Search Results (299)

Highly sensitive methods for trace-level aflatoxin determination are indispensable for cereal food safety and public health protection. This study developed a ZrO₂-assisted QuEChERS-UHPLC-MS/MS method for the simultaneous determination of AFB₁, AFB₂, AFG₁, and AFG₂ in maize, wheat, rice, and soybean. Systematic optimization identified acetonitrile as the optimal extraction solvent and 10 mg ZrO₂ in combination with PSA, C₁₈, and GCB as the optimal cleanup formulation, providing recoveries of 107.33–111.60%. Chromatographic baseline separation was achieved within 8.0 min using a moderate gradient program. The method exhibited excellent linearity (R² > 0.999) with LODs of 0.15–0.25 µg/kg and LOQs of 0.50–0.75 µg/kg. Negligible matrix effects (0.85–1.02) validated the efficacy of ZrO₂-assisted cleanup in eliminating co-extractive interferences in maize. Satisfactory accuracy (recoveries of 86.66–111.04%) and precision (RSDs < 14%) were obtained across all matrices. The method demonstrated consistent performance across diverse cereal and soybean matrices, fulfilling international regulatory requirements for routine aflatoxin monitoring in agricultural commodities. Full article

Background/Objectives: Healthy food incentive programs (HFIP), such as fruit and vegetable voucher incentives, can supplement other nutrition assistance programs to support food and nutrition security. However, little is known about the prevalence of HFIP, particularly at the municipal level. This study examines the prevalence of HFIP in a nationally representative sample of U.S. municipalities and the association between the availability of HFIP and municipal characteristics. Methods: Using data from the CDC’s 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy and Active Living (n = 1982 municipalities), a weighted bivariate analysis and multivariable logistic regression analysis were conducted to estimate the prevalence of HFIP overall and by municipal characteristics, and to assess the relationship between municipal characteristics and HFIP. Results: Only 7.8% of municipalities reported offering HFIP in 2021. The odds of having an HFIP were higher in municipalities with a food policy council (aOR 2.8; 95%CI: 1.9, 3.9) compared to those without. Larger communities (size ≥ 50,000 reported 24.6%) and those with a higher prevalence of residents living in poverty were also more likely to offer HFIP. Conclusions: Few municipalities reported offering HFIP. Results suggested that engaging institutions and individuals (e.g., via food access coalitions) may be strategies that could support municipalities initiating and implementing HFIP to improve diet quality and reduce chronic disease risk. Full article

Background: Food insecurity is defined as having limited access to food, while nutrition insecurity is characterized as a lack of consistent access to affordable and acceptable foods that support health, manage or prevent disease, and meet daily nutritional needs. College students face increased risks of food and nutrition insecurity, yet the issue is understudied. This study examined the patterns of food and nutrition insecurity among students at a public university across main and regional campuses. Methods: We conducted a cross-sectional survey using Qualtrics for participant recruitment in November 2023. The USDA’s 10-item toolFood insecurity was measured using the USDA’s 10-item tooland housing security was measured using the U.S. Census Bureau’s National Survey of Income and Program Participation 6-item tool. We used ANOVAs and logistic regression to examine differences across demographics. Data analysis was done using SPSS version 29. Results: There were 6538 student responses. Of these, 36% of students were food insecure, while 20% were nutritionally insecure. Comparatively, food and nutrition insecurity were significantly higher among students with low-income (p < 0.001), housing instability (p < 0.001), a higher number of dependents, and those indicating that they were single/unmarried (p = 0.005), first-generation (p < 0.001), and Pell grant eligible (p < 0.001). Annual income and housing security emerged as significant predictors: lower income was approximately twice as likely to be associated with food insecurity, while those reporting housing insecurity were six times more likely to experience food insecurity. Conclusions: The study findings reveal disparities in food and nutrition insecurity among a diverse student population at a public university. Addressing the issue among them is crucial and requires a multifaceted, inclusive approach. Emergency financial assistance and structural interventions that promote housing security are warranted. Full article

