Abstract
Despite their wellness mandate, many publicly funded recreational facilities offer primarily unhealthy foods. Governments have developed programs and resources to assist facilities to improve their food offerings, however the challenge to incent preferential sale of healthier foods remains substantial. In the Canadian province of Alberta, uptake of government-issued voluntary nutrition guidelines for recreational facilities has been limited, and offers of free assistance to implement them as part of a research study were not embraced. Financial constraints appear to be the most important barrier to offering healthier items in Alberta’s recreational facilities, as facility and food service managers perceive that selling healthier foods is unprofitable and might jeopardize sponsorship agreements. Mandatory government regulation may therefore be required to overcome the barriers to offering healthier foods in this setting. The advantages of a regulatory approach appear to outweigh any disadvantages, with benefits for population health, more effective use of public funds, and greater equity for the public and industry. Adverse effects on corporate profitability and freedom of choice are expected to be limited. Regulation may offer an efficient, effective and equitable means of ensuring that recreational facilities support child health and do not undermine it by exposing children to unhealthy food environments.
Key Words: Nutrition policy, obesity, public health, food industry, child, recreation
Résumé
Malgré leur mandat de favorisation du mieux-être, de nombreuses installations récréatives subventionnées par l’État servent principalement des aliments malsains. Les gouvernements élaborent des programmes et des ressources pour aider ces installations à améliorer leur menu, mais il demeure très difficile de les inciter à vendre de préférence des aliments sains. Dans la province de l’Alberta, au Canada, les lignes directrices volontaires publiées par le gouvernement en matière de nutrition sont peu suivies dans les installations récréatives, même lorsqu’on offre gratuitement une assistance pour appliquer ces lignes directrices, comme ce fut le cas dans le cadre d’une étude de recherche. Les contraintes budgétaires semblent être le principal obstacle à l’offre d’aliments sains dans les installations récréatives de l’Alberta; les gestionnaires de ces installations et des services d’alimentation jugent que la vente d’aliments sains n’est pas rentable et qu’elle peut compromettre les accords de commandites. Il faudrait peut-être envisager une approche réglementaire obligatoire pour surmonter les obstacles à l’offre d’aliments sains dans ces établissements. Les avantages de l’approche réglementaire (effets bénéfiques sur la santé des populations, utilisation plus efficace des fonds publics, plus d’équité pour le public et l’industrie) semblent l’emporter sur ses éventuels inconvénients. Ses effets indésirables sur la rentabilité des entreprises et la liberté de choix devraient être mineurs. La réglementation pourrait donc être un moyen efficient, efficace et équitable de faire en sorte que les installations récréatives favorisent la santé des enfants, au lieu de la miner en exposant ces enfants à des environnements alimentaires malsains.
Mots Clés: politique nutritionnelle, obésité, santé publique, industrie alimentaire, enfant, loisir
Footnotes
Funding: Our research program in recreational facilities has been funded by the Canadian Institutes of Health Research (CIHR) and the Canadian Foundation for Dietetic Research. These organizations had no role in study design, in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the report for publication. Dana Olstad has received scholarship support from a Vanier Canada Graduate Scholarship, a CIHR/Heart and Stroke Foundation Training Grant in Population Intervention for Chronic Disease Prevention, the Canadian Federation of University Women, the Women and Children’s Health Research Institute/Alberta Diabetes Institute, Dietitians of Canada and the University of Alberta. Kim Raine is funded by a CIHR/Heart and Stroke Foundation Applied Public Health Chair.
Acknowledgements: The authors thank Dr. Timothy Caulfield for his contribution to conceptualization of the commentary.
Conflict of Interest: DLO and KDR were members of the committee that prepared the literature review and draft version of the Alberta Nutrition Guidelines for Children and Youth, which was funded by the Government of Alberta. The authors have no other competing interests.
