As you mentioned in your post access to cheap food is everywhere, particularly, within lower income areas. While nutritious food lacks both accessibility and affordability for all. The lack of access and affordability for nutritious foods sets up consumers to rely on cheap food whether it is fast food, processed food, or non-organic produce with less nutrients.

You make a great point that while one may not want to choose cheap food it has become a necessity to a degree because of food deserts in lower income areas. Rather than attempting to find ways t provide more nutritious foods it appears that corporations have taken advantage of these communities by bringing in more cheap food options such as fast food chains.

which leads me to wonder does the government truly care? What needs to happen for the government to change and provide access to nutritious food for all? As you pointed out early, many people have busy lives, but I think ultimate responsibility lies with us.

Busy are our lives are, we should put some of that hobby time aside if our health and the health of our family is important, and make it a priority to learn about and make informed choices about food.

You must be logged in to post a comment. Carolan, Michael S. The Real Cost of Cheap Food. Routledge, Many people work full time sometimes with more than one job , have family obligations, go to school, and attempt to have hobbies. All of this activity leaves little time to wonder about the food we are eating and the system we are contributing to when we make food choices.

Many people leading this busy lifestyle reach for what is fast, convenient, and more often than not, cheap. People who live in poverty are also reaching for cheap food, not just because it will buy them more food but also because in many poor areas they are subject to food deserts.

Food deserts are areas that lack access to fresh produce and other nutritious foods that create a balanced and healthy diet.

Eating food that lacks nutrition leads to obesity which can lead to what are known as western diseases, such as diabetes, heart disease or stroke. If there is a known correlation between a lack of nutrient rich food and obesity and the diseases that often accompany it, then why is there more access to cheap food than nutritious food?

The government subsidizes the things that contribute to American obesity, such as sugar and fat. It may seem like a choice to eat the unhealthy quick meal, but it becomes less of a choice and more of a necessity when considering food prices and options.

As you mentioned in your post access to cheap food is everywhere, particularly, within lower income areas. While nutritious food lacks both accessibility and affordability for all. The lack of access and affordability for nutritious foods sets up consumers to rely on cheap food whether it is fast food, processed food, or non-organic produce with less nutrients.

You make a great point that while one may not want to choose cheap food it has become a necessity to a degree because of food deserts in lower income areas.

This study in an experimental web-based supermarket examined the effects on food purchases of price discounts on healthy foods in combination This cheap and healthy grocery list includes tips and recommendations on ways to make smart purchases on nutritious foods without breaking SNAP healthy incentive programs encourage people participating in SNAP to purchase healthy foods by providing a coupon, discount, gift card, bonus food item

Discounted food choices - 12 healthy and affordable foods for your grocery list · Brown rice. · Cans or packets of chicken or tuna. · Dried beans and lentils. · Eggs. · Frozen This study in an experimental web-based supermarket examined the effects on food purchases of price discounts on healthy foods in combination This cheap and healthy grocery list includes tips and recommendations on ways to make smart purchases on nutritious foods without breaking SNAP healthy incentive programs encourage people participating in SNAP to purchase healthy foods by providing a coupon, discount, gift card, bonus food item

Add a side of rice, beans, or salad for a satisfying lunch or dinner. Enjoy probiotics. Non-dairy probiotic foods include sauerkraut, vegetables that have been pickled in brine rather than vinegar, miso soup, and tempeh.

Use canned fish or chicken as a healthy, inexpensive option for things like sandwiches, enchiladas, casseroles, and salads. Preparing large portions of food to use over multiple meals can save you time and energy as well as money.

Cook once and eat multiple times. Cook a large meal at the beginning of the week so that you have extra to use later in the week when you don't feel like cooking. One-pot dishes , such as soups, stews, or casseroles, save on preparation time, money, and dishwashing.

Freeze leftovers or re-use them for lunch. For a cheap and nutritious breakfast, cook one pot of oatmeal and heat up a serving each morning; vary it by adding fruit, nuts, or seeds. Instead of throwing away leftovers or forgetting about them at the back of the fridge, get creative and use them to make new meals.

Soups, stews, or stir-fries. Create a base with broth or a sauce, or by sautéing onion or garlic, then add any leftovers you have.

A small amount of meat is perfect to add flavor and substance. You can also experiment with herbs and spices to create unique flavors.

