Background: Although there are numerous health benefits associated with eating fruit and 4 vegetables (FV), few children are consuming recommended amounts. Gardening interventions 5 have been implemented in various settings in an effort to increase FV consumption of children 6 by expanding knowledge, exposure, and preferences for a variety of FV. 7Objective: The purpose of this review was to identify the effectiveness of gardening 8 interventions that have been implemented to increase FV consumption among children. 9Methods: A systematic review was conducted using four electronic databases: Web of Science, 10PubMed, Scopus, and CINAHL. English language studies conducted in developed countries 11 between January 2005 and October 2015 were included in this review. Included studies 12 measured FV consumption of children ages 2-15 years old before and after implementation of a 13 gardening intervention in a school, community, or after school setting. All study designs were 14 included in this review. A total of 891 articles were identified through database searching and 15 cross-referencing. After removing duplicates, 650 articles remained and were screened using 16 inclusion and exclusion criteria. Twenty-seven full text articles were analyzed and 14 articles 17 were included in this review. 18Results: Of the 14 articles reviewed, 10 articles found statistically significant increases in fruit 19 or vegetable consumption among participants after implementation of a gardening intervention. 20However, many studies were limited by the use of convenience samples, small sample sizes, and 21 self-reported measurements of FV consumption. 22 Conclusions:Although the evidence is mixed and fraught with limitations, most studies suggest 23 a small but positive impact of gardening interventions on children's FV intake. Future studies 24 GARDENING INTERVENTIONS FOR CHILDREN 2 that include control groups, randomized designs, and assessments of FV consumption over at 25 least one year are needed to advance the literature on this topic.

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Background The COVID-19 pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support, and identify long-term impacts and needs. Objective The National Food Access and COVID research Team (NFACT) was formed to assess food security over different U.S. study sites throughout the pandemic, using common instruments and measurements. This study present results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. Methods A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA six-item module. Food security prevalence was analyzed using analysis of variance by sampling method to statistically significant differences. Results Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, as compared to before the pandemic. In nearly all study sites, there is higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but statistically higher prevalence of food insecurity among high-risk compared to convenience surveys. Conclusions This comprehensive study demonstrates higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to survey implementation method. Summary Multi-site assessment demonstrates widespread food insecurity during COVID-19, especially on households with children, job loss, and Black, Indigenous, People of Color across multiple survey methods.

Background Evidence is lacking informing the use of the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) with populations characterized by low income. Objective This study was conducted among women with low incomes to evaluate the accuracy of ASA24 recalls completed independently and with assistance. Methods Three hundred and two women, aged ≥18 y and with incomes below the Supplemental Nutrition Assistance Program thresholds, served themselves from a buffet; amounts taken as well as plate waste were unobtrusively weighed to enable calculation of true intake for 3 meals. The following day, women completed ASA24-2016 independently (n = 148) or with assistance from a trained paraprofessional in a small group (n = 154). Regression modeling examined differences by condition in agreement between true and reported foods; energy, nutrient, and food group intakes; and portion sizes. Results Participants who completed ASA24 independently and those who received assistance reported matches for 71.9% and 73.5% (P = 0.56) of items truly consumed, respectively. Exclusions (consumed but not reported) were highest for lunch (at which participants consumed approximately 2 times the number of distinct foods and beverages compared with breakfast and dinner). Commonly excluded foods were additions to main dishes (e.g., tomatoes in salad). On average, excluded foods contributed 43.6 g (46.2 kcal) and 40.1 g (43.2 kcal) among those in the independent and assisted conditions, respectively. Gaps between true and reported intake were different between conditions for folate and iron. Within conditions, significant gaps were observed for protein, vitamin D, and meat (both conditions); vitamin A, iron, and magnesium (independent); and folate, calcium, and vegetables (assisted). For foods and beverages for which matches were reported, no difference in the gap between true and reported portion sizes was observed by condition (P = 0.22). Conclusions ASA24 performed relatively well among women with low incomes; however, accuracy was somewhat lower than previously observed among adults with a range of incomes. The provision of assistance did not significantly impact accuracy.

Objective: Explore factors impacting access to and utilization of Double Up Food Bucks (DUFB), a farmers market program that doubles Supplemental Nutrition Assistance Program (SNAP) benefits for use toward the purchase of fruits and vegetables (FV).

Purpose. To evaluate the impact of a nudge program on food pantry clients’ self-reported selection and use of healthy foods. Method. A convenience sample of clients of six urban food pantries in Utah were surveyed about their experience with the Thumbs Up for Healthy Choices nudge program. Chi-square tests were used to identify associations between demographic characteristics and self-reported program impact. Results. Ninety-four percent (n = 158) of respondents agreed that the program made it easier to make healthy choices. Sixty-five percent reported healthier diets since its implementation. Additionally, Hispanic respondents were more likely to report positive impacts than non-Hispanic respondents. Conclusions and Implications. Nudge programs are effective in increasing the selection of healthy foods among pantry clients in Utah. Impacts seemed to be particularly positive for Hispanic pantry users in Utah. Nutrition programs should consider implementing these low-cost strategies to improve dietary quality of pantry users.

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