Conservation outreach that acknowledges human contributions to climate change does not inhibit action by U.S. farmers: Evidence from a large randomized controlled trial embedded in a federal program on soil health.

Technologies and practices that reduce the environmental impacts of US agriculture are well documented. Less is known about how best to encourage their adoption. We report on the results of a large randomized controlled trial conducted with nearly 10,000 agricultural producers in the United States. The experiment was embedded in US Department of Agriculture outreach efforts to improve soil conservation practices. USDA varied the content of mailings to test two sets of competing theories about outreach to agricultural producers. Contrary to conventional wisdom, we find no evidence that acknowledging the link between climate change and agricultural production discourages conservation action. Furthermore, we find that producers who were invited to a webinar were less likely to take any action to learn more about conservation practices than producers who were not told about the webinar, a result that runs counter to the popular wisdom that offering more options leads to more action.

Nutritional quality of retail food purchases is not associated with participation in the Supplemental Nutrition Assistance Program for nutrition-oriented households.

The Supplemental Nutrition Assistance Program (SNAP) provides millions of low-income Americans food benefits and other forms of nutrition assistance. Evidence indicates that SNAP reduces food insecurity. However, there is a concern that the food benefit may increase the demand for less healthy foods more than healthier foods, thereby reducing the overall nutritional quality of the participant's food basket. This paper aims to examine the association of SNAP participation with the nutritional quality of food-at-home purchases of low-income households and to investigate the potential heterogeneity among consumers with different levels of nutrition attitude. This analysis used food purchase data from the USDA National Household Food Acquisition and Purchase Survey (FoodAPS). Our study sample included 2,218 low-income households, of which 1,184 are SNAP participants, and 1,034 are income-eligible nonparticipants. Multivariate regressions were performed to explore the SNAP-nutritional quality association. A household's nutrition attitude was measured using its response to a question on whether the household searched for nutrition information online in the last 2 months. Households that affirmed they had an online nutrition search were treated as nutrition-oriented households (21.2% of the low-income sample), and households that did not were considered less nutrition-oriented households (78.8%). For robustness, we also created an alternative nutrition attitude measure based on reported use of the nutrition facts label. We found that among less nutrition-oriented households, SNAP participants had a statistically significant 0.097 points (p = 0.018) lower Guiding Stars rating than low-income nonparticipants. However, there was no significant SNAP-nutritional quality association among nutrition-oriented households. In conclusion, SNAP participation was associated with lower nutritional quality of food purchases among less nutrition-oriented households, but not among nutrition-oriented households. The results suggest that the intended nutritional benefits of restrictions on purchases of healthy foods may not reach the subgroup of nutrition-oriented SNAP participants.

Strengthening the Public Health Impacts of the Supplemental Nutrition Assistance Program Through Policy.

The US Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) is the cornerstone of the US nutrition safety net. Each month, SNAP provides assistance to 40 million low-income Americans-nearly half of them children. A number of changes could strengthen the public health impacts of SNAP. This review first presents a framework describing the mechanisms through which SNAP policy can influence public health, particularly by affecting the food security, the diet quality, and, subsequently, the health of SNAP participants. We then discusspolicy opportunities with the greatest potential to strengthen the public health impacts of SNAP, organized into three areas: (a) food production and distribution, (b) benefit allocation, and (c) eligibility and enrollment. For each section, we describe current policy and limitations of the status quo, suggest evidence-based opportunities for policy change to improve public health, and identify important areas for future research.

A Focused Review of Smartphone Diet-Tracking Apps: Usability, Functionality, Coherence With Behavior Change Theory, and Comparative Validity of Nutrient Intake and Energy Estimates.