References
- 1.Chaumette P, Morency S, Royer A, Lemieux S, Tremblay A. Food environment in the sports, recreational and cultural facilities of Quebec City: A look at the situation. Can J Public Health. 2009;100(4):310–14. doi: 10.1007/BF03403953. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Naylor PJ, Bridgewater L, Purcell M, Ostry A, Wekken SV. Publically funded recreation facilities: Obesogenic environments for children and families? Int J Environ Res Public Health. 2010;7(5):2208–21. doi: 10.3390/ijerph7052208. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Olstad D, Downs S, Raine K, Berry T, McCargar L. Improving children’s nutrition environments: A survey of adoption and implementation of nutrition guidelines in recreational facilities. BMC Public Health. 2011;11:423–35. doi: 10.1186/1471-2458-11-423. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Olstad DL, Raine KD, McCargar LJ. Adopting and implementing nutrition guidelines in recreational facilities: Public and private sector roles. A multiple case study. BMC Public Health. 2012;12(1):376. doi: 10.1186/1471-2458-12-376. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Naylor PJ, Wekken SV, Trill D, Kirbyson A. Facilitating healthier food environments in public recreation facilities: Results of a pilot project in British Columbia, Canada. J Park & Recreation Admin. 2010;28(4):37–58. [Google Scholar]
- 6.Thomas H, Irwin J. Food choices in recreation facilities: Operators’ and patrons’ perspectives. Can J Diet Pract Res. 2010;71(4):180–85. doi: 10.3148/71.4.2010.180. [DOI] [PubMed] [Google Scholar]
- 7.Nelson TF, Stovitz SD, Thomas M, Lavoi NM, Bauer KW, Neumark-Sztainer D. Do youth sports prevent pediatric obesity? A systematic review and commentary. Current Sports Med Rep. 2011;10(6):360–70. doi: 10.1249/JSR.0b013e318237bf74. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.van der Horst K, Oenema A, Ferreira I, Wendel-Vos W, Giskes K, van Lenthe F, et al. A systematic review of environmental correlates of obesity-related dietary behaviors in youth. Health Educ Res. 2007;22(2):203–26. doi: 10.1093/her/cyl069. [DOI] [PubMed] [Google Scholar]
- 9.Pearson N, Biddle SJ, Gorely T. Family correlates of fruit and vegetable consumption in children and adolescents: A systematic review. Public Health Nutr. 2009;12(2):267–83. doi: 10.1017/S1368980008002589. [DOI] [PubMed] [Google Scholar]
- 10.Fox MK, Dodd AH, Wilson A, Gleason PM. Association between school food environment and practices and body mass index of US public school children. J Am Dietetic Assoc. 2009;109(2Suppl):S108–S117. doi: 10.1016/j.jada.2008.10.065. [DOI] [PubMed] [Google Scholar]
- 11.Andrews RL. Healthy Eating in Recreation & Sport Settings–Provincial & Territorial Scan Summary. Halifax, NS: Capital District Health Authority; 2011. [Google Scholar]
- 12.Alberta HealthWellness. The Alberta Nutrition Guidelines for Children and Youth. Edmonton, AB: Alberta Health and Wellness; 2010. [Google Scholar]
- 13.Olstad DL, Raine KD, McCargar LJ. Public Health Nutr. 2012. Adopting and implementing nutrition guidelines in recreational facilities: Tensions between public health and corporate profitability; pp. 1–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Vander Wekken S, Sorensen S, Meldrum J, Naylor PJ. Exploring industry perspectives on implementation of a provincial policy for food and beverage sales in publicly funded recreation facilities. Health Policy. 2012;104(3):279–87. doi: 10.1016/j.healthpol.2011.11.014. [DOI] [PubMed] [Google Scholar]
- 15.Olstad DL, Lieffers JR, Raine KD, McCargar LJ. Implementing the Alberta nutrition guidelines for children and youth in a recreational facility. Can J Diet Pract Res. 2011;72(4):e212–e220. doi: 10.3148/72.4.2011.e212. [DOI] [PubMed] [Google Scholar]
- 16.Economos CD, Folta SC, Goldberg J, Hudson D, Collins J, Baker Z, et al. A community-based restaurant initiative to increase availability of healthy menu options in Somerville, Massachusetts: Shape Up Somerville. Prev Chronic Dis. 2009;6(3):A102. [PMC free article] [PubMed] [Google Scholar]
- 17.Sharma LL, Teret SP, Brownell KD. The food industry and self-regulation: Standards to promote success and to avoid public health failures. Am J Public Health. 2010;100(2):240–46. doi: 10.2105/AJPH.2009.160960. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Foster GD, Sherman S, Borradaile KE, Grundy KM, Vander Veur SS, Nachmani J, et al. A policy-based school intervention to prevent overweight and obesity. Pediatrics. 2008;121(4):e794–e802. doi: 10.1542/peds.2007-1365. [DOI] [PubMed] [Google Scholar]
- 19.Angell SY, Cobb LK, Curtis CJ, Konty KJ, Silver LD. Change in trans fatty acid content of fast-food purchases associated with New York City’s restaurant regulation: A pre-post study. Ann Intern Med. 2012;157(2):81–86. doi: 10.7326/0003-4819-157-2-201207170-00004. [DOI] [PubMed] [Google Scholar]
- 20.Bruemmer B, Krieger J, Saelens BE, Chan N. Energy, saturated fat, and sodium were lower in entrees at chain restaurants at 18 months compared with 6 months following the implementation of mandatory menu labeling regulation in King County, Washington. J Acad Nutr Diet. 2012;112(8):1169–76. doi: 10.1016/j.jand.2012.04.019. [DOI] [PubMed] [Google Scholar]
- 21.French SA. Pricing effects on food choices. J Nutr. 2003;133(3):841S–843S. doi: 10.1093/jn/133.3.841S. [DOI] [PubMed] [Google Scholar]