Potential consumer response to the healthy symbol proposed by the U.S. food and Drug Administration.

The U.S. Food and Drug Administration (FDA) has proposed updates to the definition of "healthy," including distinctions between types of sugar and fats and limits on added sugar, saturated fat, and sodium. To communicate the updated standards, the FDA is developing a Healthy symbol to display on food packages, which could reduce knowledge gaps by assisting U.S. consumers in meeting recommended nutritional guidelines. This study aimed to explore the potential for the label to increase consumers' ability to correctly identify a food product that met the FDA's criteria for a healthy symbol. To complete the study objective, 1018 adults were recruited to represent the U.S. population regarding gender, age, income, and geographic region, and a randomized group experiment was used to determine the potential communication value of an FDA Healthy symbol. Respondents were randomized to a group shown either a healthy yogurt with the FDA symbol, a healthy yogurt without the symbol, or an unhealthy yogurt. Respondents were then asked whether they considered the yogurt shown to be healthy, a question examining the desired criteria for the Healthy symbol, willingness to accept various costs to implement the symbol, and questions to measure objective dietary knowledge. Adding the symbol to yogurt that already met the healthy criteria only yielded about a 4 percentage point increase in the proportion of respondents identifying it as healthy. However, 53 % of participants still identified a yogurt too high in added sugars as healthy. For the desired label criteria, 64 % of respondents selected limits on added sugars, 57 % selected limits on sodium, and 54 % selected limits on saturated fats, which all align with the proposed updates to the definition of healthy. Over half of the participants supported the implementation of the label, even at a cost of $40 annually, and 86 % supported implementation at no cost.

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.

Associations between cooking self-efficacy, attitude, and behaviors among people living alone: A cross-sectional survey analysis.

Cooking-related literacy and attitudes may play important roles in preventing and reducing diet-related chronic diseases and nutrition disparities. People living alone are an under-researched but growing population who face above average food insecurity rates. This study's objectives were to 1) test how cooking self-efficacy and attitude are stratified demographically among a sample of people living alone, focusing on variations across gender, age, and food security, and 2) examine how cooking self-efficacy and attitude are associated with two indicators of cooking behavior - cooking frequency and convenience orientation. We draw from a cross-sectional survey analysis of 493 adults living alone in Illinois, USA with validated measures for cooking self-efficacy, attitude, frequency, convenience orientation, and demographic characteristics. Hierarchical linear regression models were used to examine demographic factors explaining variation in self-efficacy and attitude, with attention to interactions between gender, food insecurity, and age. Poisson and OLS linear regression models were used to examine associations between self-efficacy and attitude and cooking frequency and convenience orientation. We find cooking-related self-efficacy and attitude showed strong but distinct associations with cooking frequency and convenience orientation. Overall, food insecure groups had lower self-efficacy than those who were food secure; however, food insecure women had higher self-efficacy than men in similar positions, apart from older-adult women who held particularly low efficacy. Cooking attitudes varied in small ways, notably with food insecure younger and older women possessing more negative cooking attitudes than middle-aged women. This research highlights the importance of understanding the cooking-related orientations of single-living people, while demonstrating that this group's ability to prevent and manage food insecurity is not uniform. These results can inform targeted interventions around food and nutrition insecurity, cooking attitudes, and self-efficacy among single-living populations.

Consumer responses to rebranding to address racism.

In 2020, following the death of George Floyd and the renewed national focus on racism, many food brands with racist names and packages announced they would rebrand. Brands differed in their extent of rebranding (some only removed an image, whereas others also changed a brand name) and differed in the reasons they gave for the rebranding in PR statements and news interviews. At this point, little is known about how consumers responded to these branding changes. To address this, we conducted an online experiment using the case of Aunt Jemima pancake mix to evaluate how changes in the extent of rebranding and the reason for rebranding impact consumers' likelihood of purchase, expected taste, brand liking, and brand trust. We find that removing the image of Aunt Jemima brought moderate reductions to likelihood of purchase and expected taste and no changes to brand liking or brand trust. When the brand name was also changed to Pearl Milling Company we find larger reductions to likelihood of purchase and expected taste and reductions to brand liking and brand trust. Additionally, we find that informing consumers the change was done to address racism partially mitigated losses in likelihood of purchase following renaming the brand but provided no protection when only the image was removed. The information also had no impact on expected taste, brand liking, or brand trust following either image removal or brand name change. Last, we find evidence of heterogeneity in consumer responses across political ideologies, with liberals reacting more positively to the rebranding and conservatives reacting more negatively.

