Background—Poor lifestyle behaviors, including suboptimal diet, physical inactivity, and tobacco use, are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established. Methods and Results—For this American Heart Association scientific statement, the writing group systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use. Strategies were considered in 6 broad domains: (1) Media and educational campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change...

Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association

It has been well-documented that Americans have shifted towards eating out more and cooking at home less. However, little is known about whether these trends have continued into the 21st century, and whether these trends are consistent amongst low-income individuals, who are increasingly the target of public health programs that promote home cooking. The objective of this study is to examine how patterns of home cooking and home food consumption have changed from 1965 to 2008 by socio-demographic groups. This is a cross-sectional analysis of data from 6 nationally representative US dietary surveys and 6 US time-use studies conducted between 1965 and 2008. Subjects are adults aged 19 to 60 years (n= 38,565 for dietary surveys and n=55,424 for time-use surveys). Weighted means of daily energy intake by food source, proportion who cooked, and time spent cooking were analyzed for trends from 1965–1966 to 2007–2008 by gender and income. T-tests were conducted to determine statistical differences over time. The percentage of daily energy consumed from home food sources and time spent in food preparation decreased significantly for all socioeconomic groups between 1965–1966 and 2007–2008 (p ≤ 0.001), with the largest declines occurring between 1965 and 1992. In 2007–2008, foods from the home supply accounted for 65 to 72% of total daily energy, with 54 to 57% reporting cooking activities. The low income group showed the greatest decline in the proportion cooking, but consumed more daily energy from home sources and spent more time cooking than high income individuals in 2007–2008 (p ≤ 0.001). US adults have decreased consumption of foods from the home supply and reduced time spent cooking since 1965, but this trend appears to have leveled off, with no substantial decrease occurring after the mid-1990’s. Across socioeconomic groups, people consume the majority of daily energy from the home food supply, yet only slightly more than half spend any time cooking on a given day. Efforts to boost the healthfulness of the US diet should focus on promoting the preparation of healthy foods at home while incorporating limits on time available for cooking.

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Trends in US home food preparation and consumption: analysis of national nutrition surveys and time use studies from 1965–1966 to 2007–2008

• providing opportunities for light, moderate, and vigorous physical activity for at least 15 minutes per hour while children are in care; • providing daily outdoor time for physical activity when possible; • providing a combination of developmentally appropriate structured and unstructured physical activity experiences; • joining children in physical activity; • integrating physical activity into activities designed to promote children’s cognitive and social development; • providing an outdoor environment with a variety of portable play equipment, a secure perimeter, some shade, natural elements, an open grassy area, varying surfaces and terrain, and adequate space per child; • providing an indoor environment with a variety of portable play equipment and adequate space per child; • providing opportunities for children with disabilities to be physically active, including equipment that meets the current standards for accessible design under the Americans with Disabilities Act; • avoiding punishing children for being physically active; and RECOMMENDATIONS JUNE 2011

Early Childhood Obesity Prevention Policies

This review outlines several key aspects of the new rural-urban interface and the growing interpenetration of American rural and urban life. The historical coincidence of spatial and social boundaries in America is changing rapidly. This review highlights (a) the enormous scale of rural-urban interdependence and boundary crossing, shifting, and blurring—along many dimensions of community life—over the past several decades, and (b) the symmetrical rather than asymmetrical influences between urban and rural areas, i.e., on bidirectional relational aspects of spatial categories. These general points are illustrated by identifying 10 common conceptions of rural America that reflect both its social and economic diversity and its changing spatial and social boundaries. Here we emphasize symbolic and social boundaries—the distinctions between urban and rural communities and people and the processes by which boundaries are engaged. Placing behaviors or organizational forms along a rural-urban continuum (or within...

