Food insecurity occurs when household members experience a change in their diets due to limited resources. Compared with all households, food insecurity is more prevalent among those with children in the United States. In approximately half of those households, children did not directly experience food insecurity, indicating that coping strategies, or actions to manage food insecurity, may help prevent this situation by limiting changes to the quality and quantity of the diet. The aim of this scoping review is to summarize and examine documented coping strategies used by low-income households with children in the United States and provide insights for interventions that could improve food security. PubMed, CINAHL, Scopus, and PsycINFO were searched up to January 2026. Two independent reviewers screened articles in Covidence through title/abstract and full-text stages using predefined inclusion and exclusion criteria. Conflicts were reconciled through discussion to reach a consensus. Results and key themes of each study were extracted and synthesized narratively regarding coping strategies to manage food security. Twenty-five studies were identified through the screening process, and 5 key themes were identified: food acquisition, food management, financial coping, reliance on support from family members or friends, and coping strategies implemented by children. Most studies focused on strategies used by mothers and parents, whereas others examined strategies used by the entire household or by children. The findings suggest that multiple members of food-insecure households with children use coping strategies, providing insights for future interventions to improve food security. The protocol for this review is registered with Open Science Framework, and its registration DOI is 10.17605/OSF.IO/H7TCF.

Background: Adolescents need nutrient-dense foods for growth, and eggs are a nutritious option to help meet nutrient needs. Objectives: This study aimed to assess the relationship between egg-consumption categories and nutrient intake, nutrient adequacy and nutrient exposure scores among US adolescents. Methods: Adolescents in the 2007-2018 NHANES (14-17 y; n = 3691) with at least one 24-h dietary recall and supplement data were included. Egg consumption was categorized as nonegg consumer, consumer of eggs as ingredients, or consumer of a primarily egg dish. Usual nutrient intakes, nutrient adequacy, and nutrient exposure scores for intakes from all sources [i.e., total nutrient index (TNI); scored 0-100; foods + supplements] and foods alone [i.e., Food Nutrient Index (FNI); 0-100] were estimated using the National Cancer Institute method. Pairwise t-tests compared the nutrient markers across the 3 egg-consumption groups. Results: US adolescents failed to meet various nutrient adequacy markers, highlighting a high risk of inadequacy for calcium, magnesium, vitamin D, and vitamin E, and a low percentage above the adequate intake for choline. Primarily egg dish consumers exhibited higher mean usual intakes for lutein + zeaxanthin, choline, vitamin A, selenium, vitamin D, riboflavin, docosahexaenoic acid (DHA), and protein than nonegg consumers; and for lutein + zeaxanthin, choline, selenium, and DHA than those consuming eggs as ingredients (P < 0.001). Consuming eggs as ingredients showed higher iron and vitamin E intakes compared with not consuming eggs. Consumers of eggs, either primarily dishes or as ingredients had higher TNI scores (P < 0.001) for total (76 and 71 compared with 65), magnesium (69 and 66 compared with 60) and potassium (83 and 80 compared with 73) and FNI scores for potassium (82 and 80 compared with 73) than nonegg consumers, respectively. Conclusions: US adolescents consuming eggs, as primarily dishes or ingredients, had better compliance in meeting nutrient markers compared with nonegg consumers, highlighting associations between eggconsumption and nutrient intake.

Technology offers new opportunities to support healthier food choices, particularly for individuals in low-income communities who face systemic barriers to obtaining nutritious, affordable groceries. We introduce a novel conceptual model of grocery planning that frames food purchasing as a multi-objective optimization problem that considers cost, nutrition components, and a consumer’s personal dietary goals. Guided by Zimmerman’s model of Self-Regulated Learning and prior research on food agency, we designed the Food Information System, a planning tool that provides optimized product recommendations aligned with users’ goals by integrating store inventory, prices, and nutritional data. We evaluated our system in an eight-week within-subjects intervention with 55 participants from a food-insecure community, followed by focus group sessions. While overall Healthy Eating Index scores remained largely stable, participants reported improved nutritional awareness and greater perceived agency in planning and purchasing groceries. We discuss design implications to support food agency by promoting long-term food literacy and by enhancing autonomy in making food choices.

