Posts Tagged: food and nutrition

Universal school meals increased student participation, lessened stigma

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.

Can food banks better promote nutrition and health?

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

Study: Government shutdown stressed food assistance program participants

A U.S. federal government shutdown can represent a minor inconvenience, a delay in paychecks, or – for people living in some of the most difficult circumstances – an extended period of hunger and anxiety.

A study published recently in the journal Nutrients provides a unique glimpse into the shutdown experiences of participants in CalFresh – California's name for the federally funded Supplemental Nutrition Assistance Program (formerly known as food stamps). Currently, about 42 million people participate in SNAP across the U.S.

In focus groups conducted in 2019 with 26 low-income CalFresh participants from four diverse California counties, participants shared how the 2018-19 federal government shutdown affected their SNAP benefits, their perception of the program and their faith in government.

One of the immediate effects of the 2018-19 shutdown was that February CalFresh benefits were distributed in January. And while that meant program participants saw extra benefits that month, they then had to wait 40 to 44 days until the March issuance – much longer than the usual 28 to 31 day cycle.

“What we saw with this study is that this extended lag in benefit receipt from January to March was devastating,” said Wendi Gosliner, senior researcher and policy advisor at the Nutrition Policy Institute of UC Agriculture and Natural Resources, and an author of the study funded by UC ANR.

She recalled one participant who, despite having a gastrointestinal issue that requires a special diet, had to eat canned food from the food bank that made her sick – rather than go hungry while waiting for her March benefits. Others described cascading financial challenges after using rent money for food in February, or going into debt to pay for food and getting behind on other expenses.

The study also chronicles the experiences of a woman who was anguished to hear the suffering of her daughter, also a CalFresh participant: “She called me several times crying, ‘Ma, I don't – we don't have enough food. What am I going to do…? You know, I can't afford to this and this and this.' And I can't help her.”

For individuals grappling with food insecurity, the stress of feeding their families was compounded by the uncertainties of the government shutdown. And while many participants exercised their agency and resourcefulness in coping with the situation, they also felt a degree of powerlessness amid the “confusion and craziness,” as one person put it.

“No one knew how long that shutdown was going to last; no one knew if the March benefits were going to be paid,” Gosliner said. “And as we learned, there were all kinds of stories circulating out there about what was going on with the uncertainty – a lot of people didn't have the information about what was actually happening.”

Some participants, seeing the “double benefit” in January 2019, thought that it was the last-ever distribution and that SNAP was ending. Others described being unable to get in touch with the CalFresh agency to get their questions answered about the benefits. Most participants had not heard about the disrupted benefit schedule before receiving the benefits. As a result, many people in the focus groups shared that their overall faith in government had been shaken.

Improving customer service, boosting benefit levels and adjusting eligibility and benefit formulas to reflect high cost-of-living and expenses related to working were three recommendations that came from the focus group participants.

A fourth recommendation tackles the shutdown issue head-on: Don't let it happen again.

“Congress should do absolutely everything in their power to be sure that the program operates on the usual time schedule – even if the government is shut down,” Gosliner said.

In the context of the global pandemic, when financial and social inequities and physical and mental health disparities have been laid bare, ensuring access to healthful food is even more important. And with studies showing that hospitalizations increase with longer lags between SNAP distributions, Gosliner said the “absolute last thing” the overburdened health system needs is more people in emergency departments seeking acute care.

“It's the worst time to be having people who need money to feed their families face additional insecurity,” she said. “It's critically important that Congress acts to be sure that there is not any disruption in benefits.”

The authors of the study, “Participants' Experiences of the 2018–2019 Government Shutdown and Subsequent Supplemental Nutrition Assistance Program (SNAP) Benefit Disruption Can Inform Future Policy,” are Wendi Gosliner, Wei-Ting Chen, Cathryn Johnson, Elsa Michelle Esparza, Natalie Price, Ken Hecht and Lorrene Ritchie.

The study can be found online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353319.

Study finds 82 percent of avocado oil rancid or mixed with other oils

Consumer demand is rising for all things avocado, including oil made from the fruit. Avocado oil is a great source of vitamins, minerals and the type of fats associated with reducing the risk of heart disease, stroke and diabetes. But according to new research from food science experts at the University of California, Davis, the vast majority of avocado oil sold in the U.S. is of poor quality, mislabeled or adulterated with other oils.

In the country's first extensive study of commercial avocado oil quality and purity, UC Davis researchers report that at least 82% of test samples were either stale before expiration date or mixed with other oils. In three cases, bottles labeled as “pure” or “extra virgin” avocado oil contained near 100 percent soybean oil, an oil commonly used in processed foods that's much less expensive to produce.

“I was surprised some of the samples didn't contain any avocado oil,” said Selina Wang, UC Cooperative Extension specialist in the UC Davis Department of Food Science and Technology, who led the study recently published in the journal Food Control.“Most people who buy avocado oil are interested in the health benefits, as well as the mild, fresh flavor, and are willing to pay more for the product. But because there are no standards to determine if an avocado oil is of the quality and purity advertised, no one is regulating false or misleading labels. These findings highlight the urgent need for standards to protect consumers and establish a level playing field to support the continuing growth of the avocado oil industry.”

Testing domestic and imported brands  

Wang and Hilary Green, a Ph.D. candidate in Wang's lab, analyzed various chemical parameters of 22 domestic and imported avocado oil samples, which included all the brands they could find in local stores and online. Wang and Green received a $25,000 grant from Dipasa USA, part of the Dipasa Group, a sesame-seed and avocado-oil processor and supplier based in Mexico.

“In addition to testing commercial brands, we also bought avocados and extracted our own oil in the lab, so we would know, chemically, what pure avocado oil looks like,” Wang said.

