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Green CD, Martinez AC, Becker SP. Examining ADHD and Cognitive Disengagement Syndrome Symptoms in Relation to Food Insecurity in Early Adolescents. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01226-5. [PMID: 38967900 DOI: 10.1007/s10802-024-01226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/06/2024]
Abstract
Approximately 13.8 million U.S. households face food insecurity, which severely affects child development, with more than half of these households including children. Research links food insecurity to cognitive deficits and mental health challenges, highlighting the need for thorough understanding and intervention. Although existing studies have explored the association between food insecurity and internalizing symptomatology, less research has examined food insecurity in relation to attention-deficit/hyperactivity disorder (ADHD) symptoms. Further, no studies have explored the connection between food insecurity and cognitive disengagement syndrome (CDS) symptoms, closely related to ADHD symptoms. Despite extant research linking CDS to environmental factors, empirical attention to its potential association with food insecurity is notably lacking. Additionally, adolescents, almost twice as likely as younger children to experience household food insecurity, are likely more aware and respond differently to challenges during this developmental period. Accordingly, this study investigated the unique associations of parent-, teacher-, and youth self-reported ADHD dimensions and CDS symptoms in relation to parent-reported food insecurity in early adolescents (N = 136, ages 10-12). Controlling for age, sex, race, and medication use, no informant's ratings of ADHD symptom dimensions were uniquely related to food insecurity. In contrast, higher parent-, teacher-, and youth self-reported CDS symptoms were uniquely associated with greater food insecurity. This finding was robust to additional control of family income for teacher- and youth self-reported CDS symptoms. These findings highlight the complex link between food insecurity and mental health, suggest a connection with CDS symptoms, and stress the need to address food insecurity as a public health priority, especially in early adolescence.
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Affiliation(s)
- Cathrin D Green
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.
| | - Andrew C Martinez
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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2
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Flores AC, Sarpong C, Dou N, Na M. Food sufficiency status and sleep outcomes in older adults: the National Health and Aging Trends Study (NHATS). Nutr J 2024; 23:25. [PMID: 38414001 PMCID: PMC10898009 DOI: 10.1186/s12937-024-00918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 01/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Studies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and sleep outcomes in a nationally representative sample of older adults. METHODS Our study included 1,665 older adults (≥ 65 years), using data from the 2013 and 2014 National Health and Aging Trends Study (NHATS). Food insufficiency was determined via participants' experience and utilization of food assistance programs (FAP). Sleep outcomes, including nighttime and total sleep hours, sleep latency, and sleep quality, were derived from self-reported data. Multivariable linear regression and logistic regression models were used to estimate the associations between food sufficiency status and sleep outcomes. RESULTS In 2013-2014, 86.1% of older adults were classified as food sufficient without FAP, 9.85% as food sufficient with FAP, and 4.08% as food insufficient. Adjusting for sociodemographic characteristics, food sufficient older adults with FAP reported more total sleep hours (𝛽 = 0.31, 95% CI: -0.02, 0.64) than those participants who are food sufficient without FAP. Further adjusting for health factors, food sufficient participants with FAP had more nighttime sleep hours and greater total sleep hours compared to those participants food sufficient without FAP. Compared to those deemed as food sufficient without FAP, food sufficient participants with FAP had lower odds of having longer sleep latency (OR = 0.50, 95% CI: 0.28, 0.89), after further adjusting for physical function performance. CONCLUSIONS Among older adults, food sufficiency with FAP is associated with greater total sleep hours, greater nighttime sleep hours, and lower odds of longer sleep latency. Our findings may help inform nutrition food assistance programs targeting older populations.
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Affiliation(s)
- Ashley C Flores
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA
| | - Christopher Sarpong
- Department of Biology, The Pennsylvania State University, University Park, PA, USA
| | - Nan Dou
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA
| | - Muzi Na
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA.
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3
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Arzhang P, Sadeghi N, Harchegani FA, Rezaei M, Ghaderi M, Yekaninejad MS, Leung CW, Azadbakht L. Associations between food insecurity and Sleep Duration, Quality, and Disturbance among older adults from six low- and middle-income countries. J Nutr Health Aging 2024; 28:100018. [PMID: 38267148 DOI: 10.1016/j.jnha.2023.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES Although food insecurity has been associated with poor sleep outcomes in young and middle-aged adults, few studies have examined this relationship in older adults. This study aimed to examine the relationship between food insecurity and sleep duration, quality, and disturbance among older adults in six low-income countries (LMICs). DESIGN AND SETTING We analyzed nationally representative cross-sectional data from 33,460 adults (≥50 years) from the Study on global AGEing and adult health (SAGE). MEASUREMENTS Food insecurity (FI) was assessed using two questions regarding the frequency of eating less and hunger caused by a lack of food. Sleep outcomes included self-reported sleep duration, sleep quality, and sleep disturbances (difficulty falling asleep, frequent sleep interruptions, and early awakening) assessed based on self-reports over two nights. Multivariable logistic regression was used to assess country-specific relationships between food insecurity and sleep outcomes, and random-effects models were used to estimate pooled associations. RESULTS The prevalence of FI among older adults in the overall population was 16.2%. In pooled analyses, FI was significantly associated with long sleep duration ≥ 9 h (OR=1.58, 95% CI: 1.30 to 1.93; P=0.001). There were also significant pooled associations between FI and poor sleep quality (OR=1.34, 95% CI: 1.14 to 1.56; P < 0.001) and sleep disturbances (OR=1.44, 95% CI: 1.08 to 1.91; P = 0.014). CONCLUSIONS In conclusion, the current study found that FI is adversely associated with sleep duration, quality and disturbances in older adults, with some heterogeneity by country. The findings suggest food policies and intervention programs are needed for vulnerable households.
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Affiliation(s)
- Pishva Arzhang
- Qods Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Sadeghi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Ahmadi Harchegani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Rezaei
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Moslem Ghaderi
- School of Nursing and Midwifery, Iran University of Medical Sciences, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box: 1416643931, Tehran, Iran.