Background/Objectives: This review examined how different levels of U.S. food-security (FS) relate to dietary markers, informing the concept of nutrition security over the lifespan. Methods: The authors followed PRISMA-ScR guidelines. PubMed, CINAHL, Scopus, Embase, and CAB Abstracts were searched for eligible U.S.-based, English-language studies examining FS and dietary markers in free-living, disease-free populations, excluding COVID-19-era research. Two reviewers independently screened records in Covidence, with discrepancies resolved by a third reviewer. The percentage of studies evaluating >2 FS levels was determined. Dietary markers were classified into three domains: food and beverage (9 components), nutrient (16 components) and bioactive (2 components) markers. The percentages of studies with significant differences were estimated for each dietary domain. Results: Of 1069 records, 78 met full-text eligibility. Among these, 15% evaluated dietary markers across >2 FS levels. Among adults, differences by FS status were observed in 67% of assessed food and beverage components (6 out of 9), 50% of nutrient components (8 out of 16), and all evaluated bioactives (100%; 2 out of 2). Children exhibited differences in all assessed food and beverage components (100%; 9 out of 9) and 29% (2 out of 7) of nutrients by FS level. Adolescents had fewer dietary marker differences than children and adults. Findings among infants, pregnant women and older adults were limited, with no studies for lactating women. Conclusions: Low FS level is associated with poorer dietary markers across the lifespan compared with FS. Age-specific differences highlight the need for targeted interventions and nutrition security measures.

Background: Longer-term (≥1 y) associations between federal food assistance and federal nutrition education with BMI are unclear. Objectives: This exploratory study determined the relationship of participation in a federal nutrition education intervention and self-selected food assistance program participation, and their combination on BMI for ≥1 y. Methods: Women (≥18 y) from Indiana, the United States were experimentally assigned to receive federal nutrition education of the United States (US) Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program, including the 4 lessons fulfilling SNAP-Ed guidance (n = 59) or not (n = 47), or to a control group, in this longitudinal study from August 2015 till May 2017 (registered at www.clinicaltrials.gov as NCT03436784). Food assistance participation was self-selected. Main outcomes were averaged triplicate measured height and weight for BMI at baseline and 1-y by trained paraprofessionals. Analysis included mixed linear models comparing BMI over time by participation in the intervention or not, food assistance or not, or combinations of both programs. Results: Obesity was classified for most participants (>60%) at both time points. BMI did not differ, nor were differences observed in BMI change >1 y based on receiving SNAP-Ed, food assistance programs, or their combination. Conclusions: Weight was constant >1 y regardless of receiving federal nutrition education, food assistance programs, or their combination, suggesting neither these programs nor their combination cause weight gain among low-income US women in this preliminary study of these interventions among this sample.

Food insecurity is a situation of limited food access because of not having enough resources that ∼14% of the United States population experienced in 2023. The federal food assistance program, Supplemental Nutrition Assistance Program (SNAP), and its accompanying nutrition education program, SNAP-Education (SNAP-Ed), have kept these estimates as low as they are. The legislation enacted through the One Big Beautiful Bill Act in 2025 changed both programs, imposing expanded SNAP work requirements and completely terminating SNAP-Ed. We comment on how these changes may impact those who were formerly eligible or participating in these programs and argue for the elimination of SNAP work requirements and the expansion of SNAP-Ed to provide more support toward health and food security for all Americans.

Determining trends in what Americans eat is important for determining shortfalls, assessing overconsumption, developing dietary guidance, creating dietary interventions, informing nutrition education and food product design, and understanding dietary risks to health, among other reasons. This review uses a historical lens to consider the early estimation of diet, specifically the intake of certain nutrients in small samples of US males, as well as the nationally representative estimation and tracking of usual dietary patterns, including dietary quality and beverage and food group intake among population groups. The trends in what Americans eat currently and over time are synthesized with evidence of how the factors of age, sex, race/ethnicity, and income may or may not differentiate food and beverage intake and which are most influential to meeting dietary recommendations. The results provide a rich context to inform future trends, dietary needs, and improvement.

