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This study assessed the prevalence of interpersonal violence (IV) experienced by elite U.S. athletes. Athletes were surveyed about experiences of emotional, physical, sexual violence, and deprivation of food or water, as well as questions about mental health indices, identity characteristics, and who perpetrated the harm. Of the total sample, 57.8% reported experiencing some form of IV in sport. Most athletes who experienced IV experienced multiple forms with a large overlap between emotional abuse and other forms of violence. A significant relationship was found between reporting any form of IV and having been diagnosed with one or more psychiatric disorders – particularly anxiety, depression and Post-Traumatic Stress Disorder. IV was also significantly associated with self-reported eating disorders. A particularly strong association was found between reporting being deprived of food in sport and reporting an eating disorder. This study reveals a critical need for more research focused on the traumatic effects of IV in sport. The potential for detrimental effects on athletes' mental health also underscores the need for improvements in the prevention and early detection of IV in sport. [ABSTRACT FROM AUTHOR]

Background: To improve the healthfulness of foods offered while accelerating the use of environmental sustainability practices, it is important to engage hospital food service operators in the adoption of such practices. The purpose of this study was to explore barriers, facilitators and best practices for implementing environmental sustainability standards in food service among veterans affairs (VA) hospitals in the United States. Methods: We conducted an online survey with 14 VA hospital food service directors and then 11 qualitative interviews. The survey assessed motivations for initiating sustainability standards and included a self‐rating of implementation for each of five standards: increasing plant‐forward dishes, procuring and serving sustainable foods that meet organic/fair trade and other certifications, procuring and serving locally produced foods, reducing food waste and reducing energy consumption. Interviews were transcribed verbatim. Qualitative analysis, including coding of themes and subthemes, was conducted by two coders to determine barriers, facilitators and best practices for each of these five standards. Quantitative methods (counts and frequencies) were used to analyse the survey data. Results: Participants had an average of 5 years of experience implementing sustainability standards. The top three motivators cited were reducing food waste, serving healthier foods and increasing efficiency or cost savings. Barriers revolved around patient preferences, contractual difficulties and costs related to reducing waste. Facilitators included taste testing new recipes that include more sustainable food options and easy access to sustainable products from the prime vendor. Best practices included making familiar dishes plant‐forward and plate waste studies to prevent overproduction. Conclusions: Although there were many barriers to implementation, food service directors had solutions for overcoming challenges and implementing food service sustainability standards, which can be tested in future sustainability initiatives. Key points: There have been several studies of sustainable food service standards in hospital settings, yet few have examined how these sustainable food service practices are implemented in day‐to‐day operations in veterans affairs hospitals throughout the United States. The study findings revealed many best practices that can be tested in the future, including increasing plant‐forward dishes by modifying familiar dishes and making them plant‐forward, procuring locally produced foods by beginning with the highest‐quality product to purchase locally and having a garden onsite at the hospital and reducing food waste by food tracking studies to prevent overproduction and a food donation programme. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) is a common hematologic malignancy, but due to its incurable nature, patients experience many relapses in their lifetime and hence face unique challenges. This mixed-methods study consisting of an online survey and subsequent focus groups aimed to understand how social and identity experiences affected the diagnostic, treatment, and care journey for patients with MM. Twenty-three adult patients with MM participated in this study. The survey participants identified common determinants negatively impacting their health, including mental health concerns (experienced by 90.5% of respondents), worries about food shortage (42.9%), and transportation concerns (28.6%). Focus group participants described high physical and mental health burdens associated with MM. Frequent monitoring, fear of a relapse, and unpredictable side effects contributed to high anxiety. Participants indicated that MM differed from other types of cancer and chronic health conditions in many ways, particularly how and where the diagnosis was made, disease progression and relapse, treatments and side effects, and financial concerns. Most participants (65.0%) reported ≥1 social need that negatively impacted health outcomes including lack of knowledge about MM, financial instability, and lack of insurance, transportation, and social support. The findings reveal that patients with MM continually experience patient-specific mental and physical health burdens indicating high unmet needs throughout the disease journey. [ABSTRACT FROM AUTHOR]

Guided by the culture-centered approach to health communication (CCA), this study explores how marginalized US women understand and negotiate meanings related to hunger and health. The analysis is based on in-depth interviews with 23 women experiencing deep structural vulnerability. Findings revealed three paradoxical meanings related to hunger: (a) the "abundance versus scarcity" paradox where even though women were consistently short of food, industrially processed food was amply available to them through charitable food venues, (b) the "good food" versus "bad food" paradox, which showed that while women sometimes consumed whatever food was available, taste, healthfulness, and desirability of food were equally important factors, and (c) the "not-eating versus overeating" paradox, which showed how women experienced anxieties around both hunger and obesity; women experienced physiological hunger pangs, but were also concerned about weight-gain and obesity because of the abundance of processed food in their foodscapes. Overall, despite their best attempts at being good health citizens, women were not able choose the foods they wanted to eat because of inadequate government benefits and a lack of "good food" options in food charity settings. These paradoxical meanings reflect contradictions inherent in the neoliberal model of health citizenship, where the focus is on individual behavior change, while the role of governments in facilitating healthy foodscapes is overlooked. [ABSTRACT FROM AUTHOR]

“Food as Medicine” (FAM) is a critical link between the foods we consume and our overall health. FAM adopts nutrition-based treatment, with existing healthcare to mitigate “metabolic” diseases. Despite advancements in medicine, healthcare technology, and treatments, chronic diseases affect nearly 50% of Americans and are attributed to 86% of healthcare costs. FAM initiatives have yet to advance beyond pilot programs and remain virtually unavailable to the US population. Pilot programs are producing promising results with healthier outcomes for patients. Economic assessments indicate net cost savings in healthcare expenditures. Three primary interventions are consistently effective in achieving positive health outcomes: medically tailored meals, medically tailored groceries, and prescription food programs. The Centers for Medicare and Medicaid Services and the US Department of Agriculture are both currently advancing FAM research and pilot programs with the cooperation of the National Institutes of Health Office of Disease Prevention and Health Promotion and the Office of Nutrition Research. The full potential of FAM can be realized when the federal government is able to successfully incorporate and financially support nationwide FAM treatments, including nutrition education and healthy foods into the existing healthcare system. [ABSTRACT FROM AUTHOR]

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This paper uses distinctions between differing senses of "private," "public" and "political" in the United States to argue for the value of framing food issues as a collective problem that calls for broadscale demands for justice. We argue that food choices do not simply belong to the realm of private preferences and market transactions. Rather, they are a set of decisions that have systemic causes and public consequences. They are shaped and constrained by public policies that underwrite the transportation of food over long distances as well as particular crops and foodstuffs, and by the vendors and advertisers who try to convince us to eat more of the foods they produce. Because the consequences of eating an abundance of empty calories are not easily remedied at the personal level, citizens need to demand public, systemic solutions, including better food information, youth food education, and a healthier food supply. [ABSTRACT FROM AUTHOR]

