Researchers contribute recommendations for national strategy on hunger, nutrition, health
At the first White House Conference on Hunger, Nutrition and Health convened since 1969, President Biden announced on Sept. 28 a national strategy “to end hunger in America and increase healthy eating and physical activity by 2030 so fewer Americans experience diet-related diseases.” Much of the foundational research undergirding the strategy has been informed in part by the Nutrition Policy Institute, a program of UC Agriculture and Natural Resources.
“Science is the work of many – and no one study answers all the questions – but we have a tremendous body of work that has contributed to this conference, building from all the programs and changes that were made from the last conference,” said NPI director Lorrene Ritchie.
The original Nixon-era conference produced about 1,800 recommendations – and 1,600 were eventually implemented in the subsequent years, according to Stacy Dean, U.S. Department of Agriculture Deputy Under Secretary for Food, Nutrition and Consumer Services.
A litany of far-reaching programs grew from or were propelled by the 1969 conference: the School Breakfast Program, WIC (the Special Supplemental Nutrition Program for Women, Infants and Children), SNAP (the Supplemental Nutrition Assistance Program)-Ed and CalFresh Healthy Living UC, the Expanded Food and Nutrition Education Program, and more.
This history illustrates the potential for sweeping change from this 2022 conference – which gathered about 500 experts and advocates (with 1,000 more participating online) – and from the national strategy that represents the Biden-Harris administration's “playbook.”
“Does that document have everything in it that we would like? No – but, oh my goodness, if we could accomplish all the things that they've laid out, what a transformational impact it would have,” said Ritchie, adding that she was thrilled that the highest levels of government are prioritizing hunger and nutrition-related chronic disease.
Including beverages in the conversation
In the course of gathering ideas and input from across the country, conference organizers asked Christina Hecht, NPI senior policy advisor, to author and submit NPI recommendations on encouraging the public to choose water instead of sugary drinks. Those suggestions – which range from including water in the “MyPlate” dietary guideline graphic to ensuring that every public school has a water bottle-filling station – crystallized extensive, rigorous scholarship by a broad community.
“NPI's recommendations were built on lots of work by many water researchers and advocates over the years; they're based on many years of thinking by many people,” Hecht said.
Christina and Ken Hecht, NPI policy director, also submitted recommendations as part of the Sugar-Sweetened Beverage Reduction Workgroup, which brings together experts from national, state and local organizations. Several of their key proposals, such as targeting the marketing of sugary drinks and clarifying front-of-package nutrition labels, appear as recommended steps in the national strategy document.
Other nutrition policy changes compiled by Christina Hecht – like updating the Federal Food Service Guidelines used on federal properties and in federal programs – are also reflected in the national strategy, albeit without specifically mentioning sugary drinks. Nonetheless, Hecht believes doors have been opened for future discussions that could incorporate and promote healthy beverages.
“What those doors require are continuing to develop the evidence base, continuing to translate and share the evidence base, and continuing the advocacy to bring that evidence base to the attention of decision makers,” she said.
University of California setting an example
Suzanna Martinez, an NPI-affiliated researcher who attended the White House conference, said she hopes the convening generates momentum for two bills before Congress that would help alleviate food insecurity in higher education: one that provides funding for campuses to address students' basic needs, and another that reduces barriers to SNAP (Supplemental Nutrition Assistance Program, formerly known as food stamps). The national strategy document explicitly acknowledges that “SNAP's college student eligibility restrictions are out of date given the current population who seek higher education credentials.”
Martinez, an associate professor in the Department of Epidemiology and Biostatistics at University of California San Francisco, was invited to the conference because she's part of a group driving the UC's effort to halve the number of students facing food insecurity across the system by 2030. That commitment, and UC Berkeley's work on basic needs, were highlighted by Second Gentleman Douglas Emhoff during the closing plenary session.
“The work that we're doing here in California tends to set the stage for what happens in other states,” said Martinez, who also cited California's pioneering effort to provide meals for all public school students.
NPI's ongoing work evaluating universal school meals in California and other states is just one example of how its academics and staff are refining innovative programs so they can be adopted more effectively and broadly (perhaps nationally). In fact, the White House identified “healthy school meals for all” as the top strategy for improving food access and affordability, and Ritchie applauds the administration's consistent emphasis on early interventions for healthier outcomes.
