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Houghtaling B, Zhang N, Yaroch A, Milburn Atkinson C, Byker Shanks C. How does eligibility for GusNIP produce prescriptions relate to fruit and vegetable purchases and what factors shape the relationship? A protocol for a secondary analysis of nationally representative data in the USA. BMJ Open 2024; 14:e085322. [PMID: 38697763 PMCID: PMC11085977 DOI: 10.1136/bmjopen-2024-085322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION US Department of Agriculture (USDA) Gus Schumacher Nutrition Incentive Programme (GusNIP) produce prescription programme (PPR) 'prescriptions' provide eligible participants with low income, risk for diet-related chronic disease and food insecurity a healthcare issued incentive to purchase lower to no cost fruits and vegetables (FVs). However, GusNIP requirements specify that PPR prescriptions can only be redeemed for fresh (not frozen, canned or dried) FVs. This requirement may prevent participants from fully engaging in or benefiting from GusNIP PPR, given communities with lower healthy food access may have reduced fresh FV accessibility. METHODS AND ANALYSIS We will use the nationally representative 2012-2013 National Household Food Acquisition and Purchase Survey (FoodAPS) and complementary FoodAPS Geography Component data in a secondary data analysis to examine how household GusNIP PPR eligibility relates to the quantity and variety of fresh, frozen, canned and dried FV purchases and to what extent individual, household and food environment factors shape the relationship. FoodAPS data include household food purchasing and acquisition information across a 7 day period from 14 317 individuals among 4826 households and was collected between April 2012 and January 2013. The FoodAPS Geography Component provides information about the local community/environment relative to FoodAPS households. This study will examine the correlation or association of selected variables between different quantities and varieties of fresh, frozen, canned and dried FVs, as well as correlations among multilevel predictors. ETHICS AND DISSEMINATION We are following data integrity standards as outlined by agreements with the USDA Economic Research Service. All results of analyses will undergo a thorough disclosure review to ensure no identifiable data are shared. Results will be disseminated to research, practice and policy communities using an Open Access peer-reviewed manuscript(s), scientific and practice presentations, and a public facing report and infographic.
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Affiliation(s)
- Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Nanhua Zhang
- Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Amy Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
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Effect of Juglone and Other Allelochemicals in Walnut Leaves on Yield, Quality and Metabolites of Snack Cucumber ( Cucumis sativus L.). Foods 2023; 12:foods12020371. [PMID: 36673463 PMCID: PMC9858246 DOI: 10.3390/foods12020371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
The consumption of fresh vegetables has been consistently associated with numerous health benefits. However, several factors (such as allelochemicals) influence yield, quality, and metabolites, which inevitably affect the fruit quality and health benefits. The present study was conducted to investigate the yield, quality, metabolic responses, and potential toxicity of Cucumis sativus grown in juglone-containing soils. For the treatments, pure juglone (100 µM, 1 mM) and walnut leaf extracts (100 µM) in soil concentrations found in walnut orchards were used. A total of 36 phenolic compounds were identified and quantified in fruits, leaves, and roots using a mass spectrometer coupled with high-performance liquid chromatography. We concluded that juglone at a concentration of 100 µM or walnut leaf extract at the same juglone concentration does not affect the yield of C. sativus, while juglone at a concentration of 1 mM strongly affects it. In the case of juglone, juglone itself was found only in the roots of C. sativus, but not in the leaves or fruits, so C. sativus fruits are considered safe for cultivation in juglone-containing soils. However, this could prove problematic if the plants grown are tubers or root vegetables. The data suggest that juglone itself inhibits secondary metabolism in the plant, making it more susceptible to stress and pathogen attacks.
