scholarly journals Importance of fish for food and nutrition security among First Nations in Canada

2021 ◽  
Vol 112 (S1) ◽  
pp. 64-80
Author(s):  
Lesya Marushka ◽  
Malek Batal ◽  
Constantine Tikhonov ◽  
Tonio Sadik ◽  
Harold Schwartz ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
First Nations ◽  
Consumption Patterns ◽  
Household Food Security ◽  
Seafood Consumption ◽  
Atlantic Region ◽  
Economic Determinants ◽  
Food Security Status ◽  
Environment Study

Abstract Objective To investigate the relationships between fish/seafood consumption patterns and food security status among First Nations (FN) communities in Canada. We estimated the contribution of fish/seafood to daily nutrient requirements. Barriers to traditional food (TF) access including fish were summarized. Methods Data were collected by the First Nations Food, Nutrition and Environment Study (2008–2018). The sample of this participatory study comprised 6258 randomly selected FN adults. Fish/seafood consumption was estimated with a food frequency questionnaire. Food security status was assessed with the Household Food Security Survey Module. The contribution of fish/seafood to protein, n-3 fatty acid, vitamin (A, B12, D, niacin) and mineral (selenium, zinc) requirements was assessed by comparison to Dietary Reference Intakes. Results Regional differences were observed in fish/seafood consumption patterns and their relationship with food security status. In the eastern regions (Ontario, Quebec/Labrador and the Atlantic region), consumption of fish/seafood and other TF was significantly higher among food insecure compared with food secure FN participants. Severely food insecure men (particularly in British Columbia, Alberta, Quebec/Labrador and the Atlantic region) tended to eat a higher amount of TF, including fish/seafood, compared with food secure and moderately food insecure men, while no difference was observed in women. Fish/seafood provided good sources of selected nutrients. However, the high cost of harvesting equipment, industry-related activities and climate change reduce access to fish/seafood and other wildlife. Conclusion Fish/seafood continues to be vital to the diet of FN communities. Focusing on policies that support FN increased access to fish/seafood has the potential to decrease food insecurity and support sustainable livelihoods. Future policies should focus on socio-economic determinants of food insecurity and support traditional harvesting and sustainable fisheries among FN communities.

scholarly journals First Nations households living on-reserve experience food insecurity: prevalence and predictors among ninety-two First Nations communities across Canada

2021 ◽  
Vol 112 (S1) ◽  
pp. 52-63 ◽  
Author(s):  
Malek Batal ◽  
Hing Man Chan ◽  
Karen Fediuk ◽  
Amy Ing ◽  
Peter R. Berti ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
First Nations ◽  
Food Sovereignty ◽  
Multivariable Analysis ◽  
Household Food Security ◽  
Barriers And Enablers ◽  
Environment Study ◽  
Households With Children

Abstract Objective To describe the prevalence of food insecurity in First Nations households across Canada while identifying barriers and enablers to traditional food (TF) consumption. Methods The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of on-reserve First Nations from 2008 to 2018. The Household Food Security Survey Module was used to capture income-related challenges experienced by First Nations households. Households were classified as food secure, or marginally, moderately, or severely food insecure. Barriers and enablers to TF access and use were identified describing the Indigenous experience. Results Almost half of on-reserve First Nations households were food insecure and the prevalence was higher than that for non-Indigenous households in Canada. On-reserve food insecurity prevalence was higher in western regions of Canada. First Nations households with children experienced greater food insecurity than those without children. More adults experienced severe food insecurity than children. Most adults would like to have more TF in their diet but state that factors such as financial and household constraints, industrial activities, government regulations, climate change, and fear of contamination impede greater access. Food costs were substantially higher in remote First Nations communities, but remoteness was not associated with food security in multivariable analysis. Conclusion Existing systems have been unsuccessful in curbing the food insecurity in First Nations households. Improving food security hinges on achieving Indigenous Food Sovereignty, the key to long-term conservation and stewardship of the land and the co-management of these by Indigenous Peoples. Studies investigating the feasibility of increasing TF from an Indigenous perspective are required.

