J. A. Wolfson

University of Michigan School of Public Health · Department of Health Management and Policy

Importance There is increasing interest in strategies to encourage more environmentally sustainable food choices in US restaurants through the use of menu labels that indicate an item’s potential impact on the world’s climate. Data are lacking on the ideal design of such labels to effectively encourage sustainable choices. Objective To test the ef...

Objectives. To examine the effects of childhood participation in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on adult food security in the United States. Methods. We used data from the 1984 to 2019 waves of the Panel Study of Income Dynamics to follow a b...

Objectives To analyze the associations between food insecurity (FI) and diabetes distress (DD) related to COVID-19 in adults with pre-diabetes/diabetes in the United States (US). Methods We fielded a national, web-based survey among low-income adults in the US (N = 1,756). Measures included FI status, using the 18-item USDA Household Food Security...

Objectives. To describe food insecurity in the United States in December 2020 and examine associations with underuse of medical care during the COVID-19 pandemic. Methods. We fielded a nationally representative Web-based survey in December 2020 (n = 8318). Multivariable logistic regression models and predicted probabilities were used to evaluate fa...

Background The Yale Food Addiction Scale 2.0 (YFAS 2.0) operationalizes food addiction (FA) by applying the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5) criteria for substance use disorder (SUD) to the overconsumption of highly processed foods. The YFAS 2.0 has been quantitatively validated across numerous populations...

Background Food insecurity is a critical public health problem in the United States (US) that has been associated with poor diet quality. Cooking dinner more frequently is associated with better diet quality. Objective This study aimed to examine how food insecurity and dinner cooking frequency are associated with diet quality during the initial m...

The COVID-19 pandemic caused widespread non-essential business closures in the U.S., which may have disproportionately impacted food consumption in lower-income communities, in part due to reduced access to healthy and affordable foods, as well as occupations that may have required working outside the home. The aims of this study were to examine re...

Background Ultra-processed foods contribute to risks of obesity and cardiometabolic disease, and higher intakes have been observed in low-income populations in the US. Consumption of ultra-processed foods may be particularly higher among individuals experiencing food insecurity and participating in the Supplemental Nutrition Assistance Program (SNA...

Although Mexican immigrants to the United States (US) have historically held health and mortality advantages over US-born groups, evolving population dynamics in Mexico paired with shifts in Mexico-US immigration patterns and policy regimes have raised new concerns about the metabolic health of recent cohorts of Mexican immigrants. Using a national...

Early COVID-19 pandemic data showed a spike in both food insecurity and poor mental health. The purpose of this study was to examine the relationship between food insecurity and mental health outcomes nine months after the start of the COVID-19 pandemic. A national survey of adults 18 years and older was administered in December 2020 (N=8,355). Mul...

Objective Chefs have the potential to influence diet quality and food systems sustainability through their work. We aimed to assess the attitudes and perceptions of culinary students about nutrition and sustainability as part of their roles, responsibilities and future work as chefs. Design We surveyed students attending the Culinary Institute of...

The potential negative effects of the COVID-19 pandemic on health-compromising behaviors including overeating, processed food intake, and alcohol use have been well documented. However, it is possible the COVID-19 pandemic has had positive effects on some health-promoting behaviors like cooking and fruit and vegetable intake. The current study was...

Introduction Food insecurity has been associated with adverse health and academic outcomes among college students. However, little is known about the long-term impacts of experiencing food insecurity during college. This study examines the impacts of college food insecurity (measured from 1999 to 2003) on future food insecurity (measured from 2015...

Objective To examine the effect of food insecurity during college on graduation and degree attainment. Design Secondary analysis of longitudinal panel data. We measured food insecurity concurrent with college enrollment using the 18-question USDA Household Food Security Survey Module. Educational attainment was measured in 2015-2017 via two questi...

Nutrition during pregnancy has lifelong impacts on the health of mother and child. However, this life stage presents unique challenges to healthy cooking and eating. Cooking interventions show promising results, but often lack theoretical basis and rigorous evaluation. The objective of this formative, qualitative study was to explore motivators, st...

Background Food insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown. Objectives This study examined the association between food insecurity a...

Eating a healthy diet is important for managing diabetes. Although there are high rates of diabetes in low-income urban areas, these patients often have limited access to fruits and vegetables. The 15-week Fresh Prescription (Fresh Rx) program was designed to improve access and consumption of fruits and vegetables among low-income patients with dia...

