Consumer Acceptance and Market Potential of Iodine-Biofortified Fruit and Vegetables in Germany.

Biofortification of food crops with iodine is a novel approach to preventing iodine deficiency in humans. The present study analyses the consumer target groups and the market potential of iodine-biofortified fruit and vegetables in Germany. For this purpose, an online survey of 1016 German fruit and vegetable consumers was conducted to investigate the acceptance of different product categories as well as relevant criteria for the market launch. The results show that iodine-biofortified fruit and vegetables are particularly attractive to consumers who purchase at farmers' markets, organic food shops, and farm stores. Out of this group, 39% of consumers rate such iodine-rich foods as very appealing. They attach importance to food that naturally contains iodine and prefer produce from integrated domestic cultivation. With their focus on sustainability and naturalness, this group of consumers clearly differs from typical users of dietary supplements, who are primarily concerned with health benefits. However, overall about 85% of respondents would prefer biofortified fruits and vegetables to supplements to improve their iodine supply. The greatest market potential for iodine-biofortified fruit and vegetables is to be expected in supermarkets, as this is the preferred food shopping location for most consumers. A total of 28% of those who buy here rate the biofortified foods presented as very appealing. Nevertheless, a successful market launch requires that the benefits of the new products are communicated according to the potential consumer group needs.

Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study.

Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children's diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children's fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013-2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents' perception of produce availability was associated with household F&V availability ratings (ß = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (ß = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (ß = -0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households.

Relationship between Prefecture-Level Yield of Not-for-Sale Fruits and Vegetables and Individual-Level Fruit and Vegetable Intake in Japan: A Cross-Sectional Study.

This study investigated the relationship between prefecture-level yield of not-for-sale fruits and vegetables and individual-level fruit and vegetable intake in Japan. Data were drawn from the Japanese National Health and Nutrition Survey and National Crop Survey of 2016. Random intercept models were used for the analyses. Individual-level fruit and vegetable intake was used for the dependent variable, and prefecture-level yield of not-for-sale fruits and vegetables was used for the independent variable as a fixed effect. In addition, participants' characteristics and health-related factors at the individual level were also put into independent variables as fixed effects. The prefectures were used as random intercepts. It was found that prefecture-level yield of not-for-sale fruits and vegetables was significantly related to individual-level fruit and vegetable intake (vegetable: B = 0.390, p < 0.001; fruit: B = 0.268, p = 0.003; fruits and vegetables: B = 0.357, p < 0.001). These relationships were also significant in the gender-specific analysis. Thus, the yield of not-for-sale fruits and vegetables might contribute to the intake of fruits and vegetables in Japan.

Behavioural change box? Applying the COM-B model to understand behavioural triggers that support consumption of fruits and vegetable among subscribers of a fruit and vegetable box scheme.

OBJECTIVE: To understand the key mechanisms that support healthy dietary habits promoted by fruit and vegetable (F&V) box schemes, testing relevant behaviour change triggers identified under the COM-B model in an evaluation research study of a Portuguese F&V box scheme (PROVE). DESIGN: Correlation study with a post-test-only non-equivalent group design based on survey data. The mechanisms underpinning the differences between subscribers and non-subscribers are operationalised as mediation effects. Data availability, theoretical relevance and empirical validation supported the selection and testing of four potential mediators for the effects of subscribing to the box scheme on F&V consumption. These estimations derive from the coefficients of a structural equation model combined with the product coefficient approach and Sobel test. SETTING: The study is part of a wider evaluation study on the impact of the PROVE box scheme on sustainability, health and equity. PARTICIPANTS: A sample of PROVE box subscribers (n 294) was compared with a matched subsample of non-subscribers (n 571) in a nationally representative survey. RESULTS: Subscribing to the PROVE box correlates with an increased probability of eating at least five portions of F&V, irrespective of differences in age, education and perceived economic difficulties. Diet quality perceptions, and more robustly, the strength of meal habits and household availability were identified as relevant mediators. CONCLUSIONS: The subscription to an F&V box scheme is connected with proximal context that enables the consumption of F&V by ensuring more readily available F&V and better situational conditions associated with healthier meal habits.

