For the first time since 1980, the US Department of Agriculture Food and Nutrition Service Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package policies were revised in 2009 to meet the Institute of Medicine's nutrition recommendations. These changes included increases in fruits, vegetables, whole grains, and low-fat dairy to improve nutrition and health of WIC participants. Our systematic review of the literature assessed the influence that the 2009 WIC food package revisions have had on dietary intake, healthy food and beverage availability, and breastfeeding participation. The systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Four electronic databases were searched between April 1 and 30, 2014, for peer-reviewed research. Two reviewers screened the articles, extracted the data, and established inter-rater reliability by discussing and resolving discrepancies. Twenty articles were included that met our inclusion criteria. Nine of the studies analyzed changes in dietary intake, eight examined changes in healthy food and beverage availability, and three evaluated breastfeeding participation exclusively. The review demonstrated an improved dietary intake and an increase in the availability of healthier foods and beverages in authorized WIC stores. The revised food package was also associated with improved dietary intake of WIC participants. Mixed results were demonstrated in regard to improved breastfeeding outcomes. Further research is needed to assess the influence of WIC 2009 food package revisions on breastfeeding outcomes and to make conclusions about broad nutrition-related implications.

ObjectiveThe purpose of this review was to identify how rural and urban food access differs across small food stores as well as the types of research strategies and methodologies that have been applied in each setting in the U.S.MethodsManuscripts were included in the review if they were published in English over the past ten years, with a clear delineation between urban and/or rural, conducted in the U.S., and reported data from small food store research.ResultsAfter elimination, 19 manuscripts representing rural (n = 5) and urban (n = 14) settings were included in the final review. The review was conducted in Nebraska between January 2015 and May 2015. Findings from the reviewed manuscripts revealed that rural communities might face different challenges with healthy food access in small food stores when compared to urban settings. In particular, small food stores in rural areas lacked healthy food options largely because storeowners perceived that their customers would not purchase healthier items and due to challenges with distribution. Conversely, studies reporting on small food stores in urban areas suggest challenges with transportation and safety concerns.ConclusionResearch on small food stores is nascent and further research, especially intervention studies, is needed. Further, less evidence exists on healthy food access, in particular intervention testing on small food store research in rural areas.

Wild foods are recognized to contribute to diet and food security through enhancing the availability of 1 The term 'Native American' was determined to be the preferred term for referencing the Native American community in this study, based on consultation from our community advisory board. local, diverse, and nonmarket food sources. We investigated the contribution of wild foods to diet, food security, and cultural identity in a Native American 1 community in the context of climate

The addition of orange-fleshed sweet potato (OFSP) to the food environment is an effective nutrition-sensitive agricultural approach to improve vitamin A intakes. However, the adoption of this biofortified crop merits further study. The objective of our research was to understand factors that affect Mozambican farmers’ adoption and retention of OFSP varieties, with a specific interest in the retention of planting material. Field research was conducted in three provinces of Mozambique during 2015. Provinces with different OFSP intervention histories were selected to allow for the identification of site-specific factors and the impact of variable approaches over time. Qualitative inquiry was used to assess participants’ progress through the five stages of the Innovation-Decision process in the Diffusion of Innovations Theory. Ninety-five producers, consumers, and market stakeholders of OFSP participated in semi-structured in-depth interviews and focus groups. Results indicate that diverse factors influenced the adoption and retention of OFSP, including organoleptic qualities, taste preferences, access to planting material, agronomic traits, environmental conditions, lack of capital for inputs and labor, unstable markets, and limited sharing of information and planting material across farmer networks. Current OFSP varieties were acceptable to Mozambican farmers and consumers, but there are several remaining challenges to reaching a critical mass such as lack of access to planting material, perceptions of superior drought tolerance of white-fleshed sweet potato (WFSP), and the belief that OFSP requires additional effort to cultivate (e.g. weed removal, measuring space between plants). Key recommendations which may be considered in future planning for OFSP interventions in Mozambique and other countries include enabling decentralized vine multipliers to provide vines to community members at no cost, continued focus on breeding and distribution of more drought tolerant varieties of OFSP, and training on the similarities in agronomic practices required for producing and preserving OFSP and WFSP.

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We assessed the consumer food environment in rural areas by using the Nutrition Environment Measures Survey for Stores (NEMS–S) to measure the availability, price, and quality of fruits and vegetables. We randomly selected 20 grocery stores (17 rural, 3 urban) in 12 Montana counties using the 2013 US Department of Agriculture’s rural–urban continuum codes. We found significant differences in NEMS–S scores for quality of fruits and vegetables; of 6 possible points, the mean quality score was 4.5; of rural stores, the least rural stores had the highest mean quality scores (6.0). Intervention strategies should aim to increase fruit and vegetable quality in rural areas.

Background Food waste studies have been used for more than 40 years to assess nutrient intake, dietary quality, menu performance, food acceptability, cost, and effectiveness of nutrition education in the National School Lunch Program (NSLP). Objective Describe methods used to measure food waste and respective results in the NSLP across time. Methods A systematic review using PubMed, Science Direct, Informaworld, and Institute of Scientific Information Web of Knowledge was conducted using the following search terms: waste, school lunch, plate waste, food waste, kitchen, half method, quarter method, weight, and photography. Studies published through June 2015 were included. The systematic review followed preferred reporting items for systematic reviews and meta-analyses recommendations. Results The final review included 53 articles. Food waste methodologies included in-person visual estimation (n=11), digital photography (n=11), direct weighing (n=23), and a combination of in-person visual estimation, digital photography, and/or direct weighing (n=8). A majority of studies used a pre–post intervention or cross-sectional design. Fruits and vegetables were the most researched dietary component on the lunch tray and yielded the greatest amount of waste across studies. Conclusions Food waste is commonly assessed in the NSLP, but the methods are diverse and reporting metrics are variable. Future research should focus on establishing more uniform metrics to measure and report on food waste in the NSLP. Consistent food waste measurement methods will allow for better comparisons between studies. Such measures may facilitate better decision making about NSLP practices, programs, and policies that influence student consumption patterns across settings and interventions.

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