The relative high rates of homelessness and housing insecurity among college students has become a public health concern within the U.S. This study explores the relationship between housing instability in relation to academic and mental health outcomes. College students attending a larger public university (N = 1,416 students; M age = 22.54; 47.2% Pell Eligible; 54.6% racially/ethnically minoritized students) were surveyed employing cluster-sampling in the Fall Semester of 2019. Participants completed validated measures of housing instability, mental health outcomes, and demographics. Additional measures were matched with survey responses through the Office of Institutional Research (i.e., GPA, Pell Grant eligibility). Students who experienced housing insecurity and homelessness were more likely to have a lower GPA as well as poorer mental health outcomes. Findings highlight implications surrounding the need for housing programs and additional financial support in an effort to bolster students' academic performance and mental well-being. [ABSTRACT FROM AUTHOR]

Geospatial technologies have seen increased utilization in the social work profession for a variety of topics. Most of this usage has centered around the creation of digital maps to visualize social issues and/or affected populations. Innovative technology allows for the collection of field data resulting in real-time creation of such maps. ArcGIS Survey123 is a mobile app that allows for traditional survey data collection to be conducted digitally in the field, while also providing the ability to obtain photos and spatial coordinates. Resultant outputs can include traditional tabular datasets, photo arrays, and digital maps. A pilot project using ArcGIS Survey123 as the data collection tool was conducted in a rural area of Southwest Florida to examine access to food by establishment type as well as to expose social work students to a novel data collection technique. The result of the project was a comprehensive food system map that provided data on availability of certain food products as well as anecdotal data on the relationship between housing locations and food prices. Given the ease with which surveys could be employed for data collection purposes, it is recommended that ArcGIS Survey123 be considered for inclusion in research curricula in academic social work programs. [ABSTRACT FROM AUTHOR]

Background: Data documenting period product insecurity, or an inability to access products, in the United States have recently emerged. With multiple years of data now available, we assessed trends in period product insecurity among two nationally representative samples of U.S. adults. Materials and Methods: Data from nationally representative, cross-sectional online surveys conducted in January 2018 and April 2021 were used to run weighted logistic regressions. Those aged 18–49 years and who had menstruated in the past year (n = 922 in 2018; n = 1037 in 2021) were included. Results: In 2021, 59% experienced period product insecurity compared with 53% in 2018. In 2018 (adjusted odds ratio [aOR] 1.91, confidence interval [95% CI]: 1.29–2.83) and 2021 (aOR 1.53, 95% CI: 1.06–2.21), Hispanic respondents were more likely to find products unaffordable. Some college attainment was associated with finding products unaffordable in 2018 (aOR 1.53, 95% CI: 1.00–2.34) and 2021 (aOR 1.97, 95% CI: 1.35–2.88). Participants struggling to purchase products had higher odds of experiencing period product insecurity in 2018 (aOR 11.78, 95% CI: 8.07–17.20) and 2021 (aOR 7.71, 95% CI: 5.44–10.93). Conclusions: Hispanic ethnicity, lower educational attainment, and struggling to purchase period products were strong predictors of finding products unaffordable and experiencing product insecurity in both 2018 and 2021. Policies that improve access to or affordability of period products in the United States are needed to help those most vulnerable. [ABSTRACT FROM AUTHOR]

Objective: Ultraprocessed foods (UPF), hyper‐palatable foods (HPF), and high energy density (HED) foods may contribute to obesity risk. All have distinct definitions; however, it is unknown the degree to which they may identify overlapping or distinct foods. This study examined the availability of UPF, HPF, and HED foods in the US food system from 1988 to 2018 and the degree of distinction across definitions. Methods: Four data sets representing the US food system (1988, 2001, 2006, 2018) from the US Department of Agriculture were analyzed. UPF were identified based on the extent of industrialized processing. HPF were identified using the standardized definition that specifies palatability‐inducing nutrient combinations. HED was characterized as >2.0 kcal/g. Results: Across years, 58% to 65% of foods were classified as UPF, 55% to 69% as HPF, and 37% to 47% as HED. Prevalence of UPF, HPF, and HED foods was higher in 2018 versus 1988 (p values < 0.001); HPF evidenced the largest increase (14%) and UPF evidenced the smallest (4%) over time. There was moderate to high overlap in foods (40%–70%) across definitions. Conclusions: Together, UPF, HPF, and HED foods comprise most foods in the US food supply. Changes in availability varied across definitions, with substantial increases in HPF and HED and relative stability of UPF. [ABSTRACT FROM AUTHOR]

BACKGROUND: Participation in the US Department of Agriculture's summer meals program is consistently lower compared to National School Lunch Program (NSLP) participation, even though the programs target the same population of children. The purpose of this study was to elucidate reasons for participation and nonparticipation in the summer meals program. METHODS: A nationally representative sample of 4688 households with children ages 5 through 18 years living near a summer meals site in 2018 completed a survey about their reasons for participation or nonparticipation in the summer meals program, features that would help nonparticipants to attend, and household food security status. RESULTS: Almost half of all households living near a summer meal site were food insecure (45%) and most (77%) had incomes at or below 130% of the federal poverty level. Most participant caregivers (74%) sent their children to summer meal sites for the free meals, while 46% of nonparticipant caregivers said they did not attend because they were unaware of the program. CONCLUSIONS: Despite a high level of food insecurity among all households, the most reported reason for not attending the summer meals program was unawareness of the program. These findings highlight a need for better program visibility and outreach. [ABSTRACT FROM AUTHOR]

Purpose: To effectively meet their social objectives, humanitarian organizations need to be more innovative and find novel ways to stay competitive. Yet there has been limited focus on innovation by humanitarian organizations. Part of the issue is the lack of new practices and novel approaches that can be used as benchmarks. This study focuses on food banks, a critical hub for the delivery of food in humanitarian supply chains and where the use of innovation seems to be more reported on. Design/methodology/approach: Focusing on resource scarcity, a commonly referenced constraint by humanitarian organizations, the authors study how food and fund scarcity (versus abundance) influence the innovation efforts of twelve food banks in the United States. This study observes variations in behavior before and during the coronavirus disease 2019 (COVID-19) pandemic. Findings: The authors find that food banks operating in high resource scarcity (food-scarce and fund-scarce) settings focus on process innovations. Food banks operating in low resource scarcity (food-abundant and fund-abundant) settings focus on product innovations. Food banks operating in food-abundant and fund-scarce settings focus on marketing innovations. Food banks operating in food-scarce and fund-abundant settings show the most extensive focus on innovation by relying on imitative innovations. The innovation focus for most food banks switches to process innovation during the COVID pandemic. Originality/value: The study breaks down resource scarcity specific to food banks by differentiating food and funds, a novel approach to studying scarcity. Findings are novel as they suggest that operating context has a highly differentiating effect on what food banks focus on in terms of innovation. Operating context can lead to focus on process, product, imitative of market-related innovations. Finally, the study is novel because it explores how change in the environmental context due to disruptions can drastically modify the innovation focus of food banks. [ABSTRACT FROM AUTHOR]

