Supplemental Food Program Research Articles

Predictors of undernutrition among under-five children in geographically isolated and disadvantaged areas in the Philippines

Introduction: Geographically isolated and disadvantaged areas (GIDA) are generally characterised by high morbidity and mortality of children. Undernutrition makes under-five children more vulnerable to disease and death. This study aimed to assess nutritional status and determine factors affecting undernourished children under five in GIDA. Methods: The study utilised data from children aged 0-59 months obtained from the 2018-2021 Expanded National Nutrition Survey (ENNS). GIDA were identified and 5,600 children were included in the analysis. Descriptive and multiple logistic regression analyses were employed to investigate associations between nutritional status of children [including stunting, underweight (UW), and wasting] and various factors including child-related, household-related, and biochemical markers. Results: Prevalence of UW, stunting, and wasting among children in GIDA were 39.7%, 24.1%, and 6.2%, respectively. Anaemia was of mild public health significance. Multiple logistic analysis revealed significant associations between stunting and vitamin A deficiency (VAD), food insecurity, and unimproved sources of drinking water; underweight and older age, anaemia, VAD, urban residence, and poor wealth; wasting and younger age, being female, and poor wealth. Conclusion: Existence of all forms of undernutrition in GIDA intensifies risk of mortality and morbidity among children. This study recommends that government sectors prioritise implementation of nutrition and food supplementation programmes in GIDA where the healthcare system continues to be at a disadvantage. The persistent constraints in GIDA should be addressed to improve food accessibility.

Comorbidities and Treatment Outcomes in Patients Diagnosed with Drug-Resistant Tuberculosis in Rural Eastern Cape Province, South Africa.

Tuberculosis (TB) remains a significant global health challenge, with drug-resistant tuberculosis (DR-TB) posing a greater threat due to difficulty in treatment. This study aimed to investigate the relationship between comorbidities and treatment outcomes in patients diagnosed with DR-TB in rural Eastern Cape using logistic regression. Data on patient characteristics, comorbidities, and treatment outcomes were extracted from the medical records and analyzed using Python version 3.8. and R version 4.1.1 software. A logistic regression model was used to determine the effects of selected variables on treatment outcomes of DR-TB cases. Hearing loss and hypertension (HTN) were the most frequently observed comorbidities across various DR-TB cases, particularly rifampicin-resistant (RR), multidrug-resistant (MDR), and pre-extensively drug-resistant (pre-XDR-TB) cases. A hearing loss prevalence of 5.8% (26/445) was found among patients receiving treatment for TB, with the intensity of impairment ranging from mild to severe. Gender is significantly associated with the occurrence of HTN among these patients (p-value: 0.022). Comorbidities such as epilepsy, hearing loss, and HTN significantly impact treatment success, with higher risks of mortality and incomplete cure. Using logistic regression, obesity (OR = 3.0884; e = 1.1277; p = 0.0408) and HIV-positive status (OR = 0.4458; e = 0.8078; p = 0.0001) were highly likely and less likely associated with better treatment outcomes, respectively. The logistic regression model achieved an accuracy of 64.0%, a precision of 63.0%, and a recall of 95.0%, with an F-1 score of 76.0%. The findings underscore the importance of implementing integrated management strategies that address both DR-TB and its comorbidities, particularly in resource-limited settings where such patients are prevalent. Public health policies should incorporate strategies to provide nutritional assessments and interventions, particularly for individuals with low BMI. This could include food supplementation programs or partnerships with local food kitchens to ensure that patients have access to adequate nutrition during DR-TB treatment.

Tingkat Pengetahuan Stunting pada Ibu Hamil, Remaja Putri dan Ibu Yang Memiliki Anak Usia Dini di Kecamatan Badiri Wilayah Kerja Puskesmas Hutabalang Kabupaten Tapanuli Tengah Tahun 2023

In the Indonesian context, efforts to prevent stunting have become the focus of government programs, such as the Supplemental Food Program and the Maternal and Child Health Program. However, the level of stunting is still quite high and shows that there is a gap in understanding and knowledge about stunting among pregnant women and mothers with young children. Stunting in pregnant women and mothers with young children and teenage girls is a serious public health problem. Factors that contribute to stunting include maternal nutritional status, access to health services, knowledge about nutrition, and environmental sanitation. This research aims to investigate knowledge about stunting in pregnant women, adolescent girls and mothers of early childhood in Central Tapanuli in 2023 It is hoped that the results of this research will provide important insights for developing more effective stunting prevention programs. There are several factors that influence knowledge, such as educational factors, information source factors such as social media, environmental factors, experience factors and age factors.

