WELCOME TO NEMS

The food, or nutrition environment, is widely believed to contribute to the increasing epidemic of childhood and adult obesity in the United States.

Nutrition environments are the places in a community where people buy or eat food. In order to identify and describe community nutrition environments, there is a need for well-defined and reliable tools to measure these environments, and for trained observers who can use the measures in their communities.

With the support of our funders, we have developed an online training program on the Nutrition Environment Measures Survey for Stores (NEMS-S) and Restaurants (NEMS-R) for researchers and community advocates and leaders so they can use the tools for research and action in their own communities.

Also on this website, you will find additional NEMS tools, support materials for using any or all of the tools in your community, and NEMS related materials that other NEMS users have shared.

NEMS NEWS and Exciting Updates

NEMS Project in Rural Arizona Town

The Arizona Area Health Education Center (AHEC) is funding a project using both the NEMS-S and NEMS-R in a rural Arizona town as part of a comprehensive assessment of the community nutrition environment.  The assessment combines data collected from surveys of members of a local coalition, community meetings, community surveys, secondary data, and the NEMS tools.  The goal is to establish baseline measures and identify policy or environmental-level interventions that could potentially improve the local community nutrition environment.  The assessment, including the NEMS project, is the preliminary research of a Mel and Enid Zuckerman College of Public Health, University of Arizona, doctoral student, Elizabeth Kizer, for a planned community based participatory research dissertation project.  Six local residents are participating in the NEMS project by volunteering their time to be trained as NEMS raters and perform surveys in every licensed store and restaurant in town (a total of 35 surveys).  A community action board will review the assessment, the NEMS data collected, and develop strategies to achieve policy or environmental-level change, which will guide this researcher and the local coalition, to improve the local food environment. 

NEMS Project in Guatemala

Towards the development of a Nutrition Environment Measures Survey in Stores (NEMS-S) tool to measure the Guatemalan food environment

With greater availability of ultra-processed foods and the transition away from subsistence agriculture, Guatemala is undergoing a nutrition transition. Whereby, with a greater availability of energy-dense, inexpensive foods high in fats and sugars, there is a greater consumption of these foods; this has often been associated with obesity. Amongst Guatemalan women aged 15-49 y, overweight and obesity have increased from rates of 34% to 59% between 1995-2008 (Kanter et al. 2013). To be able to conduct studies to assess associations between individual level diet, health, and socio-demographic data and food environment measures between urban and rural areas, respectively, in Guatemala, valid and reliable food environment measures are necessary.

To develop an appropriate NEMS-S tool for Guatemala, it was important to first pilot test the original NEMS-S in Guatemala in its verbatim, original form. This work is a collaboration between the Institute of Nutrition of Central America and Panama, specifically the INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), and CeSSIAM, Center for Studies on Sensory Impairment, Aging, and Metabolism, both located in Guatemala City, Guatemala. Two certified NEMS-S raters pilot tested the original NEMS-S on two separate occasions in four different supermarkets in Zone 3 of Quetzaltenango (Xela), Guatemala, the second largest city in Guatemala. We found that the original NEMS-S had both high inter-rater and test-test reliability. However, measurement validity varied by food item. Based on a subjective analysis regarding how easy raters could fill out the original NEMS-S, it performed very good for fruits and vegetables; good for juice, bread, chips, and cereal; but poor for lean meat, milk, frozen dinners, hot dogs, diet soda, and baked goods. Based on these results and Guatemalan dietary survey data, we have begun a process to design a modified NEMS-S tool for Guatemala; and are in the process of testing this tool. Ultimately, we plan to conduct studies that assess the relationship between individual level data and food environment measures between urban and rural areas of Guatemala with survey instruments of equal reliability, but adapted to the food-offering realities of the Western Highlands.

We would like to share with others all of the exciting news and activities that relates to NEMS, whether it is a project update, a publication, grant funding, customizations, etc. Please send us an email at nems@zimbra.upenn.edu. 

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Funding

NEMS is funded with support from the National Institutes of Health, the United States Agricultural Department, the Robert Wood Johnson Foundation, the Georgia Cancer Coalition and the Center for Health Behavior Research at the University of Pennsylvania.

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