Improve Food Access Research Articles

Food retailer actions toward the National Strategy on Hunger, Nutrition, and Health to promote nutrition security: Applicability of the Business Impact Assessment-Obesity as a monitoring tool.

The White House National Strategy on Hunger, Nutrition, and Health (National Strategy) encourages actions across government and society to promote nutrition security. Nutrition security includes adequate food, diet quality, and equity, and food retail settings can promote these major concepts. Of all National Strategy whole-of-society calls to action, food retailers can contribute to 15 calls as key actors. However, there is currently no standardized monitoring tool to track food retailers' commitments and actions toward the National Strategy to promote nutrition security. The Business Impact Assessment-Obesity and population-level nutrition (BIA-Obesity), a tool originally developed for corporate accountability monitoring, can be tailored for the National Strategy and nutrition security, given its standardized indicators and process to assess food company policies and commitments across six domains. We discuss the fit of the BIA-Obesity indicators for tracking food retailers' commitments and actions across four pillars of the National Strategy. Existing indicators are appropriate to monitor components of Pillar 1: Improve Food Access and Affordability; Pillar 2: Integrate Nutrition and Health; Pillar 3: Empower All Consumers to Make and Have Access to Healthy Choices; and Pillar 5: Enhance Nutrition and Food Security Research. We suggest expanding current indicators to include equity, local foods, the digital food environment, and food waste reduction to improve alignment of the BIA-Obesity with the National Strategy. Application of the BIA-Obesity as an existing tool can facilitate data cohesion and more rapid assessment of the food retailer landscape to mutually meet nutrition security goals by 2030.

Urban Agriculture: Exploring Its Potential, Challenges, and Socio-Economic Impacts

Urban agriculture, the practice of growing and cultivating food within urban and peri-urban areas, has garnered increasing attention in recent years due to its potential to address various challenges related to food security, environmental sustainability, and socio-economic development. This review article provides a comprehensive exploration of urban agriculture, examining its multifaceted potential, the challenges it faces, and its socio-economic impacts in greater detail. The article delves into the diverse forms of urban agriculture, ranging from rooftop gardens and community allotments to vertical farming and aquaponics, highlighting their contributions to local food production, green spaces, and community cohesion. Additionally, the review discusses the challenges and constraints associated with urban agriculture in more depth, including issues related to land availability, soil contamination, water management, and regulatory hurdles. Furthermore, it examines the socio-economic impacts of urban agriculture with a nuanced perspective, exploring how it can lead to improved access to fresh produce, job creation, poverty alleviation, and social empowerment at both individual and community levels. By shedding light on the complexities of urban agriculture and providing a more comprehensive analysis of its potential and challenges, this review aims to inform policymakers, urban planners, researchers, and practitioners about the transformative potential of urban agriculture and the need for supportive policies and interventions to foster its sustainable growth and maximize its benefits for urban communities, the review dives deeper into the various forms of urban agriculture, providing detailed insights into their unique characteristics, benefits, and challenges. Rooftop gardens, for example, are explored not only for their contribution to local food production but also for their role in mitigating urban heat island effects, improving air quality, and enhancing building energy efficiency. Community allotments are examined in the context of social cohesion, community engagement, and opportunities for education and skill-building. Vertical farming and aquaponics are discussed in terms of their innovative technologies, resource efficiency, and potential scalability to meet the growing demand for fresh produce in urban areas, the review delves into the challenges and constraints associated with urban agriculture, offering nuanced analyses of their underlying causes and potential solutions. Land availability issues are examined in relation to urban sprawl, land-use planning policies, and competing demands for space in densely populated cities. Soil contamination concerns are explored in light of industrial legacies, brownfield redevelopment, and strategies for soil remediation and regeneration. Water management challenges are discussed in the context of water scarcity, pollution, and the need for sustainable irrigation practices in urban agriculture. Regulatory hurdles are analyzed in terms of their impact on the viability and scalability of urban agriculture initiatives, highlighting the importance of supportive policy frameworks, zoning regulations, and land-use planning strategies. the review provides a comprehensive examination of the socio-economic impacts of urban agriculture, drawing on empirical evidence from case studies and research findings. It explores how urban agriculture can contribute to improved food access and nutrition outcomes, particularly for vulnerable populations living in food deserts and low-income neighborhoods.

Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity

Limited access to healthy foods, resulting from residence in neighborhoods with low food access, is a public health concern. The contribution of this exposure in early life to child obesity remains uncertain. To examine associations of neighborhood food access during pregnancy or early childhood with child body mass index (BMI) and obesity risk. Data from cohorts participating in the US nationwide Environmental Influences on Child Health Outcomes consortium between January 1, 1994, and March 31, 2023, were used. Participant inclusion required a geocoded residential address in pregnancy (mean 32.4 gestational weeks) or early childhood (mean 4.3 years) and information on child BMI. Residence in low-income, low-food access neighborhoods, defined as low-income neighborhoods where the nearest supermarket is more than 0.5 miles for urban areas or more than 10 miles for rural areas. BMI z score, obesity (age- and sex-specific BMI ≥95th percentile), and severe obesity (age- and sex-specific BMI ≥120% of the 95th percentile) from age 0 to 15 years. Of 28 359 children (55 cohorts; 14 657 [51.7%] male and 13 702 [48.3%] female; 590 [2.2%] American Indian, Alaska Native, Native Hawaiian, or Other Pacific Islander; 1430 [5.4%] Asian; 4034 [15.3%] Black; 17 730 [67.2%] White; and 2592 [9.8%] other [unspecified] or more than 1 race; 5754 [20.9%] Hispanic and 21 838 [79.1%] non-Hispanic) with neighborhood food access data, 23.2% resided in low-income, low-food access neighborhoods in pregnancy and 24.4% in early childhood. After adjusting for individual sociodemographic characteristics, residence in low-income, low-food access (vs non-low-income, low-food access) neighborhoods in pregnancy was associated with higher BMI z scores at ages 5 years (β, 0.07; 95% CI, 0.03-0.11), 10 years (β, 0.11; 95% CI, 0.06-0.17), and 15 years (β, 0.16; 95% CI, 0.07-0.24); higher obesity risk at 5 years (risk ratio [RR], 1.37; 95% CI, 1.21-1.55), 10 years (RR, 1.71; 95% CI, 1.37-2.12), and 15 years (RR, 2.08; 95% CI, 1.53-2.83); and higher severe obesity risk at 5 years (RR, 1.21; 95% CI, 0.95-1.53), 10 years (RR, 1.54; 95% CI, 1.20-1.99), and 15 years (RR, 1.92; 95% CI, 1.32-2.80). Findings were similar for residence in low-income, low-food access neighborhoods in early childhood. These associations were robust to alternative definitions of low income and low food access and additional adjustment for prenatal characteristics associated with child obesity. Residence in low-income, low-food access neighborhoods in early life was associated with higher subsequent child BMI and higher risk of obesity and severe obesity. We encourage future studies to examine whether investments in neighborhood resources to improve food access in early life would prevent child obesity.

“The Dollar Store Got It Going On”: Understanding Food Shopping Patterns and Policy Preferences among Dollar Store Shoppers with Low Incomes