Rural America in an Urban Society: Changing Spatial and Social Boundaries

https://w3.biosci.utexas.edu/jha/wp-content/uploads/Lin-Philpott-Jha-2015-future-urban-agriculture-BA-Ecology.pdf

The future of urban agriculture and biodiversity-ecosystem services: Challenges and next steps

The Food, Conservation, and Energy Act of 2008 directed the U.S. Department of Agriculture to conduct a 1-year study to assess the extent of areas with limited access to affordable and nutritious food, identify characteristics and causes of such areas, consider how limited access affects local populations, and outline recommendations to address the problem. This report presents the fi ndings of the study, which include results from two conferences of national and international authorities on food deserts and a set of commissioned research studies done in cooperation with the National Poverty Center at the University of Michigan. It also includes reviews of existing literature, a national-level assessment of access to supermarkets and large grocery stores, analysis of the economic and public health effects of limited access, and a discussion of existing policy interventions. The study uses a variety of analytical methods and data to assess the extent of limited access to affordable and nutritious food and characteristics of areas with limited access. Overall, findings show that a small percentage of consumers are constrained in their ability to access affordable nutritious food because they live far from a supermarket or large grocery store and do not have easy access to transportation. Urban core areas with limited food access are characterized by higher levels of racial segregation and greater income inequality. In small-town and rural areas with limited food access, the lack of transportation infrastructure is the most defining characteristic. Existing data and research are insufficient to conclusively determine whether areas with limited access have inadequate access.

Access to Affordable and Nutritious Food-Measuring and Understanding Food Deserts and Their Consequences: Report to Congress

An estimated 85.7 percent of American households were food secure throughout the entire year in 2013, meaning that they had access at all times to enough food for an active, healthy life for all household members. The remaining households (14.3 percent) were food insecure at least some time during the year, including 5.6 percent with very low food security, meaning that the food intake of one or more household members was reduced and their eating patterns were disrupted at times during the year because the household lacked money and other resources for food. The change in food insecurity overall from the prior year (from 14.5 percent in 2012) was not statistically significant. The cumulative decline in food insecurity from 2011 (14.9 percent) to 2013 (14.3 percent) was statistically significant. The prevalence rate of very low food security was essentially unchanged from 5.7 percent in 2011 and 2012. Children and adults were food-insecure in 9.9 percent of households with children in 2013, essentially unchanged from 10.0 percent in 2011 and 2012. In 2013, the typical food-secure household spent 30 percent more on food than the typical food-insecure household of the same size and household composition. Sixty-two percent of all food-insecure households participated in one or more of the three largest Federal food and nutrition assistance programs during the month prior to the 2013 survey.

Household Food Security in the United States in 2013

An estimated 87.7 percent of American households were food secure throughout the entire year in 2016, meaning they had access at all times to enough food for an active, healthy life for all household members. The remaining households (12.3 percent) were food insecure at least some time during the year, including 4.9 percent with very low food security, meaning that at times the food intake of one or more household members was reduced and their eating patterns were disrupted because the household lacked money and other resources for obtaining food. Changes from 2015 to 2016 in food insecurity overall (from 12.7 to 12.3 percent) and in very low food security (from 5.0 to 4.9 percent) were not statistically significant, but they continued a downward trend in food insecurity from a high of 14.9 percent in 2011. Among children, changes from 2015 in food insecurity and very low food security were also not statistically significant. Children and adults were food insecure in 8.0 percent of households with children in 2016, essentially unchanged from 7.8 percent in 2015. Very low food security among children was 0.8 percent in 2016, essentially unchanged from 0.7 percent in 2015. In 2016, the typical food-secure household spent 29 percent more on food than the typical food-insecure household of the same size and household composition. About 59 percent of food-insecure households participated in one or more of the three largest Federal food and nutrition assistance programs during the month prior to the 2016 survey (food stamps (SNAP); Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and the National School Lunch Program).

Household Food Security in the United States in 2016

Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences: Report to Congress

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Anita Singh

Papers

Access to Affordable and Nutritious Food-Measuring and Understanding Food Deserts and Their Consequences: Report to Congress

Household Food Security in the United States in 2013

Household Food Security in the United States in 2016

Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences: Report to Congress

Household Food Security in the United States in 2013