This study assessed whether frequent attendance of onsite produce events at Federally Qualified Health Centers is associated with increased fruit and vegetable consumption, reduced food insecurity, and enrollment in food assistance. A deeper understanding of these relationships may help program implementers and health practitioners improve healthy food access among low-income patients by screening for food insecurity and offering onsite produce distribution events at clinic sites. Using a cross-sectional observational design, study data originated from an intercept survey of 886 adults who attended free produce events at 14 clinic locations in Los Angeles County during 2021–2023. Multivariable models assessed associations between attendance frequency and the main outcomes: fruit and vegetable consumption, food insecurity, and enrollment in food assistance (i.e., SNAP, WIC). Compared with first-time attendees, frequent attendees had higher odds of meeting the MyPlate recommendations for fruit (adjusted odds ratio [AOR] = 1.37, p = 0.012) and vegetable (AOR = 1.47, p = 0.019) consumption. Frequent attendees, compared with first-time attendees, also had marginally lower odds of food insecurity (AOR = 0.73, p = 0.077), with no effect on food assistance enrollment. These findings suggest safety-net health centers can play meaningful, multi-faceted roles in increasing patient access to healthy food by screening for food insecurity and offering onsite free produce distributions at their clinic sites. Full article

Background: Oral health is a key component of general health and quality of life in the elderly. Residents of long-term care facilities (LTCFs) are particularly vulnerable to poor oral health due to multimorbidity, polypharmacy, and dependence on caregivers. Despite increasing awareness of this issue, dental needs in institutionalized populations remain largely unmet. Objectives: The objective of this study was to evaluate the dental treatment needs of LTCF residents in Warsaw. The analysis focused on oral health status, oral hygiene practices, difficulties with food intake, and the need for assistance in daily oral and nutritional care. Material and methods: A cross-sectional study was conducted among 29 LTCF residents. Data collection included interviews on hygiene habits and dietary difficulties, followed by clinical examination assessing oral mucosa, dentition, prosthetic status, and plaque coverage (Plaque Index). Statistical analyses were performed using GraphPad Prism with Mann–Whitney U, Fisher’s exact, and Spearman’s rank correlation tests. Results: The median number of missing teeth ranged from 22 to 24. Active caries were found in 17 residents and periodontitis in 19. Oral hygiene was poor, with plaque covering up to 100.0% of tooth surfaces. Women had significantly more missing teeth than men (p = 0.0128). Difficulties with food intake were reported by 69.0% of residents. No significant associations were found between oral hygiene products use and dental or prosthetic status. Conclusions: This study revealed severely compromised oral health among LTCF residents. Extensive tooth loss, poor hygiene, and limited access to preventive dental care indicate the need for systematic, on-site oral health programs, caregiver training, and integration of dental services into standard geriatric care. Full article

Background/Objectives. Food insecurity and pediatric obesity have increased concurrently in the U.S., raising questions about the role of Federal Nutrition Assistance Programs (FNAPs) in shaping weight outcomes. This systematic review examined evidence on relationships between FNAP participation and pediatric weight outcomes. Methods. Six databases were searched for U.S.-based, peer-reviewed studies published through July 2024 that assessed FNAP participation and pediatric weight outcomes. Results. Seventy-five studies met the inclusion criteria, and no consistent pattern indicated that any single FNAP or program type (educational setting-based or direct financial support) reliably reduced or increased childhood overweight or obesity risk. Twenty studies found statistically significant beneficial relationships between FNAP participation and pediatric weight outcomes. Most studies reported mixed findings (n = 32), typically varying by subgroup (e.g., age, grade level, gender, race or ethnicity, or program characteristics). Sixteen studies found no relationship between participation and weight. Seven studies found an adverse relationship. Most studies relied on non-randomized quantitative designs and secondary data, and adverse findings were more common in lower quality studies. Among 18 studies that evaluated the effects of policy changes (e.g., the Healthy Hunger-Free Kids Act (2010), 2009 WIC package change), nearly all identified associations between the policy change and weight outcomes, with eight beneficial and nine reporting mixed results. Conclusions. The findings indicate a complex non-causal relationship between FNAP participation and weight that varies across populations, programs, and study designs. Overall, evidence does not support broad adverse weight effects of FNAPs, and policy changes that strengthen nutrition standards may contribute to healthier weight outcomes. These findings have implications for nutrition policy, program design, and future research. Full article

