School Nutrition Stakeholders Find Utility in MealSim: An Agent-Based Model.

OBJECTIVE: To obtain feedback from school nutrition stakeholders on an agent-based model simulating school lunch to inform model refinement and future applications. DESIGN: Qualitative study using online discussion groups. SETTING: School nutrition professional stakeholders across the US. PARTICIPANTS: Twenty-eight school nutrition stakeholders. PHENOMENON OF INTEREST: Perceptions and applicability of MealSim for school nutrition stakeholders to help reduce food waste. ANALYSIS: Deductive approach followed by inductive analysis of discussion group transcripts. RESULTS: Stakeholders appreciated the customizability of the cafeteria characteristics and suggested adding additional characteristics to best represent the school meal system, such as factors relating to school staff supervision of students during meals. The perceived utility of MealSim was high and included using it to train personnel and to advocate for policy and budgetary changes. However, they viewed MealSim as more representative of elementary than high schools. Stakeholders also provided suggestions for training school nutrition administrators on how to use MealSim and requested opportunities for technical assistance. CONCLUSIONS AND IMPLICATIONS: Although agent-based models were new to the school nutrition stakeholders, MealSim was viewed as a useful tool. Application of these findings will allow the model to meet the intended audience's needs and better estimate the system.

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

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

Consumer responses to rebranding to address racism.

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

Coping with the 2022 infant formula shortage.

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

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

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

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

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

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

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

The Efficacy and Cost-Effectiveness of Replacing Whole Apples with Sliced in the National School Lunch Program.

The National School Lunch Program (NSLP) serves 29.6 million lunches each day. Schools must offer ½ a cup of fruit for each lunch tray. Much of this fruit may be wasted, leaving the schools in a dilemma. The objectives of this study were to evaluate the consumption of whole vs. sliced apples and determine the cost-effectiveness of the intervention. Researchers weighed apple waste at baseline and three post-intervention time points in one rural Midwest school. The costs of the intervention were collected from the school. The cost-effectiveness analysis estimates how often apples need to be served to offset the costs of the slicing intervention. A total of (n = 313) elementary student students participated. Students consumed significantly more sliced as compared to whole apples in intervention months 3 (ß = 21.5, p < 0.001) and 4 (ß = 27.7, p < 0.001). The intervention cost was USD 299. The value of wasted apple decreased from USD 0.26 at baseline to USD 0.23 wasted at post-intervention. The school would need to serve 9403 apples during the school year (54 times) to cover the expenses of the intervention. In conclusion, serving sliced apples may be a cost-effective way to improve fruit consumption during school lunch.

Effects of Longer Seated Lunch Time on Food Consumption and Waste in Elementary and Middle School-age Children: A Randomized Clinical Trial.

Importance: Health experts recommend at least 20 minutes of seated lunch time for children, but no federal policy for lunch period duration exists in the United States. Additional strategies in the National School Lunch Program for mitigating food waste are needed to maintain the viability of the Healthy, Hunger-Free Kids Act. Objective: To assess the effect of a longer seated lunch time on food consumption and waste among elementary and middle school-age children. Design, Setting, and Participants: This randomized within-participant crossover trial was conducted from June 3 to June 28, 2019, for a total of 20 study days. All attendees of a summer camp held at the University of Illinois at Urbana-Champaign, were invited to participate in the study. Participants were elementary and middle school-age children and were provided every study day with lunch prepared according to the National School Lunch Program nutrition standards. Intervention: Five menus were served throughout the study. A 20-minute or 10-minute seated lunch condition was randomly assigned to each day within the 5 menus. Main Outcomes and Measures: The primary outcomes were food consumption, waste, and dietary intake, which were analyzed separately for each meal component (fruit, vegetable, entree [protein plus grain], beverage [both milk and water], and milk alone). Dietary intake was assessed for calories, fat, carbohydrates, fiber, protein, vitamin D, calcium, iron, and potassium. Participant behaviors were observed during the meal, including seated time as well as level of talking and phone use. Results: A total of 38 children with 241 lunch trays were observed. The 38 children had a mean (SD) age of 11.86 (1.23) years and 23 were female participants (61%); 30 had a non-Hispanic/non-Latino ethnicity (79%) and 23 were White individuals (61%). During 10 minutes of seated lunch time, participants consumed significantly less fruit (-11.3 percentage points; 95% CI, -18.1 to -4.5) and vegetables (-14.1 percentage points; 95% CI, -22.7 to -5.7) compared with 20 minutes of seated lunch time. Entree and beverage consumption and waste did not differ between the 10-minute and 20-minute seated lunch conditions. Participants also consumed significantly more and wasted significantly less calories (-22.03 kcal; 95% CI, -39.47 to -4.61 kcal), carbohydrates (-3.81 g; 95% CI, -6.20 to -1.42 g), dietary fiber (-0.51 g; 95% CI, -0.81 to -0.19 g), protein (-1.11 g; 95% CI, -2.17 to -0.04 g), iron (-0.20 mg; 95% CI, -0.38 to -0.02 mg), and potassium (-53.49 mg; 95% CI, -84.67 to -22.32 mg) during the 20-minute seated lunch condition. Conclusions and Relevance: This study found that fruit and vegetable consumption increased in school-age children during a 20-minute seated lunch condition. This finding supports policies that require children to receive at least 20 minutes of seated lunch time; such policies could have favorable implications for children's dietary intake and food waste. Trial Registration: ClinicalTrials.gov Identifier: NCT04191291.

