Associate Professor, Friedman School of Nutrition Science and Policy, Tufts University. Also Adjunct Professor, Department of Resource Economics and Environmental Sociology, University of Alberta, Edmonton, Canada. Economics and policy of food, nutrition, and the environment. Phone: (617) 636-6822 Address: Jaharis Building, Rm 127 150 Harrison Avenue Boston, MA 02111
International Journal of Behavioral Nutrition and Physical Activity
Background In June 2016, a comprehensive food policy was implemented in Chile that included front... more Background In June 2016, a comprehensive food policy was implemented in Chile that included front-of-package warning labels on key nutrients of concern (total sugars, added saturated fats, sodium, and calories), child-directed food advertisement bans, and school regulations. The policy was implemented in 3 phases from 2016 to 2019 and the primary objective was to improve children’s food environments. This study’s objective was to assess changes in child and adolescent intake of key nutrients of concern (total sugars, saturated fats, and sodium) at school after the initial implementation of Chile’s Law of Food Labeling and Advertisement. Methods Longitudinal study of 349 children from the Food Environment Chilean Cohort (FECHIC) and 294 adolescents from the Growth and Obesity Cohort Study (GOCS). Data were from single 24-hour dietary recalls collected from 2016 to 2019. Fixed-effects models stratified by school, home, and other locations compared nutrient consumption in each year to ...
OBJECTIVE Produce prescriptions have shown promise in improving diabetes care, although most stud... more OBJECTIVE Produce prescriptions have shown promise in improving diabetes care, although most studies have used small samples or lacked controls. Our objective was to evaluate the impacts of a produce prescription program on glycemic control for patients with diabetes. RESEARCH DESIGN AND METHODS Participants included a nonrandom enrollment of 252 patients with diabetes who received a produce prescription and 534 similar control participants from two clinics in Hartford, Connecticut. The start of the COVID-19 pandemic in March 2020 coincided with program implementation. Produce prescription enrollees received vouchers ($60 per month) for 6 months to purchase produce at grocery retail. Controls received usual care. The primary outcome was change in glycated hemoglobin (HbA1c) between treatment and control at 6 months. Secondary outcomes included 6-month changes in systolic (SBP) and diastolic blood pressure (DBP), BMI, hospitalizations, and emergency department admissions. Longitudina...
Although individuals with poor food security might be expected to have reduced food intake, and t... more Although individuals with poor food security might be expected to have reduced food intake, and therefore a lower likelihood of being overweight, some empirical evidence has indicated that overweight status is actually more prevalent among the food insecure. As obesity is associated with excessive energy intake, and hunger reflects an inadequate food supply, such observations would appear to be paradoxical. We develop an economic model that shows that this apparently paradoxical result is consistent with rational behavior regarding food availability risk and the effectiveness of food storage options. The amount of internal storage increases as the variance of food productivity in the second period increases, which is consistent with the empirical observation of a positive relationship between food insecurity and the incidence of overweight.
Objective:The rapid growth in web-based grocery food purchasing has outpaced federal regulatory a... more Objective:The rapid growth in web-based grocery food purchasing has outpaced federal regulatory attention to the online provision of nutrition and allergen information historically required on food product labels. We sought to characterise the extent and variability that online retailers disclose required and regulated information and identify the legal authorities for the federal government to require online food retailers to disclose such information.Design:We performed a limited scan of ten products across nine national online retailers and conducted legal research using LexisNexis to analyse federal regulatory agencies’ authorities.Setting:USA.Participants:N/A.Results:The scan of products revealed that required information (Nutrition Facts Panels, ingredient lists, common food allergens and per cent juice for fruit drinks) was present, conspicuous and legible for an average of only 36·5 % of the products surveyed, ranging from 11·4 % for potential allergens to 54·2 % for ingredi...
We investigate whether consumer preferences for food products embodying multiple credence attribu... more We investigate whether consumer preferences for food products embodying multiple credence attributes are easily satiated. Results from two treatments of an experiment suggest choices are not affected by the order in which attributes are presented. Initial evidence suggests diminishing marginal utility in the number of attributes included in food products embodying multiple credence attributes. However, further testing reveals that preferences are consistent with constant marginal utility in the number of product attributes, suggesting that preferences are not easily satiated.
We seek to examine how “adult-facing” food price interventions (such as junk food taxes) and warn... more We seek to examine how “adult-facing” food price interventions (such as junk food taxes) and warning labels may influence kids who are buying their own snacks. This work, conducted through a series of both laboratory and field experiments, also looks at the cognitive correlates of children’s market behavior. A proper understanding of the development and functioning of children as autonomous consumers has important implications for the role of labelling policies for good nutritional choices on children and the economy.