Background: Food insecurity among college students is a multidimensional challenge shaped by individual, interpersonal, institutional, community, and policy factors. Although many campuses require or provide meal plans, students may experience food insecurity when barriers related to agency (choice and autonomy), utilization (nutrition security), and availability persist. This study explored how undergraduate students at a private, urban U.S. university experience and navigate the multiple dimensions of food insecurity. Methods: We conducted in-depth, semi-structured interviews via Zoom between December 2024 and January 2025 with n = 22 undergraduate students recruited based on food security status, determined by a Fall 2024 longitudinal survey using the USDA Six-Item Short Form. Transcripts were double-coded by trained research assistants in ATLAS.ti using an inductive codebook. Thematic analyses followed a phronetic, iterative approach, organizing findings within a socio-ecological determinants framework and comparing themes by food security status. Results: We identified nine themes across four domains (individual, interpersonal, institutional and community, and political). At the individual level, constrained personal resources for groceries and cooking, time scarcity leading to skipped meals, and health impacts that detracted from academics emerged as key themes. Interpersonally, reliable family financial support was protective and informal support from peers/coaches filled gaps sporadically for some. At the institutional and community level, dining hall hours misaligned with student schedules, perceived limited variety and nutrition quality reduced food agency and utilization, and transportation impeded use of the sole grocery partner accepting university meal plan benefits. Notably, meal plans including unlimited meal swipes provided stable access but did not guarantee food security when food agency and utilization barriers persisted. Many students relied on campus events for free food; formal assistance (e.g., food pantry) was largely underused. At the policy level, Supplemental Nutrition Assistance Program (SNAP) awareness and enrollment was limited among our sample. Conclusions: Meal plan access alone is insufficient to ensure food security. Campus strategies should extend beyond access to prioritize flexibility, variety, and alignment with students’ schedules and preferences, while strengthening communication and eligibility support for external benefits. Future work should design and evaluate interventions that integrate all dimensions of food security and address institutional policies affecting students’ basic needs. Full article

Adult obesity rates have risen steadily across the United States over the past decade, with more than 40% of adults affected. Persistent geographic and demographic disparities exist in obesity prevalence across the nation. While prior research has examined individual or environmental associated factors of obesity, limited studies have addressed both physical activity and food environments across the nation using multilevel approaches. This cross-sectional ecological study (2014–2024) used a two-level random intercept model to assess the association between county- and state-level factors and adult obesity prevalence across over 3000 U.S. counties nested within 51 states. County-level associated factors included food insecurity, poverty, unemployment, median household income, limited access to stores, and the density of various food outlets (grocery stores, convenience stores, supercenters, fast-food restaurants, Supplemental Nutrition Assistance Program (SNAP)-authorized retailers, and farmers’ markets), along with access to recreational facilities. State-level factors included SNAP benefits per capita and the presence of soda and chip taxes. Variables were group-mean- or grand-mean-centered to distinguish within- and between-state effects. Results showed that food insecurity, poverty, unemployment, limited access to stores, and a higher density of fast-food and convenience stores were positively associated with adult obesity prevalence. While higher recreational facility access, supercenter availability, median household income, SNAP benefits per capita were associated with lower adult obesity prevalence, these associations varied in strength across counties and states. These results emphasize the need for place-based strategies that address both the physical activity and food environment in shaping obesity disparities. Full article

Background: Food insecurity may adversely affect cognitive function through pathways involving nutritional deficiencies, chronic stress, and comorbid health conditions, with potentially different effects across cognitive domains. Longitudinal evidence remains limited by time-varying confounding, and it is unclear whether Supplemental Food Assistance Program (SNAP) participation modifies these associations. Objectives: To examine the longitudinal association between food insecurity and cognitive function using marginal structural models (MSMs), and whether SNAP participation buffers these associations for overall cognition, episodic memory, and attention/mental processing. Methods: 30,641 adults aged ≥50 in the 1998–2020 Health and Retirement Study (HRS) contributed 156,066 person-year observations. MSMs with stabilized inverse probability of treatment weights were used to account for time-varying socioeconomic, health, and cognitive confounding affected by prior exposure. Weighted pooled linear regression models estimated marginal associations and interaction effects. Results: Moderate and high food insecurity were associated with lower overall cognition (b = −0.36 and −0.71, respectively; p < 0.001). Similar graded associations were observed for episodic memory (b = −0.22; −0.43) and attention/mental processing (b = −0.15; −0.28; all p < 0.001). SNAP participation significantly attenuated these associations across cognitive domains, with stronger buffering effects among non-Hispanic Black and Hispanic respondents. Effect sizes corresponded to differences equivalent to several years of cognitive aging. Conclusions: Food insecurity is associated with poorer cognitive function across multiple domains, while SNAP participation mitigates these associations. Despite limitations of observational data, these findings highlight the methodological value of MSMs and the potential role of food assistance programs in reducing cognitive health disparities in later life. Full article