BackgroundThe growing dollar store sector has raised concerns about nutrition and associated health outcomes, especially for low-income communities who disproportionately rely on dollar stores. Perspectives of dollar store shoppers are largely absent. ObjectiveThis study aimed to understand why low-income shoppers choose to purchase food from dollar stores and what store changes, policies, and programs would make it easier for them to purchase healthier items. MethodsIn May–June 2023, we conducted interviews with 19 dollar store shoppers in an urban county in North Carolina. We used thematic analysis and the framework method to identify emergent patterns and themes across responses. ResultsIndividuals relied on dollar stores because of the affordable prices and convenient locations. In order of frequency, most participants purchased candy and snacks from dollar stores, followed by meat, fruits, and vegetables. Participants wanted more fruits, vegetables, and higher quality proteins at dollar stores and supported policies that increase access to healthier options via increased purchasing power, increased access to a mobile farmers’ market, marketing that identifies nutritionally healthy products, and improved access to other store types. Responses to removing unhealthy items from checkout areas were mixed. ConclusionsDollar stores are affordable and convenient food retailers for people with low incomes. However, dollar stores are not meeting demand for fruits, vegetables, and proteins, items necessary for food and nutrition security. To improve food access and community health, decision makers should incorporate community perspectives into efforts aimed at improving dollar store food options.

Impact of COVID-19 on dietary diversity and food security in Pakistan: A comprehensive analysis

This study investigates the impact of COVID-19 on dietary diversity and food security in Pakistan's Punjab and Sindh provinces, assessing how the pandemic has influenced individuals' access to varied and nutritious foods. Utilizing data from 1067 respondents collected through online surveys, the research highlights significant changes in food consumption patterns, with infected individuals showing higher Dietary Diversity Scores (DDS) than those not infected. The findings indicate a shift towards more readily available and affordable food items such as cereals, fruits, and dairy products, reflecting adjustments in dietary habits during the pandemic. Socio-economic factors, including age, gender, urban residency, and wealth, were identified as key determinants of dietary diversity. Specifically, women and urban residents showed improved dietary habits during the pandemic. In addition, the study identifies nutritional awareness as a critical factor in promoting healthier food choices, suggesting that well-informed individuals have more diverse diets, which could aid in disease prevention, contributing to potential disease prevention. The research underscores the pandemic's profound effects on dietary patterns and food security. It calls for policy interventions focused on improving food access, enhancing public awareness on nutrition, and integrating food security measures into pandemic response strategies to support vulnerable populations and ensure long-term resilience against health crises.

Promoting healthy food access initiatives in urban areas of the USA: Strategies to address food insecurity and improve nutritional health

This concept paper proposes initiatives to promote healthy food access in urban areas of the USA, addressing food insecurity and improving nutritional health. By implementing strategies such as community gardens, farmers' markets, and incentives for grocery stores, this paper aims to create sustainable solutions to improve food access and health outcomes in urban communities. Access to healthy food is a critical determinant of health, yet many urban areas in the USA face challenges related to food insecurity and limited access to nutritious foods. This concept paper explores strategies to promote healthy food access initiatives in urban areas of the USA, with a focus on addressing food insecurity and improving nutritional health. The paper discusses the current state of food insecurity and its impact on health outcomes in urban areas, highlighting the need for targeted interventions to improve access to healthy foods. It then examines various strategies that have been successful in promoting healthy food access, including community gardens, farmers' markets, and mobile food markets. Key components of successful healthy food access initiatives, such as community engagement, policy advocacy, and partnerships with local organizations, are discussed. The paper also explores the role of technology, such as online grocery delivery services, in improving access to healthy foods in urban areas. Through a comprehensive analysis, this concept paper aims to provide insights into effective strategies for promoting healthy food access in urban areas of the USA. By implementing these strategies, policymakers, healthcare providers, and community organizations can work together to address food insecurity and improve nutritional health in urban communities. Keywords: Healthy Food, Insecurity, USA.