Everything burritos. Most leftovers make very tasty burritos. Simply put everything into a tortilla shell try to get whole grain with a little cheese or salsa and enjoy.

Experiment with combinations. You may be surprised how many foods with different flavors go well together. For example, try making a large green salad and adding cooked whole grains and veggies on the top, as well as pieces of meat from another meal. If you live in a dorm, bachelor apartment, hotel room, or other type of housing without a full kitchen, you may have limited space to store perishables and leftovers and minimal kitchen equipment for cooking your own meals.

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Most of us crave sweets from time to time. But instead of expensive, processed desserts packed with sugar, such as cakes, cookies, and muffins, there are healthier ways to satisfy a sweet tooth.

If you don't have a Popsicle tray, use an ice-cube tray with plastic spoons as handles. Home-baked items. Oatmeal cookies with rolled oats are a good example of a healthier, home-baked dessert.

Try reducing the amount of sugar any recipe calls for—many desserts taste just as good. Buy a large container of plain yogurt and make each serving unique by adding seasonal fruit. Frozen treats. Try freezing grapes or berries or cutting bananas or peaches into pieces and then freezing.

For an amazing dessert pour dark chocolate sauce over the fruit. Dark chocolate. Many of us have chocolate cravings—and dark chocolate is actually quite high in antioxidants. Eat Well Guide or Local Harvest. How focusing on the experience of eating can improve your diet. This diet can help fight heart disease, diabetes, cognitive decline, and more.

How choosing healthier carbs can improve your health and waistline. BetterHelp makes starting therapy easy. Take the assessment and get matched with a professional, licensed therapist. Millions of readers rely on HelpGuide. org for free, evidence-based resources to understand and navigate mental health challenges.

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Harvard Health Partnership Audio Meditations Newsletter. The challenge of eating well on a budget. Healthy Eating Eating Well on a Budget Today, many of us are living on a budget and looking for ways to reduce food expenses.

Copy Link Link copied! Download PDF. By Lawrence Robinson and Melinda Smith, M. The challenge of eating well on a budget Eating healthy for less is about more than just the cost of food Eat healthy for less tip 1: Plan ahead Tip 2: Make smart food choices Tip 3: Shop wisely Tip 4: Find cheaper protein options Tip 5: Stretch your money when you cook Tip 6: Make sweet treats healthy and affordable.

Reviewed by Tami Best, MS, RDN, CDN, IFNCP , a Certified Registered Dietitian at Top Nutrition Coaching specializing in gastrointestinal issues and mental health modifications The challenge of eating well on a budget Eating a healthy diet is crucial to your mental and emotional health as well as your physical wellbeing.

Eating healthy for less is about more than just the cost of food The pleasure of eating even the simplest of meals increases when you share it with other people.

Eat healthy for less tip 1: Plan ahead Saving money on food involves revising your shopping habits, eliminating waste, and focusing on healthier choices—and that can require a little planning ahead. Tip 2: Make smart food choices Try to eliminate unhealthy foods from your list, such as soda, cookies, crackers, prepackaged meals, and processed foods.

Can you eat organic on a budget? However, there can still be ways to enjoy the higher quality and stay within your budget: Opt for locally grown food. Tip 3: Shop wisely The neighborhood grocery store is not the only place to shop.

Shopping tips Wherever you choose to shop, these tips can help you stick within your budget. Join a grocery store savings club for more discounts and savings.

Tip 4: Find cheaper protein options Your body relies on protein for many of its functions. Plan on eating out less. But a meal for two at a fast-food restaurant in the U.

Preparing a simple, healthy beef stew or roast chicken with vegetables, for example, can cost a fraction of that and leave you with leftovers as well. Create your shopping list. As you prepare meals throughout the week, make a note of food and supplies you need.

Check your cupboards, refrigerator, and freezer to see what you already have and make a note of any upcoming expiration dates. Keep a supply of staples. These include such ingredients as olive oil, flour, old-fashioned oats, nuts, seeds, frozen vegetables and fruit, dried herbs and spices, pasta, brown rice, stock cubes, and canned tomatoes, beans, and fish.

Find cheap and healthy recipes. Try to think of foods that are versatile yet nutritious. For example, combining foods in different bowls and creating different sauces and seasonings can add variety and interest to your meals. Brown rice topped with black beans, corn, salsa, and chili-lime seasoning or sauce creates an inexpensive and easy Mexican dish.

