Iowa State University Extension

Problem:
Chronic health problems, including overweight, obesity, type 2 diabetes, high blood pressure and cardiovascular diseases are increasing in epidemic proportions. These health problems are now afflicting not only adults, but youth as well. Communities need to understand the multiple factors influencing risk for these health problems, one of which is the nutrition environment. The nutrition environment reflects those foods available in the community for consumption. The overarching premise is that individual food consumption is influenced and impacted by the food available in the environment.

Response:
The purpose of this project is to raise awareness of the nutrition environment, food availability, in six Iowa communities. These communities participate in a pilot intervention of Iowans Fit for Life, a nutrition and physical activity program funded by the Centers for Disease Control and Prevention and implemented by the Iowa Department of Public Health. The communities include Albia, Clarksville, LeMars, Manchester, Mediapolis, and Rock Rapids. The pilot intervention focuses on improving access to fruits and vegetables and physical activity in the respective communities.

The project used nationally recognized tools, Nutrition Environment Measures Survey (NEMS) from Emory University, to survey each community’s nutrition environment. NEMS is a set of tools used to assess the availability and quality of food in our environment. NEMS tools can be used to measure the availability of food choices in the grocery store, convenience store or restaurant. The tools are valuable to help communities focus on improving diet through improved accessibility and availability.

Two areas of the nutrition environment, children’s restaurant menus and convenience stores, were examined using the NEMS tools. Iowa State University Extension Nutrition and Health field specialists were trained surveyors conducting the environment surveys and will conduct community discussions.

Impact:
The nutrition Field Speicalists use the findings when they participate in local food availablity groups formed by the Iowa Department of Public Health, Fit for Life Program. The local data is used to determine community needs and actions to improve healthy food options in the local environment, especially convenience stores and children menus. Below are the compilation of findings for the six communities. Each community also has local data available.

Compiled Observations from Six Communities (36 restaurants/child menu options):
• Healthy entrees were not available at 61% of the restaurants.
• Only one menu included nutrition information.
• 100% fruit juices were available at 63% of the restaurants.
• Skim, nonfat, or low fat (1%) milk was available at 32% of the restaurants.
• Healthy sides were available at 50% of the restaurants.
• Unhealthy desserts were available at 21% of the restaurants.
• Healthy dessert options were available at 11% of the restaurants.
• All but one restaurant provided free refill of sugary beverages.

Compiled Observations from Six Communities (18 convenience stores):
• Low-fat milk (not milk products) is readily available and has a comparable price to whole milk. Single serve low-fat milk was not always available.
• Fresh fruit was available in five of the 18 stores. Grapes, apples, bananas and oranges were the fruits typically available.
• Fresh vegetables were found in none of the stores.
• Low-fat baked goods were found in none of the stores (< 3 gms fat per serving).
• Sugar-free soda and 100% juice was available in all stores and at a comparable price.
• Whole wheat bread was available in only two of the 18 stores.
• Baked chips were available in most stores and at a cost comparable to regular chips.
• Low-sugar cereal was not readily available and when it was available it was very expensive.

Additional Nutrition and Health Field Specialists will be encouraged to be trained to use the NEMS tools in the future. The six communities are creating food availability plans and will be shared at a future date.

Staff/Team Members/Community Partners Involved:
Barbara Anderson,Nutrition/Health Field Specialist,bjanders@iastate.edu,641-682-5491
Cindy Baumgartner,Nutrition/Health Field Specialist, cbaum@iastate.edu,563-927-4201
Ruth Litchfield, State Nutrition Specialist, litch@iastate.edu, 515-294-9484
Patti Steiner, Nutrition/Health Field Specialist,psteiner@iastate.edu, 319-754-7556
Jill Weber,Nutrition/Health Field Specialist, jrweber@iastate.edu, 319-234-6811
Denise Wyland, Nutrition/Health Field Specialist,dwyland@iastate.edu, 712-472-2576

Carol Voss, Iowa Department of Public Health,cvoss@idph.state.ia.us, (515) 242-5566

Contact:
Susan Klein
Polk County Extension
5201 NE 14th Street
Des Moines, Iowa 50313
515-261-4213
sklein@iastate.edu