Biodiversity effects of food system sustainability actions from farm to fork.

Diet shifts and food waste reduction have the potential to reduce the land and biodiversity footprint of the food system. In this study, we estimated the amount of land used to produce food consumed in the United States and the number of species threatened with extinction as a result of that land use. We predicted potential changes to the biodiversity threat under scenarios of food waste reduction and shifts to recommended healthy and sustainable diets. Domestically produced beef and dairy, which require vast land areas, and imported fruit, which has an intense impact on biodiversity per unit land, have especially high biodiversity footprints. Adopting the Planetary Health diet or the US Department of Agriculture (USDA)­recommended vegetarian diet nationwide would reduce the biodiversity footprint of food consumption. However, increases in the consumption of foods grown in global biodiversity hotspots both inside and outside the United States, especially fruits and vegetables, would partially offset the reduction. In contrast, the USDA-recommended US-style and Mediterranean-style diets would increase the biodiversity threat due to increased consumption of dairy and farmed fish. Simply halving food waste would benefit global biodiversity more than half as much as all Americans simultaneously shifting to a sustainable diet. Combining food waste reduction with the adoption of a sustainable diet could reduce the biodiversity footprint of US food consumption by roughly half. Species facing extinction because of unsustainable food consumption practices could be rescued by reducing agriculture's footprint; diet shifts and food waste reduction can help us get there.

Optimizing portion-size estimation aids: a formative evaluation in Malawi.

OBJECTIVE: To investigate preferences for and ease-of-use perceptions of different aspects of printed and digitally displayed photographic portion-size estimation aids (PSEA) in a low-resource setting and to document accuracy of portion-size selections using PSEA with different visual characteristics. DESIGN: A convergent mixed-methods design and stepwise approach were used to assess characteristics of interest in isolation. Participants served themselves food and water, which were weighed before and after consumption to measure leftovers and quantity consumed. Thirty minutes later, data collectors administered a meal recall using a PSEA and then a semi-structured interview. SETTING: Blantyre and Chikwawa Districts in the southern region of Malawi. PARTICIPANTS: Ninety-six women, aged 18-45 years. RESULTS: Preferences and ease-of-use perceptions favoured photographs rather than drawings of shapes, three and five portion-size options rather than three with four virtual portion-size options, a 45° rather than a 90° photograph angle, and simultaneous rather than sequential presentation of portion-size options. Approximately half to three-quarters of participants found the portion-size options represented appropriate amounts of foods or water consumed. Photographs with three portion sizes resulted in more accurate portion-size selections (closest to measured consumption) than other format and number of portion-size option combinations. A 45° angle and simultaneous presentation were more accurate than a 90° angle and sequential presentation of images. CONCLUSIONS: Results from testing PSEA visual characteristics separately can be used to generate optimal PSEA, which can improve participants' experiences during meal recalls.

Using Trials of Improved Practices to identify practices to address the double burden of malnutrition among Rwandan children.

OBJECTIVE: Low- and middle-income countries (LMIC) are increasingly experiencing the double burden of malnutrition. Studies to identify 'double-duty' actions that address both undernutrition and overweight in sub-Saharan Africa are needed. We aimed to identify acceptable behaviours to achieve more optimal feeding and physical activity practices among both under- and overweight children in Rwanda, a sub-Saharan LMIC with one of the largest recent increases in child overweight. DESIGN: We used the Trials of Improved Practices (TIPs) method. During three household visits over 1·5 weeks, we used structured interviews and unstructured observations to collect data on infant and young child feeding practices and caregivers' experiences with testing recommended practices. SETTING: An urban district and a rural district in Rwanda. PARTICIPANTS: Caregivers with an under- or overweight child from 6 to 59 months of age (n 136). RESULTS: We identified twenty-five specific recommended practices that caregivers of both under- and overweight children agreed to try. The most frequently recommended practices were related to dietary diversity, food quantity, and hygiene and food handling. The most commonly cited reason for trying a new practice was its benefits to the child's health and growth. Financial constraints and limited food availability were common barriers. Nearly all caregivers said they were willing to continue the practices and recommend them to others. CONCLUSIONS: These practices show potential for addressing the double burden as part of a broader intervention. Still, further research is needed to determine whether caregivers can maintain the behaviours and their direct impact on both under- and overweight.