Consumers' decisions to access or avoid added sugars information on the updated Nutrition Facts label.

The Nutrition Facts (NF) label was recently updated and now includes the added sugars content in an effort to reduce added sugars consumption. This study investigated whether consumers wanted to access or avoid the added sugars content using an online experiment and five product categories (yogurt, cereal, fruit juice, snack bar, ice cream). We recruited a sample of 490 U.S. adults (49% female; 73% White/Caucasian). Respondents were randomly assigned to an information treatment (simple or full) before making decisions on whether to access or avoid the added sugars content. The simple information treatment explained that added sugars information was now available on the NF label, while the full information treatment included additional details (e.g., how to interpret the added sugars content and associated diseases). After making the access or avoid decisions for each product category, respondents rated their likelihood of purchase for ten products (two per category). Rates of information avoidance were much lower than what has been observed in previous studies, and rates of avoidance did not vary by information treatment. The majority of respondents (75-87% across the five product categories) preferred to access the added sugars content. Still, we found some consumers preferred to avoid this information, with higher rates of avoidance for the ice cream product category. Additionally, we found significant differences in likelihood of purchase ratings between information accessors and avoiders. Respondents who chose to access the added sugars information exhibited healthier purchasing behaviors for all product categories; they were more likely to purchase low added sugars products and less likely to purchase high added sugars products relative to information avoiders. Given consumers' demonstrated interest in accessing the added sugars content, it is important that the new changes to the NF label be broadly communicated to promote healthy eating behaviors.

Examining Nutrition and Food Waste Trade-offs Using an Obesity Prevention Context.

Obesity and food waste are related issues, both exacerbated by an overabundance of food. Efforts to reduce food waste can have varying unintended, obesity-related consequences, which further underscores the need for a systems approach to food waste reduction. Yet, these 2 issues are rarely examined together. It is the authors' point of view that for nutrition educators and other public health practitioners to develop interventions that simultaneously address food waste and obesity, they need to understand how actions at the consumer-level may impact waste and its related food system consequences earlier in the supply chain.

Consumer Comprehension of the Nutrition Facts Label: A Comparison of the Original and Updated Labels.

PURPOSE: Compare consumers' overall label comprehension of the original Nutrition Facts (NF) label with the updated label. DESIGN: Online survey conducted in 2019. Participants randomly assigned to original label, updated-single column, or updated-dual column labeling condition and asked to complete a series of label comprehension questions. SETTING: Online survey; participants recruited through Prolific. SAMPLE: N = 992 U.S. adults. Sample similar to U.S. population in terms of sex (49.2% female), race (73.3% White/Caucasian), and household size (mean = 2.7 members). However, sample was younger (median age: 29.0), more educated (98.8% high school graduate or higher), and exhibited a lower rate of obesity (22.6% obese) than the U.S. population. MEASURES: Dependent variables: objective (% correct) NF label comprehension. Independent variables: label condition, nutrition knowledge, and socio-demographic variables. ANALYSIS: Regression analysis assessed relationships between label condition and label comprehension. Significance level of 5% used for analyses. RESULTS: Average score for objective comprehension was 81.4%. The updates did not significantly improve label comprehension. Participants in the updated NF label conditions had trouble answering questions related to total and added sugars. CONCLUSIONS: Results suggest consumers may struggle to correctly utilize information on the updated NF label, specifically total and added sugars. Consumers may benefit from educational opportunities on using the new label.

A systematic review of school meal nudge interventions to improve youth food behaviors.

