{"title":"Association between the nutritional quality of Canadian packaged foods and their prices: an analysis across five food categories.","authors":"Isabelle Petitclerc, Sonia Pomerleau, Laure Saulais, Geneviève Mercille, Marie-Ève Labonté, Véronique Provencher","doi":"10.1017/S1368980025100797","DOIUrl":"10.1017/S1368980025100797","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between nutritional quality and food prices within the same food category by: (1) identifying price differences among products above or below the nutrient thresholds of the Canadian front-of-package nutrition symbol and (2) investigating price differences among products with differing numbers of nutrients exceeding these thresholds.</p><p><strong>Design: </strong>This study is part of the Food Quality Observatory's work, Québec (Canada).</p><p><strong>Setting: </strong>For each product, nutrients exceeding the thresholds for Na, sugars and saturated fat were calculated according to Health Canada's guidelines. Prices per 100 g and per 100 kcal (418 kJ) were calculated. Statistical analyses were performed using RStudio to evaluate the association between these price metrics and nutritional quality, based on these thresholds.</p><p><strong>Participants: </strong>Five food categories were analysed: sliced breads (<i>n</i> 340), breakfast cereals (<i>n</i> 392), salty snacks (<i>n</i> 569), cookies (<i>n</i> 694) and processed cheeses (<i>n</i> 118).</p><p><strong>Results: </strong>Results indicate that nutrient type mediates the association between price and nutritional quality. Products exceeding the saturated fat threshold were generally more expensive, whereas those with elevated sugars and Na contents were cheaper. Products with two nutrients exceeding thresholds tended to cost less than those with one or no nutrient above thresholds. Notably, these results varied within each food category. These patterns varied across food categories.</p><p><strong>Conclusion: </strong>Foods high in nutrients of concern are typically cheaper within their category, except those high in saturated fat. Findings highlight the importance of monitoring food prices, especially as Canada's nutrition symbol policy becomes mandatory, to prevent worsening health inequalities.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e135"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rana Conway, Tiffany Denning, Andrew Steptoe, Clare Llewellyn
{"title":"How labelling of commercial infant food impacts parents' beliefs about sugar content and related purchasing and feeding decisions: a scoping review.","authors":"Rana Conway, Tiffany Denning, Andrew Steptoe, Clare Llewellyn","doi":"10.1017/S1368980025100827","DOIUrl":"10.1017/S1368980025100827","url":null,"abstract":"<p><strong>Objective: </strong>To assess what is known about how the labelling of commercial infant food impacts parents' beliefs about a product's sugar content and their related purchasing and feeding decisions.</p><p><strong>Design: </strong>Mixed methods scoping review. Peer-reviewed studies were identified from six electronic databases, and grey literature was identified via Google, relevant websites, government reports and by contacting organisations. Searches were completed in May 2024 using a comprehensive search string incorporating keywords and indexed terms related to 'parents', 'beliefs', 'sugar' and 'baby food labels'.</p><p><strong>Setting: </strong>Northern, Western and Southern Europe, North America, Australia and New Zealand.</p><p><strong>Participants: </strong>Parents and primary caregivers of children (≤ 37 months) or those specifically choosing commercial infant food for their children.</p><p><strong>Results: </strong>In total, 1123 records were screened, and seventeen were included for review, with all records published since 2015. Records reported on fifteen unique studies, including seven quantitative, seven qualitative and one mixed-methods study. Studies found that simply labelling products as suitable for babies elicited a trust that they were healthy, including not having a high sugar content. Interventions alerting parents to the sugar content of products were associated with less positive opinions or reduced intention to purchase. In eleven studies, parents described being drawn to products displaying labels such as 'no added sugar', which some perceived as meaning low sugar. In five studies, parents described sugar labelling as misleading, and/or they explicitly expressed a desire for clearer sugar labelling.</p><p><strong>Conclusions: </strong>Parents find the current labelling of commercial infant food misleading and desire clearer labelling to support informed purchasing and feeding decisions.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e138"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Analysis of food policymaking through a food systems lens: a review of analytical frameworks.","authors":"Isobel Stanley, Celine Murrin","doi":"10.1017/S1368980025100906","DOIUrl":"10.1017/S1368980025100906","url":null,"abstract":"<p><strong>Objective: </strong>This paper aims to summarise the frameworks currently used to analyse food policymaking processes and to critically assess whether those frameworks can be applied to the analysis of integrated, 'systems' approaches to policymaking.