Community-based nutrition education and hands-on cooking intervention increases farmers' market use and vegetable servings.

OBJECTIVE: The objective of the current study was to evaluate the impact of the Market to MyPlate (M2MP) program on participants' reported farmers' market (FM) attitudes and shopping behaviours, frequency of serving vegetables to their families, food resource management behaviours and food security. A secondary objective was to identify facilitators and barriers to shopping at FM and food waste reduction techniques used by low-income families. DESIGN: The current study used a mixed methods evaluation embedded within a cluster randomised trial of the M2MP intervention. SETTING: The 7-week M2MP program was delivered at Extension offices and community centres in central Illinois. PARTICIPANTS: Participants included 120 adults and their families. Class cohorts were randomly assigned to one of three treatment groups: (1) nutrition education and cooking classes with produce allocations (PAE, n 39); (2) nutrition education and cooking classes only (EO, n 36) or (3) control group (n 45). RESULTS: Compared with control participants, PAE participants were significantly more likely to report shopping at FM (P = 0·029) and reported serving more vegetables to their families (P = 0·010) (EO participants did not differ from the control group on any outcomes). There were no differences between conditions in survey-based measures of food security or food resource management behaviours. Interview results describe facilitators and barriers to shopping at FM and a variety of food waste reduction techniques (including food placement and food resource management). CONCLUSIONS: These findings suggest that fresh produce provision coupled with nutrition and culinary education can positively impact shopping and dietary behaviours.

Community-based culinary and nutrition education intervention promotes fruit and vegetable consumption.

OBJECTIVE: The main objective of this study was to evaluate the impact of the Market to MyPlate (M2MP) program on fruit and vegetable consumption and cooking behaviours. Secondary objectives were to examine factors that affected participant retention and program completion, and analyse program feedback provided by participants. DESIGN: This study conducted a mixed methods evaluation embedded within a cluster randomised controlled trial of the M2MP intervention. Adult participants completed a pre- and post-program survey reporting on their fruit and vegetable consumption and cooking behaviours. A subsample participated in structured interviews, providing feedback about M2MP and the impact of the program. SETTING: Seven weekly classes took place in community centres and extension offices in central Illinois. PARTICIPANTS: 120 adults and their families participated. Class cohorts were randomly assigned to one of three treatment groups: (1) nutrition education and cooking classes with produce allocations (PAE, n 39); (2) nutrition education and cooking classes only (EO, n 36) or (3) control group (n 45). RESULTS: Compared to control, PAE participants reported larger increases from pre- to post-intervention in fruit (P = 0·001) and vegetable consumption (P = 0·002), with no differences in cooking frequency. Interview analyses identified key themes in behaviour changes due to M2MP, including reported increases in dietary variety, cooking self-efficacy and children's participation in cooking. CONCLUSIONS: PAE participants who received an intervention that directly increased their access to fresh produce (via produce allocations) increased their reported fruit and vegetable consumption. Though participants' cooking frequency did not change, interviewees reported increased variety, cooking confidence and family participation in cooking.

A systematic review of school meal nudge interventions to improve youth food behaviors.

BACKGROUND: School meal programs have a large reach and thus are ideal environments in which to implement interventions targeting improved youth eating behaviors and reduced food waste. This systematic review summarizes the evidence on the effectiveness of school meal nudge interventions on influencing children's eating and waste behaviors. METHODS: Inclusion criteria required studies have participants in primary or secondary school (grades K-12) with interventions that occurred during school lunch or breakfast in the cafeteria and included at least one of the following outcomes: selection, consumption, waste, or school meal participation. Analyses of intervention outcomes were restricted to studies of strong and moderate quality. RESULTS: Twenty-nine studies were included in the quality assessment. Included interventions fell into three categories: 1) placement/convenience, 2) marketing/promotion, or 3) variety/portions. The 20 strong and moderate quality studies included in outcome analyses generally used strong data collection methods and study designs, but were limited by an overall lack of intervention fidelity checks. Multi-component interventions often did not use methods that allowed for separate analyses of outcomes for different intervention components. CONCLUSIONS: School meal nudge interventions were positively associated with food selection, and had an inconsistent relationship with food consumption. There were few studies evaluating the impact of nudge interventions on meal participation or food waste. The limited evidence available links nudges to improved meal participation, as well as undesirable increases in food waste. Future research in this area should use methods that incorporate implementation metrics, attend to systems factors, and allow the outcomes of individual intervention components to be isolated.

