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Sholeye OO, Sodeinde KJ, Animasahun VJ, Ojeahere M, Gbadebo AA. Food insufficiency and its associated factors: Experiences of in-school adolescents in Sagamu Township, southwest Nigeria. Nutr Health 2024; 30:381-388. [PMID: 36062626 DOI: 10.1177/02601060221123183] [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] [Indexed: 11/16/2022]
Abstract
Background: The burden of hunger, food insecurity and malnutrition in sub-Saharan Africa is enormous. A higher proportion of the population suffer the consequences of food insecurity, hunger and undernourishment than previously assumed. Food insecurity among adolescents has been documented to be associated with malnutrition, poor health outcomes, low educational attainment and other negative consequences. Aim: This study therefore assessed food insecurity and its associated factors among adolescents in Sagamu, Ogun State, Nigeria. Methods: A cross-sectional study was conducted among 1300 in-school adolescents in Sagamu Township, Ogun State in southwestern Nigeria, selected via multi-stage sampling. A semi-structured, self-administered questionnaire was used for data collection. Data were analyzed with the aid of SPSS 20.0. Relevant descriptive and inferential statistics were calculated, with p < 0.05. Result: The prevalence of food insecurity was 45%, of which 34.6% had mild food insecurity, 34.7% had moderate food insecurity, while others experienced the severe form of food insecurity. Gender, age; maternal occupation, maternal education, living arrangement, low sense of self-worth, alcohol intake and cigarette smoking were associated (p < 0.05) with food insecurity. Predictors of food insecurity were: age; maternal education, living arrangement and some behavioral factors. Conclusion: The prevalence of food insecurity among adolescents in Sagamu was high. Multi-sectorial action is essential in tackling the challenges of food insecurity and its numerous consequences among adolescents, at all levels of governance.
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Affiliation(s)
- Oluwafolahan O Sholeye
- Department of Community Medicine and Primary Care, Faculty of Clinical Sciences, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Kolawole J Sodeinde
- Department of Community Medicine, Benjamin Carson (Snr) School of Medicine, Babcock University, Ilishan-Remo, Nigeria
| | | | - Margaret Ojeahere
- Child and Adolescent Psychiatry Unit, Jos University Teaching Hospital, Jos, Nigeria
| | - Abiola A Gbadebo
- Department of Community Medicine and Primary Care, Faculty of Clinical Sciences, Olabisi Onabanjo University, Sagamu, Nigeria
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Hammad NM, Wolfson JA, de Ferranti SD, Willett WC, Leung CW. Food Insecurity and Ideal Cardiovascular Health Risk Factors Among US Adolescents. J Am Heart Assoc 2024; 13:e033323. [PMID: 38591328 DOI: 10.1161/jaha.123.033323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/08/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Food insecurity, a social and economic condition of limited availability of healthy food, is a risk factor for adverse cardiovascular health outcomes among adults; few studies have been conducted in adolescents. This study explores the association between food insecurity and cardiovascular health risk factors among a nationally representative sample of US adolescents, adopting the American Heart Association's Life's Essential 8 metric. METHODS AND RESULTS We analyzed data from 2534 adolescents aged 12 to 19 years from the 2013 to 2018 National Health and Nutrition Examination Surveys. In the sample, 24.8% of adolescents lived in food-insecure households. After multivariable adjustment, food insecurity was associated with a 3.23-unit lower total Life's Essential 8 score (95% CI, -6.32, -0.15) and lower scores on diet quality (β=-5.39 [95% CI, -8.91, -1.87]) and nicotine exposure (β=-4.85 [95% CI, -9.24, -0.45]). Regarding diet, food insecurity was associated with 5% lower Healthy Eating Index-2015 scores [95% CI, -7%, -2%], particularly lower intakes of whole grains and seafood/plant proteins and marginally higher intake of added sugar. Regarding nicotine exposure, food insecurity was associated with ever use of a tobacco product among m (odds ratio, 1.74 [95% CI, 1.20-2.53]). Compared with their food-secure counterparts, food-insecure male (odds ratio, 1.98 [95% CI, 1.07-3.65]) and female (odds ratio, 3.22 [95% CI, 1.60-6.45]) adolescents had higher odds of living with a current indoor smoker. CONCLUSIONS In this nationally representative sample of adolescents, food insecurity was associated with multiple indicators of cardiovascular health risk. These findings underscore the need for public health interventions and policies to reduce food insecurity and improve cardioprotective behaviors during adolescence, with particular efforts targeting diet quality and nicotine exposure.
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Affiliation(s)
- Nour M Hammad
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA
| | - Julia A Wolfson
- Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore MD
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | | | - Walter C Willett
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA
| | - Cindy W Leung
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA
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Onono MA, Frongillo EA, Sheira LA, Odhiambo G, Wekesa P, Conroy AA, Cohen CR, Bukusi EA, Weiser SD. Links between Household-Level Income-Generating Agricultural Intervention and the Psychological Well-Being of Adolescent Girls in Human Immunodeficiency Virus-Affected Households in Southwestern Kenya: A Qualitative Inquiry. J Nutr 2023; 153:3595-3603. [PMID: 37863268 PMCID: PMC10739770 DOI: 10.1016/j.tjnut.2023.10.008] [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: 04/05/2023] [Revised: 09/26/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Adolescent girls may experience poor psychological well-being, such as social isolation, shame, anxiety, hopelessness, and despair linked to food insecurity. OBJECTIVES This study aimed to investigate the experiences with and perceived effects of a household-level income-generating agricultural intervention on the psychological well-being of adolescent girls in human immunodeficiency virus (HIV)-affected households in southwestern Kenya. METHODS We conducted 62 in-depth interviews with HIV-affected adolescent girls and caregiver dyads in Adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a household member participating in Shamba Maisha (NCT01548599), a multisectoral agricultural and finance intervention trial aimed to improve food security and HIV health indicators. Participants were purposively sampled to ensure diversity in terms of age and location. Data were audiotaped, transcribed, translated, and uploaded into Dedoose (Sociocultural Research Consultants, LLC) software for management. Data were analyzed thematically based on reports from Dedoose. RESULTS We found evidence that a household-level structural intervention aimed at increasing food and financial security among persons living with HIV can contribute to better psychological well-being among adolescent girls residing in these households. The intervention also affected: 1) reduction of social isolation, 2) reduction of shame and stigma, 3) increased attendance and concentration in school, 4) improved caregiver mental health, and 5) reduced parental aggression and improved household communication. These associations were reported more commonly among those in the intervention arm than the control arm. CONCLUSIONS This study extends existing research by demonstrating how multisectoral structural interventions delivered at a household level can improve the psychological well-being of adolescents. We recommend that future research test livelihood interventions designed specifically for adolescent girls that integrate food-security interventions with other elements to address the social and psychological consequences of food insecurity holistically. This trial was registered at clinicaltrials.gov as NCT03741634.
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Affiliation(s)
- Maricianah A Onono
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States.
| | - Lila A Sheira
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California San Francisco, CA, United States
| | - Gladys Odhiambo
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Pauline Wekesa
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Amy A Conroy
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
| | - Craig R Cohen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Elizabeth A Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California San Francisco, CA, United States
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Hopkins L, Schier H, May L, Westrick M, O'Piela D, Mazurek Melnyk B, Smith L, Gunther C. Patterns of participation in summer programming among United States' elementary children from low-income urban households: Results from the project SWEAT study. Prev Med Rep 2023; 36:102475. [PMID: 37886725 PMCID: PMC10598049 DOI: 10.1016/j.pmedr.2023.102475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Food insecurity increases among marginalized children during the summer when school is out of session. Summer programming that offers access to healthy meals and snacks may reduce the risk. There is a national call in the US for more research to assure equitable access to summer programming. The objective of this prospective observational study was to characterize patterns of participation in summer programming among elementary children from low-income urban neighborhoods of metropolitan[Blinded]. Summer programming was broadly defined (e.g., church, school, recreation center, community center). Caregivers(n = 100) received weekly text messages via TextIt during the summer (Jun-Aug 2017). They were asked: "How many days this week did [ChildName] attend a summer program? Please respond with a number from 0 to 5, where 0 - no days, 2 - 2 days, etc." Weekly counts were summed. Stepwise logistic and linear regression models were conducted to examine differences in patterns of attendance according to key sociodemographic characteristics. Mean age was 7.03 ± 0.23. 52 % identified as female, 70 % were low-income, and 80.0 % identified as Black. 51 % attended summer programming at least once; 49 % never attended. Those who attended at least once vs. not at all were more likely to be male(p < 0.01); 62.75 % males vs. 37.25 % females attended summer programming at least once, whereas 67.35 % females compared to 32.65 % males never attended. Overall mean attendance was 10.40 ± 1.43 days(out of 50). Mean + SE attendance was lower for females (7.52 + 1.76) vs. males (13.52 + 2.21)(p < 0.05), and non-Black (4.30 + 1.97) vs. Black (11.93 + 1.67)(p = 0.01) children. Future research is needed to understand barriers to participation in summer programming.
