Measures of the food and nutrition environment have much in common with those used to measure physical activity, and many parallel issues arise in both contexts. Karen Glanz, George A. Weiss University Professor, professor of epidemiology in the Perelman School of Medicine, and professor of nursing in the School of Nursing at the University of Pennsylvania, provided an overview of the ways in which food environments—and the effects of policies that influence them—are measured, and reviewed some limitations of the measurement tools currently available. Susan M. Krebs-Smith, chief of the Risk Factor Monitoring and Methods Branch in the Division of Cancer Control and Population Sciences at the National Cancer Institute, focused on surveillance in this area and the potential for expanding the focus of dietary surveillance from individual-level behaviors to the community- or national-level food environment.

UNDERSTANDING FOOD ENVIRONMENTS AND POLICIES

Presenter: Karen Glanz

As with physical activity, food choices are influenced by many factors. Glanz presented an ecological model (Figure 3-1) to illustrate these factors, similar to the physical activity model presented by Sallis. In the food choice model, the large boxes connecting to the concentric circles list the specific influences by category; the smaller boxes list the primary means by which these influences affect behavior.

The picture is highly complex, Glanz acknowledged. A second illustration (Figure 3-2) models similar ideas but highlights the environmental variables that she believes can be measured but have not been adequately studied, such as the locations of food outlets and the availability of healthy options at a given outlet.

In Glanz’s view, it is important when considering food issues to distinguish between the community environment (encompassing the types and locations of restaurants and supermarkets and their accessibility within a particular community) and the consumer environment (what consumers encounter when they go out to eat or to purchase food, whether in a restaurant, at school, or elsewhere) (Glanz et al., 2005). The consumer environment is the category that encompasses such factors as the availability of healthful or less healthful food choices within food establishments, the availability of nutrition information, pricing, and product placement. “Food is a commodity, and food products are a big business,” Glanz added. While many industries and government sectors have an interest in physical activity, it is a behavior, not a commodity, and industry is “very invested in food in a different way” she said. Food is also highly regulated through safety and hygiene rules, taxation, and policies regarding both foods and



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