scholarly journals Measuring household food security: the global experience

2008 ◽  
Vol 21 (suppl) ◽  
pp. 27s-37s ◽  
Author(s):  
Hugo Melgar-Quinonez ◽  
Michelle Hackett
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
The United States ◽  
Household Food Security ◽  
United States Department ◽  
Department Of Agriculture ◽  
Governmental Agencies ◽  
Household Food ◽  
Food Security Status ◽  
New Research

Measuring household food insecurity represents a challenge due to the complexity and wide array of factors associated with this phenomenon. For over one decade, researchers and agencies throughout the world have been using and assessing the validity of variations of the United States Department of Agriculture Household Food Security Supplemental Module. Thanks to numerous studies of diverse design, size, and purpose, the Household Food Security Supplemental Module has shown its suitability to directly evaluate the perceptions of individuals on their food security status. In addition, challenges and limitations are becoming clearer and new research questions are emerging as the process advances. The purpose of this article is to describe the development, validation procedures, and use of the Household Food Security Supplemental Module in very diverse settings. The most common Household Food Security Supplemental Module related studies have been conducted using criterion validity, Rasch modeling and Cronbach-Alpha Coefficient. It is critical that researchers, policy makers, governmental and non-governmental agencies intensify their efforts to further develop tools that provide valid and reliable measures of food security in diverse population groups. Additional work is needed to synthesize a universally applicable tool able to capture the global human phenomenon of food insecurity.

scholarly journals Household food security status and associated factors among high-school students in Esfahan, Iran

2010 ◽  
Vol 13 (10) ◽  
pp. 1609-1613 ◽  
Author(s):  
Assieh Mohammadzadeh ◽  
Ahmadreza Dorosty ◽  
Mohammadreza Eshraghian
Keyword(s):  
High School ◽  
High School Students ◽  
Food Security ◽  
Food Insecurity ◽  
High Energy ◽  
Household Food Security ◽  
School Students ◽  
Household Food ◽  
Food Security Status ◽  
Food Insecure Households

AbstractObjectiveThe present study was designed to determine household food security status and factors associated with food insecurity among high-school students in Esfahan, Iran.DesignCross-sectional surveys.SettingThe present study was conducted in autumn 2008 in Esfahan, Iran. The samples were selected using systematic cluster sampling. Socio-economic questionnaires, food security questionnaires and FFQ were filled out during face-to-face interviews. In addition, data on participants’ weights and heights were collected.SubjectsA total of 580 students (261 boys and 319 girls) aged 14–17 years from forty high schools in Esfahan, Iran, were selected.ResultsThe prevalence of household food insecurity according to the US Department of Agriculture food security questionnaire was 36·6 % (95 % CI 0·33, 0·40). Food insecurity was positively associated with number of members in the household (P < 0·05) and negatively associated with parental education level and job status and household economic status (P < 0·05). Moreover, students living in food-insecure households more frequently consumed bread, macaroni, potato and egg (P < 0·05), while they less frequently consumed rice, red meat, sausage and hamburger, poultry, fish, green vegetables, root and bulb (coloured) vegetables, melons, apples and oranges, milk and yoghurt (P < 0·05).ConclusionsFood insecurity was prevalent among households in Esfahan, Iran, and food security status was associated with socio-economic factors. Students who belonged to food-secure households more frequently consumed healthy foods (except sausage and hamburger), whereas those living in food-insecure households more frequently consumed cheap foods containing high energy per kilogram. The present study suggests that intervention programmes be designed and carried out.

scholarly journals Infants from Food Insecure Households Have Altered Gut Microbiota (OR01-03-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sara Benjamin-Neelon ◽  
Moira Differding ◽  
Noel Mueller
Keyword(s):  
Food Security ◽  
Gut Microbiota ◽  
Food Insecurity ◽  
Household Food Security ◽  
Sequence Variants ◽  
Microbiota Composition ◽  
Household Food ◽  
Food Security Status ◽  
Food Insecure Households ◽  
Gut Microbiota Composition

