- Author: Katherine Lanca
- Editor: Danielle L. Lee
- Editor: Lorrene Ritchie
- Editor: Wendi Gosliner
The COVID-19 pandemic exacerbated food and nutrition challenges. Many families initially lost access to meals offered by school and childcare facilities, experienced unemployment or work reductions, and faced increasing prices for food and other necessities. National and state policies and programs provided food and cash assistance to mitigate impacts on food security. Researchers at the Nutrition Policy Institute, a research center of University of California Agriculture and Natural Resources, evaluated safety-net policies implemented during the pandemic to better support families with low incomes in the U.S.
Benefits of universal school meals
The National School Lunch Program and the School Breakfast Program meet the nutritional needs of approximately 30 million K-12 students in America each day. Typically, students from families meeting income eligibility criteria receive school meals for free or a reduced price, while others pay full price.
NPI researchers Wendi Gosliner, project scientist, and Lorrene Ritchie, director and UC Cooperative Extension specialist, are co-leading studies of school meals in California in collaboration with researchers from the NOURISH Lab for Health Inclusion Research and Practice, who study school meals in Maine and other states.
During the COVID-19 pandemic, Congress funded school meals for all students at no charge, in order to address the dramatic increase in food insecurity among families with children after schools shut down in March 2020. This federal provision allowing for meals to be free for all students ended after the 2021-2022 school year, but some states elected to continue providing universal school meals with state funding, in recognition of the importance of these meals for student health and academic success.
California was the first state to adopt a statewide Universal Meals Program starting in the 2022-23 school year. To support the program's development, $650 million were invested to help schools improve kitchen infrastructure and provide staff training and technical assistance. Investments include Farm to School programs and other mechanisms to help update and improve school meals. Maine and several other states also have adopted universal school meals at least through the 2022-23 school year.
“States often act as incubators – things that work well in states sometimes get translated into federal policy,” Gosliner said. Identifying the success of the programs – and their challenges – can lead to improvements and help inform advocates and policymakers considering universal school meals policies at the state and national level.
Two of the team's research studies in California and Maine documented the benefits and challenges of universal school meals, as reported by school food authorities. Among 581 school food-service leaders in California who responded to the survey, nearly half (45.7%) reported reductions in student stigma as a result of providing free school meals to all students. Among 43 respondents in Maine, over half (51%) reported lessened stigma related to school meals being free for all. In both studies, nearly three-quarters of respondents reported increases in student meal participation. These and other data suggest that universal school meals are meeting their aim, to increase student participation while providing nutritionally balanced meals.
But when the child leaves campus, the responsibility to put a nutritious meal on the table falls on the caregiver.
“Universal school meals provide food and can ease families' budgets, but for too many families, wages as well as time and other resources are not adequate for access to and consumption of enough healthy foods and beverages,” Gosliner noted.
That is when other public programs are helpful, for example the Earned Income Tax Credit, or EITC.
Many eligible families do not claim Earned Income Tax Credit
The Earned Income Tax Credit is a national program designed to lift families out of poverty. The supplemental income can contribute up to nearly $7,000 per year for a family. Despite the EITC's known ability to improve participants' health, research shows that many EITC-eligible households in California and across the nation don't receive the benefits for which they are eligible, leaving $2 billion unclaimed in California in 2018 alone.
Gosliner led a study along with Lia Fernald from UC Berkeley and Rita Hamad from UC San Francisco to document levels of awareness, barriers to uptake, and benefits of participation in the EITC. Their recent publication reported that among 411 EITC-eligible California female caregivers, those who were younger, spoke languages other than English, and had less awareness of the EITC were less likely to receive the tax credit.
Developing a user-friendly system for providing safety-net support and, in the meantime, providing information and support to help more EITC-eligible families receive these benefits are suggested to help alleviate financial stressors. In the long term, these strategies may reduce poverty and improve the health of children.
Increasing WIC Cash Value Benefit a boon to health
In addition to universal school meals and EITC, families with low income may be eligible for the Special Supplemental Nutrition Assistance Program for Women, Infants and Children, or WIC. The program supports women and children up to 5 years old through nutrition education, nutritious foods and access to other health and social services.
One component of the WIC food packages, the Cash Value Benefit, provides participants a fixed dollar amount to supplement their family's diet with fruits and vegetables. During the pandemic, the U.S. Department of Agriculture increased this benefit from $9 to $35 per month, which was later revised to $24 per month per child in October 2021.