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4
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Akhlaghi M, Kohanmoo A. Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices. Nutr Res Rev 2023:1-21. [PMID: 37905402 DOI: 10.1017/s0954422423000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Sleep deprivation, which is a decrease in duration and quality of sleep, is a common problem in today's life. Epidemiological and interventional investigations have suggested a link between sleep deprivation and overweight/obesity. Sleep deprivation affects homeostatic and non-homoeostatic regulation of appetite, with the food reward system playing a dominant role. Factors such as sex and weight status affect this regulation; men and individuals with excess weight seem to be more sensitive to reward-driven and hedonistic regulation of food intake. Sleep deprivation may also affect weight through affecting physical activity and energy expenditure. In addition, sleep deprivation influences food selection and eating behaviours, which are mainly managed by the food reward system. Sleep-deprived individuals mostly crave for palatable energy-dense foods and have low desire for fruit and vegetables. Consumption of meals may not change but energy intake from snacks increases. The individuals have more desire for snacks with high sugar and saturated fat content. The relationship between sleep and the diet is mutual, implying that diet and eating behaviours also affect sleep duration and quality. Consuming healthy diets containing fruit and vegetables and food sources of protein and unsaturated fats and low quantities of saturated fat and sugar may be used as a diet strategy to improve sleep. Since the effects of sleep deficiency differ between animals and humans, only evidence from human subject studies has been included, controversies are discussed and the need for future investigations is highlighted.
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Affiliation(s)
- Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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5
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Alhasan DM, Riley NM, Jackson II WB, Jackson CL. Food insecurity and sleep health by race/ethnicity in the United States. J Nutr Sci 2023; 12:e59. [PMID: 37252683 PMCID: PMC10214135 DOI: 10.1017/jns.2023.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 05/31/2023] Open
Abstract
Food insecurity, poised to increase with burgeoning concerns related to climate change, may influence sleep, yet few studies examined the food security-sleep association among racially/ethnically diverse populations with multiple sleep dimensions. We determined overall and racial/ethnic-specific associations between food security and sleep health. Using National Health Interview Survey data, we categorised food security as very low, low, marginal and high. Sleep duration was categorised as very short, short, recommended and long. Sleep disturbances included trouble falling/staying asleep, insomnia symptoms, waking up feeling unrested and using sleep medication (all ≥3 d/times in the previous week). Adjusting for socio-demographic characteristics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95 % confidence intervals (95 % CIs) for sleep dimensions by food security. Among 177 435 participants, the mean age of 47⋅2 ± 0⋅1 years, 52⋅0 % were women, and 68⋅4 % were non-Hispanic (NH)-White. A higher percent of NH-Black (7⋅9 %) and Hispanic/Latinx (5⋅1 %) lived in very low food security households than NH-White (3⋅1 %) participants. Very low v. high food security was associated with a higher prevalence of very short (PR = 2⋅61 [95 % CI 2⋅44-2⋅80]) sleep duration as well as trouble falling asleep (PR = 2⋅21 [95 % CI 2⋅12-2⋅30]). Very low v. high food security was associated with a higher prevalence of very short sleep duration among Asian (PR = 3⋅64 [95 % CI 2⋅67-4⋅97]) and NH-White (PR = 2⋅73 [95 % CI 2⋅50-2⋅99]) participants compared with NH-Black (PR = 2⋅03 [95 % CI 1⋅80-2⋅31]) and Hispanic/Latinx (PR = 2⋅65 [95 % CI 2⋅30-3⋅07]) participants. Food insecurity was associated with poorer sleep in a racially/ethnically diverse US sample.
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Affiliation(s)
- Dana M. Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Nyree M. Riley
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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6
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Maia I, Oliveira A, Santos AC. Food insecurity is associated with an unhealthy lifestyle score in middle- and older-aged adults: findings from the EPIPorto cohort. Food Secur 2023; 15:661-671. [PMID: 37223752 PMCID: PMC10088709 DOI: 10.1007/s12571-023-01366-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/15/2023] [Indexed: 05/25/2023]
Abstract
The association of food insecurity with the combined effect of lifestyles is still limited. This study evaluated the association between food insecurity and a lifestyle score in middle- and older-aged adults. A cross-sectional study (2013-2016) was performed among 595 individuals (≥ 50 years) from the EPIPorto cohort (Porto, Portugal). Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Information on fruit and vegetable consumption (F&V), physical activity (PA) practice, tobacco smoking, and alcohol consumption were included in a lifestyle score. Those with F&V < five portions/day, < 150 min/week of moderate-intensity PA or < 75 min/week of vigorous-intensity PA, current smokers, consumers of > one drink of alcoholic beverages in women, and > two in men were assigned with one point; all the others had nil points. The score could range from 0 to 4, and was further categorised into three categories. Food insecurity was positively associated with an unhealthy lifestyle profile (OR = 2.272; 95%CI:1.079-4.782), independently of the adjustment variables. Analysing each lifestyle component, food insecurity was associated with low PA practice (OR = 2.365; 95%CI:1.020-5.485). Individuals from food insecure households were more likely to have an unhealthy lifestyle profile. Public health strategies should be developed among food insecure individuals to promote healthy lifestyles.