Abstract Objectives Infancy represents a critical period for growth and development. Food insecurity (defined as the limited availability of nutritionally adequate and safe foods) in early life may have both immediate and long-term health implications. Some limited evidence suggests that food insecurity in adults may influence the gut microbiota composition, perhaps through a lack of dietary diversity. A number of studies also link malnutrition with alterations in the gut microbiota in children. However, associations between food insecurity and the gut microbiota have yet to be explored in children and especially in infants, who may have had little exposure to foods other than human milk and formula. Methods Participants were from the Nurture study, a birth cohort of predominately black women and their infants residing in the southeastern United States. We collected stool samples from 68 infants 3 months after birth. Our exposure was household food security status assessed when infants were between 2 and 3 months. We used the US Household Food Security Survey Module: Six-Item Short Form. We grouped scores of 0–1 (full or marginal food security) as food secure and 2–6 (low or very low food security) as food insecure, consistent with prior studies. For the 3-month outcome, we used an Illumina MiSeq to conduct paired-end sequencing of the 16S rRNA V4 region. We used beta-binomial regression to determine differential abundance of microbiota according to food security status. Two-sided FDR corrected P-values < 0.05 were considered significant. We adjusted for delivery method (C-section versus vaginal), breastfeeding (never versus any), and timing of introduction to solid foods (at or before 3 months versus after 3 months of age). Results Demographic characteristics of mothers and infants from food insecure households (n = 20) resembled those from food secure households (n = 45). The relative abundance of 16 microbial amplicon sequence variants were lower in food insecure infants, and 3 microbial amplicon sequence variants were higher in food secure infants (Figure). Conclusions Findings from our birth cohort suggest that infants from food insecure households had altered gut microbiota composition at 3 months of age. Future research is warranted to provide mechanistic insight into these potentially novel associations. Funding Sources NIDDK, National Institutes of Health. Supporting Tables, Images and/or Graphs

scholarly journals Household Food Insecurity in Southeastern Iran: Severity and Related Factors

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Zinat Mortazavi ◽  
Ahmad Reza Dorosty ◽  
Mohammad Reza Eshraghian ◽  
Mohtasham Ghaffari ◽  
Alireza Ansari-Moghaddam ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Cross Sectional Study ◽  
Household Food Security ◽  
Household Food Insecurity ◽  
Healthy Foods ◽  
Related Factors ◽  
Cross Sectional ◽  
Household Food ◽  
Food Security Status

Background.Today, more than one billion people globally suffer from poverty and food insecurity. This study aimed to determine the severity of and factors related to household food insecurity in Zahedan, Southeastern Iran.Methods.This cross-sectional study was conducted on a total of 2,160 households between November 2014 and December 2015. Demographic and socioeconomic data were collected through interviewing the household mothers. Household food security status was assessed through the USDA 18-item questionnaire. The data were analyzed using chi-square test, one-way ANOVA, and logistic regression model.Results.Total food insecurity in the households investigated was 58.8%. There were significant associations (P<0.001) between household food insecurity status and the socioeconomic status of the households, ethnicity, education, age, and employment status of the head of the household and the mother of the household.Discussion.The results showed that more than half of the households examined suffer from food insecurity. Interventions to improve the food security status of people should be designed and implemented to improve people’s knowledge, skills, and attitudes related to healthy eating and food preparation. People’s access to healthy foods and knowledge of how to select healthy foods (especially on a limited budget) should also be improved.

scholarly journals SNAP Participation Moderates the Association Between Household Food Insecurity and A1c Among Cambodian Americans With Depression

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 105-105
Author(s):  
Angela Bermudez-Millan ◽  
Richard Feinn ◽  
Chelsey Hahn ◽  
Shanjida Arbie Jui ◽  
S. Megan D. Berthold ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Health Workers ◽  
Household Food Security ◽  
Household Food Insecurity ◽  
Assistance Program ◽  
Cambodian Americans ◽  
Household Food ◽  
Food Security Status ◽  
Significant Difference