Measuring and modeling food accessibility by transportation mode

Food accessibility has been a subject of growing interest due to its impact on public health outcomes. This paper describes a spatial analysis method to identify gaps in geographic food access and correlate them with a variety of demographic and socioeconomic factors. The proposed food accessibility metric is the square footage of supermarkets that can be reached within 10 min travel time by walking, biking, driving, and 30 min travel time by walk/transit. The spatial analysis is conducted for the centroids of each census tract within a study area, and the approach is illustrated with an application for the state of Massachusetts. Correlations between demographic and socioeconomic explanatory variables and food accessibility are explored using the Gradient Boosted machine learning model. More specifically, the explanatory variables are percent minority population, percent of population in poverty, vehicle ownership, and population density. The spatial analysis shows a strong correlation between food accessibility and population density. The machine learning model is then used to identify gaps in food accessibility for each transportation mode while controlling for community characteristics. The residuals of the model reveal which communities have the lowest food accessibility relative to other similar communities within the state. This research provides a quantitative method to identify communities that have reduced access to food relative to state-wide trends. Lastly, it provides insights for where policy interventions would be valuable for improving food access in addition to recommendations on increasing food accessibility.

Food prescribing in Canada: evidence, critiques and opportunities.

There is growing interest in food prescriptions, which leverage health care settings to provide patients access to healthy foods through vouchers or food boxes. In this commentary, we draw on our experiences and interest in food prescribing to provide a summary of the current evidence on this intervention model and critically assess its limitations and opportunities. Food insecurity is an important determinant of health and is associated with compromised dietary adequacy, higher rates of chronic diseases, and higher health service utilization and costs. Aligning with recent discourse on social prescribing and "food is medicine" approaches, food prescribing can empower health care providers to link patients with supports to improve food access and limit barriers to healthy diets. Food prescribing has been shown to improve fruit and vegetable intake and household food insecurity, although impacts on health outcomes are inconclusive. Research on food prescribing in the Canadian context is limited and there is a need to establish evidence of effectiveness and best practices. As food prescribing continues to gain traction in Canada, there is a need to assess the effectiveness, cost-efficiency, limitations and potential paternalism of this intervention model. Further, it is necessary to assess how food prescribing fits into broader social welfare systems that aim to address the underlying determinants of food insecurity.

Implementation Of Food Security Policy In DKI Jakarta Province (A Case Study Of PT. Food Station Tjipinang Jaya)

Food security is a strategic issue for densely populated areas like the Province of DKI Jakarta, which has limited agricultural land. This research aims to analyze the implementation of food security policies in DKI Jakarta, focusing on a case study of PT Food Station Tjipinang Jaya (FSJT) as the policy implementer. The study employs a qualitative approach using literature review methods, with data collected from various written sources such as regional regulations, official reports, scientific publications, and related websites. Through content analysis and data source triangulation, this research identifies FSJT's success in maintaining food availability, improving food access, strengthening the distribution system, and supporting local farmers. However, the implementation of the policy also faces challenges such as land limitations, food price fluctuations, changing dietary patterns, and program sustainability. Supporting data shows FSJT's contribution to the reduction of the poverty rate in DKI Jakarta from 11.5% (2021) to 10.56% (2022), as well as the distribution of 1.2 million tons of rice in 2022. Surveys also noted that 82% of the public were satisfied with FSJT's performance in maintaining food availability. To enhance food security in the future, recommendations include the development of vertical farming, strengthening community food resilience, nutritional education campaigns, and diversification of food sources. Ongoing efforts through these measures are essential to ensure the effective implementation of food security policies and the sustainability of development in the Province of DKI Jakarta.

Food Insecurity and Undernutrition Are Associated With Distinct Immunologic Profiles in People With Tuberculosis and Advanced HIV Starting Antiretroviral Therapy.