Validation of a digitally displayed photographic food portion-size estimation aid among women in urban and rural Malawi.

OBJECTIVE: To validate digitally displayed photographic portion-size estimation aids (PSEA) against a weighed meal record and compare findings with an atlas of printed photographic PSEA and actual prepared-food PSEA in a low-income country. DESIGN: Participants served themselves water and five prepared foods, which were weighed separately before the meal and again after the meal to measure any leftovers. Participants returned the following day and completed a meal recall. They estimated the quantities of foods consumed three times using the different PSEA in a randomized order. SETTING: Two urban and two rural communities in southern Malawi. PARTICIPANTS: Women (n 300) aged 18-45 years, equally divided by urban/rural residence and years of education (≤4 years and ≥5 years). RESULTS: Responses for digital and printed PSEA were highly correlated (>91 % agreement for all foods, Cohen's κw = 0·78-0·93). Overall, at the individual level, digital and actual-food PSEA had a similar level of agreement with the weighed meal record. At the group level, the proportion of participants who estimated within 20 % of the weighed grams of food consumed ranged by type of food from 30 to 45 % for digital PSEA and 40-56 % for actual-food PSEA. Digital PSEA consistently underestimated grams and nutrients across foods, whereas actual-food PSEA provided a mix of under- and overestimates that balanced each other to produce accurate mean energy and nutrient intake estimates. Results did not differ by urban and rural location or participant education level. CONCLUSIONS: Digital PSEA require further testing in low-income settings to improve accuracy of estimations.

Perceived stress, unhealthy eating behaviors, and severe obesity in low-income women.

BACKGROUND: Stress has been associated with poor eating behaviors and diet quality, as well as high body mass index (BMI). Low-income women may be particularly vulnerable to stress and severe obesity. Yet it is unknown how stress increases the risk of severe obesity through disordered eating behaviors and poor diet quality or through mechanisms independent of diet. METHODS: We examined cross-sectional data from women (n = 101) with a child enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children in Cumberland County, North Carolina (spring 2012). We collected measured heights and weights to calculate BMI. Using structural equation modeling, we differentiated pathways from stress to weight status: (1) indirectly through eating behaviors (cognitive restraint, emotional eating, and uncontrolled eating) and diet quality, which we examined with the Healthy Eating Index 2010 and 24-h dietary recalls, and (2) directly through possible unmeasured risk factors independent of diet. The analysis controlled for race/ethnicity, income, age, whether the dietary recall day was typical, and whether the respondent completed one or two 24-h dietary recalls. RESULTS: Perceived stress was positively associated with uncontrolled eating (ß = 0.38, p < 0.001) and emotional eating (ß = 0.50, p < 0.001). However, higher stress was not associated with weight status through eating behaviors and diet quality. Independent of eating behaviors and diet quality, stress was positively associated with severe obesity (ß = 0.26, p = 0.007). CONCLUSIONS: Improving stress coping strategies for low-income women may improve eating behaviors and reduce severe obesity.

Analysis of the Costs and Economic Feasibility of Requiring Postharvest Processing for Raw Oysters.

Because of concerns about Vibrio vulnificus, the U.S. Food and Drug Administration is considering requirements for postharvest processing (PHP) of oysters harvested from the Gulf of Mexico during warm-weather months and intended for raw consumption. As described in the paper, feasible PHP methods for warm-weather-harvested oysters include cool pasteurization, high hydrostatic pressure, and low-dose gamma-irradiation. We estimate that the costs of applying PHP are approximately 5 to 6 cents per half-shell oyster intended for raw consumption. However, most oyster processors have insufficient volumes to cost-effectively install PHP equipment. To assist these smaller operations, central PHP facilities operated by a 3rd party would be needed. A geographic information system analysis that minimized volume-weighted travel distances from each Gulf oyster operation identified 6 optimal PHP facility locations in the Gulf region. Even with the establishment of central PHP facilities, some oyster operations will become unprofitable and be at risk for closure.