Abstract Objectives We tested whether participation in the Supplemental Nutrition Assistance Program (SNAP) moderated the relation between household food security status and HbA1c, the gold standard measure of glycemic control, among Cambodian Americans with depression enrolled in a diabetes prevention trial. Methods Participants had elevated risk factors for type 2 diabetes and elevated depressive symptoms; recruits were excluded for extant diabetes. Community health workers assessed household food security status and SNAP participation via in-person interview. HbA1c levels from venous blood samples were ascertained using direct enzymatic assay. Results Among respondents (n = 189), 19% were food insecure, 41% received SNAP benefits, and mean HbA1c = 5.5%. There was a significant interaction between SNAP and food insecurity. HbA1c was highest among participants without SNAP who were food insecure. Simple effects analysis revealed a significant difference within the no SNAP group [Mean (SD) HbA1c: Secure = 5.38 (0.38), Insecure = 5.78 (0.36)] and no difference within the SNAP group [Secure = 5.61(0.44), Insecure = 5.61(0.55)]. Differences remained significant after controlling for demographic, socioeconomic, and clinical indicators. Conclusions SNAP may protect against the deleterious association between household food insecurity and elevated HbA1c. Funding Sources R01-DK103663 to Dr. Julie Wagner.

scholarly journals Tingkat Kecukupan Energi, Protein Dan Status Ketahanan Pangan Rumah Tangga Berhubungan Dengan Status Gizi Anak Usia 6-8 Tahun

2017 ◽  
Vol 1 (3) ◽  
pp. 189
Author(s):  
Rika Kusuma Nagari ◽  
Triska Susila Nindya
Keyword(s):  
Food Security ◽  
Nutritional Status ◽  
Food Insecurity ◽  
Anthropometric Measurement ◽  
Household Food Security ◽  
Cross Sectional ◽  
Household Food ◽  
Food Security Status ◽  
Food Recall ◽  
Nutritional Status Of Children

Background: The nutritional status of elementary school children can be influence by many factors such as levels adequacy of energy and proteinand household food security status. Unbalanced levels adequacy of energy and protein possibility can cause nutritional problems in children. While the status of household food security has an impact on the household ability to access a good food. Objectives: aims of this study are to analyze the relationship between nutritional adequacy level and household food security status with nutritional status of children aged 6-8 years. Method: This study used cross sectional design with sample of 62 families with children aged 6-8 years enrolled in SDN 1 and 2 Sambirejo. Anthropometric measurement of height and weight is used to determine the nutritional status of children. The instruments used 2x24-hours food recall form (energy and protein adequacy level), and US-HFSSM (household food security status). While the statistical test used is spearman correlation test. Results: The results showed a correlation between levels of energy (p=0.000) and protein (p=0.000) adequacy and household food security status (p=0.010) with child nutritional status. Conclusion: Households with food insecurity had a higher proportion of nutritional problem than food secure family, so it is needed to children for having supplemental food, especially them who have nutritional problems and on food insecurity condition. It is intended to provide children with additional nutritious food to reduce the risk of nutritional problems.ABSTRAK Latar Belakang: Status gizi anak sekolah dasar dapat dipengaruhi oleh banyak faktor diantaranya tingkat kecukupan energi dan protein serta status ketahanan pangan rumah tangga. Ketidakseimbangan tingkat kecukupan energi dan protein, kemungkinan dapat menyebabkan masalah gizi pada anak. Status ketahanan pangan rumah tangga berdampak kepada kemampuan dalam mengakses pangan yang baik.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan antara tingkat kecukupan energi dan protein serta status ketahanan pangan rumah tangga dengan status gizi anak usia 6-8 tahun.Metode: Penelitian ini menggunakan desain cross sectional dengan sampel sebanyak 62 keluarga yang memiliki anak usia 6-8 tahun yang terdaftar di SDN 1 dan 2 Sambirejo. Pengukuran antropometri tinggi badan dan berat badan digunakan untuk mengetahui status gizi anak. Selain itu, instrumen yang digunakan adalah  formulir 2x24-hours food recall (tingkat kecukupan energi dan protein), dan US-HFSSM (status ketahanan pangan rumah tangga). Statistik uji yang digunakan adalah uji korelasi spearman.Hasil: Hasil dari penelitian ini yaitu terdapat hubungan antara tingkat kecukupan energi (p=0,000) dan protein (p=0,000) serta status ketahanan pangan rumah tangga (p=0,010) dengan status gizi anak.Kesimpulan: Rumah tangga yang rawan pangan akan memiliki risiko mengalami masalah gizi yang lebih tinggi bila dibandingkan dengan rumah tangga yang tahan pangan, sehingga perlu adanya pemberian makanan tambahan kepada anak, terutama kepada anak yang memiliki masalah gizi dan berada pada kondisi rawan pangan. Hal tersebut dimaksudkan untuk memberikan anak tambahan makanan yang bergizi agar menurunkan risiko masalah gizi.