Objective Two objectives comprise this study: determining the effect of adult-focused direct nutrition education on adult and child dietary quality and household food security using a longitudinal (1 year) randomized, waitlist-controlled, nutrition education intervention of 4 core lessons, including > 200 Indiana parent/child dyads; creating new nutrition education material to improve healthful diets in households with children. Description Nutrition education is designed to improve dietary quality and food security among limited-resource families, but potential improvements in both have not been evaluated among parents and children within the same household, nor has nutrition education focused on the specific situation of food insecurity among households with children been designed. Evaluation The longitudinal study to fulfill the first objective is being performed. Multiple 24-hour dietary recalls for both parent and child and food security from the US Household Food Security Survey Module at baseline and 1-year follow-up will be used to determine potential changes in the intervention and control groups over time using mixed models. The second objective will use those results, along with results from 2 scoping literature reviews that were completed to determine factors contributing to diet and food security and coping mechanisms in low-resource households, to develop new nutrition education content for households with children. Conclusions and Implications Recruitment for the study and baseline data collection for > 200 parent-child dyads is complete. Both scoping reviews are also complete, one showing that nutrition education holds promise for dietary and food security improvement in parents and children relevant to food procurement/preparation, along with meal and food planning, and the other identifying helpful coping mechanisms such as using food assistance and prioritizing dietary quality. Future nutrition policy may be informed by this study to foster healthful dietary behavior and food security.

Accurately assessing dietary behavior change receptivity is essential for designing effective just-in-time adaptive interventions (JITAIs) that promote healthier eating habits. However, self-report-based assessment of behavior change receptivity is sparse and delayed, limiting its practical use in continuous monitoring. To explore whether passive sensing may help address this challenge, this study conducts a pilot investigation of inferring participants' self-reported behavior change receptivity from egocentric eating images collected by a wearable camera. We use pilot data obtained from free-living eating episodes using the Automatic Ingestion Monitor v2 (AIM-2). The data included egocentric image sequences captured during eating and paired with responses to questions assessing specific dimensions of behavior change receptivity (awareness, interaction capability, and motivation). To examine whether visual information contained any relevancy to these responses, we evaluated a transfer-learning-assisted framework that combines a pre-trained Contrastive Language-Image Pre-Training (CLIP) vision encoder with a lightweight transformer classifier. The model processes eating episode image sequences to extract potential semantic and temporal cues related to behavior change receptivity. Preliminary experimental results show promising improvements over simple baseline models for behavior change receptivity indicators. These early findings suggest that egocentric eating episode images may contain cues related to dietary behavior change receptivity, and warrant further investigation with larger and more comprehensive datasets.

Objective To develop and implement strategies to improve food and nutrition security among families with young children based on comprehensive community input. Description Food and nutrition security are now more important than ever, considering recent cuts to nutrition-related programs. This abstract summarizes challenges and preferences of improving food and nutrition security of families with young children as part of a 5-year US Department of Agriculture’s Agriculture and Food Research Initiative grant project. Parents (n = 37) of children aged 0–5 years old at risk for food insecurity from 2 Florida counties were recruited to participate in an individual interview. A semistructured script contained questions on perceived challenges to obtain adequate, high-quality, and age-appropriate food for their young children and to identify preferences and needs regarding technology-based approaches for improving food and nutrition security among families. Evaluation Qualitative interview data were analyzed using thematic analysis. Data from parents were triangulated with prior collected qualitative and quantitative feedback from community stakeholders with a vested interest in food security or early childhood (n = 31), food pantry site inventories (n = 38), food pantry workers (n = 25), and an advisory committee (n = 31). Major barriers to accessing food exist for families with young children, including limited awareness of available resources, transportation challenges, restrictive eligibility requirements for nutrition assistance, and stigma. In addition, parents requested centralized and digitally accessible information to include assistance in locating food, nutrition education, nonfood essentials (e.g., diapers), child care, and transportation assistance. Conclusions and Implications New strategies are needed to improve food and nutrition security in families with young children. To address identified barriers and needs to improving food and nutrition security, an early childhood food security strategy toolkit and mini-grant program will be disseminated to community partners to implement recommended strategies.

