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Summary: Increasing the healthiness of food retail environments is an identified mechanism to help halt rising rates of diet‐related non‐communicable diseases. Previous studies on healthy food environment adoption report that retailers' perceptions of loss of profitability and higher food costs are often barriers to change. Despite this, actual changes to profitability and food costs have not been fully explored. This study aimed to systematically scope the evidence relating to changes to food costs or profitability when changes are made to increase the healthiness of food and drinks sold by food service retailers. Nine databases were searched, with studies included from settings that sold ready‐to‐consume items, with interventions to increase the healthiness of menus, and reporting food environment/nutrition outcomes, and cost/profit outcomes. Of the 12 studies included, the majority were conducted in the United States and in school settings. Most studies indicated that increasing the healthiness of food service retail environments resulted in neutral or favorable financial outcomes. Food costs and/or profit changes were most often monitored via simple accounting measures. While further research is needed to strengthen the evidence on financial outcomes of healthier food provision, this review indicates that some perceived barriers to change may not be warranted. [ABSTRACT FROM AUTHOR]

Introduction: Chronic household food insecurity (HFI) and lack of food availability and accessibility in isolated communities are longstanding public health crises. This review aims to paint a more fulsome picture of food security initiatives in remote and isolated communities by examining programs across circumpolar countries, Australia, and Aotearoa New Zealand. This synthesis of research will contribute to an understanding of what types of initiatives exist and aid in the identification of best practices. Methods: The authors conducted a scoping review identifying articles that include either (1) an evaluation of an initiative with a quantitative food security outcome in remote and isolated communities, or (2) quantitative associations between exposure factors with food security outcomes. Inclusion criteria included English and French articles focused on remote and isolated communities in Canada, the US, Australia, New Zealand, Sweden, Norway, Finland, Greenland, and Russia from January 1997 to July 2022. Results: The article search yielded 1882 results, of which 96 fulfilled the inclusion criteria, including 26 studies evaluating initiatives, 66 studies evaluating exposure factors, and four studies that included both initiatives and exposure factors. The majority of the studies included in this review were conducted in Canada and Australia. No initiative studies conducted in Russia, Greenland, Norway, Finland, or Sweden fulfilled the criteria for inclusion in this review. The most common types of initiatives evaluated included school-based programs, market subsidies, and education initiatives, though a small number (<5) of other programs were evaluated, including traditional food programs and greenhouses. Though multiple programs resulted in lower food costs or increases in healthy food consumption in remote regions, the cost of a healthy diet in these areas remained high, as do levels of HFI. Factors associated with improved food security outcomes included higher income level, access to adequate housing, higher education level, access to transportation for harvesting, and the level of remoteness of a community. The studies included in this review also stressed the importance of access to and affordability of harvesting traditional foods in these regions. Conclusion: Those living in remote and isolated communities are particularly vulnerable to food insecurity and lack of access and availability of healthy foods, which are compounded by a variety of socioeconomic factors. This study highlights the lack of quantitative evaluations of food security initiatives in remote and isolated communities, as well as the wide variety in measured outcomes. Authors of several of the included articles note that community-led initiatives, with strong partnerships and local champions, were recommended in these populations, given the culturally and geographically diverse groups living in remote and isolated areas. [ABSTRACT FROM AUTHOR]

Introduction: Chronic household food insecurity (HFI) and lack of food availability and accessibility in isolated communities are longstanding public health crises. This review aims to paint a more fulsome picture of food security initiatives in remote and isolated communities by examining programs across circumpolar countries, Australia, and Aotearoa New Zealand. This synthesis of research will contribute to an understanding of what types of initiatives exist and aid in the identification of best practices. Methods: The authors conducted a scoping review identifying articles that include either (1) an evaluation of an initiative with a quantitative food security outcome in remote and isolated communities, or (2) quantitative associations between exposure factors with food security outcomes. Inclusion criteria included English and French articles focused on remote and isolated communities in Canada, the US, Australia, New Zealand, Sweden, Norway, Finland, Greenland, and Russia from January 1997 to July 2022. Results: The article search yielded 1882 results, of which 96 fulfilled the inclusion criteria, including 26 studies evaluating initiatives, 66 studies evaluating exposure factors, and four studies that included both initiatives and exposure factors. The majority of the studies included in this review were conducted in Canada and Australia. No initiative studies conducted in Russia, Greenland, Norway, Finland, or Sweden fulfilled the criteria for inclusion in this review. The most common types of initiatives evaluated included school-based programs, market subsidies, and education initiatives, though a small number (

The United States Department of Agriculture approved an increase to the Cash Value Benefit (CVB) for the purchase of fruits and vegetables issued to participants receiving an eligible Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package. In order to understand satisfaction, perceptions, and the overall impact of additional benefits for fruits and vegetables at the household level, a qualitative study consisting of structured phone interviews was conducted with families served by WIC in Southern California from November to December 2021 (n = 30). Families were selected from a large longitudinal study sample (N = 2784); the sample was restricted by benefit redemption and stratified by language and race. WIC participants were highly satisfied with the CVB increase, reporting increased purchasing and consumption of a variety of fruits and vegetables. Respondents noted the improved quality and variety of fruits and vegetables purchased due to the increased amount. Findings are expected to inform policy makers to adjust the CVB offered in the WIC food package with the potential to improve participant satisfaction and increase participation and retention of eligible families with benefits from healthy diets supported by WIC.