BACKGROUND: Smartphone diet-tracking apps may help individuals lose weight, manage chronic conditions, and understand dietary patterns; however, the usabilities and functionalities of these apps have not been well studied. OBJECTIVE: The aim of this study was to review the usability of current iPhone operating system (iOS) and Android diet-tracking apps, the degree to which app features align with behavior change constructs, and to assess variations between apps in nutrient coding. METHODS: The top 7 diet-tracking apps were identified from the iOS iTunes and Android Play online stores, downloaded and used over a 2-week period. Each app was independently scored by researchers using the System Usability Scale (SUS), and features were compared with the domains in an integrated behavior change theory framework: the Theoretical Domains Framework. An estimated 3-day food diary was completed using each app, and food items were entered into the United States Department of Agriculture (USDA) Food Composition Databases to evaluate their differences in nutrient data against the USDA reference. RESULTS: Of the apps that were reviewed, LifeSum had the highest average SUS score of 89.2, whereas MyDietCoach had the lowest SUS score of 46.7. Some variations in features were noted between Android and iOS versions of the same apps, mainly for MyDietCoach, which affected the SUS score. App features varied considerably, yet all of the apps had features consistent with Beliefs about Capabilities and thus have the potential to promote self-efficacy by helping individuals track their diet and progress toward goals. None of the apps allowed for tracking of emotional factors that may be associated with diet patterns. The presence of behavior change domain features tended to be weakly correlated with greater usability, with R2 ranging from 0 to .396. The exception to this was features related to the Reinforcement domain, which were correlated with less usability. Comparing the apps with the USDA reference for a 3-day diet, the average differences were 1.4% for calories, 1.0% for carbohydrates, 10.4% for protein, and -6.5% for fat. CONCLUSIONS: Almost all reviewed diet-tracking apps scored well with respect to usability, used a variety of behavior change constructs, and accurately coded calories and carbohydrates, allowing them to play a potential role in dietary intervention studies.

Trends in Dietary Sodium Intake in the United States and the Impact of USDA Guidelines: NHANES 1999-2016.

BACKGROUND: Moderation in sodium consumption is recommended to reduce morbidity and mortality; however, trends in intake and the impact of guidelines have not been examined. METHODS: Sodium intake data collected from 1999-2016 in the National Health and Nutrition Examination Surveys were analyzed. Trends in sodium intake for individuals aged 18 years or over and in subgroups based on age, sex, race and ethnicity, and sodium-sensitive chronic diseases were examined. Adherence to US Department of Agriculture guidelines was assessed. Multivariable regression analysis was performed to identify predictors of sodium intake from 2011-2016. RESULTS: A total of 47,509 individuals (median age = 44.0 years, 48.3% male) were included in the study. Median sodium consumption was 3232 mg per day (95% confidence interval [CI], 3210-3255), increasing from 3156 mg per day (95% CI 3,038-3,273) in 1999-2000 to 3273 mg per day (95% CI, 3218-3328) in 2015-2016 (P < .001). Intake declined with age (3427 mg per day for individuals aged 18-50 years, 3101 mg per day for individuals aged 51-70 years, and 2620 mg per day for individuals aged ≥71 years; P < .001) and was greater in males than in females (3827 mg per day vs 2778 mg per day; P < .001). Caucasians, Hispanics, and African Americans consumed 3278, 3117, and 3027 mg of dietary sodium per day respectively (P < .001). Individuals with hypertension, diabetes mellitus, and chronic kidney disease consumed 3073, 3062, and 2658 mg of dietary sodium per day respectively. Population adherence to US Department of Agriculture recommendations declined from 34% to 23% and all high-risk subgroups had < 10% adherence. Daily total calories was the strongest predictor of sodium consumption (overall r2 = 0.680). CONCLUSION: Sodium intake has remained above recommended levels in all segments of the adult population and adherence to guidelines is poor. Novel interventions are needed to reduce sodium intake.

Likelihood of Breastfeeding Within the USDA's Food and Nutrition Service Special Supplemental Nutrition Program for Women, Infants, and Children Population.

BACKGROUND: Breastfeeding is an important public health initiative. Low-income women benefiting from the U.S. Department of Agriculture's Food and Nutrition Service Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are a prime population for breastfeeding promotion efforts. Research aim: This study aims to determine factors associated with increased likelihood of breastfeeding for WIC participants. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guided the systematic review of literature. Database searches occurred in September and October 2014 and included studies limited to the previous 10 years. The following search terms were used: low-income; WIC; women, infants, and children; breastfeeding; breast milk; and maternal and child health. The criterion for inclusion was a study sample of women and children enrolled in the WIC program, thereby excluding non-United States-based research. RESULTS: Factors that increased the likelihood of breastfeeding for WIC participants included sociodemographic and health characteristics ( n = 17); environmental and media support ( n = 4); government policy ( n = 2); intention to breastfeed, breastfeeding in hospital, or previous breastfeeding experience ( n = 9); attitudes toward and knowledge of breastfeeding benefits ( n = 6); health care provider or social support; and time exposure to WIC services ( n = 5). CONCLUSION: The complexity of breastfeeding behaviors within this population is clear. Results provide multisectored insight for future research, policies, and practices in support of increasing breastfeeding rates among WIC participants.