Changes in food pricing and availability on the Navajo Nation following a 2% tax on unhealthy foods: The Healthy Diné Nation Act of 2014.

INTRODUCTION: In 2014, the Navajo Nation Healthy Diné Nation Act (HDNA) was passed, combining a 2% tax on foods of 'minimal-to-no-nutritional value' and waiver of 5% sales tax on healthy foods, the first-ever such tax in the U.S. and globally among a sovereign tribal nation. The aim of this study was to measure changes in pricing and food availability in stores on the Navajo Nation following the implementation of the HDNA. METHODS: Store observations were conducted in 2013 and 2019 using the Nutrition Environment Measurement Survey-Stores (NEMS-S) adapted for the Navajo Nation. Observations included store location, type, whether healthy foods or HDNA were promoted, and availability and pricing of fresh fruits and vegetables, canned items, beverages, water, snacks and traditional foods. Differences between 2013 and 2019 and by store type and location were tested. RESULTS: The matched sample included 71 stores (51 in the Navajo Nation and 20 in border towns). In 2019, fresh produce was available in the majority of Navajo stores, with 71% selling at least 3 types of fruit and 65% selling at least 3 types of vegetables. Compared with border town convenience stores, Navajo convenience stores had greater availability of fresh vegetables and comparable availability of fresh fruit in 2019. The average cost per item of fresh fruit decreased by 13% in Navajo stores (from $0.88 to $0.76) and increased in border stores (from $0.63 to $0.73), resulting in comparable prices in Navajo and border stores in 2019. While more Navajo stores offered mutton, blue corn and wild plants in 2019 compared to 2013, these changes were not statistically significant. DISCUSSION: The findings suggest modest improvements in the Navajo store environment and high availability of fruits and vegetables. Navajo stores play an important role in the local food system and provide access to local, healthy foods for individuals living in this rural, tribal community.

Agricultural cooperatives participating in vegetable supply chain integration: A case study of a trinity cooperative in China.

Supply chain integration plays an important role in the development of the vegetable industry in terms of vegetable quality, vegetable safety, and vegetable security in rural China. This paper explores how agricultural cooperatives integrate the vegetable supply chain by taking a trinity cooperative as an example in China. It explains the translation concatenation of supply chain integration for this cooperative by constructing actor networks in four development stages, including the seed stage, start-up stage, development stage, and mature stage. The findings show that supply chain integration in production cooperation, supply & sales cooperation, and credit cooperation is a useful trinity cooperative model of supply chain integration for investigating vegetable supply chain integration through internal integration and external integration. This paper suggests that cooperatives in the vegetable supply chain should facilitate close coordination among different shareholders and further improve the efficiency of supply chain integration. The government should provide training opportunities and funding to encourage cooperatives to participate in supply chain integration within the vegetable industry.

Farming System for Nutrition-a pathway to dietary diversity: Evidence from India.

Farming is the main livelihood of a majority of people in India. The country is also home to a large population of undernourished people. This indicates potential for mainstreaming the nutrition dimension in the farming system to impact on nutrition outcomes. A Farming System for Nutrition (FSN) study was conducted in two agro-ecologically different locations from 2013-2018, to explore the feasibility of nutrition-sensitive agricultural interventions. The baseline survey in 2013-2014 revealed that the population in the study area was largely undernourished and that household diets were cereal-dominated. The FSN model was designed in consultation with community members, to increase availability of nutrient-dense cereals and pulses, by enhancing production and crop diversification at the farm level, promoting cultivation of nutrient-rich fruits and vegetables in nutrition gardens and supporting interventions to promote access to animal foods. Nutrition awareness initiatives were undertaken to build capacity at the local level and translate production diversity to consumption diversity. An endline survey was conducted in 2017 (July-October), following three years of intervention. Crop, vegetable and animal food production and food consumption was compared with the baseline data. There was evidence of higher production and consumption of nutrient rich foods, improved household dietary diversity; and understanding and acceptance of nutrition-sensitive agriculture. The number of items consumed under each food group, frequency of consumption of food and average per capita intake of nutrient-rich foods were found to have improved. The results provide evidence regarding feasibility of location-specific FSN models to promote sustainable and healthy diets, using locally available plant and animal food resources, to address nutrition deficiencies in farm families.