Ritchie contributed to a growing body of evidence on the importance and multidimensional benefits of the WIC Cash Value Benefit increase.
“Nine dollars buys only a quarter of what a child is recommended to eat every day,” Ritchie said. “The increase in Cash Value Benefit during the pandemic was an ideal natural experiment to investigate its impact.”
In collaboration with Shannon Whaley and her team at the Public Health Foundation Enterprises-WIC, NPI launched a longitudinal cohort study of nearly 2,000 California WIC participants. They found that the increased Cash Value Benefit improved WIC participant satisfaction with the program and allowed families to purchase greater quantities and varieties of fruits and vegetables.
“The increased Cash Value Benefit enabled WIC families to expose young children to new fruits and vegetables. Early exposure to a variety of fruits and vegetables is critical to establishing lifelong healthy habits,” said Ritchie.
The researchers found that the benefit increase also reduced food insecurity. It is hoped that the increase in program satisfaction translates into more eligible families enrolling and continuing to receive WIC. In November 2022, the U.S. Department of Agriculture proposed making the increased Cash Value Benefit a permanent part of WIC.
Knowing the proven benefits of the WIC program, Ritchie and colleagues from the National WIC Association, and Loan Kim at Pepperdine University, also engaged with WIC participants in other states.
In 2021, all state WIC agencies were invited to participate in a WIC satisfaction survey. Of the 12 WIC state agencies that opted to participate, Connecticut, Inter Tribal Council of Arizona, Nevada, New Hampshire and New Mexico added questions on the survey to understand how the increased Cash Value Benefit impacted children's dietary intake.
The study showed consumption of fruits and vegetables by children on WIC increased by one-third cup per day on average, which is sizable when considering the impact across the WIC population.
NPI research on universal school meals, the EITC and WIC constitute a small part of a more comprehensive approach to make healthy food more accessible, affordable, equitable and sustainable for all. The NPI provides resources such as policy briefs, peer-reviewed publications and technical assistance on several research areas such as safe drinking water, childcare and education. To learn more, please visit the Nutrition Policy Institute website.
- Author: Beatriz Adrianna Rojas
- Author: Andra Nicoli
CalFresh Healthy Living (CFHL), UCCE Kern County aims to improve health in farm working families by encouraging healthy eating and physical activity. As a result of a partnership with Head Start centers serving migrant communities, youth completed over 140 hours of physical activity and 92% of adult family members intended to use nutrition facts when shopping.
The Issue
According to County Health Rankings & Roadmaps, Kern County is ranked among the least healthy counties in California in terms of length and quality of life and a significant portion of residents have one or more risk factors that threaten their longevity and quality of life. For instance, 34% of adults are either overweight or obese, 35% of residents are physically inactive, and 23% are food insecure.
Children and adults with these risk factors are more likely to develop chronic diseases like heart disease and diabetes.
How UC Delivers
In order to work with residents on early healthy start interventions, CFHL, UCCE Kern County partnered with Community Action Partnership of San Luis Obispo (CAPSLO), which has five migrant Head Start centers in Kern County. CAPSLO provides no-cost childcare and preschool services to low-income families whose primary occupation is agricultural production and harvesting in the Arvin, Lamont/Weedpatch, Wasco, and Delano communities.
CFHL, UCCE Kern has conducted evening adult nutrition education at the centers.
- 94 parents received evidence based lessons from Plan, Shop, Save, and Cook (PSSC) and Healthy, Happy Families.
- Parents learned how to read the nutrition facts label, save money on food and how to start healthy habits with their children. Parents also learned how to incorporate physical activity in their everyday family routine. Physical Activity Guidelines for Americans (2018)recommends moderate-to-vigorous physical activity to reduce the risk of many chronic diseases among children and adults.
In order to impact families CFHL, UCCE Kern provided CAPSLO teachers with four hour training on Coordinated Approach to Child Health Early Childhood Education (CATCH ECE). CATCH ECE provides children with skill development exercises to develop locomotor, non-locomotor, manipulative skills and nurture their love for physical activity through games and activities. Teachers conducted CATCH 2-4 days per week for 30 minutes.
The Impact
Seventeen parents who received the PSSC lesson on understanding food labels completed an “Intent to Change” survey. Results of the survey include:
- Of the 12 respondents who did not use the “Nutrition Facts” label prior to the lesson, 92% reported that they will use the nutrition facts on the food label to choose foods the next time they go shopping.
- A parent shared how the workshop helped her family and that they are “eating better and know how to choose foods with better nutrition.”