Background/Objectives: The study’s objective was to determine whether social isolation serves as a mediator in the cross-sectional relationship between food insecurity, both as a short-term and longer-term situation, with resource use and depressive symptoms as outcomes. Methods: This cross-sectional design study utilized secondary survey data, including 30-day and 12-month food security measured by the U.S. Household Food Security Survey Module. The Baron–Kenny mediation approach was used to determine whether social isolation mediated the relationship between food security, depressive symptoms, and resource use (p ≤ 0.05). Results: Social isolation mediates the association between both 30-day and 12-month food security with depressive symptoms but not resource use. Conclusions: Acknowledging and targeting social isolation, policies, and interventions that integrate peer support and community outreach to promote food security could support rural veterans food security and mental health.

Deep learning-based food recognition has made significant progress in predicting food types from eating occasion images. However, two key challenges hinder real-world deployment: (1) continuously learning new food classes without forgetting previously learned ones, and (2) handling the long-tailed distribution of food images, where a few common classes and many more rare classes. To address these, food recognition methods should focus on long-tailed continual learning. In this work, We introduce a dataset that encompasses 186 American foods along with comprehensive annotations. We also introduce three new benchmark datasets, VFN186-LT, VFN186-INSULIN and VFN186-T2D, which reflect real-world food consumption for healthy populations, insulin takers and individuals with type 2 diabetes without taking insulin. We propose a novel end-to-end framework that improves the generalization ability for instance-rare food classes using a knowledge distillation-based predictor to avoid misalignment of representation during continual learning. Additionally, we introduce an augmentation technique by integrating class-activation-map (CAM) and CutMix to improve generalization on instance-rare food classes. Our method, evaluated on Food101-LT, VFN-LT, VFN186-LT, VFN186-INSULIN, and VFN186-T2DM, shows significant improvements over existing methods. An ablation study highlights further performance enhancements, demonstrating its potential for real-world food recognition applications.

The potential of using Large Language Models (LLMs) themselves to evaluate LLM outputs offers a promising method for assessing model performance across various contexts. Previous research indicates that LLM-as-a-judge exhibits a strong correlation with human judges in the context of general instruction following. However, for instructions that require specialized knowledge, the validity of using LLMs as judges remains uncertain. In our study, we applied a mixed-methods approach, conducting pairwise comparisons in which both subject matter experts (SMEs) and LLMs evaluated outputs from domain-specific tasks. We focused on two distinct fields: dietetics, with registered dietitian experts, and mental health, with clinical psychologist experts. Our results showed that SMEs agreed with LLM judges 68% of the time in the dietetics domain and 64% in mental health when evaluating overall preference. Additionally, the results indicated variations in SME-LLM agreement across domain-specific aspect questions. Our findings emphasize the importance of keeping human experts in the evaluation process, as LLMs alone may not provide the depth of understanding required for complex, knowledge specific tasks. We also explore the implications of LLM evaluations across different domains and discuss how these insights can inform the design of evaluation workflows that ensure better alignment between human experts and LLMs in interactive systems.

The marked individual variability in response to common dietary exposures necessitates tailoring of dietary guidance to individuals, or small groups of individuals with similar needs, to optimize health. This is a complex task requiring integration of environmental, cultural, psychological, and biological contributions. Work in the area of precision nutrition is an effort to translate science into practice. A research roadmap developed through a National Institutes of Health conference identified many of the inputs that require quantification. Better characterization of ingestive behaviors is one key area. The aim of this narrative review is to summarize current understanding of the influences of age, sex, body mass index, ethnicity, and genetics on ingestive behaviors, including culture, sensory function, appetite, dietary intake, the gut-brain axis, and microbiome. To do so, the extant literature was accessed through search engines relevant to the various topics covered. Outcomes assessed varied topically. In addition to compiling evidence on the nature and magnitude of these relationships, this review highlights the degree of individual variability in attributes or responses to an intervention. More broadly, it documents: 1) that cause-and-effect relationships are difficult to establish as most are dynamic and interactive; 2) there are inherent and learned contributions to both behavior and biology that will require different considerations and offer different opportunities for manipulation; 3) a focus on intuitive approaches may not be as successful as desired; 4) that external influences can, and often do, override internal influences of biology; and 5) there are multiple ways to construct healthful diets. At the same time, it is vital that improved methods to characterize the multiple relevant inputs to ingestive behavior be developed. It is hoped that the evidence compiled here will inform efforts to develop precision nutrition guidance.