Assessing the environmental impacts of halving food loss and waste along the food supply chain.

Reducing food loss and waste (FLW) is widely recognized as an important lever for lowering the environmental impacts of food systems. The United Nations Sustainable Development Agenda includes a goal to reduce FLW by 50% by 2030. Given differences in resource inputs along the food supply chain (FSC), the environmental benefits of FLW reduction will vary by stage of the FSC. Here, we identify the points along the supply chain where a 50% FLW reduction could yield the largest potential environmental benefits, assuming that decreases in consumption propagate back up the supply chain to reduce production. We use an environmentally extended input-output (EEIO) model combined with data on rates of FLW to calculate the scale of the total environmental impacts of the U.S. food system resulting from lost or wasted food. We evaluate the maximum potential environmental benefit resulting from 50% FLW reduction at all possible combinations of six supply chain stages (agricultural production, food processing, distribution/retail, restaurant foodservice, institutional foodservice, and households). We find that FLW reduction efforts should target the foodservice (restaurant) sector, food processing sector, and household consumption. Halving FLW in the foodservice sector has the highest potential to reduce greenhouse gas output and energy use. Halving FLW in the food processing sector could reduce the most land use and eutrophication potential, and reducing household consumption waste could avert the most water consumption. In contrast, FLW reduction at the retail, institutional foodservice, and farm level averts less environmental impact. Our findings may help determine optimal investment in FLW reduction strategies.

Analysis of Salmonella control performance in U.S. young chicken slaughter and pork slaughter establishments.

In the 1996 U.S. Food Safety and Inspection Service's (FSIS) "Pathogen Reduction; Hazard Analysis and Critical Control Point (PR/HACCP) Systems, Final Rule," Salmonella was selected for microbiological testing and monitoring. Using data from an FSIS-sponsored survey of meat and poultry slaughter establishments, inspection results, and other establishment characteristics, potential variables affecting pathogen control, as measured by Salmonella test results, were investigated. The analysis data sets included 153 federally inspected young chicken slaughter establishments, of which 111 exceeded half the Salmonella performance standard at least once from 2003 through 2005, and 121 federally inspected pork slaughter establishments, of which 28 exceeded half the Salmonella performance standard. Logistic regression results for young chicken slaughter establishments indicate they were more likely to exceed half the standard if they had higher inspection noncompliance rates (P = 0.10) and older production space (P = 0.10), and were less likely to exceed it if they used a higher percentage of raw poultry inputs purchased from outside sources (P = 0.10). Results for pork slaughter establishments indicate they were more likely to exceed half the standard if they had a higher rate of voluntary microbiological testing (P = 0.08), and were less likely to exceed it if they were larger (P = 0.08) and used a higher percentage of raw pork inputs purchased from outside sources (P = 0.02). In general, indicators of plant characteristics, food safety practices, and management philosophy are associated with different levels of pathogen control performance that vary by species slaughtered.

Certified kitchen managers: do they improve restaurant inspection outcomes?

Restaurants are associated with a significant number of foodborne illness outbreaks in the United States. Certification of kitchen managers through an accredited training and testing program may help improve food safety practices and thus prevent foodborne illness. In this study, relationships between the results of routine restaurant inspections and the presence of a certified kitchen manager (CKM) were examined. We analyzed data for 4461 restaurants in Iowa that were inspected during 2005 and 2006 (8338 total inspections). Using logistic regression analysis, we modeled the outcome variable (0 = no critical violations [CVs]; 1 = one or more CVs) as a function of presence or absence of a CKM and other explanatory variables. We estimated separate models for seven inspection categories. Restaurants with a CKM present during inspection were less likely to have a CV for personnel (P < 0.01), food source or handling (P < 0.01), facility or equipment requirements (P < 0.05), ware-washing (P < 0.10), and other operations (P < 0.10). However, restaurants with a CKM present during inspection were equally likely to have a CV for temperature or time control and plumbing, water, or sewage as were restaurants without a CKM present. Analyses by type of violation within the temperature and time control category revealed that restaurants with a CKM present during inspection were less likely to have a CV for hot holding (P < 0.05), but the presence of a CKM did not affect other types of temperature and time control violations. Our analyses suggest that the presence of a CKM is protective for most types of CVs, and we identify areas for improving training of CKMs.