Learning What Works: A Mixed-Methods Study of American Self-identified Food Conservers.

OBJECTIVE: Identify psychosocial factors influencing food waste mitigation and explore motivations and strategies for successful conservation among self-identified food conservers. METHODS: Mixed-methods study consisting of an online survey estimating food waste production and psychosocial factors and a focus group to explore waste mitigation strategies and motivations. RESULTS: Sampled 27 self-identified conservers (female, aged 18-30 years, White/Asian). Mean household food waste was 6.6 cups/wk (range, 0.0-97.9 cups/wk; median 1.3 cups). Reported waste mitigation strategies include proactive mitigation and adaptive recovery measures in each phase of the food management continuum. Conservers reported various intrinsic and extrinsic motivations to reduce food waste and viewed barriers as manageable. CONCLUSIONS AND IMPLICATIONS: Food conservers act on high intentions to reduce waste by consistently employing both proactive waste mitigation and adaptive food recovery measures. Future research is needed to determine if these findings hold in larger, more diverse samples and link specific behaviors to waste volume.

School Nutrition Stakeholders Find Utility in MealSim: An Agent-Based Model.

OBJECTIVE: To obtain feedback from school nutrition stakeholders on an agent-based model simulating school lunch to inform model refinement and future applications. DESIGN: Qualitative study using online discussion groups. SETTING: School nutrition professional stakeholders across the US. PARTICIPANTS: Twenty-eight school nutrition stakeholders. PHENOMENON OF INTEREST: Perceptions and applicability of MealSim for school nutrition stakeholders to help reduce food waste. ANALYSIS: Deductive approach followed by inductive analysis of discussion group transcripts. RESULTS: Stakeholders appreciated the customizability of the cafeteria characteristics and suggested adding additional characteristics to best represent the school meal system, such as factors relating to school staff supervision of students during meals. The perceived utility of MealSim was high and included using it to train personnel and to advocate for policy and budgetary changes. However, they viewed MealSim as more representative of elementary than high schools. Stakeholders also provided suggestions for training school nutrition administrators on how to use MealSim and requested opportunities for technical assistance. CONCLUSIONS AND IMPLICATIONS: Although agent-based models were new to the school nutrition stakeholders, MealSim was viewed as a useful tool. Application of these findings will allow the model to meet the intended audience's needs and better estimate the system.

Policy, Systems, and Environmental Changes in Child Nutrition Programs: A Systematic Literature Review.

The National School Lunch Program (NSLP) provides healthy food to millions of children annually. To promote increased lunch consumption, policy, systems, and environmental (PSE) change strategies are being implemented in child nutrition programs. An evaluation of the current evidence supporting PSE interventions in school nutrition programs is needed to facilitate evidence-based practices across the nation for programs. This systematic review aims to determine the quality and breadth of available evidence of the effectiveness of PSE strategies on the consumption and waste of fruits, vegetables, milk, and water in the NSLP. The inclusion criteria required studies to occur in a United States K-12 school setting, data collection after 2012, report consumption and waste findings for fruit, vegetable, milk, or water, and be an original research article. Articles included in the review are restricted to positive or neutral quality. Thirty studies are included, policy level (n = 4), systems level (n = 8), environmental level (n = 10), and multi-category (n = 8). Results from positively rated policy-level studies suggest that recess before lunch may increase milk consumption, whereas removing flavored milk may decrease consumption. System-level studies of offering vegetables first in isolation of other meal components and offering spiced vegetables compared with traditional preparations may increase vegetable consumption, and locally procuring produce may increase fruit and vegetable consumption. Environmental-level studies such as water promotion strategies such as placing cups near drinking fountains may increase water consumption. Improving the convenience, attractiveness, and palatability of fruits and vegetables may increase consumption. Future PSE research in child nutrition programs should incorporate implementation aides and metrics into their study designs to allow a better understanding of how to sustain interventions from the perspective of school nutrition professionals.

