Fruit and Vegetable Intake During Infancy and Early Childhoodhttp://pediatrics.aappublications.org/content/134/Supplement_1/S63 located on the World Wide Web at:The online version of this article, along with updated information and services, is ISSN: . 60007.

The participatory process appeared to be an effective means for stimulating change. The intervention may have slowed and perhaps reversed the tendency of adults to gain weight progressively with age.

Most Americans do not eat enough fruits and vegetables with significant variation by state. State-level self-reported frequency of fruit and vegetable consumption is available from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS). However, BRFSS cannot be used to directly compare states’ progress towards national goals because of incongruence in units used to measure intake and because distributions from frequency data are not reflective of usual intake. To help states track progress, we developed scoring algorithms from external data and applied them to 2011 BRFSS data to estimate the percent of each state’s adult population meeting United States Department of Agriculture Food Patterns fruit and vegetable intake recommendations. We used 24 hour dietary recall data from the 2007–2010 National Health and Nutrition Examination Survey to fit sex- and age-specific models that estimate probabilities of meeting recommendations as functions of reported consumption frequency, race/ethnicity, and poverty-income ratio adjusting for intra-individual variation. Regression parameters derived from these models were applied to BRFSS to estimate percent meeting recommendations. We estimate that 7–18% of state populations met fruit recommendations and 5–12% met vegetable recommendations. Our method provides a new tool for states to track progress towards meeting dietary recommendations.

IntroductionMore than 42 million people in the United States are food insecure. Although some health care entities are addressing food insecurity among patients because of associations with disease risk and management, little is known about the components of these initiatives.MethodsThe Systematic Screening and Assessment Method was used to conduct a landscape assessment of US health care entity–based programs that screen patients for food insecurity and connect them with food resources. A network of food insecurity researchers, experts, and practitioners identified 57 programs, 22 of which met the inclusion criteria of being health care entities that 1) screen patients for food insecurity, 2) link patients to food resources, and 3) target patients including adults aged 50 years or older (a focus of this assessment). Data on key features of each program were abstracted from documentation and telephone interviews.ResultsMost programs (n = 13) focus on patients with chronic disease, and most (n = 12) partner with food banks. Common interventions include referrals to or a list of food resources (n = 19), case managers who navigate patients to resources (n = 15), assistance with federal benefit applications (n = 14), patient education and skill building (n = 13), and distribution of fruit and vegetable vouchers redeemable at farmers markets (n = 8). Most programs (n = 14) routinely screen all patients.ConclusionThe programs reviewed use various strategies to screen patients, including older adults, for food insecurity and to connect them to food resources. Research is needed on program effectiveness in improving patient outcomes. Such evidence can be used to inform the investments of potential stakeholders, including health care entities, community organizations, and insurers.

As development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women. In the least-developed countries, programmes to prevent parity-related overweight should target wealthy women, whereas such programmes should be provided to all women in more developed countries.