An easy switch-up could be to use the same rice, but with edamame, cubed chicken, and soy or stir-fry sauce for a balanced meal with an Asian flare. Try to eliminate unhealthy foods from your list, such as soda, cookies, crackers, prepackaged meals, and processed foods.

These foods are packed with unhealthy ingredients and offer little in the way of nutrition. These junk foods can also often cost you much more than the price on the sticker. A poor diet can take a toll on your health and lead to increased medical and drug bills as well as reduced energy and productivity.

Choose whole foods. Convenience foods can save you time, but will cost you more. For example, buying a block of cheese and slicing or grating it yourself is cheaper than buying processed cheese slices or bags of grated cheese—and helps you avoid additives to prevent caking, etc.

Similarly, buying a head of lettuce and washing and chopping it yourself is cheaper than purchasing bagged salad—and will often stay fresher for longer. Buy frozen fruits and vegetables. Frozen fruits and veggies are just as nutritious as their fresh counterparts and still taste good, but are often less expensive.

They'll also last longer than fresh fruits and vegetables, preventing expensive food waste. If you have freezer room, the largest frozen bags tend to offer the best value.

When you shop at conventional grocery stores, the store or generic brand will often be cheaper than the name brand for the same quality product. Look for simple ways to save money throughout the day. Instead of picking up a morning coffee on your way to work or school, for example, make your coffee at home.

Instead of buying breakfast or lunch, prepare your own using leftovers or home-made salads, sandwiches, or boiled eggs. Buy in bulk. Buying non-perishable items, such as dried beans and canned fish, in bulk can save you money as well as shopping time.

If you have the space, you can store bulk-bought grains and cereals in airtight containers and freeze perishable items, such as meat and bread, in smaller portions to use as needed.

Alternatively, you can split them with a friend—saving you both money. Shop for produce in season and buy by the bag.

When produce is in season it is at its cheapest, as well as its tastiest and most nutritious. Look for whole grains. Whole, unprocessed grains such as brown rice, oats, and quinoa are often less expensive than their processed alternatives sugar-laden cereals, white rice, and white bread and contain little to no harmful added sugar and refined flour.

Drink water instead of soda. While organically grown food reduces the potential health and environmental hazards posed by pesticides, genetically modified organisms, irradiation, and additives, it can often cost more than conventionally grown food.

However, there can still be ways to enjoy the higher quality and stay within your budget:. Opt for locally grown food. Some small local farmers use organic methods but aren't certified organic due to the cost involved. Be selective.

Some fruits and vegetables have more chemical residue than others. Generally, if you eat the skin such as apples, strawberries, cucumbers choose organic. For produce such as bananas, pineapple, or avocados, stick to cheaper, conventionally grown items. Compare prices. Having an organic label on baked goods, desserts, and snacks might make them sound healthier, but even organic processed foods are still high in sugar, salt, fat, or calories.

Always read the labels carefully. The neighborhood grocery store is not the only place to shop. Sometimes other venues can offer significantly cheaper ways to purchase healthy food. Discount stores. Warehouse or club stores like Costco offer great bargains for seasonal produce, and foods such as chicken and cheese.

To avoid waste, freeze large portions in smaller, more manageable sizes. Search out Farmers' Markets. Many places host weekly farmers' markets where local farmers sell fresh food directly, often cheaper than the grocery store.

Towards the end of the market, some vendors sell remaining perishable items at a discount. Join a CSA community supported agriculture group. A CSA is a great way to have local, seasonal food delivered directly from a farmer.

Buying clubs can also help make grocery shopping a more social experience. Ethnic markets and corner stores are worth looking into. Many feature an impressive, affordable selection of fruits and vegetables, as well as other products.

Online retailers. There are plenty of websites available that offer grocery deliveries—which can save you plenty of time and in some cases also money. Some online retailers offer discounted rates over traditional grocery stores while others such as Thrive Market in the U.

also focus on healthy, non-processed foods. Always factor in any delivery charges or membership fees when comparing prices.

Shop the perimeter of the store first. Eat a healthy snack before shopping. Take advantage of sales. If you have the shelf or freezer space, stock up on staples or products that you use often when they go on sale. Be smart about coupons. For instance, according to a report prepared for Congress by the Economic Research Service of the US Department of Agriculture, about 2.

Studies have found that wealthy districts have three times as many supermarkets as poor ones do, [2] that white neighborhoods contain an average of four times as many supermarkets as predominantly black ones do, and that grocery stores in African-American communities are usually smaller with less selection.

