Food-Aid Quality Correlates Positively With Diet Quality of Food Pantry Users in the Leket Israel Food Bank Collaborative.

Introduction: In many affluent countries, including Israel, networks of food banks and pantries have increasing responsibility to alleviate endemic poverty and food insecurity. While they may relieve acute hunger, their long-term influence on health and well-being is poorly understood. Methods: An exploratory cross-sectional telephone survey assessed both adequacy and quality of food aid provided via food pantries in the Leket Israel food bank network, in relation to recipients' dietary needs and health. The quality of food baskets and recipient diets were given a Healthy Portions Score (HPS) to measure compliance with Government guidelines for a "Basic Healthy Food Basket," and a Nutrient Density Score (NDS) to capture how well the food achieved the recommended dietary allowance (RDA) for vital macro and micronutrients. A total of 105 pantry users were surveyed from 16 pantries around the country. Results: The basket HPS correlated positively and highly significantly with dietary quality (individual NDS) after adjusting for gender, marital status and country of birth (standardized ß = 0.22, p = 0.03). Nearly half (46%) reported food insecurity with hunger. Two thirds were overweight or obese, and anemia, cardiovascular and metabolic disease were prevalent. The average food basket provides 30% of energy, 55% of protein, 50% of fiber, but only 33% or less of the household requirement for most minerals and vitamins. Only 60% of participants met their estimated energy requirements, and the intake of many essential micronutrients was well below the RDA. Fruits and vegetable portions contributed by Leket Israel correlated positively with the dietary quality (individual NDS) after adjustment for the same covariates (Standardized ß = 0.20, p = 0.04). Discussion: A structured telephone survey proved a feasible method to study the impact of food-aid quality on the nutrition and health of food pantry users in an affluent country. Food baskets with fruits, vegetables and higher quality nutrition were correlated with healthier diets among the recipients. Data correlating food-aid quality and recipient diet and health is essential to effective policy making.

A Technical and Policy Case Study of Large-Scale Rescue and Redistribution of Perishable Foods by the "Leket Israel" Food Bank.

BACKGROUND: Food banks seeking to rescue and redistribute highly nutritious perishable foods to simultaneously alleviate food insecurity and reduce food waste often encounter practical, ethical, and political dilemmas. OBJECTIVES: We present a case study of "Leket Israel," an Israeli food bank that uses an effective large-scale logistical model for the rescue and redistribution of perishable food and discuss the challenges and solutions it offers. RESULTS: The organization operates in a rich country plagued with poverty and inequality, where the government passively encourages nongovernmental organizations to respond to the serious and growing problem of food insecurity. Operating under a business-to-business model, Leket Israel distributes food via intermediary nonprofit organizations (NPOs), enriching the food they provide with fresh produce. Food is obtained through an Agricultural Gleaning project, Self-Growing Farm project, and Meal Rescue project. The partnering NPOs then distribute the food to people in need. Although the rescue and redistribution of highly perishable food is more costly and complex than acquiring, storing, and distributing dried and staple foods and it requires specialized knowledge and infrastructure in order to maintain rigorous safety standards, it improves the nutritional quality of the aid. In 2015, Leket Israel distributed 15 217 389 kg of food, 90% of which was fruit and vegetables, to 180 partnering NPOs nationwide, reaching an estimated 175 000 recipients. CONCLUSION: "Leket Israel" offers a valuable model that can be studied and emulated by international nutrition scientists, practitioners, and policy makers who are seeking to reduce food insecurity and food waste in other countries.

Dihydrofolate reductase 19-bp deletion polymorphism modifies the association of folate status with memory in a cross-sectional multi-ethnic study of adults.

BACKGROUND: Folate status has been positively associated with cognitive function in many studies; however, some studies have observed associations of poor cognitive outcomes with high folate. In search of an explanation, we hypothesized that the association of folate with cognition would be modified by the interaction of high-folate status with a common 19-bp deletion polymorphism in the dihydrofolate reductase (DHFR) gene. To our knowledge, the cognitive effects of this gene have not been studied previously. OBJECTIVE: We examined the association between cognitive outcomes with the 19-bp deletion DHFR polymorphism, folate status, and their interaction with high or normal plasma folate. DESIGN: This was a pooled cross-sectional study of the following 2 Boston-based cohorts of community living adults: the Boston Puerto Rican Health Study and the Nutrition, Aging, and Memory in Elders study. Individuals were genotyped for the DHFR 19-bp deletion genotype, and plasma folate status was determined. Cognitive outcomes included the Mini-Mental State Examination, Center for Epidemiologic Studies Depression Scale, and factor scores for the domains of memory, executive function, and attention from a set of cognitive tests. RESULTS: The prevalence of the homozygous deletion (del/del) genotype was 23%. In a multivariable analysis, high folate status (>17.8 ng/mL) was associated with better memory scores than was normal-folate status (fourth-fifth quintiles compared with first-third quintiles: ß ± SE = -0.22 ± 0.06, P < 0.01). Carriers of the DHFR del/del genotype had worse memory scores (ß ± SE = -0.24 ± 0.10, P < 0.05) and worse executive scores (ß = -0.19, P < 0.05) than did those with the del/ins and ins/ins genotypes. Finally, we observed an interaction such that carriers of the del/del genotype with high folate had significantly worse memory scores than those of both noncarriers with high-folate and del/del carriers with normal-folate (ß-interaction = 0.26 ± 0.13, P < 0.05). CONCLUSIONS: This study identifies a putative gene-nutrient interaction that, if confirmed, would predict that a sizable minority carrying the del/del genotype might not benefit from high-folate status and could see a worsening of memory. An understanding of how genetic variation affects responses to high-folate exposure will help weigh risks and benefits of folate supplementation for individuals and public health.