The American Public Health Association (APHA) Annual Meeting and Expo is the largest yearly gathering of public health professionals. This year, the annual meeting is being held virtually October 24-28, 2020. Researchers from the University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute will be presenting their work on a variety of collaborative food and nutrition policy studies related to the child care food environment, school meals, the federal Supplemental Program for Women, Infants and Children (WIC), and more. A full list of on-demand poster presentations and live oral presentations is below.

Child care food environment: 

• California childcare centers and homes in the federal child and adult care food program offer more nutritious foods to infants
  Presenters: Danielle Lee, Klara Gurzo, Lilly Nhan, Elyse Homel Vitale, Sallie Yoshida, Lorrene Ritchie
  Poster presentation
  
  
• Online training increases child care provider knowledge of healthy beverage policy and practices for young children
  Presenters: Kaela Plank, Danielle Lee, Abbey Alkon, Marisa Neelon, L. Karina Diaz Rios, Katherine Soule, Lorrene Ritchie
  Poster presentation

School meals: 

• Impact of a district-wide chocolate milk removal policy on students' milk selection and consumption 
  Presenters: Hannah Thompson, Lorrene Ritchie, Kristine Madsen, Esther Park, Wendi Gosliner
  Oral presentation, Wednesday, October 28, 2020, 8:15-8:30 AM PDT

WIC: 

• Families with children 1-5 years old: WIC program perspectives on nutrition education and food benefits
  Presenters: Marisa Tsai, Lorrene Ritchie, Shannon Whaley, Catherine Martinez, Martha Meza, Lauren Au, Hallie Randel-Schreiber, Susan Sabatier
  Oral presentation, Wednesday, October 28, 2020, 8:00-8:15 AM PDT
  
  
• Children on WIC followed through age 4 years: What are they eating?
  Presenters: Lorrene Ritchie, Lauren Au, Shannon Whaley, Christine Borger
  Oral presentation, Wednesday, October 28, 2020, 9:30-9:50 AM PDT
  
  
• Feeding beliefs and practices among low-income caregivers: Findings from year 4 of the WIC infant and toddler feeding practices study-2
  Presenters: Courtney Paolicelli, Christine Borger, Lorrene Ritchie, Shannon Whaley
  Oral presentation, Wednesday, October 28, 2020, 9:50-10:10 AM PDT

• Prevalence of overweight and obesity among children receiving WIC
  Presenters: Christine Borger, Shannon Whaley, Lorrene Ritchie
  Oral presentation, Wednesday, October 28, 2020, 10:10-10:30 AM PDT
  
  
• Longer participation in WIC is associated with healthier outcomes for children at age 4 years
  Presenters: Shannon Whaley, Christine Borger, Lauren Au, Lorrene Ritchie
  Oral presentation, Wednesday, October 28, 2020, 10:30-10:50 AM PDT

Other topics: 

• Exploring housing and food insecurity among California university students: A holistic and comprehensive definition of students' basic needs
  Presenters: Suzanna Martinez, Erin Esaryk, Laurel Moffat, Lorrene Ritchie
  Oral presentation, Tuesday, October 27, 12:00-12:15 PM PDT
  
  
• Healthy default beverages in kids' meals: Evaluating policy implementation and impact in California and Delaware
  Presenters: Allison Karpyn, Wendi Gosliner, Laura Lessard, Kathleen McCallops, Marisa Tsai, Tara Tracy, Phoebe Harpainter, Danielle Lee, Anna Martin, Lorrene Ritchie, Gail Woodward-Lopez
  Oral presentation, Tuesday, October 27, 4:45-5:00 PM PDT
  
  
• Perceived produce availability and child fruit and vegetable intake: The healthy communities study
  Presenters: Laurel Moffat, Lorrene Ritchie, Wendi Gosliner, Kaela Plank, Lauren Au
  Oral presentation, Wednesday, October 28, 2020, 10:15-10:30 AM PDT
  
  
• Limited progress found in healthy checkout among food stores in economically disadvantaged California neighborhoods, 2011-2017
  Presenters: Wendi Gosliner, Sriddharshi Hewawitharana, Janice Kao, Sadie Costello, Gail Woodward-Lopez
  Poster presentation
  
  
• A replication study of school-based SNAP-ed programmatic efforts to address student nutrition and physical activity outcomes
  Presenters: John Pugliese, Lauren Whetstone, Sridharshi Hewawitharana, Gail Woodward-Lopez
  Poster presentation
  

Children in child care can consume up to two-thirds of their daily nutrition in these settings, and healthy feeding practices and obesity prevention efforts in childcare can support childrens' health later in life. Lorrene Ritchie, director of the Nutrition Policy Institute and University of California Cooperative Extension (UCCE) specialist, is a leading expert in the field of infant and toddler feeding. Ritchie presented findings on transitional feeding practices for infants in child care – with a focus on family child care home settings – to attendees of the 95th Nestlé Nutrition Institute Workshop - Building Future Health and well-being of thriving toddlers and young children. The workshop was hosted virtually September 14-16, 2020. Ritchie's presentation was titled “Transition from breastfeeding and complementary feeding to toddler nutrition in childcare settings.” Ritchie shared findings from collaborative research on infant and child nutrition and feeding practice standards for child care providers with NPI researcher Danielle Lee, Lauren Au of the University of California, Davis, and Elyse Homel Vitale of the Childcare Food Program Roundtable. A recording of Ritchie's presentation is available for viewing online.

