Socio-economic and racial/ethnic disparities in the nutritional quality of packaged food purchases in the USA, 2008-2018.

OBJECTIVE: To determine whether disparities exist in the nutritional quality of packaged foods and beverage purchases by household income, education and race/ethnicity and if they changed over time. DESIGN: We used Nielsen Homescan, a nationally representative household panel, from 2008 to 2018 (n = 672 821 household-year observations). Multivariate, multilevel regressions were used to model the association between sociodemographic groups and a set of nutritional outcomes of public health interest, including nutrients of concern (sugar, saturated fat and Na) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, sugar-sweetened beverages and junk foods). SETTING: Household panel survey. PARTICIPANTS: Approximately 60 000 households each year from the USA. RESULTS: Disparities were found by income and education for most outcomes and widened for purchases of fruits, vegetables and the percentage of calories from sugar between 2008 and 2018. The magnitude of disparities was largest by education. Disparities between Black and White households include the consumption of processed meats and the percentage of calories from sugar, while no disparities were found between White and Hispanic households. Disparities have been largely persistent, as any significant changes over time have been substantively small. CONCLUSIONS: Policies to improve the healthfulness of packaged foods must be expanded beyond SSB taxes, and future research should focus on what mediates the relationship between education and diet so as not to exacerbate disparities.

Associations Among Select State Policies and the Nutritional Quality of Household Packaged Food Purchases in the United States from 2008 Through 2017.

BACKGROUND: Policy interventions are important public health tools because they can reach large numbers of people. State context has been associated with health outcomes, yet few studies have examined the extent to which state-level policies are associated with dietary quality. OBJECTIVES: The objective of this study was to evaluate whether state policies are associated with the nutritional quality of household packaged food purchases. DESIGN: This observational study used data from Nielsen Homescan, an open-cohort household panel where participants track purchases, and a combination of state-level food and social safety net policy variables from 2008 through 2017. PARTICIPANTS AND SETTING: This study included 615,634 household-year observations in the United States from 2008 through 2017. Household-year observations were excluded in the case that a household did not make a minimum number of purchases and in the case that they had incorrect geographic information. The final analytic sample was 611,719 household-years. MAIN OUTCOME MEASURES: Study outcomes included a set of nutrition-related measures of public health interest, including nutrients of concern (eg, sugar, saturated fat, and sodium) and calories from specific food groups (eg, fruits, nonstarchy vegetables, processed meats, mixed dishes, sugar-sweetened beverages, and desserts and snacks). STATISTICAL ANALYSIS: This study used multilevel generalized linear models with state fixed effects on three samples: all households, only households with low income, and only households with low educational attainment. RESULTS: Few significant associations were found between healthy food retail policies and the nutritional quality of purchases, and mixed associations were found between social safety net policies and lower or higher quality packaged food purchases. CONCLUSIONS: Little evidence was found that state policy context in 2008 through 2017 was associated with the quality of packaged food purchases. However, variation in state policies is increasing over time, warranting future research into the relationship between these policies, the quality of packaged food purchases, and the rest of the diet.

Geographic patterns and socioeconomic differences in the nutritional quality of household packaged food purchases in the United States.

BACKGROUND: It is unclear whether dietary quality varies by geography in the US. PURPOSE: Assess patterns in packaged food purchases (PFPs). METHODS: We characterized variation in PFP quality from 2008 to 2018 by 1) examining geographic clustering and 2) using regression analysis to control for household characteristics. RESULTS: Lower quality purchases clustered in the Southeast and Appalachia, whereas higher quality purchases clustered in the West and Northeast. Spatial patterns were similar for low socioeconomic households but not high socioeconomic households. Geographic differences in quality remained after controlling for demographic composition. CONCLUSION: This analysis should inform research into systemic drivers of PFP quality.

Sugar-sweetened beverage (SSB) consumption is associated with lower quality of the non-SSB diet in US adolescents and young adults.

BACKGROUND: Since 2003-4, the United States has seen large declines in sugar-sweetened beverage (SSB) intake overall, especially among non-Hispanic white (NHW) subpopulations. However, obesity prevalence has not shown comparable declines in the 2 highest SSB-consuming groups, adolescents and young adults. Little is understood about the quality of the diet excluding SSBs (non-SSB diet). OBJECTIVES: The objective of this study was to evaluate differences in non-SSB diet quality in SSB consumers and nonconsumers in adolescents and young adults and in the 3 major race/ethnic subgroups. METHODS: This study utilized data from the NHANES, a cross-sectional, nationally representative survey of the US population. Data from 6426 participants aged 12-29 y from the NHANES (2009-2014) was included. Quality of the non-SSB diet was measured using the 2015 Healthy Eating Index (HEI). Multivariate linear regressions controlled for sociodemographic characteristics and included interactions by race/ethnicity [NHWs, non-Hispanic blacks (NHBs), Hispanics]. Individuals were classified as non-, low- (<10% of daily calories), or high-SSB consumers (≥10% of daily calories), according to the US Dietary Guidelines added sugar intake recommendation. RESULTS: Non-SSB HEI scores differed among SSB consumer groups (53 for adolescent nonconsumers compared with 46 for high consumers, P < 0.001; 57 for young adult nonconsumers compared with 45 for high consumers, P < 0.001), although all scores were low and require improvement. Among NHBs, significant differences in non-SSB HEI were found only between non- and low-SSB consumers. In Hispanics, associations varied by age group, with significant differences found for young adults but no association found for adolescents. CONCLUSIONS: Low non-SSB HEI scores in SSB consumers suggest that reducing SSB consumption alone will not be a sufficient strategy for improving dietary quality in adolescents and young adults. Future policies must also consider improving the non-SSB diet.