An investigation of a novel milk allergy-friendly food supplement program.

Compared to households not managing food allergy, households managing food allergy are faced with greater direct and indirect costs. To address these cost burdens, we developed and piloted a milk allergy-friendly food supplement program for lower- and middle-income households managing a dairy allergy in a child age <6 years. Herein, we aimed to evaluate to the impact of this program on food costs, food security, and caregiver mental health using a longitudinal design. Participants living in or near the city of Winnipeg, in Manitoba, Canada were recruited from January to February 2022 via social media, word-of-mouth, and a database maintained by the principal investigator. Consenting participants took part in a 6-month allergen-friendly food supplement program that provided them with biweekly deliveries of allergen-friendly foods free of charge. To evaluate the impact of the program on food costs, food security, and well-being, participants completed a series of questionnaires at baseline, mid-point, and at the end of the program. Changes in these variables were assessed via a series of Friedman tests. The final sample was comprised of 8 households. Relative to baseline, participants reported higher total direct food costs at midpoint (+5.6%) and endpoint (+13.5%), but these changes did not reach statistical significance. In contrast, total indirect food costs decreased over the course of the study relative to baseline (midpoint = -28.2%; endpoint = -18.5%), but the changes were not found to be statistically significant. Participants did, however, report a statistically significant decrease in costs related to lost time from work or school as a result of their child's food allergy at endpoint relative to baseline (-100%). Few changes in food security, caregiver well-being, or child food allergy quality of life were noted. The provision of allergen-friendly foods helped keep grocery costs below the pace of inflation. Participants also reported reduced costs associated with missed time from work or school as a result of their child's food allergy. Despite these encouraging findings, a relatively high proportion of the current sample reported experiencing food insecurity throughout the study period, suggesting that additional financial support for families is needed.

Analisis Model Pengambilan Keputusan Dalam Program Pemberian Suplemen Makanan Pada Anak-Anak Stunting Kota Surabaya

Stunting in children and toddlers is an urgent health issue in the city of Surabaya, Indonesia. This research aims to develop effective decision-making strategies in tackling stunting in the city. Through a risk factor analysis approach, evaluation of local needs, and cross-sector collaboration, a holistic and sustainable intervention strategy can be formulated. This study highlights the importance of active community involvement, including the role of mothers and families, as well as support from local governments and health institutions. Regular evaluation of program implementation and monitoring of its impact are also the main focus. Surabaya has allocated a special budget, formed a Stunting Reduction Acceleration Team, and designed an integrated recording system. Even though the food supplement program is supported by the pregnant women class, there are still obstacles such as managing a large population and low food availability. The Fishbone model is used to analyze children's nutritional needs and the factors that cause stunting. It is hoped that the results will provide practical guidance for decision makers and stakeholders in designing and implementing effective stunting prevention programs, with the ultimate aim of improving the health and welfare of children in the city of Surabaya.

Adoption of the Supplemental Food for School Children Program at Kulon Progo City

One of the national programs is providing Supplementary Food for School Children, which was launched to accelerate the achievement of national development goals. This complete food-based program was the first to be carried out in Kulon Progo Regency; in the previous year, this supplementary food program was provided in the form of snacks. This research aims to explore the adoption of the Supplementary Food for School Children program in Kulon Progo Regency. This research used a qualitative design with a case study approach. The selection of informants used a purposive sampling technique. Data collection is done by in-depth interview method and focus group discussion. The validity of the data is done by using source triangulation, member checking, and peer debriefing. This aspect of adoption consists of the program implementer's intention to adopt a program, how the activity implementer tries to implement a program and implements the innovations needed for program development. This is demonstrated by their being able to prepare a team to implement the Supplementary Food for School Children program in schools consisting of cooks and administrative staff, prepare the facilities and infrastructure for implementing the program, and carry out initial anthropometric measurements of school children. Schools receiving the Supplementary Food for School Children program show that they are ready and able to adopt this new program in their respective school settings

Improving the Nutritional Status of Socially Vulnerable Children in Manaus, Brazilian Amazon, through a Food Supplementation Programme.