Background/Objectives: Food is Medicine (FIM) programs have been shown to be effective at addressing food and nutrition insecurity among individuals. However, more evidence is needed to determine effective interventions at the household level and their impact on child health outcomes. Feeding the Family is a randomized controlled trial which aims to determine whether the amount of food provided and the ability to select foods in FIM interventions have an incremental effect on child and caregiver clinical outcomes relative to nutrition counseling alone. The objective of this paper is to describe the population at baseline among those enrolled in Feeding the Family, an FIM family intervention. Methods: A pragmatic randomized controlled trial (pRCT) with a 2 × 2 factorial study design was used at an urban primary care clinic. Participants were randomized into one of four arms for a 3-month intervention: (1) medically tailored meals (MTMs), (2) grocery prescription (GP), (3) combined MTMs + GP, and (4) delayed control. Primary outcomes consisted of child and caregiver biomarkers (BMI, blood pressure, A1c, LDL, and HDL). Secondary outcomes included child and caregiver dietary behaviors, nutrition security, and food security. Spearman correlations and Kruskal–Wallis rank sum tests determined correlations between caregiver and child biomarkers, as well as correlations between caregiver socioeconomic factors and child outcomes, respectively. Results: Thirty-one caregivers and fifty-one children were enrolled. Nearly 90% of caregivers reported low–very low household food security; 93.6% experienced ongoing financial strain. Several caregiver–child biomarker correlations were observed, including caregiver and child BMI (r = 0.59, p = 0.043), caregiver LDL and child A1c (r = −0.79, p = 0.004), and caregiver total cholesterol and child BMI (r = −0.62, p = 0.032). In addition, food assistance status was associated with child vegetable intake (H = 6.16, df = 2, p = 0.046), and caregiver food security score was associated with child food security score (H = 18.31, df = 9, p = 0.032). Conclusions: There are robust correlations between caregiver and child clinical outcomes at baseline. These findings underscore the need for FIM research to examine how a tailored program can improve the clinical outcomes of entire households to address health disparities effectively. Full article

Sweetpotato genotypes, often known by regional names, are easily propagated via cuttings, which can lead to mixing and misidentification of cultivars. This complicates traceability and commercialization. Accurate characterization of common genotypes would support their formal registration and strengthen the sweetpotato value chain. Sweetpotato is a staple crop in Brazil, and in this study, four states, representing different geographic regions in Brazil, were selected. A total of 37 samples were collected in these states, and the samples were evaluated by SSR molecular markers and morphological traits. The samples were cleaned of virus and compared to the global sweetpotato collection held at the International Potato Center under the International Treaty on Plant Genetic Resources for Food and Agriculture. SSR markers effectively distinguished among accessions. The genotype locally known as “Canadense” matched closely both genetically and morphologically to the CIP accession ‘Blesbok’. This alignment paves the way for formalizing cuttings and root production of “Canadense”/‘Blesbok’ for commercial use. In contrast, several accessions marketed in Sergipe as “white skin sweetpotato” did not correspond to any known CIP accession, suggesting that they may be unique regional genotypes or acquired from other sources, since sweetpotato is an exotic crop in Brazil. Overall, the research identified key genotypes, supporting their official registration with Brazil’s Ministry of Agriculture, Livestock, and Supply, thereby enhancing the legal commercialization of cuttings and roots. Additionally, the clear molecular and trait-based classification will assist sweetpotato crop improvement programs in selecting appropriate parent lines for future crosses. Full article

Food insecurity disproportionately affects Hispanic households in the US. This study examines food access perceptions among rural Latinos, acknowledging that food environments are complex systems influenced by factors such as availability, accessibility, affordability, acceptability, and accommodation. This phenomenological qualitative study was conducted with adult Latinas living in Nebraska’s rural areas. Data was collected through participatory mapping, semi-structured interviews guided by the five dimensions of food access, and demographic surveys. Eighteen women participated in in-person interviews, and 68.3% of participants met the criteria for food insecurity. While chain stores were the primary shopping option in rural areas, challenges included limited availability of foods that are culturally relevant and accommodate special dietary needs. Ethnic stores were valued for cultural relevance despite concerns about quality and pricing. Overall, affordability was a significant barrier due to high rural costs, worsened by challenges in navigating nutrition program benefits and documentation status. Research or interventions targeting improvements in rural food security must extend beyond mere store availability, focusing on economic development, policy reform, and enhanced education in assistance programs to address these complex challenges. Full article