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Affiliation(s)
- Isabel Maia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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7
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Jacob L, Smith L, Kostev K, Oh H, Gyasi RM, López Sánchez GF, Song TJ, Tully MA, Haro JM, Yon DK, Shin JI, Koyanagi A. Food insecurity and insomnia-related symptoms among adults from low- and middle-income countries. J Sleep Res 2023:e13852. [PMID: 36808652 DOI: 10.1111/jsr.13852] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Abstract
Little is known about the relationship between food insecurity and sleep problems in low- and middle-income countries, while the mediators of this association are largely unknown. Therefore, we investigated the association between food insecurity and insomnia-related symptoms in six low- and middle-income countries (i.e., China, Ghana, India, Mexico, Russia, South Africa), and the potential mediators of this relationship. Cross-sectional, nationally representative data from the Study on Global AGEing and Adult Health (2007-2010) were analysed. Past 12-month food insecurity was assessed with two questions on the frequency of eating less, and on hunger owing to a lack of food. Insomnia-related symptoms referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression and mediation analysis were conducted. Data on 42,489 adults aged ≥18 years were analysed (mean [standard deviation] age 43.8 [14.4] years; 50.1% females). The prevalence of any food insecurity and insomnia-related symptoms was 11.9% and 4.4%, respectively. After adjustment, compared with no food insecurity, moderate (odds ratio = 1.53, 95% confidence interval = 1.11-2.10) and severe food insecurity (odds ratio = 2.35, 95% confidence interval = 1.56-3.55) were significantly associated with insomnia-related symptoms. Anxiety, perceived stress, and depression mediated 27.7%, 13.5%, and 12.5% of the relationship between any food insecurity and insomnia-related symptoms, respectively (total percentage = 43.3%). Food insecurity was positively associated with insomnia-related symptoms in adults from six low- and middle-income countries. Anxiety, perceived stress, and depression explained a substantial proportion of this relationship. Addressing food insecurity itself or the identified potential mediators among people with food insecurity may lead to a reduction in sleep problems among adults in low- and middle-income countries, pending confirmation with longitudinal studies.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, Ewha Womans University, Seoul, South Korea
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
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Mazloomi SN, Talebi S, Kazemi M, Ghoreishy SM, Moosavian SP, Amirian P, Mohammadi H, Nouri-Majd S, Marx W, Hojjati Kermani MA, Moradi S. Food insecurity is associated with the sleep quality and quantity in adults: a systematic review and meta-analysis. Public Health Nutr 2022; 26:1-11. [PMID: 36416108 PMCID: PMC10131157 DOI: 10.1017/s1368980022002488] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/14/2022] [Accepted: 11/07/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We evaluated associations between food insecurity (FI) and the quality and quantity of sleep in adults (≥18 years). DESIGN The current study represented a systematic review and meta-analysis of observational studies. SETTING Databases of PubMed, Scopus, Embase and Web of Science were searched from inception until 6 June 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as OR and 95 % CI. PARTICIPANTS Data from ten eligible observational studies, including 83 764 participants, were included. RESULTS FI was associated with an increased risk of poor sleep quality (OR = 1·45; 95 % CI (1·24, 1·70), I2 = 95, P < 0·001, n 7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR = 1·31; 95 % CI (1·16, 1·48), I2 = 0 %, P < 0·001, n 5), moderate (OR = 1·49; 95 % CI (1·32, 1·68), I2 = 0 %, P < 0·001, n 5) and severe (OR = 1·89; 95 % CI (1·63, 2·20), I2 = 0 %, P < 0·001, n 5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR = 1·39; 95 % CI (1·05, 1·83), I2 = 91 %, P = 0·002, n 3) and trouble staying asleep (OR = 1·91; 95 % CI (1·37, 2·67), I2 = 89 %, P < 0·001, n 3). Moreover, FI was associated with the odds of shorter (OR = 1·14; 95 % CI (1·07, 1·21), I2 = 0 %, P < 0·001, n 4) and longer sleep duration (OR = 1·14; 95 % CI (1·03, 1·26), I2 = 0 %, P = 0·010, n 4). CONCLUSIONS Collective evidence supports that FI is associated with poor sleep quality and quantity in adults. Preventative and management strategies that address FI may provide health benefits beyond improving nutritional status per se.
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Affiliation(s)
- Seyadeh Narges Mazloomi
- The Health of Plant and Livestock Products Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Food and Drug Administration, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Kazemi
- Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Seyed Mojtaba Ghoreishy
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Parisa Moosavian
- Department of Community Nutrition, Vice-Chancellery for Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parsa Amirian
- General Practitioner, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Nouri-Majd
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Wolfgang Marx
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Mohammad Ali Hojjati Kermani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajjad Moradi
- Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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9
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Gyasi RM, Asamoah E, Gyasi-Boadu N, Zornu O, Asiki G, Phillips DR. Food insecurity and sleep quality among older adults: Findings from a population-based study in Ghana. Maturitas 2022; 157:27-33. [DOI: 10.1016/j.maturitas.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/21/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022]
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10
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Wang Q. Food Insecurity and Sleep Disturbance Among 223,561 Adolescents: A Multi-Country Analysis of Cross-Sectional Surveys. Front Public Health 2021; 9:693544. [PMID: 34660509 PMCID: PMC8517446 DOI: 10.3389/fpubh.2021.693544] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
This study was to investigate the association between food insecurity (FI) and sleep disturbance among adolescents. Based on the cross-sectional data of the Global School-based Student Health Survey, this study analyzed self-reported data from adolescents in 68 countries. Multivariate logistic regression and meta-analysis were used to evaluate the association between FI and sleep disturbance. The final sample included 223,561 adolescents. The prevalence of severe FI and sleep disturbance was 6.4% and 8.0%, respectively. Severe FI was significantly associated with a higher risk of sleep disturbance in 48 of the 68 countries after adjusting for covariates, with a pooled OR (95% CI) of 1.94 (1.79-2.09). Overall, the association between FI and sleep disturbance was similar across countries and gender, though a large level of heterogeneity existed across upper- and middle-income countries. Identifying adolescents suffering from FI and remedying the FI severity may be important to improve sleep quality in global adolescents.
