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Objective: Sugar-sweetened beverage (SSB) consumption has declined steadily. This study uses the latest national data to examine trends in SSB consumption among children and adults by race and/or ethnicity and to document whether long-standing disparities in intake remain. Design: Trend analyses of demographic and dietary data measured by 24-hour dietary recall from the National Health and Nutrition Examination Survey (NHANES). Setting: Data from the 2003-2004 through 2017-2018 NHANES survey cycles were analyzed in 2020. Participants: The study sample included 21,156 children aged 2-19 years and 32,631 adults aged 20+ years. Results: From 2003-2004 to 2017-2018, the prevalence of drinking any amount of SSBs on a given day declined significantly among all race and/or ethnicity groups for children (non-Hispanic [NH] White: 81.6% to 72.7%; NH Black: 83.2% to 74.8%, Hispanic: 86.9% to 77.2%) and most race and/or ethnicity groups for adults (NH White: 72.3% to 65.3%; Hispanic: 84.6% to 77.8%). Consumption declined at a higher rate among NH Black and Hispanic children aged 12-19 years compared to their NH White peers; among NH Black children aged 6-11 years, the rate of decline was lower. Despite significant declines in per capita SSB calorie consumption from soda and fruit drinks, consumption of sweetened coffee/tea beverages increased among older children and nearly all adults, and consumption of sweetened milk beverages increased among NH White and Hispanic children. Conclusions: SSB consumption has declined steadily for children and adults of all race and/or ethnicity groups, but disparities persist, and overall intake remains high.

The United States Department of Agriculture (USDA) National School Lunch and Breakfast Programs are critical for the health and food security of U.S. schoolchildren, but access to these programs was disrupted by COVID-19 pandemic-related school closures in spring 2020. While temporary policy changes to the programs enabled school food authorities (SFAs) to pivot towards distributing meals throughout their communities instead of within school buildings, SFAs faced complex challenges during COVID-19 with minimal external support. This mixed methods study investigates the implementation and financial challenges experienced by twelve of the largest urban SFAs in the U.S. during COVID-19. We conducted semi-structured interviews with SFA leaders and analyzed alongside quantitative financial data. We found that SFAs reconfigured their usual operations with nearly no preparation time while simultaneously trying to keep staff from contracting COVID-19, accommodate stakeholders with sometimes competing priorities, and remain financially solvent. Because student participation was much lower than during regular times, and revenue is tied to the number of meals served, SFAs saw drastic decreases in revenue even as they carried regular operating costs. For future crises, disaster preparedness plans that help SFAs better navigate the switch to financially viable community distribution methods are needed.

Background: Making decisions about food is a critical part of everyday life and a principal concern for a number of public health issues. Yet, the mechanisms involved in how people decide what to eat are not yet fully understood. Here, we examined the role of visual attention in healthy eating intentions and choices. We conducted twoalternative forced choice tests of competing food stimuli that paired healthy and unhealthy foods that varied in taste preference. We manipulated their perceptual salience such that, in some cases, one food item was more perceptually salient than the other. In addition, we manipulated the cognitive load and time pressure to test the generalizability of the salience effect. Results: Manipulating salience had a powerful effect on choice in all situations; even when an unhealthy but tastier food was presented as an alternative, healthy food options were selected more often when they were perceptually salient. Moreover, in a second experiment, food choices on one trial impacted food choices on subsequent trials; when a participant chose the healthy option, they were more likely to choose a healthy option again on the next trial. Furthermore, robust effects of salience on food choice were observed across situations of high cognitive load and time pressure. Conclusions: These results have implications both for understanding the mechanisms of food-related decisionmaking and for implementing interventions that might make it easier for people to make healthy eating choices.

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