Abstract Objective: To describe environmentally sustainable (ES) and healthy food provision practices in childcare services in Victoria, Australia. Design: Cross-sectional study. Setting: Childcare services providing food onsite. Participants: Staff completed an online survey that explored ES food provision practices including purchasing seasonal/local food, food waste awareness/management, and food cost/child/d. A purposively sampled subgroup conducted weighed audits to determine compliance with guidelines and total waste, serving waste (prepared, not served) and plate waste. Results: Survey results found 8 % of services (n 129) had previously conducted food waste audits. Service audits (n 12) found 27 % total food waste (range: 9 % - 64 %). Statistically significant differences in plate waste were found between services who had previously conducted food waste audits (7 %) and those who had not (17 %) (P = 0·04). The most common ES practice was ‘providing seasonal food’; the least common was ‘maintaining a compost system’ and ‘less packaged foods’. Most services (95 %) purchased foods from supermarkets with 23 % purchasing from farmers’ markets. This was statistically lower for regional/rural services (8 %), compared to metropolitan services (27 %) (P = 0·04). Twenty-seven per cent of services spent AUD2·50 or less per child per day on food. Only one audited service provided a menu compliant with childcare food provision guidelines. Conclusions: Childcare settings procure and provide large volumes of food; however, food waste awareness appears limited, and environmentally sustainable food procurement practices may be less affordable and difficult to achieve. Understanding the impact of food waste awareness on food waste practices and food costs across time merits further research.

Objective: To describe environmentally sustainable (ES) and healthy food provision practices in childcare services in Victoria, Australia. Design: Cross-sectional study. Setting: Childcare services providing food onsite. Participants: Staff completed an online survey that explored ES food provision practices including purchasing seasonal/local food, food waste awareness/management, and food cost/child/d. A purposively sampled subgroup conducted weighed audits to determine compliance with guidelines and total waste, serving waste (prepared, not served) and plate waste. Results: Survey results found 8 % of services (n 129) had previously conducted food waste audits. Service audits (n 12) found 27 % total food waste (range: 9 % - 64 %). Statistically significant differences in plate waste were found between services who had previously conducted food waste audits (7 %) and those who had not (17 %) (P = 0·04). The most common ES practice was 'providing seasonal food'; the least common was 'maintaining a compost system' and 'less packaged foods'. Most services (95 %) purchased foods from supermarkets with 23 % purchasing from farmers' markets. This was statistically lower for regional/rural services (8 %), compared to metropolitan services (27 %) (P = 0·04). Twenty-seven per cent of services spent AUD2·50 or less per child per day on food. Only one audited service provided a menu compliant with childcare food provision guidelines. Conclusions: Childcare settings procure and provide large volumes of food; however, food waste awareness appears limited, and environmentally sustainable food procurement practices may be less affordable and difficult to achieve. Understanding the impact of food waste awareness on food waste practices and food costs across time merits further research. [ABSTRACT FROM AUTHOR]

COVID-19 harms health and income generation activities. The pandemic caused poverty, and food crisis in the most vulnerable and underprivileged segments. Economic turbulence and massive poverty during epidemic period probably resulted in short-term food insecurity and low food consumption. Based on these concerns, the current study examined how COVID-19 has impacted Pakistan's cost of purchasing food. The study surveyed total 1067 Punjab and Sindh residents in Pakistan, from July to October 2021. A structural equation model was used to examine the interrelationship among food intake, food purchasing cost, and health effects. We investigated whether people experienced substantial effects from the loss of a source of income, work hours, debt burden, and food inflation on their food intake. These circumstances all negatively affected food intake, reducing food consumption. Besides COVID-19′s effects on direct income, 41% more people fall into poverty and 23% can't afford healthy food. People's socioeconomic circumstances affects poverty levels and affordable healthy food costs. The cost of purchasing food is significantly correlated with health outcomes. A significant and positive correlation between COVID-19 and income effects, and a negative correlation between food consumption and adverse income effects was explored. In addition, people increased their demand for food assistance during COVID-19 to mitigate negative income shocks. People who cannot afford minimal food costs should be offered food through mobile vehicles or delivery channels in the short term. Cash transfers or subsidies could also be provided to the needy during crisis time.

Understanding food prices and affordability is crucial for promoting healthy dietary habits and informing policy actions. We assessed changes in the cost and affordability of habitual and recommended healthy diets in Northwest Tasmania from 2021 to 2023. The recommended diet was 16–22% less expensive than the habitual diet during the period. Notably, 60% of the total cost of the habitual diet was spent on discretionary items. The cost of the habitual diet increased by 9% in this period, whereas the cost of the recommended diet increased by only 2%. The habitual diet was unaffordable for households with median gross, minimum wage disposable or welfare-dependent incomes. The recommended diet, however, was affordable for some groups but posed a risk of food stress for those with median gross and minimum wage disposable income and remained unaffordable for those who were welfare dependent. Our findings reveal that adhering to a healthy Australian Dietary Guidelines-recommended diet can be more cost-effective than following a habitual unhealthy diet. However, adopting a healthy diet can be challenging for low-income families. Interventions such as financial support, nutrition education, community gardens and food hubs, as well as price regulation and subsidies for farmers, can help address food insecurity in Northwest Tasmania. [ABSTRACT FROM AUTHOR]

Background and aim: Household food and food security are important issues that require policy attention and intervention. This research aims to examine trends in household food expenses in Gilan province with the national average and to explore their social and policy implications for household food and food security. Data and method: The study used secondary analysis of data obtained from Central Bank of the Islamic Republic of Iran and the Statistical Center of Iran. Bivariate and multivariate analysis performed to compare two periods of 2005-2013 and 2013- 2020 which correspond to two presidential administrations in Iran. We also compared the food expenses of households in Gilan province with those of the whole country for each period to show how household food expenses changed over these periods. Findings: The findings showed that the average cost of domestic food in Gilan province and nationally was significantly lower in the second period than in the first period. However, there was no statistically significant difference between the average cost of domestic food in Gilan province and nationally in the first period. The results indicated that period had a significant impact on the cost of food inside and outside the home. Conclusion: The share of food cost in the total cost of households in Gilan province was higher than that of the whole country during 2005-2020. The ability to buy food outside the home among Gilan households declined during 2012-2019, consistent with the national pattern. The period variable affected the cost changes of households in Gilan province. [ABSTRACT FROM AUTHOR]

Debates about whether a healthy diet is affordable often overlook how low-income consumers themselves evaluate food cost. This question is relevant to explaining food choices and measuring food prices. Drawing on interviews with 49 low-income primary caregivers and grocery-shopping observations with 34 of these interviewees, I find that respondents judge food cost in two ways: 1) absolute judgments, or assessments of whether a food covers a family's needs with scarce resources and 2) relative judgments, or interpretations of price relative to another food that frames an item as affordable or pricey by contrast. Absolute judgments reflect actual expenditures, including not just the sticker price, but also four underappreciated monetary costs. These underappreciated costs stem from food waste; packages containing more than is needed; food that is consumed too quickly; and unsatiating foods. When monetary costs go unmeasured and when consumers interpret prices in relative terms, researchers' views of food cost diverge from the experiences of low-income people. Divergent views have two results: food-cost estimates overstate the affordability of a healthy diet and observers may misconstrue purchases as financially imprudent. These findings can inform policy, programming, and public discourse.