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Affiliation(s)
- Laura Hopkins
- Department of Public Health and Prevention Science, College of Education and Health Sciences, Baldwin Wallace University, USA
| | - Heather Schier
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Leah May
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Miranda Westrick
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Devin O'Piela
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Bernadette Mazurek Melnyk
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Laureen Smith
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
| | - Carolyn Gunther
- College of Nursing, Martha S. Pitzer Center for Woman, Children, and Youth, The Ohio State University, USA
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Sanjeevi N, Monsivais P. Association of Food Insecurity Status with Resolution of Mental Health Conditions in Children and Adolescents. J Dev Behav Pediatr 2023; 44:e536-e542. [PMID: 37796631 DOI: 10.1097/dbp.0000000000001212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/06/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE Adverse consequences related to unresolved mental health issues underscore the importance of identifying factors that impede resolution of mental health conditions. Although studies have identified food insecurity as a risk factor for the diagnosis of mental health conditions, its impact on unresolved mental health issues is not understood. The objective of this study is to investigate the association of food insecurity status with resolution of depression, anxiety, and behavioral/conduct problems in children and adolescents. METHODS Using National Survey of Children's Health 2016 to 2019, logistic regression analyses examined the relationship of food insecurity status with the diagnosis and resolution of depression, anxiety, and behavioral/conduct problems in children (aged 5-11 years) and adolescents (aged 12-17 years). RESULTS Mild, moderate, and severe food insecurity were significantly associated with higher odds of being diagnosed with depression, anxiety, and behavioral/conduct problems. Severe food insecurity was significantly associated with higher odds of unresolved behavioral/conduct problems in children (adjusted odds ratio [aOR], 10.09; 95% confidence interval [CI], 2.99-34.04), after adjustment for demographic covariates. In adolescents, severe food insecurity was significantly related to greater odds of unresolved depression (aOR, 6.64; 95% CI, 2.13-20.70), anxiety (aOR, 3.27; 95% CI, 1.31-8.14), and behavioral/conduct problems (aOR, 5.57; 95% CI, 2.09-14.85). These associations of severe food insecurity with unresolved mental health conditions were significant even after adjustment for the receipt of mental health care. Mild and moderate food insecurity were not significantly associated with unresolved mental health conditions. CONCLUSION The findings suggest that severe food insecurity is associated with increased odds of unresolved mental health conditions in children and adolescents. This study highlights the importance of tailoring interventions to provide appropriate mental health services for children and adolescents from severely food insecure households.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA
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Frank ML, Sato AF. Food Insecurity and Depressive Symptoms Among Adolescents: Does Federal Nutrition Assistance Act as a Buffer? J Dev Behav Pediatr 2023; 44:e41-e48. [PMID: 36563345 PMCID: PMC9793962 DOI: 10.1097/dbp.0000000000001143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Food insecurity has been associated with a variety of adverse outcomes in adolescents. However, further research is needed to elucidate whether adolescent self-report food insecurity contributes to depressive symptoms. This study examined the (1) association between food insecurity and depressive symptoms and (2) moderating role of federal nutrition assistance in a nonclinical sample of adolescents. METHOD Adolescents aged 12 to 17 years (N = 141) and one parent/guardian completed self-report questionnaires as part of 2 larger studies examining adolescent stress and eating behaviors. Adolescents (M age = 13.79 years, SD = 1.60, 53.9% female) completed measures of food insecurity and depressive symptoms. RESULTS A bootstrapped linear regression model demonstrated that adolescent food insecurity was significantly, positively associated with depressive symptoms, 95% confidence interval (CI) (0.19-1.64), after controlling for biological sex. Among dyads eligible for federal nutrition assistance (N = 64), the interaction between adolescent food insecurity and National School Lunch Program (NSLP) participation did not reach significance, ΔF(1, 59) = 1.06, 95% CI (-3.80 to 9.29). The interaction between adolescent food insecurity and Supplemental Nutrition Assistance Program (SNAP) participation trended toward significance, ΔF(1, 59) = 2.88, 95% CI (-5.73 to 0.47). CONCLUSION Adolescents with food insecurity may be at a greater risk for experiencing elevated depressive symptoms. Whereas NSLP participation did not act as a buffer, SNAP participation may attenuate the association between food insecurity and depressive symptoms. Larger longitudinal studies are needed to develop a greater understanding of factors that may alter the relationship between adolescent food insecurity and depressive symptoms.
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Affiliation(s)
- Miranda L. Frank
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | - Amy. F. Sato
- Department of Psychological Sciences, Kent State University, Kent, Ohio
- Brain Health Research Initiative, Kent State University, Kent, Ohio
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Lin WC, Liu C, Kosillo P, Tai LH, Galarce E, Bateup HS, Lammel S, Wilbrecht L. Transient food insecurity during the juvenile-adolescent period affects adult weight, cognitive flexibility, and dopamine neurobiology. Curr Biol 2022; 32:3690-3703.e5. [PMID: 35863352 PMCID: PMC10519557 DOI: 10.1016/j.cub.2022.06.089] [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: 11/25/2021] [Revised: 04/01/2022] [Accepted: 06/29/2022] [Indexed: 10/17/2022]
Abstract
A major challenge for neuroscience, public health, and evolutionary biology is to understand the effects of scarcity and uncertainty on the developing brain. Currently, a significant fraction of children and adolescents worldwide experience insecure access to food. The goal of our work was to test in mice whether the transient experience of insecure versus secure access to food during the juvenile-adolescent period produced lasting differences in learning, decision-making, and the dopamine system in adulthood. We manipulated feeding schedules in mice from postnatal day (P)21 to P40 as food insecure or ad libitum and found that when tested in adulthood (after P60), males with different developmental feeding history showed significant differences in multiple metrics of cognitive flexibility in learning and decision-making. Adult females with different developmental feeding history showed no differences in cognitive flexibility but did show significant differences in adult weight. We next applied reinforcement learning models to these behavioral data. The best fit models suggested that in males, developmental feeding history altered how mice updated their behavior after negative outcomes. This effect was sensitive to task context and reward contingencies. Consistent with these results, in males, we found that the two feeding history groups showed significant differences in the AMPAR/NMDAR ratio of excitatory synapses on nucleus-accumbens-projecting midbrain dopamine neurons and evoked dopamine release in dorsal striatal targets. Together, these data show in a rodent model that transient differences in feeding history in the juvenile-adolescent period can have significant impacts on adult weight, learning, decision-making, and dopamine neurobiology.
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Affiliation(s)
- Wan Chen Lin
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
| | - Christine Liu
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
| | - Polina Kosillo
- Department of Molecular and Cellular Biology, University of California Berkeley, Berkeley, CA 94720, USA
| | - Lung-Hao Tai
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
| | - Ezequiel Galarce
- Robert Wood Johnson Foundation Health and Society Scholar, University of California Berkeley, Berkeley, CA 94720, USA
| | - Helen S Bateup
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cellular Biology, University of California Berkeley, Berkeley, CA 94720, USA; Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Stephan Lammel
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cellular Biology, University of California Berkeley, Berkeley, CA 94720, USA
| | - Linda Wilbrecht
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Department of Psychology, University of California Berkeley, Berkeley, CA 94720, USA.
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Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Acad Pediatr 2022; 22:1105-1114. [PMID: 35577282 PMCID: PMC10153634 DOI: 10.1016/j.acap.2022.04.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/07/2022] [Accepted: 04/30/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Food insecurity affects 13.7 million US households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. OBJECTIVE To identify the associations of food insecurity and mental health outcomes in parents and children DATA SOURCES: PubMed, Embase, Web of Science, and PsycInfo STUDY ELIGIBILITY CRITERIA: We included original research published in English from January 1990 to June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the United States. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. RESULTS We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. LIMITATIONS Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.
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Affiliation(s)
- Kathryn S Cain
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Stephanie C Meyer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Elaina Cummer
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Kishan K Patel
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Nicholas J Casacchia
- Clinical and Translational Science Institute (NJ Casacchia), Wake Forest University, Winston-Salem, NC
| | - Kimberly Montez
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Deepak Palakshappa
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Internal Medicine (D Palakshappa), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC
| | - Callie L Brown
- Department of Pediatrics (KS Cain, SC Meyer, E Cummer, KK Patel, K Montez, D Palakshappa, and CL Brown), Wake Forest School of Medicine, Winston-Salem, NC; Department of Epidemiology and Prevention (D Palakshappa, CL Brown), Wake Forest School of Medicine, Winston-Salem, NC.