Food insecurity and undernutrition are related but distinct concepts contributing to poor HIV and tuberculosis outcomes. Pathways linking them with immunologic profile, which may relate to clinical outcomes, remain understudied. We analyzed data from a cohort study of 165 antiretroviral therapy (ART)-naïve adults with advanced HIV and newly diagnosed tuberculosis in Botswana from 2009 to 2013. Twenty-nine plasma biomarkers were measured pre-ART and 4 weeks post-ART initiation. We used principal components analysis (PCA) and multivariable linear regression models to assess relationships between immunological profiles and food insecurity (based on the Household Food Insecurity Access Scale), undernutrition (body mass index <18.5 kg/m 2 ), and clinical outcomes. PCA identified 5 principal components with eigenvalues >1. After adjustment, food insecurity was associated with PC3 pre-ART (0.19 per increased category of severity, 95% CI: 0.02 to 0.36) and post-ART (0.24, 95% CI: 0.07 to 0.41). PC3 was driven by higher levels of IFN-α, IFN-γ, interleukin (IL)-12p40, vascular endothelial growth factor, IL-1α, and IL-8 and decreased concentrations of IL-3. Undernutrition was associated with PC5 post-ART (0.49, 95% CI: 0.16 to 0.82). PC5 was driven by higher levels of IL-8, MIP-1α, IL-6, and IL-10 and decreased concentrations in IP-10 and IFN-α. Post-ART PC3 (4.3 percentage point increased risk per increased score of 1, 95% CI: 0.3 to 8.9) and post-ART PC5 (4.8, 95% CI: 0.6 to 8.9) were associated with death in adjusted models. We identified 2 distinct immunologic profiles associated with food insecurity, undernutrition, and clinical outcomes in patients with advanced HIV and tuberculosis. Different pathophysiologic processes may link food insecurity and undernutrition with poor outcomes in this vulnerable patient population. Future studies should assess the impact of improving food access and intake on immune function and clinical outcomes.

Birth outcomes in relation to neighborhood food access and individual food insecurity during pregnancy in the Environmental Influences on Child Health Outcomes (ECHO)-wide cohort study

BackgroundLimited access to healthy foods, resulting from residence in neighborhoods with low-food access or from household food insecurity, is a public health concern. Contributions of these measures during pregnancy to birth outcomes remain understudied. ObjectivesWe examined associations between neighborhood food access and individual food insecurity during pregnancy with birth outcomes. MethodsWe used data from 53 cohorts participating in the nationwide Environmental Influences on Child Health Outcomes-Wide Cohort Study. Participant inclusion required a geocoded residential address or response to a food insecurity question during pregnancy and information on birth outcomes. Exposures include low-income-low-food-access (LILA, where the nearest supermarket is >0.5 miles for urban or >10 miles for rural areas) or low-income-low-vehicle-access (LILV, where few households have a vehicle and >0.5 miles from the nearest supermarket) neighborhoods and individual food insecurity. Mixed-effects models estimated associations with birth outcomes, adjusting for socioeconomic and pregnancy characteristics. ResultsAmong 22,206 pregnant participants (mean age 30.4 y) with neighborhood food access data, 24.1% resided in LILA neighborhoods and 13.6% in LILV neighborhoods. Of 1630 pregnant participants with individual-level food insecurity data (mean age 29.7 y), 8.0% experienced food insecurity. Residence in LILA (compared with non-LILA) neighborhoods was associated with lower birth weight [β –44.3 g; 95% confidence interval (CI): –62.9, –25.6], lower birth weight-for-gestational-age z-score (–0.09 SD units; –0.12, –0.05), higher odds of small-for-gestational-age [odds ratio (OR) 1.15; 95% CI: 1.00, 1.33], and lower odds of large-for-gestational-age (0.85; 95% CI: 0.77, 0.94). Similar findings were observed for residence in LILV neighborhoods. No associations of individual food insecurity with birth outcomes were observed. ConclusionsResidence in LILA or LILV neighborhoods during pregnancy is associated with adverse birth outcomes. These findings highlight the need for future studies examining whether investing in neighborhood resources to improve food access during pregnancy would promote equitable birth outcomes.

Household food insecurity is associated with greater autonomic dysfunction testing score in Latinos with type 2 diabetes.