Background: High intake of food away from home is associated with poor diet quality. This study examines how the COVID-19 pandemic period and Food Away from Home (FAFH) inflation rate fluctuations influenced dining out behaviors. Methods: Approximately 2800 individuals in Texas reported household weekly dining out frequency and spending. Responses completed prior to the COVID-19 pandemic (2019 to early 2020) were compared to the post-COVID-19 period (2021 through mid-2022). Multivariate analysis with interaction terms was used to test study hypotheses. Results and Conclusion: From the COVID-19 period (before vs. after), the unadjusted frequency of dining out increased from 3.4 times per week to 3.5 times per week, while the amount spent on dining out increased from $63.90 to $82.20. Once the relationship between dining out (frequency and spending) was adjusted for FAFH interest rate and sociodemographic factors, an increase in dining out frequency post-COVID-19 remained significant. However, the unadjusted increase in dining out spending did not remain significant. Further research to understand the demand for dining out post-pandemic is warranted. [ABSTRACT FROM AUTHOR]

Abstract Introduction Food security is attracting more attention in Malaysia not only at the national level that concern toward the enhancement of food self-sufficiency but also at the individual level which concerns more on nutrition and health. The economic recession triggered by the COVID-19 pandemic has brought the food and nutrition security challenge to the higher priority. In this study, we assessed the feasibility of encouraging a healthy eating plan by taking into account two important elements, food cost and nutrient intake, to help tackle the food and nutrition insecurity challenges at the individual level. Method and materials This study used a goal programming model with dietary intake data from Malaysian Adult Nutrition Survey reports to develop food plans that can improve nutrition quality without increasing food cost. Missing data, such as nutrient compositions and food prices, were collected separately from existing governmental and non-governmental sources. Benchmark nutrient intakes were derived from Malaysian Dietary Guidelines and Malaysian Recommended Nutrient Intakes reports, whereas benchmark costs were estimated by mapping food prices to dietary intake. The cost of healthier diets was also assessed to examine the acceptability of dietary changes for the low-income population. Results The results showed that healthier diets following national dietary guidelines are achievable with reasonable food choices shift without changing the cost of meal plan. Greater intake of milk and vegetables (for more calcium) and smaller intake of seafood and egg products (for less protein) will contribute to raise diet quality and achieve more adequate nutrition. However, the cost attached to healthier food plan is still likely to be burdensome for the food-insecure and low-income population. Conclusions Our results suggest that policymakers should implement income-relevant laws to cut poverty and improve the population’s dietary intake. Income growth as a result of better skills and education is needed to ensure that the real incomes of Malaysian are well sustained, and increased to help low-income population make better and healthier food choices.

IntroductionSustainable diets and their overall impact on the environment and human health have garnered global attention. Environmental impact, human nutrition, and affordability are three relevant dimensions for assessing overall sustainability of diets. Using a relative sustainability score, we compare the Mediterranean, paleo, ketogenic, vegetarian, and vegan diets, along with the World Health Organization dietary guidelines in order to evaluate which diets are most sustainable.MethodsEnvironmental, nutrition, and price data on individual food items were collected and used to analyze diets. Using an online meal- prep program, one week's worth of meals standardized at 2,000 kilocalories per day was generated for each diet. Estimates of greenhouse gas emissions, eutrophication, land use, water withdrawals, nutritional quality, and affordability were calculated. Ultimately an overall relative sustainability score based on these metric averages were used to compare diets.ResultsOur model indicates that vegan, Mediterranean, and vegetarian diets are the most sustainable across all metrics while meat-heavy diets, such as the ketogenic diet, have the greatest negative environmental impact. A diet based on the World Health Organization's dietary guidelines performed poorly with regards to affordability, environmental impacts, and nutritional quality. Diets with higher nutritional quality included the vegan, paleo, and Mediterranean diets. Diets that eliminate meat were the cheapest both by total cost and by cost per gram of food.DiscussionDiets with the highest overall sustainability score share a common characteristic: they all suggest that consumers committed to sustainability should prioritize ‘plant-forward' diets. In contrast, diets rich in meat and animal products perform poorly overall but especially in terms of environmental sustainability.

This study aimed to identify adherence to the Mediterranean diet (MedDiet) and its effect on health and environmental and socioeconomic sustainability during the COVID-19 pandemic among a sample of the Italian population. Notably, it intended to assess the effect of adherence to the MedDiet on ecological footprints and food expenditure. A survey was conducted from the 5th to the 24th of April 2020 on Google Forms. The MEDAS questionnaire was used to determine the level of adherence to the MedDiet. The carbon footprint (CO2), water footprint (H2O), and food cost were calculated. In total, 3353 participants completed the questionnaire, ranging from 18 to 86 years old. A statistically significant difference was observed in the CO2 and H2O among BMI groups (p < 0.001). The low- and medium-MEDAS groups showed higher CO2 (p < 0.001). The food cost (EUR/week) resulted in statistically significant differences among the MEDAS groups. The CO2 results were significantly lower in organic-market buyers compared to non-organic-market buyers (p < 0.001). Public health must promote awareness of how adhering to a healthy lifestyle and making appropriate food choices can positively impact our health and social and economic well-being. [ABSTRACT FROM AUTHOR]