Chemical Treatments for Mobilizing Arsenic from Contaminated Aquifer Solids to Accelerate Remediation.

Arsenic is a prevalent contaminant at US Superfund sites where remediation by pump and treat systems is often complicated by slow desorption of As from Fe and Al (hydr)oxides in aquifer solids. Chemical amendments that either compete with As for sorption sites or dissolve Fe and Al (hydr)oxides can increase As mobility and improve pump and treat remediation efficiency. The goal of this work was to determine optimal amendments for improving pump and treat at As contaminated sites such as the Vineland Chemical Co. Superfund site in southern New Jersey. Extraction and column experiments were performed using As contaminated aquifer solids (81 ± 1 mg/kg), site groundwater, and either phosphate (NaH(2)PO(4)·H(2)O) or oxalic acid (C(2)H(2)O(4)·2H(2)O). In extraction experiments, phosphate mobilized between 11% and 94% of As from the aquifer solids depending on phosphate concentration and extraction time (1 mM-1 M; 1-24 h) and oxalic acid mobilized between 38 and 102% depending on oxalic acid concentration and extraction time (1-400 mM; 1-24 h). In column experiments, phosphate additions induced more As mobilization in the first few pore volumes but oxalic acid was more effective at mobilizing As overall and at lower amendment concentrations. At the end of the laboratory column experiments, 48% of As had been mobilized from the aquifer sediments with 100 mM phosphate and 88% had been mobilized with 10 mM oxalic acid compared with 5% with ambient groundwater alone. Furthermore, simple extrapolations based on pore volumes suggest that chemical treatments could lower the time necessary for clean up at the Vineland site from 600 a with ambient groundwater alone to potentially as little as 4 a with 10 mM oxalic acid.

Urban vs. Rural Socioeconomic Differences in the Nutritional Quality of Household Packaged Food Purchases by Store Type.

The U.S. food system is rapidly changing, including the growth of mass merchandisers and dollar stores, which may impact the quality of packaged food purchases (PFPs). Furthermore, diet-related disparities exist by socioeconomic status (SES) and rural residence. We use data from the 2010-2018 Nielsen Homescan Panel to describe the nutritional profiles of PFPs by store type and to assess whether these vary by household urbanicity and SES. Store types include grocery stores, mass merchandisers, club stores, online shopping, dollar stores, and convenience/drug stores. Food and beverage groups contributing the most calories at each store type are estimated using survey-weighted means, while the associations of urbanicity and SES with nutritional quality are estimated using multivariate regression. We find that households that are customers at particular store types purchase the same quality of food regardless of urbanicity or SES. However, we find differences in the quality of foods between store types and that the quantity of calories purchased at each store type varies according to household urbanicity and SES. Rural shoppers tend to shop more at mass merchandisers and dollar stores with less healthful PFPs. We discuss implications for the types of store interventions most relevant for improving the quality of PFPs.

Grocery Stores Are Not Associated with More Healthful Food for Participants in the Supplemental Nutrition Assistance Program.

BACKGROUND: Despite interventions to improve the nutrition of grocery store purchases, also referred to as at-home (AH) foods, by participants in the Supplemental Nutrition Program (SNAP), little is known about what proportion of participants' intake is from AH foods and how the dietary quality of AH food compares with participants' away-from-home (AFH) food. Although recent research indicates SNAP participants have dietary quality that is slightly worse than that of income-eligible nonparticipants, it is unknown whether this is attributable to AH or AFH consumption. OBJECTIVE: The objective of this study is to examine differences in self-reported dietary intake by food source for SNAP participants compared with income-eligible nonparticipants using 2011-2014 data from the National Health and Nutrition Examination Survey (NHANES). DESIGN: This study included data from the NHANES, a cross-sectional, nationally representative survey of the United States population. STUDY PARTICIPANTS: This study included 2,523 adults with low incomes (≤130% of the federal poverty level) in NHANES (2011-2014). MAIN OUTCOME MEASURES: Self-reported intake of calories, solid fats, added sugars, and servings of nonstarchy vegetables, whole fruits, and whole grains was assessed by food source in SNAP participants and income-eligible nonparticipants. STATISTICAL ANALYSIS: Multivariate linear regression was used for each outcome, controlling for relevant sociodemographic characteristics. Data were stratified by food source, including grocery stores, sit-down restaurants, and fast food. RESULTS: SNAP participants had a higher intake of solid fats and added sugar from AH foods than nonparticipants. Added sugar from AH food accounted for 15.3% of total calories consumed by SNAP participants, compared with 11.8% for nonparticipants (P<0.001). SNAP participants consumed fewer calories from sit-down restaurants, but both groups consumed similar amounts of calories from fast food. Consumption of nonstarchy vegetables, whole fruits, and whole grains was low for both groups. CONCLUSIONS: SNAP participants had poorer diet quality from consumption of AH food than did nonparticipants. Future research should focus on interventions to improve the healthfulness of grocery store purchases as a mechanism to improve dietary quality of SNAP participants.