Background The COVID-19 pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support, and identify long-term impacts and needs. Objective The National Food Access and COVID research Team (NFACT) was formed to assess food security over different U.S. study sites throughout the pandemic, using common instruments and measurements. This study present results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. Methods A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA six-item module. Food security prevalence was analyzed using analysis of variance by sampling method to statistically significant differences. Results Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, as compared to before the pandemic. In nearly all study sites, there is higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but statistically higher prevalence of food insecurity among high-risk compared to convenience surveys. Conclusions This comprehensive study demonstrates higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to survey implementation method. Summary Multi-site assessment demonstrates widespread food insecurity during COVID-19, especially on households with children, job loss, and Black, Indigenous, People of Color across multiple survey methods.

Self-reported fruit and vegetable (FV) consumption in children has limitations that could be overcome with objective measures that are easy to implement. The Veggie Meter (VM) is a non-invasive portable device that measures skin carotenoid levels, a concentration biomarker of usual FV intake. While VM has been used to measure FV consumption in adults, few studies have explored its use in elementary school settings. Designing research studies using the VM with elementary school-age children requires an understanding of how well this device can be used in a school setting and of the distribution of VM scores in this population. We used VM to measure skin carotenoids in a diverse sample of 143 elementary school children who also answered commonly asked questions about consumption frequency of FV the previous day. Multivariable regression was used to assess the independent association of demographic variables with VM scores. VM scores were also compared with student-reported FV intake. There was a weak but statistically significant correlation between reported frequency of total vegetable consumption the previous day and observed VM scores (r = 0.174, p = 0.042). This study provides an example of the successful use of the VM in a school setting to collect an objective measure of FV intake and provides important description of data that can inform future studies.

No abstract

Exposures to favorable environments in childhood, including those in schools, are associated with healthy habits among children. In this study, we developed a series of indices aimed at measuring students' exposure to different dimensions of the school food and physical activity (PA) environment. We implemented these indices to investigate how different aspects of the school food and PA environment changed over time and examined their correspondence with known changes in relevant policies and programs. Methods: All public schools (n¼ 141) in four school districts in New Jersey provided detailed food and PA environment data for each school year from 2010e2011 to 2015e2016. Seven food environment indices, three PA environment indices, and two additional indices that capture healthpromoting initiatives at the school level and at the state or federal level were developed. Results: Although the school PA environment largely remained unchanged, several dimensions of the school food environment changed between 2010e2011 and 2015e2016. Overall, the number of healthy items increased over time in vending machines (p < .001), a la carte (p < .05), or through reimbursable school lunches (p < .001); decreases in number of unhealthy items were only detected in school lunches (p < .05). For most food indices, both the number of items offered and the trend over time varied across school levels. Conclusions: Schools are a key venue for implementing policy and environment interventions aimed to promote healthy behaviors. Indices developed from easy-to-use survey questions captured multiple dimensions of the school food and PA environments and were sensitive to policy changes over time.

(1) Background: It is unknown whether parents’ perception of school meals, a determinant of student meal participation, align with the nutritional quality of meals served in schools. This study compares the healthfulness of foods offered in schools with parental perception of school meals at those same schools. (2) Method: Parents were asked to rate the healthfulness of school meals at their child’s school. Data on the types of foods offered were collected from public schools in four cities in New Jersey and matched with parent-reported data. Measures were developed to capture the presence of healthy and unhealthy items in the National School Lunch Program and the presence of a la carte offerings as well as vending machines. Multivariable analysis examined the association between parental perceptions of school meals and the school food measures after adjusting for covariates. (3) Results: Measures of the school food environment and parental perceptions were available for 890 pre-K to 12th grade students. No significant associations were observed between parental perceptions and food environment measures when examined one by one or in a comprehensive model. (4) Conclusions: Parents’ perception of the healthfulness of meals served do not align with the nutritional quality of foods offered at schools.