Coping with the 2022 infant formula shortage.

To estimate the proportion of US consumers who sought formula during the shortage, what coping mechanisms they used, and public support for formula policies, we conducted an online survey of approximately 1,000 US consumers in August 2022 via Qualtrics. Approximately 35% of consumers attempted to purchase formula during the shortage, for their own household or on behalf of someone else, and the most common coping mechanisms were focused on searching different outlets (e.g., multiple stores, online). During the shortage public health agencies published recommendations for consumers - some were highly utilized (e.g., searching multiple stores), however, some were utilized less frequently (e.g., brand switching, breastfeeding). Additionally, despite warnings, some consumers still attempted to make their own formula. Understanding what coping mechanisms were and were not utilized, and their related risks has important implications for improving public health outreach in the future. Finally, we find considerable public support for regulation to ensure adequate supply of formula in the future, in particular regulation allowing imported formula and increased government involvement in the number of firms producing formula.

The Curious Case of Baby Formula in the United States in 2022: Cries for Urgent Action Months after Silence in the Midst of Alarm Bells.

The shortages of baby formula in the US resulting from the voluntary recall of contaminated products and shutdown of manufacturing facility in February led to increases in the national out-of-stock rate of the baby formula from 18 to 70% over the summer of 2022. This study utilizes social media listening and data analysis to examine how online media reactions to the physical shortage changed over time and how the reaction to the shortage differed from to the initial recall announcements. Improved understanding of reactions to emergent issues in foods through this lens may improve communication efficiency to mitigate potential consequences.

Persistent and Episodic Food Insecurity and Associated Coping Strategies Among College Students.

OBJECTIVE: To determine the rates of episodic and persistent food insecurity among college students and whether coping strategies employed differs on the basis of food security status. DESIGN: Online cross-sectional survey administered in March 2021. SETTING: A large Midwestern university. PARTICIPANTS: A random sample of students (n = 5,000) were invited to participate via email with a response rate of 20% (n = 888). MAIN OUTCOME MEASURES: Food insecurity was assessed using the 10-item US Department of Agriculture Adult Food Security Survey Module. Food acquisition and management coping strategies were measured using modified questionnaires. ANALYSIS: Pearson's chi-squared tests, 1-way ANOVAs, and post hoc analyses were conducted to examine associations of sociodemographic factors and coping strategies with food security status. Linear regression models were used to estimate the association between the coping strategies scale and subscales with food insecurity status. RESULTS: The food insecurity rate was 22%, with 11% and 10% of students experiencing episodic and persistent food insecurity, respectively. Coping strategies varied significantly by food security status (P < 0.001), with students facing persistent food insecurity employing coping strategies most frequently. CONCLUSIONS AND IMPLICATIONS: Future research is needed to better understand the persistent nature of food insecurity and coping strategies to develop tailored policies and programs for the college student population.

U.S. household food acquisition behaviors during the COVID-19 pandemic.

The COVID-19 pandemic upended how many Americans acquire foods. In this paper, we analyze eight food acquisition activities at different points in the pandemic, which allows us to evaluate how food acquisition changed as case rates changed and vaccine rollouts occurred. We collected data from three nationally representative online samples in September 2020, December 2020, and March 2021. We evaluate changes across time and across demographics using a multivariate probit model. Across time, we find that in-person grocery shopping remained extremely common (over 90%) throughout the pandemic. Food acquisition activities with less in-person contact (e.g., ordering from a meal kit service, online grocery shopping) peaked in December 2020, likely due to the surge in cases during that period. Ordering take-out from a restaurant remained common throughout the pandemic, but indoor dining increased significantly in March 2021 when vaccines were becoming more widely available. Food acquisition activities also varied across consumer groups, particularly indoor and outdoor restaurant dining. Overall our results offer evidence that in-person grocery shopping is a staple food acquisition activity that is unlikely to be changed; however, there is a segment of consumers who complement their in-person grocery shopping with online grocery shopping options. Further, relative to grocery stores, restaurants may be more vulnerable to surges in COVID-19 case rates. We conclude with implications for grocery retailers and restaurants as they continue to navigate operational challenges associated with the COVID-19 pandemic.

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.