How Much Can Product Reformulation Improve Diet Quality in Households with Children and Adolescents?

Improvements in the healthfulness of packaged foods and beverages through reformulation could help reduce the prevalence of obesity among children and adolescents through improved diet quality. This study assessed changes in calories and four nutrients (saturated fat, total sugars, sodium, and dietary fiber) from 2012 through 2014 for packaged products frequently consumed by children and adolescents, simulated effects of potential improvements in 12 frequently consumed product categories based on actual purchasing patterns, and compared differences in prices of healthier versus less healthy products. Analysis of trends showed limited evidence that healthfulness of foods improved over the years examined. Simulation results showed minimal changes for calories and sodium, but daily intake of saturated fat could decrease by 4%, sugar consumption could decrease by 5%, and dietary fiber consumption could increase by 11% if products were reformulated to meet an existing healthfulness standard. Using a higher standard, caloric intake could decline by 4%, saturated fat by 6%, sugar by 9%, and sodium by 4%, and dietary fiber could increase by 14%. Healthier versions of most products ranged from an average of 3 to 12 cents more per serving, but not all healthier versions were more costly. Overall, reformulation is a potential avenue for improving diet quality in households with children and adolescents, but price could be a barrier to purchasing healthier products for some households.

A systems approach to assessing environmental and economic effects of food loss and waste interventions in the United States.

Reducing food loss and waste (FLW) is critical for achieving healthy diets from sustainable food systems. Within the United States, 30% to 50% of food produced is lost or wasted. These losses occur throughout multiple stages of the food supply chain from production to consumption. Reducing FLW prevents the waste of land, water, energy, and other resources embedded in food and is therefore essential to improving the sustainability of food systems. Despite the increasing number of studies identifying FLW reduction as a societal imperative, we lack the information needed to assess fully the effectiveness of interventions along the supply chain. In this paper, we synthesize the available literature, data, and methods for estimating the volume of FLW and assessing the full environmental and economic effects of interventions to prevent or reduce FLW in the United States. We describe potential FLW interventions in detail, including policy changes, technological solutions, and changes in practices and behaviors at all stages of the food system from farms to consumers and approaches to conducting economic analyses of the effects of interventions. In summary, this paper comprehensively reviews available information on the causes and consequences of FLW in the United States and lays the groundwork for prioritizing FLW interventions to benefit the environment and stakeholders in the food system.

Costs of Food Safety Investments in the Meat and Poultry Slaughter Industries.

To develop regulations efficiently, federal agencies need to know the costs of implementing various regulatory alternatives. As the regulatory agency responsible for the safety of meat and poultry products, the U.S. Dept. of Agriculture's Food Safety and Inspection Service is interested in the costs borne by meat and poultry establishments. This study estimated the costs of developing, validating, and reassessing hazard analysis and critical control points (HACCP), sanitary standard operating procedures (SSOP), and sampling plans; food safety training for new employees; antimicrobial equipment and solutions; sanitizing equipment; third-party audits; and microbial tests. Using results from an in-person expert consultation, web searches, and contacts with vendors, we estimated capital equipment, labor, materials, and other costs associated with these investments. Results are presented by establishment size (small and large) and species (beef, pork, chicken, and turkey), when applicable. For example, the cost of developing food safety plans, such as HACCP, SSOP, and sampling plans, can range from approximately $6000 to $87000, depending on the type of plan and establishment size. Food safety training costs from approximately $120 to $2500 per employee, depending on the course and type of employee. The costs of third-party audits range from approximately $13000 to $24000 per audit, and establishments are often subject to multiple audits per year. Knowing the cost of these investments will allow researchers and regulators to better assess the effects of food safety regulations and evaluate cost-effective alternatives.

