Demographic and Socioeconomic Correlates of Disproportionate Beef Consumption among US Adults in an Age of Global Warming.

Concern for the environment when making dietary choices has grown as the contribution of the food sector to global greenhouse gas emissions becomes more widely known. Understanding the correlates of beef eating could assist in the targeting of campaigns to reduce the consumption of high-impact foods. The objective of this study was to identify the demographic, socioeconomic, and behavioral correlates of disproportionate beef consumption in the United States. We analyzed 24-h dietary recall data from adults (n = 10,248) in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Disproportionate beef consumption was defined as an intake greater than four ounce-equivalents per 2200 kcal. Associations of this indicator variable with gender, age, race/ethnicity, education, family income, diet knowledge, and away-from-home meals were assessed using logistic regression, incorporating survey design and weighting. Disproportionate beef diets were consumed by 12% of individuals, but accounted for half of all beef consumed. Males were more likely than females (p < 0.001) to consume these diets. This relationship was seen in all bivariate and multivariable models. Older adults, college graduates, and those who looked up the MyPlate educational campaign online were less likely (p < 0.01) to consume a disproportionate beef diet. While almost one-third of reported consumption came from cuts of beef (e.g., steak or brisket), six of the top ten beef sources were mixed dishes: burgers, meat mixed dishes, burritos and tacos, frankfurters, soups, and pasta. Efforts to address climate change through diet modification could benefit from targeting campaigns to the highest consumers of beef, as their consumption accounts for half of all beef consumed.

Popular diets as selected by adults in the United States show wide variation in carbon footprints and diet quality.

BACKGROUND: Carbon footprints of vegetarian, pescatarian, and other popular diets have been studied previously, but mostly as idealized versions modeled to meet dietary recommendations. Less is known about the footprints of popular diets as they are consumed by US adults, and thus the potential trade-offs with diet quality for free-living individuals. OBJECTIVES: This study estimated the carbon footprint and diet quality of popular diets as selected by a nationally representative sample of US consumers, including the recently trending keto- and paleo-style diets. METHODS: The 2005-2010 NHANES 24-h recall data were used to categorize individual adult diets (n = 16,412) into 6 types: vegan, vegetarian, pescatarian, paleo, keto, and all other diets, referred to here as omnivore diets. Average daily greenhouse gas emissions in kilograms of carbon dioxide equivalents per 1000 kcal (kg CO2-eq/1000 kcal) were calculated for each diet by matching our previously developed database to NHANES individual diet data. Diet quality was determined using the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index. Survey-weighted ordinary least-squares regression was used to assess mean differences in diets. RESULTS: The average carbon footprints of vegan (0.69 ± 0.05 kg CO2-eq/1000 kcal) and vegetarian (1.16 ± 0.02) diets were lower (P < 0.05) than those of the pescatarian (1.66 ± 0.04), omnivore (2.23 ± 0.01), paleo (2.62 ± 0.33), or keto (2.91 ± 0.27) diets. Mean HEI scores were highest for pescatarian diets (58.76 ± 0.79) and higher (P < 0.05) for vegetarian (51.89 ± 0.74) than for omnivore (48.92 ± 0.33) or keto (43.69 ± 1.61) diets. CONCLUSIONS: Our results highlight the nuances when evaluating the nutritional quality of diets and their carbon footprints. On average, pescatarian diets may be the healthiest, but plant-based diets have lower carbon footprints than other popular diets, including keto- and paleo-style diets.

Emergency food distribution efforts in New Orleans, LA after Hurricane Ida.

Background: The provision of food aid after a natural disaster is necessary to prevent hunger, particularly in low-resourced and low-income communities. Little is known about the operational challenges associated with ensuring equitable distribution of emergency food resources to communities in need following a disaster. To address this gap, this study assessed emergency food distribution efforts in New Orleans, LA during the 2 weeks following Hurricane Ida's landfall on August 29, 2021. Methods: Information on free food distribution events was gathered from online sources. A list of distribution sites was generated that included data on operational logistics (e.g., address, days of operation, hours of operation, etc.), food offerings (e.g., prepared meals, groceries, etc.), and socio-demographic characteristics of the surrounding community. Geospatial mapping and bivariate analyses were used to analyze the site data. Results: Seventy-four distribution sites operated in the 2 weeks after Hurricane Ida. Approximately 47.3% were located in census tracts with >80% Black residents, and 39.2% were in tracts with >30% poverty. A large proportion of sites offered prepared meals (86.2%) and only operated 1 day (36.5%). Tracts with >80% Black residents had more sites that operated only 1 day (p = 0.04). Tracts with >30% poverty had more sites that started distributing food resources 7-15 days after the hurricane (p = 0.02). Conclusions: Most low-income and low-resourced communities in New Orleans had access to emergency food resources; however, several limitations in operations were identified that may have influenced access. Future initiatives to prevent hunger after a natural disaster in New Orleans, and elsewhere, should improve operational logistics for food aid.