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Affiliation(s)
- Qiuying Wang
- Educational Science Research Institute of Shenzhen, Shenzhen, China
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11
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Do EK, Bowen GA, Ksinan AJ, Adams EL, Fuemmeler BF. Sleep, Food Insecurity, and Weight Status: Findings from the Family Life, Activity, Sun, Health, and Eating Study. Child Obes 2021; 17:125-135. [PMID: 33493402 PMCID: PMC7984656 DOI: 10.1089/chi.2020.0259] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Shorter sleep duration and lower sleep quality have been previously associated with greater obesity risk among adult samples. Food insecurity has also been found to impact sleep patterns and obesity. Yet few studies have explored associations between sleep, food insecurity, and obesity in adolescent populations, who may have more irregular sleep patterns. Thus, the objectives of this study were to determine associations between measures of sleep, food insecurity, and weight status. Methods: Data were obtained from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, an online cross-sectional study of parent and adolescent (12-17-year old) dyads. Participants were drawn from a Consumer Opinion Panel representative of the general population of the United States with respect to sex, education, income, age, household size, and region. First, multinomial logistic regression analyses were conducted to determine associations between sleep measures (adolescent-reported average nighttime sleep duration, having a regular bedtime, and having difficulty staying asleep), food insecurity (a validated two-item parent-reported measure), and weight status (being underweight, of healthy weight, overweight, and obese). Weight status was based upon adolescent BMI z-scores using Centers for Disease Control and Prevention growth charts using information from parent report of adolescent height and weight and adolescent-reported age and sex among adolescents (N = 1544). Conditional process models were also fitted to the data to determine whether food insecurity moderates the associations between sleep measures and weight status, and to determine whether the association between food insecurity and weight status is mediated by average sleep duration. Results: Compared to those with food security, a greater percentage of those with food insecurity reported having difficulties staying asleep and a longer average sleep duration. Multinomial logistic regression models demonstrated that having a regular bedtime was associated with lower odds of having obesity, having difficulties staying asleep was associated with greater odds of being underweight, and having food insecurity was associated with greater odds of being overweight. Conditional process models demonstrated that food insecurity did not moderate associations between sleep measures and weight status and that average nighttime sleep duration did not mediate the association between food insecurity and weight status. Conclusions: This is one of the first studies to examine associations between sleep, food insecurity, and weight status among adolescents. Results provide additional support for the need to uncover mechanisms for how sleep and food insecurity affect pediatric obesity using longitudinal data.
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Affiliation(s)
- Elizabeth K. Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabrielle A. Bowen
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.,Department of Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Albert J. Ksinan
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth L. Adams
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA
| | - Bernard F. Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.,Department of Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.,Address correspondence to: Bernard F. Fuemmeler, PhD, MPH, Department of Health Behavior and Policy, Virginia Commonwealth University, Box 980430, Richmond, VA 23298, USA
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12
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Acceptability and feasibility of using actigraphy to assess habitual physical activity and sleep parameters in men and women living in rural communities in conflict-affected Eastern Democratic Republic of Congo. Glob Ment Health (Camb) 2020; 7:e33. [PMID: 33489248 PMCID: PMC7786272 DOI: 10.1017/gmh.2020.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/06/2020] [Accepted: 10/15/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The goals of this study were to (1) determine the feasibility and acceptability of using actigraphy to objectively measure sleep quality and habitual physical activity in rural Democratic Republic of Congo (DRC) and (2) examine the relationship between sleep parameters, self-report symptoms, daytime physical activity, and physical function, including the ability to work. METHOD Thirty individuals were asked to wear a wrist-worn accelerometer for 5 nights and 4 days. Nighttime sleep parameters derived were average and intra-individual variability (IIV) in total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), and wake after sleep onset (WASO). Daytime habitual physical data derived were average and peak activity and daytime napping. RESULTS Ninety-three percent (n = 28) of participants completed the study. All participants who wore the device marked sleep and wake cycles and periods of non-wear using the marker. Trauma-related symptoms were not associated with mean or IIV in TST, SE, SOL, or WASO (p > 0.01). Those with higher levels of bodily pain slept longer (β = 0.633, p = 0.003, adjusted R 2 = 0.279), were more likely to report that their physical health limited their physical activities (β = 0.71, p < 0.001, adjusted R 2 = 0.679) and had greater difficulty doing daily work (β = 0.84, p = 0.001, adjusted R 2 = 0.665). CONCLUSION The use of actigraphy to collect objective measures of activity and sleep quality in rural post-conflict settings is feasible and acceptable. Our preliminary findings suggest that bodily pain and not trauma-related symptoms have a significant impact on sleep and functional outcomes in men and women survivors of prolonged conflict in the DRC.
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13
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Troxel WM, Haas A, Ghosh-Dastidar B, Richardson AS, Hale L, Buysse DJ, Buman MP, Kurka J, Dubowitz T. Food Insecurity is Associated with Objectively Measured Sleep Problems. Behav Sleep Med 2020; 18:719-729. [PMID: 31545653 PMCID: PMC8152928 DOI: 10.1080/15402002.2019.1669605] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective/Background: Food Insecurity (FI) can be a profound source of stress, which may increase the risk for sleep disturbance. This is the first study to examine the association between FI and objectively and subjectively measured sleep. Participants: The sample included 785 adults living in two low-income neighborhoods (mean age = 56; 95% African American). Methods: FI was measured using a validated 10-item survey that assesses conditions and behaviors that characterize households when they lack financial resources to meet basic food needs. Sleep duration, efficiency, wakefulness after sleep onset (WASO), and variability in sleep duration were measured via actigraphy. Sleep quality was assessed via sleep diary. Sleep outcomes were analyzed as a function of FI, adjusting for covariates. Psychological distress was tested as a potential mediator. Results: Greater FI was associated with shorter actigraphy-assessed sleep duration (B = -2.44; SE = 1.24; i.e., 24 minutes shorter for the most as compared to least insecure group), poorer sleep efficiency (B = -.27; SE = .13); p's < .05), and poorer subjective sleep quality (B = -.03; SE = .01; p < .01). Greater FI was also associated with greater likelihood of short (<7 hours; OR = 1.11; CI: 1.02-1.21) and long sleep (>9 hours; OR = 1.19; CI: 1.01-1.39), compared to the recommended sleep duration of 7-9 hours. Psychological distress partially mediated the association between FI and subjective sleep quality. Conclusions: Addressing or mitigating food insecurity may present a novel opportunity for improving sleep health among low-income populations.
