SNAP timing and food insecurity.

This paper makes several contributions to the literature regarding the measurement of food insecurity and implications for estimating factors that affect this outcome. First, we show that receipt of benefits from the Supplemental Nutrition Assistance Program (SNAP) has a systematic effect on responses to questions in the 12-month food security module (FSM). We find that the probability of affirming more severe food hardships items, and the probability of being classified as having very low food security (VLFS), is higher just before and just after households receive their benefits. This leads to an under-estimate of VLFS by 3.2 percentage points for the SNAP sample (about 17 percent of prevalence). We also provide informative bounds on the relationship between SNAP and VLFS and show that the treatment effect of SNAP on VLFS is also likely underestimated.

The effects of skipping a meal on daily energy intake and diet quality.

OBJECTIVE: To examine whether skipping breakfast or lunch increased the next meal's energy content and changed total daily energy content and the quality of food intake measured by the 2010 Healthy Eating Index (HEI-2010). DESIGN: Means were compared across intake days and meal patterns. Multivariate individual fixed-effects model was used to account for individual food intake and diet quality preferences. SETTING: National Health and Nutrition Examination Survey, 2007-2016. PARTICIPANTS: Adults aged 18 years or older who reported 2 d (24-h periods) of dietary intake and were not pregnant or lactating (n 23 488). RESULTS: Adults consumed 193 more kJ at lunch after skipping breakfast and 783 more kJ at dinner after skipping breakfast and lunch. Skipping at least one meal reduced total daily intake between 1053 (breakfast) and 1464 (dinner) kJ and reduced the daily HEI score. Skipping breakfast or skipping lunch reduced the HEI component scores for fruit, whole grains, dairy and empty energy; skipping lunch reduced the component scores for fruit, vegetables, whole grain, dairy, seafood and plant protein, and empty energy. Skipping dinner reduced component scores for vegetables, greens and beans, dairy, protein food, seafood and plant proteins, and empty energy. Skipping one or more meals increased component scores for total vegetables (breakfast), whole grains (dinner), Na (lunch or dinner) and refined grains (breakfast, lunch or dinner). CONCLUSIONS: Skipping meals (particularly dinner) reduces daily energy intake, but the reduction in daily diet quality (particularly when skipping breakfast) may impact health negatively over time.

Shiga Toxin-Producing Escherichia coli (STEC) O157:H7 and Romaine Lettuce: Source Labeling, Prevention, and Business.

From May to November most romaine lettuce shipments in the United States come from California's Central Coast region, whereas from December to April most come from the Yuma, Arizona, region. During 2017-2018, the 3 outbreaks of Shiga toxin-producing Escherichia coli (STEC) O157:H7 in US romaine lettuce all occurred at the tail end of a region's production season. During the fall 2018 outbreak, the US Food and Drug Administration (FDA) recommended that suppliers begin labeling romaine packaging so that consumers can identify the product's harvest region.We used publicly available data to show that labels may not avert many illnesses in future outbreaks but may reduce suppliers' financial losses and reduce food loss.Market data available during both 2018 outbreak investigations showed that there was no romaine production from one of the 2 regions when the first illness onset occurred. That is, at the beginning of an outbreak investigation, market data may allow the FDA to quickly rule out an entire production region as a source of contamination.

How Much Can Product Reformulation Improve Diet Quality in Households with Children and Adolescents?

Improvements in the healthfulness of packaged foods and beverages through reformulation could help reduce the prevalence of obesity among children and adolescents through improved diet quality. This study assessed changes in calories and four nutrients (saturated fat, total sugars, sodium, and dietary fiber) from 2012 through 2014 for packaged products frequently consumed by children and adolescents, simulated effects of potential improvements in 12 frequently consumed product categories based on actual purchasing patterns, and compared differences in prices of healthier versus less healthy products. Analysis of trends showed limited evidence that healthfulness of foods improved over the years examined. Simulation results showed minimal changes for calories and sodium, but daily intake of saturated fat could decrease by 4%, sugar consumption could decrease by 5%, and dietary fiber consumption could increase by 11% if products were reformulated to meet an existing healthfulness standard. Using a higher standard, caloric intake could decline by 4%, saturated fat by 6%, sugar by 9%, and sodium by 4%, and dietary fiber could increase by 14%. Healthier versions of most products ranged from an average of 3 to 12 cents more per serving, but not all healthier versions were more costly. Overall, reformulation is a potential avenue for improving diet quality in households with children and adolescents, but price could be a barrier to purchasing healthier products for some households.

Changes in consumption of food away from home and intakes of energy and other nutrients among US working-age adults, 2005-2014.

OBJECTIVE: To document changes in consumption of food away from home (FAFH) and intakes of selected nutrients by working-age adults between 2005-06 and 2013-14, covering the most recent recessionary period and recovery. DESIGN: Means were compared across survey rounds relative to 2005-06. Multivariate regression was used to account for changes in demographic characteristics over time. SETTING: National Health and Nutrition Examination Survey (NHANES), 2005-2014. SUBJECTS: Working-age adults born in 1951-80 (n 12 129) and adolescents and young adults born in 1981-90 (n 5197) who reported day 1 dietary intake data. RESULTS: Approximately 34 % of energy consumed by working-age adults came from FAFH (14 % from fast foods) in 2005-06. Levels of FAFH consumption were lowest in 2009-10, at 28 and 11 % of energy from FAFH and fast foods, respectively. Percentage of energy from fast foods was 1·9 percentage points higher in 2013-14. Percentage of energy from saturated fat and total mg of cholesterol consumed were lower in 2009-14, while intake of fibre was higher in 2011-14. At-home foods had less saturated fat and more fibre in 2009-14. The greater the percentage of energy from FAFH in the day, the greater the intakes of fat and cholesterol. Percentage of energy from FAFH was highest among those born in 1981-90 and lowest among those born in 1951-60. CONCLUSIONS: FAFH is a significant source of energy, fat and cholesterol among working-age adults. Menu labelling may lower FAFH's energy content and make it easier for consumers to choose more healthful items.