Climate change is impacting crop performance and agricultural systems around the world with impli... more Climate change is impacting crop performance and agricultural systems around the world with implications for farmers and consumers. We carried out a systematic review to synthesize evidence regarding the effects of environmental factors associated with climate change and management conditions associated with climate adaptation on the crop quality of a culturally-relevant perennial crop, coffee (Coffea arabica and Coffea canephora). Seventy-three articles were identified that addressed the study's research question including 42 articles on environmental factors, 20 articles on management conditions, and 11 articles on both. While variation was found between studies, findings highlight that coffee quality is vulnerable to changes in light exposure, altitude, water stress, temperature, carbon dioxide, and nutrient management. Both increases as well as decreases were found in secondary metabolites and sensory attributes that determine coffee quality in response to shifts in environm...
Children regularly consume foods from quick service restaurants (QSRs) in the United States, but ... more Children regularly consume foods from quick service restaurants (QSRs) in the United States, but little is known about how ordering decisions are made and the impact on selection and consumption. A total of n = 218 parents dining with a child (ages 4–16 years) inside a participating QSR completed interviews and demographic surveys and provided their child’s leftover foods at the end of the meal. Children’s meal consumption was measured using plate-waste methodology. The majority of children selected their meal without parental involvement (80%) and decided what to order prior to entering the QSR (63%). Using mixed-model analysis of variance, children selected and consumed significantly fewer calories and less total fat and sodium when a parent ordered the meal compared with when the child ordered the meal alone. There were no significant differences in selection or consumption when a parent and child ordered the meal together. Approximately one-third of the children consumed foods t...
Consumers are increasingly concerned about the environmental and social impacts of their purchase... more Consumers are increasingly concerned about the environmental and social impacts of their purchases. Prior research has assessed willingness to pay (WTP) for environmental and ethical attributes on foods and beverages such as locally grown, fairly traded, and organically produced. However, few studies have examined WTP for agricultural greenhouse gas (GHG) mitigation, especially in the U.S. and to date, no prior study has examined how knowledge or concerns about climate change motivate WTP for climate-friendly products. The objective of this study was to estimate WTP for agricultural GHG mitigation and examine variability in WTP across consumer characteristics, climate change knowledge and risk perception. A sensory-grounded choice experiment and survey assessing climate change knowledge and risk perception was administrated to specialty food and beverage shoppers in the Midwest and Northeastern U.S. Male and lower-income participants, as well as those at the Midwestern study site we...
International Journal of Behavioral Nutrition and Physical Activity
Background In June 2016, a comprehensive food policy was implemented in Chile that included front... more Background In June 2016, a comprehensive food policy was implemented in Chile that included front-of-package warning labels on key nutrients of concern (total sugars, added saturated fats, sodium, and calories), child-directed food advertisement bans, and school regulations. The policy was implemented in 3 phases from 2016 to 2019 and the primary objective was to improve children’s food environments. This study’s objective was to assess changes in child and adolescent intake of key nutrients of concern (total sugars, saturated fats, and sodium) at school after the initial implementation of Chile’s Law of Food Labeling and Advertisement. Methods Longitudinal study of 349 children from the Food Environment Chilean Cohort (FECHIC) and 294 adolescents from the Growth and Obesity Cohort Study (GOCS). Data were from single 24-hour dietary recalls collected from 2016 to 2019. Fixed-effects models stratified by school, home, and other locations compared nutrient consumption in each year to ...
OBJECTIVE Produce prescriptions have shown promise in improving diabetes care, although most stud... more OBJECTIVE Produce prescriptions have shown promise in improving diabetes care, although most studies have used small samples or lacked controls. Our objective was to evaluate the impacts of a produce prescription program on glycemic control for patients with diabetes. RESEARCH DESIGN AND METHODS Participants included a nonrandom enrollment of 252 patients with diabetes who received a produce prescription and 534 similar control participants from two clinics in Hartford, Connecticut. The start of the COVID-19 pandemic in March 2020 coincided with program implementation. Produce prescription enrollees received vouchers ($60 per month) for 6 months to purchase produce at grocery retail. Controls received usual care. The primary outcome was change in glycated hemoglobin (HbA1c) between treatment and control at 6 months. Secondary outcomes included 6-month changes in systolic (SBP) and diastolic blood pressure (DBP), BMI, hospitalizations, and emergency department admissions. Longitudina...
