Sally Mackay

Bio: Sally Mackay is an academic researcher from University of Auckland. The author has contributed to research in topics: Population & Medicine. The author has an hindex of 7, co-authored 23 publications receiving 132 citations.

Paying for convenience: comparing the cost of takeaway meals with their healthier home-cooked counterparts in New Zealand.

Abstract: Objective: Convenience and cost impact on people's meal decisions. Takeaway and pre-prepared foods save preparation time but may contribute to poorer-quality diets. Analysing the impact of time on relative cost differences between meals of varying convenience contributes to understanding the barrier of time to selecting healthy meals.Design: Six popular New Zealand takeaway meals were identified from two large national surveys and compared with similar, but healthier, home-made and home-assembled meals that met nutrition targets consistent with New Zealand Eating and Activity Guidelines. The cost of each complete meal, cost per kilogram, and confidence intervals of the cost of each meal type were calculated. The time-inclusive cost was calculated by adding waiting or preparation time cost at the minimum wage.Setting: A large urban area in New Zealand.Results: For five of six popular meals, the mean cost of the home-made and home-assembled meals was cheaper than the takeaway meals. When the cost of time was added, all home-assembled meal options were the cheapest and half of the home-made meals were at least as expensive as the takeaway meals. The home-prepared meals were designed to provide less saturated fat and Na and more vegetables than their takeaway counterparts; however, the home-assembled meals provided more Na than the home-made meals.Conclusions: Healthier home-made and home-assembled meals were, except one, cheaper options than takeaways. When the cost of time was added, either the home-made or the takeaway meal was the most expensive. This research questions whether takeaways are better value than home-prepared meals.

Cost and Affordability of Diets Modelled on Current Eating Patterns and on Dietary Guidelines, for New Zealand Total Population, Māori and Pacific Households.

Abstract: The affordability of diets modelled on the current (less healthy) diet compared to a healthy diet based on Dietary Guidelines was calculated for population groups in New Zealand. Diets using common foods were developed for a household of four for the total population, Māori and Pacific groups. Māori and Pacific nutrition expert panels ensured the diets were appropriate. Each current (less healthy) diet was based on eating patterns identified from national nutrition surveys. Food prices were collected from retail outlets. Only the current diets contained alcohol, takeaways and discretionary foods. The modelled healthy diet was cheaper than the current diet for the total population (3.5% difference) and Pacific households (4.5% difference) and similar in cost for Māori households (0.57% difference). When the diets were equivalent in energy, the healthy diet was more expensive than the current diet for all population groups (by 8.5% to 15.6%). For households on the minimum wage, the diets required 27% to 34% of household income, and if receiving income support, required 41–52% of household income. Expert panels were invaluable in guiding the process for specific populations. Both the modelled healthy and current diets are unaffordable for some households as a considerable portion of income was required to purchase either diet. Policies are required to improve food security by lowering the cost of healthy food or improving household income.

The Timing, Nature and Extent of Social Media Marketing by Unhealthy Food and Drinks Brands During the COVID-19 Pandemic in New Zealand

Abstract: Background: Concerns have been raised that health and societal causes surrounding the COVID-19 pandemic were misappropriated by companies to promote their unhealthy products to vulnerable populations during a time of increased stress and hardship (i.e., COVID-washing). Social media is a common medium for unhealthy foods and beverage marketing due to lack of regulation and low levels of monitoring. Purpose: This study aimed to investigate the timing, nature and extent of COVID-washing on public social media accounts by New Zealand's major food and drink brands in the initial stage of the pandemic after the first case was detected in New Zealand and when stay-at-home lockdown restrictions (Level 4 and 3 Alert levels) were in place. Methods: A content analysis of social media posts from February to May 2020 by the twenty largest confectionery, snacks, non-alcoholic beverages, and quick-service restaurant (fast-food) brands was undertaken. COVID-19 related posts were identified and classified to investigate the timing, themes and engagement with social media marketing campaigns, flagging those that may breach New Zealand's Advertising Standards. Results: 14 of 20 unhealthy food and drink brands referenced COVID-19 in posts during the 4-month period, peaking during nationwide lockdown restrictions. Over a quarter of all posts by the 14 brands (n = 372, 27.2%) were COVID-19 themed. Fast-food brands were most likely to use COVID-19 themed posts (n = 251/550 posts, 46%). Fast-food brands also had the highest number of posts overall during the pandemic and the highest engagement. The most commonly-used theme, present in 36% of all social media posts referring to COVID-19, was to draw on feelings of community support during this challenging time. Suggesting brand-related isolation activities was also common (23%), and the message that "consumption helps with coping" (22%). Six posts were found to potentially breach one of New Zealand's advertising standards codes by promoting excessive consumption or targeting children. Conclusion: COVID-washing was used by unhealthy food and drinks brands to increase brand loyalty and encourage consumption. The current Advertising Standards system is ineffective and must be replaced with a government-led approach to effectively regulate social media advertising to protect all New Zealanders, particularly in times of crisis.