scholarly journals Tingkat Kecukupan Energi, Protein Dan Status Ketahanan Pangan Rumah Tangga Berhubungan Dengan Status Gizi Anak Usia 6-8 Tahun

2017 ◽  
Vol 1 (3) ◽  
pp. 189
Author(s):  
Rika Kusuma Nagari ◽  
Triska Susila Nindya
Keyword(s):  
Food Security ◽  
Nutritional Status ◽  
Food Insecurity ◽  
Anthropometric Measurement ◽  
Household Food Security ◽  
Cross Sectional ◽  
Household Food ◽  
Food Security Status ◽  
Food Recall ◽  
Nutritional Status Of Children

Background: The nutritional status of elementary school children can be influence by many factors such as levels adequacy of energy and proteinand household food security status. Unbalanced levels adequacy of energy and protein possibility can cause nutritional problems in children. While the status of household food security has an impact on the household ability to access a good food. Objectives: aims of this study are to analyze the relationship between nutritional adequacy level and household food security status with nutritional status of children aged 6-8 years. Method: This study used cross sectional design with sample of 62 families with children aged 6-8 years enrolled in SDN 1 and 2 Sambirejo. Anthropometric measurement of height and weight is used to determine the nutritional status of children. The instruments used 2x24-hours food recall form (energy and protein adequacy level), and US-HFSSM (household food security status). While the statistical test used is spearman correlation test. Results: The results showed a correlation between levels of energy (p=0.000) and protein (p=0.000) adequacy and household food security status (p=0.010) with child nutritional status. Conclusion: Households with food insecurity had a higher proportion of nutritional problem than food secure family, so it is needed to children for having supplemental food, especially them who have nutritional problems and on food insecurity condition. It is intended to provide children with additional nutritious food to reduce the risk of nutritional problems.ABSTRAK Latar Belakang: Status gizi anak sekolah dasar dapat dipengaruhi oleh banyak faktor diantaranya tingkat kecukupan energi dan protein serta status ketahanan pangan rumah tangga. Ketidakseimbangan tingkat kecukupan energi dan protein, kemungkinan dapat menyebabkan masalah gizi pada anak. Status ketahanan pangan rumah tangga berdampak kepada kemampuan dalam mengakses pangan yang baik.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan antara tingkat kecukupan energi dan protein serta status ketahanan pangan rumah tangga dengan status gizi anak usia 6-8 tahun.Metode: Penelitian ini menggunakan desain cross sectional dengan sampel sebanyak 62 keluarga yang memiliki anak usia 6-8 tahun yang terdaftar di SDN 1 dan 2 Sambirejo. Pengukuran antropometri tinggi badan dan berat badan digunakan untuk mengetahui status gizi anak. Selain itu, instrumen yang digunakan adalah  formulir 2x24-hours food recall (tingkat kecukupan energi dan protein), dan US-HFSSM (status ketahanan pangan rumah tangga). Statistik uji yang digunakan adalah uji korelasi spearman.Hasil: Hasil dari penelitian ini yaitu terdapat hubungan antara tingkat kecukupan energi (p=0,000) dan protein (p=0,000) serta status ketahanan pangan rumah tangga (p=0,010) dengan status gizi anak.Kesimpulan: Rumah tangga yang rawan pangan akan memiliki risiko mengalami masalah gizi yang lebih tinggi bila dibandingkan dengan rumah tangga yang tahan pangan, sehingga perlu adanya pemberian makanan tambahan kepada anak, terutama kepada anak yang memiliki masalah gizi dan berada pada kondisi rawan pangan. Hal tersebut dimaksudkan untuk memberikan anak tambahan makanan yang bergizi agar menurunkan risiko masalah gizi.