</p><p><strong>Design: </strong>Two electronic databases were searched to identify publications analysing food policymaking processes. Data from the publications were charted using an iterative coding process, and details of the underlying analytical frameworks were recorded. Identified frameworks were evaluated using theories of systems approaches to food policy development.</p><p><strong>Setting: </strong>Governmental food policy at the supranational, national and local levels.</p><p><strong>Results: </strong>The search process yielded 532 results. After screening, a final forty-three publications and twenty-four frameworks were identified. In the studies, frameworks were used to analyse agenda-setting, stakeholder networks, policy coherence and development of national food and nutrition policies. All twenty-four frameworks allowed for analysis of actors and context in policymaking processes, while space for considering policy coherence featured less (<i>n</i> 11).</p><p><strong>Conclusions: </strong>Three frameworks were highlighted as particularly applicable to the context of food systems approaches to policymaking. The application of analytical frameworks for policymaking processes is limited in food policy research. However, this review demonstrates that there are considerable benefits to using such frameworks to understand the ideas, knowledge, power and decision-making that lead to food policy development. This is particularly useful in understanding the complex stakeholder networks and policy coherence necessary for successful policies for sustainable food systems.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e158"},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Calorie labelling regulations in England: menu change not behaviour change?","authors":"Alexandra Kalbus, Chiara Rinaldi","doi":"10.1017/S1368980025100682","DOIUrl":"10.1017/S1368980025100682","url":null,"abstract":"","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":"28 1","pages":"e125"},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kimberly R Lush, Amy T Hutchison, Jessica A Grieger
{"title":"Evaluating the quality of online fertility nutrition claims.","authors":"Kimberly R Lush, Amy T Hutchison, Jessica A Grieger","doi":"10.1017/S1368980025100876","DOIUrl":"10.1017/S1368980025100876","url":null,"abstract":"<p><strong>Objective: </strong>To (1) explore and analyse current online preconception health and nutrition-related claims, (2) assess identified online preconception health claims against current preconception guidelines and (3) understand the perceived health claims among reproductive-aged men and women.</p><p><strong>Setting: </strong>Five online media platforms were searched using fertility nutrition-related search terms.</p><p><strong>Participants: </strong>All claims were assessed by an expert panel against nine Australian and International preconception guidelines. A sample of eighty reproductive-aged men and women rated a random sample of claims.</p><p><strong>Design: </strong>A content analysis of 191 claims was conducted using NVivo 12 Plus to group recurring topics into themes and then categories. Survey participants rated forty claims using a 5-point Likert scale from 'Not at all likely' to 'Highly likely'. If at least 75 % of the surveyed population considered a claim 'likely' or 'unlikely', it was classified as such.</p><p><strong>Results: </strong>Two themes were generated: <i>nutrition claims</i> and <i>lifestyle claims</i>. Five percent of claims were present in preconception guidelines, while 54 % had no evidence to support the claim. The highest percentage of no evidence claims was for <i>whole foods and their components</i> and <i>dietary patterns</i>. TikTok and Instagram contained the highest proportion of non-evidence-based claims. The community considered 3/40 claims likely to be true and 3/40 claims unlikely to be true.</p><p><strong>Conclusions: </strong>There is a myriad of inaccurate information online related to fertility nutrition and lifestyle behaviours. Social media public health campaigns to disseminate quality evidence for preconception health are necessary to improve awareness among those who access online information.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e151"},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving early childhood nutrition practices through parents' evening forums in rural Rwanda.","authors":"Fabien Nsanzabera, Evangeline Irakoze, Alexis Manishimwe, Jean Bosco Nsengiyumva, Aimable Mwiseneza, Emmanuel Ntakirutimana, Fabien Nkurikiyimana","doi":"10.1017/S1368980025100803","DOIUrl":"10.1017/S1368980025100803","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate early childhood nutrition knowledge and practices in Gicumbi District, Rwanda, and assess the potential of parents' evening forums as platforms for community-based nutrition education.</p><p><strong>Design: </strong>This study employed a mixed-methods design incorporating structured questionnaires (quantitative) and focus group discussions and interviews (qualitative). Quantitative data were analysed using descriptive statistics and Spearman's rank correlation to explore associations among participation, knowledge application and access barriers. Thematic analysis was applied to qualitative data to capture contextual insights and educational preferences.</p><p><strong>Setting: </strong>The study was conducted in Gicumbi District, a rural region in northern Rwanda, characterised by high malnutrition rates.