title: Improved Overall Quality of Diets Reported by Expanded Food and Nutrition Education Program Participants in the Mountain Region.
abstract: OBJECTIVE
  To evaluate the Expanded Food and Nutrition Education Program, a large US Department of Agriculture nutrition education program for low-income people, by comparing the overall quality and cost of diets when entering and exiting the program.
  
  
  METHODS
  Secondary analysis of data collected in 2011 from female participants in the Mountain region. Dietary recalls were collected by paraprofessionals. Outcome measures were the differences between Healthy Eating Index-2005 scores and costs of diets at entry and exit. Significance was determined using the Wilcoxon signed-rank test.
  
  
  RESULTS
  At entry the mean total Healthy Eating Index-2005 score was 49.1 (out of a possible 100) and at exit, 55.2 (P < .001) (n = 3,338). Eight of 12 component scores also improved significantly whereas the sodium score worsened. The estimated median cost of diets was 13% higher at exit compared with entry.
  
  
  CONCLUSIONS
  Participants' overall diet quality improved and was accompanied by an increase in food cost.
authors.affiliation: Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, UT. Electronic address: Patricia.Guenther@utah.edu.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Guenther
authors.affiliation: Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK.
authors.forename: Bret R
authors.initials: BR
authors.lastname: Luick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004032:Diet / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011203:Poverty; D014481:United States / Q000453:epidemiology; D016885:United States Department of Agriculture; D055815:Young Adult
keywords: Dietary Guidelines for Americans; US Department of Agriculture; diet; evaluation; poverty