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Back to Basics: Lifestyle Interventions for Adolescent Depression. Harv Rev Psychiatry 2022; 30:283-302. [PMID: 36103683 DOI: 10.1097/hrp.0000000000000343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
LEARNING OBJECTIVES After completing this activity, practitioners will be better able to:• Discuss and better understand the recently adopted screening standards for adolescents with depression and the potential advantages of using "lifestyle medicine"• Set up a process for providing effective interventions for the increased number of patients with adolescent depression• Design or update their toolbox of treatment options for adolescents with depression based on the new literature and increased demand. ABSTRACT Recently adopted quality standards recommend that pediatricians screen adolescents for depression and that they document follow-up plans for those who screen positive. As a result of these new recommendations, pediatricians and other pediatric providers, as well as psychiatrists and other mental health professionals, may face an increasing number of referrals and a growing need for effective interventions for adolescent depression. Given the widely acknowledged scarcity of traditional mental health resources, the current study reviewed the rapidly expanding array of evidence-based, but nontraditional, interventions applicable to outpatient pediatric and mental health care settings. Many of these interventions come from a lifestyle medicine framework. Lifestyle medicine interventions are congruent with the cultures of pediatrics and outpatient psychiatry, and offer additional evidence-based tools for providers managing adolescent depression. These interventions can be implemented individually or within group or community settings, and may be used in conjunction with more common interventions such as psychotherapy or psychotropic medications.
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Brown AD, Seligman H, Sliwa S, Barnidge E, Krupsky KL, Demissie Z, Liese AD. Food Insecurity and Suicidal Behaviors Among US High School Students. THE JOURNAL OF SCHOOL HEALTH 2022; 92:898-906. [PMID: 35610158 PMCID: PMC9378726 DOI: 10.1111/josh.13199] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/23/2022] [Accepted: 04/07/2022] [Indexed: 06/03/2023]
Abstract
BACKGROUND Food insecurity (FI) rates in the United States are particularly high among households with children. This research set aims to analyze if high school students experiencing FI had higher risk for mental health and suicidal behaviors. METHODS Using combined data from 11 states that conducted the 2017 Youth Risk Behavior Survey, a total of 26,962 and 24,051 high school students were used to estimate race/ethnicity and sex-stratified prevalence ratios (PRs) from Poisson regression models. A single-question was used to measure the exposure of FI and outcomes of mental health and suicidal behaviors. RESULTS Overall, 10.8% of students reported FI. Students experiencing FI had increased risk for all mental health and suicide behavior outcomes, regardless of their race/ethnicity or sex. PRs ranged from 1.9 (95% confidence interval [CI]:1.8, 2.0) to 3.1 (CI: 2.7, 3.6). Among males, PRs for the association between FI and all outcomes were highest among non-Hispanic black students (PRs ranged from 2.4 [CI: 1.7, 3.2] to 5.5 [CI: 2.3, 13.3]). Among females, PRs were highest among non-Hispanic white students (PRs ranged from 1.9 [CI:1.7, 2.1] to 3.6 [CI:2.9, 4.5]). CONCLUSIONS FI is consistently associated with mental health and suicidal behaviors among different subgroups of students.
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Affiliation(s)
- Andrea D. Brown
- Department of Epidemiology and BiostatisticsArnold School of Public Health, University of South Carolina915 Greene Street, ColumbiaSC29208USA
| | - Hilary Seligman
- Departments of Medicine and of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCAUSA
| | - Sarah Sliwa
- Division of Population HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGAUSA
| | - Ellen Barnidge
- Saint Louis University College of Public Health and Social JusticeSaint LouisMOUSA
| | | | - Zewditu Demissie
- Division of Adolescent and School HealthNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; US Public Health Service Commissioned CorpsRockvilleMDUSA
| | - Angela D. Liese
- Department of Epidemiology and BiostatisticsArnold School of Public Health, University of South Carolina915 Greene StreetColumbiaSC29208USA
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Yang TC, Power M, Moss RH, Lockyer B, Burton W, Doherty B, Bryant M. Are free school meals failing families? Exploring the relationship between child food insecurity, child mental health and free school meal status during COVID-19: national cross-sectional surveys. BMJ Open 2022; 12:e059047. [PMID: 35680269 PMCID: PMC9184996 DOI: 10.1136/bmjopen-2021-059047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Food insecurity is linked to poor health and well-being in children and rising prevalence rates have been exacerbated by COVID-19. Free school meals (FSM) are considered a critical tool for reducing the adverse effects of poverty but apply a highly restrictive eligibility criteria. This study examined levels of food security and FSM status to support decision-making regarding increasing the current eligibility criteria. DESIGN Two cross-sectional national surveys administered in August-September 2020 and January-February 2021 were used to examine the impact of COVID-19 on the food experiences of children and young people. SETTING UK. PARTICIPANTS 2166 children (aged 7-17 years) and parents/guardians. MAIN OUTCOME MEASURES Participant characteristics were described by food security and FSM status; estimated marginal means were calculated to obtain the probability of poor mental health, expressed as children reporting feeling stressed or worried in the past month, by food security status and FSM status. RESULTS We observed food insecurity among both children who did and did not receive of FSM: 23% of children not receiving FSM were food insecure. Children who were food insecure had a higher probability of poor mental health (31%, 95% CI: 23%, 40%) than children who were food secure (10%, 95% CI: 7%, 14%). Food insecure children receiving FSM had a higher probability of poor mental health (51%, 95% CI: 37%, 65%) than those who were food insecure and not receiving FSM (29%, 95% CI: 19%, 42%). CONCLUSION Many children experienced food insecurity regardless of whether they received FSM, suggesting the eligibility criteria needs to be widened to prevent overlooking those in need.
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Affiliation(s)
- Tiffany C Yang
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Madeleine Power
- Health Sciences, University of York, York, North Yorkshire, UK
| | - Rachael H Moss
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Bridget Lockyer
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Wendy Burton
- Health Sciences, University of York, York, North Yorkshire, UK
| | - Bob Doherty
- The York Management School, University of York, York, UK
| | - Maria Bryant
- Health Sciences, University of York, York, North Yorkshire, UK
- York Hull Medical School, University of York, York, UK
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12
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Myers KP, Majewski M, Schaefer D, Tierney A. Chronic experience with unpredictable food availability promotes food reward, overeating, and weight gain in a novel animal model of food insecurity. Appetite 2022; 176:106120. [PMID: 35671918 DOI: 10.1016/j.appet.2022.106120] [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: 01/14/2022] [Revised: 05/08/2022] [Accepted: 06/01/2022] [Indexed: 11/19/2022]
Abstract
Ubiquitous, easy access to food is thought to promote obesity in the modern environment. However, people coping with food insecurity have limited, unpredictable food access and are also prone to obesity. Causal factors linking food insecurity and obesity are not understood. In this study we describe an animal model to investigate biopsychological impacts of the chronic unpredictability inherent in food insecurity. Female rats were maintained on a 'secure' schedule of highly predictable 4x/day feedings of uniform size, or an 'insecure' schedule delivering the same total food over time but frequently unpredictable regarding how much, if any, food would arrive at each scheduled feeding. Subgroups of secure and insecure rats were fed ordinary chow or high-fat/high-sugar (HFHS) chow to identify separate and combined effects of insecurity and diet quality. Insecure chow-fed rats, relative to secure chow-fed rats, were hyperactive and consumed more when provided a palatable liquid diet. Insecure HFHS-fed rats additionally had higher progressive ratio breakpoints for sucrose, increased meal size, and subsequently gained more weight during 8 days of ad libitum HFHS access. Insecurity appeared to maintain a heightened attraction to palatable food that habituated in rats with secure HFHS access. In a second experiment, rats fed ordinary chow on the insecure schedule subsequently gained more weight when provided ad libitum chow, showing that prior insecurity per se promoted short-term weight gain in the absence of HFHS food. We propose this to be a potentially useful animal model for mechanistic research on biopsychological impacts of insecurity, demonstrating that chronic food uncertainty is a factor promoting obesity.
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Affiliation(s)
- Kevin P Myers
- Department of Psychology and Neuroscience Program, Bucknell University, USA.
| | - Marta Majewski
- Department of Psychology and Neuroscience Program, Bucknell University, USA
| | - Dominique Schaefer
- Department of Psychology and Neuroscience Program, Bucknell University, USA
| | - Alexis Tierney
- Department of Psychology and Neuroscience Program, Bucknell University, USA
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13
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Prevalence and correlates of depression among pregnant adolescents in primary maternal care in Nigeria. Arch Womens Ment Health 2022; 25:441-450. [PMID: 35089429 DOI: 10.1007/s00737-021-01198-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/02/2022]
Abstract
To examine the prevalence as well as the clinical and psychosocial factors associated with depression and depression severity in pregnant adolescents. Participants were consecutively registered pregnant adolescents presenting to 30 selected primary maternal and child healthcare centers in Ibadan, Nigeria, who were screened for enrolment into an intervention trial for perinatal depression (depression defined as a score of ≥ 12 on the Edinburg Postnatal Depression Scale [EPDS] and met the DSM-IV diagnostic criteria for depression). Of the 1359 pregnant adolescents screened, 246 (18.1%) had depression. Mean age was 18.4 (sd 1.00), 58.9% were either married or cohabiting, 91.4% were primipara, and the mean gestational age was 23.8 weeks (sd 5.4 weeks). Food insecurity (going to bed hungry at least once in the previous week because there was no food to eat) was reported by 13.3%. In bivariate analysis, younger age, not living with a partner, unemployment, and food insecurity were associated with depression. In bivariate analysis, younger age, not living with a partner, unemployment and food insecurity were associated with depression, while younger age, being single and food insecurity were independently associated with being depressed in multivariate analysis. Severity of depression was related to age, higher anxiety and disability scores, lower quality of life scores across all domains and poorer attitudes towards pregnancy. Depression was associated with indices of higher social disadvantage among adolescents. Delaying childbearing and measures aimed at alleviating poverty may be important in preventing depression in this vulnerable group.
