 outcome variables investigated in this study, 10 were not different between the study groups and two of them (locomotor skills and vegetables and fruits servings) showed a significant improvement. This suggests that HSDS is an effective intervention for the promotion of some healthy behaviours among preschoolers attending ECC.Trial registration: Clinical TrialsNCT02375490. Registered on February 24, 2015; 77 retrospectively registered.