BACKGROUND: School meal programs have a large reach and thus are ideal environments in which to implement interventions targeting improved youth eating behaviors and reduced food waste. This systematic review summarizes the evidence on the effectiveness of school meal nudge interventions on influencing children's eating and waste behaviors. METHODS: Inclusion criteria required studies have participants in primary or secondary school (grades K-12) with interventions that occurred during school lunch or breakfast in the cafeteria and included at least one of the following outcomes: selection, consumption, waste, or school meal participation. Analyses of intervention outcomes were restricted to studies of strong and moderate quality. RESULTS: Twenty-nine studies were included in the quality assessment. Included interventions fell into three categories: 1) placement/convenience, 2) marketing/promotion, or 3) variety/portions. The 20 strong and moderate quality studies included in outcome analyses generally used strong data collection methods and study designs, but were limited by an overall lack of intervention fidelity checks. Multi-component interventions often did not use methods that allowed for separate analyses of outcomes for different intervention components. CONCLUSIONS: School meal nudge interventions were positively associated with food selection, and had an inconsistent relationship with food consumption. There were few studies evaluating the impact of nudge interventions on meal participation or food waste. The limited evidence available links nudges to improved meal participation, as well as undesirable increases in food waste. Future research in this area should use methods that incorporate implementation metrics, attend to systems factors, and allow the outcomes of individual intervention components to be isolated.

Implementation of a Multi-Component School Lunch Environmental Change Intervention to Improve Child Fruit and Vegetable Intake: A Mixed-Methods Study.

Nudge interventions are widely used to promote health in schools, yet implementation metrics are seldom used to understand intervention outcomes. A multi-component intervention consisting of cafeteria decorations, creative names, social norming taste tests, and flavor station components was implemented in three rural elementary school cafeterias by school nutrition services (SNS) and extension staff. Selection and consumption of fruits and vegetables at lunch were measured through monthly plate waste assessments over eight months (n = 1255 trays). Interviews were conducted with SNS staff (n = 3) upon completion of the intervention to assess implementation outcomes using validated acceptability and feasibility metrics. Consumption findings were generally inconsistent across schools and time points, yet fruit consumption increased at School 1 (p < 0.05) during the taste test and flavor station intervention months and School 2 (p < 0.001) during the creative names intervention months compared to baseline. Odds of selecting a vegetable at School 3 were three times higher than baseline during the taste test intervention months (odds ratio (OR), 3.0; 95% confidence interval (CI), 1.3-6.5). Cafeteria decorations and taste tests had higher reported implementation metrics for acceptability and feasibility than other interventions. Thematic analysis underscored the facilitating role of extension support, as well as systems factors, which served as facilitators and barriers across schools and interventions. These findings suggest that nudge interventions are a promising strategy to improve vegetable selection and fruit consumption in school meal programs.

Food Insecurity among College Students Differs by Questionnaire Modality: An Exploratory Study.

Objectives: Literature suggests that college (ie, post-secondary) students experience food insecurity (FI) at alarming rates. However, the commonly used FI questionnaires have undergone limited evaluations for accuracy in this sub-population. The objective of this exploratory study was to evaluate if FI estimates among college students differ by survey distribution modality. Methods: A test-retest study was conducted from October to December 2017. A random sample of undergraduate students (N = 343) participated in an online survey. After completing the survey, a random sample of these students (N = 66; 29%) completed the same items in paper-and-pencil format. Responses were compared with percent agreement and kappa (κ) coefficients. Results: Students were less likely to affirm each item on paper-and-pencil questionnaires. Percent agreement ranged from 71.2% to 96.9% across items, and κ coefficients ranged from poor to fair. FI prevalence differed by 15% between online and paper-and-pencil assessments (40.9% and 25.8%, respectively). Percent agreement for FI categorization was 75.8% and κ=0.47. Conclusions: Differing survey modalities resulted in varying FI classifications in a sample of under-graduate students. Though limited by size and representativeness, this supports the need for further testing of FI surveys, as accurate FI estimates are essential to serving college students.

Food Insecurity among College Students in the United States: A Scoping Review.

Reports of college students experiencing food insecurity (FI), defined as inadequate access, availability, adequacy, and stability of food, have sparked national calls for alleviation and prevention policies. However, there are a wide variety of FI rates reported across studies and even among recent literature reviews. The current scoping review aimed to develop a weighted estimated prevalence of FI among US students using a comprehensive search approach. In addition, study characteristics that may be related to the high variability in reported FI prevalence were explored. To address these aims, the peer-reviewed and gray literature on US college student FI was systematically searched to identify 12,044 nonduplicated records. A total of 51 study samples, across 62 records, met inclusion criteria and were included in the current review. The quality of the included studies was moderate, with an average rate of 6.4 on a scale of 0-10. Convenience (45%) and census (30%) sampling approaches were common; only 4 study samples were based on representative sampling strategies. FI estimates ranged from 10% to 75%. It was common for very low security to be as prevalent as, or more prevalent than, low food security. The surveying protocols used in the studies were related to the FI estimates. The USDA Short Form Food Security Survey Module (FSSM; 50%) and the USDA Adult FSSM (40%) prevalence estimates were larger than for the full USDA Household FSSM (13%). When these surveys referenced a 12-mo period, FI estimates were 31%. This was a lower FI estimate than surveys using reference periods of 9 mo or shorter (47%). The results indicate that FI is a pressing issue among college students, but the variation in prevalence produced by differing surveys suggests that students may be misclassified with current surveying methods. Psychometric testing of these surveys when used with college students is warranted.