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14
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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: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [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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15
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Zheng S, Ngo AL, Forman MR, Barcellos AL, Liao L, Ferrara A, Zhu Y. Associations of household food insufficiency with childhood depression and anxiety: a nationwide cross-sectional study in the USA. BMJ Open 2021; 11:e054263. [PMID: 34493526 PMCID: PMC8424875 DOI: 10.1136/bmjopen-2021-054263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Household food insufficiency (HFIS) is a major public health threat to children. Children may be particularly vulnerable to HFIS as a psychological stressor due to their rapid growth and accelerated behavioural and cognitive states, whereas data focusing on HFIS and childhood mental disorders are as-yet sparse. We aimed to examine the associations of HFIS with depression and anxiety in US children. DESIGN Cross-sectional study. SETTING The 2016-2018 National Survey of Children's Health, a nationally-representative study. PARTICIPANTS Primary caregivers of 102 341 children in the USA. PRIMARY AND SECONDARY OUTCOME MEASURES Physician diagnosed depression and anxiety were assessed by questionnaires administered to primary caregivers of 102 341 children. Multivariable logistic regression models estimated adjusted OR (aOR) for current depression or anxiety associated with HFIS measured through a validated single-item instrument. RESULTS Among children aged 3-17 years, 3.2% and 7.4% had parent-reported physician-diagnosed current depression and anxiety, respectively. Compared with children without HFIS, children with HFIS had approximately twofold higher weighted prevalence of anxiety or depression. After adjusting for covariates, children with versus without HFIS had a 1.53-fold (95% CI 1.15 to 2.03) and 1.48-fold (95% CI 1.20 to 1.82) increased odds of current depression and anxiety, respectively. Associations were slightly more pronounced among girls (aOR (95% CI): depression 1.69 (1.16 to 2.48); anxiety 1.78 (1.33 to 2.38)) than boys (1.42 (0.98 to 2.08); 1.32 (1.00 to 1.73); both P-for-interaction <0.01). The associations did not vary by children's age or race/ethnicity. CONCLUSIONS HFIS was independently associated with depression and anxiety among US children. Girls presented slightly greater vulnerability to HFIS in terms of impaired mental health. Children identified as food-insufficient may warrant mental health assessment and possible intervention. Assessment of HFIS among children with impaired mental health is also warranted. Our findings also highlight the importance of promptly addressing HFIS with referral to appropriate resources and inform its potential to alleviate childhood mental health issues.
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Affiliation(s)
- Siwen Zheng
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Amanda L Ngo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Michele R Forman
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Anna L Barcellos
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Lauren Liao
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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16
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Eldred D, Kameg BN. Addressing Food Insecurity in Primary Care. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Trajectory of Food Insecurity and Its Association with Longitudinal Mental Health and Sleep Outcomes in Adolescents from Economically Disadvantaged Families. Nutrients 2021; 13:nu13051696. [PMID: 34067617 PMCID: PMC8157056 DOI: 10.3390/nu13051696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adolescence is a critical transition period in the course of human development. Although food insecurity (FI) has been shown to be associated with adverse mental health and sleep outcomes in US adolescents, there is a paucity of research examining the relationships between FI, mental health, and sleep outcomes in Taiwanese adolescents. Furthermore, it is unknown how the change of FI over time (i.e., the trajectory of FI) is related to health outcomes. METHODS The data come from the Taiwan Database of Children and Youth in Poverty, which is a national longitudinal project measuring FI in five survey waves (2009-2017). We employed group-based trajectory modeling to classify various FI trends over the five waves using STATA. Furthermore, a generalized estimating equation analysis was conducted with FI trajectories as the independent variable to see how FI trajectory is related to mental health and sleep outcomes. RESULTS In total, 1921 participants aged 12-18 years in the first wave were deemed valid for the analysis. We classified the participants into four FI trajectory groups: persistently low FI (24.8%), persistently moderate FI (64.7%), declining from high to low FI (4.1%), and food-secure groups (6.4%). As compared to food-secure adolescents, the persistently moderate FI group was more likely to have mental problems (β = 0.30, [95% confidence interval 0.21-0.38]), while the other FI groups were only marginally associated with mental health problems. Moreover, adolescents in the persistently low FI group (β = 0.13, [0.02-0.23]) and persistently moderate FI group (β = 0.39, [0.29-0.48]) were found to have more sleep problems than those in the food-secure group. CONCLUSIONS Our study describes the FI profile of adolescents from economically disadvantaged families and the difficulties they might encounter. With this information, healthcare providers can aid adolescents in the early stages of mental health problems and provide guidance when appropriate.
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18
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Hartline-Grafton H, Hassink SG. Food Insecurity and Health: Practices and Policies to Address Food Insecurity among Children. Acad Pediatr 2021; 21:205-210. [PMID: 32653691 PMCID: PMC7347342 DOI: 10.1016/j.acap.2020.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 11/23/2022]
Affiliation(s)
| | - Sandra G Hassink
- AAP Institute for Healthy Childhood Weight (SG Hassink), Itasca, Ill
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19
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Health-related quality of life of people living with HIV/AIDS: the role of social inequalities and disease-related factors. Health Qual Life Outcomes 2021; 19:63. [PMID: 33632270 PMCID: PMC7905594 DOI: 10.1186/s12955-021-01702-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 02/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background Health-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilization of health care has on quality of life. The purpose of this study is to assess the HRQoL of people living with HIV (PLHIV), and to ascertain its association with the social inequalities and clinical determinants among people living with HIV in Benishangul Gumuz Regional State, Ethiopia. Methods A cross-sectional study was conducted between December 2016 and February 2017; 390 people at two referral hospitals and three health centers participated in the study. The Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10) was used to measure key HRQoL domains. Global Physical Health (GPH) and Global Mental Health (GPH) summary scores were employed. GPH and GMH summary scores below 50 (the standardized mean score) were determined as poor HRQoL. Bivariate and multivariate logistic regression analyses were used to identify factors associated with GPH and GMH summary scores. Results This study included 259 (66.4%) females and 131 (33.6%) males. The GPH summary scores ranged from 16.2 to 67.7 with a mean of 48.8 (SD = 8.9). Almost 44.6% of the study population has a GPH summary score of below 50; the GMH summary scores ranged from 28.4 to 67.6 with a mean of 50.8 (SD = 8.1). About 41.8% of the study population has a GMH summary score of below 50. Unemployment, household food insecurity and comorbidities with HIV were associated with both poor GPH and poor GMH summary scores. Age below 25 years and being a member of Christian fellowship were inversely associated with poor GPH. The least wealth index score and CD4 count below 350 cells/mL were also associated with poor GMH. Conclusion Overall, socioeconomic inequalities and HIV-related clinical factors play an important role in improving the HRQoL of PLHIV. Many of these determinants are alterable risk factors. Appropriate strategies can improve the holistic management of chronic HIV care and maximize PLHIVs’ HRQoL. Such strategies require the adoption of comprehensive interventions, including policies and programmes that would improve the health, wellbeing and livelihood of PLHIV.
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20
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Men F, Elgar FJ, Tarasuk V. Food insecurity is associated with mental health problems among Canadian youth. J Epidemiol Community Health 2021; 75:741-748. [PMID: 33579754 DOI: 10.1136/jech-2020-216149] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Research has linked food insecurity to mental health problems, though little is known about this relationship among Canadian youth. We investigate the association between food insecurity severity and mental illnesses in a nationally representative youth sample. METHODS We sampled 55 700 youth 12-24 years from recent cycles of Canadian Community Health Survey. Household food insecurity was measured using a standard 18-item questionnaire. We fitted Poisson regressions on self-rated mental health and diagnosed mood and anxiety disorders, controlling for sociodemographic confounders. Clinical assessments of emotional distress, major depression and suicidal ideation were examined in subsamples with available data. We stratified the sample by gender, age and survey cycle to test potential demographic heterogeneity. RESULTS One in seven youth lived in marginal (5.30%), moderate (8.08%) or severe (1.44%) food insecurity. Results showed that food insecurity was associated with higher likelihood of every mental health problem examined. The association was graded, with more severe food insecurity linked to progressively worse mental health. Notably, marginal, moderate and severe food insecurity were associated with 1.77, 2.44 and 6.49 times higher risk of suicidal thoughts, respectively. The corresponding relative risk for mood disorders were 1.57, 2.00 and 2.89; those for anxiety disorders were 1.41, 1.65 and 2.58. Moderate food insecurity was more closely associated with mental health problems in 18-24 year olds than in 12-17 year olds. CONCLUSIONS Food insecurity severity was associated with poorer mental health among Canadian youth independent of household income and other socioeconomic differences. Targeted policy intervention alleviating food insecurity may improve youth mental health.