Background Consumer demand for vegetarian options is growing. Fast-food restaurants have responded by adding high-profile vegetarian offerings, but little is known about the overall availability or nutrient profile of vegetarian options at these establishments, or how these items compare with nonvegetarian items. Objective The purpose of this stud...

The Supplemental Nutrition Assistance Program (SNAP) is critical to alleviating food insecurity, but low diet quality among program participants is a concern. Nutrition-related interventions have focused on SNAP-authorized food retailers, but the perspectives of small food store owners and managers have not been represented in national policy discu...

The coronavirus SARS-CoV-2 (COVID-19) pandemic has created widespread stress. Since many people cope with stress by eating, the current study investigated whether eating behaviors shifted among U.S. adults after the emergence of the pandemic. Data from national, crowdsourced surveys conducted on March 31st, 2020 and February 13th, 2019 were compare...

Purpose: To understand associations between food insecurity and depression, anxiety, and stress during the COVID-19 pandemic among low-income adults in the United States. Methods: During March 19-24, 2020, we fielded a national, web-based survey (53% response rate) among low-income adults (<250% of the federal poverty line) in the United States (N=...

Cooking interventions have been criticised for their weak designs and ‘kitchen sink’ approach to content development. Currently, there is no scientific guidance for the inclusion of specific skills in children’s cooking interventions. Therefore, a four step method was used to develop age-appropriate cooking skill recommendations based on relevant d...

The frequency of cooking at home has not been assessed globally. Data from the Gallup World Poll in 2018/2019 wave (N=145,417) were collected in 142 countries using telephone and face to face interviews. We describe differences in frequency of ‘scratch’ cooking lunch and dinner across the globe by gender. Poisson regression was used to assess predi...

Public efforts to limit the spread of the coronavirus rely on motivating people to cooperate with the government. We test the effectiveness of different governmental messengers to encourage preventive health actions. We administered a survey experiment among a sample (n=1,545) of respondents across the United States, presenting them with the same s...

Background/objectives: Food insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of the present study were to: (1) examine national trends in food insecurity across a 10-year perio...

This study examined the prevalence of loneliness and relationship with cooking and eating habits among older adults using data collected in December 2019 from a nationally representative sample age 50-80 through the National Poll on Healthy Aging. Older adults who live alone were more likely those who lived with others (19% vs. 8%) and those with a...

Context Frequent consumption of home-prepared meals is associated with higher diet quality in children and adults. Therefore, increasing the culinary skills of women and couples during their childbearing years may be an effective strategy for the prevention of overweight and obesity. Objective To determine the impact of culinary nutrition-educatio...

Background Health-related warning labels may reduce the intake of sugar-sweetened beverages (SSBs), but the effectiveness of such labels in real-world settings is not well established. Objectives We investigated the influence of warning labels on SSB intake among college students at a large public Midwestern university. Methods We conducted a qua...

Importance: Restaurants spend billions of dollars on marketing. However, little is known about the association between restaurant marketing and obesity risk in adults. Objective: To examine associations between changes in per capita county-level restaurant advertising spending over time and changes in objectively measured body mass index (BMI) f...

As of this writing, more than 177 000 Americans have died of COVID-19, and nearly 6 million cases have been confirmed in the United States. The pandemic has exposed and exacerbated serious disparities along racial/ethnic and socioeconomic lines with low-income Americans and Black and Hispanic Americans being the most likely to get sick and die from...

In the past two decades, food insecurity has increased by 45% among older adults but its relationship to health outcomes has not been extensively studied. The objective of this study was to examine the associations between food insecurity, multiple chronic conditions, and self-reported health status among a nationally representative sample of older...

Purpose Food insecurity is a concern on college campuses and is correlated with other basic needs insecurities. We examined the cumulative burden of food, financial, and housing insecurities on college students’ health and academic performance. Design Cross-sectional survey. Setting Large, public Midwestern university. Sample A total of 793 coll...

Domestic cooking education programs are typically designed to improve an individual’s food and cooking skills, although not necessarily diet quality. Currently, there are no comprehensive models to guide the planning, implementation and evaluation of domestic cooking education programs that focus on improving diet and health. Our aim was to address...