Although individuals with poor food security might be expected to have reduced food intake, and t... more Although individuals with poor food security might be expected to have reduced food intake, and therefore a lower likelihood of being overweight, some empirical evidence has indicated that overweight status is actually more prevalent among the food insecure. As obesity is associated with excessive energy intake, and hunger reflects an inadequate food supply, such observations would appear to be paradoxical. We develop an economic model that shows that this apparently paradoxical result is consistent with rational behavior regarding food availability risk and the effectiveness of food storage options. The amount of internal storage increases as the variance of food productivity in the second period increases, which is consistent with the empirical observation of a positive relationship between food insecurity and the incidence of overweight.
Objective:The rapid growth in web-based grocery food purchasing has outpaced federal regulatory a... more Objective:The rapid growth in web-based grocery food purchasing has outpaced federal regulatory attention to the online provision of nutrition and allergen information historically required on food product labels. We sought to characterise the extent and variability that online retailers disclose required and regulated information and identify the legal authorities for the federal government to require online food retailers to disclose such information.Design:We performed a limited scan of ten products across nine national online retailers and conducted legal research using LexisNexis to analyse federal regulatory agencies’ authorities.Setting:USA.Participants:N/A.Results:The scan of products revealed that required information (Nutrition Facts Panels, ingredient lists, common food allergens and per cent juice for fruit drinks) was present, conspicuous and legible for an average of only 36·5 % of the products surveyed, ranging from 11·4 % for potential allergens to 54·2 % for ingredi...
We investigate whether consumer preferences for food products embodying multiple credence attribu... more We investigate whether consumer preferences for food products embodying multiple credence attributes are easily satiated. Results from two treatments of an experiment suggest choices are not affected by the order in which attributes are presented. Initial evidence suggests diminishing marginal utility in the number of attributes included in food products embodying multiple credence attributes. However, further testing reveals that preferences are consistent with constant marginal utility in the number of product attributes, suggesting that preferences are not easily satiated.
We seek to examine how “adult-facing” food price interventions (such as junk food taxes) and warn... more We seek to examine how “adult-facing” food price interventions (such as junk food taxes) and warning labels may influence kids who are buying their own snacks. This work, conducted through a series of both laboratory and field experiments, also looks at the cognitive correlates of children’s market behavior. A proper understanding of the development and functioning of children as autonomous consumers has important implications for the role of labelling policies for good nutritional choices on children and the economy.
Climate change is impacting crop performance and agricultural systems around the world with impli... more Climate change is impacting crop performance and agricultural systems around the world with implications for farmers and consumers. We carried out a systematic review to synthesize evidence regarding the effects of environmental factors associated with climate change and management conditions associated with climate adaptation on the crop quality of a culturally-relevant perennial crop, coffee (Coffea arabica and Coffea canephora). Seventy-three articles were identified that addressed the study's research question including 42 articles on environmental factors, 20 articles on management conditions, and 11 articles on both. While variation was found between studies, findings highlight that coffee quality is vulnerable to changes in light exposure, altitude, water stress, temperature, carbon dioxide, and nutrient management. Both increases as well as decreases were found in secondary metabolites and sensory attributes that determine coffee quality in response to shifts in environm...
Children regularly consume foods from quick service restaurants (QSRs) in the United States, but ... more Children regularly consume foods from quick service restaurants (QSRs) in the United States, but little is known about how ordering decisions are made and the impact on selection and consumption. A total of n = 218 parents dining with a child (ages 4–16 years) inside a participating QSR completed interviews and demographic surveys and provided their child’s leftover foods at the end of the meal. Children’s meal consumption was measured using plate-waste methodology. The majority of children selected their meal without parental involvement (80%) and decided what to order prior to entering the QSR (63%). Using mixed-model analysis of variance, children selected and consumed significantly fewer calories and less total fat and sodium when a parent ordered the meal compared with when the child ordered the meal alone. There were no significant differences in selection or consumption when a parent and child ordered the meal together. Approximately one-third of the children consumed foods t...
Consumers are increasingly concerned about the environmental and social impacts of their purchase... more Consumers are increasingly concerned about the environmental and social impacts of their purchases. Prior research has assessed willingness to pay (WTP) for environmental and ethical attributes on foods and beverages such as locally grown, fairly traded, and organically produced. However, few studies have examined WTP for agricultural greenhouse gas (GHG) mitigation, especially in the U.S. and to date, no prior study has examined how knowledge or concerns about climate change motivate WTP for climate-friendly products. The objective of this study was to estimate WTP for agricultural GHG mitigation and examine variability in WTP across consumer characteristics, climate change knowledge and risk perception. A sensory-grounded choice experiment and survey assessing climate change knowledge and risk perception was administrated to specialty food and beverage shoppers in the Midwest and Northeastern U.S. Male and lower-income participants, as well as those at the Midwestern study site we...
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Papers by Sean Cash