Food Safety Practices in the U.S. Meat Slaughter and Processing Industry: Changes from 2005 to 2015.

Meat slaughter establishments use a multipronged approach to ensure beef and pork products are safe for human consumption. To determine the approaches most commonly used, we conducted a national survey of federally inspected meat slaughter and processing establishments (376 completed surveys, 66% response rate) in 2015. We compared the results with a survey that was conducted in 2005, albeit of potentially different establishments, by using a similar questionnaire and similar data collection methods, thus allowing for an evaluation of trends in food safety practices over time. The use of some food safety practices has increased over the 10-yr time period, whereas others remained the same or decreased. For example, the use of chemical sanitizers or hot water for food contact surfaces and tools increased from 51 to 93%. As another example, microbiological testing of raw meat after fabrication, in addition to that required by regulation, increased from 50 to 72%. However, the use of organic acid rinse on carcasses in the slaughter area remained the same, at 66% of establishments. Written policies and procedures to control the use of hazardous chemicals decreased from 75 to 65% of establishments. The survey findings can be used to characterize food safety practices and technologies in the meat slaughter and processing industry and identify areas for improvement.

Food Safety Practices in the Egg Products Industry.

We conducted a national census survey of egg product plants (n = 57) to obtain information on the technological and food safety practices of the egg products industry and to assess changes in these practices from 2004 to 2014. The questionnaire asked about operational and sanitation practices, microbiological testing practices, food safety training for employees, other food safety issues, and plant characteristics. The findings suggest that improvements were made in the industry's use of food safety technologies and practices between 2004 and 2014. The percentage of plants using advanced pasteurization technology and an integrated, computerized processing system increased by almost 30 percentage points. Over 90% of plants voluntarily use a written hazard analysis and critical control point (HACCP) plan to address food safety for at least one production step. Further, 90% of plants have management employees who are trained in a written HACCP plan. Most plants (93%) conduct voluntary microbiological testing. The percentage of plants conducting this testing on egg products before pasteurization has increased by almost 30 percentage points since 2004. The survey findings identify strengths and weaknesses in egg product plants' food safety practices and can be used to guide regulatory policymaking and to conduct required regulatory impact analysis of potential regulations.

Beyond the sticker price: including and excluding time in comparing food prices.

BACKGROUND: An ongoing debate in the literature is how to measure the price of food. Most analyses have not considered the value of time in measuring the price of food. Whether or not the value of time is included in measuring the price of a food may have important implications for classifying foods based on their relative cost. OBJECTIVE: The purpose of this article is to compare prices that exclude time (time-exclusive price) with prices that include time (time-inclusive price) for 2 types of home foods: home foods using basic ingredients (home recipes) vs. home foods using more processed ingredients (processed recipes). The time-inclusive and time-exclusive prices are compared to determine whether the time-exclusive prices in isolation may mislead in drawing inferences regarding the relative prices of foods. DESIGN: We calculated the time-exclusive price and time-inclusive price of 100 home recipes and 143 processed recipes and then categorized them into 5 standard food groups: grains, proteins, vegetables, fruit, and dairy. We then examined the relation between the time-exclusive prices and the time-inclusive prices and dietary recommendations. RESULTS: For any food group, the processed food time-inclusive price was always less than the home recipe time-inclusive price, even if the processed food's time-exclusive price was more expensive. Time-inclusive prices for home recipes were especially higher for the more time-intensive food groups, such as grains, vegetables, and fruit, which are generally underconsumed relative to the guidelines. CONCLUSION: Focusing only on the sticker price of a food and ignoring the time cost may lead to different conclusions about relative prices and policy recommendations than when the time cost is included.

Effects of front-of-package and shelf nutrition labeling systems on consumers.