The first INFORMAS national food environments and policies survey in New Zealand: A blueprint country profile for measuring progress on creating healthy food environments

Abstract: The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support aims to benchmark national food environments. This study proposes a blueprint country profile to measure progress on creating healthy food environments, based on the results of the first, comprehensive survey in New Zealand (NZ). We assessed the implementation of national food environment policies and food industry commitments to improve population nutrition and the strength and comprehensiveness of public sector settings' nutrition policies. The healthiness of the packaged food supply, including health-related labelling, was evaluated. Food environments were measured in 833 schools, 204 supermarkets, 1500 takeaway outlets, 28 hospitals, 70 sport centres, and around all NZ schools. Food swamps, defined as areas with high relative density of unhealthy food outlets, were identified, and food marketing to children on television, websites, social media and packages, in magazines, and in and around schools was measured. The cost differential between healthy and current household diets was calculated for different population groups. NZ's food environment profile is largely unhealthy, and there are inequalities in access to healthy food environments. It is anticipated that the proposed country profile can help other countries tackle unhealthy food environments through increasing accountability of governments and the industry.

Measuring and stimulating progress on implementing widely recommended food environment policies: the New Zealand case study

Abstract: Monitoring the degree of implementation of widely recommended food environment policies by national governments is an important part of stimulating progress towards better population nutritional health. The Healthy Food Environment Policy Index (Food-EPI) was applied for the second time in New Zealand in 2017 (initially applied in 2014) to measure progress on implementation of widely recommended food environment policies. A national panel of 71 independent (n = 48) and government (n = 23) public health experts rated the extent of implementation of 47 policy and infrastructure support good practice indicators by the Government against international best practice, using an extensive evidence document verified by government officials. Experts proposed and prioritised concrete actions needed to address the critical implementation gaps identified. Inter-rater reliability was good (Gwet’s AC2 > 0.8). Approximately half (47%) of the indicators were rated as having ‘low’ or ‘very little, if any’ implementation compared to international benchmarks, a decrease since 2014 (60%). A lower proportion of infrastructure support (29%) compared to policy (70%) indicators were rated as having ‘low’ or ‘very little, if any’ implementation. The experts recommended 53 actions, prioritising nine for immediate implementation; three of those prioritised actions were the same as in 2014. The vast majority of experts agreed that the Food-EPI is likely to contribute to beneficial policy change and increased their knowledge about food environments and policies. The Food-EPI has the potential to increase accountability of governments to implement widely recommended food environment policies and reduce the burden of obesity and diet-related diseases.

Ultra-processed Food Intake and Obesity: What Really Matters for Health—Processing or Nutrient Content?

Abstract: The aim of this narrative review was to summarize and critique recent evidence evaluating the association between ultra-processed food intake and obesity. Four of five studies found that higher purchases or consumption of ultra-processed food was associated with overweight/obesity. Additional studies reported relationships between ultra-processed food intake and higher fasting glucose, metabolic syndrome, increases in total and LDL cholesterol, and risk of hypertension. It remains unclear whether associations can be attributed to processing itself or the nutrient content of ultra-processed foods. Only three of nine studies used a prospective design, and the potential for residual confounding was high. Recent research provides fairly consistent support for the association of ultra-processed food intake with obesity and related cardiometabolic outcomes. There is a clear need for further studies, particularly those using longitudinal designs and with sufficient control for confounding, to potentially confirm these findings in different populations and to determine whether ultra-processed food consumption is associated with obesity independent of nutrient content.