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Affiliation(s)
| | - Ann Haas
- RAND Corporation, Health Division, Pittsburgh, PA 15213
| | | | | | - Lauren Hale
- Stony Brook University, Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook, NY 11794-8338
| | - Daniel J. Buysse
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA 15213
| | - Matthew P. Buman
- Arizona State University, College of Health Solutions, Phoenix, AZ 85004
| | - Jonathan Kurka
- Arizona State University, College of Health Solutions, Phoenix, AZ 85004
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14
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Food insecurity is associated with suboptimal sleep quality, but not sleep duration, among low-income Head Start children of pre-school age. Public Health Nutr 2019; 23:701-710. [PMID: 31775944 DOI: 10.1017/s136898001900332x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the association between food insecurity and child sleep outcomes and to investigate whether parent psychosocial factors mediate such associations. DESIGN Cross-sectional study. Usual wake time and bedtime, bedtime routine and sleep quality were reported by parents using the adapted Brief Infant Sleep Questionnaire. Food insecurity was assessed using the eighteen-item US Department of Agriculture Household Food Security Module. Parent psychosocial factors, including perceived stress, parenting self-efficacy and depressive symptomology, were assessed using validated scales. Multivariable logistic regression models were performed to determine the association between food insecurity and sleep outcomes controlling for potential confounders. Mediation analyses and Sobel tests were applied to test the mediating effect of psychosocial factors. SETTING Head Start pre-school classrooms in four regions across central Pennsylvania, USA. PARTICIPANTS Low-income children of pre-school age (n 362) and their caregivers. RESULTS Prevalence of household, adult and child food insecurity was 37·3, 31·8 and 17·7 %, respectively. Food security status at any level was not associated with child sleep duration or bedtime routine. Child food insecurity, but not household or adult food insecurity, was associated with 2·25 times increased odds (95 % CI 1·11, 4·55) of poor child sleep quality in the adjusted model. Perceived stress, self-efficacy and depressive symptomology mediated less than 2 % of the observed effect (all Sobel test P > 0·6). CONCLUSION Food insecurity, particularly at the child level, is a potential modifiable risk factor for reducing sleep-related health disparities in early childhood. Future studies are needed to explore the plausible mechanisms underlying the associations between food insecurity and adverse child sleep outcomes.
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15
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Bermúdez-Millán A, Wagner JA, Feinn RS, Segura-Pérez S, Damio G, Chhabra J, Pérez-Escamilla R. Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes. J Nutr 2019. [PMID: 31006809 DOI: 10.1093/jn/nxz021+[doi]] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Household food insecurity (HFI) is a stressor that is associated with type 2 diabetes (T2D). However, little is known about HFI and the insulin resistance (IR) underlying T2D, and the mechanisms involved. OBJECTIVE We examined the cross-sectional association between HFI and IR among low-income Latinos with T2D and tested whether inflammation and stress hormones mediated this association. METHODS HFI was measured with the 6-item US Household Food Security Survey module. IR was calculated from fasting plasma blood glucose and serum insulin. Inflammation was indicated by high-sensitivity C-reactive protein (hsCRP), and stress hormones included urinary cortisol, metanephrine, and normetanephrine. To test for an indirect effect of HFI on homeostasis model assessment of IR, a parallel multiple mediation model was run with biological markers that significantly differed between food security status-entered as mediators in the model. We used 95% bias-corrected bootstrap CIs, with 10,000 bootstrap samples, to assess the significance of the indirect effects. RESULTS The 121 participants with T2D were primarily Puerto Rican (85.8%), aged mean = 60.7 y, and 74% were female. Eighty-two (68%) were classified as food insecure. Compared with food-secure individuals, food-insecure individuals had a significantly higher IR [mean difference (Δ) = 7.21, P = 0.001], insulin (Δ = 9.7, P = 0.019), glucose (Δ = 41, P < 0.001), hsCRP (Δ = 0.8, P = 0.008), cortisol (Δ = 21, P = 0.045), and total cholesterol (Δ = 29, P = 0.004). Groups did not differ on other lipids, metanephrine, normetanephrine, or A1c. The mediation model showed a significant direct effect of HFI on hsCRP (P = 0.020) and on cortisol (P = 0.011). There was a direct effect of cortisol (P = 0.013), hsCRP (P = 0.044), and HFI on IR (P = 0.015). The total combined indirect effect of HFI through cortisol and hsCRP indicated partial mediation. CONCLUSIONS Among Latinos with T2D, HFI is associated with IR partially through inflammation and stress hormones. Interventions to ameliorate HFI and mitigate its effects on inflammation, stress, and IR are warranted. This trial was registered at clinicaltrials.gov as NCT01578096.