Assessing the Use of Social Cognitive Theory Components in Cooking and Food Skills Interventions.

Increased cooking skill development may reduce the risk of disease and promote healthy eating behaviors in the home. The social cognitive theory (SCT) is one of the most common theories used in cooking and food skill interventions. This narrative review aims to understand how commonly each SCT component is implemented in cooking interventions, as well as identifying which components are associated with positive outcomes. The literature review was conducted using three databases: PubMed, Web of Science (FSTA and CAB), and CINHAL, yielding thirteen included research articles. None of the studies in this review comprehensively included all SCT components; at most, five of the seven were defined. The most prevalent SCT components were behavioral capability, self-efficacy, and observational learning, and the least implemented component was expectations. All studies included in this review yielded positive outcomes for cooking self-efficacy and frequency, except for two studies with null outcomes. Findings from this review suggest that the SCT may not be fully realized, and future studies should continue to define how theory influences intervention design for adult cooking interventions.

The Role of Campus Food Pantries in the Food Security Safety Net: On-Going or Emergency Use at a Midwest Campus Pantry.

Food pantries are an integral part of the food security safety net and were designed to distribute emergency food to alleviate short-term hunger. Given many rely on assistance long-term, food pantries may no longer meet the nutritional needs of the typical food pantry user. Less is known about the extent college students use campus food pantries and whether they seek ongoing food support. A comprehensive analysis of food pantry use, including reach, awareness, and student satisfaction was conducted using a cross-sectional campus survey, a student satisfaction survey, and observational data from pantry logs collected from August 2020 to May 2022. During the first year of operation, 20.6% of students were aware of the pantry, 3.1% of students were reached, and student satisfaction was high. About half of users visited once, while 15.4% visited 8 or more times during an academic year. On average, students that visited more had a larger span of use (6.5 months), visited more frequently (2 weeks between visits), and were more likely to be graduate students and older. While most students used the pantry in the short-term, chronic use of the pantry increased from year 1 to year 2. This suggests need may be growing and additional policies or programs are warranted to support students with chronic food needs.

The Relationship between Fluid Milk, Water, and 100% Juice and Health Outcomes among Children and Adolescents.

Beverages can provide improved nutrient intake and hydration, but also pose concerns related to overnutrition or contamination for children and adolescents who are in a time of critical growth. This narrative review aims to understand the impact of milk, 100% juice, and water consumption on health-related outcomes in youth. The literature review conducted used PubMed, Web of Science, and CABI global. Forty-five research articles met the quality criteria and were included. Health organization and governmental resources were also reviewed to identify current intake and consumption recommendations. All beverages in this review were associated with a variety of desirable and undesirable findings that spanned over 40 different health outcomes. Most studies that assessed milk lacked clear distinction between milk type (flavored vs. unflavored) or fat percentage, making it difficult to understand the impact of milk consumption. The relationship between milk intake and anthropometric-related outcomes were mixed within and across studies. Water was consistently associated with better hydration, while 100% juice and flavored milk intake was associated with more desirable dietary patterns or nutrients that children are currently not consuming adequate amounts of. The implications of these findings were discussed in the context of the National School Lunch Program (NSLP), while considering the impact of issues such as contaminated water and lactose intolerance. This review suggests that water may be an optimal default beverage option in the NSLP to promote hydration and accommodate beverage preferences for those with lactose intolerance.

Chili pepper preference development and its impact on dietary intake: A narrative review.