Background: Many states and localities throughout the U.S. have adopted higher minimum wages. Higher labor costs among low-wage food system workers could result in higher food prices. Methods: Using a market basket of 106 foods, food prices were collected at affected chain supermarket stores in Seattle and same-chain unaffected stores in King County (n = 12 total, six per location). Prices were collected at 1 month pre- (March 2015) and 1-month post-policy enactment (May 2015), then again 1-year post-policy enactment (May 2016). Unpaired t-tests were used to detect price differences by location at fixed time while paired t-tests were used to detect price difference across time with fixed store chain. A multi-level, linear differences-in-differences model, was used to detect the changes in the average market basket item food prices over time across regions, overall and by food group. Results: There were no significant differences in overall market basket or item-level costs at one-month (-$0.01, SE = 0.05, p = 0.884) or one-year post-policy enactment (-$0.02, SE = 0.08, p = 0.772). No significant increases were observed by food group. Conclusions: There is no evidence of change in supermarket food prices by market basket or increase in prices by food group in response to the implementation of Seattles minimum wage ordinance.

The objective of this study was to evaluate the effects of replacing soybean meal with peanut meal on milk production, chemical and fatty acid composition, nutritional quality indicators of the lipid fraction, and the economic viability of the diets. Twelve crossbred cows in the initial lactation third, with a bodyweight of 545 ± 37 kg and average milk production of 28 kg/day of milk were distributed in a 4 × 4, triple Latin square design. The treatments consisted of diets with substitution levels of soybean meal for peanut meal (0; 330; 670; and 1000 g/kg in DM). The peanut meal inclusion to replace soybean meal in the diets provided a decreasing linear effect for the protein (P = 0.02) and casein (P = 0.01) concentration in milk. Milk production, total solids concentration, feed efficiency, fatty acid composition, and nutritional quality indicators of the milk lipid fraction were not influenced by the substitution levels. The diet cost per kg DM decreased due to the peanut meal inclusion as a protein source. The partial or total substitution of soybean meal for peanut meal in the feedlot cows diet reduces the cost of feed, without affecting milk production and total solids yield. [ABSTRACT FROM AUTHOR]

Abstract Background Healthier dietary patterns are generally more costly than less healthy patterns, but dietary costs may be more important for dietary quality in lower educated and ethnic minority groups. The aim of this study was to investigate the association between dietary costs and dietary quality and interactions with ethnicity and socioeconomic position (SEP). Methods We used cross-sectional data from 4717 Dutch, Surinamese, Turkish and Moroccan origin participants of the multi-ethnic HELIUS study (the Netherlands), who completed an ethnic-specific food frequency questionnaire (FFQ). The primary outcome measure was dietary quality according to adherence to the Dutch Healthy Diet index 2015 (DHD15-index, range 0–130). Individual dietary costs (the monetary value attached to consumed diets in Euros) were estimated by merging a food price variable with the FFQ nutrient composition database. Regression analyses were used to examine main and interaction effects. Analyses were adjusted for age, sex, smoking, energy intake, physical activity, ethnicity and educational level. Results Having higher dietary costs was associated with higher dietary quality. Analyses stratified by educational level showed that associations were stronger in higher educated (Btertile3 = 8.06, 95%CI = 5.63; 10.48) than in lower educated participants (Btertile3 = 5.09, 95%CI = 2.74; 7.44). Stratification by ethnic origin showed strongest associations in Turkish participants (Btertile2 = 9.31, 95%CI = 5.96; 12.65) and weakest associations in Moroccan participants (Btertile3 = 4.29, 95%CI = 0.58; 8.01). Regardless of their level of education, Turkish and Moroccan individuals consumed higher quality diets at the lowest cost than Dutch participants. Conclusions The importance of dietary costs for dietary quality differs between socioeconomic and ethnic subgroups. Increasing individual food budgets or decreasing food prices may be effective for the promotion of healthy diets, but differential effects across socioeconomic and ethnic subgroups may be expected.

As population rises, more people need to be fed. With increasing income, the potential exists for increases in the demand for cereals (i.e., barley). Since barley has a high level of tolerance to environmental stressors, this crop has been recommended as a potential crop for food security in marginal environments. In this study, a crop growth Agricultural Land Management Alternatives with Numerical Assessment Criteria model, was parameterized and used to simulate the yields of two barley types grown in a temperate environment at a latitude of 35°N. In order to apply this crop model to barley, 19 years of field data were used to model calibration and validation. As a result, the ALMANAC model accurately simulated yields for both barley types. The validated model was used to predict yields under three diverse seasonal rainfall scenarios associated with different patterns of the Central Pacific El Niño influence. According to the simulation results, excessively high seasonal rainfall decreased barley yields. Crop price and annual revenue of the two barley types were also evaluated using a non-linear regression model. For the malt type, the food price was higher with a higher rainfall, while naked barley had a higher revenue under the conditions of a lower rainfall. [ABSTRACT FROM AUTHOR]

Objective: To develop a questionnaire to measure food nutrition, food expenditures and time spent in food-related activities; and to assess the association between diet quality, time spent in food-related activities and food expenditures using data from a pilot study.Design: Cross-sectional study. Multiple linear regression models were used to analyse participants' survey response behaviours and the relationship between food nutritional quality and time and money expenditures.Setting: Online survey using Qualtrics software in a public university located in West Texas, USA.Participants: Faculty and staff aged 18 years and older from a public university located in West Texas, USA.Results: Combining questions from three survey instruments that collect data on food nutrition, food expenditures and time spent in food-related activities resulted in a thirty-page survey instrument. The median completion time of the survey instrument was about 30 min. Preliminary results suggest that time and money expenditures are associated with food quality but that their role is small relative to sociodemographic characteristics such as race and gender.Conclusions: Time and money expenditures are associated with food quality but their role is small relative to sociodemographic characteristics such as race and gender. [ABSTRACT FROM AUTHOR]

