Extension's Role in Developing "Choice" Food Pantries in Southwest Ohio

Background

Although United States' is the "land of plenty," hunger and food insecurity continue to be a reality of life for families (Nord, Andrews, & Carlson, 2004). Food insecurity occurs when there is limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways (Life Sciences Research Office, 1990).

According to a recent USDA report, 11.9% (13.5 million) of U.S. households experienced food insecurity (Nord, Andrews, & Carlson, 2004). Similarly, 11.4% of all Ohio households (approximately 1.3 million) experienced some food insecurity on an annual basis from 2002 - 2004. Food insecure households may or may not experience hunger. Approximately one out of three of food insecure households in both the U.S. and Ohio actually experienced hunger (Nord, Andrews, & Carlson, 2004). Low-income, single women with children and Black and Hispanic households have higher rates of food insecurity than the population as a whole (Nord, Andrews, & Carlson, 2004).

Previous research has demonstrated an association between low socioeconomic status and high obesity rates in industrialized countries. (Flegal, Carroll, Kuczmarski, & Johnson, 1998; Paeratuku, Lovejoy, Ryan, & Bray, 2002). However, the disparity in obesity across socioeconomic status has narrowed in the past three decades (Zhang & Wang, 2004). According to the 1971-1974 National Health and Nutrition Examination Survey (NHANES), the prevalence of obesity was 50% higher for those with low socioeconomic status than high (Zhang & Wang, 2004). However the 1999-2000 NHANES suggests the gap has narrowed to 14% (Zhang & Wang, 2004). In other words, obesity and chronic disease are a problem in all demographic groups.

Studies suggest that even food insecure populations are also especially vulnerable to becoming overweight and developing overweight-related chronic diseases such as diabetes (Healthy People 2010, 2000; Townsend, Peerson, Love, Achterberg, & Murphy, 2001; Drewnowski & Specter, 2004). The reasons for this paradoxical relationship are not entirely understood. However, research suggests that the poor diet quality is largely to blame (Drewnowski & Specter, 2004). Poverty and food insecurity are associated with lower food expenditures, low fruit and vegetable consumption, and overall low diet quality (Drewnowski & Specter, 2004).

The economics of food may contribute to poor diet quality; high-fat, high-calorie diets are often more affordable than healthy diets containing lean meats, fish, fresh vegetables, and fruit (Drewnowski, 2004). Accessibility to fresh fruits and vegetables might also pose another contributor to poor diet quality. Several studies suggest that low-income families that live in rural areas or poor central cities have less access to high quality food stores and face higher prices for fresh produce that is available (Kaufman, 1999; Mantovani, Daft, Macaluso, Welsh, & Hoffman, 1997.)

Other contributing factors to poor diet quality aside from affordability and accessibility include lack of nutrition knowledge, lack of food preparation skills, high palatability of fats and sweets (Drewnoski, 1999; Drewnoski & Specter, 2004; Bowman, Linn, Gerrion, & Bostiotes,  1998), the need to maximize caloric intake, maximizing food quantity at the expense of food quality, and overeating when food is available (Center on Hunger and Poverty and Food Research and Action Center, 2004).

Food pantries have the potential to address both food insecurity and poor diet quality by distributing a variety of nutritious food at no cost to low-income families. However according to a report by the Indiana Family and Social Services Administration, many families who need food assistance are sometimes reluctant to use traditional food pantries because they might feel ashamed to ask for hand-outs (Indiana Family and Social Services Administration, 2004). Another problem with traditional pantries is that food items are not distributed based on family needs or preferences. Many families may not know how to prepare the commodity foods distributed to them. Therefore, many of the commodities are wasted (Indiana Family and Social Services Administration, 2004).