Unhealthy diets are a major impediment to achieving a healthier population in the United States. Although there is a relatively clear sense of what constitutes a healthy diet, most of the US population does not eat healthy food at rates consistent with the recommended clinical guidelines. An abundance of barriers, including food and nutrition insecurity, how food is marketed and advertised, access to and affordability of healthy foods, and behavioral challenges such as a focus on immediate versus delayed gratification, stand in the way of healthier dietary patterns for many Americans. Food Is Medicine may be defined as the provision of healthy food resources to prevent, manage, or treat specific clinical conditions in coordination with the health care sector. Although the field has promise, relatively few studies have been conducted with designs that provide strong evidence of associations between Food Is Medicine interventions and health outcomes or health costs. Much work needs to be done to create a stronger body of evidence that convincingly demonstrates the effectiveness and cost-effectiveness of different types of Food Is Medicine interventions. An estimated 90% of the $4.3 trillion annual cost of health care in the United States is spent on medical care for chronic disease. For many of these diseases, diet is a major risk factor, so even modest improvements in diet could have a significant impact. This presidential advisory offers an overview of the state of the field of Food Is Medicine and a road map for a new research initiative that strategically approaches the outstanding questions in the field while prioritizing a human-centered design approach to achieve high rates of patient engagement and sustained behavior change. This will ideally happen in the context of broader efforts to use a health equity-centered approach to enhance the ways in which our food system and related policies support improvements in health. [ABSTRACT FROM AUTHOR]

Limited research on food systems and food insecurity (FI) following disasters finds contextual differences in post-disaster food systems that shape dimensions of FI. Measurement limitations make it difficult to address FI and develop effective practices for disaster-affected communities. To develop, validate, and test a Disaster Food Security Framework (DFSF). Mixed-methods approach was used, including in-depth interviews to understand lived experiences during disasters; expert panel input to validate DFSF designed using responses from in-depth interviews; and quantitative testing of robustness of DFSF using the coronavirus disease 2019 pandemic as a disaster example. The in-depth interviews included participants from Vermont (n = 5), North Carolina (n = 3), and Oklahoma (n = 2) who had been living in those states during Hurricane Irene (2011), Hurricane Florence (2018), the Moore tornadoes (2013), and coronavirus disease 2019 pandemic (2020). The expert panel consisted of researchers and practitioners from different US geographical regions and food-related disciplines (n = 18). For the quantitative testing survey, data from 4 US states (New York, New Mexico, Vermont, and Maryland; n = 3,228) from the National Food Access and COVID Research Team was used. The outcomes from the in-depth interviews were dimensions of disaster FI, those from the expert panel was a content validity ratio, and those from the quantitative testing was the number of items and components to be included. Inductive and deductive reasoning were using when reporting on the in-depth interviews and expert panel results, including frequencies. The quantitative testing was conducted using multiple correspondence analysis. The in-depth interviews revealed four dimensions of FI: availability (supply and donation), accessibility (economic, physical, and social), acceptability (preference and health), and agency (infrastructure and self-efficacy). The panel of experts reported high content validity for the DFSF and its dimensions (content validity ratio >0.42), thus giving higher credibility to the DFSF. Multiple correspondence analysis performed on 25 food-related variables identified one component with 13 indicators representing three of the four dimensions: availability, acceptability, and accessibility, but not agency. [ABSTRACT FROM AUTHOR]

In the United States, food banks play an important role in helping to reduce the rate of food insecurity by distributing donated food among the population in need. One of the challenges that food banks face is to equitably distribute food donations among their clients such that, ideally, each recipient receives the same amount of food. They aim to do so while minimizing waste that occurs due to spoilage and capacity limitations. Perishable food items present specific challenges since they are susceptible to spoilage and need to be distributed before their expiry dates. Based on our longstanding partnership with a large food bank located in the southeastern United States, we present a capacitated, multiperiod, multiproduct network flow model to help them equitably and effectively distribute perishable food donations among the food‐insecure population in their service region. The model is applied within the context of a case study and reveals managerial insights that would be useful to practitioners. Our findings show that although equity is one of the food bank's highest priorities, inequities cannot be eliminated completely. Given the inevitability of inequitable food allocations in practice, this paper provides food banks guidance on how to strategically control inequities using two approaches: (i) by increasing the number of periods for which equity should be satisfied or (ii$ii$) by allowing deviations from a perfectly equitable distribution. The results show that modest deviations from perfect equity using either approach can lead to significant improvements in both the quality and quantity of food distributed and can also reduce food waste. While approach (ii$ii$) is preferable, the most desirable outcomes occur when both are applied simultaneously. We also find that county capacities inhibit a food bank's ability to achieve balance between equity and effectiveness when distributing perishables. Our framework provides food banks the flexibility to balance the trade‐off between effectiveness and equity based on their preferences. [ABSTRACT FROM AUTHOR]

The article examines food insecurity among college students, focusing on the prevalence of nontraditional students who struggle to afford adequate food. It discusses the distinction between food insecurity and hunger, the eligibility criteria for the Supplemental Nutrition Assistance Program (SNAP), and findings from a Government Accountability Office (GAO) report revealing that many eligible food-insecure students do not receive necessary benefits.

U.S. Latinx/Hispanic families experience higher food insecurity rates than the general population. Few studies have examined factors that contribute to food insecurity among the Latinx/Hispanic population, and none have done so using a national dataset. Drawing from the ecological theory of human development framework, this study explores the following research questions: What micro-, meso-, and exo/macro-system factors are related to adult and child food insecurity? How do these factors compare for Latinx/Hispanic, Black, and White mothers? This study uses data from the Fragile Families and Child Wellbeing Study (FFCWS), a national survey that follows a birth cohort of mostly unwed parents and their children over a 15-year period. The sample was limited to Hispanic (both foreign-born and native-born), non-Hispanic Black mothers, and non-Hispanic White mothers. This yielded a final sample size of 2,636 for all mothers and 665 for Latinx/Hispanic mothers. While micro-level factors were influential for food insecurity, they alone could not explain the variation. Social support, a meso-level factor, remained a consistently significant predictor for both adult and child food insecurity, regardless of race/ethnicity. There were also several key differences in predictors across racial/ethnic groups. Being Spanish speaking and mother's health status were only significant for Latinx/Hispanic mothers, and neighborhood support was not significant for Latinx/Hispanic mothers. Drawing from ecological theory, our study explores the micro-, meso-, and exo-/macro-level variables that influence food insecurity. Findings suggest that access to social support is crucial for disadvantaged families avoiding food insecurity, despite race/ethnicity. Still, factors predicting food insecurity may be racialized and should be recognized as such. [ABSTRACT FROM AUTHOR]