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Affiliation(s)
| | - Julie A Wagner
- Psychiatry, University of Connecticut School of Medicine.,Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, UConn Health, Farmington, CT
| | - Richard S Feinn
- School of Medicine, Medical Sciences, Quinnipiac University, Hamden, CT
| | | | | | - Jyoti Chhabra
- Research Administration, Hartford Hospital, Hartford, CT
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
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16
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Bermúdez-Millán A, Wagner JA, Feinn RS, Segura-Pérez S, Damio G, Chhabra J, Pérez-Escamilla R. Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes. J Nutr 2019; 149:982-988. [PMID: 31006809 PMCID: PMC6543200 DOI: 10.1093/jn/nxz021] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 11/27/2018] [Accepted: 01/28/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Household food insecurity (HFI) is a stressor that is associated with type 2 diabetes (T2D). However, little is known about HFI and the insulin resistance (IR) underlying T2D, and the mechanisms involved. OBJECTIVE We examined the cross-sectional association between HFI and IR among low-income Latinos with T2D and tested whether inflammation and stress hormones mediated this association. METHODS HFI was measured with the 6-item US Household Food Security Survey module. IR was calculated from fasting plasma blood glucose and serum insulin. Inflammation was indicated by high-sensitivity C-reactive protein (hsCRP), and stress hormones included urinary cortisol, metanephrine, and normetanephrine. To test for an indirect effect of HFI on homeostasis model assessment of IR, a parallel multiple mediation model was run with biological markers that significantly differed between food security status-entered as mediators in the model. We used 95% bias-corrected bootstrap CIs, with 10,000 bootstrap samples, to assess the significance of the indirect effects. RESULTS The 121 participants with T2D were primarily Puerto Rican (85.8%), aged mean = 60.7 y, and 74% were female. Eighty-two (68%) were classified as food insecure. Compared with food-secure individuals, food-insecure individuals had a significantly higher IR [mean difference (Δ) = 7.21, P = 0.001], insulin (Δ = 9.7, P = 0.019), glucose (Δ = 41, P < 0.001), hsCRP (Δ = 0.8, P = 0.008), cortisol (Δ = 21, P = 0.045), and total cholesterol (Δ = 29, P = 0.004). Groups did not differ on other lipids, metanephrine, normetanephrine, or A1c. The mediation model showed a significant direct effect of HFI on hsCRP (P = 0.020) and on cortisol (P = 0.011). There was a direct effect of cortisol (P = 0.013), hsCRP (P = 0.044), and HFI on IR (P = 0.015). The total combined indirect effect of HFI through cortisol and hsCRP indicated partial mediation. CONCLUSIONS Among Latinos with T2D, HFI is associated with IR partially through inflammation and stress hormones. Interventions to ameliorate HFI and mitigate its effects on inflammation, stress, and IR are warranted. This trial was registered at clinicaltrials.gov as NCT01578096.
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Affiliation(s)
| | - Julie A Wagner
- Psychiatry, University of Connecticut School of Medicine
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, UConn Health, Farmington, CT
| | - Richard S Feinn
- School of Medicine, Medical Sciences, Quinnipiac University, Hamden, CT
| | | | | | - Jyoti Chhabra
- Research Administration, Hartford Hospital, Hartford, CT
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
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17
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Patterson F, Robson S, McGarry C, Taylor D, Halvorsen S, Rex S, Landgraf R. Testing the feasibility of a system-based approach to deliver a smoking cessation and food nudging intervention at food pantry sites. Transl Behav Med 2019; 10:146-154. [PMID: 31150558 PMCID: PMC7529036 DOI: 10.1093/tbm/ibz078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Food-insecure adults disproportionately experience high cardiovascular risk. Guided by the Feeding America recommendations, we tested the feasibly of a system-based approach to address the cardiovascular risk behaviors of current smoking and dietary choice at food distribution sites. Food pantries affiliated with the Food Bank of Delaware organization (N = 14) were invited to take part. Pantries who agreed solicited personnel within the pantry (i.e., staff, active volunteers) to become trained as quit-smoking coaches and/or food environment "nudging" interventionists. After training, trained personnel implemented the evidence-based treatments. Across a 6-month observation period, quit coaches reported each month on the number of (a) enrolled food pantry clients, (b) total quit-smoking sessions scheduled and attended, and (c) the smoking status of clients who attended the final, third session. Trained evaluators visited participating pantries once per month across the observation period to assess adherence to nudging guidelines. One in five (21%; 3/14) invited pantries participated in the study, and five personnel were trained to deliver intervention components. Across the observation period, quit coaches reported that 86 new smoking cessation clients were enrolled, 228 quit coaching sessions were scheduled, and 187 attended (82% attendance rate). Smoking cessation rates were estimated at 19%-36%. A 100% adherence to the food nudging approach was observed. These data demonstrate the feasibility of a system-based approach to build the capacity of food distribution sites and personnel to deliver smoking cessation quit-coaching and food nudging interventions on-site.
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Affiliation(s)
- Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, The Tower at STAR, University of Delaware, Newark, DE, USA,Correspondence to: F Patterson,
| | - Shannon Robson
- Department of Behavioral Health and Nutrition, College of Health Sciences, The Tower at STAR, University of Delaware, Newark, DE, USA
| | | | - Denise Taylor
- Department of Behavioral Health and Nutrition, College of Health Sciences, The Tower at STAR, University of Delaware, Newark, DE, USA
| | - Samantha Halvorsen
- Department of Behavioral Health and Nutrition, College of Health Sciences, The Tower at STAR, University of Delaware, Newark, DE, USA
| | - Samantha Rex
- Department of Behavioral Health and Nutrition, College of Health Sciences, The Tower at STAR, University of Delaware, Newark, DE, USA
| | - Rita Landgraf
- Partnership for Healthy Communities, College of Health Sciences, The Tower at STAR, University of Delaware, Newark, DE, USA
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18
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Bermúdez-Millán A, Wagner JA, Feinn RS, Segura-Pérez S, Damio G, Chhabra J, Pérez-Escamilla R. Inflammation and Stress Biomarkers Mediate the Association between Household Food Insecurity and Insulin Resistance among Latinos with Type 2 Diabetes. J Nutr 2019. [DOI: 10.1093/jn/nxz021 [doi]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
ABSTRACT
Background
Household food insecurity (HFI) is a stressor that is associated with type 2 diabetes (T2D). However, little is known about HFI and the insulin resistance (IR) underlying T2D, and the mechanisms involved.
Objective
We examined the cross-sectional association between HFI and IR among low-income Latinos with T2D and tested whether inflammation and stress hormones mediated this association.
Methods
HFI was measured with the 6-item US Household Food Security Survey module. IR was calculated from fasting plasma blood glucose and serum insulin. Inflammation was indicated by high-sensitivity C-reactive protein (hsCRP), and stress hormones included urinary cortisol, metanephrine, and normetanephrine. To test for an indirect effect of HFI on homeostasis model assessment of IR, a parallel multiple mediation model was run with biological markers that significantly differed between food security status—entered as mediators in the model. We used 95% bias-corrected bootstrap CIs, with 10,000 bootstrap samples, to assess the significance of the indirect effects.
