FIO-FOOD, Food Insecurity in people living with Obesity - improving sustainable and healthier food choices in the retail FOOD environment.

在英国，肥胖水平是一个关键的公共卫生问题，67%的英国人超重或肥胖。肥胖的人更容易出现一系列健康问题，包括心脏病和2型糖尿病。他们也更有可能生活在高度贫困的地区。几十年来，减少肥胖水平一直是英国公共卫生的优先事项，但我们尚未成功实现这一目标。这部分是由于影响体重的各种因素。肥胖人群面临的一个关键挑战是能否负担得起健康、均衡的饮食。营养不良和能量密集的食物通常是超加工的，它们更便宜，更容易获得。为了开始应对这一挑战，我们需要更好的证据，说明如何支持更健康的食品购买模式，以改善他们的健康和福祉，同时考虑到环境影响和可持续性。粮食不安全是“无法可靠地获得足够数量的负担得起的营养食物的状态”。低收入家庭更有可能出现食品不安全状况，他们每月在超市的食品预算中所占的比例更大（四分之三）。超市促销、广告和在线产品植入的决定会影响这一群体获得健康食品的机会。重要的是，健康饮食还需要在温室气体排放、水消耗和土地利用方面具有可持续性；被描述为“可持续性足迹”。我们的研究将把肥胖的粮食不安全人群、消费者、零售商、政策制定者和学者聚集在一起，共同制定和测试能够支持未来粮食系统变革潜力的战略。我们在社会科学、应用健康、肥胖和数据科学方面的多元化学术专家团队将把我们对大规模人口数据的了解与对肥胖人群和食物的生活体验的理解结合起来，开发出切实可行的解决方案，以促进这一群体可持续和更健康的食物选择。为了实现这一目标，我们设计了一个创新的四部分项目。视角：我们将与肥胖和食品不安全人群合作，了解他们在购物时面临的关键问题。我们还将与零售部门和政策制定者接触，了解他们的观点。这将确定当前战略的局限性和障碍，并为我们的项目确定未来的机会，以确保我们的工作保持相关性和有用性。大数据：我们将使用从一家全国性商业街超市（零售商）获得的匿名大规模数据（来自160万购物者）来了解人们购买的食品，这些购买的健康程度，其可持续性足迹以及这些选择在不同家庭类型（包括低收入家庭）中的差异。这将有助于确定店内的变化，从而鼓励肥胖和粮食不安全人群购买更健康、更可持续的食品。解决方案空间：我们将利用该项目前两部分的研究结果共同设计新方法，并在店内和网上对这些方法进行测试，评估它们对更健康和可持续的食品购买行为的影响。我们还将在一组积极寻求减肥的人群（MoreLife患者队列）中测试和衡量这些策略的有效性，这些人群生活在食物不安全的环境中。这将有助于确定可以帮助超市转型的策略，以促进更健康和更可持续的食品。交付：我们将与食品生产商、食品零售商、患者群体、政策制定者和慈善团体代表合作，确保我们的项目具有相关性和变革性。我们将通过网络研讨会、社交媒体、研讨会和研究简报等方式与这些团体分享我们的发现。

Obesity levels in the UK represent a key public health issue, with 67% of its population living with overweight or obesity. People living with obesity are more likely to experience a range of health issues including heart conditions, and Type 2 diabetes. They are also more likely to be living in areas of high deprivation. Reducing obesity levels has been a public health priority in the UK for decades but we have not yet managed to achieve that goal. This is partly due to the range of factors that influence body weight. One key challenge facing people living with obesity is being able to afford a healthy, balanced diet. Nutritionally poor and energy-dense foods that are often ultra-processed, are cheaper and more readily available. To start to address this challenge, we need better evidence on how to support healthier food purchasing patterns to improve their health and wellbeing, while considering environmental impact and sustainability. Food insecurity is 'the state of being without reliable access to a sufficient quantity of affordable, nutritious food'. Families on low incomes are more likely to be food insecure and they spend a greater proportion (three quarters) of their monthly food budget in supermarkets. Supermarket promotions, advertising, and online product placement decisions can impact this group's access to healthy foods. Importantly, healthy diets also need to be sustainable in terms of greenhouse gas emissions, water consumption, and land use; described as the 'sustainability footprint'. Our research will bring together food insecure people living with obesity, consumers, retailers, policy makers, and academics to co-develop and test strategies that can support future transformative potential in the food system. Our diverse team of academic experts in social science, applied health, obesity, and data science, will combine our knowledge of large-scale population data with an understanding of lived experiences of food shopping for people living with obesity and food to develop practical solutions to promote sustainable and healthier food choices in this group. To achieve this, we have designed an innovative four-part project. Perspective: we will work with people living with obesity and food insecurity to understand the key issues facing them while shopping. We will also engage with the retail sector and policy makers to understand their perspectives too. This will identify limitations and barriers of current strategies and scope out future opportunities for our project to make sure our work remains relevant and useful. Big Data: we will use anonymous large-scale data (from >1.6 million shoppers) obtained from a national high-street supermarket (retailer) to understand what foods people buy, how healthy these purchases are, their sustainability footprints and how these choices vary across different household types including those on low income. This will help identify in- store changes that would encourage healthier and more sustainable food purchasing for people living with obesity and food insecurity. Solution Space: we will use the findings from the first two parts of this project to co-design new approaches and test these in-store and online assess their effect on healthier and sustainable food purchasing behaviours. We will also test and measure the effectiveness of these strategies in a group of people who are actively seeking to lose weight (MoreLife patient cohort) and living with food insecurity. This will help to identify strategies that can help transform supermarkets to promote healthier and more sustainable foods. Delivery: we will engage with food producers, food retailers, patient groups, policy makers, and charity group representatives to ensure our project is relevant and transformative. We will do this by sharing our findings with those groups, using webinars, social media, workshops, and research briefing notes.