Background: Snacking is nearly universal and contributes significant energy to U.S. children's diets. Little is known, however, about where and when snacking intake occurs and if such patterns change with age. This research evaluated age-related differences in eating location, food source location, and timing of snacking among U.S. children aged 1–19 years (y). Methods: A cross-sectional analysis of snacking among 14,666 children in the 2007–2018 U.S. National Health and Nutrition Examination Survey was conducted using a single 24-hour dietary recall. Snacking was participant-defined and included all eating occasions outside of meals. Linear regression and analysis of covariance were used to examine the effects of age (toddler 1–2 y, preschooler 3–5 y, school-age 6–11 y, adolescent 12–19 y) on the percentage of daily snack energy consumed by eating location (at home vs. away from home), food source location (grocery store, convenience store, school/childcare, restaurant, from someone else (i.e. "socially"), and other), and time of day (morning, 6am-12pm; early afternoon, 12pm-3pm; late afternoon/afterschool 3pm-6pm; evening 6pm-9pm, late-night 9pm-12am, and overnight 12am-6am). Results: On average, U.S. children consumed most of their daily snacking energy at home (71%), from foods and beverages obtained from grocery stores (75%), and in the late afternoon/afterschool (31%). Toddlers and preschoolers consumed a greater percentage of their daily snack energy during the morning hours compared to school-age children and adolescents (both p < 0.001); school-age children consumed the most in the evening (27%, p < 0.001), and adolescents consumed the most in the late-night period (22%, p < 0.001). Age-related increases were seen in the percentage of daily snacking energy eaten outside the home (p < 0.001), and obtained socially (p < 0.001), from restaurants (p < 0.001), and convenience stores (p < 0.001). Conclusion: Findings reveal age-related differences in eating location, food source location, and timing of snack intake among U.S. children aged 1–19 y. Younger children consume a greater percentage of snacking calories in the morning and at home relative to older children. School-age children and adolescents show greater snacking in the evening and at night and from foods obtained and eaten outside the home. Efforts to promote healthy snacking behaviors among children should consider developmental differences in snacking patterns. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID‐19) pandemic increased food insecurity among US households, however, little is known about how infants, who rely primarily on human milk and/or infant formula, were impacted. We conducted an online survey with US caregivers of infants under 2 years of age (N = 319) to assess how the COVID‐19 pandemic impacted breastfeeding, formula‐feeding and household ability to obtain infant‐feeding supplies and lactation support (68% mothers; 66% White; 8% living in poverty). We found that 31% of families who used infant formula indicated that they experienced various challenges in obtaining infant formula, citing the following top three reasons: the formula was sold out (20%), they had to travel to multiple stores (21%) or formula was too expensive (8%). In response, 33% of families who used formula reported resorting to deleterious formula‐feeding practices such as diluting formula with extra water (11%) or cereal (10%), preparing smaller bottles (8%) or saving leftover mixed bottles for later (11%). Of the families who fed infants human milk, 53% reported feeding changes directly as a result of the pandemic, for example, 46% increased their provisioning of human milk due to perceived benefits for the infant's immune system (37%), ability to work remotely/stay home (31%), concerns about money (9%) or formula shortages (8%). Fifteen percent of families who fed human milk reported that they did not receive the lactation support they needed and 4.8% stopped breastfeeding. To protect infant food and nutrition security, our results underscore the need for policies to support breastfeeding and ensure equitable and reliable access to infant formula. Key messages: One in three families who fed infants formula reported using one or more deleterious formula‐feeding practices during the coronavirus disease 2019 pandemic, likely due to formula shortages and financial strain.Of the families who fed infants human milk, 15% reported difficulties accessing lactation support directly as a result of the pandemic, although 46% of families reported increased provision of human milk.Flexible government programmes and policies are needed to ensure equitable access to lactation support and infant formula during crises. [ABSTRACT FROM AUTHOR]

Routines and rituals are ubiquitous across scholarship in family communication yet are overlapping and idiosyncratic concepts, making a clear distinction between them difficult. This paper builds clarification around the concepts by arguing for attending to what we call the routinized and ritualized aspects of family activities. We demonstrate this approach's utility through a qualitative thematic discourse analysis of 697 Twitter posts discussing the COVID-19 pandemic's impact on family food practices in the United States. We identify three themes that convey the broad impacts of lockdown conditions on family food practices: bolstering, disruption, and reimagining. We then analyze each theme's salience within daily meals and holiday meals – two food provisioning sites frequently considered routines and rituals, respectively. Theoretically, this paper forwards a conceptualization of routines and rituals that delineates the symbolic and instrumental elements embedded within each; empirically, it demonstrates the multifaced effects of the pandemic on family food life. [ABSTRACT FROM AUTHOR]

Local and regional food supply chains are gaining increasing support from public and private sectors for their contributions to economic development and promoting sustainability. However, the impacts of regionalization are not well understood. We employ a spatial-temporal model of production and transportation to evaluate the supply chain outcomes of a decade-long process of food regionalization for fresh broccoli in the eastern United States (US). Our results indicate that eastern broccoli supply chains displaced products sourced from the western US and met over 15% of the annual demand in eastern markets in 2017. We find that total broccoli supply chain costs and food miles increased in the period 2007–2017. Nevertheless, eastern-grown broccoli has contributed to reducing regional food miles in the eastern region (from 365 miles in 2007 to 255 miles in 2017) and experienced only modest increases in supply chains costs (a 3.4% increase, compared to a 16.5% increase for broccoli shipped from western US) during the same period. Our results provide valuable information for policymakers and the fresh produce industry interested in promoting regional food supply chains. [ABSTRACT FROM AUTHOR]