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Byker Shanks C, Ahmed S, Dupuis V, Tryon M, Running Crane M, Houghtaling B, Garvin T. Dietary Quality Varies Among Adults on the Flathead Nation of the Confederated Salish and Kootenai Tribes in Montana. J Community Health 2021; 45:388-399. [PMID: 31602533 DOI: 10.1007/s10900-019-00753-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Diet-related chronic disease is among the most pressing public health issues and represents a health disparity among Native American communities. A community-based participatory approach was taken to evaluate dietary quality of adult residents of the Flathead Reservation of the Confederated Salish & Kootenai Tribes in Montana (the Flathead Nation). A survey was administered to collect basic demographic information and food security status (N = 80). Dietary quality was assessed using the 24-h dietary recall method with subsequent calculation of Healthy Eating Index 2010 (HEI-2010) scores, modified HEI without a dairy category, and the Dietary Diversity Scores (DDS). Participants included 80 adults from different households across eight communities (n = 10 per community) at the Flathead Nation. Approximately 50% of participants reported low or very low food security status while the remainder scored high or marginal food security. The mean total HEI-2010 score of study participants was 45.5 out of 100 points with a range between 20.0 and 78.1. The mean DDS of study participants was 4.6 (± 1.365) out of a total of 9 points. Participants with higher DDS had significantly higher intake of dietary fiber (p < 0.0003), potassium (0.0024), and cholesterol (p < 0.0048) compared to the lower DDS group. No significant correlations were found between HEI-2010 scores with DDS, demographic information, or food security status while significant differences were found between food security status and income (p < 0.01) and enrollment in nutrition assistance programs (p < 0.03). This study highlights the need to evaluate multiple parameters of dietary quality coupled with a community-based participatory approach in order for findings to be culturally relevant and support food and nutrition interventions.
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Affiliation(s)
- Carmen Byker Shanks
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA
| | - Selena Ahmed
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA.
| | | | - Mike Tryon
- Salish Kootenai College, Pablo, MT, 59855, USA
| | | | - Bailey Houghtaling
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA
| | - Teresa Garvin
- Gretchen Swanson Center for Nutrition, Omaha, NE, 68114, USA
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Byker Shanks C, Ahmed S, Dupuis V, Houghtaling B, Running Crane MA, Tryon M, Pierre M. Perceptions of food environments and nutrition among residents of the Flathead Indian Reservation. BMC Public Health 2020; 20:1536. [PMID: 33046034 PMCID: PMC7549225 DOI: 10.1186/s12889-020-09584-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/21/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Indigenous food systems have been displaced with the emergence of colonization, industrialization, and cultural, economic, political, and environmental changes. This disruption can be seen in marked health and food environment disparities that contribute to high obesity and diabetes mellitus prevalence among Native American peoples. METHODS A Community-Based Participatory Research (CBPR) approach was used to document food environment experiences among residents of the Flathead Reservation in rural Montana. Participants were identified using purposive sampling techniques to participate in a survey and a semi-structured interview. Descriptive statistics helped to describe participant demographics, food access variables, and household food security status. Food environment perceptions were analyzed using the constant comparison method among trained researchers. RESULTS Participants completed surveys (n = 79) and interviews (n = 76). A large number participated in federal nutrition assistance programs. Many self-reported experiencing diet-related chronic diseases. Major themes included the community food environment, dietary norms, and food-health connections. Subthemes were represented by perceptions of food environment transitions and the important role of food in familial life. Further, opportunities and challenges were identified for improving community food environments. CONCLUSIONS Perceptions of the food environment were linked to strategies that could be targeted to improve dietary quality along a social-ecological model continuum. There is need for skill-based education that directly addresses the time and monetary constraints that were commonly experienced by residents. Coinciding food environment interventions to promote dietary quality that engage community members, store management, and government policy stakeholders are also needed to reestablish healthy Native American food systems and environments within this community.