We examined household food insecurity (HFI) and autonomic nervous system (ANS) function in a subset of low-income Latinos with type 2 diabetes with data from a stress management trial. InclusionLatino or Hispanic, Spanish speaking, age less than 18 years, ambulatory status, type 2 diabetes more than 6 months, A1c less than 7.0%. ExclusionPain or dysfunction in hands (e.g., arthritis) precluding handgrip testing; medical or psychiatric instability. HFI was assessed with the 6-item U.S. household food security survey module; with responses to > = 1 question considered HFI. An ANS dysfunction index was calculated from xix autonomic function tests which were scored 0 = normal or 1 = abnormal based on normative cutoffs and then summed. Autonomic function tests were: 1) 24-hour heart rate variability as reflected in standard deviation of the normal-to-normal (SDNN) heart rate acquired with 3-channel, 7-lead ambulatory electrocardiogram (Holter) monitors; 2) difference between the highest diastolic blood pressure (DBP) during sustained handgrip and the average DBP at rest; 3) difference between baseline supine and the minimal BP after standing up; and, from 24-hour urine specimens 4) cortisol, 5) normetanephrine, and, 6) metanephrine. Thirty-five individuals participated, 23 (65.7%) of them were women, age mean = 61.6 (standard deviation = 11.2) years, HbA1c mean = 8.5% (standard deviation = 1.6) and 20 participants (57.1%) used insulin. Twenty-two participants (62.9%) reported HFI and 25 (71.4%) had one or more abnormal ANS measure. Independent t-tests showed that participants with HFI had a higher ANS dysfunction index (mean = 1.5, standard deviation = 0.9) than patients who were food secure (mean = 0.7, standard deviation = 0.8), p = 0.02. Controlling for financial strain did not change significance. Total ANS index was not related to glycemia, insulin use or other socioeconomic indicators. In this sample, HFI was associated with ANS dysfunction. Policies to improve food access and affordability may benefit health outcomes for Latinos with diabetes.

Mutual aid food sharing during the COVID-19 pandemic: case study of Tompkins County, NY.

The COVID-19 pandemic led to greater food insecurity across the world, and government and charitable organisations did not always respond quickly enough or adequately to meet food needs. Mutual aid (MA) - neighbours helping neighbours to meet survival needs - mobilised residents to share food, often through outdoor food cabinets and refrigerators. This study aims to understand how MA food sharing was implemented, including food availability, acceptability, accessibility and impact on food access. This case study describes one MA food sharing system by triangulating data from flyers, notes from nineteen volunteer meetings, six cabinet host interviews, data extracted from 1387 social media posts and 356 photographs, and 111 resident surveys. Tompkins County, NY, USA (total population about 100 000). We estimated high availability of food: approximately 250 000 food servings were shared monthly, mostly carbohydrates. Most residents obtaining food found it acceptable, including satisfaction with food safety and cleanliness, food quantity, and ease of travel to the cabinets but were less satisfied with food variety. MA food sharing was accessible to food-insecure, unemployed and disabled residents, but not other priority populations. About two-thirds of residents reported improved food access. Volunteers exhibited tenacity and ingenuity in meeting operational challenges which included trash and vandalism, winter weather and unusable food contributions while foregrounding residents' safety and privacy as shared values and navigating conflicting views about fairness. In times of crisis, MA can improve food access through free food sharing cabinets, but barriers include unacceptable food contributions and outdoor conditions.