SUMMARY: Background: Food insecurity is linked to an increased risk of childhood obesity and other adverse health issues. Objectives: To examine the disproportionate impact of food insecurity on childhood obesity among children with special healthcare needs (CSHCN). Methods: In this cross‐sectional study, we pooled data from 4 years (2016 to 2019) of the National Survey of Children's Health (NSCH) for a nationally representative sample of 10 to 17 years old noninstitutionalized U.S. children (N = 68 942). Using logistic regression models, we examined the odds of childhood obesity or overweight by including an interaction between family food situation and CSHCN status. Results: Among 10–17 years old U.S. children, 31% (95% confidence interval [CI]: 30.1%–31.9%) had obesity or overweight, 24.1% had special healthcare needs, 27.2% were from families with food insecurity, and 6.4% were from families with food insufficiency. CSHCN were more likely to be impacted by obesity or overweight than non‐CSHCN (Odds Ratio [OR] = 1.29, 95% CI = 1.18–1.141). Moreover, children living in food insecurity (OR = 1.75, 95% CI = 1.52–1.92) and food insufficiency (OR = 2, 95% CI = 1.67–2.4) were more likely than those living in food‐secure families to be impacted by obesity or overweight. CSHCN living in food insecurity were significantly more likely to be impacted by obesity or overweight than non‐CSHCN in similar households. Conclusions: It appears that food insecurity can put CSHCN at disproportionately greater risk of obesity or overweight than non‐CSHCN. The findings underscore considering CSHCN status in conjunction with household food insecurity in designing and implementing medical interventions or public policies targeted at childhood obesity or overweight. [ABSTRACT FROM AUTHOR]

The first epidemiologic study was conducted to prospectively examine the association between Food Environment Index (FEI) and gastric cancer (GC) risk in the US. Surveillance, Epidemiology, and End Results provided information on GC incident cases diagnosed between 2000 and 2015 from 16 population-based cancer registries across the US. The county-level food environment was assessed using the FEI, an indicator of access to healthy foods (0 is worst, 10 is best). Poisson regression was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between FEI and GC risk adjusting for individual-level and county-level covariates. Higher levels of FEI were associated with a statistically significant reduced risk for GC (n = 87,288 cases; adjusted IRR for every score increase = 0.50, 95% CI 0.35, 0.70; P < 0.001; adjusted IRR for the medium vs. low category = 0.87, 95% CI 0.81, 0.94; and adjusted IRR for the high vs. low category = 0.89, 95% CI 0.82, 0.95). These results suggest that a healthy food environment, as measured by FEI, may be a protective factor for GC in the US. To reduce the GC incidence, further strategies to improve food environment at the county level are warranted. [ABSTRACT FROM AUTHOR]

Food insecurity in the United States is a public health crisis and particularly impacts individuals in rural areas.1 Efforts to improve food access, including pilot programs to increase online ordering, have reduced food insecurity and improved diet quality for participants enrolled in supplemental nutrition programs.3,4 We discuss the nutritional and economic benefits of public and private partnerships that enhance the supplemental nutrition programs of the United States Department of Agriculture Food and Nutrition Service (eg, Special Supplemental Nutrition Program for Women, Infants, and Children; Supplemental Nutrition Assistance Program), and propose the expansion of technology and transportation resources through public and private partnerships to better address rural food insecurity. [ABSTRACT FROM AUTHOR]

Background: In recent reviews of available measures, no existing measures assessed all four pillars of food security and most only assessed one or two pillars–predominantly the access pillar. The purpose of this study was to preliminarily develop novel measures of availability, utilization, and stability that are complementary to the USDA's household food security survey measure (HFSSM). Methods: A formative phase included an expert advisory group, literature scans, and interviews with individuals experiencing food insecurity. From April-June 2021, the new measures were piloted in five states (California, Florida, Maryland, North Carolina, and Washington). The cross-sectional pilot survey included the new measures (perceived limited availability, utilization barriers, and food insecurity stability), scales and items for validation (e.g., food security, and self-reported dietary and health outcomes), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal consistency was assessed using Kuder-Richardson formula 21 (KR21), and convergent and discriminant validity were assessed using Spearman's correlation coefficients. Also, a brief screener version was created for the utilization barriers measure that may be necessary for certain applications (e.g., clinical intake screening to inform referrals to assistance programs). Results: The analytic samples (perceived limited availability (n = 334); utilization barriers (n = 428); food insecurity stability (n = 445)) were around 45 years old on average, most households had children, over two-thirds were food insecure, over three-fourths were women, and the samples were racially/ethnically diverse. All items loaded highly and unambiguously to a factor (factor loadings range 0.525–0.903). Food insecurity stability showed a four-factor structure, utilization barriers showed a two-factor structure, and perceived limited availability showed a two-factor structure. KR21 metrics ranged from 0.72 to 0.84. Higher scores for the new measures were generally associated with increased food insecurity (rhos = 0.248–0.497), except for one of the food insecurity stability scores. Also, several of the measures were associated with statistically significantly worse health and dietary outcomes. Conclusions: The findings support the reliability and construct validity of these new measures within a largely low-income and food insecure sample of households in the United States. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may be used in various applications to promote a more comprehensive understanding of the food insecurity experience. Such work can help inform novel intervention approaches to address food insecurity more fully. [ABSTRACT FROM AUTHOR]

Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions. [ABSTRACT FROM AUTHOR]

Introduction: Food insecurity (FI) has been associated with adverse health outcomes and increased healthcare expenditures. Many families experienced reduced access to food during the coronavirus disease 2019 (COVID-19) pandemic. A 2019 study revealed that the prepandemic prevalence of FI at an urban, tertiary care hospital's emergency department (ED) was 35.3%. We sought to evaluate whether the prevalence of FI in the same ED patient population increased during the COVID-19 pandemic. Methods: We performed a single-center, observational, survey-based study. Surveys assessing for FI were administered to clinically stable patients presenting to the ED over 25 consecutive weekdays from November-December 2020. Results: Of 777 eligible patients, 379 (48.8%) were enrolled; 158 (41.7%) screened positive for FI. During the pandemic, there was a 18.1% relative increase (or 6.4% absolute increase) in the prevalence of FI in this population (P=0.040; OR=1.309, 95% CI 1.012-1.693). The majority (52.9%) of food-insecure subjects reported reduced access to food due to the pandemic. The most common perceived barriers to access to food were reduced food availability at grocery stores (31%), social distancing guidelines (26.5%), and reduced income (19.6%). Conclusion: Our findings suggest that nearly half of the clinically stable patients who presented to our urban ED during the pandemic experienced food insecurity. The prevalence of FI in our hospital's ED patient population increased by 6.4% during the pandemic. Emergency physicians should be aware of rising FI in their patient population so that they may better support patients who must choose between purchasing food and purchasing prescribed medications. [ABSTRACT FROM AUTHOR]

Dollar stores have rapidly expanded their food offerings in recent years. These foods tend to be higher in calories and lower in nutrients, raising public health concerns, especially in rural and low-income areas where food-access challenges are often greatest. However, there is limited empirical evidence evaluating the impact of this expansion on household food purchases on a national scale. Using data from a yearly, nationally representative panel of approximately 50 000 households, we estimated the share of food purchases from 2008 to 2020 by store type and evaluated the role of dollar stores as food retailers in the United States. We found that dollar stores were the fastest-growing food retailers by household expenditure share (increasing by 89.7%), with rural growth outpacing growth elsewhere (increasing by 102.9%). Though dollar stores still represent a small share of national household food purchases (2.1% in 2020), they play an increasingly prominent role in food-at-home purchases for certain disadvantaged and rural communities. Understanding the quality of the foods they offer and how this may affect diet-related health outcomes is warranted. (Am J Public Health. 2023;113(3):331–336. https://doi.org/10.2105/10.2105/AJPH.2022.307193) [ABSTRACT FROM AUTHOR]