「逐条解説」子どもの権利条約 = Convention on the rights of the child

Abstract: １ 総論・子どもの権利条約のいま（子どもの権利条約の成立・内容・実施；子どもの権利条約と子どもの現場、ＮＰＯ、自治体；福祉分野における条約の実施 ほか） ２ 逐条解説・子どもの権利条約（第１条（子どもの定義）；第２条（差別の禁止）；第３条（子どもの最善の利益） ほか） ３ 資料編（児童の権利に関する条約；武力紛争における児童の関与に関する児童の権利に関する条約の選択議定書；児童の売買、児童買春及び児童ポルノに関する児童の権利に関する条約の選択議定書 ほか）

Food Insecurity and Hunger in Rich Countries—It Is Time for Action against Inequality

Abstract: Household food insecurity is a serious public health concern in rich countries with developed economies closely associated with inequality. The prevalence of household food insecurity is relatively high in some developed countries, ranging from 8 to 20% of the population. Human rights approaches have the potential to address the structural causes, not just the symptoms of food insecurity. Despite most developed countries ratifying the Covenant on Economic, Social and Cultural Rights over 40 years ago, food insecurity rates suggest current social protections are inadequate. The contemporary framing of the solution to food insecurity in developed countries is that of diverting food waste to the hungry to meet the United Nations Sustainable Development Goals agenda (Goals 2 and 12.3). An estimated 60 million people or 7.2% of the population in high income countries used food banks in 2013. Although providing food assistance to those who are hungry is an important strategy, the current focus distracts attention away from the ineffectiveness of government policies in addressing the social determinants of food insecurity. Much of the action needed to improve household food security falls to actors outside the health sector. There is evidence of promising actions to address the social determinants of food insecurity in some developed countries. Learning from these, there is a strong case for government leadership, for action within and across government, and effective engagement with other sectors to deliver a coordinated, collaborative, and cooperative response to finding pathways out of food insecurity.

COVID-19 Place Confinement, Pro-Social, Pro-environmental Behaviors, and Residents' Wellbeing: A New Conceptual Framework

Abstract: Residents' wellbeing in the present COVID-19 global health crisis requires a deeper understanding to determine appropriate management strategies to promote sustainable behaviors and contribute to human and planetary health. Residents' behavior can have a profound influence in contributing to personal and global community's health by responding effectively to emergency strategies in disease outbreaks such as the Coronavirus. It is evident that an understanding of residents' behavior(s) pre COVID-19 across fields have relied on over-simplistic models, many of which will need to be revisited. Our interaction with people and nature while respecting social distancing has profound positive impacts on our physical, mental, emotional, and spiritual wellbeing. The current health pandemic has called that people be confined in their homes across many nations as a means to control the spread of the virus and save lives. This calls for research exploring the mechanisms; this paper develops and proposes a conceptual framework suggesting that place confinement promotes pro-social and household pro-environmental behaviors which could become habitual and contribute further to our people's and our planet's health. The proposed model concerns socio-economically favored social sectors whose survival is not as threatened by the pandemic as the poor sectors where wellbeing (and mental health) are at high risk. Some evidence shows that human connectedness to place may contribute to engagement in desirable behaviors. Interaction with other members of the household can help create meanings leading to collective actions promoting psychological wellbeing. Promoting hygienic behaviors in the household (frequent hand washing) while at the same time being conscious not to keep the water flowing when not required would contribute to a range of benefits (health, financial, biospheric, altruistic) and promote wellbeing. Engaging in pro-social behaviors may result in positive effects on psychological wellbeing, reducing mental distress giving rise to a sense of attachment and belongingness, trust and overall life satisfaction. Engaging people in low-effort pro-environmental behavior to maintain some levels of physical activity and biological harmony with natural environmental settings (e.g., gardening) may help reduce anxiety and distress. This is the first study exploring the interplay of relationships between place confinement, pro-social behavior, household pro-environmental behaviors, place attachment as a multi-dimensional construct and presenting their relationships to residents' wellbeing. Behavioral change interventions are proposed to promote lifestyle change for people's wellbeing and broader societal benefits.