Nutrition Policy Institute's Lorrene Ritchie, director and University of California Cooperative Extension (UCCE) specialist, has been studying the diet quality of low-income children enrolled in the federal Supplemental Nutrition Assistance Program for Women, Infants and Children (WIC). This research is part of the United States Department of Agriculture's (USDA) WIC Infant and Toddler Feeding Practices Study (WIC ITFPS-2), also known as the "Feeding My Baby" study. Ritchie and her research colleagues Christine Borger of Westat, Inc., Courtney Paolicelli of the USDA Food and Nutrition Services, and Shannon Whaley of Public Health Foundation Enterprise WIC, presented the latest findings from children enrolled in WIC at age four years during the virtual  National WIC Association Nutrition Education and Breastfeeding Promotion Annual Conference on September 10, 2020. Their presentation was titled, “Now we are four! Findings at age four from the WIC Infant and Toddler Feeding Practices Study (WIC ITFPS-2)."

The federal Supplemental Nutrition Assistance Program for Women, Infants and Children (WIC) provides nutritious foods, information on healthy eating including breastfeeding promotion and support, and referrals to health care to over 6.3 million low-income pregnant, postpartum, and breastfeeding women, infants, and children up to age 5 in the US. Nutrition Policy Institute's (NPI) Lorrene Ritchie is the Co-Principal Investigator of the national WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2), which received additional funding from the United States Department of Agriculture (USDA) in partnership with Westat, Inc. to extend data collection for children up to 9 years of age enrolled in the national WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2). Ritchie and her NPI research team will contribute to the investigation of dietary practices and the health and nutritional status of children in this cohort during their ninth year of life. This project builds off the WIC ITFPS-2 study funded by the USDA Food and Nutrition Services, which began in 2011. The study extension begins in October 2020 and continues for five years.

Nutrition Policy Institute's Wendi Gosliner was awarded a $439,345 California Department of Food and Agriculture (CDFA) Specialty Crop Block Grant to partner with Impact Justice and ChangeLab Solutions to increase demand for California-grown fruits, vegetables and nuts in California Department of Corrections and Rehabilitation (CDCR) state prisons. The CDCR is the largest California state food purchaser, with over $150 million in purchases annually. The project will educate CDCR stakeholders about the benefits of procuring and serving more California grown specialty crops; work with stakeholders to develop policy and systems-level changes to promote procurement of California grown specialty crops; and work with formerly incarcerated individuals to understand opportunities and barriers to increasing consumption of California grown specialty crops in CDCR facilities and to provide them with nutrition education. The project broadly will reach 120,000 incarcerated people. The two-year project begins November 2020.

Daily physical activity supports youth physical and phychosocial health and is also important for obesity prevention. Schools are an important location for physical activity promotion and obesity prevention given youth spend up to half of their waking hours in school. The latest study from Nutrition Policy Institute (NPI) researchers suggests that United States Department of Agriculture (USDA) Supplemental Nutrition Assistance Program Education (SNAP-Ed, and known asCalFresh Healthy Living (CFHL) in California) physical activity interventions at school-sites are associated with slightly lower body mass index (BMI) and greater cardiovascular fitness in students compared to sites that did not receive these interventions. Further, schools with higher intervention levels had students with the highest cardiovascular fitness levels. Interventions included physical activity-related direct education, where students were actively engaged with an educator; indirect education, where students received information or resources related to physical activity; or changes to the school or district's physical activity related policies, systems, and/or environments (PSE). Student-level FitnessGram(R) data from between 2015-2016 was obtained from the California Department of Education for the study. Researchers compared BMI and student cardiovascular fitness levels from over 97,000 fifth and seventh grade students from 904 California public schools that implemented the SNAP-Ed physical activity interventions to over 372,000 fifth and seventh grade students from 3,506 California public schools that did not implement the interventions. These findings are important as the California Department of Public Health's Nutrition Education and Obesity Prevention Branch distributes over $50 million in CFHL funding to local health departments to implement physical activity and nutrition interventions, which primarily occur in the public school setting. Also, California has more public schools than any other US state. The study was published online in the journal Preventive Medicine Reports. The study was conducted by NPI's Hannah Thompson, Sridharshi Hewawitharana, Janice Kao, Carolyn Rider, Evan Talmage, Wendi Gosliner and Gail Woodward-Lopez in collaboration with Lauren Whetstone of the California Department of Public Health. The study was funded by the California Department of Public Health, with funding from the USDA Supplemental Nutrition Assistance Program. The full study is available online.

