Availability and Promotion of Healthful Foods in Stores and Restaurants ― Guam, 2015

Abstract

Chronic disease, which is linked to unhealthy nutrition environments, is highly prevalent in Guam. The nutrition environment was assessed in 114 stores and 63 restaurants in Guam. Stores had limited availability of some healthier foods such as lean ground meat (7.5%) and 100% whole-wheat bread (11.4%), while fruits (81.0%) and vegetables (94.8%) were more commonly available; 43.7% of restaurants offered a healthy entrée or main dish salad, 4.1% provided calorie information, and 15.7% denoted healthier choices on menus. Improving the nutrition environment could help customers make healthier choices.

The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review

“…In Greenland, for example, some remote stores do not carry any fresh items (e.g., produce, dairy, and/or meat) [56] and variety can be extremely limited among those that do. Results are similar in Alaska [93], where less than half of fruits (20-40%) and vegetables (20-30%) in a standard checklist are available, and in Guam [82], where less than half (47%) of stores surveyed sold more than two varieties of fresh fruit.…”

“…Store level factors (including store type/size and management/operating practices) have been related to both the food supply and consumer health among Indigenous Peoples in HICs. Small stores and nontraditional food retailers tend have higher prices and carry fewer healthful items such as fresh produce and lower-sodium products than do larger stores and supermarkets, which tend to be less present in these settings [56,67,71,73,77,82,83]. For example, in a study conducted on an AI reservation, convenience stores carried approximately one-fifth of the items in a standard checklist (compared to 86% of items in supermarkets) [73].…”

“…Store food availability audits conducted in Australia [91], Canada [92], Greenland [56], Guam [82], and the US [71,73,83,93,94] also capture these issues, with dramatic disparities in northern and remote stores. In Greenland, for example, some remote stores do not carry any fresh items (e.g., produce, dairy, and/or meat) [56] and variety can be extremely limited among those that do.…”

“…The relative price between more/less healthful food (e.g., nutrient/energy density, reduced-sodium items [77]) is observed in empirical pricing studies [26,101], with a few exceptions [82].…”

“…While community members have expressed concerns regarding what is sold and how it is promoted [63], and point-of-purchase media constitutes a main dimension of store-based public health interventions in Indigenous communities in both the US and Canada (see Section 3.6), few observational studies have examined these factors in the literature, and most have emphasized nutritional labels-notably the importance of culturally/ethnically appropriate information in Indigenous languages [56,89,112]. Among available studies, store signage in Guam more commonly promoted less-healthy eating than healthy eating [82].…”