Caloric beverage intake among adult supplemental nutrition assistance program participants.

OBJECTIVES: We compared sugar-sweetened beverage (SSB), alcohol, and other caloric beverage (juice and milk) consumption of Supplemental Nutrition Assistance Program (SNAP) participants with that of low-income nonparticipants. METHODS: We used 1 day of dietary intake data from the 2005-2008 National Health and Nutrition Examination Survey for 4594 adults aged 20 years and older with household income at or below 250% of the federal poverty line. We used bivariate and multivariate methods to compare the probability of consuming and the amount of calories consumed for each beverage type across 3 groups: current SNAP participants, former participants, and nonparticipants. We used instrumental variable methods to control for unobservable differences in participant groups. RESULTS: After controlling for observable characteristics, SNAP participants were no more likely to consume SSBs than were nonparticipants. Instrumental variable estimates showed that current participants consumed fewer calories from SSBs than did similar nonparticipants. We found no differences in alcoholic beverage consumption, which cannot be purchased with SNAP benefits. CONCLUSIONS: SNAP participants are not unique in their consumption of SSBs or alcoholic beverages. Purchase restrictions may have little effect on SSB consumption.

Predicting the Effects of Sugar-Sweetened Beverage Taxes on Food and Beverage Demand in a Large Demand System.

A censored Exact Affine Stone Index incomplete demand system is estimated for 23 packaged foods and beverages and a numéraire good. Instrumental variables are used to control for endogenous prices. A half-cent per ounce increase in sugar-sweetened beverage prices is predicted to reduce total calories from the 23 foods and beverages but increase sodium and fat intakes as a result of product substitution. The predicted decline in calories is larger for low-income households than for high-income households, although welfare loss is also higher for low-income households. Neglecting price endogeneity or estimating a conditional demand model significantly overestimates the calorie reduction.

Food Away from Home and Childhood Obesity.

Childhood obesity is associated with a number of serious health risks that can persist into adulthood. While trends in food away from home and fast-food consumption have paralleled trends in childhood obesity, it is important to identify whether this is a causal relationship. This paper reviews recent literature in this area to summarize if there is a consensus in research findings. We group the literature into two areas - consumption of and access to food away from home (FAFH). While no consensus findings have been reached in either area, the evidence of an association between FAFH consumption and childhood obesity has gained strength. Further, there is evidence that FAFH meals add calories to children's diets. The literature on the role of FAFH access and childhood obesity has continued producing mixed results.

Implications of a sugar-sweetened beverage (SSB) tax when substitutions to non-beverage items are considered.

Using the 2006 Homescan panel, we estimate the changes in energy, fat and sodium purchases resulting from a tax that increases the price of sugar-sweetened beverages (SSBs) by 20% and the effect of such a tax on body weight. In addition to substitutions that may arise with other beverages, we account for substitutions between SSBs and 12 major food categories. Our main findings are that the tax would result in a decrease in store-bought energy of 24.3kcal per day per person, which would translate into an average weight loss of 1.6 pounds during the first year and a cumulated weight loss of 2.9 pounds in the long run. We do not find evidence of substitution to sugary foods and show that complementary foods could contribute to decreasing energy purchases. Despite their significantly lower price elasticity, the tax has a similar effect on calories for the largest purchasers of SSBs.

The effect of early interventions in health and nutrition on on-time school enrollment: evidence from the Oportunidades Program in rural Mexico.

This article assesses whether early intervention to improve children's health and nutrition increases the probability of enrolling in primary school on time. Using experimental data from the Mexican conditional cash transfer (CCT) program, Oportunidades, a cross-sectional double-difference estimator on observations from two age cohorts of children is used to identify the impact of early intervention. The results indicate that early health and nutrition interventions can have a positive impact on the timing of enrollment and that caregiver characteristics affect the magnitude of the impact. Early intervention also appears to decrease days of school missed. Overall the results indicate that the full impact of CCT programs on education cannot be measured in the short run as benefits of early health and nutrition interventions may be also felt in the distant future.

Impact of targeted beverage taxes on higher- and lower-income households.

BACKGROUND: Sugar-sweetened beverage (SSB) taxes are increasingly being considered as a strategy for addressing the obesity epidemic. We sought to investigate the differential impact of targeted beverage taxes on higher- and lower-income households. METHODS: This analysis relied on data from the 2006 Nielsen Homescan panel, which included a national sample of households that scan and transmit their store-bought food and beverage purchases weekly for a 12-month period. We assessed associations among beverage prices, energy intake, and weight using multivariate regression models. RESULTS: A 20% and 40% tax on carbonated SSBs only would reduce beverage purchases by a mean (SE) of 4.2 (1.6) and 7.8 (2.8) kcal/d per person, respectively. Extending the tax to all SSBs generates mean (SE) reductions of 7.0 (1.9) and 12.4 (3.4) kcal/d per person, respectively. Estimated mean (SE) weight losses resulting from a 20% and 40% tax on all SSBs are 0.32 (0.09) and 0.59 (0.16) kg/y per person, respectively. The 40% tax on SSBs, which costs a mean (SE) of $28.48 ($0.87) per household per year, would generate $2.5 billion ($77.5 million) in tax revenue, with the largest share coming from high-income households. CONCLUSIONS: Large taxes on SSBs have the potential to positively influence weight outcomes, especially for middle-income households. These taxes would also generate substantial revenue that could be used to fund obesity prevention programs or for other causes.