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Affiliation(s)
- Fei Men
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada .,Consumer Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - Valerie Tarasuk
- Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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21
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O'Reilly NL, Hager ER, Harrington D, Black MM. Assessment of risk for food insecurity among African American urban households: utilizing cumulative risk indices and latent class analysis to examine accumulation of risk factors. Transl Behav Med 2020; 10:1322-1329. [PMID: 33421086 DOI: 10.1093/tbm/ibaa027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
African American caregivers in low-income, urban communities have high rates of food insecurity. Unemployment, education, smoking, stress, and depressive symptoms are associated with household food insecurity. A cumulative risk model suggests that accumulation of risk may compound food insecurity risk, and certain risk factors are more likely to co-occur. This study utilizes two approaches to examine food insecurity risk among African American caregivers with an adolescent daughter-a cumulative risk index to examine accumulation of risk and food insecurity risk; latent class analysis (LCA) to determine if certain risk profiles exist and their relation to food insecurity risk. Caregivers completed surveys including demographic, psychosocial, and behavioral questions (to create a cumulative risk index) and a validated 2-item food insecurity screen. LCA was used to identify risk profiles. Logistic regression was used to examine relations between cumulative risk, risk profiles, and food insecurity risk. Each additional cumulative risk index factor was associated with a 54% increase in odds of risk of food insecurity. LCA identified three subgroups: high stress/depression (class #1), low education/low stress and depression (class #2), and low risk overall (class #3). Odds of food insecurity risk were 4.7 times higher for class #1, and 1.5 times higher for class #2 compared with class #3. This study contributes to understanding of how food insecurity risk relates to cumulative risk and risk profiles. Findings can be used to improve food insecurity risk screening in clinical settings, enhancing intervention/referral for food security risk and mental health among African American caregivers and their households.
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Affiliation(s)
- Nicole L O'Reilly
- School of Social Work, Boise State University, Boise, ID.,School of Social Work, University of Maryland, Baltimore, Baltimore, MD
| | - Erin R Hager
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.,Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, MD
| | - Donna Harrington
- School of Social Work, University of Maryland, Baltimore, Baltimore, MD
| | - Maureen M Black
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.,Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, MD.,RTI International, Research Triangle Park, NC
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22
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Kotchick BA, Whitsett D, Sherman MF. Food Insecurity and Adolescent Psychosocial Adjustment: Indirect Pathways through Caregiver Adjustment and Caregiver-Adolescent Relationship Quality. J Youth Adolesc 2020; 50:89-102. [PMID: 32980969 PMCID: PMC7520077 DOI: 10.1007/s10964-020-01322-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 12/02/2022]
Abstract
Household food insecurity is associated with youth behavioral problems, yet few studies have examined potential mechanisms that underline this association, particularly among adolescents. The Family Stress Model (FSM) states that food insecurity potentially impacts adolescent psychosocial adjustment indirectly through its effects on parental psychological functioning and parenting. The current study examined data from the Children, Welfare, and Families study (N = 687, 53% female, Mage of child at baseline = 11.74 years, SD = 1.39) to determine whether household food insecurity at the beginning of adolescence predicts later behavioral outcomes and whether that association is mediated through caregiver depression and caregiver–adolescent relationship quality. Caregivers completed measures of past-year household food insecurity, current self-reported depressive symptoms and adolescent behavior problems, while adolescents completed a measure of current caregiver–adolescent relationship quality. A serial multiple mediator model, controlling for baseline values of mediators, outcomes, and relevant demographic covariates, indicated a significant total indirect effect, whereas the total direct effect was not significant. Significant indirect effects through both caregiver depression and caregiver–adolescent relationship quality were also found. These results are the first to explicitly examine the FSM with respect to household food insecurity and to demonstrate the indirect effects of food insecurity on adolescent adjustment. The findings indicate the need to improve food security and address subsequent intra- and inter-personal difficulties among low-income families that contribute to behavioral problems among adolescents facing household food insecurity.
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Affiliation(s)
- Beth A Kotchick
- Department of Psychology, Loyola University Maryland, Baltimore, MD, USA.
| | | | - Martin F Sherman
- Department of Psychology, Loyola University Maryland, Baltimore, MD, USA
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23
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Hatem C, Lee CY, Zhao X, Reesor-Oyer L, Lopez T, Hernandez DC. Food insecurity and housing instability during early childhood as predictors of adolescent mental health. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:721-730. [PMID: 32191051 PMCID: PMC7483158 DOI: 10.1037/fam0000651] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examined the effects of food insecurity and housing instability experiences during early childhood on adolescent anxiety and depressive symptoms through maternal depression and parenting stress. This longitudinal study included 4 waves of data from the Fragile Families and Child Well-Being Study (n = 2,626). Food insecurity was measured when the child was 5 years of age using the U.S. Department of Agriculture's 18-item Food Security Scale. Housing instability was also measured when the child was 5 years of age based on an affirmative response to 6 housing adversity items. Maternal depression and parenting stress were measured when the child was 9 years of age. Anxiety and depressive symptoms were assessed when the child (now adolescent) was 15 years of age using 6 items of the Brief Symptom Inventory 18 anxiety subscale and 5 items of the Centers for Epidemiologic Studies Depression Scale, respectively. Two structural equation models assessed the associations between food insecurity and housing instability on adolescent anxiety (Model 1) and depressive symptoms (Model 2) through maternal depression and parenting stress simultaneously, controlling for sociodemographic characteristics. Results suggest that experiencing both food insecurity and housing instability during early childhood increases the risk of long-term adolescent depressive (indirect: B = 0.008, 95% CI [0.002, 0.016]) and anxiety (indirect: B = 0.012, 95% CI [0.002, 0.026]) symptoms through maternal depression to parenting stress. Screening for food insecurity and housing instability during early childhood could potentially identify both mothers who are at risk for depression and parenting stress and children who are at increased risk for anxiety or depressive symptoms during adolescence. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Cherine Hatem
- Department of Health and Human Performance, University of
Houston, Houston, Texas, USA
| | - Che Young Lee
- Department of Health and Human Performance, University of
Houston, Houston, Texas, USA
| | - Xue Zhao
- Department of Health and Human Performance, University of
Houston, Houston, Texas, USA
| | - Layton Reesor-Oyer
- Department of Health and Human Performance, University of
Houston, Houston, Texas, USA
| | - Tabbetha Lopez
- Department of Health and Human Performance, University of
Houston, Houston, Texas, USA
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Household food insecurity and educational outcomes in school-going adolescents in Ghana. Public Health Nutr 2020; 24:1349-1361. [PMID: 32713415 DOI: 10.1017/s1368980020001974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We examined the association of household food insecurity with educational outcomes and explored the moderating effect of gender and school lunch programme. DESIGN The study used a cross-sectional design. Data were collected in 2014 using interviewer-administered questionnaires and school administrative records. We measured household food insecurity using the Household Food Insecurity Access Scale. Educational outcomes referred to knowledge, attitudes and skills that students are expected to obtain while attending school. We obtained sixteen different measures of educational outcomes, ranging from academic grades to beliefs and attitudes towards school and education. Data were analysed using multilevel modelling with covariates at the student and school levels. We conducted moderation tests by adding a two-way interaction between food insecurity and gender, and between food insecurity and school lunch programme. SETTING The study was conducted in 100 schools located in fifty-four districts within Ghana's eight administrative regions in 2014. PARTICIPANTS Participants included 2201 school-going adolescents aged 15-19 years. RESULTS More than 60 % of adolescents were from food-insecure households. Household food insecurity was negatively associated with Math grade and school attendance. Food insecurity was also inversely associated with socio-emotional outcomes, including academic self-efficacy, commitment to school and academic aspirations and expectations. We did not find a moderating effect of gender and school lunch programme. CONCLUSIONS Food insecurity is negatively associated with wide-ranging educational outcomes related to both learning and socio-emotional abilities. Our study supports prior evidence suggesting the importance of food access on both cognitive and non-cognitive educational outcomes.
