Trends in Food Sources and Diet Quality Among US Children and Adults, 2003-2018

Liu, Junxiu; Micha, Renata; Li, Yan; Mozaffarian, Dariush

doi:10.1001/jamanetworkopen.2021.5262

Cited by 104 publications

(107 citation statements)

References 15 publications

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“…Nearly 30 million U.S. youth participate in NSLP and over 17 million participate in SBP; about 75% of these youth qualify for FRPM [ 8 , 9 ]. Particularly for children who qualify for FRPM, these programs reduce food insecurity, improve diet quality, and promote healthy weight [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Feeding Children and Maintaining Food Service Operations during COVID-19: A Mixed Methods Investigation of Implementation and Financial Challenges

et al. 2021

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The United States Department of Agriculture (USDA) National School Lunch and Breakfast Programs are critical for the health and food security of U.S. schoolchildren, but access to these programs was disrupted by COVID-19 pandemic-related school closures in spring 2020. While temporary policy changes to the programs enabled school food authorities (SFAs) to pivot towards distributing meals throughout their communities instead of within school buildings, SFAs faced complex challenges during COVID-19 with minimal external support. This mixed methods study investigates the implementation and financial challenges experienced by twelve of the largest urban SFAs in the U.S. during COVID-19. We conducted semi-structured interviews with SFA leaders and analyzed alongside quantitative financial data. We found that SFAs reconfigured their usual operations with nearly no preparation time while simultaneously trying to keep staff from contracting COVID-19, accommodate stakeholders with sometimes competing priorities, and remain financially solvent. Because student participation was much lower than during regular times, and revenue is tied to the number of meals served, SFAs saw drastic decreases in revenue even as they carried regular operating costs. For future crises, disaster preparedness plans that help SFAs better navigate the switch to financially viable community distribution methods are needed.

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Section: Introductionmentioning

confidence: 99%

Feeding Children and Maintaining Food Service Operations during COVID-19: A Mixed Methods Investigation of Implementation and Financial Challenges

et al. 2021

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“…The NHANES data have been used to study the quality of meals consumed from food outlets such as schools and restaurants [ 21 , 22 ]. A recent study evaluated diet quality based on two different diet quality scores [ 23 ]. There remains a gap in the literature comparing the quality of foods consumed from different food outlets and changes over time using the most recent NHANES data and the advised analytical technique, the population ratio method, to obtain HEI-2015 scores [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Healthy Eating Index-2015 Scores Vary by Types of Food Outlets in the United States

et al. 2021

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Diet quality in the United States is improving over time but remains poor. Food outlets influence diet quality and represent the environments in which individuals make choices about food purchases and intake. The objective of this study was to use the Healthy Eating Index-2015 (HEI-2015) to evaluate the quality of foods consumed from the four major outlets where food is obtained—stores, full-service restaurants, quick-services restaurants, and schools—and to assess changes over time. This cross-sectional study used 24 h dietary recall data from eight cycles (2003–2004 to 2017–2018) of the National Health and Nutrition Examination Survey (NHANES). Linear trend estimation was used to test for changes in HEI scores over time, and balanced repeated replicate weighted linear regression was used to test for differences in total and component scores between types of food outlets. Overall, Americans are not consuming a mix of foods from any major category of food outlet that aligns with dietary guidelines. The total score for schools (65/100 points) and stores (62/100 points) was significantly higher than full-service (51/100 points) and quick-service (39/100 points) restaurants (p < 0.0001). HEI scores significantly improved over time for schools (p < 0.001), including an increase in whole grains from less than 1 point in 2003–2004 to 7 out of 10 points in 2017–2018. In 2017–2018, schools received the maximum score for total fruits, whole fruits, and dairy. Continued research on strategies for improving the quality of foods consumed from restaurants and stores is warranted.

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“…For the consumption of the entrées, the students in the WITS schools consumed 11% less than students in the Control schools. This is concerning as it may indicate that the WITS students found the entrées less appealing and were eating less, as school meals have been shown to be healthier than other food students eat [ 22 ]. These data indicate that two years of ongoing exposure to these new entrées was not enough to increase consumption.…”

Section: Discussionmentioning

confidence: 99%

Wellness in the Schools: A Lunch Intervention Increases Fruit and Vegetable Consumption

et al. 2021

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Wellness in the Schools (WITS) is a national non-profit organization partnering with public schools to provide healthy, scratch cooked, less processed meals (called an Alternative Menu), and active recess. This study examined the effects of WITS programming on school lunch consumption, including fruit and vegetable intake, in second and third grade students in New York City public schools serving a high proportion of students from low-income households. The intervention was evaluated with a quasi-experimental, controlled design with 14 elementary schools (7 that had initiated WITS programming in fall 2015 and were designated as intervention schools, and 7 matched Control schools). School lunch consumption was assessed by anonymous observation using the System of Observational Cafeteria Assessment of Foods Eaten (SOCAFE) tool in the fall of 2015 (Time 0, early intervention) and the spring of 2016 (Time 1) and 2017 (Time 2). There were no baseline data. Data were also collected on the types of entrées served in the months of October, January, and April during the two school years of the study. Across time points, and relative to students in the Control schools, students in WITS schools ate more fruits and vegetables (units = cups): Time 0: Control 0.18 vs. WITS 0.28; Time 1: Control 0.25 vs. WITS 0.31; and Time 2: Control 0.19 vs. WITS 0.27; p < 0.001. They also had more fruits and vegetables (cups) on their trays, which included more vegetables from the salad bar. However, students in the WITS schools ate fewer entrées (grain and protein) and drank less milk than students in the Control schools. Compared to the Control schools, WITS schools offered more homestyle entrées and fewer finger foods and sandwich entrees, i.e., less processed food. Students in WITS schools who received the Alternative menu and all of the WITS programming at all data collection time points selected and consumed more fruits and vegetables. Replication studies with randomized designs and true baseline data are needed to confirm these findings and to identify avenues for strengthening the effects of the program on other school lunch components.

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Trends in Food Sources and Diet Quality Among US Children and Adults, 2003-2018

Cited by 104 publications

References 15 publications

Feeding Children and Maintaining Food Service Operations during COVID-19: A Mixed Methods Investigation of Implementation and Financial Challenges

Feeding Children and Maintaining Food Service Operations during COVID-19: A Mixed Methods Investigation of Implementation and Financial Challenges

Healthy Eating Index-2015 Scores Vary by Types of Food Outlets in the United States

Wellness in the Schools: A Lunch Intervention Increases Fruit and Vegetable Consumption

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