Processed foods such as snack cakes, chips and soda typically sold by corner delis, convenience stores and liquor stores are usually just as unhealthy.

According to the NAICS code, small corner grocery stores are statistically lumped together with supermarkets, such as Safeway, Whole Foods Market, etc. In other words, a community with no supermarket and two corner grocery stores that offer liquor and food would be counted as having two retail food outlets even though the food offered may be extremely limited and consist mainly of junk food.

In addition to this, we found that many of the convenience stores that had items such as a bunch of bananas or a few apples would sell the fruits individually. Because these items are not priced, the customers are often at the mercy of the person behind the counter who determines the cost then and there.

Those living in food deserts may also find it difficult to locate foods that are culturally appropriate for them, and dietary restrictions, such as lactose intolerance, gluten allergies, etc.

Additionally, studies have found that urban residents who purchase groceries at small neighborhood stores pay between 3 and 37 percent more than suburbanites buying the same products at supermarkets.

Healthier foods are generally more expensive than unhealthful foods, particularly in food deserts. For instance, while the overall price of fruits and vegetables in the US increased by nearly 75 percent between and , the price of fatty foods dropped by more than 26 percent during the same period.

While unhealthy eating may be economically cheaper in the short-term, the consequences of long-term constrained access to healthy foods is one of the main reasons that ethnic minority and low-income populations suffer from statistically higher rates of obesity, type 2 diabetes , cardiovascular disease , and other diet-related conditions than the general population.

Whatever their age, obesity puts people at a greater risk for serious, even fatal health disorders particularly coronary heart disease and diabetes, [7] the first and seventh leading causes of death in the US respectively : [8]. The highest rates of escalation have been identified in Native American youth [12] and African-Americans and Latinos of all age groups, with these groups suffering disproportionately higher rates of type 2 diabetes compared to whites.

One study of Chicago neighborhoods found the death rate from diabetes in food deserts to be twice that of areas offering access to grocery stores, [14] while another conducted in California found that adults ages 50 and over from black and brown communities had double the diabetes rate of whites from the same age demographic.

Researchers explain this disparity by emphasizing that the high-calorie foods most readily available in food deserts put residents living in these areas at greater risk for diabetes in the first place, and that having restricted access to healthy foods also makes it harder for them to manage diabetes once they are diagnosed.

Heart disease causes more than 2.

Discounted food choices - 12 healthy and affordable foods for your grocery list · Brown rice. · Cans or packets of chicken or tuna. · Dried beans and lentils. · Eggs. · Frozen This study in an experimental web-based supermarket examined the effects on food purchases of price discounts on healthy foods in combination This cheap and healthy grocery list includes tips and recommendations on ways to make smart purchases on nutritious foods without breaking SNAP healthy incentive programs encourage people participating in SNAP to purchase healthy foods by providing a coupon, discount, gift card, bonus food item

Home Nutrition News What Should I Eat? In the U. Additionally, there is a wide network of food pantries nationwide that provide access to some foods and beverages. Produce Leafy greens kale , collards Whole heads lettuce or cabbage Broccoli Radishes Fresh carrots Fresh apples Fresh bananas Any fresh produce on sale Frozen unsweetened fruit Frozen or canned vegetables without added salt.

Whole grains and pastas Generic store-brand high-fiber cereals plain shredded wheat, bran Whole rolled oats Whole grains, dried brown rice , millet, barley, bulgur Whole grain pasta.

Snacks Peanuts Dried popcorn kernels to cook in an air-popper String cheese. Low-sodium seasonings Sodium-free herbs cumin, curry, thyme, paprika, onion powder, garlic powder and herb blends Canned reduced-sodium tomato paste Vinegars Olive oil and other liquid vegetable oils.

Veggie burgers Drain one can black beans and place into a large bowl. Mash the beans with a fork and add in 1 medium cooked sweet potato, ½ cup old-fashioned rolled oats, 1 small diced carrot, and a pinch of salt and pepper.

Mix all ingredients together with a spoon or your hands. Refrigerate for 20 minutes and shape into patties. Add 2 tablespoons oil into a pan and heat on medium-high. When oil is warm, add patties and cook on each side for about 3 minutes.