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Abstract
OBJECTIVE The present study aims at measuring the association between household food insecurity and psychological distress in adolescents in Inuit communities, concurrently and overtime from childhood to adolescence. DESIGN The study used measures of internalising behaviours (anxiety, withdrawn attitude, somatic complaints and depression) as indicators of psychological distress during adolescence, a concurrent measure of household food insecurity in adolescence and an assessment of longitudinal patterns of household food insecurity from childhood to adolescence. We collected descriptive information at birth, childhood and adolescence on potential confounders. SETTING Inuit communities of Nunavik in northern Quebec, Canada. PARTICIPANTS The study consisted of 212 participants from the Nunavik Child Development Study, who have been assessed at birth, childhood (mean age = 11 years, range = 9-13 years) and adolescence (mean age = 18 years, range = 16-21 years). RESULTS Concurrent severe household food insecurity in adolescence was associated with higher measures of psychological distress: depression (βstd = 0·26, P < 0·01) and withdrawn attitude (βstd = 0·20, P = 0·04). Persistent household food insecurity (both at childhood and adolescence) was associated with higher levels of adolescent depression (βstd = 0·18, P = 0·02) and anxiety (βstd = 0·17, P = 0·03). CONCLUSIONS Adolescents from Nunavik living with higher food insecurity and those having experienced food insecurity in both childhood and adolescence were more likely to report symptoms of psychological distress. Considering the high level of distress experienced by young Inuit, existing initiatives to reduce food insecurity in Nunavik communities should be targeted to include children and adolescents.
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Ghafuri DL, Rodeghier M, DeBaun MR. Rate of Food Insecurity Among Households with Children with Sickle Cell Disease is Above the National Average. South Med J 2020; 113:150-155. [PMID: 32239226 DOI: 10.14423/smj.0000000000001082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Despite studies demonstrating the negative impact of food insecurity on health in children, limited research has been done to assess the prevalence and sequelae of food insecurity in sickle cell disease (SCD). We tested the hypothesis that food insecurity is common in children with SCD and is associated with increased SCD morbidity. METHODS Between May and November 2017, we conducted a single-center cross-sectional study using the previously validated, self-administered, US 18-item household food security survey module and the 9-item youth (12-17 years old) food security survey module during regular outpatient clinic visits. We also included the incidence of vaso-occlusive pain or acute chest syndrome requiring hospitalizations in the year before the questionnaire. RESULTS A total of 75 caregivers and 24 children completed the surveys. The median age of the children was 10.4 years (interquartile range 5.5-15.3), 46.7% were boys. The rate of household food insecurity was 21.3% (16 of 75). Among the 24 children who completed the youth survey, 45.8% were classified as food insecure. Discordance occurred between caregivers' and children's assessment of food insecurity. A total of 81.8% (9 of 11) children reported being food insecure, whereas their caregivers reported to be food secure. The incidence for pain and acute chest syndrome in the year pre-enrollment was not different between food-secure and food-insecure children (59.3 and 43.8/100 patient-years, P = 0.54; 8.5 and 12.5/100 patient-years, P = 0.49, respectively). CONCLUSIONS In a tertiary care medical center in Tennessee, one in five households with children with SCD were assessed as food insecure, with a substantial discordance between caregiver and child assessment of food insecurity.
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Affiliation(s)
- Djamila Labib Ghafuri
- From the Department of Pediatrics, Vanderbilt-Meharry Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University of Medicine, Nashville, Tennessee, and Rodeghier Consultants, Chicago, Illinois
| | - Mark Rodeghier
- From the Department of Pediatrics, Vanderbilt-Meharry Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University of Medicine, Nashville, Tennessee, and Rodeghier Consultants, Chicago, Illinois
| | - Michael Rutledge DeBaun
- From the Department of Pediatrics, Vanderbilt-Meharry Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University of Medicine, Nashville, Tennessee, and Rodeghier Consultants, Chicago, Illinois
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Park J, Ten Hoor GA, Cho J, Kim S. Service Providers' Perspectives on Barriers of Healthy Eating to Prevent Obesity among Low-income Children Attending Community Childcare Centers in South Korea: A Qualitative Study. Ecol Food Nutr 2020; 59:311-328. [PMID: 32024393 DOI: 10.1080/03670244.2020.1722948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to identify individual and socio-ecological barriers in managing healthy eating among low-income children from the perspective of community childcare (CCC) center workers (n = 18) through focus group interviews. They perceived the increase in obesity among low-income children. The interviews revealed that the child's eating habits are affected by not only individual determinants including self-regulation and risk awareness but also environmental factors such as family, CCC centers, policy and social structure. To enhance children's health and behavior, it is necessary to consider the interactions among systems at a variety of levels, for example, local community and health care policies.
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Affiliation(s)
- Jiyoung Park
- Department of Nursing, Institute of Health Science, College of Medicine, Inje University , Busan, South Korea
| | - G A Ten Hoor
- Deprtment of Work & Social Psychology, Maastricht University , Maastricht, The Netherlands
| | - Jeonghyun Cho
- Department of Nursing, Institute of Health Science, College of Medicine, Inje University , Busan, South Korea
| | - Soobin Kim
- School of Social Work, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
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Dush JL. Adolescent food insecurity: A review of contextual and behavioral factors. Public Health Nurs 2020; 37:327-338. [PMID: 31970826 PMCID: PMC9292303 DOI: 10.1111/phn.12708] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/03/2019] [Accepted: 01/02/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The purpose of this review is to examine recent research on contextual and behavioral factors that will lead to better understanding of adolescent food insecurity and health outcomes. DESIGN A literature search for peer-reviewed, English language, research articles published between 2009 and 2019, using CINAHL, Embase® , Pubmed, and the Cochrane Library. SAMPLE The final sample represents thirty studies on food insecurity with a sample including adolescents, and that employ a measure of food insecurity. RESULTS Variables of interest and results on topics such as weight-related factors, maternal parenting and behaviors, mental health, and adolescent-level behavioral factors are summarized. CONCLUSION Food insecurity is associated with poor adolescent health and mental health. All adolescents should be screened for food insecurity, involving pediatric and mental health care settings. Future research on adolescent food insecurity should explore parent and parenting factors, household composition and family dynamics, psychological factors, health behaviors, and stress; peer influences might also be an important area of research with adolescents. While previous research has relied on parents' reports, adolescents'experiences are unique, and they are willing and reliable research participants; they should be included in future food insecurity research.
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Affiliation(s)
- Jennifer L Dush
- Instructor of Clinical Practice, The Ohio State University, Columbus, OH, USA
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Naja F, Itani L, Kharroubi S, Diab El Harake M, Hwalla N, Jomaa L. Food insecurity is associated with lower adherence to the Mediterranean dietary pattern among Lebanese adolescents: a cross-sectional national study. Eur J Nutr 2020; 59:3281-3292. [PMID: 31900578 DOI: 10.1007/s00394-019-02166-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To derive dietary patterns (DPs) of Lebanese adolescents (10-18 years) and evaluate associations between identified DPs and household food insecurity (HFI). METHODS Data on adolescents (n = 693) were drawn from a national survey conducted in 2015 on a representative sample of Lebanese households with children. In addition to a sociodemographic questionnaire, data collection included the validated Arabic-version of the Household Food Insecurity Access Scale, used to evaluate HFI. Dietary intake was assessed using a 187-item validated food frequency questionnaire. Associations between HFI scores and DPs were examined using multiple linear regressions. RESULTS HFI was observed in 55.2% of the study sample. Two DPs were derived among adolescents: Western and Lebanese-Mediterranean (LM). The Western DP was characterized by higher consumption of sweetened beverages, fast foods, sweets, and refined grains, whereas the LM DP was characterized by higher intakes of fruits, vegetables, dairy products, and whole grains. Scores of the Western DP were negatively associated with fiber, calcium, iron, and vitamins A and D, while the LM DP scores were positively correlated with fiber, proteins, iron, calcium, and vitamins A and D (p < 0.01). LM DP scores were also negatively correlated with total fat, saturated and polyunsaturated fats, p < 0.05. After adjustment for sociodemographics, multiple linear regression showed that higher HFI scores were associated with lower adherence to LM DP among adolescents (β = - 0.026, 95% CI - 0.046, - 0.006). CONCLUSIONS HFI was associated with lower adherence to the Mediterranean pattern among Lebanese adolescents. Preventive strategies are needed to promote better diet quality among food-insecure youth.
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Affiliation(s)
- Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, PO Box 11-5020, Riad El Solh, Beirut, 1107-2809, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Marwa Diab El Harake
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Lamis Jomaa
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon.