The COVID-19 pandemic has dramatically increased food insecurity in the United States (US). The objective of this study was to understand the early effects of the COVID-19 pandemic among low-income adults in the US as social distancing measures began to be implemented. On 19–24 March 2020 we fielded a national, web-based survey (53% response rate)...

“Food agency” is one’s ability to procure and prepare food within the contexts of one’s social, physical, and economic environment. In 2018, we used Amazon TurkPrime to field two large national surveys in the United States (US) to examine food agency and several food- and cooking-related factors. The first survey (n = 1,457) was fielded in a nation...

Introduction Fast food restaurants, including top burger chains, have reduced calorie content of some menu items in recent years. However, the extent to which the nutrition profile of restaurant menus is changing over time is unknown. Methods Data from 2,472 food items on the menus of 14 top-earning burger fast food chain restaurants in the U.S.,...

Background: Prior research on the restaurant environment and obesity risk is limited by cross-sectional data and a focus on specific geographic areas. Objective: To measure the impact of changes in chain restaurant calories over time on body mass index (BMI). Design: We used a first-difference model to examine whether changes from 2012 to 2015...

Cooking at home is likely to be associated with benefits to diet and health. However, the nuanced perceptions and practices linked to different types of cooking are not yet fully understood. This research aimed to explore the specific concept of ‘home cooking’, using qualitative research from the UK and US. Data from two previously completed studie...

Objective To examine the association between cooking frequency and Healthy Eating Index (HEI)-2015, overall and by income, among US adults. Design Cross-sectional analysis using multivariable linear regression models to examine the association between cooking frequency and total HEI-2015 score adjusted for sociodemographic variables, overall and s...

Introduction: Food insecurity during young adulthood affects physical health, mental health, and academic performance. However, little is known about parental and behavioral factors during childhood that may contribute to risk of food insecurity during young adulthood. Methods: Data were obtained from the Panel Study of Income Dynamics’ Child Deve...

Objective:To understand price incentives to upsize combination meals at fast-food restaurants by comparing the calories (i.e. kilocalories; 1 kcal = 4·184 kJ) per dollar of default combination meals (as advertised on the menu) with a higher-calorie version (created using realistic consumer additions and portion-size changes). Design:Combination mea...

Introduction: During the past 2 decades, gun owners have become more likely to store household firearms loaded and unlocked, and believe that guns make homes safer rather than more dangerous. Methods: Self-reported household firearm storage practices were described among 2,001 gun owners in relation to whether they report that firearms make home...

Background: Food insecurity is a growing issue of concern on college campuses. While many studies have focused on predictors of food insecurity, fewer studies have examined how food insecurity affects diet and diet-related outcomes among college students. Objective: The objective of this study was to examine differences in dietary intake, food a...

Introduction: The nutrient profile of combination meals in large chain restaurants is not well understood. Methods: Combination meals from 34 U.S. fast food and fast casual restaurants (lunch/dinner, n=1,113; breakfast, n=366) were identified from online menus in 2017-2018 and corresponding nutrition information for each menu item was obtained f...

Objective To measure whether parenthood is associated with changes in produce purchasing behavior, overall and stratified by income. Design Retrospective examination of retail grocery purchases in the Nielsen Consumer Panel, a nationally representative sample of US households, 2007–2015. Participants and Setting A total of 21,939 households in th...

Objectives: To characterize the nutrient profile of combination meals and understand price incentives to upsize at large U.S. fast food and fast casual restaurants. Methods: Combination meals (n = 1479) from 34 U.S. fast food and fast casual restaurants were identified from online menus and corresponding nutrition information was obtained from a...

Purpose: Food insecurity is a psychosocial stressor with deleterious effects on mental health. This study examined whether the local food environment moderates the association of individual food insecurity with poor mental health. Methods: Cross-sectional survey data were collected from adult residents of Flint, Michigan (n=291), in 2015. Multivari...

Purpose: Supplemental Nutrition Assistance Program (SNAP) participants are important stakeholders in improving program policies, but their voices have not been included in the public discourse. Methods: We assessed the opinions of 202 SNAP participants and 368 food-insufficient nonparticipants on proposed SNAP policies. Results: The majority of SNA...

To examine how barriers to healthy food access and household income are associated with cooking and eating behaviors we fielded a nationally representative survey among 1112 adults in the United States in 2015. The survey included measures of barriers to accessing healthy food, household income, and frequency of cooking and eating meals, cooking pr...

