Support for Policies and Strategies to Promote Healthy Food Retail In-Store and Online: Perspectives From a National Sample of Supplemental Nutrition Assistance Program Participants.

OBJECTIVE: Gather perspectives on healthy retail policies and strategies from a national sample of Supplemental Nutrition Assistance Program (SNAP) participants. DESIGN: Anonymous web-based survey fielded in English and Spanish. The survey measured support for healthy retail policies and strategies. SETTING: National Qualtrics panel fielded on September 30 and October 19, 2022. PARTICIPANTS: A total of 1,559 adult SNAP participants (in the last 12 months) participated in the Qualtrics SNAP survey panel. VARIABLES MEASURED: Overall support for retail policies and strategies was calculated using response frequencies and proportions. ANALYSIS: Cross-tabulations and chi-square tests of independence assessed differences in policy support by online shopping behavior and nutrition security status. Significance was determined at P < 0.05. RESULTS: Most SNAP participants were broadly supportive of policies and strategies to improve the healthy food retail environment. More restrictive policies were less popular than policies that expanded consumer choice. Support also varied by online shopping status and nutrition security status. CONCLUSIONS AND IMPLICATIONS: Policies and strategies that improve the healthy food retail environment are popular among a national sample of SNAP participants. Policy discussions must understand SNAP participants' perspectives regarding changes to the retail environment that may impact their ability to access healthy foods.

The Quality of Menu Offerings in Independently Owned Restaurants in Baltimore, Maryland: Results from Mixed-Methods Formative Research for the FRESH Trial.

(1) Background: Independently owned restaurants (IORs) are prevalent in under-resourced racial and ethnic minority communities in the US and present a unique setting for public health nutrition interventions. (2) Methods: We conducted 14 in-depth interviews with IOR owners in Baltimore about their perceptions of healthy food, and customers' acceptance of healthier menus and cooking methods and concurrent observations of the availability of healthy options on their menus. Qualitative data were coded and analyzed using ATLAS.ti. Observations were analyzed with statistical analysis performed in R. (3) Results: Owners perceived non-fried options, lean proteins, and plant-based meals as healthy. While open to using healthier cooking fats, they had mixed feelings about reducing salt, adopting non-frying methods for cooking, and adding vegetables and whole grains to the menu, and were reluctant to reduce sugar in recipes and beverages. Only 17.5% of 1019 foods and 27.6% of 174 beverages in these IORs were healthy, with no significant differences in the healthfulness of restaurant offerings within low-healthy-food-access/low-income neighborhoods and those outside. (4) Conclusion: Healthy options are generally scarce in Baltimore's IORs. Insights from owners inform future interventions to tailor healthy menu offerings that are well-received by customers and feasible for implementation.

Greater Frequency of Cooking Dinner at Home and More Time Spent Cooking Are Inversely Associated With Ultra-Processed Food Consumption Among US Adults.

BACKGROUND: Cooking at home has been promoted as a strategy to improve diet quality; however, the association between cooking behavior and ultra-processed food intake is unknown. OBJECTIVE: The objective of this study was to examine associations between frequency of cooking dinner at home and time spent cooking dinner with ultra-processed food intake. DESIGN: Cross-sectional, nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey were analyzed. PARTICIPANTS/SETTING: Participants were 9,491 adults (20 years and older) in the United States. MAIN OUTCOME MEASURES: The main outcome measure was the proportion of energy intake (averaged from two 24-hour dietary recalls) from the following 4 Nova food-processing groups: (1) unprocessed or minimally processed foods, (2) processed culinary ingredients, (3) processed foods, and (4) ultra-processed foods. STATISTICAL ANALYSES PERFORMED: Separate linear regression models examined associations between cooking frequency and time spent cooking dinner and proportion of energy intake from the 4 Nova food-processing groups, adjusting for sociodemographic characteristics and total energy intake. RESULTS: Ultra-processed foods comprised >50% of energy consumed independent of cooking frequency or time spent cooking. Higher household frequency of cooking dinner and greater time spent cooking dinner were both associated with lower intake of ultra-processed foods (P trends < .001) and higher intake of unprocessed or minimally processed foods (P trends < .001) in a dose-response manner. Compared with cooking 0 to 2 times/wk, adults who cooked dinner 7 times/wk consumed a mean of 6.30% (95% CI -7.96% to -4.64%; P < .001) less energy from ultra-processed foods. Adults who spent more than 90 minutes cooking dinner consumed 4.28% less energy from ultra-processed foods (95% CI -6.08% to -2.49%; P < .001) compared with those who spent 0 to 45 minutes cooking dinner. CONCLUSIONS: Cooking at home is associated with lower consumption of ultra-processed foods and higher consumption of unprocessed or minimally processed foods. However, ultra-processed food intake is high among US adults regardless of cooking frequency.

Associations Between Household Frequency of Cooking Dinner and Ultraprocessed Food Consumption and Dietary Quality Among US Children and Adolescents.

Introduction: Dietary quality is poor and intake of ultraprocessed foods (UPFs) is high among children and adolescents in the United States. Low dietary quality and high UPF intake are associated with obesity and higher risk of diet-related chronic diseases. It is unknown whether household cooking behavior is related to improved dietary quality and lower consumption of UPFs among US children and adolescents. Methods: Nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey (n = 6032 children and adolescents ≤19 years of age) were used to examine the relationships between household cooking frequency of evening meals and children's dietary quality and UPF intake using multivariate linear regression models adjusted for sociodemographics. Two 24-hour diet recalls were used to assess UPF intake and dietary quality [Healthy Eating Index-2015 (HEI-2015)]. Food items were categorized according to Nova classification to obtain the UPF percent of total energy intake. Results: A higher household frequency of cooking dinner was associated with lower UPF intake and higher overall dietary quality. Compared to children in households cooking dinner 0-2 times per week, children in households cooking dinner 7 times/week had lower intake of UPFs [ß = -6.30, 95% confidence interval (CI) -8.81 to -3.78, p < 0.001] and marginally higher HEI-2015 scores (ß = 1.92, 95% CI -0.04 to 3.87, p = 0.054). The trends toward lower UPF intake (p-trend <0.001) and higher HEI-2015 scores (p-trend = 0.001) with increasing cooking frequency were significant. Conclusions: In this nationally representative sample of children and adolescents, more frequent cooking at home was associated with lower intake of UPFs and higher HEI-2015 scores.

Consumer behaviour and experiences in a naturalistic online grocery store: implications for nutrition research.

Naturalistic online grocery stores could provide a novel setting for evaluating nutrition interventions. In 2021-2022, we recruited US adults (n 144, 59% low-income) to complete two weekly study visits: one in a naturalistic ('mock') online grocery store developed for research and one in a real online grocery store. Participants selected groceries and responded to survey questions. Analyses examined survey responses and expenditures on fifteen food categories (e.g., bread, sugar-sweetened beverages). Nearly all enrolled participants completed both visits (98% retention). Moreover, nearly participants all reported that their selections in the naturalistic store were similar to their usual purchases (95%) and that the naturalistic store felt like a real store (92%). Participants' spending on food categories in the naturalistic store were moderately-to-strongly correlated with their spending in the real store (range of correlation coefficients: 0⋅36-0⋅67, all P-values < 0⋅001). Naturalistic online grocery stores may offer a promising platform for conducting nutrition research.