Eat the patties over a bed of greens or assemble on a whole grain bun with your favorite toppings. Homemade chicken nuggets Preheat oven to F. Place 1 cup nonfat plain yogurt in a bowl. Cut 1 pound of boneless skinless chicken breast or thighs into 2-inch pieces. Dip each chicken piece into the yogurt and then dredge in cornflakes.

Place onto baking sheet and repeat with all chicken pieces. Bake for about 25 minutes or until chicken is cooked through. Three-bean chili Heat 1 tablespoon olive oil on medium-high heat in a large pot. Add 1 large diced onion, 1 ½ teaspoons garlic powder, and 3 tablespoons chili powder and cook until onions soften.

Add one ounce can each of drained rinsed black beans, kidney beans, and pinto beans; one ounce can diced tomatoes with the juice; and 2 cups water or low-sodium broth. Bring to a boil and then reduce heat to low. Cover pot and simmer for 20 minutes, stirring occasionally.

Serve plain or over cooked brown rice. References Rao M, Afshin A, Singh G, Mozaffarian D. Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta-analysis.

BMJ open. We instructed CloudResearch to recruit a national sample of adults 18 years or older who have ever received SNAP benefits, read and speak English, and live with fewer than 4 people to maximize incentives. The sample was recruited to approximately match the distribution of sex and age of US adults in We used Qualtrics, an online survey platform, 30 to create and distribute a survey, which was completed by participants on a personal computer, laptop, tablet, or mobile phone between October 7 and December 2, The survey included questions about sociodemographic characteristics, food security, fruit and vegetable intake, and diet and food shopping behaviors eAppendix 1 in Supplement 2 ; details are described elsewhere.

A detailed description of methods for acquiring and cleaning online store data and the design of our 2-dimensional platform and its validity and acceptability are published elsewhere. Their shopping budget was based on food-at-home expenditure data from the National Household Food Acquisition and Purchase Survey FoodAPS , a nationally representative survey of food purchases by households receiving SNAP benefits and those that did not in to After completing the shopping task, participants answered 8 questions related to the process of shopping in our store 36 and the degree to which they would support default options as a retailer strategy, with or without discounts.

To incentivize participation and truthful responses, participants were notified they would be automatically entered into a lottery on completion of the shopping task and that participants would have their cart items delivered to their household.

At the end of the study, however, we revealed to all participants that individuals who won the lottery were instead provided a gift card with the equivalent amount of money loaded onto it that they spent in the study. This approach was used to mitigate potential issues related to delivery and to minimize the collection of personally identifiable information.

Fruits and vegetables that qualified for the discount were labeled as eligible in the store, and the discount was applied to items at the point of selection. Based on healthy eating guidelines, 39 eligible items included fresh, frozen, and canned fruits and vegetables with no more than mg of sodium per serving and prepared produce intended for off-premises consumption.

Ineligible items included herbs and spices, dried fruits and vegetables, fruit and vegetable juices, and fruits and vegetables with added sugars or fat. Participants randomized to the default condition had their cart prefilled with 1 fruit product and 1 vegetable product, which they could remove at any point while shopping.

Default items were based on expenditure data from FoodAPS, which we used to identify the 5 most frequently purchased fruits apples, bananas, grapes, oranges, and strawberries and vegetables carrots, green beans, lettuce, onions, and tomatoes in SNAP-participating households.

We then identified 10 corresponding products from our online store database. In the survey, participants were asked to select which of the 5 fruits and 5 vegetables they purchased the most frequently, and we used their selections to tailor their default options, for a total of 25 possible combinations of default products eAppendix 3 in Supplement 2.

Participants randomized to the control condition received no discount or default products. To account for differences in item prices across conditions and shopping budget by household size, our primary outcome was the percentage of nondiscounted dollars spent on eligible fruit and vegetables per basket ie, dollars spent before subtracting a discount.

Secondary outcomes included nondiscounted and out-of-pocket dollars spent on fruits and vegetables; nondiscounted dollars spent on fruits only, vegetables only, fresh fruits and vegetables, frozen fruits and vegetables, and canned fruits and vegetables; and total calories, fat in grams , saturated fat in grams , carbohydrates in grams , fiber in grams , protein in grams , and salt in milligrams from fruits and vegetables.

We calculated spending or nutrient value in each category by multiplying the price or nutrient value per item by the quantity purchased of that item, then summed across all items purchased in that category. We used linear regression to regress the outcome variable on indicator variables for each of the experimental conditions, with the control condition as referent.

