The findings of this research led to the following broad areas of improvement in US Title II food aid products: 1) Improve the formulation of existing FBF products used in Title II programming. This includes the addition of a dairy source of protein to products targeted to children 6 to 24 months of age, pregnant and lactating women, wasted children, and wasted individuals undergoing HIV/AIDS treatment. 2) Upgrade the vitamin and mineral mixes used and diversify approaches to addressing micronutrient needs. Enhance the composition of premixes used to fortify blended foods as well as milled grains and vegetable oil; facilitate shipping offortificant premix with bulk cereals for in-country fortification; and develop micronutrient powders (sachets) and other point-of-use fortification options. 3) Develop or adopt non-cereal-based (e.g., lipid-based) products for the management of nutritional deficiencies. This is an argument for more choice among appropriate tools, not for discarding products that have already shown their value over many years. It also does not reduce the need to maintain a focus on supplying high volumes of quality grains as the main staple in food aid baskets.
Objective: To explore the effect of seasonality on fruit and vegetable availability and prices across three outlet types (farmers' markets, roadside stands and conventional supermarkets). Design: Cross-sectional survey of geographically clustered supermarkets, farmers' markets and roadside stands. Enumerators recorded the availability and lowest price for eleven fruits and eighteen vegetables in each season of 2011. Setting: Price data were collected at retail outlets located in central and eastern North Carolina. Subjects: The sample consisted of thirty-three supermarkets, thirty-four farmers' markets and twenty-three roadside stands. Results: Outside the local harvest season, the availability of many fruits and vegetables was substantially lower at farmers' markets and roadside stands compared with supermarkets. Given sufficient availability, some items were significantly cheaper (P < 0·05) at direct retail outlets in the peak season (e.g. cantaloupe cost 36·0 % less at roadside stands than supermarkets), while others were significantly more expensive (e.g. carrots cost 137·9 % more at farmers' markets than supermarkets). Although small samples limited statistical power in many non-peak comparisons, these results also showed some differences by item: two-thirds of fruits were cheaper at one or both direct outlets in the spring and autumn, whereas five of eighteen vegetables cost more at direct retail year-round. Conclusions: Commonly consumed fruits and vegetables were more widely available at supermarkets in central and eastern North Carolina than at direct retail outlets, in each season. Contingent on item availability, price competitiveness of the direct retail outlets varied by fruit and vegetable. For many items, the outlets compete on price in more than one season.
Objectives Regular collection and use of dietary data, particularly in low- and middle-income countries (LMICs), is hindered by the lack of available and accessible dietary data research infrastructure (e.g., accessible food composition tables (FCT), portion conversions, and standard recipes; electronic dietary assessment tools). INDDEX24 is a global dietary assessment platform that addresses these bottlenecks. Methods Priority technical specification were drafted and reviewed by experts with extensive dietary assessment experience in LMICs. Specifications included use of the multiple pass 24-hour dietary recall method, offline data collection capability, contextual adaptability, and an interviewer-administered format. Existing dietary assessment platforms were evaluated against the technical specifications via a structured literature review and key informant interviews. An initial version of INDDEX24 was developed and tested through feasibility studies in Vietnam and Burkina Faso. Feedback from potential users of the platform was gathered during webinars. The platform was subsequently revised, and its relative validity, time, and cost compared to use of paper-based 24-hour dietary recalls were then evaluated in Vietnam and Burkina Faso. Results INDDEX24 is comprised of a mobile application (app) that is linked with a web app. The web app is used by researchers to manage the dietary data inputs for their survey context (i.e., FCT data, recipes, food descriptors, and portion conversions). Users can search the web app for dietary data inputs and integrate them into their workspace or upload their own inputs. The INDDEX24 mobile app is a 24-hour dietary recall app that has been built using CommCare mobile platform technology. Users can adapt mobile app questionnaire text to their survey language and context, add survey modules, conduct data monitoring, and basic food matching. To maximize the time and cost saving benefits of the platform, a concerted effort will be needed to populate the web app with dietary data inputs from LMICs. Conclusions The extensive consultative process and evidence driven design has produced a high-quality platform that balances flexibility of adaptation to a range of contexts with quality control and standardization. Funding Sources Bill and Melinda Gates Foundation.
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