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Nagata JM, Palar K, Gooding HC, Garber AK, Whittle HJ, Bibbins-Domingo K, Weiser SD. Food Insecurity Is Associated With Poorer Mental Health and Sleep Outcomes in Young Adults. J Adolesc Health 2019; 65:805-811. [PMID: 31587956 PMCID: PMC6874757 DOI: 10.1016/j.jadohealth.2019.08.010] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/15/2019] [Accepted: 08/10/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE The aim of the study was to determine the association between food insecurity, mental health, and sleep outcomes among young adults. Young adulthood represents an important developmental period when educational and economic transitions may increase the risk for food insecurity; however, little is known about associations between food insecurity and health outcomes in this period. METHODS Cross-sectional nationally representative data of U.S. young adults aged 24-32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2018. Multiple logistic regression analysis was conducted with food insecurity as the independent variable and self-reported mental health (depression, anxiety, and suicidality) and sleep (trouble falling and staying asleep) outcomes as the dependent variables. RESULTS Of the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of mental health problems including a depression diagnosis (1.67, 95% confidence interval [CI] 1.39-2.01), anxiety or panic disorder diagnosis (1.47, 95% CI 1.16-1.87), and suicidal ideation in the past 12 months (2.76, 95% CI 2.14-3.55). Food insecurity was also associated with poorer sleep outcomes including trouble falling (adjusted odds ratio 1.78, 95% CI 1.52-2.08) and staying (adjusted odds ratio 1.67, 95% CI 1.42-1.97) asleep. CONCLUSIONS Food insecurity is associated with poorer mental and sleep health in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should test interventions to simultaneously combat food insecurity and mental health problems in young adulthood.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California.
| | - Kartika Palar
- Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Holly C Gooding
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Andrea K Garber
- Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Henry J Whittle
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kirsten Bibbins-Domingo
- Department of Medicine, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Sheri D Weiser
- Department of Medicine, University of California, San Francisco, San Francisco, California
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Zhang L, Yang F. Food insecurity and school performance among the left-behind children in rural China: Depression and educational expectation as mediators. SCHOOL PSYCHOLOGY INTERNATIONAL 2019. [DOI: 10.1177/0143034319869048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study aims to explore the associations between food insecurity and school performance, and the serial mediation of depression and educational expectation on the focal association, among Chinese rural left-behind children. This study conducted a cross-sectional survey on 2128 students (Grades 5–9, mean age = 13.21 years) who reported one or both parents had migrated into the urban sector. They responded to questions on school performance, educational expectation, The Food Insecurity Experience Scale, and The Birleson Depression Self-Rating Scale. Serial mediation modelling was used to test the mediating role of depression and educational expectation. It is found that food insecurity was significantly associated with school performance. Moreover, depression and educational expectation functioned as serial mediators and were fully mediating the association between food insecurity and school performance. The findings as with the severity of childhood food insecurity in rural China as well as its association with the negative consequences in children's education provide empirical support for contentions that food insecurity problem should be taken into account in designing and implementing school-based intervention programs for left-behind children. Moreover, schools shall pay special attention to the mental health risks of food insecurity among rural left-behind children.
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Affiliation(s)
- Lufa Zhang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Fan Yang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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Ling J, Robbins LB, Xu D. Food Security Status and Hair Cortisol among Low-income Mother-Child Dyads. West J Nurs Res 2019; 41:1813-1828. [PMID: 31342883 DOI: 10.1177/0193945919867112] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
This cross-sectional study among low-income mother-child dyads examined the relationship between food security status and hair cortisol concentration (HCC), and how mother and child food security status was interactively related to mothers' perceived distress and coping. Data from 32 dyads were analyzed. Approximately 46.9% had household food insecurity, 37.5% children had food insecurity, and 34.4% mothers had food insecurity. Children with food insecurity had significantly higher HCC than those with food security. A significant interaction effect occurred between child food security status and race on children's HCC, with White children's HCC being more likely to be influenced by food security status. Mother food security and child food security status together explained about 6% of the variance in mothers' HCC, 27% in perceived distress, and 18% in perceived coping. These findings indicate that assisting low-income families with food insecurity to get enough food can benefit both children's and mothers' mental health.
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Affiliation(s)
- Jiying Ling
- Michigan State University College of Nursing, East Lansing, MI, USA
| | | | - Dongjuan Xu
- Purdue University School of Nursing, West Lafayette, IN, USA
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Whitsett D, Sherman MF, Kotchick BA. Household Food Insecurity in Early Adolescence and Risk of Subsequent Behavior Problems: Does a Connection Persist Over Time? J Pediatr Psychol 2019; 44:478-489. [PMID: 30407579 DOI: 10.1093/jpepsy/jsy088] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 10/04/2018] [Accepted: 10/08/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Household food insecurity is common among U.S. families, and adolescents are almost twice as likely as school-aged children to be food insecure. However, little is known about how household food insecurity relates to adolescent behavioral outcomes over time. The purpose of this study was to examine whether food security status in early adolescence is associated with behavioral problems over a 6-year period in an ethnically diverse sample of teenagers from low-income households. METHODS The study examined longitudinal data from the Welfare, Children, and Families: A Three-City Study. A total of 1,049 primary caregivers completed measures of child/adolescent behavioral problems and household food insecurity during the past year. Data were collected across three waves, when focal children were between 10 and 14 years old, 11 and 16 years old, and 16 and 18 years old, respectively. Generalized estimating equations were used to assess initial household food insecurity as a time-invariant effect on adolescent behavioral problems over time. RESULTS Baseline household food insecurity in pre- or early adolescence was significantly associated with greater internalizing problems and total behavioral problems over time. CONCLUSIONS These findings indicate that household food insecurity is associated with behavioral problems throughout adolescence. This suggests the need for health providers to screen for household food insecurity during scheduled health visits and highlight the need for integration of psychosocial services into pediatric care and expansions in current federal assistance programs.
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Lu S, Perez L, Leslein A, Hatsu I. The Relationship between Food Insecurity and Symptoms of Attention-Deficit Hyperactivity Disorder in Children: A Summary of the Literature. Nutrients 2019; 11:nu11030659. [PMID: 30893802 PMCID: PMC6470829 DOI: 10.3390/nu11030659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/06/2019] [Accepted: 03/14/2019] [Indexed: 12/21/2022] Open
Abstract
Food insecurity is a major public health concern characterized by an individual or household lacking access to adequate food to support a healthy lifestyle. Food insecurity has been associated with predisposing or exacerbating mental health symptoms in children. However, the evidence is scarce with regards to Attention-Deficit Hyperactivity Disorder (ADHD) symptoms in children. The purpose of this review is to summarize and identify gaps in the existing literature, as well as to explore associations between food insecurity and symptoms of childhood ADHD. Literature for this review was pulled from Ovid MEDLINE and PubMed library databases, with a focus on food insecurity, food insufficiency, hunger, and ADHD symptoms such as inattention, hyperactivity, and impulsivity in children. The limited evidence to date shows a predictive and inverse relationship between childhood experience of food insecurity and symptoms of ADHD, with lasting impacts into adulthood. Evidence exists to hypothesize that childhood food insecurity is associated with predisposing or exacerbating ADHD symptoms in children, yet the literature needed to confirm this relationship is scarce and utilizes inconsistent methodology. Future research is needed to further characterize this complex relationship and inspire community or public health interventions addressing food insecurity in children with ADHD. Additionally, it may be clinically useful to routinely screen for food insecurity when assessing pediatric ADHD symptoms.
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Affiliation(s)
- Stacy Lu
- Department of Human Sciences, Ohio State University, Columbus, OH 43210, USA.
| | - Leanna Perez
- Department of Human Sciences, Ohio State University, Columbus, OH 43210, USA.
| | - Abby Leslein
- Department of Neuroscience, Ohio State University, Columbus, OH 43210, USA.
| | - Irene Hatsu
- Department of Human Sciences, Ohio State University, Columbus, OH 43210, USA.
- OSU Extension, Ohio State University, Columbus, OH 43210, USA.
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Parent and Child Reports of Food Insecurity and Mental Health: Divergent Perspectives. Ochsner J 2018; 18:318-325. [PMID: 30559615 DOI: 10.31486/toj.18.0037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Food insecurity-the inability to provide adequate food for at least one household member sometime during the year-is linked to negative physical and mental health outcomes. Child reports of experiences in other domains of life are only moderately related to parental proxy reports of the same experiences. The goal of our study was to assess the convergence of parent and child reports of food insecurity and several specific mental health symptoms. Methods Dyads of parents and children attending medical appointments were surveyed. Inclusion criteria consisted of English-speaking adults and their children between the ages of 8 and 17 years. Results Sixty-two percent of adults and 50% of children self-reported meeting screening criteria for food insecurity, and adult-child dyad reports were significantly correlated. However, when asked about the child worrying about food running out or having eaten less than desired in order to conserve food, adult and child reports diverged significantly, with adults more frequently underestimating worry and conservation behaviors compared to child self-reports. Similar discrepancies were found for items probing specific symptoms of depression, general anxiety, and obsessive-compulsive disorder. Conclusion Our data show that adults may not accurately perceive the subjective effects of food insecurity on children in their household, particularly in households receiving food assistance, perhaps because of objectively greater need. Because food insecurity may have profound effects on child development, pediatricians should be aware of the mental health risks for children in food-insecure homes.