Integrated Community‐Based Nutrition Interventions Improve Diet Quality, Food, and Credit Access among Rural Women in Northern Ghana

Globally, micronutrient deficiencies are widespread in women due to poor diet quality and elevated needs of the subgroup. Undernutrition, specifically micronutrient deficiencies, is a major problem in Ghana, especially in northern Ghana during the prolonged dry/lean season. Recent data indicate high prevalence of poor‐quality diets intake among women, which buttresses the observed high prevalence of micronutrient deficiencies in northern Ghana. In this study, we investigated the potential of integrated community‐based interventions (ICI) to improve diet quality and food access in a quasi‐experimental study. The experimental design comprised an experimental group of women (n = 150) from the Sakaa and Nakolo communities and a control group of women (n = 123) from the Bonia and Bugani communities. The experimental group was provided with credit access and solar‐powered irrigation facility for dry‐season community gardening, while the control group had access to only credit. The study revealed that during the dry/lean season, when food and nutrition insecurity is historically at its worst, ICI significantly improved diet quality (p ≤ 0.0001), access to food, and credit access. Our findings suggest that ICI is an effective approach in tackling food and nutrition insecurity in Northern Ghana than standalone interventions. While the findings from our study are encouraging, we acknowledge that more long‐term research is necessary.

Ours to eat and own: assessing the feasibility of a cooperative meal-kit service to improve food access.

Although typically serving higher income and younger demographic groups, meal-kit subscription services have the potential to improve food availability and dietary quality in communities experiencing low food access due to systemic discrimination. This study describes the development and characteristics of a pilot community-led meal-kit service (SouthEats) and evaluates key implementation outcomes of adoption, acceptability, and feasibility among households experiencing less income. We utilised a mixed methods study design, including data from administrative records, customer surveys and worker interviews. Thematic qualitative analyses and descriptive quantitative analyses were conducted to illuminate the characteristics and extent the pilot meal-kit service was adopted, acceptable, and financially feasible among the target populations. The study took place in Washington DC, USA. Study participants included SouthEats consumers (n 35) and workers (n 3). During the pilot period, sixty-seven community members signed up for the meal-kit service, with 52 % making recurring purchases. Our results suggest that the meal-kit service is acceptable among people living in low food access areas. Our feasibility analysis indicates that, although not without challenges, the SouthEats model could be financially feasible. These preliminary insights can inform the scalability and potential replication of this service and provide foundational evidence for an approach that may be used to improve food access.

Illuminating Child and Adult Care Food Program Partnerships That Improved Food Access and Waiver Utilization for Feeding Young Children in Early Care and Education Programs During COVID-19: A Qualitative Study

BackgroundLittle is known about the partnerships formed between early care and education (ECE) programs and the Child and Adult Care Food Program (CACFP) and other organizations to continue to feed young children during the COVID-19 pandemic. Such information can provide important lessons to build ECE capacity for feeding children during future emergencies and has the potential strengthen the ECE food systems. ObjectiveThis study aimed to identify the unique partnerships that CACFP state agencies established to provide nutrition to young children during the COVID-19 pandemic DesignQualitative semi-structured interviews with 24 participants representing 21 states across the United States. Participants/SettingVirtual interviews with CACFP directors from December 2020 through May 2021. AnalysisFollowing the realist method, transcripts were analyzed using thematic analysis. Codes were developed inductively and grouped to identify themes and subthemes. ResultsFour themes were identified: (1) CACFP partnerships that supported children and families directly; (2) CACFP partnerships that built the capacity of ECE providers to provide food to children in their own settings; (3) CACFP systems-level partnerships that improved coordination of efforts to continue to feed children in ECE; and (4) CACFP directors encouraged other CACFP state agencies to build nontraditional, diverse partnerships that can be leveraged during pandemics and other natural disasters. Within these themes (subthemes), the purpose of the partnerships focused on improving waiver utilization (eg, Department of Transportation, state health departments), improving food access (eg, Summer Food Service Program [SFSP], food banks, grocery stores, dairy councils), supporting ECE programs to participate in food reimbursement programs (eg, SFSP, CACFP sponsors), and resource sharing (eg, coalitions, CACFP sponsors). ConclusionsThe CACFP state directors reported that existing and new partnerships between CACFP state agencies and external entities successfully facilitated feeding young children in ECE during the COVID-19 pandemic. States may consider developing a road map to proactively explore potential partners in their state to meet specific needs such as accessibility, availability, and affordability for feeding young children in ECE.