scholarly journals Food Insecurity among Senior Citizens in High Out-migration Areas: Evidence from Western Nepal

2019 ◽  
Author(s):  
Devendra Raj Singh ◽  
Saruna Ghimire ◽  
Eva M Jeffers ◽  
Sunita Singh ◽  
Dhirendra Nath ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Senior Citizens ◽  
Senior Citizen ◽  
The United States ◽  
Household Food Security ◽  
United States Department ◽  
Lower Odds ◽  
Household Food ◽  
Food Security Status

Abstract Background: Food insecurity is a critical public health challenge, in particular in low and middle-income countries. Nepal, a low-income country, is undergoing rapid demographic and epidemiological transitions with a growing population of senior citizens. However, the determinants of food security status among Nepali senior citizens are still unknown. This study aims to fill this gap focusing on the elderly populations in the far-western region, one of the poorest regions of the country. The study also aims to assess the potential impact of adult child migration on the food security status of the left behind elderly parents. Methods: A community-based cross-sectional study was conducted among 260 randomly selected senior citizens in the Kanchanpur district in far-western Nepal. The short form of the household food security scale, originally developed by the United States Department of Agriculture, was used to measure household food security. Associations were examined by means of logistic regression. Results: The prevalence of food insecurity, in senior citizens’ households, was 41.1%. Senior citizen households with their adult children’s migration (AOR= 0.49, 95% CI: 0.24- 0.98) had lower odds of being food insecure and households with lower family income (<$100 compared to ≥ $100) (AOR= 2.24, 95% CI: 1.08 - 4.65) had two times higher odds of being food insecure. Also, households owning a cultivable land/farm (AOR= 0.14, 95% CI: 0.05-0.37) and involved in agriculture (AOR= 0.29, 95% CI: 0.09-0.99) or business (AOR= 0.20, 95% CI: 0.05-0.74) had lower odds of being food insecure. Conclusion: The prevalence of food insecurity among households with senior citizen in Kanchanpur district was high and associated with migration status of adult children, household income and ethnicity. This calls for a greater policy response focused specifically on the households with elderly citizens and integration of gerontological evidence into the existing food security and nutrition strategies.

scholarly journals The association of household food security, household characteristics and school environment with obesity status among off-reserve First Nations and Métis children and youth in Canada: results from the 2012 Aboriginal Peoples Survey

2017 ◽  
Vol 37 (3) ◽  
pp. 77-86 ◽  
Author(s):  
Jasmin Bhawra ◽  
Martin Cooke ◽  
Yanling Guo ◽  
Piotr Wilk
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
First Nations ◽  
School Environment ◽  
Weight Status ◽  
Children And Youth ◽  
Aboriginal Peoples ◽  
Household Food Security ◽  
Household Food ◽  
Indigenous Children

Introduction Indigenous children are twice as likely to be classified as obese and three times as likely to experience household food insecurity when compared with non-Indigenous Canadian children. The purpose of this study was to explore the relationship between food insecurity and weight status among Métis and off-reserve First Nations children and youth across Canada. Methods We obtained data on children and youth aged 6 to 17 years (n = 6900) from the 2012 Aboriginal Peoples Survey. We tested bivariate relationships using Pearson chi-square tests and used nested binary logistic regressions to examine the food insecurity−weight status relationship, after controlling for geography, household and school characteristics and cultural factors. Results Approximately 22% of Métis and First Nations children and youth were overweight, and 15% were classified as obese. Over 80% of the sample was reported as food secure, 9% experienced low food security and 7% were severely food insecure. Off-reserve Indigenous children and youth from households with very low food security were at higher risk of overweight or obese status; however, this excess risk was not independent of household socioeconomic status, and was reduced by controlling for household income, adjusted for household size. Negative school environment was also a significant predictor of obesity risk, independent of demographic, household and geographic factors. Conclusion Both food insecurity and obesity were prevalent among the Indigenous groups studied, and our results suggest that a large proportion of children and youth who are food insecure are also overweight or obese. This study reinforces the importance of including social determinants of health, such as income, school environment and geography, in programs or policies targeting child obesity.

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