“The earlier you can create healthy habits – meaning in utero all the way through childhood – the more likely you are going to have adults who don't end up with nutrition-related chronic diseases,” she explained. “The last thing you want to do is to wait until people are really sick before they start to change their habits.”
Another overarching theme that excites Ritchie is the national strategy's “whole of government” approach to addressing a host of nutrition and hunger issues. One example is how the strategy calls for agencies not traditionally associated with food to contribute to reducing waste, such as the Department of the Treasury clarifying tax benefits for businesses that donate food.
“Throughout the document, over and over again, there are countless examples of creating synergies across government agencies and with local and state governments that can help move the needle,” Ritchie said. “It's just this kind of bold call to action that we really need.”/h3>/h3>/h3>
Nutrition Policy Institute researchers contribute to studies that inform policy changes
Marcela Gonzalez, who had wanted to be a physical therapist since she was a teenager, was in the final stage of realizing her dream.
But when she started in the PT program at the University of California San Francisco in 2021, a vexing struggle of her undergraduate years came back. Academic pressures and stomach troubles, compounded by financial worries, drained her of any energy and capacity to feed herself.
“I didn't eat; I lost a lot of weight because I just couldn't eat,” Gonzalez recalled. “I was too stressed out all the time; I was a mess.”
During her first year at UCSF, Gonzalez, for whom food has “always just been hard,” discovered that she qualified for CalFresh (California's version of the Supplemental Nutrition Assistance Program, formerly known as “food stamps”). Her participation in the program – as well as the presence of a campus food pantry – helped lift a heavy mental burden and allowed her to refocus on school.
To understand the mechanisms that connect eligible students with CalFresh benefits, which could greatly improve their lives and education, University of California researchers interviewed UC campus staff responsible for guiding undergraduate and graduate students through the application process. Their recently published study, which involved researchers at UC Agriculture and Natural Resources' Nutrition Policy Institute, illuminated several major facilitators and barriers to CalFresh enrollment.
Campus-county coordination, boosting staffing key factors
Ensuring that college students have access to CalFresh is especially crucial, given that food insecurity affects that segment of the population roughly four times the rate of the general population, according to the study's principal investigator and co-author Suzanna Martinez, an associate professor in the department of epidemiology and biostatistics at UCSF.
It's estimated that more than 40% of college students face uncertain access to healthy food – and inflation, the rising cost of attending college and increasingly unaffordable housing are likely to swell those numbers.
That's why researchers say it's critical for campus staff who work on CalFresh outreach to collaborate with the financial aid office and the county office that administers the CalFresh program locally. Through close coordination, staff members can determine if students meet the necessary exemptions and help them with the paperwork.
“When that happens, it's much easier than when a student applies without their campus Basic Needs coordinator, or when they just go to the county and apply on their own,” Martinez explained. “Maybe they don't know all of the verification documents that have to be included, or they might not know their financial aid status.”
Erin Esaryk, NPI research data analyst and first author of the study published in the Journal of Nutrition Education and Behavior, also highlighted the need for increased campus staffing to help with CalFresh enrollment, as well as more outreach by campus and county staff to student populations about the benefits.
“When there's a lot of outreach, that helps alleviate some of the stigma, to normalize the receiving of CalFresh,” Esaryk said.
Helping others worry less about food
Given her own history of travails, Gonzalez, the physical therapy student, wanted to help others at UCSF “de-stress” about food. In summer and fall 2021, she served as a “CalFresh ambassador” for her cohort of new PT students, developing presentations and guides that break down how to apply for or renew CalFresh benefits.
She became the go-to person for her classmates' questions on the logistics and details of applying for the program, and also encouraged fellow health-professional students who, like herself, did not think they would qualify.
“To take out less loans, or to not worry about food a little bit every week, is a great thing,” said Gonzalez, pointing out that subtracting food costs allows students to shave down their loans.
After helping introduce her classmates to CalFresh, she transitioned to working at the food pantry at the Parnassus campus. In addition to setting up and distributing the items, Gonzalez also posts on Instagram and TikTok (@ucsf_basicneeds) to promote the “food market,” which attracts about 100 students and campus community members every Thursday afternoon.