Obesity is inversely associated with natural amenities and recreation facilities per capita.

BACKGROUND: Little is known about the associations between natural amenities, recreation facility density, and obesity, at a national level. Therefore, the purpose of this paper was to examine associations between county-level natural amenities, density of recreation facilities, and obesity prevalence among United States counties. METHODS: Data were obtained from a compilation of sources within the United States Department of Agriculture Economic Research Service Food Environment Atlas. Independent variables of interest were the natural amenities scale and recreation facilities per capita. The dependent variable was county-level obesity prevalence. Potential covariates included a measure of county-level percent Black residents, percent Hispanic residents, median age, and median household income. All models were stratified by population loss, persistent poverty, and metro status. Multilevel linear regression models were used to examine the association between obesity and natural amenities and recreation facilities, with "state" as a random effects second level variable. RESULTS: There were statistically significant negative associations between percent obesity and 1) natural amenities and 2) recreation facilities per capita. CONCLUSIONS: Future research should examine environmental and policy changes to increase recreation facilities and enhance accessible natural amenities to decrease obesity rates.

Examining associations among obesity and per capita farmers' markets, grocery stores/supermarkets, and supercenters in US counties.

Fruit and vegetable consumption is an important component of a healthful diet, yet fruits and vegetables are underconsumed, especially among low-income groups with high prevalence rates of obesity. This study used data from the US Department of Agriculture Economic Research Service Food Environment Atlas to examine county-level associations among obesity prevalence and per capita farmers' markets, grocery stores/supermarkets, and supercenters, adjusted for natural amenities, percent black, percent Hispanic, median age, and median household income, stratified by county metropolitan status. In models that included all three of the food venues, supercenters and grocery stores per capita were inversely associated with obesity in the combined (metro and nonmetro) and metro counties. Farmers' markets were not significant in the model for combined (metro and nonmetro) or for metro counties alone, but were significantly inversely related to obesity rates in the model for nonmetro counties. In this ecologic study, density of food venues was inversely associated with county-level obesity prevalence. Thus, future research should examine similar associations at the individual-level.

Trends in meat consumption in the USA.

OBJECTIVE: To characterize the trends, distribution, potential determinants and public health implications of meat consumption within the USA. DESIGN: We examined temporal trends in meat consumption using food availability data from the FAO and US Department of Agriculture (USDA), and further evaluated the meat intake by type (red, white, processed) in the National Health and Nutrition Examination Surveys (NHANES) linked to the MyPyramid Equivalents Database (MPED). RESULTS: Overall meat consumption has continued to rise in the USA and the rest of the developed world. Despite a shift towards higher poultry consumption, red meat still represents the largest proportion of meat consumed in the USA (58 %). Twenty-two per cent of the meat consumed in the USA is processed. According to the NHANES 2003-2004, total meat intake averaged 128 g/d. The type and quantities of meat reported varied by education, race, age and gender. CONCLUSIONS: Given the plausible epidemiological evidence for red and processed meat intake in cancer and chronic disease risk, understanding the trends and determinants of meat consumption in the USA, where meat is consumed at more than three times the global average, should be particularly pertinent to researchers and other public health professionals aiming to reduce the global burden of chronic disease.

Dietary intake of carotenoid isomers in Israel.

Controversy exists regarding the possible protective role of carotenoids against cancer. Evidence is mainly against all-E-beta-carotene, while there is no evidence against other carotenoids or against mixtures of beta-carotene stereoisomers. Carotenoid isomers could account for the variability in study results but are rarely estimated, and reference to the degree of their consumption is lacking. The aim of our study was to create a comprehensive database of carotenoid isomers content in food items commonly consumed in Israel. Food items were analyzed using a liquid chromatography system to determine the content of carotenoid isomers in Israeli food. The main sources of carotenoids detected in Israeli foods were tomato juice, tomato, watermelon, parsley, coriander, spinach, carrot, sweet potato, banana, zucchini, mango, loquat, pepper, eggplant, and chickpeas. Data were used to measure consumption in healthy participants of a case-control study, using a semi-quantitative food-frequency 187-item questionnaire. Compared to reference studies, the median carotenoid isomers intake in 712 Israeli healthy controls (age range 23-95 years, mean 71 +/- 10.9 years, median 73 years) was higher for beta-carotene, alpha-carotene, beta-cryptoxanthin, and zeaxanthin, while the intake of lycopene was lower. Major differences in consumption were noticed between ethnic groups consuming Mediterranean diets and those consuming Western-type diets. Population consumption patterns of carotenoid isomers using a comprehensive database are used to improve our understanding in disease prevention. Consumption in Israel seems to be generally higher than that reported in studies conducted elsewhere, and varies by ethnic group.