Information on the effects of government nutrition programmes provided to socially vulnerable children to improve their nutritional status is scarce. We analysed the effectiveness of a nutritional programme, including food supplementation with infant formula, on the evolution of the weight and height of socially vulnerable children from Manaus in the Brazilian Amazon. This study included 7752 children aged 12-24 months admitted to the programme between 2017 and 2020. Weight and height measurements at admission and every three months thereafter were extracted from the programme database. Weight-for-age, weight-for-height, body mass index-for-age (BMI/A), and height-for-age z-scores were analysed using a multilevel linear regression model, which showed a statistically significant decrease in nutritional deficits toward nutritional recovery at follow-up. The programme's effectiveness was evaluated in 1617 children using a paired analysis comparing data from between 12 and 15 months of age at admission and follow-up after 6-9 months. Children admitted with wasting presented an increase in the BMI/A z-score, whereas children admitted with a risk of being overweight and obese had a statistically significant decrease in the BMI/A z-score. Children admitted with stunted growth also showed increased height-for-age z-scores. The nutrition programme was effective for children experiencing wasting and reducing excess weight.

Before and after study of a national complementary and supplementary feeding programme in Rwanda, 2017-2021.

To address high rates of malnutrition among children from vulnerable households in Rwanda, the government initiated a national food supplementation programme. A before and after evaluation, using repeat cross-sectional surveys in randomly selected villageswas conducted; aimed at assessing the effectiveness of providing fortified blended food (FBF) to children 18-23 months of age, pregnant and lactating women in the lowest tier of Rwanda's social support system. Data were collected in 2017, 2018and 2021 through interviews with caregivers; anthropometric measurements and a capillary blood sample were obtained from children. The primary statistical analysis compared the nutritional status of children before and after the introduction of FBF. We enroled 724 children during each survey. The prevalence of stunting declined from 47% to 35% between 2017 and 2021; in 2018, the prevalence of stunting was 43%. Children had a 42% reduction in the odds of being stunted (adjusted odds ratio [AOR]: 0.58, 95% confidence interval [CI]: 0.47-0.74, p < 0.001) from 2017 to 2021 even after adjusting for inherent, distal, proximal, and intermediate covariates. The reduction in stunting observed within the first year of the programme was not statistically significant (AOR: 0.83, 95%CI: 0.67-1.03, p < 0.091). We observed meaningful reductions in the prevalence of stunting among children which coincided with the introduction of Government-led initiative to reduce malnutrition. The Rwandan Government has committed to improving the living conditions of vulnerable households and has made strong investments in reducing malnutrition. The impact of these investments can be seen in the overall trend towards improved nutritional status highlighted in this evaluation.

Unmetabolized folic acid and organ fibrosis: Are they nefarious partners?

Recent publications raise the possibility that folic acid (FA), specifically unmetabolized folic acid (UMFA), might promote the progression of organ fibrosis via signaling through folate receptors, leading to excessive extracellular matrix production by myofibroblasts and other cell types. Clinical research over the past two decades adds credence to this largely unexplored contention. FA is a synthetic form of folate, first made in 1945, that has been added to the food supply in the US since 1998 to decrease neural tube defects; subsequently, other countries have followed suit. Notably, synthetic FA, compared to natural dietary folates, is metabolized differently, and potentially activates cellular signaling pathways, leading to fibrosis progression. Although FA food supplementation programs have resulted in a roughly 2-fold increase in serum folate concentrations and a decrease in the prevalence of neural tube defects, other concerns have surfaced. As such, due to the incomplete metabolism of ingested FA, before it can enter cellular processes, most individuals exhibit concentrations of unmetabolized folic acid (UMFA) in the circulation. We hypothesize that it is UMFA, but not natural occurring food folates, which in part promotes the progression of organ fibrosis in many systems. We feel the issue is relevant since organ fibrosis is involved in nearly half of all mortality in industrialized nations. Finally, this proposed nexus of UMFA and organ fibrosis might have preventive and therapeutic implications, and more research is needed on the topic.