Results
The 121 participants with T2D were primarily Puerto Rican (85.8%), aged mean = 60.7 y, and 74% were female. Eighty-two (68%) were classified as food insecure. Compared with food-secure individuals, food-insecure individuals had a significantly higher IR [mean difference (Δ) = 7.21, P = 0.001], insulin (Δ = 9.7, P = 0.019), glucose (Δ = 41, P < 0.001), hsCRP (Δ = 0.8, P = 0.008), cortisol (Δ = 21, P = 0.045), and total cholesterol (Δ = 29, P = 0.004). Groups did not differ on other lipids, metanephrine, normetanephrine, or A1c. The mediation model showed a significant direct effect of HFI on hsCRP (P = 0.020) and on cortisol (P = 0.011). There was a direct effect of cortisol (P = 0.013), hsCRP (P = 0.044), and HFI on IR (P = 0.015). The total combined indirect effect of HFI through cortisol and hsCRP indicated partial mediation.
Conclusions
Among Latinos with T2D, HFI is associated with IR partially through inflammation and stress hormones. Interventions to ameliorate HFI and mitigate its effects on inflammation, stress, and IR are warranted. This trial was registered at clinicaltrials.gov as NCT01578096.
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Affiliation(s)
| | - Julie A Wagner
- Psychiatry, University of Connecticut School of Medicine
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, UConn Health, Farmington, CT
| | - Richard S Feinn
- School of Medicine, Medical Sciences, Quinnipiac University, Hamden, CT
| | | | | | - Jyoti Chhabra
- Research Administration, Hartford Hospital, Hartford, CT
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
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Kalousová L, Xiao B, Burgard SA. Material hardship and sleep: results from the Michigan Recession and Recovery Study. Sleep Health 2019; 5:113-127. [PMID: 30864549 DOI: 10.1016/j.sleh.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 10/29/2018] [Accepted: 11/02/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Sleep is unequally distributed in the US population. People with low socioeconomic status report worse quality and shorter sleep than people with high socioeconomic status. Past research hypothesized that a potential reason for this link could be exposure to material hardship. This study examines the associations between several material hardships and sleep outcomes. METHODS We use population-representative cross-sectional data (n = 730) from the Michigan Recession and Recovery Study collected in 2013 and examine the associations between 6 indicators of material hardship (employment instability, financial problems, housing instability, food insecurity, forgone medical care, and the total number of material hardships reported) and 3 sleep outcomes (short sleep, sleep problems, and nonrestorative sleep). We build multivariable logistic regression models controlling for respondents' characteristics and light pollution near their residence. RESULTS In unadjusted models, all material hardships were associated with negative sleep outcomes. In adjusted models, forgone medical care was a statistically significant predictor of nonrestorative sleep (average marginal effect 0.16), as was employment instability (average marginal effect 0.12). The probability of sleep problems and nonrestorative sleep increased with a greater number of hardships overall (average marginal effects of .02 and .05, respectively). We found marginally statistically significant positive associations between food insecurity and short sleep and sleep problems. CONCLUSIONS This study finds that, except when considering foregone medical care, employment instability, and total count of material hardships, associations between material hardship and negative sleep outcomes are not statistically significant after adjusting for a robust set of sociodemographic and health characteristics.
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20
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Mundo-Rosas V, Vizuet-Vega NI, Martínez-Domínguez J, Morales-Ruán MDC, Pérez-Escamilla R, Shamah-Levy T. [Evolution of food insecurity in Mexican households: 2012-2016]. SALUD PUBLICA DE MEXICO 2019; 60:309-318. [PMID: 29746748 DOI: 10.21149/8809] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 03/07/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To describe three relevant aspects of household food insecurity (FI) in Mexico: its magnitude, its distribution by social and nutritional vulnerability characteristics; its evolution between 2012 and 2016 and the effect of food assistance programs on FI in Mexican households. MATERIALS AND METHODS Data on 9 019 households were drawn from the 2016 National Health and Nutrition Survey (Ensanut 2016 for its Spanish initials) and were compared with data from the 2012 Ensanut. An analysis of differences in differences was made to measure the effect of food assis-tance programs on the evolution of FI. RESULTS As many as 69.5% of households were classified as FI. Families located in rural areas (78.0%) and residing in southern Mexico (76.3%). Households with support from a food assistance program experienced a decrease in moderate and severe FI between 2012 and 2016. CONCLUSIONS Findings can be used to design and target public policies seeking to improve food security governance in Mexico.
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Affiliation(s)
| | | | | | | | | | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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21
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Narcisse MR, Long CR, Felix H, Rowland B, Bursac Z, McElfish PA. The Mediating Role of Sleep Quality and Quantity in the Link Between Food Insecurity and Obesity Across Race and Ethnicity. Obesity (Silver Spring) 2018; 26:1509-1518. [PMID: 30226012 DOI: 10.1002/oby.22266] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 07/03/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of the study was to examine the mediating role of sleep quality and quantity in the relationship between food insecurity and obesity across races/ethnicities. METHODS Bivariate negative binomial regression and multinomial logistic regression were used to examine direct associations between food insecurity and sleep quality and quantity among non-Hispanic Native Hawaiian and other Pacific Islanders (NHPI) relative to non-Hispanic White, Black, Asian, and Hispanic individuals with obesity. The potential outcomes approach and adjusted Wald test were used to explore the mediating role of sleep quality and quantity and the moderating role of race/ethnicity, respectively. RESULTS Among adults with obesity, the study found a positive and direct relationship between food insecurity and trouble falling asleep in each racial/ethnic group. Trouble staying asleep was associated with food insecurity in each racial/ethnic group, except in the Asian group. Positive and direct associations were observed between food insecurity and short/very short sleep. A positive and direct relationship was found between food insecurity and having obesity in each racial/ethnic group, except in the Black group. Sleep quality and sleep quantity partially mediated the relationship between food insecurity and obesity in non-Hispanic NHPI, White, Asian, and Hispanic individuals. Race/ethnicity moderated the indirect effects of food insecurity on sleep quality and quantity. CONCLUSIONS Food security and sleep hygiene should be an integral part of the fight against obesity.
