The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial

Background The Supplemental Nutrition Assistance Program (SNAP) is the largest anti-hunger program in the United States. Two proposed interventions to encourage healthier food expenditures among SNAP participants have generated significant debate: financial incentives for fruits and vegetables, and restrictions on foods high in added sugar. To date, however, no study has assessed the impact of these interventions on the benefit cycle, a pattern of rapid depletion of SNAP benefits that has been linked to worsening nutrition and health outcomes over the benefit month. Methods Low-income households not currently enrolled in SNAP (n = 249) received benefits every 4 weeks for 12 weeks on a study-specific benefit card. Households were randomized to one of four study arms: 1) incentive (30% incentive for fruits and vegetables purchased with study benefits), 2) restriction (not allowed to buy sugar-sweetened beverages, sweet baked goods, or candy using study benefits), 3) incentive plus restriction, or 4) control (no incentive or restriction). Weekly household food expenditures were evaluated using generalized estimating equations. Results Compared to the control group, financial incentives increased fruit and vegetable purchases, but only in the first 2 weeks after benefit disbursement. Restrictions decreased expenditures on foods high in added sugar throughout the benefit month, but the magnitude of the impact decreased as the month progressed. Notably, restrictions mitigated cyclical expenditures. Conclusions Policies to improve nutrition outcomes among SNAP participants should consider including targeted interventions in the second half of the month to address the benefit cycle and attendant nutrition outcomes. Trial registration ClinicalTrial.gov, NCT02643576. Retrospectively registered December 22, 2014.

Food security analysis based on the proportion of food expenditure and energy consumption of carrot farm households in Tawangmangu Karanganyar

Food security is reflected in two indicators, the level of energy intake and the proportion of household food expenditure (PFE). In 2015, the Tawangmangu sub-district in Karanganyar, Central Java, experienced a rice deficit, causing rice prices to hinder food access. It affects the food expenditures of carrot farm households in the Tawangmangu sub-district. The income of carrot farmers, which is highly unpredictable, affects nutrition fulfillment to determine food security. This study analyzes PFE, energy and protein consumption, and food security of carrot farm households in Tawangmangu, Karanganyar. The number of respondents in this study was 40 carrot farm households, and the sampling method used the accidental sampling technique. The data analysis method in this study used household income and expenditures, PFE, food consumption, and food security. The results showed that the average PFE of the household was 44%. The average energy and protein consumptions are 1,803 kcal/person/day and 58 grams/person/day with 84% energy level intake and 96% protein intake. The distribution of household food security conditions are 62.5% food secure, 5% food vulnerable, 30% food less secure, and 2.5% are food insecure.

FACTORS AFFECTING HOUSEHOLD FOOD EXPENDITURE THROUGH THE UTILIZATION OF YARD LAND IN DEWANTARA SUBDISTRICT, ACEH UTARA

Food is a basic need that must be met by households. Utilization of home yard land is one of the alternatives to realize food self-sufficiency in households in Dewantara District which iscan save on food expenditure and ensure the fulfillment of household food needs which are always available, easily accessible and can be used at any time. This study aims to analyze the factors that influence household food expenditures that utilize yard land with horticultural cultivation in Dewantara Subdistrict, Aceh Utara. The sample in this study was 60 families who were selected by simple random sampling. Data were analyzed descriptively quantitatively using multiple linear regression test. The results showed that simultaneously the factorIncome (X1), yard area (X2), number of household members (X3), housewife education (X4), and number of working household members (X5) have a significant effect on food expenditure. Partially, only the income factor (X1) and the number of household members (X3) have a significant effect on household food expenditure.

Analysis of Household Food Security of Fishermen in Coastal Area, Bangil District, Pasuruan Regency

The low income of fishermen makes it difficult to fulfill basic household food needs and non-food basic needs. The purpose of this study was to analyze the level of energy adequacy and the level of protein adequacy and identify the factors that affect the food security of fishermen's households. The first analysis was carried out descriptively by combining food expenditure and energy consumption indicators. The second analysis uses a logit model regression analysis. The analysis results show that the food security condition of fishermen's households is at the food shortage level of 43.34%. Fisherman households in the food insecurity criteria are 10%, and food security is 23.33%. It means that more than 60% of fishermen's household income is spent on food consumption. The low income received has resulted in fisherman households being unable to allocate food expenditures to meet the nutritional adequacy of their household. The factors that influence the food security of fishermen's households are the size of the household members, household expenditures, and the nutritional knowledge of housewives. Local governments should coordinate with other institutions to formulate policies and plans for economic development in coastal areas.