“You never know what you're going to get, but there's so much really good, fresh produce,” she said.
Campus food pantries deliver health benefits
Researchers are also studying how campus food pantries affect students' overall health, including easing the challenges of anxiety, depression and sleep deprivation. Another recent study published in the Journal of Nutrition Education and Behavior analyzed health-survey responses of 1,855 undergraduate and graduate students at all 10 UC campuses – before and after access to a campus food pantry.
“What we found was that students reported improvements in their perceived health and sufficient sleep,” said UCSF's Martinez, the lead author. “We also found that they reported fewer depressive symptoms, compared to before having access to the food pantry.”
By 2019, all UC campuses had established food pantries, although nationwide only about 25% of four-year colleges have one. The significant health benefits reported by UC students in this study give researchers hope that campus food pantries will see additional governmental support, in California and beyond.
“It was important to evaluate whether the food pantries were actually making a difference…if you don't have numbers or evidence, then you're not going to get funded to support future programming,” Martinez said.
Research guides state policy changes
Studies of food insecurity in the college setting have already informed policymaking aimed at smoothing the application process for CalFresh – benefits regarded by Martinez as a better long-term solution than food pantries, which constitute an emergency “short-term response” to the problem.
One example of the research's impact is a law passed last year in California that requires community colleges and California State University campuses to designate a campus-county liaison who would help students procure social services, including CalFresh. A separate law expanded the list of training programs within which students would potentially qualify for CalFresh, and another bill currently under consideration by the state Legislature would make the processing of students' CalFresh applications more consistent from county to county, through more standardized training of staff.
Meanwhile, on the research front, Esaryk, Martinez and their colleagues are completing a follow-up study on students and CalFresh enrollment, this time looking at the perspectives of county staff. And while their broader goal remains clarifying and streamlining student eligibility rules and processes at all levels, they remain focused on students and meeting their needs.
“Right now, our main mission is just to try to increase awareness of CalFresh for students and to let them know they may be eligible,” Martinez said, “and then assist them through that application process so they can actually get the benefits.”
In addition to Esaryk and Martinez, NPI director Lorrene Ritchie and Laurel Moffat of Washington State University are also authors of the CalFresh/SNAP benefits study, while co-authors of the college food pantry study are Ritchie, Gwen Chodur of UC Davis, Sevan Kaladijian of UC Irvine and Michael Grandner of the University of Arizona./h3>/h3>/h3>/h3>/h3>
The buzz or chirp of an incoming text message started some San Diego County residents on the path to a healthier diet during this past year. In September 2020, most CalFresh participants in the county – more than 172,000 households – began receiving monthly text messages about the benefits of California-grown fruits and vegetables as part of a pilot program.
This novel approach to delivering nutrition messages to California food assistance program participants was developed by a partnership of the Nutrition Policy Institute of UC Agriculture and Natural Resources, the UC San Diego Center for Community Health and the County of San Diego Health and Human Services Agency, which administers CalFresh in the county.
The HHSA, which had been using its text messaging platform to send administrative reminders and alerts, was receptive to using the tool for sending nutrition-focused information. NPI and CCH partnered with ideas42, a firm that applies behavioral science to solutions for social change, to develop a series of five text messages promoting California-grown fruits and vegetables.
The text messages – originally delivered in English and Spanish, with the addition of Arabic beginning in July 2021 – were friendly and conversational in tone.
“In a text, you have very few characters you're communicating with people, so we wanted to make sure we were using cutting-edge behavioral science to construct those messages to have the most impact,” said Wendi Gosliner, NPI senior researcher and policy advisor.
Each text included a link directing recipients to a website developed as part of the project, with information on selecting, storing and preparing California-grown fruits and vegetables; health benefits; tips to reduce food waste; and recipes – including TikTok videos.
Initially running from September 2020 to March 2021, the pilot program was well-received. Nearly 90% of CalFresh participants responding to a survey said they appreciated receiving the texts. “It is very important for us to eat healthy, to teach our children to eat healthy,” wrote one participant. “I love the recipes…they're so delicious and easy to make…I'm very, very grateful for the help because without you guys, I would be struggling more and I just want a better life for my children.”
Gosliner said it was encouraging to see that two-thirds of the approximately 5,000 survey respondents reported eating more California-grown fruits and vegetables after receiving the messages, and 85% expressed a desire to see more texts.