Longer Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children Is Not Associated with Reduced Sugar-Sweetened Beverage Intake among Black Participants.

This study assessed relationships of duration of family Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participation with racial/ethnic disparities in child sugar-sweetened beverage (SSB) and water intake. Child beverage intake and family duration on WIC were collected during three cross-sectional surveys of WIC-participating families in Los Angeles County, California (2014, 2017 and 2020; n = 11,482). The associations of family duration of WIC participation, a proxy for the amount of WIC services received, with daily intake of total SSBs, fruit-flavored SSBs and water were assessed in race/ethnicity strata with multivariable negative binomial and Poisson regression models. Among English-speaking Hispanic children, those of families reporting 10 years of WIC participation consumed 33% and 27% fewer servings of total and fruit-flavored SSBs compared to those of families reporting 1 year on WIC. Among Black children, those from families reporting 5 and 10 years of participation in WIC consumed 33% and 45% more daily servings of fruit-flavored SSBs than those from families reporting 1 year on WIC. Disparities in daily total and fruit-flavored SSB intake between Black and White children increased with longer family duration on WIC. Duration of family WIC participation is associated with healthier beverage choices for infants and children, but does not appear to be equally beneficial across racial/ethnic groups in Los Angeles County.

Longer Family Participation in WIC is Associated With Lower Childhood Sugar-Sweetened Beverage Intake.

OBJECTIVE: To evaluate if children of families with a longer duration of participation in the Special Supplementation Nutrition Program for Women, Infants, and Children (WIC) consume fewer sugar-sweetened beverages (SSB) and more water. DESIGN: A repeated cross-sectional study. SETTING: Conducted among representative samples of WIC-participating families in Los Angeles County, California, in 2014, 2017, and 2020. PARTICIPANTS: Children aged 4-59 months participating in WIC. MAIN OUTCOME MEASURES: Daily servings of total SSBs, daily servings of specific types of SSBs, and daily servings of water. ANALYSIS: Multivariable count regression models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) for associations of the duration of family WIC participation with daily servings of total SSBs, water, and specific types of SSBs. Zero-inflated negative binomial regression models were used for total SSBs and specific types of SSBs, and Poisson regression was used for water. RESULTS: Children of families with 2 years of WIC participation consumed significantly fewer daily servings of total SSBs (IRR, 0.95; 95% CI, 0.93-0.98; P = 0.002), fruit-flavored SSBs (IRR, 0.95; 95% CI, 0.91-0.99; P = 0.02), soda (IRR, 0.86; 95% CI, 0.76-0.98; P = 0.02), and water (IRR, 0.99; 95% CI, 0.98 to < 1.00; P = 0.03) than children of families with 1 year of WIC participation. Protective associations for total SSBs, fruit-flavored SSBs, and soda remained statistically significant and increased in magnitude through 10 years of family WIC participation. CONCLUSIONS AND IMPLICATIONS: Duration of WIC participation was associated with decreased SSB intake by young children. Given the role that increasing water intake in lieu of SSBs plays in child obesity, improving the effectiveness of WIC nutrition education on parental perceptions and provision of fruit-flavored SSBs and water to their children merits detailed evaluation.

Diet Quality Is Lower for Those Who Skip Lunch Among a Sample of Predominantly Black Adolescents.

PURPOSE: To compare the dietary quality among adolescents who skip lunch and those who do not and explore associations between school-level variables, demographic variables and lunch skipping. DESIGN: Cross-sectional. SETTING: Public schools in New Orleans, Louisiana (n = 21). PARTICIPANTS: 718 adolescents. METHODS: Adolescents participated in a 24-hour dietary recall using the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool early in 2013. Data were converted into Healthy Eating Index (HEI-2010) scores. Mean scores were compared between students who skipped lunch and those who did not. A multilevel analysis was conducted to assess relationships between school environment, demographics, and lunch skipping. RESULTS: Of the 718 respondents, 88.3% were Black and 15.3% skipped lunch. Students who ate lunch had a mean HEI score of 46.6 compared to a mean score of 41.7 for students who skipped lunch (p < .001). Students who skipped lunch also had significantly lower intake of total vegetables (p = .02), whole fruits (p < .001), total dairy (p = .003), total protein (p < .001). CONCLUSIONS: Skipping lunch was associated with lower quality diet, though diet quality was low among all students. Considering over 15% of the sample did not eat lunch in a closed-campus school setting, further research should consider how to encourage students to participate in the National School Lunch Program, which has the ability to increase diet quality in adolescents.