Recent Trends in Dietary Habits of the Italian Population: Potential Impact on Health and the Environment.

Population growth, globalization, urbanization, and economic pressures are causing changes in food consumption all over the world. The study's aims are (1) to evaluate trends in food habits in Italy to highlight deviations from the traditional Mediterranean diet, (2) to analyze the features of the present Italian diet that should be modified to meet evidence-based global scientific targets for a healthy and sustainable diet proposed by the EAT-Lancet Commission. Trends in food availability for human consumption during the period 2000-2017 were assessed using the food balance sheets (FBSs). Greenhouse gas (GHG) emission was estimated according to life cycle assessment (LCA) analyses. During the study period, the availability of animal fat and beef meat greatly declined (-58% and -32%, respectively), followed by fruit, potatoes, vegetables, milk, and non-tropical oils (-20%, -15%, -13%, -14%, and -11%, respectively). A substantial increase has occurred for tropical oils, fish, and nuts (+156, +26%, and +21%, respectively). In order to meet the targets of consumption proposed by the EAT-Lancet Commission, the consumption of legumes and nuts should be almost doubled, whereas the consumption of meat, eggs, dairy products, animal fat, tropical oils, and sugars should be reduced by proportions ranging from 60% to 90%. If implemented, these changes would reduce the diet-related greenhouse gas emission by nearly 50%. In conclusion, these data call for nutritional education programs and interventions on the food system aimed at promoting a healthier and more environmentally sustainable diet. To this end, the availability and affordability of products with a better impact on human health and the environment should be promoted.

Pilot Study of a Farm-to-Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Intervention Promoting Vegetable Consumption.

BACKGROUND: Vegetable intake is below recommended levels among adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). OBJECTIVE: The aim of this study was to determine whether a novel, theory-driven, farm-to-WIC intervention to promote vegetable intake showed promise of being successful and is therefore appropriate for efficacy testing. DESIGN: From June 2019 to January 2020, the intervention was piloted in three WIC agency sites (one randomized to the intervention study group and two to the control group) selected based on similarity in size and the demographics of participants served. PARTICIPANTS/SETTING: Recruited between June 3, 2019 and August 1, 2019, participants were 297 primarily Hispanic adults served by a large WIC agency located in a densely populated urban area in New Jersey (160 were enrolled at the intervention site and 137 at control sites). INTERVENTION: The intervention combined behaviorally focused instruction and handouts with the introduction of a WIC-based farmers' market, field trips to an area farmers' market, telephone coaching and support before and after trips, and recipe demonstrations and tastings. MAIN OUTCOME MEASURES: The primary outcomes were vegetable intake (measured objectively using dermal carotenoids as a biomarker of intake and via self-report) and the redemption of vouchers provided through the WIC Farmers' Market Nutrition Program (FMNP) for fruit and vegetable purchases at farmers' markets (objectively assessed using data provided by WIC). STATISTICAL ANALYSES PERFORMED: Between-group differences in vegetable intake were examined at mid- and post-intervention (3 and 6 months post-baseline, respectively) with linear mixed-effects models adjusted for baseline vegetable intake and covariates. Logistic regression analysis was used to relate FMNP voucher redemption to study group and covariates. RESULTS: At mid-intervention, objectively measured vegetable intake was higher among participants in the control group as compared with the intervention group; self-reported intake did not differ by group. Post-intervention, objectively measured and self-reported vegetable intake were higher among participants in the intervention group as compared with the control group. Receipt of the intervention was associated with a greater likelihood of FMNP voucher redemption. Voucher redemption rates were 87% in the intervention group and 28% in the control group (odds ratio = 17.39, 95% confidence interval [8.64, 35.02]). CONCLUSIONS: Meaningful associations found between the intervention, vegetable intake, and FMNP voucher redemption suggest that the program is appropriate for efficacy testing.