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Affiliation(s)
- Carmen Byker Shanks
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717 USA
- Food and Health Lab at Montana State University, Montana State University, 960 Technology Boulevard Room 245, Bozeman, MT 59718 USA
| | - Selena Ahmed
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717 USA
- Food and Health Lab at Montana State University, Montana State University, 960 Technology Boulevard Room 245, Bozeman, MT 59718 USA
| | | | - Bailey Houghtaling
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA 70803 USA
| | | | - Mike Tryon
- Wellness/Group Fitness Program Supervisor, Kalispell Regional Healthcare, Kalispell, MT 59901 USA
| | - Mike Pierre
- Food Department of Human Resources Development, The Confederated Salish and Kootenai Tribes, P.O. Box 278, Pablo, Montana 59855 USA
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Ahmed S, Dupuis V, Tyron M, Running Crane M, Garvin T, Pierre M, Byker Shanks C. Intended and Unintended Consequences of a Community-Based Fresh Fruit and Vegetable Dietary Intervention on the Flathead Reservation of the Confederated Salish and Kootenai Tribes. Front Public Health 2020; 8:331. [PMID: 32850578 PMCID: PMC7426441 DOI: 10.3389/fpubh.2020.00331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/15/2020] [Indexed: 11/13/2022] Open
Abstract
Tribal communities in the United States face disparities to accessing healthy foods including high-quality produce. A six-week fresh fruit and vegetable (FV) dietary intervention, Eat Fresh, was co-designed with a Community Advisory Board of local food and nutrition stakeholders on the Flathead Reservation of the Confederated Salish and Kootenai Tribes in Montana. Eat Fresh was implemented as a pilot study with low-income participants (n = 19) enrolled in the Food Distribution Program on Indian Reservations toward improving dietary quality and perceptions of well-being. We evaluated Eat Fresh at pre- and post-intervention on the basis on food procurement practices, dietary quality using the Healthy Eating Index (HEI), Body Mass Index (BMI), blood pressure, and participant perceptions of health. Participants reported consuming a greater number of types of FVs daily during the intervention (p < 0.005 for fruits and p > 0.19 for vegetables). Overall, participants found Eat Fresh moderately challenging to adhere to with the main barriers being access to ingredients in recipes (39.51% of responses), time constraints to cook (35.80%), and lack of financial resources (33.33%). Dietary quality improved during the intervention from a mean HEI score of 48.82 (± 11.88) out of 100-56.92 (± 11.88; (p > 0.12). HEI scores for fruit consumption significantly increased (p < 0.05) from 1.69 (out of 5 points) during the pre-intervention to 2.96 during the post-intervention. BMI and blood pressure increased for several participants, highlighting an unintended consequence. Most participants responded that FV consumption made them feel either very good (51.16%) or good about their health (43.02%) with the majority (83%) perceiving an improvement in energy. Findings of this pilot study highlight both intended and unintended consequences of a dietary intervention that provide lessons in co-designing community-based programs.
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Affiliation(s)
- Selena Ahmed
- Food and Health Lab, Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | - Virgil Dupuis
- Extension, Salish Kootenai College, Pablo, MT, United States
| | - Michael Tyron
- Extension, Salish Kootenai College, Pablo, MT, United States
| | | | - Teresa Garvin
- Gretchen Swanson Center for Nutrition, Omaha, NE, United States
| | - Michael Pierre
- Flathead Food Distribution Program on Indian Reservations, Pablo, MT, United States
| | - Carmen Byker Shanks
- Food and Health Lab, Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT, United States
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Downs SM, Ahmed S, Fanzo J, Herforth A. Food Environment Typology: Advancing an Expanded Definition, Framework, and Methodological Approach for Improved Characterization of Wild, Cultivated, and Built Food Environments toward Sustainable Diets. Foods 2020; 9:E532. [PMID: 32331424 PMCID: PMC7230632 DOI: 10.3390/foods9040532] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
The food environment is a critical place in the food system to implement interventions to support sustainable diets and address the global syndemic of obesity, undernutrition, and climate change, because it contains the total scope of options within which consumers make decisions about which foods to acquire and consume. In this paper, we build on existing definitions of the food environment, and provide an expanded definition that includes the parameter of sustainability properties of foods and beverages, in order to integrate linkages between food environments and sustainable diets. We further provide a graphical representation of the food environment using a socio-ecological framework. Next, we provide a typology with descriptions of the different types of food environments that consumers have access to in low-, middle-, and high-income countries including wild, cultivated, and built food environments. We characterize the availability, affordability, convenience, promotion and quality (previously termed desirability), and sustainability properties of food and beverages for each food environment type. Lastly, we identify a methodological approach with potential objective and subjective tools and metrics for measuring the different properties of various types of food environments. The definition, framework, typology, and methodological toolbox presented here are intended to facilitate scholars and practitioners to identify entry points in the food environment for implementing and evaluating interventions that support sustainable diets for enhancing human and planetary health.