</p><p><strong>Participants: </strong>523 participants: 471 household heads completed questionnaires; 52 took part in focus group discussions and interviews.</p><p><strong>Results: </strong>The study revealed substantial knowledge gaps, with only 46 % of participants aware of the symptoms of malnutrition and just 32 % identifying nutrient-rich complementary foods. Despite 68 % of participants reporting social connection as a key motivator for joining parents' evening forums, logistical challenges such as time and travel barriers were cited by 41 % as constraints. Lectures were the most preferred teaching method (78 %), followed by cooking demonstrations (56 %). Qualitative findings emphasised the importance of local relevance, peer support and interactive learning for fostering participation and knowledge retention.</p><p><strong>Conclusions: </strong>Parents' evening forums represent a viable and contextually appropriate platform for delivering early childhood nutrition education. Their expansion, alongside the integration of digital tools and tailored, experiential teaching approaches, could strengthen community engagement and address persistent malnutrition challenges in Rwanda and comparable settings.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e136"},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janet Adede Carboo, Jennifer Ngounda, Liska Robb, Marizeth Jordaan, Corinna May Walsh
{"title":"Nutritional status and household food security of pregnant women: insights from the Nutritional Status of Expectant Mothers and their Newborn Infants (NuEMI) study in South Africa.","authors":"Janet Adede Carboo, Jennifer Ngounda, Liska Robb, Marizeth Jordaan, Corinna May Walsh","doi":"10.1017/S1368980025100815","DOIUrl":"10.1017/S1368980025100815","url":null,"abstract":"<p><strong>Objective: </strong>To describe the nutritional intake and status of pregnant women in Bloemfontein and compare across different household food security categories.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Pelonomi Tertiary Hospital.</p><p><strong>Participants: </strong>427 pregnant women were interviewed using a standard questionnaire and a quantitative FFQ to collect socio-demographic, HIV status, household food security, supplement and dietary intake data. Weight and height were measured using standard anthropometric techniques and capillary blood taken by finger-prick for anaemia, Fe and inflammation status assessment.</p><p><strong>Results: </strong>26·7 % of participants were food secure, while 11·5 %, 32·1 % and 29·5 % experienced mild, moderate and severe food insecurity, respectively. 54·5 %, 41·7 % and 31·1 % were obese, anaemic and Fe deficient. Median energy intake was 8808 (6978-9223) KJ/d, with no significant differences between the food security groups (<i>P</i> = 0·517). Based on the dietary reference intakes, 98·1 % met the estimated average requirement (EAR) for carbohydrates, but the majority had sub-optimal intake of protein (58·3 %), fibre (60·9 %), pantothenic acid (67·0 %), vitamins C (65·6 %), D (68·4 %), E (59·0 %) and K (61·8 %), potassium (99·8 %), dietary Ca (95·8 %) and Fe (80·8 %). Compared with the moderately and severely food-insecure counterparts, food-secure participants had a higher intake of animal protein (<i>P</i> < 0·001), total fat (<i>P</i> = 0·014), monounsaturated fat (<i>P</i> = 0·002), vitamins B<sub>12</sub> (<i>P</i> = 0·014), C (<i>P</i> < 0·001) and D (<i>P</i> = 0·003) and dietary Ca (<i>P</i> = 0·001). Dietary folate intake was below the EAR in 69·9 %, but was higher among severely food-insecure participants (463·94 (327·39, 609·71) µg than food secure (378·49 (265·99, 496·15) µg, <i>P</i> = 0·007)).</p><p><strong>Conclusion: </strong>The findings show widespread inadequate nutrient intake among pregnant women in Bloemfontein, with food-insecure women showing significantly lower intake of specific nutrients.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e137"},"PeriodicalIF":3.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"NewTools: a novel collaboration across the Norwegian food system with the aim of developing tools for food system transformation.","authors":"Helle Margrete Meltzer, Kaja Lund-Iversen, Arnfinn Helleve, Marianne Hope Abel, Anne Lene Løvhaug, Marianne S Morseth, Hanne Fjerdingby Olsen, Trond Arild Ydersbond, Knut-Inge Klepp","doi":"10.1017/S1368980025100785","DOIUrl":"10.1017/S1368980025100785","url":null,"abstract":"<p><strong>Objective: </strong>The NewTools project aims to support the transformation of the food system by developing summary scores for the nutritional value and environmental and social sustainability of foods and exploring potential applications. In this conceptual paper, we present the governance, objectives, conceptualisation and expected outcomes of the NewTools project.</p><p><strong>Design: </strong>A cross-sector research partnership involving actors across the Norwegian food system.</p><p><strong>Setting: </strong>The need to transform food systems both globally, regionally and nationally.</p><p><strong>Participants: </strong>A broad constellation of twenty-eight project partners includes research institutions, governmental agencies, food industry and Non-governmental organization (NGO).