Purpose: Tobacco use prevalence is higher in rural compared to urban settings, possibly due to differences in tobacco availability, including the option to purchase food and other essential items in stores that do not sell tobacco (tobacco‐free food retailers). The goal of this research is to determine whether tobacco‐free food retailer availability varies by urbanicity/rurality. Methods: Using the 2017 National Establishment Time‐Series database, we identified food retailers across all census tracts containing food retailers in the United States (n = 66,053). We used multivariable logistic and linear regression models to test whether tobacco‐free food retailer availability varied across 4‐levels of census tract urbanicity/rurality (urban, suburban, large town, and small town/rural) for 2 outcomes: (1) the presence of at least 1 tobacco‐free food retailer and (2) the percent of all food retailers that were tobacco‐free. Findings: Compared to urban core census tracts, suburban census tracts had a lower odds (aOR = 0.77, 95% CI = 0.73, 0.81) of having at least 1 tobacco‐free food retailer, while small town/rural census tracts had greater odds (aOR = 1.23, 95% CI = 1.15, 1.32). Suburban census tracts (B = –2.29, P <.001) and large town census tracts (B = –1.90, P <.001) also had a lower percentage of tobacco‐free food retailers compared to urban census tracts. Conclusions: Compared to urban cores, tobacco‐free food retailers were less prevalent in suburban and large town areas, though similarly or slightly more available in rural areas. Future research should assess whether these differences depend on varying store types. [ABSTRACT FROM AUTHOR]

The study objective is to examine the factors associated with the use of different community food resources using the Andersen Model. Adults In a cross-sectional study conducted among 1,830 adults 18 years and older on REDCap (a web-based platform) through Amazon Mechanical Turk. Participants were asked about their socio-demographics, motivation for shopping decisions, shopping transportation modes and estimated travel time, food security status, and perceived community-level food-related needs. This information was organized into predisposing, enabling, and need factors (predictors) that are related to food access using the Andersen Model. The outcome variables were about how they use different community food resources, such as healthy food retail stores, less healthy food retail stores, food assistance programs, food service resources, and mobile food resources. Descriptive and hierarchical regression analyses were conducted using SAS, with significance set at p < 0.05. The participants have a mean age of 37.9 ± 12.1 years; were predominantly White (87.6%), non-Hispanic (85.8%), and urban residents (56.6%). Majority use the supermarkets (66%), supercenters (55%), and friend's/relative's places (53.2%) as their food resources. Predisposing factors that were statistically associated with the use of different community food resources were age, marital status, race, ethnicity, and household size. The enabling factors included travel time, transportation mode, income, and motivator of shopping decisions such as coupons and great sales, use of WIC benefits, and delivery services. The need factors included food security and community-level food-related needs such as culturally relevant and low-price foods. However, these vary by the types of food resources. Recommendations include designing multi-level initiatives that would transform food stores and programs' food offerings, distribution logistics, and transportation access into conduits for healthier food access among underserved populations. None [ABSTRACT FROM AUTHOR]

The article offers information on the current status of food assistance programs in the United States, focusing on the U.S. Department of Agriculture's (USDA's) efforts. Topics discussed include the decrease in federal spending on these programs in 2023; the distribution of funds across major programs like Supplemental Nutrition Assistance Program (SNAP) & Child Nutrition Programs; and the participation trends in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).

Medical financial hardship is an increasingly common consequence of cancer treatment and can lead to food insecurity. However, food security status is not routinely assessed in the health care setting, and the prevalence of food insecurity among cancer survivors is unknown. This scoping review aimed to identify the prevalence of food insecurity among cancer survivors in the United States before the COVID-19 pandemic. Five databases (PubMed, Scopus, CINAHL [Cumulative Index to Nursing and Allied Health Literature], Web of Science, and ProQuest Dissertations and Theses) were systematically searched for articles that reported on food security status among US patients receiving active cancer treatment or longer-term cancer survivors and were published between January 2015 and December 2020. Among the 15 articles meeting the inclusion criteria, overall food insecurity prevalence ranged from 4.0% among women presenting to a gynecologic oncology clinic to 83.6% among patients at Federally Qualified Health Centers. Excluding studies focused specifically on Federally Qualified Health Center patients, prevalence of food insecurity ranged from 4.0% to 26.2%, which overlaps the food insecurity prevalence in the general US population during the same time period (range, 10.5% to 14.9%). Women were more likely than men to report being food insecure, and the prevalence of food insecurity was higher among Hispanic and Black patients compared with non-Hispanic White patients. Given significant heterogeneity in study populations and sample sizes, it was not possible to estimate an overall food insecurity prevalence among cancer survivors in the United States. Routine surveillance of food security status and other social determinants of health is needed to better detect and address these issues. [ABSTRACT FROM AUTHOR]

Aim: US federal, state, and local governments implemented numerous COVID-19 shelter-in-place orders (lockdowns) starting in March 2020 to ensure social distancing regulations and help stop the spread of COVID-19. It is important to know how these lockdowns affected businesses, such as restaurants, in regions that vary in terms of poverty status and geography. In this paper, we analyze the differential changes in rural and urban restaurant visits by the restaurants' NAICS codes following the COVID-19 lockdowns. Our analysis contributes to the public policy literature and helps operational planning for food distribution during a pandemic. Methods: Since urban and rural consumer behavior and food resources are significantly different, it is crucial to conduct a comparative analysis. Our study applies a difference-in-differences model to capture the differential effects lockdowns have on urban and rural restaurants. Results: We find that restaurant visits declined significantly in both rural and urban counties after shelter-at-home orders. The decrease in total restaurant visits was almost twice as high in urban counties as in rural counties. We also find that visits to fast-food restaurants increased in rural counties during shelter-at-home orders. Conclusions: These results contribute to previous studies on the dearth of healthy food in rural and poorer regions, and inform important public policy response in the wake of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence of pediatric chronic pain by household food sufficiency status and examine whether food insufficiency would be associated with greater risk for chronic pain. We analyzed data from the 2019–2020 National Survey of Children's Health of 48,410 children (6–17 years) in the United States. Across the sample, 26.1% (95% CI: 25.2–27.0) experienced mild food insufficiency and 5.1% (95% CI: 4.6–5.7) moderate/severe food insufficiency. The prevalence of chronic pain was higher among children with mild (13.7%) and moderate/severe food insufficiency (20.6%) relative to children in food-sufficient households (6.7%, p < 0.001). After adjusting for a priori covariates (individual: age, sex, race/ethnicity, anxiety, depression, other health conditions, adverse childhood events; household: poverty, parent education, physical and mental health; community: region of residence), multivariable logistic regression revealed that children with mild food insufficiency had 1.6 times greater odds of having chronic pain (95% CI: 1.4–1.9, p < 0.0001) and those with moderate/severe food insufficiency, 1.9 higher odds (95% CI: 1.4–2.7, p < 0.0001) relative to food-sufficient children. The dose–response relationship between food insufficiency and childhood chronic pain highlights the importance of further research to identify underlying mechanisms and evaluate the impact of food insufficiency on the onset and persistence of chronic pain across the lifespan. [ABSTRACT FROM AUTHOR]