Prespecified analyses indicated that a sample size of adults also allowed for examination of interaction effects by age, sex, and race and ethnicity. Race and ethnicity were self-reported by participants using National Health and Nutrition Examination Survey categories American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or other Pacific Islander, White, multiple races or ethnicities, and other race or ethnicity , given demographic differences in fruit and vegetable consumption.

In post hoc analyses, we also examined interaction effects by income, educational level, and food security status. To assess robustness of our results to differences in online grocery shopping history, we conducted a sensitivity analysis excluding participants who reported they had never shopped online for groceries.

We also used logistic regression to assess differences in the likelihood of purchasing a default shopping cart item from the shopping cart or store aisles by condition. We calculated the percentage of participants who endorsed positive statements about their experience in the store.

To assess attrition bias, we compared the characteristics of those who completed the survey task but not the shopping task with the characteristics of those who completed both tasks. All analyses were conducted using Stata, version The final sample included adults who had ever received SNAP benefits.

The mean SD age of participants was A total of 39 participants 1. Mean SD household size was 2. A little over half of participants [ Those who completed the survey and shopping task vs survey only were more likely to be women of [ Compared with the control condition, those in the discount condition spent 4.

Default cart items were purchased by participants Spending on fruits only, vegetables only, and fresh fruits and vegetables was higher among participants randomized to receive discounts alone or in combination vs no intervention.

Total calories, carbohydrates, and fiber from fruits and vegetables were higher in the discount and combination conditions compared with no intervention. We did not observe meaningful differences in expenditures on frozen or canned fruits and vegetables across conditions, or in other nutrient groups.

We observed no interaction effects by age, sex, race and ethnicity, income, educational level, or food security status and no differences when excluding those who reported never shopping online for groceries eTable 3 in Supplement 2. Most participants reported that the store felt like a real online grocery store [ There was a high degree of support for default options as a retailer strategy, with [ Previous research has found that nutrition labels, 42 - 45 product placement, 44 , 46 - 48 and offering healthy alternatives 44 , 46 promote healthier food choices in online supermarkets.

We found that financial incentives are also effective in promoting online fruit and vegetable purchases in a large, diverse sample of individuals with low income. The effect from our discount alone 4.

Participants also expressed a high degree of support for default options as a retailer strategy. Taken together, these results suggest that default options are effective in motivating individuals to purchase fruits and vegetables. We also found evidence that combining discounts and default options had a synergistic effect, which provides support for the implementation of multiple healthy eating strategies in an online setting.

Given how changes in expenditures translated into positive changes in fruit and vegetable intake in the Healthy Incentives Pilot, 50 we expect that effects observed in this study would meaningfully improve population health.

Participants were recruited online, so they may have been more likely to shop online than the broader SNAP population. However, results did not differ when we excluded those who reported never shopping online for groceries.

The sample may not have been representative of the target population, given how non-English speakers were excluded and those who started the shopping task were slightly more likely to be women and have higher education.

It is possible that hypothetical shopping choices do not reflect actual purchases, but we informed participants they were entered into a lottery to receive the items in their cart, so we expect participants selected items they actually wanted to receive.

Furthermore, most reported their purchases were similar to their regular purchases. The results of this randomized clinical trial support the use of financial incentives to meaningfully increase fruit and vegetable purchases for those shopping with SNAP benefits online.

We also found evidence that prefilling shopping carts with fruits and vegetables motivated individuals to purchase default products, with a synergistic effect with discounts. Future research should explore the effectiveness of strategies designed to mitigate lack of trust and other noneconomic barriers on purchases of fresh products online.

Evaluating other interventions in online settings, such as restrictions on targeted marketing, is also a valuable next step.

Published: March 10, Open Access: This is an open access article distributed under the terms of the CC-BY License.

JAMA Network Open. Corresponding Author: Pasquale E. Rummo, PhD, MPH, Section on Health Choice, Policy and Evaluation, Department of Population Health, New York University Grossman School of Medicine, Madison Ave, 3rd Floor, New York, NY pasquale. rummo nyulangone. Author Contributions: Dr Rummo had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Acquisition, analysis, or interpretation of data: Rummo, Roberto, Thorpe, Troxel. Critical revision of the manuscript for important intellectual content: All authors.