</p><p><strong>Expected results: </strong>Outputs from the project will include the development and testing of a score for nutritional quality using the European Nutri-Score version 2023 as a starting point, identifying of indicators to measure social and environmental sustainability, proposing weighting of these into one or several summary scores, pilots testing potential applications of use for the scores and protocols for relevant spin-off projects.</p><p><strong>Conclusion: </strong>The multitude of perspectives represented by this unique variety of partners is seen as valuable to better understand the opportunities and limitations of the proposed tools designed to foster transformations towards a more resilient and sustainable food system.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e134"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Macronutrient intake inadequacy and associated factors among school adolescent girls in Meshenti, Northwest Ethiopia, 2020: 24-h recall.","authors":"Birtukan Gizachew Ayal, Yeshalem Mulugeta Demilew, Hunegnaw Almaw Derseh","doi":"10.1017/S1368980025100736","DOIUrl":"10.1017/S1368980025100736","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed macronutrient intake and associated factors among school adolescent girls in Meshenti, Northwest Ethiopia, 2020.</p><p><strong>Design: </strong>A cross-sectional study was conducted from 7 to 23 February 2020, among 401 randomly selected adolescent girls. Macronutrient intake was assessed using a 24-h dietary recall with portion size estimation. Nutrient data were analysed with Elizabeth Stewart Hands and Associates FOOD PROCESSOR software and compared with WHO/FAO recommendations - 2200 kcal for energy and 34-46 g for protein. Factors associated with inadequate macronutrient intake were identified using multivariable logistic regression.</p><p><strong>Setting: </strong>The study was conducted in an institutional setting.</p><p><strong>Participants: </strong>This study was conducted among school adolescent girls.</p><p><strong>Results: </strong>The median (IQR) energy intake was 2040·23 (1648·24-2744·51), and the mean (sd) protein intake was 63·88 (20·99). About 57·6 % (95 % CI: 52·9, 62·8 %) had inadequate energy intake, and 18·5 % (95 % CI: 14·7, 22·2 %) had inadequate protein intake. Inadequate energy intake was associated with dietary diversity (AOR = 4·31, 95 % CI: 2·20, 8·47), knowledge (AOR = 2·10, 95 % CI: 1·34, 3·28) and meal frequency (AOR = 2·5, 95 % CI: 1·06, 5·95). Factors linked to inadequate protein intake included early adolescence (AOR = 1·89, 95 % CI: 1·08, 3·31), residency (AOR = 0·27, 95 % CI: 0·15, 0·48), dietary diversity (AOR = 3·28, 95 % CI: 1·08, 9·98), knowledge (AOR = 1·82, 95 % CI: 1·04, 3·19) and meal frequency (AOR = 2·94, 95 % CI: 1·35, 6·37).</p><p><strong>Conclusion: </strong>This study revealed high inadequate energy and protein intake. Contributing factors included dietary diversity, knowledge and meal frequency, with age and residence affecting protein intake. Emphasis is needed on early adolescent girls' nutrition education.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e130"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammadhassan Rostami, Mina Babashahi, Arezoo Rezazadeh, Nasrin Omidvar, Hamed Zamanpoor
{"title":"Development and validation of a food retail environment analysis protocol in Iran.","authors":"Mohammadhassan Rostami, Mina Babashahi, Arezoo Rezazadeh, Nasrin Omidvar, Hamed Zamanpoor","doi":"10.1017/S1368980025100773","DOIUrl":"10.1017/S1368980025100773","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to adapt and validate a Food Retail Environment Analysis Protocol in Shiraz, Iran.</p><p><strong>Design: </strong>The protocol was developed by integrating the Nutrition Environment Measurement Survey in Stores with the food retail module from the International Network for Food and Obesity/Non-communicable Diseases Research, Monitoring, and Action Support. After translating, synthesising and back-translating the protocol, a panel of experts reviewed and refined it to ensure cultural and contextual appropriateness. Its validity was assessed through expert evaluation, and the pre-final version was field-tested to assess reliability across different food retail environments.</p><p><strong>Setting: </strong>Shiraz City, a metropolis in Iran.</p><p><strong>Participants: </strong>Nine food retail stores, including kiosks, small- and medium-sized food retailers (comparable to convenience stores) and large food retailers (comparable to grocery stores).</p><p><strong>Results: </strong>Content and face validity were assessed using the content validity ratio (0·64-1), content validity index (0·78-1) and item impact score (2·84-4·83). Reliability testing by two researchers showed a 93·77 % agreement and an intraclass correlation coefficient of 0·89-1. The protocol includes fourteen food groups, most of which are categorised as either healthy or unhealthy. It evaluates product availability, prominence, quality, pricing and both in-store and out-of-store food promotions.</p><p><strong>Conclusion: </strong>The validated protocol effectively assesses diverse retail food environments, offering essential data for evaluating policies and guiding interventions to improve healthy food access. It is adaptable for broader regional or international application in public health and food policy contexts.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e132"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}