Effect of Neighborhood Food Environment and Socioeconomic Status on Serum Phosphorus Level for Patients on Chronic Dialysis.

BACKGROUND: Elevated blood phosphorus levels are common and associated with a greater risk of death for patients receiving chronic dialysis. Phosphorus-rich foods are prevalent in the American diet, and low-phosphorus foods, including fruits and vegetables, are often less available in areas with more poverty. The relative contributions of neighborhood food availability and socioeconomic status to phosphorus control in patients receiving dialysis are unknown. METHODS: Using longitudinal data from a national dialysis provider, we constructed hierarchical, linear mixed-effects models to evaluate the relationships between neighborhood food environment or socioeconomic status and serum phosphorus level among patients receiving incident dialysis. RESULTS: Our cohort included 258,510 patients receiving chronic hemodialysis in 2005-2013. Median age at dialysis initiation was 64 years, 45% were female, 32% were Black, and 15% were Hispanic. Within their residential zip code, patients had a median of 25 "less-healthy" food outlets (interquartile range, 11-40) available to them compared with a median of four "healthy" food outlets (interquartile range, 2-6). Living in a neighborhood with better availability of healthy food was not associated with a lower phosphorus level. Neighborhood income also was not associated with differences in phosphorus. Patient age, race, cause of ESKD, and mean monthly dialysis duration were most closely associated with phosphorus level. CONCLUSIONS: Neither neighborhood availability of healthy food options nor neighborhood income was associated with phosphorus levels in patients receiving chronic dialysis. Modifying factors, such as nutrition literacy, individual-level financial resources, and adherence to diet restrictions and medications, may be more powerful contributors than food environment to elevated phosphorus.

FEEDING PRACTICES IN THE FIRST YEAR OF LIFE: CHALLENGES TO FOOD AND NUTRITION POLICIES.

OBJECTIVE: To evaluate the feeding practices for infants under one year of age, according to food and nutrition policies. METHODS: This is a descriptive cross-sectional study based on secondary data from the Chamada Neonatal project (research on prenatal, childbirth, and infant care) in the state of Rio Grande do Norte. The sample analyzed comprised 837 mother/child (under one year of age) pairs. We found a prevalence of data on exclusive breastfeeding (EBF) in the first hour of life - partial and total -, as well as on food consumed by children 24 hours prior to the interview. We estimated the probability of consumption according to the child's age in days using the probit analysis. RESULTS: Among the interviewed mothers, 64.8% (95%CI 62.4-70.8) declared breastfeeding in the first hour of life, and 60% (95%CI 56.41-63.07) of the children were still breastfed at the end of their first year of life. The median duration of EBF was 63 days (95%CI 60-67). Water or tea, dairy products, fruits, and vegetables were introduced early, with medians lower than 180 days. The probit analysis revealed that the consumption of breast milk tended to decrease and food intake to increase as the child gets older, with exponential growth in the "unhealthy food" group. CONCLUSIONS: Although most children were breastfed up to one year of life, few did so exclusively. Foods were introduced early, with increased consumption of unhealthy ones, resulting in inadequate dietary quality according to recommendations from food and nutrition public policies.

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Disparities in Access to Healthy Diets: How Food Security and Food Shopping Behaviors Relate to Fruit and Vegetable Intake.