Test samples included oils of various prices, some labeled extra virgin or refined. Virgin oil is supposed to be extracted from fresh fruit using only mechanical means, and refined oil is processed with heat or chemicals to remove any flaws.

Fifteen of the samples were oxidized before the expiration date. Oil loses its flavor and health benefits when it oxidizes, which happens over time and when exposed to too much light, heat or air. Six samples were mixed with large amounts of other oils, including sunflower, safflower and soybean oil.

Only two brands produced samples that were pure and non-oxidized. Those were Chosen Foods and Marianne's Avocado Oil, both refined avocado oils made in Mexico. Among the virgin grades, CalPure produced in California was pure and fresher than the other samples in the same grade.

A push for standards

Ensuring quality is important for consumers, retailers, producers and people throughout the avocado oil industry. Retailers want to sell quality products, shoppers want to get their money's worth and honest producers want to keep fraudulent and low-quality oil out of the marketplace.

But since avocado oil is relatively new on the scene, the Food and Drug Administration (FDA) has not yet adopted “standards of identity,” which are basic food standards designed to protect consumers from being cheated by inferior products or confused by misleading labels. Over the last 80 years, the FDA has issued standards of identity for hundreds of products, like whiskey, chocolate, juices and mayonnaise. Without standards, the FDA has no means to regulate avocado oil quality and authenticity.

Avocado oil isn't the only product without enforceable standards. Honey, spices and ground coffee are other common examples. Foods that fetch a higher price are especially ripe for manipulating, especially when adulterations can be too subtle to detect outside a lab.

Wang is working to develop faster, better and cheaper chemical methods to detect adulteration so bulk buyers can test avocado oil before selling it. She is also evaluating more samples, performing shelf-life studies to see how time and storage affects quality, and encouraging FDA officials to establish reasonable standards for avocado oil.

Wang has experience collaborating with industry and the FDA. Ten years ago, she analyzed the quality and purity of extra virgin olive oil and discovered that most of what was being sold in the U.S. was actually a much lower grade. Her research sparked a cascade of responses that led California to establish one of the world's most stringent standards for different grades of olive oil. The FDA is working with importers and domestic producers to develop standards of identity for olive oil.

“Consumers seeking the health benefits of avocado oil deserve to get what they think they are buying,” Wang said. “Working together with the industry, we can establish standards and make sure customers are getting high-quality, authentic avocado oil and the companies are competing on a level playing field.”

Tips for consumers

• The flavor of virgin avocado oil can differ by varieties and region. In general, authentic, fresh, virgin avocado oil tastes grassy, buttery and a little bit like mushrooms.
• Virgin avocado oil should be green in color, whereas refined avocado oil is light yellow and almost clear due to pigments removed during refining.
• Even good oil becomes rancid with time. It's important to purchase a reasonable size that can be finished before the oil oxidizes. Store the oil away from light and heat. A cool, dark cabinet is a good choice, rather than next to the stove.  
• How do you know if the oil is rancid? It starts to smell stale, sort of like play dough.
• When possible, choose an oil that's closest to the harvest/production time to ensure maximum freshness. The “best before date” is not always a reliable indicator of quality.

NPI study finds that prices for fruits and vegetables may be higher in low-income neighborhoods

Shoppers purchasing fruits and vegetables in stores located in low-income neighborhoods in California may pay more for those fruits and vegetables than shoppers in other neighborhoods, according to a study that examined prices in a large sample of stores throughout the state.

Published online in March 2018 in the journal Public Health Nutrition, the study, conducted by researchers at UC's Nutrition Policy Institute, involved more than 200 large grocery stores, 600 small markets, and 600 convenience stores in 225 low-income neighborhoods (where at least half of the population was at or below 185 percent of the Federal Poverty Level) and compared observed prices to purchased price data from chain grocery stores in the same counties during the same months.

The study found that produce prices for the items examined (apples, bananas, oranges, carrots and tomatoes) were higher in stores in low-income neighborhoods than the average prices of those items sold in stores in the same counties during the same month. Fruits and vegetables for sale in convenience stores in low-income neighborhoods were significantly more expensive than those for sale in small markets or large grocery stores. Yet even in large grocery stores the study found prices in the low-income neighborhoods to be higher than average county grocery store prices during the same month.

“Americans eat too few fruits and vegetables to support optimal health, and we know that dietary disparities among socioeconomic groups are increasing,” said study author Wendi Gosliner. “This study suggests that one important issue may be fruit and vegetable prices — not just that calorie-per-calorie fruits and vegetables are more expensive than many unhealthy foods, but also that there are equity issues in terms of relative prices in neighborhoods where lower-income Californians live.”

Additionally, the study examined the quality and availability of fruits and vegetables in stores and found that while less than half of convenience stores (41 percent) sold fresh produce, even fewer (1 in 5) sold a wide variety of fruits or vegetables, and few of the items that were for sale were rated by trained observers to be high quality (25 percent for fruits and 14 percent for vegetables).

“This study suggests that convenience stores in low-income neighborhoods currently fail to provide access to high-quality, competitively priced fresh fruits and vegetables," said Pat Crawford, nutrition expert and study author. “A healthy diet can prevent disease and reduce health care costs in the state. States need to explore new ways to help ensure that families, particularly those living in low-income neighborhoods where convenience stores are the only food retailers, have access to healthy, high-quality foods that are affordable,” Crawford added.

The study also found that convenience stores participating in federal food programs (the Supplemental Nutrition Assistance Program [SNAP] and/or the Supplemental Nutrition Program for Women, Infants, and Children [WIC]) were more likely to sell fresh produce and to offer higher quality and a wider variety of fruits and vegetables than stores not participating in either program.

The study was conducted under contract with the California Department of Public Health. Funding is from USDA SNAP. USDA is an equal opportunity provider and employer.

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