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Affiliation(s)
- Shauna M. Downs
- Department of Urban-Global Public Health, School of Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Selena Ahmed
- Sustainable Food Systems Program, Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA
| | - Jessica Fanzo
- Berman Institute of Bioethics, Nitze School of Advanced International Studies and Bloomberg School of Public Health, Johns Hopkins University, Washington, DC 21205, USA;
| | - Anna Herforth
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard, University Boston, MA 02125, USA;
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Ahmed S, Shanks CB, Dupuis V, Pierre M. Advancing healthy and sustainable food environments: The Flathead Reservation case study. UNSCN NUTRITION 2019; 44:38-45. [PMID: 31930207 PMCID: PMC6953901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This case study describes a methodological approach to evaluating and improving food environments in an indigenous community in the United States of America. A community-research partnership was developed to support healthy diets from sustainable food systems. Our team implemented complementary methodologies to evaluate multiple dimensions of the food environment, including food availability, convenience, affordability and desirability. Our findings were used to design and implement multiphase food-environment interventions that elucidated the following: (1) food-environment measurements should be multifaceted and context-specific; (2) food desirability, including sensory attributes, diversity and phytonutrient quality, are important but overlooked aspects of the food environment; (3) successful food-environment interventions are community-based and incremental; (4) food-environment interventions should seek to forge links with existing institutional structures to influence policy; and (5) findings from food-environment interventions should be disseminated in various ways to diverse stakeholders.
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Affiliation(s)
| | | | | | - Mike Pierre
- Flathead Food Distribution Program on Indian Reservations
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Houghtaling B, Shanks CB, Ahmed S, Smith T. Resources Lack as Food Environments Become More Rural: Development and Implementation of an Infant Feeding Resource Tool (InFeed). JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2019; 15:170-189. [PMID: 32467747 PMCID: PMC7254963 DOI: 10.1080/19320248.2019.1613275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Evaluating the availability and affordability of breastfeeding and formula-feeding supplies are critical for building food environments that support healthy infant development. This study details the development and implementation of the Infant Feeding Resource Tool (InFeed) in retail settings across Montana (n = 21). Interrater reliability was tested (n = 9), kappa 0.620. Analysis of variance found significant differences by rurality for InFeed scores, with infant feeding resources lacking in more rural Montana retail settings: Formula, p = .05 (rounded value); Equipment, p = .02; and Total, p = .03. Prices of infant feeding resources did not differ by rurality and InFeed scores did not differ by store type.
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Affiliation(s)
- Bailey Houghtaling
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Carmen Byker Shanks
- Food and Nutrition and Sustainable Food Systems, Department of Health and Human Development, Montana State University, Bozeman, MT, USA
| | - Selena Ahmed
- Sustainable Food and Bioenergy Systems, Department of Health and Human Development, Montana State University, Bozeman, MT, USA
| | - Teresa Smith
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
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Supporting Sustainable Development Goals Through Sustainable Diets. ENCYCLOPEDIA OF THE UN SUSTAINABLE DEVELOPMENT GOALS 2019. [DOI: 10.1007/978-3-319-69627-0_101-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Jilcott Pitts SB, Wu Q, Gray W, Lyonnais MJ. Examining changes in farmers’ markets and in customers’ farmers’ market shopping frequency and fruit and vegetable purchase and consumption: evaluation data from the Partnerships to Improve Community Health Project, 2014–2017. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1512924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Qiang Wu
- Department of Biostatistics, East Carolina University, Greenville, NC, USA
| | - Wes Gray
- Martin-Tyrrell-Washington District Health, Plymouth, NC, USA
| | - Mary Jane Lyonnais
- Healthy Foods Coordinator, Northeastern NC Partnership for Public Health and Albemarle Regional Health Services, Elizabeth City, NC, USA
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