Introduction Little is known about female gun owners in the USA. We describe the number and type of firearms owned, and reasons for owning, by sex. Methods An online survey conducted in 2015 of 3949 US adults; cross-tabulations using survey weights generated nationally representative estimates. Results Twelve per cent (95% CI 10.6% to 13.6%) of w...

Objective The goal of this study was to understand the association between children's neighborhood food access and overweight/obesity in a national sample of US households, and whether this association differs by Supplemental Nutrition Assistance Program (SNAP) participation or household purchases. Methods Data were obtained from the National Hous...

Objective Excess meat consumption, particularly of red and processed meats, is associated with nutritional and environmental health harms. While only a small portion of the population is vegetarian, surveys suggest many Americans may be reducing their meat consumption. To inform education campaigns, more information is needed about attitudes, perce...

Introduction: Large chain restaurants have reduced calories in their new menu items. No research has examined the calorie content of items eliminated from these menus. Methods: Data are from the MenuStat project (2012-2015), which includes 66 of the 100 largest U.S. chain restaurants (n=27,238 items), to compare: (1) mean calories for items on t...

Introduction: Consuming too much sodium is associated with increased risk for cardiovascular disease, and restaurant foods are a primary source of sodium. This study assessed recent trends in sodium content of menu items in U.S. chain restaurants. Methods: Data from 21,557 menu items in 66 top-earning chain restaurants available from 2012 to 201...

Researchers studying consumer food-behaviors, like cooking, in everyday life require better tools for assessment of food-related abilities. This study presents a measurement tool for assessing cooking and food-preparation practices: the Cooking and Food Provisioning Action Scale (CAFPAS). The CAFPAS is based on the “Food Agency” framework for under...

Purpose The purpose of this paper is to describe the development of – and need for – an expanded understanding of cooking (skills and knowledge) to inform research on the connection between cooking and health. Design/methodology/approach This paper describes a concept of “food agency” and contrasts it with how cooking is commonly conceived in food...

Objectives: To estimate US public opinion, overall and by gun ownership status, about the public places where legal gun owners should be allowed to carry firearms. Methods: We fielded an online survey among 3949 adults, including an oversample of gun owners and veterans, in April 2015. We used cross-tabulations with survey weights to generate na...

No prior studies examining changes in the calorie content of chain restaurants have included national data before and after passage of federal menu labeling legislation, required by the 2010 Affordable Care Act. This paper describes trends in calories available in large U.S. chain restaurants in 2008 and 2012 to 2015 using data were obtained from t...

Objective: Investigate attention to Nutrition Facts Labels (NFLs) with numeric only vs both numeric and activity-equivalent calorie information, and attitudes toward activity-equivalent calories. Design: An eye-tracking camera monitored participants' viewing of NFLs for 64 packaged foods with either standard NFLs or modified NFLs. Participants s...

Declines in cooking skills in the United States may contribute to poor diet quality and high obesity rates. Little is known about how Americans learn to cook or their support for cooking education policies. The objective of this study was to examine how Americans learn to cook, attributions of responsibility for teaching children how to cook, and p...

Introduction: A high intake of fast food is associated with increased obesity risk. This study assessed recent changes in caloric content and macronutrient composition in large U.S. fast food restaurants. Methods: Data from the MenuStat project included 11,737 menu items in 37 fast food restaurants from 2012 to 2014. Generalized linear models we...

Objective: Despite the importance of cooking in modern life, public perceptions about what it means to cook are unknown. We aimed to examine perceptions of cooking and their association with cooking confidence, attitudes and behaviours in the USA. Design: We designed and fielded a nationally representative survey among US adults (n 1112) in Apri...

Every year, gun violence imposes an unacceptable toll on people in the United States. In 2014, the most recent year for which final data are available, 33 599 people died from gun violence; the majority of these deaths were suicides (> 21 000 deaths), and firearm homicides accounted for more than 11 000 deaths.(1) Unintentional shootings, in which...

Background Little is known about national patterns in the use of fast food and packaged food labels among adults by weight loss strategies and demographic characteristics. Methods We analyzed the Consumer Behavior Module in the National Health and Nutrition Examination Survey 2007–2010 among adults (N = 9,690). For each of the outcome variables –...