Conflict of Interest Disclosures: Dr Troxel reported receiving grant funding from the National Institutes of Health NIH during the conduct of the study. No other disclosures were reported. Data Sharing Statement: See Supplement 3.

Additional Contributions: Jamie Halula, MPH, University of North Carolina UNC at Chapel Hill, Sophia Hurr, BS, Advisory Board, Rhea Naik, MS, Carmen Prestemon, BSPH, UNC at Chapel Hill, and Carla Seet, MPH, New York University Grossman School of Medicine, helped in cleaning the dataset and reviewing the online grocery store.

Emily Busey, MPH, RD, UNC at Chapel Hill, designed our online grocery store logo, Bridgett Hollingsworth, MPH, RD, UNC at Chapel Hill, provided guidance on how to tag red meat and processed red meat, Yiqing Zhang, BS, Barnard College of Columbia University, provided insight into the data scraping process, and Wilma Waterlander, PhD, Amsterdam UMC, contributed general feedback on store development and the process evaluation.

We thank the researchers involved in developing the Woods supermarket platform for their support, including Susan Jebb, PhD, and Brian Cook, PhD, at the Nuffield Department of Primary Care Health Sciences at the University of Oxford.

full text icon Full Text. Download PDF Comment. Top of Article Key Points Abstract Introduction Methods Results Discussion Conclusions Article Information References. Visual Abstract. RCT: Effect of Financial Incentives and Default Options on Food Choices in Online Retail Settings.

View Large Download. Table 1. Sociodemographic Characteristics and Diet Behaviors of Adult Study Participants, Overall and by Condition, a. Table 2. Shopping Task Purchase Descriptive Statistics, Overall and by Condition.

Table 3. Experimental Results, Primary and Secondary Outcomes. Supplement 1. Trial Protocol. Supplement 2. Sociodemographic Characteristics and Diet Behaviors of Adult Study Participants eTable 2.

Grocery Shopping Behaviors and Attitudes Overall and by Condition eTable 3. Sensitivity and Interaction Analyses eTable 4. Postshopping Task Question Responses eAppendix 1. Preshopping and Postshopping Task Surveys eAppendix 2.

Experimental Online Grocery Store Appearance and Instructions eAppendix 3. Supplement 3. Data Sharing Statement. Hu EA, Steffen LM, Coresh J, Appel LJ, Rebholz CM. Adherence to the Healthy Eating Index and other dietary patterns may reduce risk of cardiovascular disease, cardiovascular mortality, and all-cause mortality.

doi: Zhan J, Liu YJ, Cai LB, Xu FR, Xie T, He QQ. Fruit and vegetable consumption and risk of cardiovascular disease: a meta-analysis of prospective cohort studies.

Fang Zhang F, Liu J, Rehm CD, Wilde P, Mande JR, Mozaffarian D. Trends and disparities in diet quality among US adults by Supplemental Nutrition Assistance Program participation status. Lee SH, Moore LV, Park S, Harris DM, Blanck HM. Adults meeting fruit and vegetable intake recommendations—United States, mma1  PubMed Google Scholar Crossref.

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Olsho LE, Klerman JA, Wilde PE, Bartlett S. Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: a randomized controlled trial of the USDA Healthy Incentives Pilot. Rummo PE, Noriega D, Parret A, Harding M, Hesterman O, Elbel BE.

Evaluating a USDA program that gives SNAP participants financial incentives to buy fresh produce in supermarkets. Verghese A, Raber M, Sharma S. Interventions targeting diet quality of Supplemental Nutrition Assistance Program SNAP participants: a scoping review.

Lyerly R, Rummo P, Amin S, et al. Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors. Rummo PE, Lyerly R, Rose J, Malyuta Y, Cohen ED, Nunn A.

The impact of financial incentives on SNAP transactions at mobile produce markets. Atoloye AT, Savoie-Roskos MR, Durward CM. Higher fruit and vegetable intake is associated with participation in the Double Up Food Bucks DUFB.

Engel K, Ruder EH. Fruit and vegetable incentive programs for Supplemental Nutrition Assistance Program SNAP participants: a scoping review of program structure. Public Assistance Act. RI H July 8, Accessed January 20, Roberto CA, Kawachi I, eds.

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Anzman-Frasca S, Mueller MP, Sliwa S, et al. Coffino JA, Han GT, Evans EW, Luba R, Hormes JM. A Default option to improve nutrition for adults with low income using a prefilled online grocery shopping cart.

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