PURPOSE/OBJECTIVES: Although meals offered through the National School Lunch Program (NSLP) have been found to be of higher dietary quality than packed lunches, roughly 40% of students bring packed lunches for a variety of reasons, including cost. The purpose of this study was to explore costs, including time, of NSLP and packed lunches. METHODS: Data from the lunches of 1,289 pre-kindergarten and kindergarten students enrolled in three schools in southwest Virginia were used for this study, and categorized as homemade packed lunches, convenience packed lunches, replicated school lunches, and NSLP lunches. Each lunch was assigned a food cost based on retail purchase of lunch contents. Each lunch was also assigned a time cost by evaluating the amount of time to prepare each lunch, with a monetary value for labor computed. A full-cost for each lunch was determined by combining food cost and time cost. Nonparametric tests were used to compare the food cost, time cost, and the full cost of the meals. Medians were computed and compared due to outliers in the data. Descriptive statistics were used to calculate the median food cost of sugar-sweetened beverages and desserts in packed lunches. RESULTS: Statistically significant differences in median food costs were found between homemade packed lunches ($1.55) and replicated school lunches ($2.11), convenience packed lunches ($2.12), and NSLP lunches ($2.15). The homemade packed lunch provided a statistically significant reduction in food cost compared to NSLP. When incorporating preparation time (full cost), all one-sided pairwise comparisons of lunch cost were found to be statistically significant (p-values less than .0001) in terms of their median values: NSLP ($2.15), convenience packed lunches ($2.56), homemade packed lunches ($2.92), and replicated school lunches ($11.32). Seventy-six percent (414 of 545) of packed lunches contained sugar-sweetened beverages and/or dessert food items, accounting for one-fifth (median of 20.07%) of the food cost of all observed packed lunches. APPLICATIONS TO CHILD NUTRITION PROFESSIONALS: When time is computed as part of the total cost of NSLP versus packed lunch options, including homemade packed lunches, replicated school meals, and convenience lunch options, the NSLP is the least expensive choice. In conjunction with the nutritional benefits of the NSLP, time-cost data may be used to develop interventions or campaigns on the benefits of participating in the NLSP. [ABSTRACT FROM AUTHOR]

Abstract Objective: To assess the impact of changing the Australian Goods and Services Tax (GST) on household food stress, which occurs when >25% of disposable income needs to be spent on food. Methods: Weekly healthy meal plan costs for average‐income (AI), low‐income (LI) and welfare‐dependent (WDI) families were calculated using the 2013 Western Australian (WA) Food Access and Costs Survey. Four GST scenarios were compared: 1) status quo; 2) increasing GST to 15%; 3) expanding base to include exempt foods at 10% GST; and 4) expanding base to include exempt foods and increasing the tax to 15%. Results: Single‐parent families risk food stress regardless of their income or the GST scenario (requiring 24–42% of disposable income). The probability of food stress in Scenario 1 is 100% for WDI two‐parent families and 36% for LI earners. In Scenarios 3 and 4, food stress probability is 60–72% for two‐parent LI families and AI single‐parent families, increasing to 88–94% if residing in very remote areas. Conclusion: There is food stress risk among single‐parent, LI and WDI families, particularly those residing in very remote areas. Implications for public health: Expanding GST places an additional burden on people who are already vulnerable to poor nutrition and chronic disease due to their socioeconomic circumstances.

PURPOSE: The USDA requires children with food allergies be offered modified menus with no additional meal reimbursement. Food allergies affect up to 8% of children in the U.S.; eight allergens account for over 90% of allergic reactions. This study assessed perceptions of child nutrition program menu planners in California, a state with a high and diverse population, of costs associated with allergy related meal accommodations. METHODS: An online survey was sent to the population of menu planners for children with food allergies at all California public schools (N = 902). RESULTS: Child nutrition program menu planners (n = 212) frequently identified two factors affecting cost of food in providing meals for children with food allergies: type of allergy and additional cost of special foods. Multiple factors were frequently identified as affecting labor costs including purchase of special foods, planning menus, training foodservice workers, communication with nutrition staff and others, separation of food production areas to avoid cross-contact, research of suitable food substitutions, and time for documentation on production records. Participants perceived accommodating children with wheat, soy, milk products, and multiple allergens cost more than providing non-modified meals. Ready availability and ease of sourcing substitute foods reduced perceptions of negative labor impacts on operations. APPLICATIONS FOR CHILD NUTRITION PROFESSIONALS: Knowledge of the local frequency of accommodations for children with specific food allergies can be used to plan lower cost menus for the most frequently modified allergens. Short cycle menus could be prepared in advance for the most common allergens or allergen combinations in the district reducing the time spent and potentially reducing cost of labor for menu planning of modified meals. Further, information about types and frequency of allergen accommodations within the district can be useful when developing specifications for bid purchases of foods and inclusion of identified acceptable substitutes. [ABSTRACT FROM AUTHOR]

Aim: To measure the relative change in price of healthier and less healthy foods over 10 years in New Zealand. Methods: Foods in the New Zealand food price index were classified as healthy and less healthy (WHO Europe Nutrient Profile Model) and by degree of processing (according to the NOVA classification). The change in price from February 2007 to January 2017 was analysed using a mixed model for repeated measures with healthiness (or level of processing), season and time added as covariates. Results: Eighty‐eight (of 155) relevant items had sufficient information on weight and healthiness. The trend of increasing food prices over time was similar for healthier and less healthy foods and between the three categories of processing. There was a statistically significant interaction (P = 0.014) between seasons and healthiness of foods, and seasons and degrees of processing (P < 0.001). The price of healthy foods and minimally processed foods fluctuated more by season compared to less healthy foods and processed foods. Conclusions: Food prices increased over time with no significant difference in the rate of change for healthier and less healthy foods, and between foods of different degrees of processing. This method can be used to routinely monitor relative changes in food prices according to healthiness. [ABSTRACT FROM AUTHOR]