BACKGROUND: Food shopping behaviors may help determine how local food environments influence fruit and vegetable (F/V) intake, especially among food insecure households. OBJECTIVE: To examine whether household food security, food access, and food shopping behaviors are associated with F/V intake among residents of a low-income neighborhood. DESIGN: Study design is cross-sectional. PARTICIPANTS/SETTING: A simple random sample of 451 adults from a low-income neighborhood in Montreal (Canada) were recruited through telephone interviews in 2014. Final analyses included 417 participants. MAIN OUTCOME MEASURES: Validated assessment tools were applied to measure F/V intake and to distinguish food secure (FS) from food insecure (FI) participants. Neighborhood food access was calculated according to number of food stores within 0.5 miles of road network buffer of participants' homes. Self-reported food shopping behaviors included trip frequency, store types, and transport used to reach the 3 most frequented stores. Participants also reported on mobility constraints, use of F/V markets, gardening, and perceived access to healthy food. STATISTICAL ANALYSES: F/V intake was modeled using multivariable linear regression. RESULTS: A sample of adults, of whom 21.3% were living in FI households, reported consuming F/V an average of 4.1 times daily. FI participants had a lower intake of F/V (b = -0.69, P = .04), independent of sociodemographics, food access, resource constraints, perceived access to healthy food, and food shopping behaviors. Participants with mobility constraints had lower F/V intake (b = -0.68, P = .02), while gardening was associated with higher F/V intake (b = 0.59, P = .01). Number of supermarkets (b = -0.06, P = .03) and specialty stores (b = 0.10, P = .04) were associated with F/V intake, although the strength of the association was weak. CONCLUSIONS: For FI households, barriers to food access linked to financial challenges are associated with lower intake of F/V. Studies on food environment should include people's experience of food access to better understand the numerous barriers to F/V consumption faced by FI households.

Definitions, Sources and Self-Reported Consumption of Regionally Grown Fruits and Vegetables in Two Regions of Australia.

Regional food systems are complex networks, with numerous retail sources that underpin a local economy. However, evidence is limited regarding how consumers define, identify, and source regionally grown fresh fruits and vegetables (RGFFV). A cross-sectional study was conducted in Tasmania (TAS) and South Western Australia (SWA) to compare how RGFFV are defined, identified and sourced by consumers, including self-reported consumption of selected RGFFV. Survey data were analyzed using the Chi-square test and t-tests. Results (TAS n = 120, SWA n = 123) identified that consumers had mixed perceptions of how RGFFV are defined, including produce sold at farmers markets, or grown within their region (TAS/SWA). RGFFV were commonly identified using product labelling (55% TAS, 69% SWA; p > 0.05). Respondents reported frequently shopping for RGFFV at major supermarkets, with more TAS respondents shopping weekly in comparison to SWA respondents (67% vs. 38%; p < 0.001). Supermarkets offered convenience and consumers enjoyed the experience of farmers' markets, especially in TAS (42%) in comparison to SWA (21%; p = 0.012). The major RGFFV consumed were root vegetables and apples/pears, but consumers were frequently unsure about the produce's provenance. Our findings indicate multiple opportunities to improve consumption of fresh, regional produce in TAS and SWA, which may positively impact regional economic growth and community health.

The complexities of selling fruits and vegetables in remote Navajo Nation retail outlets: perspectives from owners and managers of small stores.

OBJECTIVE: Navajo Nation residents experience extreme rates of poverty, food insecurity and diet-related diseases. While many residents travel far to shop at grocery stores, there are small stores closer to home that could provide more healthy options, like fruits and vegetables (F&V). Little is known from the perspective of store owners and managers regarding the barriers and facilitators to offering F&V; the present study contributes to filling that gap. DESIGN: Data were collected through structured interviews from a sampling frame of all store owners or managers in the setting (n 29). SETTING: Small stores in Navajo Nation, New Mexico, USA. Navajo Nation is predominantly rural and the largest federally recognized Native American tribe in the USA. PARTICIPANTS: Sixteen managers and six owners at twenty-two stores. RESULTS: When asked about the types of foods that were most commonly purchased at their stores, most participants reported snacks and drinks (82 and 68 %, respectively). Many participants reported they would like to offer more fresh F&V. However, barriers included varying perceived customer demand, limited F&V choices from distributors and (for some managers) limited authority over product selection. CONCLUSIONS: Findings contribute to the discussion on engaging store owners and managers in providing quality, healthy foods close to home in low-income, rural regions.