From August to October 2022, 130 children participated in 143 hours of physical activity through CATCH ECE lessons delivered by 15 teachers at CAPSLO's centers. Research shows that regular moderate-to-vigorous physical activity reduces the risk of many chronic diseases among children and adults.
“All my children enjoy the CATCH activities. The CATCH program is fun and beneficial,” one teacher shared. The Center Director said “I really like how teachers and children are physically active with CATCH. The nutrition sessions given to the parents also makes it more impactful for the whole family.”
By motivating and teaching CFHL participants to adopt healthier lifestyle practices, and training ECE teachers to support physical activity, CFHL, UCCE Kern helps create healthier families and communities.
- Author: Amy Quinton, UC Davis News and Media Relations
New tool helps assess policies and practices
An estimated 53 million people in the U.S. turned to food banks and community programs for help putting food on the table in 2021. In recent decades, food banks have adopted policies and practices to make sure people not only have access to food but also healthy and nutritious food.
But until now, food banks have had few ways to evaluate those initiatives.
University of California, Davis, Assistant Professor of Cooperative Extension Cassandra Nguyen led a team of researchers to develop the Food Bank Health and Nutrition Assessment to address that concern. Their findings were published in the journal Public Health Nutrition.
“This tool will allow food banks to reflect on their current practices and determine whether they can adopt additional strategies to promote nutrition and health. It also serves as a benchmark, which they can use to track their progress over time,” said Nguyen, with the UC Davis Department of Nutrition.
Nutrition policy is more than what's on the shelf
Food banks face some common challenges in promoting nutrition, health and equity. While food banks could assess the nutritional quality of their inventory, Nguyen said promoting nutrition requires more than knowing the types of food on the shelf.
“Food banks can have nutrition policies that outline where they source food and which foods they prioritize when funding is available. They can also ensure that food pantry clients are either represented on advisory boards or are able to provide feedback about foods they would like to receive,” Nguyen said.
Additionally, food banks can take steps to make sure nutrition education materials and information about federal assistance programs for health and nutrition are available in languages spoken by recipients.
Partnerships with outside organizations and local farmers can also increase the variety and availability of nutritious foods. Food banks with diverse connections may also adapt better to unexpected spikes in need, such as during the COVID-19 pandemic.
The Food Bank Health and Nutrition Assessment was designed to evaluate these and additional objectives so food banks can identify areas of success as well as potential strategies they hadn't considered before.
Importance of data
“By having data from this assessment to show that some practices to promote nutrition and health may be difficult to implement, several food banks can raise their voices to advocate for policy changes,” Nguyen said.
Food banks with Feeding America and the Midwest Food Bank in four Midwestern states participated in the initial development of the Food Bank Health and Nutrition Assessment. In this small initial sample, most food banks asked food recipients about their preferences or whether diet-related diseases (for example, diabetes) were common, but few had current or former charitable food recipients on advisory boards.
The assessment is available for free through Feeding America, the largest nonprofit organization supporting the charitable food system, and online through the University of Illinois Extension. Food bank staff and partnering community-based professionals such as extension staff can use the assessment to improve promotion of nutrition and health.
Other authors include Caitlin Kownacki, Veronica Skaradzinski, Kaitlyn Streitmatter, Stephanie Acevedo and Jennifer McCaffrey with the University of Illinois at Urbana-Champaign; Stephen D. Ericson with Feeding Illinois; and Jessica E. Hager with Feeding America.
Funding for the research was supported by the Supplemental Nutrition Assistance Program-Education, or SNAP-Ed, in Illinois
- Author: Mike Hsu
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.”
- Author: Norma De la Vega
A fin de combatir las disparidades sociales que estorban en el aprendizaje y desarrollo de los niños, California extiende permanentemente, a partir del próximo año escolar 2022-2023, el Programa Universal de Comidas Escolares.
Al ofrecer 2 de 3 comidas al día gratis a todos los niños en las escuelas, los estudiantes tendrán una alimentación adecuada que les ayudará aprender y alcanzar su potencial y el Instituto de Políticas de Nutrición, NPI, estará a cargo de ejecutar un estudio para evaluar sobre la marcha el enorme reto logístico que esto implica para las escuelas y deberá buscar soluciones prácticas a los problemas que se presenten sobre la marcha.
“Va a ser un desafío para las escuelas el tener un aumento tan grande de estudiantes que estarán participando en el programa” sostiene Mónica Daniela Zuercher, experta de nutrición de NPI, la unidad de investigación la División de Agricultura y Recursos Naturales de la Universidad de California.