Sosialisasi Makanan Sehat Dan Dampak Stunting Terhadap Pertumbuhan Perkembangan Anak Usia Dini

Stunting is a serious problem in the growth and development of early childhood which can have an impact on their health and quality of life. Therefore, it is necessary to carry out effective outreach and intervention to prevent stunting. The KKN (Real Work Lecture) program in Karangrowo Undaan Village is a forum for implementing this effort. In this context, PMT (Extension and Socialization of the Supplemental Food Program) is the main instrument in educating mothers of toddlers about stunting and the importance of balanced nutrition. This abstract describes the stages of the KKN program which involves counseling, discussion, measuring children's height and weight, as well as the practice of preparing a healthy, nutritious lunch menu. Through the "learning by doing" method, participants are actively involved in this activity to increase their understanding of stunting and how to prevent it. This program has great potential to increase public awareness and knowledge regarding stunting and improve early childhood health through PMT.

Evaluation of Local Supplementary Feeding Program in Toddler Nutrition Recovery House (Pelita) in Kedung Banteng District, Tegal Regency

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;One approach taken to reduce the prevalence of stunting is by providing additional recovery food to malnourished toddlers. The Rumah Pelita supplementary food program has been running in Kedung Banteng District since 2020. In the implementation of the Rumah Pelita Program, there are still existing cases of stunting and the nutritional status of targets and there has never been an evaluation of the Rumah Pelita program. The aim of the research is to determine the evaluation of the supplementary feeding program made from local food in Kedungbanteng District, Tegal Regency in terms of input, process and output aspects. This research method is qualitative research which is descriptive and evaluative in nature. The research period is January-March 2023. The research was conducted in 5 villages in the Kedungbanteng Community Health Center area. The main informants were 1 nutrition officer and 5 village midwives, and triangulation informants were 5 Rumah Pelita cadres and 5 mothers of toddlers. Data collection used in-depth interviews, while the source triangulation method was used to validate the data. Research data analysis is data reduction, data presentation and drawing conclusions. The results of the research show that the number of cadres is still insufficient, and there are still villages that have not budgeted for equipment rental and transportation for cadres, there are deficiencies in reporting and recording and there are still toddlers who experience stunting. There needs to be integration of central and regional government policies regarding handling stunting in toddlers, so that there is a division of the budget for handling stunting. and it is recommended that health workers provide health education about stunting prevention and routinely monitor the development of toddlers. &lt;/em&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keyword: Stunting, Policy, Nutrition, Provision of supplementary food, Toddler&lt;/em&gt;&lt;/strong&gt;

Factors Affecting Food-Related Activity Performance in Low-Income Older Adults

In an effort to reduce food access issues for older adults, the United States Department of Agriculture’s (USDA) Commodity Supplemental Food Program (CSFP) provides monthly food assistance specifically for low-income older adults through local food banks. The purpose of this study was to explore factors that influence an older adult’s performance in food-related activities. Older adults eligible to receive a monthly senior food box from community food distribution sites were recruited to complete a survey. The survey included home information, Patient-Reported Outcomes Measurement Information Systems (PROMIS®) v1.1 Global Health measure, individualized supplemental food utilization profile (FP), and a kitchen inventory. Descriptive and statistical analyses were performed. From December 2021 until March 2023, n = 200 participants were recruited and n = 36 took the survey for an 18% completion rate with a mean age of 71 years old; 61% were female and 36% were male. Of the participants who took the survey, 64% ( n = 23) acknowledged having at least one chronic disease and 89% ( n = 32) indicated they prepared meals for themselves. The OPMF revealed grocery shopping, cooking, and eating as “extremely important” and directly related to their performance and satisfaction. The FP rate revealed that 61% ( n = 22) of participants always use 100% of their food box by the end of each month. While the participants in this study report having at least one chronic disease, most are functional and independent when it comes to food-related activities, and most report that they have the tools to manage and use their food resources.