Perceptions of the Built Environment and Support for Policies That Promote Physical Activity.

BACKGROUND: To assess how perceptions of the community built environment influence support for community policies that promote physical activity (PA). METHODS: A national cross-sectional survey assessed perceptions of the local built environment and support of community policies, including school and workplace policies, promoting PA. A random digit-dialed telephone survey was conducted in US counties selected on Behavioral Risk Factor Surveillance System data for high or low prevalence of obesity and inactivity. A total of 1208 subjects were interviewed, 642 from high-prevalence counties and 566 from low-prevalence counties. Analyses were stratified by county prevalence of obesity and inactivity (high or low). Linear models adjusted for covariates were constructed to assess the influence of built environment perceptions on policy support. RESULTS: Perception of more destinations near the residence was associated with increased support for community policies that promote PA, including tax increases in low-prevalence (obesity and inactivity) counties (P < .01). Positive perception of the workplace environment was associated (P < .001) with increased support for workplace policies among those in high-, but not low-, prevalence counties. CONCLUSIONS: Support for community policies promoting PA varies by perception of the built environment, which has implications for policy change.

Lunch Salad Bars in New Orleans' Middle and High Schools: Student Intake of Fruit and Vegetables.

The school lunch salad bar (SB) is a recommended food environmental strategy to increase access to, and consumption of fruit and vegetables (F/V). In a study to examine use of school lunch SBs, middle and high school students provided data via the Automated Self-Administered 24-h dietary recall (24HDR) tool for kids (ASA24-Kids-2012), a web-based data collection platform. Kilocalories were computed, food groups were assigned and F/V sources were obtained. Students (n = 718) from 12 schools with SBs and nine schools without SBs were approximately 87% African American, over 64% female and most were 7th and 8th graders. SB school students had higher median energy consumption at lunch but a higher percent of non-SB students reported eating fruit at lunch compared to SB students. Most students reporting eating F/V at lunch obtained F/V from the cafeteria main line; only 19.6% reported eating F/V exclusively from the SB. In SB schools median intake of cups F/V was higher among students using the SB (0.92) compared to those not using the SB (0.53). Results of this study are mixed, but encouraging. Additional factors, e.g., nutrition education, marketing, and kinds of foods offered on the SB need to be examined for potential influence on SB use.

Personal characteristics, cooking at home and shopping frequency influence consumption.

This study examines how the consumption of fruits and vegetables is affected by home cooking habits and shopping patterns, including distance to patronized stores and frequency of shopping, in two low-income predominantly African American urban neighborhoods in New Orleans, Louisiana. In-person interviews were conducted in 2013 with 901 adult residents who identified themselves as the primary household shopper. Respondents were asked where and how often they shopped and answered a food frequency questionnaire. Addresses were geocoded and distances to the stores where respondents shopped were calculated. Multivariable logistic regression was used to examine the relationship between food consumption and personal factors, neighborhood factors and shopping habits. Consumption of daily servings of fresh produce increased by 3% for each additional trip to a grocery store, by 76% for shopping at a farmer's market, and by 38% for preparing food at home. Each additional trip to a convenience store increased the frequency of consumption of chips, candy and pastries by 3%. The distance from residence to the type of store patronized was not associated with consumption of produce or chips, candy or pastries. Shopping at full-service grocery stores, farmer's markets and cooking at home were positively associated with the consumption of fresh produce while shopping at convenience stores was associated with increased consumption of chips, candy and pastries. These findings are useful for designing programmatic interventions to increase fresh fruit and vegetable consumption among residents in low-income urban communities.

Individual- and School-Level Factors Related to School-Based Salad Bar Use Among Children and Adolescents.