En una economía difícil, cuando la inseguridad alimentaria alcanza niveles inimaginables, finalmente se adopta, un viejo anhelo de las expertas de nutrición: ofrecer alimentos saludables a todos los estudiantes.
“Tenemos que pensar a largo plazo, al tener niños saludables tendremos adultos saludables, entonces habrá un ahorro en medicinas. Pero además está la parte cognitiva y de desarrollo, ¿cómo esperamos que aprenda un niño en la escuela si tiene hambre o sí está cansado?” señala la experta.
De manera permanente, alrededor de 6 millones de estudiantes en todo el estado podrán obtener los beneficios del Programa Universal sin formularios y sin preguntas molestas y los más beneficiados serán los latinos, porque son mayoría en las escuelas, representan 55 por cientos y son el grupo con más desventajas económicas junto con los afroamericanos.
Habrá estudiantes bien alimentados, padres menos estresados y a largo plazo, California obtendrá ahorros en la salud, toda vez que desde temprana edad los niños aprenderán a preferir los alimentos saludables previniendo problemas de salud como obesidad, diabetes y enfermedades crónicas.
En el 2010 ocurrió una revolución en las cafeterías escolares con el establecimiento de la Ley Niños Saludables y Sin Hambre Healhty Hunger-Free Kids Act. A partir de entonces se sirven en las cafeterías escolares, más frutas, verduras y granos integrales, menos grasas, sodio, azucares y se han ido eliminado las bebidas azucaradas.
California, es el primer estado en implementar las comidas gratis permanentemente. Se trata de un proceso logístico complejo que debe ser evaluado por expertos, y por esa razón NPI recibió fondos por 2.4 millones de dólares, para llevar a cabo un seguimiento, que durará 4 años, para identificar problemas y emitir soluciones con celeridad durante todo este periodo.
“Es un estudio muy emocionante porque evalúa diferentes etapas, desde inició como una medida por el Covid-19 hasta el desafío que va a ser para las escuelas el tener un aumento tan grande de estudiantes que estarán participando en el programa. Entonces vamos a captar el reto que tuvieron (las escuelas) para adaptarse durante la pandemia misma y los problemas que irán surgiendo en la marcha” explica Zuercher.
Esta investigación se ejecutará junto con representantes del Departamento de Educación de California y con todos los involucrados en el proceso: responsables de los servicios de alimentos en las escuelas, los padres de familia y estudiantes.
Las encuestas que forman parte del estudio, se han planeado en base a las necesidades de la población escolar, por lo que se están implementando en inglés y español para reflejar las inquietudes y opiniones de los latinos.
He aquí algunos de los resultados preliminares que por ahora solo incluyen opiniones de los directores de servicios de alimentos en las escuelas:
- Los trabajadores de las cafeterías hicieron un trabajo increíble durante la crisis de la pandemia para adaptar las comidas escolares que se servían en las escuelas, en comidas para llevar. Ellos sortearon con éxito todo tipo de cambios imprevistos por la falta de trabajadores y los retos en el suministro de alimentos.
- Ofrecer las comidas escolares para todos los estudiantes permitió disminuir la inseguridad alimentaria entre los estudiantes durante la emergencia de Covid-19.
- Aumentó el número de estudiantes que participan en las comidas escolares.
- Disminuyó la deuda de los padres de familia cuyos hijos no recibían comidas escolares subsidiadas. Un beneficio tanto para las escuelas como para las familias.
- Hubo una ligera reducción en el estigma que prevalece sobre los alimentos escolares.
Las comidas escolares han sido un elemento básico en la lucha contra la inseguridad alimentaria, pero han generado conflicto y presión social dentro de las escuelas. Alrededor de los alimentos gratis hay sentimientos de culpa, rechazo y vergüenza.
Zuercher enfatiza que en la memoria de muchos padres y estudiantes persisten la idea, equivocada, de que los alimentos escolares son comida chatarra o comidas de pobres.
“Hemos escuchado tanto de directores de alimentos como de algunos padres de familia que aún prevalece la vieja idea de que las comidas escolares no son saludables. Es una asociación comida escolar no es saludable, no es comida fresca, no es recién hecha”, sostiene Zuercher.
La hipótesis de los expertos es que al extender las comidas escolares gratis a todos los estudiantes también se podrá eliminar el conflicto y la presión social que estas generan y eso es algo que el tiempo podrá corroborar.