Background/Objectives: Policies to promote healthy eating often work through local food systems, which link food supply chains and food environments to individuals. The COVID-19 pandemic exposed vulnerabilities in national and global supply chains and emphasized the importance of local food systems in meeting community and individual needs. Unfortunately, we know too little about how to shape local food systems. This case study reports the impacts of the COVID-19 pandemic on the New Orleans food system and the subsequent response from the community and local government to strengthen it through city and state policy changes, public–private collaborations, and grassroots citizens’ efforts. Methods: This study uses a participant–observer approach in which observations from an online 2020 survey of local food organizations (n = 56) were fielded by the New Orleans Food Policy Action Council (FPAC), a local coalition of food and agriculture groups. The authors, who worked with or were a part of FPAC, analyzed survey data for recurrent themes and then synthesized this with archived written materials and the authors’ own observations. Results: Key themes from this survey are detailed, along with an exploration of related efforts within the community, including: (1) Greaux the Good, a campaign developed by local food system stakeholders to successfully advocate for increased food assistance funds from the Supplemental Nutrition Assistance Program; (2) policy change related to food vendor permitting; and (3) establishment of two positions within the local government: a City Food Specialist to increase collaboration between organizations in the food system and an Urban Agriculture Liaison to support local food production. Lastly, innovative programs of grassroots citizens’ organizations are detailed due to their positive impact on food access for community members. Conclusions: The cumulative impacts of these efforts added to the resiliency of the local food system and may protect it against the effects of future disasters as well as strengthen its ability to promote healthy eating. Full article

Background/Objectives: Transportation is a critical social determinant of health with direct impacts on healthcare access and utilization. This study examines transportation challenges faced by low-income individuals with chronic conditions who participated in the Food as Medicine (FAM) program offered by their primary care provider and explores the strategies they employ to overcome those challenges, particularly during the COVID-19 pandemic. Methods: We conducted semi-structured interviews with 36 FAM participants from Grady Health System in Atlanta, Georgia between May 2022 and October 2023. Interviews explored their ability to access routine care, FAM, and healthy food as prescribed by their physicians and nutritionists, as well as how the COVID-19 pandemic affected their transportation challenges and solutions. Results: Participants reported various transportation barriers including long wait times, delays, cost burdens, unreliable services, and coordination failures, which contributed to missing doctor appointments and FAM attendance. To overcome those challenges, participants planned trips in advance, used multiple transportation options, relied on social networks, or reduced and sometimes forwent trips. The COVID-19 pandemic limited their accessibility to healthcare, FAM, and healthy food options by reducing business hours and disrupting transportation services. Alternatives such as telemedicine and online ordering were less utilized due to distrust, dissatisfaction, and limited digital literacy. Conclusions: Transportation barriers can substantially restrict healthcare and food access for low-income individuals managing chronic conditions, especially during public crises that may lead to service disruptions. Transportation assistance that accommodates individuals’ financial circumstances and health conditions, implemented through collaborative efforts of healthcare institutions, transportation agencies, and governments, is essential to facilitating chronic disease management and reducing health disparities. Full article

Background/Objectives: In FY 2024, 12.3% of the U.S. population was enrolled in the Supplementary Nutrition Assistance Program or SNAP, the principal food and nutrition program of the U.S. government. Herein, we analyze the cost of the Harvard (HHEP), Mediterranean (MED) and Dietary Approaches to Stop Hypertension (DASH) eating patterns (EPs) to ascertain if they are affordable with the maximum allowable SNAP benefit. Methods: We utilize the 2021 Thrifty Food Plan (TFP) framework to analyze the cost of each of these alternative EPs across 15 age/sex groups. Results: We find that the MED and DASH EPs’ costs typically exceed the daily maximum SNAP benefit for those consuming more than 2100 calories. Conclusions: Our result suggests that reliance on fluid milk, allowance of more refined grains, starchy vegetables, red meat, added sugar and sodium and indifference toward food quality and freshness when calculating the maximum SNAP benefit reduces its cost in comparison to diets less reliant on fluid milk and more reliant on whole grains, fish, nuts, and fresh fruits and vegetables, a commonality shared by the HHEP, MED and DASH EPs. Health-centered alternative diets such as MED and DASH cannot be purchased with maximum allowable allocations of SNAP benefits, meaning that a poverty tax is placed on SNAP beneficiaries. Full article