Effects of a kindergarten intervention on vegetables served and staff's food-related practices: results of a cluster randomised controlled trial - the BRA study.

OBJECTIVE: The aim of the current study was to evaluate the effect on frequency, variety and amount of vegetables served and staff's food-related practices in the multicomponent BRA intervention. DESIGN: Cluster randomised controlled trial, conducted between Spring 2015 and Spring 2016. For allocation of the kindergartens, a stratified block randomisation was used. Data were collected in three ways: (i) a questionnaire for pedagogical leaders assessing the variety and frequency of vegetables served, including staff's food-related practices assumed to be related to vegetable intake; (ii) a questionnaire for kindergarten assistants assessing staff's food-related practices; (iii) a 5-d weighted vegetable diary assessing amount of vegetables served in a department. SETTING: The target group for this study was public and private kindergartens in the counties of Vestfold and Buskerud, Norway. PARTICIPANTS: A total of seventy-three kindergartens participated. RESULTS: At follow-up I, the amount of vegetables served increased by approximately 20 g per person per day (P = 0·002), and the variety in served vegetables increased by one-and-a-half kind per month (P = 0·014) in the intervention group compared to the control group. No effects on the frequency of vegetables served or on staff's food-related practices were found. CONCLUSIONS: The BRA intervention was successful in increasing the amount and variety of vegetables served within intervention kindergartens. Further research is needed to understand the mechanisms that can affect the staff's food-related practices.

Urban organic community gardening to promote environmental sustainability practices and increase fruit, vegetables and organic food consumption / Prácticas agrícolas ecológicas urbanas para promover la sostenibilidad ambiental y aumentar el consumo de frutas, verduras y alimentos orgánicos

OBJECTIVE: To describe the environmental practices of participants in an urban organic community garden at the beginning of their gardening experience and after a period of six months, and to discover their opinion about how this activity influenced the consumption of vegetables, fruits and organic food. METHOD: Interviews using structured questionnaires were conducted twice with 115 city dwellers: when they started in the vegetable garden and about 6 months later. The questionnaire included questions related to environmental practices. The second evaluation also included questions related to the consumption of organic food, vegetables and fruit. RESULTS: This research showed significant behavioural transformation, including positive outcomes in environmental practices such as recycling and trying to persuade friends or family to recycle, compost leftovers or choose to walk/bike to save petrol. In the opinion of the participants, activities in the organic community garden helped to increase consumption of fruits, vegetables and organic food. CONCLUSIONS: The study results reinforce the hypothesis that an organic community vegetable garden can induce significant, positive behavioural changes among its users. In particular this research suggests horticulture is associated with positive improvements in personal environmental behaviours, awareness of the environment's high social priority and increased consumption of organic food, fruit and vegetables

OBJETIVO: Caracterizar las prácticas ambientales de los participantes de un jardín comunitario orgánico urbano al inicio de su experiencia en prácticas agrícolas y después de 6 meses, así como conocer su opinión sobre cómo esta actividad influyó en el consumo de verduras, frutas y alimentos orgánicos. MÉTODO: Las entrevistas con cuestionarios estructurados se realizaron dos veces a 115 habitantes de la ciudad: cuando comenzaron en la huerta y unos 6 meses después. El cuestionario incluyó preguntas relacionadas con las prácticas ambientales. La segunda evaluación incluyó también preguntas sobre el consumo de alimentos orgánicos, verduras y frutas. RESULTADOS: Se observó una transformación conductual significativa, incluidos resultados positivos en prácticas ambientales como el reciclaje e intentar que amigos o familiares reciclen, la composta de sobras o elegir caminar o ir en bicicleta para ahorrar gasolina. En opinión de los participantes, las prácticas agrícolas de la comunidad orgánica contribuyeron a aumentar el consumo de frutas, verduras y alimentos orgánicos. CONCLUSIÓN: Los resultados del estudio refuerzan la hipótesis de que un huerto comunitario orgánico puede inducir cambios conductuales significativos entre sus usuarios. En particular, esta investigación sugiere que la horticultura se asocia con mejoras positivas en los comportamientos ambientales y la conciencia de la alta prioridad social del medio ambiente y un mayor consumo de alimentos orgánicos, frutas y verduras