Objective: This study examined the prevalence of food insecurity (FI) among students attending Historically Black Colleges and Universities (HBCUs) in the Southeastern United States. Participants: Students attending four HBCUs (N = 351) completed an anonymous Web-based survey. Methods: Food insecurity was assessed using the 2-item Hunger Vital Sign Tool. Summary statistics were used to quantify FI experiences. Logistic regression was conducted to determine if student demographic characteristics were significantly associated with FI outcomes. Results: Nearly 3 in 4 students (72.9%) reported some level of FI in the past year. Students representing all levels of postsecondary education reported FI. Meal plan participation did not prevent FI. Conclusions: Students attending HBCUs experience FI at levels that exceed estimates reported among students attending predominantly White institutions. More work is needed to understand the lived experience of food-insecure HBCU students as a means to ensure institution-level food policies support student academic success and wellbeing. [ABSTRACT FROM AUTHOR]

Background: Research is needed that identifies environmental resource disparities and applies multiple rural definitions. Therefore, this study aims to examine urban‐rural differences in food and physical activity (PA) environment resource availability by applying several commonly used rural definitions. We also examine differences in resource availability within urban‐rural categories that are typically aggregated. Methods: Six food environment variables (access to grocery/superstores, farmers' markets, fast food, full‐service restaurants, convenience stores, and breastfeeding‐friendly facilities) and 4 PA environment variables (access to exercise opportunities and schools, walkability, and violent crimes) were included in the childhood obesogenic environment index (COEI). Total COEI, PA environment, and food environment index scores were generated by calculating the average percentile for related variables. US Department of Agriculture Urban Influence Codes, Office of Management and Budget codes, Rural‐Urban Continuum Codes, Census Bureau Population Estimates for percent rural, and Rural Urban Commuting Area Codes were used. One‐way ANOVA was used to detect urban‐rural differences. Results: The greatest urban‐rural disparities in COEI (F=310.2, P<.0001) and PA environment (F=562.5, P<.0001) were seen using RUCC codes. For food environments, the greatest urban‐rural disparities were seen using Census Bureau percent rural categories (food: F=24.9, P<.0001). Comparing remote rural categories, differences were seen for food environments (F=3.1, P=.0270) and PA environments (F=10.2, P<.0001). Comparing metro‐adjacent rural categories, differences were seen for PA environment (F=4.7, P=.0090). Conclusion: Findings inform future research on urban and rural environments by outlining major differences between urban‐rural classifications in identifying disparities in access to health‐promoting resources. [ABSTRACT FROM AUTHOR]

In this forum I provide a response to the infant formula shortage crisis in the U.S. ongoing since May. I argue that government supported monopoly control of the infant formula market is a geopolitics that has nothing to do with infant feeding and everything to do with profit. I suggest that a diversity of strategies as well as a diversity of feeding options must be undertaken to avoid such human-caused crises in the future. [ABSTRACT FROM AUTHOR]

In response to economic distress and food insecurity during the COVID-19 pandemic, Congress expanded the Supplemental Nutrition Assistance Program (SNAP) by introducing emergency allotments to increase monthly benefits, starting in March 2020. In March 2023, emergency allotments expired in the thirty-five states and territories still offering them. We provide some of the first evidence of the impacts of this loss of nutrition support-in some cases, more than $250 a month-for economically disadvantaged households. Our quasi-experimental study examined the effects of the program's expiration on food insufficiency, mental health, and financial well-being, using data from the Census Bureau's Household Pulse Survey. In difference-in-differences analyses, we compared pre-post differences among SNAP participants with pre-post differences among income-eligible nonparticipants. The emergency allotment expiration led to a substantial increase in food insufficiency (8.4 percentage points) and greater food pantry use (2.1 percentage points) and difficulty paying expenses (2.0 percentage points). Non-Hispanic Black SNAP participants experienced a greater increase in anxiety symptoms compared with non-Hispanic White SNAP participants. This study has implications for ongoing policy making with respect to nutrition and safety-net programs to support vulnerable families, especially amid inflated food prices.

Reducing the environmental pressures stemming from food production is central to meeting global sustainability targets. Shifting diets represents one lever for improving food system sustainability, and identifying sustainable diet opportunities requires computational models to represent complex systems and allow users to evaluate counterfactual scenarios. Despite an increase in the number of food system sustainability models, there remains a lack of transparency of data inputs and mathematical formulas to facilitate replication by researchers and application by diverse stakeholders. Further, many models lack the ability to model multiple geographic scales. The present study introduces Foodprint 2.0, which fills both gaps. Foodprint 2.0 is an updated biophysical simulation model that estimates the agricultural resource requirements of diet patterns and can be adapted to suit a variety of research purposes. The objectives of this study are to: 1) describe the new features of Foodprint 2.0, and 2) demonstrate model performance by estimating the agricultural resource requirements of food demand in the United States (US) using nationally representative dietary data from the National Health and Nutrition Examination Survey from 2009-2018. New features of the model include embedded functions to integrate individual-level dietary data that allow for variance estimation; new data and calculations to account for the resource requirements of food trade and farmed aquatic food; updated user interface; expanded output data for over 200 foods that include the use of fertilizer nutrients, pesticides, and irrigation water; supplementary files that include input data for all parameters on an annual basis from 1999-2018; sample programming code; and step-by-step instructions for users. This study demonstrates that animal-sourced foods consumed in the US accounted for the greatest share of total land use, fertilizer nutrient use, pesticide use, and irrigation water use, followed by grains, fruits, and vegetables. Greater adherence to the Dietary Guidelines for Americans was associated with lower use of land and fertilizer nutrients, and greater use of pesticides and irrigation water. Foodprint 2.0 is a highly modifiable model that can be a useful resource for informing sustainable diet policy discussions., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: ZC has research awards from the US Department of Agriculture and The Thomas F. and Kate Miller Jeffress Memorial Trust, and received honoraria from the National Dairy Council for professional activities unrelated to the present research. ER has research awards from the US Department of Agriculture and the Foundation for Food & Agriculture Research for projects unrelated to the present study. DCL was supported by the Johns Hopkins Center for a Livable Future with a gift from the Greater Kansas City Community Foundation. NB receives funding from the Robert Wood Johnson Foundation as a Health Policy Research Scholar., (Copyright: © 2024 Conrad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Food security among rural veteran populations is an understudied subject. This study uses qualitative data from 106 semi-structured interviews conducted with staff from programs at the United States Department of Veterans Affairs (VA) and other federal agencies, staff from non-governmental organizations (NGOs), food security researchers, and food insecure veterans to identify the barriers to and facilitators for rural veteran food security. Barriers identified included external, structural barriers that exist in rural areas; internal barriers to using food assistance, such as feeling stigmatized; and barriers related to other social determinants of health, including a lack of education, employment, or housing stability.