Successful Incorporation of a Plant-Based Menu Into a Large Academic Hospital

Unhealthy food choices and poor diet have a significant impact on development and progression of cardiovascular disease. Further, plant-based diets have been shown to mitigate cardiovascular risk factors and improve the health status of patients with cardiovascular disease. Currently, hospitals spend substantial healthcare dollars on food expenditures for inpatient services and recent pushes by the American Heart Association (AHA) and American College of Cardiology (ACC) encourage predominantly or full plant-based diets. The University of Florida has been one of the first institutions to incorporate a fully plant-based menu offering to their inpatient population. Herein, we discuss the program instituted at UF, the challenges faced while making this institutional change, and our solutions to these obstacles. The success of our plant-based initiative can serve as a foundation for other healthcare institutions to incorporate plant-based menu programs.

Genre et pouvoir de prise de décision du type et de l’heure de repas: implications pour la sécurité alimentaire des ménages au Nord-Bénin (Afrique de l’Ouest)

Le genre se trouve au centre des débats sur l’insécurité alimentaire des ménages. La présente étude vise à analyser l’influence de la participation des deux sexes au processus de prise de décision de l’heure de prise de repas et du type de repas consommé dans les ménages. Elle a été réalisée au Nord-Bénin auprès de 295 ménages aléatoirement sélectionnés. Les données collectées à l’aide d’un questionnaire digitalisé ont porté sur les caractéristiques socioéconomiques, le sexe du preneur de décision de l’heure de prise de repas et du type de repas consommé, les huit questions de l’échelle d’expérience de l’insécurité alimentaire des ménages. La statistique descriptive et la régression linéaire ont été utilisées pour analyser les données. Les résultats révèlent que la prise de décision unilatérale de l’heure de prise de repas par l’homme ou la femme a affecté négativement le niveau de sécurité alimentaire des ménages par rapport aux ménages dans lesquels la décision est prise par les deux sexes. Le choix du type de repas par l’homme a amélioré le niveau de sécurité alimentaire des ménages plus que les ménages où la décision est bilatérale. La dépense alimentaire de l’homme a négativement affecté le niveau de sécurité alimentaire des ménages alors que celle de la femme a contribué à son amélioration. La taille de ménage a influencé positivement le niveau de sécurité alimentaire des ménages. La promotion du genre doit être renforcée pour faciliter les décisions bilatérales de l’heure de prise de repas et responsabiliser les hommes face aux dépenses alimentaires. Gender is at the center of the debate on household food insecurity. This study aims to analyze the influence of gender participation in the decisionmaking process of mealtime and type of meal consumed in households. A sample of 295 households was randomly selected to be surveyed in NorthBenin. Data collected using a digitized questionnaire included socioeconomic characteristics, gender of the decision-maker of mealtime and type of meal consumed, the eight questions of the Household Food Insecurity Experience Scale,, etc. Data were analyzed using descriptive statistics and linear regression. The results reveal that unilateral decision-making on mealtimes by either the man or the woman negatively affected the level of household food security more than households in which the decision is made by both sexes. Man’s choice of meal type improved household food security more than households where the decision is bilateral. Man's food expenditure negatively affected the level of household food security, while women's expenditure has contributed to its improvement. Household size positively influenced the level of household food security. Gender promotion should be strengthened to facilitate bilateral decisions of mealtime and empower men to take responsibility for the food expenditures of their households.