Written Nutrition Guidelines, Client Choice Distribution, and Adequate Refrigerator Storage Are Positively Associated with Increased Offerings of Feeding America's Detailed Foods to Encourage (F2E) in a Large Sample of Arkansas Food Pantries.

BACKGROUND: Millions of food-insecure households in the United States obtain food from food pantries each year. These foods are often of insufficient nutritional quality. OBJECTIVE: Our aim was to describe the frequency with which Arkansas food pantries offer foods included in Feeding America's Detailed Foods to Encourage (F2E) framework, and examine food pantry characteristics associated with increased frequency of offering F2E and other foods. DESIGN: This was a 27-item cross-sectional online survey that assessed food pantries' characteristics (eg, storage capacities, number of clients served) and typical food offerings. PARTICIPANTS/SETTING: Partnering with five of Arkansas's six food banks, 764 e-mail invitations were sent to food agency managers across the state. A final sample of 357 food pantries was included in the analyses. MAIN OUTCOME MEASURES: The primary outcomes of interest were the frequencies of offering specific F2E and F2E in general. The F2E framework was developed by Feeding America to more accurately assess food banks' inventories, and its categories (Fruits and Vegetables; Protein; Dairy; and Grains) are generally consistent with MyPlate. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were computed for all food pantry characteristics and frequency of foods offered. Associations between food pantry characteristics and the frequency of offering F2E were examined via multiple linear regression and path analysis. RESULTS: Only 18.5% of food pantries had written nutrition guidelines, and only 19.3% offered client choice distribution. The F2E most commonly offered were meat/poultry/seafood without breading and not fried (59.6%) and peanut butter (58.2%). The least commonly offered F2E were nuts/seeds with nothing added (3.8%) and low-fat/1%/skim cheese (8.2%). Written nutrition guidelines (P<0.001), client choice distribution (P=0.003), and adequate refrigerator storage (P=0.010) were associated with more frequently offering F2E. CONCLUSIONS: This study fills a gap in knowledge by documenting food pantry characteristics that are associated with the frequencies of offering specific types of healthy foods.

Association of Food Access, Recreational Opportunities, and Natural Amenities with Engagement in the Veterans MOVE! Weight Management Program.

OBJECTIVE: The aim of this study was to examine the association of county-level food access, recreational opportunities, and natural amenities with participant engagement in a weight management program. METHODS: In this cohort study, participants in the Veterans Health Administration MOVE! weight management program between October 1, 2007, and September 30, 2013, were observed for 12 months after enrollment. Engagement was measured as the number of program visits per year at 12 months. Cross-sectional analysis and spatial regression were used to examine county characteristics associated with greater participant engagement at 12 months. RESULTS: A total of 321,624 participants in 2,708 counties were included. Greater engagement was associated with older age, female sex, white race, being married, and being retired. After accounting for similarities between nearby communities, engagement at 12 months was 3.1 visits higher for each additional farmers' market per 1,000 population (P = 0.01). Engagement was highest for participants living in counties with the most natural amenities (P < 0.001). Recreational opportunities had only a small effect on engagement in the program (ß = 0.02 visits at 12 months; P = 0.002). CONCLUSIONS: Consideration of a participant's county characteristics in addition to other known demographics and program factors may help to explain variation in engagement in weight management programs.