Abstract Objective: To monitor the cost and affordability of a nutritious diet and to assess the influence of distance from the capital city and socioeconomic status on the cost of nutritious food in Victoria. Methods: Twenty‐six of Victoria's 79 local government areas (33%) were randomly chosen for inclusion in the study. A random sample of stores was selected for inclusion from each local government area. The cost of the 44 ‘healthy’ and 10 ‘discretionary’ food and drinks in the healthy food basket for a family of four for a fortnight was collected during the winter and summer of 2012, 2013 and 2014. Results: The mean cost of the basket increased from $424.06 ± 38.22 in winter 2012 to $451.19 ± 33.83 in summer 2014 (p

Highlights • Feeding a family of four costs 2 as much in the Arctic, relative to Ottawa. • Energy-dense nutrient-poor foods are cheaper than nutrient-rich foods. • Adhering to national food serving recommendations may be prohibitively expensive. • Policy is needed to lessen the cost of nutritious foods relative to cheap calories. Abstract Indigenous Peoples living in rural and remote regions of Canada, the United States, and Australia experience the highest food prices in each country. High food prices, low incomes, and limited access to nutritious perishable foods foster increased reliance on poor quality non-perishable foods. In northern Canada, Inuit experience food insecurity at over eight times the rate of the general Canadian population. This study aims to contribute to the evidence-base for informing food policy in remote northern communities by documenting food prices and investigating the economic dimensions of diet quality and nutrition in one region of Arctic Canada. A participatory food costing study was undertaken seasonally in six communities of the western Canadian Arctic during a 14-month period (late 2014 to early 2016). Community research assistants systematically collected food prices for a list of 106 market foods. Food prices in the region were markedly higher than the national average. The average cost of the Revised Northern Food Basket (to feed a family of four for one week) was CAD $410, over two times the equivalent cost of feeding a family of four in the capital city of Ottawa (CAD $192). Results from this study also provide evidence of significant price differentials between energy-dense nutrient-poor foods, and costlier nutrient-rich foods. Evidenced-based policy is needed to overcome the unique challenges of food retailing in remote northern environments. Such policies must be pursued with due recognition of community priorities and self-determination, and pursued in parallel to initiatives that enhance access to traditional (country) food. [ABSTRACT FROM AUTHOR]

Aim: To assess Mediterranean diet (MD) adherence and food insecurity (FI) among university students in Greece.Methods and Results: A non-probability sample of 236 students was recruited from Athens and Thessaloniki during 2016. FI was assessed with the Household Food Insecurity Access Scale and MD adherence with the MEDAS questionnaire. Mean MEDAS score of the sample was 6.4 ± 1.9, with women demonstrating greater MD adherence compared to men (p = 0.016) and Dietetics students exhibiting increased score compared to the rest (p ≤ 0.001). A low proportion of participants were food-secure (17.8%), 45.3% were severely food-insecure, 22.0% experienced moderate FI and the remaining 14.8% had low FI. Participants studying in the city they grew up exhibited lower FI compared to those studying in other cities (p = 0.009), while, additionally, a trend was noted for increased FI among students with an unemployed family member (p = 0.05). Students working night shifts had lower MD adherence and increased FI compared to the rest (p = 0.004 and p = 0.003, respectively). The same pattern was observed among participants who smoked (p = 0.003 for MD adherence and p = 0.009 for FI, respectively). Multivariate regression analyses did not reveal any connections between FI categories, waist circumference or BMI, but showed an inverse relationship between severe FI and MD adherence.Conclusions: The majority of the surveyed university students from Greece demonstrate some degree of FI, with a great proportion being severely food-insecure. Increased FI is inversely associated with MD adherence. [ABSTRACT FROM AUTHOR]

Abstract: Background: The gluten‐free (GF) food market has expanded considerably, although there is limited comparative evidence for the nutritional quality and cost of GF food products. The present study aims to compare the nutrient composition and cost of GF and gluten‐containing (regular) foods across 10 food categories in the UK. Methods: Nutritional information and the cost of GF foods available in the UK (n = 679) and comparable regular foods (n = 1045) were systematically collected from manufacturer and supermarket websites. Foods were classified using UK front‐of‐pack labelling for content of fat, saturated fat, sugar and salt and nutrient content, and cost per 100 g were identified and compared between GF and regular foods. Results: Overall, more GF foods were classified as containing high and medium fat, saturated fat, sugar and salt than regular foods, although this was not universally consistent. More GF bread and flour products contained high fat and sugar, whereas fewer GF crackers contained high fat and sugar compared to regular foods. High salt content was found more frequently in GF than regular products. On average, GF products were 159% more expensive than regular (£0.44/100 g versus £1.14/100 g). GF items were also more likely to be lower in fibre and protein content than regular foods. Conclusions: Differences exist in the nutritional composition of GF and regular food. GF food is unlikely to offer healthier alternatives to regular foods, except for those who require a GF diet for medically diagnosed conditions, and it is associated with higher costs. [ABSTRACT FROM AUTHOR]

We examine the shopping behavior of Women, Infants, and Children (WIC) Program participants located in food deserts in the Greater Los Angeles area relative to peers in GLA located outside of food-desert boundaries. Results indicate that food-desert participants traveled slightly farther to shop than comparison participants. However, food-desert and non-food-desert participants were equally likely to visit multiple vendors and to visit a supermarket vendor. Food-desert participants did not pay more for program foods relative to comparison participants. On balance, the results indicate that WIC shopping behavior is very similar among food-desert and comparison participants. [ABSTRACT FROM AUTHOR]