Background/Objectives: Eggs, a nutritious and affordable food, are not widely consumed by adolescents, who show many nutrient inadequacies. Modeling dietary substitutions with eggs and their costs can provide dietary insights while considering economic constraints. This study theoretically modeled the impact of substituting an egg for another protein source, considering nutrient quality and cost, using exemplary menus with application to adolescents. Methods: The substitution was modeled in four different seven-day exemplary menus: (1) the Healthy U.S.-Style Dietary Pattern (HUSS), (2) Harvard Medical School's Heathy Eating Guide, (3) the National Heart, Lung, and Blood Institute's Dietary Approaches to Stop Hypertension (DASH) diet and (4) the Healthy U.S.-Style Vegetarian Dietary Pattern (HVEG). One egg replaced the gram amount and nutrient profile of a protein source food in each menu. Micronutrient quality was assessed using the Food Nutrient Index (FNI), scored 0-100. The Center for Nutrition Policy and Promotion Food Price Database informed the food prices. Pairwise t-tests compared the effects of egg substitution on micronutrient scores and daily costs. Results: The daily egg substitution increased FNI scores for choline and vitamin D in the HUSS (83 to 95 and 69 to 75, respectively), DASH (80 to 91 and 55 to 59, respectively), and HVEG (91 to 100 and 44 to 51, respectively), and choline alone (89 to 98) in the Harvard menu. Daily menu prices were not significantly different after the egg substitution (p > 0.01). Conclusions: Substituting one egg for another protein source food increased the micronutrient quality of choline and vitamin D in exemplary menus without increasing the cost; however, factors such as food preferences and the economic accessibility of eggs in different contexts should also be considered.

Large Language Models (LLMs) have the potential to contribute to the fields of nutrition and dietetics in generating food product explanations that facilitate informed food selections. However, the extent to which these models offer effective and accurate information remains unverified. In collaboration with registered dietitians (RDs), we evaluate the strengths and weaknesses of LLMs in providing accurate and personalized nutrition information. Through a mixed-methods approach, RDs validated GPT-4 outputs at various levels of prompt specificity, which led to the development of design guidelines used to prompt LLMs for nutrition information. We tested these guidelines by creating a GPT prototype, The Food Product Nutrition Assistant, tailored for food product explanations. This prototype was refined and evaluated in focus groups with RDs. We find that the implementation of these dietitian-reviewed template instructions enhance the generation of detailed food product descriptions and tailored nutrition information.

In the United States, the pay-what-you-can restaurant model (community cafes) is an increasingly popular approach to addressing food insecurity in local communities. We conducted semi-structured interviews (n = 13) with community café executive managers and directors to assess their perceptions of the role that their cafes play in addressing food security (FS). Analysis of interviews revealed two major areas of emphasis by participants. Filling an unoccupied space in the food security landscape. Interviewees regularly cited the goal of making meals available through a dependable schedule, convenient location, and welcoming atmosphere for guests to promote regular visits to the café, and they did so with an awareness of how their practices were shaped by perceived shortcomings in comparable services. In addition, guest agency and social aspects of the café as components of utilization, was another major area. Interviewees often regarded the opportunity of the food insecure guest to choose healthy options (i.e., nutritionally dense) over less healthful ones (i.e., calorically dense) from the menu as a critical component of their service. The social component of the café (e.g., community atmosphere, ‘dining-out’ experience) was another aspect of the café’s function that promoted dignity for the guest which can lead to greater likelihood of return visits. Perceptions shared by participants of the café’s role in addressing food security suggest that rather than simply adding to the available options of hunger relief services, the café model attempts to address many areas of concern, such as structural and cultural barriers, found in the traditional forms of charitable food provision.