BACKGROUND: Consumption levels of fruits and vegetables (F/V) among children/adolescents are low. Programs like school-based salad bars (SB) provide children/adolescents increased F/V access. AIMS: The purpose of this study was to examine the relationship between SB use and individual and school-level factors among elementary and secondary school students in New Orleans public schools. METHOD: Twelve schools receiving SB units from the Let's Move Salad Bars to Schools Campaign participated in this study. Self-reported data were collected from students ( n = 1,012), administrators ( n = 12), and food service staff ( n = 37). School environmental data were obtained through direct observation. Generalized estimating equation regression methods were used to develop a multilevel model including both school-level (e.g., length of lunchtime, SB marketing, vending machines) and individual-level (e.g., sex, food preferences, nutrition knowledge) effects. RESULTS: Female students had higher odds of using the SB compared to males. Students with healthier food preferences had higher odds of using the SB than those who reported less healthy food preferences. Within the multilevel model for all students, only sex and healthy food preferences remained significant. In a multilevel model assessing secondary students only, student encouragement toward others for healthy eating and school-based SB marketing were significantly related to SB use. CONCLUSIONS: Little research has examined factors related to school-based SB use. These findings suggest recommendations that may help improve student use of SBs. For example, increasing the promotion of SB, particularly in secondary schools, might encourage their use among students.

Adolescent Student Use of School-Based Salad Bars.

BACKGROUND: Childhood obesity continues to be a public health problem in the United States. Increasing consumption of fruits and vegetables (F/V) is one strategy for decreasing high consumption of energy-dense, high-fat foods, thereby improving weight status. Many Orleans Parish public schools were provided with salad bars (SBs) to augment school lunch with increased access to F/V. This study identified factors associated with student use of SBs. METHODS: Surveys examining SB use, demographics, food preference, nutrition knowledge, and social support were administered to students in the 7th to 12th grades (N = 702) in Orleans Parish (New Orleans, Louisiana). Generalized estimating equations, which incorporate clustering at the school level, helped to determine associations between independent variables and SB use. RESULTS: Sixty percent of participants were SB users. Non-African-American students were more likely to be SB users than African-American students (odds ratio [OR] = 2.35, confidence interval [CI]: 1.35-4.07) and students who had high preference for healthy food were more likely to use the SB than those who had low preference (OR = 2.41, CI: 1.44-4.01). Students who encouraged others to consume F/V were more likely to use the SB than those who did not (p = .015). CONCLUSIONS: Individual and interpersonal factors related to SB use can provide guidance in the development of school-based interventions to increase SB use and F/V consumption.

Use of a new availability index to evaluate the effect of policy changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the food environment in New Orleans.

OBJECTIVE: Changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) occurred in 2009 when supplemental foods offered through the programme were updated to align with current dietary recommendations. The present study reports on a new index developed to monitor the retail environment's adoption of these new food supply requirements in New Orleans. DESIGN: A 100-point WIC Availability Index (WIC-AI) was derived from new minimum state stocking requirements for WIC vendors. A sample of supermarkets, medium and small food stores was assessed in 2009 before changes were implemented and in 2010 after revisions had gone into effect. WIC-AI scores were utilized to compare differences in meeting requirements by store type, WIC vendor status and year of measurement. SETTING: Supermarkets, medium and small WIC and non-WIC food stores in New Orleans, Louisiana, USA. RESULTS: At baseline supermarkets had the highest median WIC-AI score (93·3) followed by medium (69·8) and small food stores (48·0). Small WIC stores had a higher median WIC-AI score at baseline than small non-WIC stores (66·9 v. 38·0). Both medium and small WIC stores significantly increased their median WIC-AI scores between 2009 and 2010 (P<0·01). The increased median WIC-AI score in small food stores was largely attributed to increased availability of cereals and grains, juices and fruit, and infant fruit and vegetables. CONCLUSIONS: The WIC-AI is a simple tool useful in summarizing complex food store environment data and may be adapted for use in other states or a national level to inform food policy decisions and direction.

Fresh produce consumption and the association between frequency of food shopping, car access, and distance to supermarkets.

BACKGROUND: Fresh fruit and vegetables are important components of a healthy diet. Distance to a supermarket has been associated with the ability to access fresh produce. METHODS: A randomly sampled telephone survey was conducted with the main shopper for 3000 households in New Orleans, Louisiana in 2011. Individuals were asked where and how often they shopped for groceries, frequency of consumption of a variety of foods, and whether they had access to a car. Bivariate models assessed the relationship between four outcomes: car access, distance to the store patronized by the respondent, number of monthly shopping trips, and daily servings of produce. Structural equation modeling (SEM) was used to distinguish direct and indirect effects. RESULTS: In bivariate models, car access was positively associated with number of shopping trips and produce consumption while distance was inversely associated with shopping trips. In SEM models, produce consumption was not associated with car access or distance, but to the number of monthly shopping trips. CONCLUSION: The frequency of shopping is associated with car access but a further distance deters it. Access to stores closer to the shopper may promote more frequent shopping and consumption of produce.