College students' interpretations of food security questions: results from cognitive interviews.

BACKGROUND: Food insecurity (FI) - the lack of sufficient access to food to maintain a healthy lifestyle - among college (i.e. post-secondary or higher education institution) students has become a prominent issue in the U.S. However, it is not clear if high rates of FI among students are due to the modern experience in higher education institutions or due to underlying issues in common surveying methods. To understand if there were underlying content validity issues, the present study had two primary research questions: 1) How do students interpret the U.S. Department of Agriculture (USDA) Food Security Survey Module (FSSM) questionnaire items, and 2) How do responses of students experiencing FI compare with the theorized experiences and coping responses? METHODS: Thirty-three undergraduate students, aged 18- to 24-years old and fluent in English were recruited from a single 4-year university. During a 60-min session, participants completed the 10-item Adult FSSM and then were cognitively interviewed about their responses using the think-aloud method. Interview transcripts were analysed by two researchers using a collaborative process and basic interpretative approach. RESULTS: Students were on average 19.5 years old (± 1.2 years), the majority were in their freshman or sophomore (i.e., first or second) year, and 67% (n = 22) experienced FI. Results indicated that students' interpretations of key terms - such as "money for more," "balanced meals," and "real hunger" - diverge from expectations. Furthermore, students categorized as food insecure reported experiences and responses to FI that varied from theoretical dimensions of the process. CONCLUSIONS: Though limited by sample size and representativeness, the present results indicate that the content validity of the FSSM may be compromised in this population and the managed process of FI may present differently among college students. Further psychometric research on modifications to the FSSM or with new FI assessment tools should be conducted with college students.

Are estimates of food insecurity among college students accurate? Comparison of assessment protocols.

A growing body of literature suggests that post-secondary students experience food insecurity (FI) at greater rates than the general population. However, these rates vary dramatically across institutions and studies. FI assessment methods commonly used in studies with college students have not been scrutinized for psychometric properties, and varying protocols may influence resulting FI prevalence estimates. The objective of this study was to assess the performance of standard food security assessment protocols and to evaluate their agreement as well as the relative accuracy of these protocols in identifying student FI. A randomized sample of 4,000 undergraduate students were invited to participate in an online survey (Qualtrics, LLC, Provo, Utah, USA) that evaluated sociodemographic characteristics and FI with the 2-item food sufficiency screener and the 10-item USDA Adult Food Security Survey Module (FSSM; containing the abbreviated 6-item module). Four hundred sixty-two eligible responses were included in the final sample. The psychometric analysis revealed inconsistencies in college student response patterns on the FSSM when compared to national evaluations. Agreement between FI protocols was generally high (>90%) but was lessened when compared with a protocol that incorporated the 2-item screener. The 10-item FSSM with the 2-item screener had the best model fit (McFadden's R2 = 0.15 and Bayesian Information Criterion = -2049.72) and emerged as the tool providing the greatest relative accuracy for identifying students with FI. Though the 10-item FSSM and 2-item screener yields the most accuracy in this sample, it is unknown why students respond to FSSM items differently than the general population. Further qualitative and quantitative evaluations are needed to determine which assessment protocol is the most valid and reliable for use in accurately identifying FI in post-secondary students across the U.S.

Grit is Associated with Food Security among US Parents and Adolescents.

Objectives: We investigated whether the Short Grit Scale (Grit-S) predicted odds of food insecurity (FI) among adults and their children. Methods: A cross-sectional panel of parent-child dyads completed an online questionnaire. Eligible dyads included parents with household income below the 2015 median ($52,250 USD/year) and their self-selected household child between the ages of 13 to 17 years. An online questionnaire assessed: (1) FI using the 18-item Household Food Security Survey Module and the Food Security Survey Module for Youth; (2) perseverance and determination using the validated 8-item Grit-S; and (3) sociodemographic FI predictors. Logit regression models estimated the relationship between odds of FI and predictors among parents and children, separately. Results: Among 252 parents, 61.1% reported household FI. Parents' Grit-S score (N = 179) was associated with a significantly lower odds of household FI (OR= 0.4; 95%CI= 0.2, 0.8; p < .01) while adjusting for established predictors. Mean (±SD) Grit-S was 3.1 (±0.7). Children's Grit-S score (N = 178) was associated with a significantly lower odds of child FI (OR= 0.6; 95%CI= 0.4, 0.9; p < .05) while adjusting for established predictors. Conclusions: Perseverance and determination, also known as "grit," may be one further explanation for why some poor households are food secure.