“What we see is that there's definitely a decent-sized population of people participating in CalFresh –now this is just in San Diego County but imagine the entire state – who would benefit from having this kind of information available to them,” Gosliner said. “And there is at least a subset of people who really liked it.”
UC San Diego's Center for Community Health was instrumental in facilitating the partnership between UC ANR and the HHSA. Further, CCH, in partnership with the San Diego County Childhood Obesity Initiative, formed a community council composed of residents representing diverse communities throughout San Diego County. Together, the council facilitated CalFresh participants to take part in focus groups, which provided feedback and guidance on the messaging and design for online resources. Gosliner said the success of the text program has been a direct result of community input and involvement.
“The Center for Community Health-led focus groups were integral to ensuring CalFresh resources were accessible and informative to a wide range of CalFresh participants, and local individuals and families more broadly,” said Blanca Meléndrez, executive director at the UC San Diego Center for Community and Population Health, Altman Clinical Translational Research Institute. “In the process, the text-based campaign also placed a greater focus on the local production of nutritious fruits and vegetables, ensuring access to healthy and nutritious food in all communities, and building new streams of income for the region's farmers and producers.”
This effort also suggests a simple way to reach CalFresh participants and bridge gaps between the Supplemental Nutrition Assistance Program and programming that offers nutrition education and healthy eating resources.
“By combining UCSD and UC ANR knowledge about healthy eating with our outreach capability, we are able to reach thousands of families via text message each month,” said Michael Schmidt, human services operations manager for the HHSA. “With the click of a button, these families are provided with resources to assist them in making healthier lifestyle choices, supporting a region that is building better health, living safely and thriving.”
The effort has been so effective that HHSA has asked for additional messages, beyond the original five months' worth of texts and resources.
“The partnership between UC ANR's Nutrition Policy Institute, UC San Diego's Center for Community Health, the County of San Diego Health and Human Services Agency and San Diego County community residents brought together a great team to develop an innovative, technology-based intervention,” said Shana Wright, San Diego County Childhood Obesity Initiative co-director at CCH. “Each partner provided knowledge, resources and assets that enhanced the project beyond the initial pilot phase, exceeding preliminary expectations.”
Gosliner said the pilot program has been a “great example and wonderful experience” of partnership in action.
“You can sit with your research or program ideas for a long time but if you don't have people who can help you implement them, then they really aren't helpful in any way,” she said. “In this case, it was just a nice combination of an idea…with partners who wanted to work to make something happen.”
- Author: Rachael Callahan
- Author: Cooper Limon
The COVID-19 pandemic hit farmers hard. Supply chains were disrupted and even non-traditional agritourism revenue streams such as hay mazes and on-farm events had to be canceled due to shelter-in-place mandates.
On the other hand, demand for local farm products skyrocketed, and thus many farmers and ranchers needed a quick pivot strategy and a set of new skills.
UC Sustainable Agriculture Research and Education Program (SAREP) was well-positioned to support this shift toward direct sales, pulling in trusted community partners and experienced farmers and ranchers to put together a comprehensive webinar series, “Agritourism and Direct Sales: Best Practices in COVID Times and Beyond”.
Funded by a USDA Farmers Market Promotion Program (FMPP) grant, the webinar series is part of a three-year project, Strengthening California Local Food Networks with Agritourism and Direct Sales, which provides trainings and technical assistance to farmers and ranchers on how to diversify their revenue streams.
The strength of the series, which includes eight webinars that were recorded earlier this year and are available online, lies in the collaborations among the UC SAREP Agritourism Program, UCCE, community groups, and farmers and ranchers.
The series features a range of speakers, including representatives from community organizations, technical experts, academic researchers, and farmers – all coming together to build resilience and adaptability for small-farming operations and the agritourism industry across California during the pandemic and after.
“It's great to collaborate with other organizations and regions, to learn from each other and to broaden our networks, as we are all working to create more resilient and sustainable food systems,” said Carmen Snyder, executive director of Sonoma County Farm Trails, one of the nonprofit partners on this project.
And because of those strong partnerships, the webinar topics reflected the on-the-ground needs facing agricultural producers.