Evaluating WIC Engagement andFood Insecurity Among Active Duty Military Families.

Nearly a quarter of active duty service members identified as food insecure in a 2022 Department of Defense report. Food insecurity impacts military readiness, retention, and recruitment. The Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federal food supplementation program that can mitigate food insecurity for service members with children less than 5 years of age. To date, there is a lack of standardized screening for WIC eligibility or enrollment for service members and their families. This project sought to evaluate WIC awareness and enrollment as well as the prevalence of food insecurity at Walter Reed National Military Medical Center. A 26-question survey was developed to assess WIC awareness, source of WIC information, food insecurity, and nutritional insecurity. Our team developed and utilized a novel WIC screening algorithm to rapidly screen families for WIC eligibility. These tools were administered to families presenting for care at the Walter Reed National Military Medical Center pediatrics and obstetric outpatient clinics during the month of July 2022. This study was approved by the institutional review board at Walter Reed. A total of 108 (25%) of the 432 surveyed participants were eligible for WIC, with odds of WIC eligibility increasing for lower-ranking and younger service members. Of the 432 participants, 354 (81.9%) were aware of WIC. Enlisted service members were more likely than officers to know about WIC (P = 0.03), and of the 354 participants aware of WIC, a higher proportion of enlisted rank respondents learned about WIC from a military source (P = 0.01). Among the 108 participants eligible for WIC, only 38 (35.2%) reported being enrolled in WIC. Among WIC-eligible respondents who knew about WIC, being enrolled in the WIC program was not associated with rank, branch of service, sponsor gender, or sponsor age. Despite proven efficacy, WIC remains an underutilized resource for eligible military families. Our results show that a standardized screening approach at Walter Reed National Military Medical Center increased identification of WIC-eligible active duty service members by 180%, with approximately $150,000 a year in increased food supplementation benefits. Military healthcare and readiness leaders should embrace efforts to increase knowledge of, referral to, and enrollment in WIC to increase family health, well-being, and military family readiness.

Evaluasi Pemberian Makanan Tambahan pada Ibu Hamil dengan Kekurangan Energi Kronis (KEK) dari Program Corporate Social Responsibility (CSR) di Wilayah Kerja Puskesmas Tegal Angus Kabupaten Tangerang Tahun 2022

The condition of pregnant women who are at risk of CED can cause a decrease in the ability of the muscles that support the birth process. This can cause prolonged labor as well as bleeding, which is dangerous for the mother. Based on this, PT. Agung Sedayu Group pays special attention to the condition of chronic energy deficiency in pregnant women by creating a supplementary food program in the form of a unique and complete menu in the hope of helping to reduce the prevalence of chronic energy deficiency in pregnant women. The aim of this research is to find out how to evaluate the provision of additional food to pregnant women with chronic energy deficiency (KEK) from the Corporate Social Responsibility (CSR) program in the Tegal Angus Community Health Center work area in 2022. This type of research applies the Mixed Methods method with a Sequential Explanatory design The design starting from the first step of the research was carried out using quantitative methods and the second step was carried out using qualitative methods. Secondary data collection techniques were taken from Community Health Center data, while primary data were collected using in-depth interviews. Data analysis was carried out using the Wilxocon test. The research results showed that there were differences in the nutritional status of KEK pregnant women seen from LiLA with a significance value of 0.000 (p

FOOD SUPPLEMENTATION INCREASES MULE DEER (Odocoileus hemionus eremicus) RETENTION AT THE RANCHO SAN HUBERTO WILDLIFE CONSERVATION MANAGEMENT UNIT, SONORA, MEXICO