The influence of the WIC food package changes on the retail food environment in New Orleans.

OBJECTIVE: To examine the effect of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package changes on availability of healthy foods in small stores. DESIGN: Pre-post comparison group design with repeat in-store observations. SETTING: New Orleans. PARTICIPANTS: Small stores (n = 102; 77% of total) were visited in 2009. Of these, 91% were observed again in 2010, including both WIC (n = 27) and non-WIC (n = 66) stores. INTERVENTION: The 2009 WIC food package changes to include healthier foods. MAIN OUTCOME MEASURES: Change in store availability of fruits, vegetables, lower-fat milks, whole wheat bread, and brown rice. Change in number of varieties and shelf length of fruits and vegetables. ANALYSIS: Difference-in-differences analysis using logit models for change in availability and regression models for change in number of varieties or shelf length. RESULTS: The WIC stores were more likely to improve availability of lower-fat milks than non-WIC stores (adjusted odds ratio, 5.0, 95% confidence interval, 1.2-21.0). An even greater relative improvement was seen with whole grains. The WIC stores showed a relative increase in number of varieties of fresh fruits (0.9 ± 0.3; P < .01) and shelf length of vegetables (1.2 ± 0.4 meters; P < .01). CONCLUSIONS AND IMPLICATIONS: Results suggest that WIC changes improved the availability of healthy foods in small stores in New Orleans. Similar changes throughout the country could have a significant impact on neighborhood food environments.

Support for physical activity policies and perceptions of work and neighborhood environments: variance by BMI and activity status at the county and individual levels.

PURPOSE: To examine support for local policies encouraging physical activity and perceived neighborhood environment characteristics by physical activity and weight status of respondents across U.S. counties. DESIGN: We used a random-digit-dial, computer-assisted telephone interview (CATI) to conduct a cross-sectional telephone questionnaire in selected U.S. counties in 2011. SETTING: Counties with high prevalences of obesity and sedentary behavior (HH; n = 884) and counties with low prevalences of obesity and sedentary behavior (LL; n = 171) were selected nationally. SUBJECTS: Adult respondents from HH (n = 642) and LL (n = 566) counties. MEASURES: Questions were asked of respondents, pertaining to support for physical activity policies in various settings, neighborhood features, time spent in physical activity and sedentary behaviors, self-reported weight and height, and personal demographic information. ANALYSIS: Means and frequencies were calculated; bivariable and multivariable linear and logistic regression models, developed. Models were adjusted for individual characteristics and county HH/LL status. RESULTS: Respondents in LL counties perceived their neighborhood and work environments to be more supportive of healthy behaviors and were more supportive of local physical activity policies than respondents in HH counties (p < .001 for all). Positive neighborhood environment perceptions were related to reduced body mass index, increased physical activity, and decreased sedentary behavior. CONCLUSION: Policy support and neighborhood environments are associated with behaviors. Results can inform targeting policy agendas to facilitate the improvement of environments (community, work, and school) to be more supportive of physical activity.

Feasibility of increasing access to healthy foods in neighborhood corner stores.

The feasibility of working with neighborhood corner stores to increase the availability of fresh fruit and vegetables in low-income neighborhoods in New Orleans was assessed. Household interviews and 24-hour dietary recalls (n = 97), corner store customer intercept interviews (n = 60) and interviews with corner store operators (owners/managers) (n = 12) were conducted in three neighborhoods without supermarkets. Regional produce wholesalers were contacted by phone. Results indicated that the majority of neighborhood residents use supermarkets or super stores as their primary food source. Those who did shop at corner stores typically purchased prepared foods and/or beverages making up nearly one third of their daily energy intake. Most individuals would be likely to purchase fresh fruit and vegetables from the corner stores if these foods were offered. Store operators identified cost, infrastructure and lack of customer demand as major barriers to stocking more fresh produce. Produce wholesalers did not see much business opportunity in supplying fresh produce to neighborhood corner stores on a small scale. Increasing availability of fresh fruit and vegetables in corner stores may be more feasible with the addition of systems changes that provide incentives and make it easier for neighborhood corner stores to stock and sell fresh produce.