Food insecurity is a pervasive problem that impacts health and well-being across the lifespan. The human research linking food insecurity to poor metabolic and behavioral health outcomes is inherently correlational and suffers from a high degree of variability both between households and even within the same household over time. Further, food insecurity is impacted by societal and political factors that are largely out of the control of individuals, which narrows the range of intervention strategies. Animal models of food insecurity are being developed to address some of the barriers to mechanistic research. However, animal models are limited in their ability to consider some of the more complex societal elements of the human condition. We believe that understanding the role that food insecurity plays in ingestive behavior and chronic disease requires a truly translational approach, and that understanding the health impacts of this complex social phenomenon requires understanding both its psychological and physiological dimensions. This brief review will outline some key features of food insecurity, highlighting those that are amenable to investigation with controlled animal models and identifying areas where integrating animal and human studies can improve our understanding of the psychological burden and health impacts of food insecurity. In the interest of brevity, this review will largely focus on food insecurity in the United States, as the factors that contribute to food insecurity vary considerably across the globe., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose of Review: Because nutrition plays a crucial role in the development of chronic diseases, ensuring nutrition security is important for promoting population health. Nutrition security is defined as having consistent and equitable access to healthy, safe, affordable foods essential to optimal health and well-being. Distinguished from food security, nutrition security consists of two constructs: healthy diets and nutritional status. The study aimed to identify population measures that reflect the important constructs of nutrition security (i.e., healthy diets and nutritional status) to inform U.S. nutrition security assessment and monitoring., Recent Findings: Through a narrative review conducted across multiple databases, associations between subconstructs of healthy diets and nutritional status were identified. Of the six subconstructs that constitute healthy diets, nutrient adequacy and moderation were most often used to assess and monitor healthfulness of U.S. population diets and were associated with health outcomes. There is little evidence of an association between health outcomes and macronutrient balance or diversity in the U.S. Thirteen instruments were identified as potentially suitable for measuring at least one subconstruct of healthy diet in the population. This review highlights the importance of nutrition security in addressing population health challenges. It emphasizes the potential use of multiple instruments and measures to comprehensively monitor population nutrition security and inform intervention strategies. Identifying feasible and practical measures for assessing and monitoring nutrition security is imperative for advancing population health and mitigating the burden of chronic diseases., (© 2024. The Author(s).)

The article discusses research by the U.S. Government Accountability Office (GAO), reported in the "Nutrition Today" issue dated May/June 2024, on food safety issues beyond animal products, emphasizing the risks associated with dairy, plant foods, and seafood, and highlighting the importance of enhanced traceability under the Food Safety Modernization Act (FSMA) to mitigate these risks and improve public health.

Objective: The 2018-2019 federal government partial shutdown resulted in a one-time disruption to the usual disbursement schedule of Supplemental Nutrition Assistance Program (SNAP) benefits nationwide. We assessed the relationship between this disruption and hyperglycemia and hypoglycemia medical encounters among beneficiaries with diabetes.Research Design and Methods: To estimate whether the one-time change in benefit disbursement affected the monthly cycle of hyperglycemia or hypoglycemia encounter rates, we used linked administrative Medicaid claims and SNAP disbursement data from West Virginia in a fixed-effects model with interactions between week of the month and the two months of interest-January and February 2019. We controlled for week, month, year, and county effects as well as individual characteristics, and we clustered SEs by individual.Results: We found that the early disbursement of SNAP benefits in January 2019 resulted in a spike in hyperglycemia four times the rate in a typical month. Further, we found a decrease in both hyperglycemia and hypoglycemia in late February.Conclusions: Our findings suggest that the early distribution of benefits led to a temporary increase in food consumption among West Virginia Medicaid beneficiaries with diabetes. Findings from late February also imply that individuals may have a way to prepare for reduced food resources. These results shed new light on the effects of unexpected changes to the timing of safety net payments as well as an understanding of unintended consequences of government shutdowns. [ABSTRACT FROM AUTHOR]

Introduction: The Supplemental Nutrition Assistance Program; Free/Reduced Priced Lunch Program; and Special Supplemental Nutrition Program for Women, Infants, and Children reduce food insecurity for millions of Americans with lower incomes. However, critics have questioned whether they increase obesity. This study examined whether program participation was associated with BMI z-score from kindergarten to fifth grade.Methods: Data from 4,457 primary-grade students whose household incomes were equal to or below 200% of the federal poverty level from kindergarten to fifth grade as part of the Early Childhood Longitudinal Study, Kindergarten Class of 2010‒2011 were analyzed. Marginal structural models with inverse probability of treatment/censoring weights were used to estimate associations between Supplemental Nutrition Assistance Program/Free and Reduced Priced Lunch participation over time and fifth-grade BMI z-score, accounting for lost-to-follow-up and time-varying confounders. Weighted generalized estimating equations were used to examine associations between Special Supplemental Nutrition Program for Women, Infants, and Children participation and BMI z-score trends. All analyses incorporated sampling weights. The Early Childhood Longitudinal Study, Kindergarten Class of 2010‒2011 data were collected from 2010-2016; analyses were conducted in 2021 and 2022.Results: At baseline, 2,419 (54.3%) respondents participated in the Supplemental Nutrition Assistance Program, 3,993 (89.6%) participated in Free/Reduced Priced Lunch, and 3,755 (84.2%) reported past participation in the Special Supplemental Nutrition Program for Women, Infants, and Children. No associations were found between any program and fifth-grade BMI z-score or between Special Supplemental Nutrition Program for Women, Infants, and Children participation and BMI z-score trend.Conclusions: Previous findings of relationships between program participation and BMI may have been because of weaker study designs and uncontrolled confounding. Participation in the Supplemental Nutrition Assistance Program; Free/Reduced Priced Lunch; and Special Supplemental Nutrition Program for Women, Infants, and Children was not associated with increased risk of childhood obesity in this recently conducted longitudinal study. [ABSTRACT FROM AUTHOR]