Artificial food and water supplementation programs are common in Wildlife Conservation Management Units (UMAs) in arid northern Mexico to attract and retain mule deer as quality trophies. However, implementing these actions represents a high economic cost, and there is no convincing evidence of their effectiveness. This study evaluated the effect of food and water supplementation by capture-mark-recapture using camera traps at the UMA San Huberto, Sonora, Mexico. During the winter of 2015-2016, male mule deer counts and detection histories were collected at 62 photo-trapping stations spread across four supplementation treatments: 1) water and food, 2) water, 3) food, and 4) no supplementation. In addition, to assess the impact of natural vegetation on trough and feeder utilization on the ranch, the Normalized Difference Vegetation Index was calculated using Landsat 8 satellite images. A log-Poisson regression model for deer counts per photo-trapping station found that food supplementation increased mule deer numbers by 42 % when compared to stations without food supplementation. Vegetation biomass had no effect on the frequency of use of feeders and waterers in any of the treatments. According to the multistate model for detection histories, male mule deer at waterers receiving food-only supplementation are more likely to remain in that treatment than to move to either of the other two treatments (water and feed or water). This finding suggests that food-only supplementation is more effective in retaining male mule deer.

Improving Nutritional Status of School Going Children Through School-based Nutrition Program in Rajasthan, India

This case control research was conducted in the tribal block of Sirohi district of Rajasthan, India to assess the impact of the food supplementation program on the nutritional status of school-going children. With 1:1 matching using parameters of sex and age of children from six villages each, data of 430 1st to 8th grade children, 215 cases and controls each, were analysed. World Health Organization (WHO) Anthro plus tool was used to determine the Weight for Age, Height for Age and Body Mass Index (BMI) for age indicators. Results showed that children who were on the intervention of milk were found to be 1.7 times more active as compare to those not receiving milk. It was also found that the proportion of children with severe malnutrition- in terms of wasting, stunting and underweight – was less among cases as compare to the controls. However, the difference was found significant only for wasting and underweight respectively. Therefore, it was concluded that milk-based interventions have been proved to be successful strategy in combating acute malnutrition among school-going children. More research is needed to evaluate the impact of such interventions on stunting, and to improve the program planning for scaling up and replication.

Social Determinants of Child Undernutrition in Adivasi Population in Northern Kerala: A Study Using Syndemic Framework.

To understand the complex interaction of structural inequalities, co-occurring health conditions, and child undernutrition among the Adivasi population in North Kerala, India. A mixed-method approach was employed in this study, which combined a cross-sectional survey and a case study design. A multistage cluster sampling method was used to select 167 children aged 24 to 60 mo from the study population. The mothers of these children were interviewed using a structured questionnaire to assess individual, parental, and household-level factors associated with child undernutrition. Two Paniya settlements, one with a high prevalence of child undernutrition (HPS) and the other with a low prevalence (LPS), were chosen as the primary units of the case study. The study found that the absence of a kitchen garden with fruits and vegetables [adjusted odds ratio (AOR) 2.85; 95% confidence interval (CI): 1.04-7.81] and a history of cough and fever (AOR2.93; 95% CI: 1.24-6.93) were both associated with a higher risk of undernutrition in children. The case studies revealed that Adivasi children are undernourished due to a complex set of factors that persist throughout their lives, including unequal access to social capital, healthcare, and food security, as well as differences in hygiene practices due to the lack of access to clean water and sanitation. The findings underscore the need for social interventions to complement the current focus almost entirely on food supplementation programmes. Equitable action on Adivasi child malnutrition requires urgent policy and programmatic attention to social inequalities and access to basic amenities in Adivasi areas.

Evaluation of USDA Foods Programs for households using nutrition guidelines for the charitable food system.

