The impact of sodium reduction on overall nutrient content in Child and Adult Care Food Program meals.

OBJECTIVE: To understand the impact of Na reduction on the nutrient content of Child and Adult Care Food Program (CACFP) meals served through At-Risk Afterschool Meals (ARASM) without compromising the nutritional quality of the meals served. DESIGN: Sodium Reduction in Communities Program (SRCP) partnered with a CACFP ARASM programme from October 2016 to September 2021. We assessed changes in Healthy Eating Index 2015 (HEI-2015) food component scores and macro- and micronutrients using cross-sectional nutrient analyses of October 2016 and 2020 menus. SETTING: ARASM programme sites in Indianapolis, IN, USA. PARTICIPANTS: October 2016 and 2020 menus from one CACFP ARASM programme. INTERVENTION: Na reduction strategies included implementing food service guidelines, modifying meal components, changing procurement practices and facilitating environmental changes to promote lower Na items. RESULTS: From baseline in 2016 to 2020, fifteen meal components were impacted by the intervention, which impacted 17 (85 %) meals included in the analysis. Average Na per meal reduced significantly between 2016 (837·9 mg) and 2020 (627·9 mg) (P = 0·002). Between 2016 and 2020, there were significant increases in whole grains (P = 0·003) and total vegetables (P < 0·001) and significant reductions in refined grains (P = 0·001) and Na (P = 0·02), all per 1000 kcal served. CONCLUSIONS: This study demonstrates that Na content can be reduced in CACFP meals without compromising the nutritional quality of meals served. Future studies are needed to identify feasible best practices and policies to reduce Na content in the CACFP meal pattern.

"You Feel Out of Place": A PhotoVoice Study of the Impact of Food Insecurity on College Students.

Purpose: There is a high prevalence of food insecurity on college campuses in the United States. Quantitative research has shown that experiencing food insecurity during college is associated with adverse academic, health, and social-emotional outcomes. Research is needed to better understand how food insecurity impacts the lived experiences of students. This study aims to understand students' experiences of food insecurity, with a particular focus on their coping strategies and the effects of food insecurity on their health and academic achievement. Methods: An adaptation of the PhotoVoice method was used to understand how food insecurity affected 10 college students at a large, Midwestern university. Students submitted photos around their experiences of food insecurity and completed an in-depth interview about their photos. The interviews were analyzed for thematic content using an iterative, inductive approach. Results: Four themes emerged from the results: (1) economic coping mechanisms, (2) behavioral coping mechanisms; (3) alternate ways to acquire food; and (4) psychosocial and academic consequences. Conclusion: These findings provide context to the negative impacts of food insecurity on students' academic and health outcomes, and add to the growing body of qualitative research that is needed to inform practices and policies to address food insecurity on college campuses.

Sodium Reduction in Distributive Meals Through Speed-Scratch Cooking.

PURPOSE AND OBJECTIVES: Through the Centers for Disease Control and Prevention's Sodium Reduction in Communities Program, the Marion County Public Health Department and partners implemented sodium reduction strategies in distributive meal programs (ie, low- or no-cost meals available to under-resourced populations) to meet the long-term goal of reducing the burden of sodium-related chronic disease among adults aged 60 or older. The purpose of our study was to evaluate results from the first 2 years of the program, which modified recipes to reduce overall sodium levels through speed-scratch cooking (combining prepared food products with those made from scratch). INTERVENTION APPROACH: We modified recipes to reduce sodium content in 2 potato products served frequently as side dishes in distributive programs for older adults for congregate meals - those provided to groups in a community setting - and home-delivered meals. EVALUATION METHODS: We compared average sodium content of a 3-month menu cycle between 2 program years, the costs and consumer acceptance of recipe modifications, and consumer perceptions of product changes. Primary data included a nutrient analysis and key informant interviews. RESULTS: Approximately 2,000 distributive meal clients of CICOA Aging and In-Home Solutions were served reduced-sodium potato dishes over the 2 years of the intervention. From year 1 to year 2, the sodium content of scalloped potatoes was reduced by 65%, and the sodium content of mashed potatoes was reduced by 87%. Client acceptance of the modified recipes met the target threshold of a mean Likert-scale score of 3.75 out of 5.0, and the combined cost savings for both potato dishes was 45 cents per serving. Key informants noted the themes of economics of cost and labor, knowledge of how to identify reduced sodium options, and quality of the replacement food as essential factors for recipe modification. IMPLICATIONS FOR PUBLIC HEALTH: Using speed-scratch recipe modification for 2 potato dishes significantly reduced the sodium content of distributive meals for older adults. Speed-scratch recipe modification can be used as a tool to improve the nutritional value of meals and reduce the chronic disease burden of high-risk populations.