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Affiliation(s)
- Marie-Rachelle Narcisse
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
| | - Christopher R Long
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
| | - Holly Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
| | - Zoran Bursac
- Health Science Center, University of Tennessee, Memphis, Tennessee, USA
| | - Pearl A McElfish
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
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22
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Pérez-Escamilla R. Food Security and the 2015-2030 Sustainable Development Goals: From Human to Planetary Health: Perspectives and Opinions. Curr Dev Nutr 2017; 1:e000513. [PMID: 29955711 PMCID: PMC5998358 DOI: 10.3945/cdn.117.000513] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/05/2017] [Accepted: 06/17/2017] [Indexed: 12/11/2022] Open
Abstract
Food security exists when "all people, at all times have physical and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life" (http://www.fao.org/wfs/index_en.htm). Close to 800 million individuals do not have access to enough food, >2 billion individuals experience key micronutrient deficiencies, and ∼60% of individuals in low-income countries are food insecure. Food insecurity negatively affects human physical, social, emotional, and cognitive development throughout the life course and is a major social and environmental disruptor with serious repercussions for planetary health (i.e., the health of human civilization and the state of the natural systems on which it depends). Food security is related to all of the United Nations Sustainable Development Goals (SDGs). Improved food security governance based on sound, equitable, and sustainable food systems that benefit from modern information and sustainable and equitable agricultural technologies is essential for countries to meet the SDGs.
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Affiliation(s)
- Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences and Global Health Concentration, Yale School of Public Health, New Haven, CT
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23
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Bermúdez-Millán A, Pérez-Escamilla R, Segura-Pérez S, Damio G, Chhabra J, Osborn CY, Wagner J. Psychological Distress Mediates the Association between Food Insecurity and Suboptimal Sleep Quality in Latinos with Type 2 Diabetes Mellitus. J Nutr 2016; 146:2051-2057. [PMID: 27489004 PMCID: PMC5037870 DOI: 10.3945/jn.116.231365] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/27/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Evidence increasingly indicates that poor sleep quality is a major public health concern. Household food insecurity (HFI) disproportionately affects Latinos and is a novel risk factor for poor sleep quality. Psychological distress may be a potential mechanism through which HFI affects sleep quality. Sleep, food insecurity, and distress are linked to type 2 diabetes mellitus. OBJECTIVES We examined the relations between HFI, psychological distress, and sleep quality and tested whether psychological distress mediates the relation between HFI and sleep in people with diabetes mellitus. METHODS Latinos with type 2 diabetes mellitus (n = 121) who completed baseline assessments for the CALMS-D (Community Health Workers Assisting Latinos Manage Stress and Diabetes) stress management intervention trial completed the US Household Food Security Survey, and measures of depressive symptoms [Personal Health Questionnaire Depression Scale (PHQ-8)], anxiety symptoms [Patient-Reported Outcomes Measurement Information System (PROMIS)-short], diabetes distress [Problem Areas in Diabetes Questionnaire (PAID-5)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Psychological distress was operationalized with the PHQ-8, PROMIS-short, and PAID-5 scales. We used unadjusted and adjusted indirect effect tests with bias-corrected bootstrapped 95% CIs on 10,000 samples to test both relations between variables and potential mediation. RESULTS Mean age was 61 y, 74% were women, and 67% were food insecure. Experiencing HFI was associated with both greater psychological distress and worse sleep quality (P < 0.05). Depressive symptoms (adjusted R2: 2.22, 95% CI: 1.27, 3.42), anxiety symptoms (adjusted R2: 1.70, 95% CI: 0.87, 2.85), and diabetes mellitus distress (adjusted R2: 0.60, 95% CI: 0.11, 1.32) each mediated the relation between HFI and worse sleep quality with and without adjustment for age, education, income, marital status, and employment status. CONCLUSIONS Household food insecurity is a common and potent household stressor that is associated with suboptimal sleep quality through psychological distress. Efforts to improve food security and decrease psychological distress may yield improved sleep in this high-risk population. The CALMS-D stress management trial was registered at clinicaltrials.gov as NCT01578096.
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Affiliation(s)
- Angela Bermúdez-Millán
- Division of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut Health, Farmington, CT;
| | | | | | | | - Jyoti Chhabra
- Research Program, Hartford Hospital, Hartford, CT; and
| | - Chandra Y Osborn
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Julie Wagner
- Division of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut Health, Farmington, CT
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Association of Household Food Insecurity with the Mental and Physical Health of Low-Income Urban Ecuadorian Women with Children. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2016; 2016:5256084. [PMID: 27752266 PMCID: PMC5056290 DOI: 10.1155/2016/5256084] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/28/2016] [Indexed: 12/11/2022]
Abstract
Chronic physical and mental health conditions account for a rising proportion of morbidity, mortality, and disability in the Americas region. Household food insecurity (HFI) has been linked to chronic disease in US and Canadian women but it is uncertain if the same is true for low- and middle-income Latin American countries in epidemiologic transition. We conducted a survey to investigate the association of HFI with the physical and mental health of 794 women with children living in low-income Quito, Ecuador, neighborhoods. Data were collected on HFI and health indicators including self-reported health (SF-1), mental health (MHI-5), blood pressure, and self-reported mental and physical health complaints. Fasting blood glucose and lipids were measured in a subsample. The multivariate analyses revealed that HFI was associated with poorer self-rated health, low MHI-5 scores, and mental health complaints including stress, depression, and ethnospecific illnesses. It was also associated with chest tightness/discomfort/pain, dental disease, and gastrointestinal illness but not other conditions. The findings suggest that improving food security in low-income households may help reduce the burden of mental distress in women with children. The hypothesized link with diabetes and hypertension may become more apparent as Ecuador moves further along in the epidemiologic transition.
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