Partnering agencies in Butler County Ohio are using the choice food pantry model to address food insecurity and poor diet quality among low-income families. Although it is not clear where the choice pantry model originates, a search of the literature suggests Indiana or Michigan (Indiana Family and Social Services Administration, 2004, and Second Harvest Gleaners Food Bank of West Michigan, 2005). A choice food pantry is organized like a grocery store where families walk through the pantry and choose food items using a point system. Typical choice food pantry commodities include canned and fresh fruits and vegetables, grains, beans, and limited meat and dairy products (dry milk). Commodities originate from private donations, food banks, and religious organizations.

The choice pantry model has many advantages over the traditional pantry model, especially in regards to addressing food insecurity and health issues. Because families choose food based on need and preference, food is less likely to be wasted (Indiana Family and Social Services Administration, 2004). Also, if families are not used to accepting donated food items, the grocery store-like atmosphere of a choice pantry might be a more dignified option than that of a traditional food pantry.

In order to address health and resource management issues, choice food pantries can integrate nutrition education within their point system to allow families to choose. For example, families learn about the food pyramid through nutrition workshops and then practice new skills when they choose food via the food groups. Education promotes nutrition and food security, a goal of choice food pantries. The differences between traditional food pantries and choice food pantries are summarized in Table 1.

Table 1.
Differences Between Traditional Food Pantries and Choice Food Pantries

Traditional Food Pantry	Choice Food Pantry
No Choice- families are handed food in a box or bag	Families choose food based on preference and need
Nutrition and resource management education is possible but not integrated	Integrates nutrition education and resource management with the choice system
Food is often wasted because families do not need or want certain food items	Food is chosen so there is less waste
Atmosphere can be degrading especially if families are not used to handouts	Dignified atmosphere- pantry is often set up like a grocery store
Goal is to alleviate immediate hunger	Goal is to promote long-term health and food security

Collaboration between Extension and Choice Food Pantries

In Butler County, Ohio choice pantries are supported by the F.E.E.D. (Feed, Educate, Empower, Distribute) alliance. The F.E.E.D. alliance is a coalition of agencies and volunteers addressing food security. Members include Shared Harvest regional food bank, pantries, community action agencies, churches, Ohio State University (OSU) Extension, Miami University, and Butler County Job and Family Services.

OSU Extension played a key role in the development of several choice pantries in Butler County. The OSU Extension Family and Consumer Sciences Educator helped develop the "Rainbow of Choice" system that allows families to choose foods based on the USDA MyPyramid Food Guidance System (USDA, 2004).

Every month, families are allowed a predetermined number of choices from each of the USDA MyPyramid food groups based on their family size. For example, a family of two may be allowed two choices from the Milk group, whereas a family of four may be allowed three choices. The "Rainbow" system is flexible enough to accommodate each individual pantry's inventory capacity. The food pantry director usually determines how many points can be distributed based on the pantry's inventory.

Commodities are placed on color-coded shelves according to where they belong in MyPyramid. For example, grains are placed on a "blue" shelf, while vegetables are placed on a "green" shelf. Extension educators, program assistants from Ohio's Family Nutrition Program (FNP), and volunteers can encourage families to choose a "Rainbow of Colors" in order to promote dietary variety.

Nutrition Education Within the Choice Food Pantry

The Family Nutrition Program (FNP) can play an integral role in the development of choice food pantries. Ohio FNP is part of the USDA Food Nutrition Service's Food Stamp Nutrition Education Program. Butler County FNP's Cupboard Cents was launched to introduce families to nutrition education while being served by choice food pantries. The FNP program assistant focuses on food safety, food security, basic nutrition, and food resource management through interactive workshops and food preparation demonstrations. Food preparation demonstrations at the food pantry might help families learn how to incorporate pantry food items into healthy well-balanced meals and snacks. Budgeting information through FNP also supports the choice food pantry's goal of helping families become more food secure.

Although families are currently not required to participate, workshops and food demonstrations during pantry hours are popular. Since Cupboard Cents was launched in January of 2004, 492 families have participated in Butler County, Ohio. Food demonstrations often focus on nutrient dense commodities that are not readily chosen by families. The FNP educator teaches food preparation skills and allows families to taste-test samples. To promote nutrition variety, the educators highlight the "colors" (food groups) used in the cooking demonstrations and encourage families to choose a "Rainbow of Colors."