Background: Poor dietary habits are associated with higher rates of cardiovascular disease. However, the cost of foods associated with lower risk of cardiovascular disease can be a significant barrier to healthy eating. Objective: The aim of this study is to determine whether food prices per serving differed across Kentucky counties based on health ranking and overall nutritional quality. Methods: Fifteen counties were randomly selected based on County Health Ranking. Overall Nutritional Quality Index and cost of 75 foods were assessed in all 15 counties in the same week. A generalized estimating equations model and post hoc analyses were used to assess differences in food cost by nutritional quality and health ranking. Results: Food prices were significantly less in the most healthy counties compared with the least healthy (Z = 3.8; P G .001 ; $0.08 per serving). Prices were also significantly higher in least healthy counties (tertile 3) compared with moderately healthy counties (tertile 2) (Z = 2.3; P = .024; $0.05 per serving). Conclusions: Disproportionately higher food costs are associated with poor health outcomes in Kentucky counties. Community-based interventions can potentially improve access to affordable healthy foods. Current supplemental nutritional policies do not address disparate food costs. Health professionals should advocate for policy changes that are reflective of these food cost disparities. [ABSTRACT FROM AUTHOR]

Competing studies use food consumption to measure the impact of political regime on the welfare of the poor. Democracies may outperform autocracies by using growth to hide redistribution, improving caloric consumption and currying favor. Alternatively, autocracies may have greater incentives to lower food prices to quell urban unrest. We test these competing theories using a more detailed, continuous, nuanced measure of food consumption quality - cereal equivalent values. We find evidence to support the second hypothesis, that autocracies outperform democracies at low incomes. For higher incomes, democracies perform significantly better. Segregated by growth, autocracies again outperform democracies at low incomes. [ABSTRACT FROM AUTHOR]

Background: Nutrition North Canada (NNC) is a retail subsidy program implemented in 2012 and designed to reduce the cost of nutritious food for residents living in Canada’s remote, northern communities. The present study evaluates the extent to which NNC provides access to perishable, nutritious food for residents of remote northern communities. Design: Program documents, including fiscal and food cost reports for the period 2011–2015, retailer compliance reports, audits of the program, and the program’s performance measurement strategy are examined for evidence that the subsidy is meeting its objectives in a manner both comprehensive and equitable across regions and communities. Results: NNC lacks price caps or other means of ensuring food is affordable and equitably priced in communities. Gaps in food cost reporting constrain the program’s accountability. From 2011–15, no adjustments were made to community eligibility, subsidy rates, or the list of eligible foods in response to information provided by community members, critics, the Auditor General of Canada, and the program’s own Advisory Board. Measures to increase program accountability, such as increasing subsidy information on point-of-sale receipts, make NNC more visible but do nothing to address underlying accountability issues Conclusions: The current structure and regulatory framework of NNC are insufficient to ensure the program meets its goal. Both the volume and cost of nutritious food delivered to communities is highly variable and dependent on factors such as retailers’ pricing practices, over which the program has no control. It may be necessary to consider alternative forms of policy in order to produce sustainable improvements to food security in remote, northern communities.

Abstract Objective: To determine the average price difference between foods and beverages in remote Indigenous community stores and capital city supermarkets and explore differences across products. Methods: A cross‐sectional survey compared prices derived from point‐of‐sale data in 20 remote Northern Territory stores with supermarkets in capital cities of the Northern Territory and South Australia for groceries commonly purchased in remote stores. Average price differences for products, supply categories and food groups were examined. Results: The 443 products examined represented 63% of food and beverage expenditure in remote stores. Remote products were, on average, 60% and 68% more expensive than advertised prices for Darwin and Adelaide supermarkets, respectively. The average price difference for fresh products was half that of packaged groceries for Darwin supermarkets and more than 50% for food groups that contributed most to purchasing. Conclusions: Strategies employed by manufacturers and supermarkets, such as promotional pricing, and supermarkets’ generic products lead to lower prices. These opportunities are not equally available to remote customers and are a major driver of price disparity. Implications: Food affordability for already disadvantaged residents of remote communities could be improved by policies targeted at manufacturers, wholesalers and/or major supermarket chains.

Background: Nutrition North Canada (NNC) is a retail subsidy program implemented in 2012 and designed to reduce the cost of nutritious food for residents living in Canada's remote, northern communities. The present study evaluates the extent to which NNC provides access to perishable, nutritious food for residents of remote northern communities. Design: Program documents, including fiscal and food cost reports for the period 2011–2015, retailer compliance reports, audits of the program, and the program's performance measurement strategy are examined for evidence that the subsidy is meeting its objectives in a manner both comprehensive and equitable across regions and communities. Results: NNC lacks price caps or other means of ensuring food is affordable and equitably priced in communities. Gaps in food cost reporting constrain the program's accountability. From 2011– 15, no adjustments were made to community eligibility, subsidy rates, or the list of eligible foods in response to information provided by community members, critics, the Auditor General of Canada, and the program's own Advisory Board. Measures to increase program accountability, such as increasing subsidy information on point-of-sale receipts, make NNC more visible but do nothing to address underlying accountability issuesConclusions: The current structure and regulatory framework of NNC are insufficient to ensure the program meets its goal. Both the volume and cost of nutritious food delivered to communities is highly variable and dependent on factors such as retailers' pricing practices, over which the program has no control. It may be necessary to consider alternative forms of policy in order to produce sustainable improvements to food security in remote, northern communities. [ABSTRACT FROM AUTHOR]

The aim of this research study is to reveal how the restaurants operating in Antakya, which have one of the most famous cuisines of Turkey calculate and control their food costs and make pricing decisions of food they produce. In order to conduct the present survey, data related with cost calculation methods and pricing decision process used by the said restaurants were obtained by applying a questionnaire in face to face manner to some restaurants selected knowingly and operating in the city Antakya. The data obtained was analyzed by using chi-square method in order to define whether the restaurants use the known methods in the relevant literature or not. Thus some suggestions are made in order to help solving the problems and shortcomings the said restaurants have faced. [ABSTRACT FROM AUTHOR]