A preference for chili pepper can be an acquired taste. The contrast between a chili lover and a hater illustrates the complexities involved in forming an appreciation for food that evokes a fiery pain sensation. This narrative review aims to understand the factors behind chili pepper preference formation across the life course and how individual chili pepper preferences can impact eating behaviors and dietary intake. This review was conducted using three databases, yielding 38 included articles. Results suggest five determinants of chili pepper preferences: culture, exposure, gender, genetics, and personality. Collective findings indicate that the strongest influences on preference acquisition include the individual environment from childhood to adulthood and repeated exposure to spicy flavors. With frequent exposure to spicy food, the perceived burn becomes less intense. Culture also influences exposure to chili peppers, with the highest consumption patterns seen within Mexico and some Asia countries. Additionally, males reported having a stronger preference for spicy foods than females. Twin studies illustrated that genetics influenced spicy taste preferences, underscoring the complexity of developing individual taste preferences. As for the impact of capsaicin-containing food on individual eating behaviors and dietary behaviors, appetite effects depend on the dose of capsaicin consumed, but three studies found a change in sensory desires for sweet and fatty foods after finishing a capsaicin-containing dish. Inconsistent results were reported for chili pepper's effects on hunger and satiety after consumption, but changes in specific food desires were observed. The impact of chili pepper on appetite and calories consumed was inconsistent, but the greater amount of capsaicin ingested, the greater the effect. Capsaicin's potential to be used for weight control needs to be further reviewed. In conclusion, evidence suggests that chili pepper preferences may be linked to innate and environmental aspects such as an individual's culture, gender, and genetics. Extrinsic factors like repeated exposure may increase the liking for spicy foods.

Nutrition Environment at Food Pantries Improves After Fresh Produce Donation Program.

OBJECTIVE: To evaluate the influence of the Growing Together Illinois fresh produce donation program and understand factors that affect produce distribution at participating food pantries. METHODS: In this intervention at 17 Illinois food pantries, Master Gardeners supported food donation gardens, and Supplemental Nutrition Assistance Program Education provided educational and environmental interventions to increase selection and use of fresh produce. This mixed-methods pre-post study assessed pantry characteristics and program impact via Nutrition Environment Food Pantry Assessment Tool evaluations, interview feedback from pantry staff, and structured pantry observations. RESULTS: Pantries experienced significant increases from preintervention to postintervention in providing various types of produce, marketing and nudging healthful products, providing additional resources, and total Nutrition Environment Food Pantry Assessment Tool scores. Participants had positive feedback about the program and educational interventions and reported the weekly timing of donations mitigated potential storage and spoilage issues. CONCLUSIONS AND IMPLICATIONS: Future research could focus on approaches to increase fresh produce in food pantries while supporting clients via nutrition and cooking education.

The Relationship between School Infrastructure and School Nutrition Program Participation and Policies in New York City.

School nutrition programs (SNP) provide much needed access to fruits, vegetables, and other healthy foods at low or no cost. Yet, the infrastructure of school kitchens and cafeteria vary across schools, potentially contributing to systematic barriers for SNP operation and equity. The purpose of this paper is to examine the association between school infrastructure and outcomes including meal participation, untraditional lunch periods, and having an open campus. Regression analyses were conducted using administrative data for 1804 schools and school nutrition manager survey data (n = 821) in New York City (NYC). Co-location was significantly associated with open campus status (OR = 2.84, CI: 1.11, 7.26) and high school breakfast participation (ß = -0.056, p = 0.003). Overcrowding was associated with breakfast (elementary: ß = -0.046, p = 0.03; middle: ß = 0.051, p = 0.04; high: ß = 0.042, p = 0.04) and lunch participation (elementary: ß = -0.031, p = 0.01) and untraditional lunchtimes (elementary: OR = 2.47, CI: 1.05, 5.83). Higher enrollment to cafeteria capacity ratios was associated with breakfast (elementary: ß = -0.025, p = 0.02) and lunch (elementary: ß = -0.015, p = 0.001; high: ß = 0.014, p = 0.02) participation and untraditional lunchtimes (middle: OR = 1.66, CI: 1.03, 2.68). Infrastructure characteristics are an important source of variation across NYC schools that may hinder the equity of school nutrition programs across the city.