Billions for biodefense: federal agency biodefense funding, FY2001-FY2005.

Over the past several years, the United States government has spent substantial resources on preparing the nation against a bioterrorist attack. This article analyzes the civilian biodefense funding by the federal government from fiscal years 2001 through 2005, specifically analyzing the budgets and allocations for biodefense at the Department of Health and Human Services, the Department of Homeland Security, the Department of Defense, the Department of Agriculture, the Environmental Protection Agency, the National Science Foundation, and the Department of State. In total, approximately $14.5 billion has been funded for civilian biodefense through FY2004, with an additional $7.6 billion in the President's budget request for FY2005.

Annual per capita apparent consumption of tobacco products in the United States: 1900-1990.

BACKGROUND: Analyses of secular trends in tobacco consumption can provide evidence of potential tobacco-disease relationships and have utility in terms of public health projections and policy. The purpose of this project was to provide a unique set of continuous apparent tobacco product consumption estimates for the United States over the period spanning 1900 through 1990. METHODS: Two U.S. Department of Agriculture data sources provide information on long-term apparent tobacco consumption in the United States; however, differences exist between these data sets. The consumption estimates in these reports were adjusted to a common population base. A 9-year overlap of the data sets was then used to calibrate one data series to the other using inverse regression. Predicted tobacco consumption estimates for the years 1900 through 1944 were then combined with the adjusted 1945-1990 data. RESULTS: Inverse regression showed a strong linear relationship between the two U.S. Department of Agriculture summaries for each tobacco product during the 9-year overlap period. A continuous set of annual per capita tobacco consumption estimates is reported by product for the United States. CONCLUSIONS: The two U.S. Department of Agriculture reports can be combined to provide a history of tobacco product consumption in the United States over the period 1900-1990.

Survey of veterinary extension in the United States.

OBJECTIVE: To assess veterinary extension in the United States as perceived by veterinary extension personnel. DESIGN: Cross-sectional survey. SAMPLE POPULATION: Extension veterinarians in the United States. PROCEDURE: 2 surveys were designed and mailed to extension veterinarians listed by the USDA and the American Association of Extension Veterinarians. RESULTS: 34 states had > or = 1 extension veterinarian. The majority (> 60%) of extension veterinarians did not commit time to resident education and were not involved in research activities. Paradoxically, 23% of responding extension veterinarians did not report extension work. Programs for food animal producers, horse owners, and companion animal owners were provided by 100, 63, and 37% of states, respectively. Continuing education (CE) programs were provided for food animal veterinarians, equine veterinarians, and companion animal veterinarians by 96, 63, and 52% of states, respectively. Challenges facing veterinary extension included limited recognition of veterinary extension activities by universities, lack of university personnel to support CE programs, and decreased support for companion animal extension programs. CONCLUSIONS AND CLINICAL RELEVANCE: Extension veterinarians need to identify and clearly articulate the mission of veterinary extension, develop more collaborative programs across regions, and continue to serve as catalysts to bring diverse constituents together. Extension veterinarians must distinguish their mission not solely as information transfer, which can be accomplished in a variety of ways outside of extension, but as a coherent and consistent program of education and policy developed on a national level and distributed locally.

National surveillance for antibiotic resistance in zoonotic enteric pathogens.

Treatment of food-producing animals with antimicrobial agents that are important in human therapy may present a public health risk by the transfer of resistant zoonotic pathogens from animals to humans. Resistant bacteria can diminish the effectiveness of antibiotics and demand the use of more expensive or less safe alternatives. In 1996, the Centers for Disease Control (CDC), United States Department of Agriculture (USDA), and Food and Drug Administration (FDA) established the National Antimicrobial Monitoring System to prospectively monitor changes in antimicrobial susceptibilities of zoonotic pathogens from human and animal clinical specimens, healthy farm animals, and carcasses of food-producing animals at slaughter plants. This article describes the development, implementation, and objectives of the monitoring system and presents initial data generated by the system.