“COVID initially dramatically affected farmers' restaurant contracts, with many losing more than 80% of their accounts overnight,” Snyder said. “CSAs [Community Supported Agriculture], on the other hand, couldn't keep up with the demand, and all of our CSA members were full and had wait lists for the first time ever. Producers pivoted by creating more online stores, including pick-up and delivery options. It was a challenge for them to navigate the new technology and platforms.”
The “Online Sales Options and Methods” webinar, a partnership with the Community Alliance with Family Farmers (CAFF), provided an overview of several e-commerce marketing and online sales strategies that farmers can implement to diversify their revenue pathways and reach new customers. CAFF stressed the importance of farmers enhancing their resiliency through e-commerce.
The webinar also featured Ciara Shapiro, the owner of AM Ranch in Penn Valley, who shared her experience with online marketing and how it helped her and her husband survive the pandemic when the restaurants and farmers markets they sold to shut down. This personal and informative webinar demonstrated the effectiveness of online sales and marketing, while highlighting available resources from groups like CAFF.
The “Safe, Healthy and Successful Farm Stands” webinar was aimed at farms of all sizes and organizations that operate or advise agricultural operations using farm stands as a form of revenue. The webinar provided an outline of the rules and regulations that farm stand operators needed to follow during COVID – as well as during business-as-usual times.
Both farmers saw an increase in farm stand business during the pandemic, which Yagi attributed to the “traffic storm of people” who attended their annual plant sale fundraiser and came to participate in new farm outdoor activities and volunteer opportunities. Yagi also noted the growing number of low-income individuals who were unable to access fresh produce during the pandemic.
The speakers' shared experiences running successful farm stands gave audience members tangible examples and real-time information on how to incorporate farm stands into their businesses.
Carmen Snyder of Sonoma County Farm Trails, which helped circulate the recorded webinars to their network of farmers and ranchers, remarked: “These webinars were extremely helpful for local producers, to get clarity on best pandemic practices during these challenging times and to learn how other producers are adapting and navigating the circumstances.”
- Author: Jeannette E. Warnert
“Santa Cruz County farmers provide an array of quality fresh fruits and vegetables that can help residents to be healthier,” said Laura Tourte, UC Cooperative Extension advisor and one of the project's coordinators. “Everybody wins.”
The 40-page booklet – titled Fresh • Starts • Here – was developed by UCCE, the Palo Alto Medical Foundation (PAMF) and the Santa Cruz County Farm Bureau. It assembles a wide variety of resources into a compact form, with information about the seasons for local fruits and vegetables, nutritional information and directions for choosing, storing and preparing healthy foods using some of Santa Cruz County's top crops. Six farmers are profiled in the booklet along with four medical doctors and a registered dietitian, who provide suggestions about accessing fresh fruits and vegetables and reasons for eating them.
“It's not often you'll find stories about farmers and doctors in the same place, but it's a natural fit,” Tourte said. “Doctors know the health benefits of eating fresh fruits and vegetables, and farmers grow them.”
Dr. Karen Harrington, a family medicine physician, shared a seasonal salad recipe that includes cabbage, kale, tomatoes, bell peppers, cucumbers, scallions and parsley.
“Making a salad that uses many different fruits and vegetables and keeps for several days is a great and convenient way to help improve your health,” she said.
Pediatrician Casey Schirmer is pictured in the guide with his cousin Joe Schirmer, owner of an organic farming operation in Santa Cruz.
The development committee, local farmers and physicians donated their time and effort to the project. UCCE funded the printing of the first 2,000 copies of the booklet. The guide was recently the focus of three outreach events at PAMF clinics, where farmers and PAMF staff teamed up to distribute the guide and other health information at no cost to PAMF patients, visitors and staff. A Spanish language version – which was funded with contributions from UCCE, PAMF and Lakeside Organic Gardens – is in press and expected to be available to the community later this month.
Tourte said the committee has received more requests for the guide than they can currently accommodate. They are now seeking funding to print additional copies, and planning to partner with others in the community to share the information.
“This guide, two years in the making, is our group's foundational piece. It is the beginning of many more activities and educational events we have planned for the future,” Tourte said.
An initiative to enhance competitive and sustainable food systems is part of the UC Division of Agriculture and Natural Resources Strategic Vision 2025.