Examining Nutrition and Food Waste Trade-offs Using an Obesity Prevention Context.

Obesity and food waste are related issues, both exacerbated by an overabundance of food. Efforts to reduce food waste can have varying unintended, obesity-related consequences, which further underscores the need for a systems approach to food waste reduction. Yet, these 2 issues are rarely examined together. It is the authors' point of view that for nutrition educators and other public health practitioners to develop interventions that simultaneously address food waste and obesity, they need to understand how actions at the consumer-level may impact waste and its related food system consequences earlier in the supply chain.

Consumer Comprehension of the Nutrition Facts Label: A Comparison of the Original and Updated Labels.

PURPOSE: Compare consumers' overall label comprehension of the original Nutrition Facts (NF) label with the updated label. DESIGN: Online survey conducted in 2019. Participants randomly assigned to original label, updated-single column, or updated-dual column labeling condition and asked to complete a series of label comprehension questions. SETTING: Online survey; participants recruited through Prolific. SAMPLE: N = 992 U.S. adults. Sample similar to U.S. population in terms of sex (49.2% female), race (73.3% White/Caucasian), and household size (mean = 2.7 members). However, sample was younger (median age: 29.0), more educated (98.8% high school graduate or higher), and exhibited a lower rate of obesity (22.6% obese) than the U.S. population. MEASURES: Dependent variables: objective (% correct) NF label comprehension. Independent variables: label condition, nutrition knowledge, and socio-demographic variables. ANALYSIS: Regression analysis assessed relationships between label condition and label comprehension. Significance level of 5% used for analyses. RESULTS: Average score for objective comprehension was 81.4%. The updates did not significantly improve label comprehension. Participants in the updated NF label conditions had trouble answering questions related to total and added sugars. CONCLUSIONS: Results suggest consumers may struggle to correctly utilize information on the updated NF label, specifically total and added sugars. Consumers may benefit from educational opportunities on using the new label.

Effects of Longer Seated Lunch Time on Food Consumption and Waste in Elementary and Middle School-age Children: A Randomized Clinical Trial.

Importance: Health experts recommend at least 20 minutes of seated lunch time for children, but no federal policy for lunch period duration exists in the United States. Additional strategies in the National School Lunch Program for mitigating food waste are needed to maintain the viability of the Healthy, Hunger-Free Kids Act. Objective: To assess the effect of a longer seated lunch time on food consumption and waste among elementary and middle school-age children. Design, Setting, and Participants: This randomized within-participant crossover trial was conducted from June 3 to June 28, 2019, for a total of 20 study days. All attendees of a summer camp held at the University of Illinois at Urbana-Champaign, were invited to participate in the study. Participants were elementary and middle school-age children and were provided every study day with lunch prepared according to the National School Lunch Program nutrition standards. Intervention: Five menus were served throughout the study. A 20-minute or 10-minute seated lunch condition was randomly assigned to each day within the 5 menus. Main Outcomes and Measures: The primary outcomes were food consumption, waste, and dietary intake, which were analyzed separately for each meal component (fruit, vegetable, entree [protein plus grain], beverage [both milk and water], and milk alone). Dietary intake was assessed for calories, fat, carbohydrates, fiber, protein, vitamin D, calcium, iron, and potassium. Participant behaviors were observed during the meal, including seated time as well as level of talking and phone use. Results: A total of 38 children with 241 lunch trays were observed. The 38 children had a mean (SD) age of 11.86 (1.23) years and 23 were female participants (61%); 30 had a non-Hispanic/non-Latino ethnicity (79%) and 23 were White individuals (61%). During 10 minutes of seated lunch time, participants consumed significantly less fruit (-11.3 percentage points; 95% CI, -18.1 to -4.5) and vegetables (-14.1 percentage points; 95% CI, -22.7 to -5.7) compared with 20 minutes of seated lunch time. Entree and beverage consumption and waste did not differ between the 10-minute and 20-minute seated lunch conditions. Participants also consumed significantly more and wasted significantly less calories (-22.03 kcal; 95% CI, -39.47 to -4.61 kcal), carbohydrates (-3.81 g; 95% CI, -6.20 to -1.42 g), dietary fiber (-0.51 g; 95% CI, -0.81 to -0.19 g), protein (-1.11 g; 95% CI, -2.17 to -0.04 g), iron (-0.20 mg; 95% CI, -0.38 to -0.02 mg), and potassium (-53.49 mg; 95% CI, -84.67 to -22.32 mg) during the 20-minute seated lunch condition. Conclusions and Relevance: This study found that fruit and vegetable consumption increased in school-age children during a 20-minute seated lunch condition. This finding supports policies that require children to receive at least 20 minutes of seated lunch time; such policies could have favorable implications for children's dietary intake and food waste. Trial Registration: ClinicalTrials.gov Identifier: NCT04191291.