The Family and Consumer Science or Community Development Educator can also facilitate volunteer trainings for choice pantries. Volunteers play a key role in that they help families make healthy choices using the "Rainbow" system, stock the shelves, and perform other critical operations. Thus, the opportunity exists to train the volunteers to offer basic nutrition education within the pantry to support nutrition education objectives.

Evaluation

Evaluation efforts are currently in progress. Focus groups of participating families, volunteers, and service providers are planned to gather qualitative opinions, attitudes, and behaviors related to choice pantries. The information will be used to improve choice pantries and to develop evaluation strategies that might assess short-term, immediate, and long-term outcomes related to diet quality and food security. Other indicators might include records of commodity inventories to document healthy choices. After several FNP food demonstration using figs in the recipe, 10,000 Ibs. of figs were chosen by families at a particular choice pantry. According to the choice pantry director, this outcome was remarkable considering the unpopularity of figs!

References

Bowman, S. A., Linn, M., Gerrion, S. A., & Bostiotes, P. P. (1998). The healthy eating index 1994-1996. Washington D.C. USDA 1998 (CNPP-5).

Center on Hunger and Poverty and Food Research and Action Center, (2004). The paradox of hunger and obesity in America. Accessed on November 2004 from http://www.frac.org/html/news/071403hungerandObesity.htm

Drewnowski, A., & Specter, S. E. (2004). Poverty and obesity: The role of energy density and energy costs. American Journal of Clinical Nutrition 79:6-16.

Drewnowski, A. (1999). Taste preference and food intake. Annual Review of Nutrition 17:237-53.

Flega,l K. M., Carroll, M. D., Kuczmarski, R. J., & Johnson, C. L. (1998). Overweight and obesity in the United States, prevalence and trends, 1960-1994. International Journal of Obesity Related Metabolic Disorders 22:39-47.

Indiana Family and Social Services Administration. Client choice food pantries: Models for now and the future. (2004). Accessed on December 2006 from http://www.in.gov/fssa/family/pdf/tefap10.pdf

Kauffman, P. K. (1999) Rural poor have less access to supermarkets, large grocery stores. Rural Development Perspective 13:19:25.

Life Sciences Research Office, S. A. Andersen, ed. (1990) Core indicators of nutritional state for difficult to sample populations. The Journal of Nutrition 120:1557S-1600S.

Mantovani, R. E., Daft, L., Macaluso, T., Welsh, J. & Hoffman, K. (1997). Authorized food retailer characteristics study: Technical support IV (Authorized Food Retailers' Characteristics and Access Study), United States Department of Agriculture, Food and Consumer Service, Office of Analysis and Evaluation.

MyPyramid.gov. United States Department of Agriculture. Accessed on December 15, 2005 from http://www.mypyramid.gov

Nord, M., Andrews, M., & Carlson, S. (October, 2004). Household food security in the United States. USDA Assistance Research Report Number 42.

Paeratakul, S., Lovejoy, J. C., Ryan, D. H, & Bray, G. A. (2002). The relation of gender, race, and socioeconomic status to obesity and obesity co-morbidities in the United States. International Journal of Obesity Related Metabolic Disorders 26:1205-10.

Second Harvest Gleaners of West Michigan. (2005). Accessed on November, 2005 from http://www.wmgleaners.org

Townsend, M. S. Peerson, J., Love, B., Achterberg C., & Murphy, S. P. (2001). Food insecurity is positively related to overweight in women. Journal of Nutrition 1; 131:1738-1745.

Zhang, Q., & Whang, Y. (2004) Trends in the association between obesity and socioeconomic status in U.S. Adults: 1971 to 2000. Obesity Research 12(10): 1622-1632.

U.S. Department of Health and Human Services. (2000) Healthy people 2010. 2nd Edition. Washington DC: US Government Printing Office.