Aims: The traditional Mediterranean diet (MD) is reportedly associated with lower risk of major chronic diseases and long considered to contribute to the reduced rates of cardiovascular and cerebrovascular events and to the highest life expectancy in adults who lived near the Mediterranean Sea. But despite its widely documented health benefits, adherence to this dietary pattern has been rapidly declining over the last decades due to a clear socioeconomic influence. The present review provides an overview of the evidence on the current major determinants of adherence to the Mediterranean diet, with a particular emphasis on Mediterranean Countries at a time of economic crisis; second it explores emerging socioeconomic inequalities in other domains of healthy dietary behaviours such as dietary variety, access to organic foods and food purchasing behaviour.Data Synthesis: According to ecological evidence, the Mediterranean Countries that used to have the highest adherence to the Mediterranean pattern in the Sixties, more recently experienced the greatest decrease, while Countries in Northern Europe and some other Countries around the world are currently embracing a Mediterranean-like dietary pattern. A potential cause of this downward trend could be the increasing prices of some food items of the Mediterranean diet pyramid. Recent evidence has shown a possible involvement of the economic crisis, material resources becoming strong determinants of the adherence to the MD just after the recession started in 2007-2008. Beyond intake, the MD also encourages increasing dietary diversity, while international dietary recommendations suggest replacing regular foods with healthier ones.Conclusions: Socioeconomic factors appear to be major determinants of the adherence to MD and disparities also hold for other indices of diet quality closely related to this dietary pattern. [ABSTRACT FROM AUTHOR]

We have shown previously that mice given access to four discrete feeding opportunities (FOs) per day show a characteristic sequence of sizes across ordinal FOs. The purpose of the present experiments was to determine the relative contributions of external and internal factors on the sequencing of FO size. The external factors were the light:dark Zeitgeber and the cost of food, imposed via different fixed unit prices (FUP) in a closed operant economy, and the internal factors were signals relating to energy status including time since last food and weight loss. In the first experiment, mice were given 4 FOs spaced 4-h apart, but with the timing of the FOs relative to the Zeitgeber altered by a 4-h Zeitgeber advance or delay of the cycle. Food intake, and associated body weight, declined as price increased, but the temporal order of FO size was invariant within a Zeitgeber condition. The Zeitgeber advanced group showed clear evidence of a shift in meal sequence relating to the light:dark cycle. Thus, external factors seem to be a more important determinant of total intake and sequencing than internal factors. In the second experiment, mice were given the choice between continuous costly (CC) and intermittent inexpensive (II) food. II food was available for four-15 min intervals every 4-h, and the timing of the 15 min intervals was varied relative to the Zeitgeber cycle. In spite of a 20-fold difference in price between CC and II food, mice took approximately equal amounts from each, and all food intake took place during the dark phase. Mice consumed II food only if it was available during the dark phase. Food intake was strongly linked to the light:dark cycle, largely independent of food cost. [ABSTRACT FROM AUTHOR]

We reflect on Daniel's (2016) finding that a challenge to improving the diets of lower income children is parental worry over food waste that results from children's rejection of healthier food options such as vegetables. This finding has important implications because previous research has indicated novel foods that have a bitter or sour flavor profile (as is the case with many vegetables) must be introduced to children several times before these foods are accepted. We suggest research-based techniques that parents could utilize to reduce the risk of costly food waste, and discuss obstacles that could impede well-intended parents from reaching their goals of improving their children's diets. [ABSTRACT FROM AUTHOR]

This article shows how an interaction between economic constraints and children's taste preferences shapes low-income families' food decisions. According to studies of eating behavior, children often refuse unfamiliar foods 8 to 15 times before accepting them. Using 80 interviews and 41 grocery-shopping observations with 73 primary caregivers in the Boston area in 2013e2015, I find that many lowincome respondents minimize the risk of food waste by purchasing what their children likedoften calorie-dense, nutrient-poor foods. High-income study participants, who have greater resources to withstand the cost of uneaten food, are more likely to repeatedly introduce foods that their children initially refuse. Several conditions moderate the relationship between children's taste aversion and respondents' risk aversion, including household-level food preferences, respondents' conceptions of adult authority, and children's experiences outside of the home. Low-income participants' risk aversion may affect children's taste acquisition and eating habits, with implications for socioeconomic disparities in diet quality. This article proposes that the cost of providing children a healthy diet may include the possible cost of foods that children waste as they acquire new tastes. [ABSTRACT FROM AUTHOR]

The rising rates of obesity in the United States are a major public health concern. Disproportionately high rates of obesity among low-income individuals are partially attributable to disparities in access to healthful food. Given the limited budgets of low-income populations, recent research on food price differences between affluent and low-income communities has implications for public health policy. This systematic review looks at studies of food price differences throughout the United States. The studies provide evidence that food is more expensive in higher-income areas relative to low-income areas, healthy food is generally more expensive than less healthy options, and farmers’ markets are less expensive than conventional retail food stores. Suggestions are made to improve the reliability and validity of measures for each dimension of access before conducting additional studies of the comprehensive environment. [ABSTRACT FROM PUBLISHER]

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ObjectiveAn important debate in the literature is whether or not higher energy-dense foods are cheaper than less energy-dense foods. The present communication develops and applies an easy statistical test to determine if the relationship between food price and energy density is an artifact of how the data units are constructed (i.e. is it ‘spurious’ or ‘real’?).DesignAfter matching data on 4430 different foods from the National Health and Nutrition Examination Survey with corresponding prices from the Center for Nutrition Policy and Promotion’s Food Prices Database, we use a simple regression model to test if the relationship between food price and energy density is ‘real’ or ‘spurious’.SettingUSA.SubjectsTotal sample size is 4430 observations of consumed foods from 4578 participants from the non-institutionalized US adult population (aged 19 years and over).ResultsOver all 4430 foods, the null hypothesis of a spurious inverse relationship between food price per energy density and energy density is not rejected. When the analysis is broken down by twenty-five food groups, there are only two cases where the inverse relationship is not spurious. In fact, the majority of non-spurious relationships between food price and energy density are positive, not negative.ConclusionsOne of the main arguments put forth regarding the poor diet quality of low-income households is that high energy-dense food is cheaper than lower energy-dense food. We find almost no statistical support for higher energy-dense food being cheaper than low energy-dense food. While economics certainly plays a role in explaining low nutritional quality, more sophisticated economic arguments are required and discussed. [ABSTRACT FROM AUTHOR]