E‐commerce improves dietary quality of rural households in China

AbstractE‐commerce is gaining importance in the food sector of many countries, and its potential influence on people's access to food and dietary choices is yet to be thoroughly investigated. In this study, we analyze data from a food consumption survey conducted in rural China in 2021 to examine the impact of e‐commerce on individual food consumption patterns and dietary quality. Our results with instrumental variable models show that e‐commerce significantly reduces the consumption of staple foods, such as cereals and potatoes, while it increases the consumption of legumes, nuts, milk, and milk products, even after controlling for income and other confounding factors. Additionally, e‐commerce contributes to higher dietary diversity and dietary quality among rural households. In the face of shrinking physical markets in rural areas, it seems that rural e‐commerce can serve as an important mechanism to improve food access and meet the diversifying dietary demands of rural residents. [EconLit Citations: Q13, L81].

Fit Around the Farm: A holistic approach to health promotion for elders

As a consequence of historical and contemporary structural racism, people from minoritized communities are burdened with higher incidence, more severe morbidity, and earlier mortality from chronic diseases, including diabetes, heart disease, and hypertension. To advance health equity, public health policies and programs must address racialized inequities in the social and environmental determinants of health and support individuals in making the behavioral changes that can prevent the onset of chronic disease and intervene in its progression. Based on analysis of in-depth, qualitative interviews with elder Black women (n = 13), this article examines the experiences and perspectives of participants in Fit Around the Farm, an innovative, farm-based, multicomponent health promotion program in Boston, MA. Drawing on their narratives, we describe how the program supports participants’ health and well-being by improving food access and nutrition, increasing physical activity (and capacity for physical activity), creating a supportive community oriented to wellness, and providing access to safe and culturally resonant green space. This analysis suggests that community based urban farms offer a compelling site for multicomponent health promotion programs for Black elders in urban communities, a structurally disadvantaged population at risk for chronic disease.

What role can farmers markets play in the larger context of food access? A simulation model with application to the state of Maine

For areas of low food access, farmers markets and associated incentive programs have often been proposed as a means to increase the accessibility of fresh, nutritious food. Despite these efforts, access to healthful foods remains complicated. We discuss a multi-dimensional indicator of access – reflecting the availability, affordability, acceptability of nutritious food – that acknowledges the constraints under which households operate. We then use a simulation model to evaluate how access to local foods changes as farmers markets and conventional food retailers are added and removed from areas of low access. To give context to these results, we use various public data sources to consider food access in the state of Maine. Our simulated model shows that across Maine counties, SNAP households’ access to grocery stores plays a much larger role in overall food access than farmers markets and that, for additional farmers markets to improve food access, explicit consideration of the barriers facing households is necessary.

Nutritional habits in Spanish female students of childbearing age

AimTo analyse the dietary habits, alcohol consumption, healthy eating index and student performance of a sample of students at a Spanish university to determine if their intake of nutrients reach optimal levels for fertility. MethodsDescriptive cross-sectional study of female university students in Madrid, data were collected in Nutrition classes. Participants were 470 women nursing studying at a private university in Madrid, non-random sample was used. An AUDIT test was conducted to determine alcohol consumption. Habits and dietary assessment with a three-day record using DIAL® program to know main nutrients intake. Quantitative variables appeared as mean ± standard deviation, adjusted for all pairwise comparisons using the Bonferroni correction Statistical analysis was performed using SPSS 25®. ResultsThe majority of the Spanish university women of reproductive age participating in the study did not have the recommended intake of some macro and micronutrients carbohydrates, vitamins D and B9, Mg, Fe, and I. ConclusionsThis study opens further lines of research. It is necessary to carry out qualitative research into students’ self-perception and their dietary and sleeping habits. Addressing ways to improve food access, dietary quality, and healthy lifestyle, should be focused on future intervention programs and policies for college students.