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Greater food variety is related to increased energy intake, and one approach to reduce food intake is to reduce food variety. The effects of varying the variety of foods at the dinner meal to reduce energy intake was assessed in laboratory and field experiments. Experiment 1 randomly assigned 31 overweight children to one of three conditions that provided one laboratory meal per day over a week. Conditions were the SAME macaroni and cheese, SIMILAR types of macaroni and cheese, or a VARIETY of high-energy-dense foods. On days 1 and 5 all children consumed the same macaroni and cheese meal. Results showed significant differences in energy consumed between SAME and SIMILAR versus VARIETY from day 1 to 5, with SAME and SIMILAR decreasing and VARIETY increasing energy intake. Trials to habituation, a potential mechanism for the variety effect, showed the same pattern of between group differences as energy intake. Experiment 2 randomly assigned 30 overweight children to conditions that provided the SAME, SIMILAR or VARIETY of high-energy-dense entrees along with a variety of low-energy-dense dinner entrees to eat in their homes for four weeks. Results showed significant between group differences in energy intake across weeks, with significant decreases over weeks for the SAME and SIMILAR versus VARIETY groups. The pattern of results across the experiments shows the same pattern of reduction in energy intake if children eat the same or similar characteristics of foods (types of macaroni and cheese), which may provide ideas about how to develop dietary variety prescriptions that can reduce intake and be tested in clinical trials.

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Objectives. To estimate the population-level effectiveness and cost-effectiveness of a subsidized community-supported agriculture (CSA) intervention in the United States. Methods. In 2019, we developed a microsimulation model from nationally representative demographic, biomedical, and dietary data (National Health and Nutrition Examination Survey, 2013–2016) and a community-based randomized trial (conducted in Massachusetts from 2017 to 2018). We modeled 2 interventions: unconditional cash transfer ($300/year) and subsidized CSA ($300/year subsidy). Results. The total discounted disability-adjusted life years (DALYs) accumulated over the life course to cardiovascular disease and diabetes complications would be reduced from 24 797 per 10 000 people (95% confidence interval [CI] = 24 584, 25 001) at baseline to 23 463 per 10 000 (95% CI = 23 241, 23 666) under the cash intervention and 22 304 per 10 000 (95% CI = 22 084, 22 510) under the CSA intervention. From a societal perspective and over a life-course time horizon, the interventions had negative incremental cost-effectiveness ratios, implying cost savings to society of –$191 100 per DALY averted (95% CI = –$191 767, –$188 919) for the cash intervention and –$93 182 per DALY averted (95% CI = –$93 707, –$92 503) for the CSA intervention. Conclusions. Both the cash transfer and subsidized CSA may be important public health interventions for low-income persons in the United States.