Federal nutrition program changes and healthy food availability.

BACKGROUND: Literature on food environments is expanding rapidly, yet a gap exists regarding the role of the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on healthy food availability. In October 2009, the U.S. Department of Agriculture revised the WIC food package, requiring certified stores to stock fresh produce, whole grains, and lower-fat milk. PURPOSE: The goal of this study is to compare availability of foods in stores that are versus those that are not WIC-certified before and after the policy change. METHODS: Store inventories were collected in 45 corner stores in Hartford CT with four inventories each (180 total inventories) from January 2009 to January 2010. Data on availability and variety of fresh fruits, fresh vegetables, whole grains, and lower-fat milk were recorded. Analyses were completed in 2012 using Fisher's exact test, chi-square, and t-tests for descriptive analyses and multilevel models to measure food availability longitudinally (significance at p<0.05). RESULTS: Controlling for covariates, WIC-certified vendors carried more varieties of fresh fruit (p<0.01); a greater proportion of lower-fat milk (p<0.01); and had greater availability of whole grain bread (p<0.01) and brown rice (p<0.05) than vendors without WIC authorization after the policy change. Conversely, for all outcomes, stores without WIC authorization did not significantly increase healthy food availability. CONCLUSIONS: The 2009 WIC revisions increased availability of healthy foods among WIC-certified vendors compared to those without WIC authorization in Hartford CT. For many residents without a car, these changes can create a convenient shopping location for healthy foods when a larger supermarket is not nearby.

Correlates of weight loss in persons with metabolic syndrome.

OBJECTIVE: To identify correlates of weight loss in persons with metabolic syndrome. METHODS: Overweight adults (1851) with metabolic syndrome were identified among 5643 eligible participants in the U.S. National Health and Nutrition Examination Survey, 1999-2004. Survey analysis techniques were used to study variation in the frequency of self-reported, intentional weight loss (> or =10 lb in the past year) relative to 28 survey variables representing characteristics in seven domains: demographic, socioeconomic, lifestyle, health status, metabolic risk factor, health advice, and disease diagnosis. RESULTS: An estimated 34.8% (SE=0.9) of U.S. adults had metabolic syndrome during the 1999-2004 period, and among them, 88.4% (0.8) were overweight. The overall frequency of weight loss was 14.9% (0.9), but multivariate analysis confirmed significantly higher frequencies in persons who had BMI between 35.0 and 39.9 kg/m(2) [24.5% (2.8)], who were informed of overweight status by a health professional [19.4% (1.6)], who were advised to lose weight for hypertension [23.2% (1.9)], or who were diagnosed with diabetes [26.4% (3.2)]. CONCLUSION: In metabolic syndrome, the frequency of weight loss may be enhanced when patients understand the reality and degree of their overweight status, are advised by a health professional about the need to lose weight, and/or appreciate connections between excess weight and other co-morbidities.