As standards are considered for nutrition front-of-package (FOP) and shelf-labeling systems in the United States, it is important to know what types of systems are most effective in conveying scientifically accurate and useful information to consumers. A systematic literature review identified 38 empirical studies on consumer response to FOP nutrition labeling and shelf labeling. Studies indicate that consumers can more easily interpret and select healthier products with nutrient-specific FOP nutrition labels that incorporate text and symbolic color to indicate nutrient levels rather than nutrient-specific labels that only emphasize numeric information, such as Guideline Daily Amounts expressed as percentages and/or grams. Summary systems may influence consumers to purchase healthier products. However, more research is needed to assess the influence of nutrient-specific labels on consumers' purchases. This review identified few studies that compared consumers' ability to select healthier products using nutrient-specific systems that incorporate text and color codes with multiple-level summary icons. More research is needed to determine the effects of FOP nutrition labeling on consumers' actual shopping behaviors and dietary intakes.

A novel approach to selecting and weighting nutrients for nutrient profiling of foods and diets.

BACKGROUND: Nutrient profiling of foods is the science of ranking or classifying foods based on their nutrient composition. Most profiling systems use similar weighting factors across nutrients due to lack of scientific evidence to assign levels of importance to nutrients. OBJECTIVE: Our aim was to use a statistical approach to determine the nutrients that best explain variation in Healthy Eating Index (HEI) scores and to obtain ß-coefficients for the nutrients for use as weighting factors for a nutrient-profiling algorithm. DESIGN: We used a cross-sectional analysis of nutrient intakes and HEI scores. PARTICIPANTS: Our subjects included 16,587 individuals from the National Health and Nutrition Examination Survey 2005-2008 who were 2 years of age or older and not pregnant. MAIN OUTCOME MEASURE: Our main outcome measure was variation (R(2)) in HEI scores. STATISTICAL ANALYSES: Linear regression analyses were conducted with HEI scores as the dependent variable and all possible combinations of 16 nutrients of interest as independent variables, with covariates age, sex, and ethnicity. The analyses identified the best 1-nutrient variable model (with the highest R(2)), the best 2-nutrient variable model, and up to the best 16-nutrient variable model. RESULTS: The model with 8 nutrients explained 65% of the variance in HEI scores, similar to the models with 9 to 16 nutrients, but substantially higher than previous algorithms reported in the literature. The model contained five nutrients with positive ß-coefficients (ie, protein, fiber, calcium, unsaturated fat, and vitamin C) and three nutrients with negative coefficients (ie, saturated fat, sodium, and added sugar). ß-coefficients from the model were used as weighting factors to create an algorithm that generated a weighted nutrient density score representing the overall nutritional quality of a food. CONCLUSIONS: The weighted nutrient density score can be easily calculated and is useful for describing the overall nutrient quality of both foods and diets.

Analysis of the relationship between economic measures and Salmonella testing results in young chicken slaughter establishments.

Food processing establishments incur costs to install, maintain, and operate equipment and implement specific food safety practices. During times of economic recession, establishments might reduce their food safety efforts to conserve resources and reduce costs of operation. This study was conducted to determine whether financial performance measures are systematically associated with Salmonella test results. The association between Salmonella test results from 182 federally inspected young chicken slaughter establishments from 2007 to 2009 and financial performance was examined while controlling for other establishment characteristics. Results indicated that the smallest establishments, which slaughtered fewer than 0.2 million chickens per year, had three times as many positive test results as did the largest establishments, which slaughtered more than 86.0 million chickens per year (P < 0.01). Establishments that slaughtered more than 0.2 million but fewer than 18.5 million chickens had 1.5 times as many positive test results (P = 0.02). Two statistically significant financial performance measures were identified, but the effects were limited. Establishments in bankruptcy had 1.4 times as many positive test results as did those not in bankruptcy (P = 0.02); however, only five establishments were in bankruptcy. Establishments with better payment performance generally had better Salmonella test results, but the effect was significant only in the winter season.