Food supplying in Ukraine and the world under COVID-19 pandemic

The purpose of the article is to study an impact of COVID-19 pandemic on the functioning of global agricultural market, situation with food supplying in Ukraine and other countries, as well as to assess development of related processes in the near future. Research methods. Methods used: theoretical generalization - for describing the overall situation in global, regional and national agri-food markets due to the effects of coronavirus pandemic from 2020 to the present, analysis and synthesis - for studying food security in separate countries and globally for now and in the near future, taking into account current situation, finding aggregate values of world agricultural trade for the analyzed period, comparative evaluation - for comparing quantitative, cost and other relative indicators that characterize food supplying in 2019 and 2020, finding confirmatory or negative relevant trends during the incomplete year 2021, graphical and tabular - for better visualization of quantitative indicators used in the article. Research results. The dissemination of anti-pandemic measures in the world and in Ukraine is considered, the growth of absolute and relative food expenditures in different regions of the world is shown, quantitative data on undernourished people in some parts of the world are given, the situation with agri-food imports to Ukraine and its influence in 2020-2021 on the domestic market is determined, price indices for food in the world according to FAO and Ukraine according to state statistics, including quantitative consumption, are described, showed summary estimations for production major groups of crop and livestock products until 2030 inclusive. Scientific novelty. The difference in indicators of agri-food trade, food expenditures, number of people suffering from hunger, as well as price indices for basic food products in the world in general and in Ukraine in particular between "pre-pandemic" 2019 and 2020-2021, which are characterized by significant spread of the pandemic. Practical significance. The provisions of the article are aimed at informing Ukrainian agricultural enterprises with foreign economic profile, consumers of products and government agencies about changes in domestic and foreign agricultural markets in order to develop a common strategy and tactics of possible actions and systematical measures to prevent negative consequences due to significant increase in uncertainties over the past period. Tabl.: 2. Figs.: 2. Refs.: 17.

Ambient Temperature and Food Behavior of Consumer: A Case Study of China

Human behaviors are believed to be sensitive to environmental conditions. However, little is known about the role of temperature in individual daily behaviors. We examine the links between temperature and food intake using nearly one million purchasing records from China. The results show that a 1-degree Celsius increase in temperature would cause a 0.11% decrease in food intake, which amounts to 4.2 million U.S. dollars of daily food expenditures nationwide. Moreover, females appear to be more sensitive to the temperature in their food intake than males. Besides, we observe a U-shaped relationship between the temperature and the willingness to order a take-out online, and this observation is robust under multiple alternative estimations. Our results indicate that a higher temperature would reduce energy demand for body thermoregulation, resulting in less food intake. Both extreme high and low temperatures can cause disutility. Therefore, the consumers who still want to satisfy their needs for food intake feel compelled to alter their willingness to pay under the extreme temperature events. The quantitative analysis can provide helpful references for modeling the climate-consumer relationship in the IAM model. Thus, it is an interesting avenue for future research to bridge the climate and consumers to identify welfare loss and inequality due to climate change.

Catastrophic Health Expenditure and Its Determinants Among Households With Breast Cancer Patients in China: A Multicentre, Cross-Sectional Survey

Background: Although numerous studies have examined catastrophic health expenditures (CHE) worldwide, most focus on the general population, not on specific vulnerable groups. We aimed to analyse the extent and the influencing factors of CHE in households with breast cancer patients in China, and explore the ability of different insurances to protect these households from CHE.Methods: A multicentre, cross-sectional interview surveys was conducted in households with breast cancer patients across seven provinces/municipalities in China. CHE were defined as out-of-pocket expenditures ≥ 40% of households' non-food expenditures. Chi-square tests and logistic regression analysis were performed to identify the determinants of CHE in household with breast cancer patients.Results: In the 639 participating households with breast cancer patients, the mean out-of-pocket (OOP) expenditure accounted for ~55.20% of the mean households' non-food expenditures. The overall incidence of CHE was 87.95 and 66.28% before and after insurance compensation, respectively. The logistic regression model revealed that education, disease course, health insurance, treatment method, and income were significant predictors of CHE.Conclusions: The results indicated that medical insurance protects some households with breast cancer patients from the impact of CHE. However, their reimbursement rates were relatively low. Therefore, breast cancer still had a significant catastrophic effect on the economy of households. Policy efforts should focus on improving insurance compensation rates and relieving the economic burden of critical illnesses such as breast cancer.