Using Qualitative Interviews to Better Understand Differences in How Local Health Departments Inspect School Share Tables.

ABSTRACT: Environmental and health advocates are increasingly promoting food donations to reduce landfilled food waste and feed hungry people. Share tables are locations where students can put unwanted school food or beverage items, allowing their uneaten food items to be "shared" with other students and providing food donation opportunities for the 4.9 billion lunches served annually in the U.S. National School Lunch Program. The purpose of this qualitative study was to identify differences in health inspector interpretations of the Food Code as it relates to share table operations and risk mitigation techniques preferred by inspectors for preventing foodborne illness from recovered food. A snowball sampling technique was used to identify Illinois health inspectors (n = 13) engaged in share table inspections. Telephone interviews were audio recorded and transcribed verbatim. The transcripts were coded using a hybrid process of deductive and inductive content analysis. Participants considered contamination, rather than temperature abuse, to be the primary risk factor for foodborne illness. Those participants with permissive Food Code interpretations considered contamination risk in the context of the overall school environment. Participants had the lowest degree of consensus on whether to allow whole apple recovery via a share table. Participants also lacked consensus on reuse of unclaimed share table items in future meal programs (reservice). This lack of consensus indicates that further research is needed to develop data-driven strategies to assess and manage the microbial risks associated with share tables and ultimately to facilitate increased food recovery.

Consumers' decisions to access or avoid added sugars information on the updated Nutrition Facts label.

The Nutrition Facts (NF) label was recently updated and now includes the added sugars content in an effort to reduce added sugars consumption. This study investigated whether consumers wanted to access or avoid the added sugars content using an online experiment and five product categories (yogurt, cereal, fruit juice, snack bar, ice cream). We recruited a sample of 490 U.S. adults (49% female; 73% White/Caucasian). Respondents were randomly assigned to an information treatment (simple or full) before making decisions on whether to access or avoid the added sugars content. The simple information treatment explained that added sugars information was now available on the NF label, while the full information treatment included additional details (e.g., how to interpret the added sugars content and associated diseases). After making the access or avoid decisions for each product category, respondents rated their likelihood of purchase for ten products (two per category). Rates of information avoidance were much lower than what has been observed in previous studies, and rates of avoidance did not vary by information treatment. The majority of respondents (75-87% across the five product categories) preferred to access the added sugars content. Still, we found some consumers preferred to avoid this information, with higher rates of avoidance for the ice cream product category. Additionally, we found significant differences in likelihood of purchase ratings between information accessors and avoiders. Respondents who chose to access the added sugars information exhibited healthier purchasing behaviors for all product categories; they were more likely to purchase low added sugars products and less likely to purchase high added sugars products relative to information avoiders. Given consumers' demonstrated interest in accessing the added sugars content, it is important that the new changes to the NF label be broadly communicated to promote healthy eating behaviors.