Lorrene Ritchie, director and UC Cooperative Extension (UCCE) specialist at the University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute (NPI), Hannah Thompson, NPI epidemiologist and research scientist at the UC Berkeley School of Public Health, and Marisa Neelon, UCCE nutrition, family and consumer sciences advisor, were quoted in an October 12, 2020 article in The Daily Californian titled "UC Berkeley study shows intervention affect school lunch participation." The article highlights a collaborative three-year study with San Francisco Unified School District Student Nutrition Services (SFUSD SNS) to evaluate a dining redesign intervention with the goal of increasing school lunch participation among SFUSD middle and high school students. The article highlights research findings that were published in two journals, the International Journal of Environmental Research and Public Health and Childhood Obesity. Dr. Thompson is quoted, “While interventions helped stave off the decline of student lunch participation, a big conclusion of this study is that larger economic policies and conditions are actually much more impactful on participation.” Dr. Ritchie is quoted, "We found that these positive perceptions towards school lunch also increased reports of consumption of fruits and vegetables among students very modestly.” Neelon added, “Increasing participation and consumption of school meals can potentially address the shortfall in adolescent's intake of fruits and vegetables. Additionally, the closure of schools due to COVID-19 has elevated the importance of school meals to meet the nutritional needs of food-insecure families.” The study was funded by the US Department of Agriculture (USDA) through a grant from the Agriculture and Food Research Initiative (AFRI). Read the full article online.

Schools across the US are removing chocolate milk from their offerings in an effort to reduce students' added sugar intake and support their long-term health. University of California, Division of Agriculture and Natural Resources, Nutrition Policy Institute (NPI) researchers' latest study exploring the effects of these policies on students' milk intake was featured in an article in Feedstuffs. The article highlights the researchers findings that chocolate milk removal policies produced no significant reductions in average intake per student of calcium, protein or vitamin D from milk and that added sugar consumption from milk declined significantly, by 3.1 g per student. The study was conducted by NPI affiliated researchers Hannah Thompson and Esther Park from the UC Berkeley School of Public Health in collaboration with NPI researchers Lorrene Ritchie and Wendi Gosliner, and Kristine Madsen from the Berkeley Food Institute and UC Berkeley School of Public Health.

Plain water is recommended to replace sugar-sweetened beverages to support health, yet concerns about tap water safety and barriers to access present challenges to making water the beverage of choice. In a new article, Nutrition Policy Institute (NPI) researchers and collaborators review evidence through a socioecological lens – considering the complex web of individual, relationship, community, and societal factors that influence water consumption. The paper reviews intake of drinking water in the US compared to requirements across age and racial/ethnic groups showing that most people do not drink enough plain water. It describes US regulations that support safe drinking water as well as strategies to reduce drinking water exposure to lead. Programs, policies, and environmental interventions that support access to safe and appealing drinking water, which is necessary to improve water intake, are also discussed, concluding with recommendations for research, policies, regulations, and practices needed to ensure optimal water intake by all. The review was published online in September 2020 by the journal Annual Review of Nutrition. Authors include Anisha Patel of Stanford Medicine Division of General Pediatrics, NPI researchers Christina Hecht and Lorrene Ritchie, Angie Cradock of Harvard T.H. Chan School of Public Health, and Marc Edwards of Virginia Polytechnic Institute and State University.

Behavioral health disorders, such as depression and anxiety, affect a significant number of Americans each year. In 2017 one in eight youths between 12 to 17 years old experienced a major depressive episode compared to one in 14 adults. Approximately one in three people in the US have experienced an anxiety disorder in their lifetimes, with women experiencing anxiety at rates two times that of men. Further, rates of these illness have increased since the coronavirus pandemic came to the US. Poor diet quality has been implicated with the development of depression, anxiety and other psychiatric conditions given the essential role of key dietary nutrients in the body's nervous and hormone systems. Nutrients naturally found in food and beverages--such as tryptophan, vitamin B6, vitamin B12, folate, phenylalanine, tyrosine, histidine, choline, and glutamic acid--are critical for the production of the key neurotransmitters--serotonin, dopamine, and norepinephrine--involved in the regulation of mood, appetite and cognition. Therefore, improving diet quality may contribute to the prevention and treatment of these illnesses.

Nutrition Policy Institute (NPI) researcher Gail Woodward-Lopez contributed to a collaborative narrative review that describes the global burden and features of depression and anxiety and summarizes the latest scientific evidence on diet and nutrition in the prevention and management of these illnesses. The review concludes with a call for nutritional medicine to be incorporated into psychiatric practice to support individuals in achieving a healthy dietary pattern, one rich in fruits, vegetables, whole grains, low-fat dairy, and lean protein foods. It further recommends additional research be conducted to better understand how diet affects behavioral health disorders. The review was published online in the journal Nutrition Reviews on May 24, 2020. The study was conducted in collaboration with Penny Kris-Etherthon and Kristina Petersen of the Pennsylvania State University, Department of Nutritional Sciences; Joseph Hibbeln of the National Institute of Health, National Institute on Alcohol Abuse and Alcoholism; Daniel Hurley of the Mayo Clinic; Valerie Kolick of the US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; Sevetra Peoples of the George Washington University, Milken Institute School of Public Health; and Nancy Rodriguez of the University of Connecticut, Department of Nutritional Sciences. The study was conducted as a project of the President's Council on Fitness, Sports & Nutrition Science Board, of which NPI's Woodward-Lopez was a member. The study is available online.