The United States Department of Agriculture (USDA) Foods programs for households (i.e., The Emergency Food Assistance Program (TEFAP), the Food Distribution Program on Indian Reservations (FDPIR), and the Commodity Supplemental Food Program (CSFP)) are designed to provide nutritious foods at no cost to income-eligible individuals in the U.S. To evaluate the nutritional quality of the foods available from three USDA Foods programs for households (i.e., TEFAP, FDPIR, and CSFP) according to the Healthy Eating Research (HER) Guidelines for the Charitable Food System. Review of the nutritional information of the foods available from USDA Foods programs for households. Using the HER Guidelines, foods were categorized into a three-tiered system (i.e., choose often/green; choose sometimes/yellow; choose rarely/red) based on levels of saturated fat, sodium, and added sugar per serving, and presence of whole grains. All unique foods available from TEFAP, FDPIR, and CSFP (N=152) for fiscal year 2022 were evaluated. Nutritional quality of the foods available from USDA Foods programs for households according to the HER Guidelines. Foods were ranked green, yellow, red, or not ranked. The proportion of foods in each HER Guidelines' rank was calculated across the three USDA Foods programs for households and by each program. The majority of USDA Foods were ranked green (57.2%) or yellow (35.5%). A small number of items were ranked red (3.3%) or were unranked condiments or cooking staples (3.9%). The USDA Foods available in the household programs were primarily fruits and vegetables; lean proteins; whole grains; and low-fat dairy products that were consistent with national dietary guidelines. There is some room for improvement, and adjustments in the specifications for certain items are recommended to further strengthen the nutritional value of the foods provided through these important federal programs.

Analysis of the food and medicines provision in the northern regions of the USA and Canada

The article is devoted to the analysis of foreign experience in ensuring the availability of medicines and food products for the population of the northern regions of the United States and Canada. The author considers in detail the work of support mechanisms in hard-to-reach places in Alaska and the Northwest Territories of Canada, where there is no transport communication all year round. The content of the U.S. government programs on drug coverage (Medicare and Medicaid), mechanisms of subsidizing food and essential commodities (Supplemental Nutrition Assistance Program (SNAP), Women/Infants and Children Program (WIC), Commodity Supplemental Food Program (CSFP), Farmers’ Market Nutrition Program (FMNP), Senior Farmers’ Market Nutrition Program (SFMNP)) were analyzed. The delivery of food by the Alaska ByPass mail program, which delivers food and necessary goods to hard-to-reach settlements where there are no roads, was studied. The article also pays attention to the state policy on a healthy lifestyle, which includes proper and balanced nutrition, considers state programs and recommendations on nutrition for Americans (Dietary Guidelines for Americans) and Canadians (Canada’s Food Guide). The results of the work can be used in the development of programs and proposals for improving measures to support and provide Arctic regions of the Russian Federation with food products and medicines.

Abstract P379: Groceries for Black Residents of Boston to Stop Hypertension (GoFresh): A Randomized Clinical Trial

Background: Diet is a major cause of disparities in hypertension among Black adults. While the Dietary Approaches to Stop Hypertension (DASH) Eating Plan is proven to lower blood pressure (BP), access to DASH-patterned groceries is a major barrier for residents of urban food deserts. Objective: To test whether dietitian-assisted, home-delivered, DASH-patterned groceries lower BP among Black adults with elevated BP who reside in Boston area food deserts. Methods: The Groceries for Black Residents of Boston to Stop Hypertension (GoFresh) study is one of five projects in the RESTORE Network, an AHA-funded initiative focused on hypertension prevention. This individual level, parallel-arm trial will enroll up to 176 Black adults with a systolic BP (SBP) between 120 and &lt;150 mm Hg, who reside in communities identified by the MA Department of Health as urban food deserts. Following a 1:1 randomization scheme, half of participants will be assigned to weekly sessions with a dietitian, who will assist in ordering DASH-patterned groceries online for home delivery. The remaining participants will receive an unrestricted monthly stipend (referent). Both interventions will last 3 months followed by a 9-month maintenance phase. The trial is powered to detect a difference in SBP (primary) of -5.8 mm Hg measured after 3 months (DASH vs stipend). Secondary outcomes are 24-hour ambulatory BP, body mass index, 24-hour urine sodium and potassium, hemoglobin A1C, lipids, and intake of fruits, vegetables, and saturated fat. Qualitative interviews will be conducted with 45 participants after 6 months to determine barriers and facilitators of long-term intervention maintenance. The study will establish a biorepository of blood and urine. A Community Advisory Board collaborates with the study team on all aspects of the trial. Discussion: Findings from this study will inform ongoing work on scalable interventions to prevent hypertension among Black adults with implications for public and healthcare-based food supplementation programs.