A Systems Examination of Food Packaging and Other Single-Use Item Waste in School Nutrition Programs.

OBJECTIVE: Identify types of food packaging used in school nutrition programs and competing priorities, barriers, and facilitators for sustainable packaging waste use and recovery. DESIGN: Qualitative interviews (n = 20) and structured kitchen observations were conducted. SETTING: Data were collected from 3 school districts in Northern Colorado. PARTICIPANTS: Three nutrition program directors, 14 kitchen managers, and 3 sustainability staff. PHENOMENON OF INTEREST: Barriers and facilitators for sustainable food packaging waste practices among school nutrition programs. ANALYSIS: Interviews were recorded and transcribed, followed by inductive content analysis to identify themes. RESULTS: Commonly used food packaging included cardboard, aluminum, paper, plastic, and styrofoam. Four competing priorities were identified as impacting school nutrition programs' ability to reduce or recover food packaging: serving line speed, labor, food quality, and cost. One key barrier was that school staff had difficulty understanding the total system impact of their food packaging use and recovery decisions. CONCLUSIONS AND IMPLICATIONS: Food packaging is commonly used in school nutrition programs, and participants felt that its use offered key benefits, such as facilitating faster serving lines. More research is needed to quantify the direct and indirect impacts of packaging waste reduction and recovery in school nutrition programs.

The Efficacy and Cost-Effectiveness of Replacing Whole Apples with Sliced in the National School Lunch Program.

The National School Lunch Program (NSLP) serves 29.6 million lunches each day. Schools must offer ½ a cup of fruit for each lunch tray. Much of this fruit may be wasted, leaving the schools in a dilemma. The objectives of this study were to evaluate the consumption of whole vs. sliced apples and determine the cost-effectiveness of the intervention. Researchers weighed apple waste at baseline and three post-intervention time points in one rural Midwest school. The costs of the intervention were collected from the school. The cost-effectiveness analysis estimates how often apples need to be served to offset the costs of the slicing intervention. A total of (n = 313) elementary student students participated. Students consumed significantly more sliced as compared to whole apples in intervention months 3 (ß = 21.5, p < 0.001) and 4 (ß = 27.7, p < 0.001). The intervention cost was USD 299. The value of wasted apple decreased from USD 0.26 at baseline to USD 0.23 wasted at post-intervention. The school would need to serve 9403 apples during the school year (54 times) to cover the expenses of the intervention. In conclusion, serving sliced apples may be a cost-effective way to improve fruit consumption during school lunch.

Characterizing and Assessing the Quality of State K-12 Share Table Policies as a Potential Mechanism to Reduce Food Waste and Promote Food Security.

OBJECTIVE: To identify the prevalence of state-level share table policies, assess the quality of available policies, and determine common policy characteristics. DESIGN: In this qualitative policy analysis, state-level share table policies and resources were collected from March to June, 2018 from the State Department of Education Child Nutrition Office Web sites and/or staff communication across 50 states and Washington, DC. VARIABLES MEASURED: Frequency of state-level policy documents assessed, as well as the allowable share table items, marketing and outreach guidance, and requirements for health code clearance, critical limits, monitoring, corrective actions, record keeping, redistribution plans, and allergy considerations. ANALYSIS: After a deductive analysis approach, each collected policy document was scored on 10 a priori components primarily derived from existing food safety policies. Descriptive statistics were used to present common policy characteristics. RESULTS: About half of the US (n = 27) had a state-level share table policy document. Most states with a policy document (81%; n = 22) allowed unused share table items to be redistributed through reservice, food donation, or use as a cooked ingredient in future meals. Few states provided adequate guidance on monitoring, corrective actions, record keeping, allergy considerations, and best practices for share table marketing and outreach. CONCLUSIONS AND IMPLICATIONS: The high prevalence of state share table guidance suggests that this is a common food recovery strategy. Yet, states differed in allowable share table items and on permitted future use of share table items.