Gun violence is a critical public health problem in the United States, but it is rarely at the top of the public policy agenda. The 2012 mass shooting in Newtown, Connecticut, opened a rare window of opportunity to strengthen firearm policies in the United States. In this study, we examine the American public's exposure to competing arguments for a...

Beginning in December 2016, calorie labeling on menus will be mandatory for US chain restaurants and many other establishments that serve food, such as ice cream shops and movie theaters. But before the federal mandate kicks in, several large chain restaurants have begun to voluntarily display information about the calories in the items on their me...

The relationship between food and health is complex. Everyone needs food to live, but too little food, too much food, or the wrong type of food has negative consequences for health. To increase understanding of this relationship, we describe trends and patterns in food-related diseases among both adults and children. Using an ecological framework,...

Despite the importance of cooking in American life and evidence suggesting that meals cooked at home are healthier, little is known about perceptions of what it means to cook in the United States. The objective of this study was to describe perceptions of cooking and factors important to how cooking is perceived and practiced among American adults....

Large chain restaurants reduced the number of calories in newly introduced menu items in 2013 by about 60 calories (or 12%) relative to 2012. This paper describes trends in calories available in large U.S. chain restaurants to understand whether previously documented patterns persist. Data (a census of items for included restaurants) were obtained...

To describe national trends in discretionary calories from sugar sweetened beverage (SSB) and snacks by age-specific body weight categories and by age- and weight-specific race/ethnicity groups. Examining these subpopulations is important as population averages may mask important differences. 24-hour dietary recall data obtained from the National H...

More frequent cooking at home may help improve diet quality and be associated with food values, particularly for individuals participating in the Supplemental Nutrition Assistance Program (SNAP). To examine patterns of fruit and vegetable consumption and food values among adults (aged 20 and older) in the United States, by SNAP participation and ho...

ContextThe public's views of parents’ behaviors and choices—and the attitudes held by parents themselves—are likely to influence the success of efforts to reverse obesity rates.Methods We analyzed data from 2 US national public opinion surveys fielded in 2011 and 2012 to examine attributions of blame and responsibility to parents for obesity, both...

Caramel color is added to many widely-consumed beverages as a colorant. Consumers of these beverages can be exposed to 4-methylimidazole (4-MEI), a potential carcinogen formed during its manufacture. California's Proposition 65 law requires that beverages containing 4-MEI concentrations corresponding to exposures that pose excess cancer risks >1 ca...

Objective: To provide national estimates of snack patterns for sugar-sweetened beverage (SSB) drinkers and non-SSB drinkers among U.S. children and adults. Methods: We analyzed 24-h dietary recall data obtained from the National Health and Nutrition Examination Survey 1999-2010 among children (ages 2 to 19) and adults (aged 20 and older) (N=46,9...

Introduction: Cooking is recommended as a healthy diet behavior. This research examines national patterns in cooking frequency and diet quality among adults in the USA, overall and by weight loss intention. Methods: Analysis of cross-sectional 24-hour dietary recall data (adults aged ≥20 years old) from the 2007-2010 National Health and Nutrition...

Background Supply-side reductions to the calories in chain restaurants are a possible benefit of upcoming menu labeling requirements. Purpose To describe trends in calories available in large U.S. restaurants. Methods Data were obtained from the MenuStat project, a census of menu items in 66 of the 100 largest U.S. restaurant chains, for 2012 and...

To examine whether weight loss strategies are associated with consumption of sugar-sweetened beverages (SSBs), snacks or food values. Cross-sectional analysis of 24-h dietary recall data obtained from the National Health and Nutrition Examination Survey 2007-2010 (N=9440). Adults trying to lose weight consumed roughly 2000 total calories, 250 calor...

Objectives: We examined national patterns in adult diet-beverage consumption and caloric intake by body-weight status. Methods: We analyzed 24-hour dietary recall with National Health and Nutrition Examination Survey 1999-2010 data (adults aged ≥ 20 years; n = 23 965). Results: Overall, 11% of healthy-weight, 19% of overweight, and 22% of obes...

There is considerable debate about whether sugar-sweetened beverages (SSBs) should be allowable purchases with benefits from the Supplemental Nutrition Assistance Program (SNAP). To examine national patterns in adult consumption of SSBs by SNAP eligibility. Cross-sectional analysis of 24-hour dietary recall data obtained from the National Health an...