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Aceves-Martins M, Cruickshank M, Fraser C, Brazzelli M. Child food insecurity in the UK: a rapid review. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundFood insecurity (FI) is a multifaceted, socioeconomic problem involving difficulties accessing sufficient, safe and nutritious food to meet people’s dietary requirements and preferences for a healthy life. For children experiencing FI, there are some potentially negative developmental consequences and it is, therefore, important to understand the links between FI and children’s health and well-being as well as any strategies undertaken to address FI. The overall objective of this assessment was to determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.ObjectiveTo determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.Data sourcesThe databases searched on 4 December 2017 included MEDLINE (including In-Process & Other Non-Indexed Citations and E-pub ahead of print files), EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Commonwealth Agricultural Bureaux (CAB) abstracts, The Cochrane Library, Education Resources Information Centre (ERIC), PsycINFO, the Social Science Citation Index and the Applied Social Sciences Index and Abstracts (ASSIA).MethodsA rapid review of the current published and unpublished literature was conducted, including all study designs from specified high-income countries in children aged ≤ 18 years. Searches were conducted of major health-care, nutrition, education and social science databases from 1995 onwards, and websites of relevant UK and international organisations. Final searches were undertaken in December 2017.ResultsIn total, 109 studies were selected. Only five studies were conducted in the UK, four of which provided qualitative data. Possible factors associated with child FI were identified, for example socioeconomic status, material deprivation, living in public housing and having unemployed or poorly educated parents. Children’s health, well-being and academic outcomes were all negatively affected by FI. The mediating effects of family stressors and parenting practices in the relationship between FI and children’s health and well-being outcomes were not clear. Food assistance programmes were generally effective in mitigating FI and improving nutritional outcomes (including hunger) in the short term, but did not eradicate FI, eliminate its effects on children’s health or have an impact on academic outcomes. No reports assessing the prevalence of child FI in the UK or the cost-effectiveness and sustainability of interventions to tackle FI were identified.LimitationsThere was a lack of consistency in how FI was defined and measured across studies. Most of the studies used indirect measurements of child FI through parental reports. The majority of studies were conducted in North America. Only five studies were conducted in the UK. Thirty potentially relevant studies were not included in the review as a result of time and resource constraints. Most studies were observational and caution is advised in interpreting their results.ConclusionsA number of factors that were related to child FI were identified, as were negative associations between child FI and physical, mental and social outcomes. However, these findings should be interpreted with caution because of the correlational nature of the analyses and the fact that it is difficult to determine if some factors are predictors or consequences of FI.Future researchThere is an urgent requirement for the development of a reliable instrument to measure and monitor child FI in the UK and for well-designed interventions or programmes to tackle child FI.Study registrationThis study is registered as PROSPERO CRD42017084818.FundingThe National Institute for Health Research Public Health Research programme. The Health Services Research Unit is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.
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Affiliation(s)
| | | | - Cynthia Fraser
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Tan ML, Laraia B, Madsen KA, Au LE, Frongillo EA, Ritchie LD. Child Food Insecurity Is Associated with Energy Intake among Fourth- and Fifth-Grade Girls. J Acad Nutr Diet 2018; 119:1722-1731.e2. [PMID: 30318250 DOI: 10.1016/j.jand.2018.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 07/11/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Food insecurity is associated with poor diet and obesity among adult women, but evidence among children is mixed, and few studies have examined differences between boys and girls. OBJECTIVE This study examined the relationship between self-reported food insecurity and dietary intake among boys and girls. DESIGN Cross-sectional survey data were used from the Children's PowerPlay! Campaign evaluation. PARTICIPANTS AND SETTING In all, 3,547 fourth- and fifth-grade students (9 to 11 years old) from 44 San Diego-area elementary schools in 2012 completed diary-assisted 24-hour recalls and a questionnaire that included five questions from the Child Food Security Assessment. MAIN OUTCOME MEASURES Individual dietary components (including total energy, nutrients, and sugar-sweetened beverages), Healthy Eating Index-2010 scores, and meal patterns (such as meal sizes and missed meals) were derived from 24-hour recalls. STATISTICAL ANALYSES Multivariable linear and logistic regression models were used to estimate the relationships between food insecurity and diet characteristics. RESULTS Girls with the highest food insecurity consumed 135 total kilocalories (P<0.005) and 60 snack kilocalories (P<0.05) more per day than girls with no food insecurity. These relationships were absent among boys. CONCLUSIONS Food insecurity among girls in grades 4 and 5 was associated with higher energy intake. Findings support the need for further research to better understand the nature of this relationship and its implications for energy balance.
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Food Insecurity Is Associated with Body Dissatisfaction among Children in California. J Acad Nutr Diet 2018; 119:1732-1737. [PMID: 30177299 DOI: 10.1016/j.jand.2018.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 07/05/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Food insecurity affects 13 million children in the United States. Body dissatisfaction is also prevalent, affecting up to 46% of children. Both food insecurity and body dissatisfaction are associated with poor health outcomes, and both are associated with body weight and racial/ethnic disparities. The association between food insecurity and body dissatisfaction among children has not been examined. OBJECTIVE The purpose of this study was twofold: to examine, in a sample of children in grades 4 through 8, the relationship of child food insecurity with body dissatisfaction and to gain an understanding of the interactive roles of body mass index (BMI), race/ethnicity, and sex in the relationship between food insecurity and body dissatisfaction. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTING This study examined data obtained from 14,768 children in grades 4 through 8 from 54 public schools in California between 2014 and 2016. MAIN OUTCOME MEASURES The primary outcome of interest was body dissatisfaction (five items converted to a binary indicator), and the exposure of interest was child-reported food insecurity (three items converted to a binary indicator). Subsets of validated questionnaires were used to assess body dissatisfaction and food insecurity. STATISTICAL ANALYSES PERFORMED Data were analyzed using multivariable logistic regression, and effect modification was examined by BMI category (underweight, normal, overweight, obese), race/ethnicity, and sex. RESULTS In this large and diverse sample, after adjusting for cofounders, children experiencing food insecurity, in all BMI categories and from all racial/ethnic backgrounds, had higher odds of body dissatisfaction than their food-secure counterparts. The strength of the relationship differed by BMI and race/ethnicity, with the strongest associations observed for African-American children (odds ratio=2.32; P<0.001) and children with a normal children (odds ratio=1.76; P<0.001). CONCLUSIONS Experiencing food insecurity was associated with greater body dissatisfaction, with the magnitude of the association modified by BMI and race/ethnicity.
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Lee AM, Scharf RJ, DeBoer MD. Association between kindergarten and first-grade food insecurity and weight status in U.S. children. Nutrition 2018; 51-52:1-5. [PMID: 29547734 DOI: 10.1016/j.nut.2017.12.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/27/2017] [Accepted: 12/30/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to determine if food insecurity is an independent risk factor for obesity in U.S. children. METHODS We analyzed data from a nationally representative sample of children participating in the Early Childhood Longitudinal Study-Kindergarten Cohort 2011. Statistical analyses were performed to evaluate longitudinal associations between food security and body mass index (BMI) z-score. All regression models included race/ethnicity, household income, and parental education. Survey and anthropometric data was collected from teachers and parents of 8167 U.S. children entering kindergarten in fall 2010 with regular follow-up through third grade. Complete data regarding food security, socioeconomic assessment, and BMI z-score data were included for statistical analyses. All analyses were weighted to be nationally representative. RESULTS Children with household food insecurity had increased obesity prevalence from kindergarten through grade 3; for example, at kindergarten, with food insecurity 16.4% (95% confidence interval [CI], 13.7-19) versus food secure 12.4% (95% CI, 11.3-13.6). Adjusted means analysis showed first-grade food insecurity was significantly correlated with increased BMI z-score in first through third grades; for example, at first grade, with food insecurity 0.6 (95% CI, 0.5-0.7) versus food secure 0.4 (95% CI, 0.4-0.5). Logistic regression showed first-grade food insecurity was correlated with increased risk for obesity in that grade (odds ratio 1.4; 95% CI, 1.1-2). CONCLUSION Obesity is more prevalent among food-insecure children. First-grade food insecurity is an independent risk factor for longitudinal increases in BMI z-score. There are differences in the association between food insecurity and weight status between kindergarten and first grade.
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Affiliation(s)
- Arthur M Lee
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Rebecca J Scharf
- Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Mark D DeBoer
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
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Maynard MS, Perlman CM, Kirkpatrick SI. Food insecurity and perceived anxiety among adolescents: An analysis of data from the 2009–2010 National Health and Nutrition Examination Survey (NHANES). JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2017. [DOI: 10.1080/19320248.2017.1393363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Merryn S. Maynard
- School of Public Health and Health Systems, University of Waterloo. Waterloo, Ontario, Canada
| | - Christopher M. Perlman
- School of Public Health and Health Systems, University of Waterloo. Waterloo, Ontario, Canada
| | - Sharon I. Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo. Waterloo, Ontario, Canada
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Association of Food Insecurity with Children's Behavioral, Emotional, and Academic Outcomes: A Systematic Review. J Dev Behav Pediatr 2017; 38:135-150. [PMID: 28134627 DOI: 10.1097/dbp.0000000000000383] [Citation(s) in RCA: 224] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Food Insecurity (FI) occurs in 21% of families with children and adolescents in the United States, but the potential developmental and behavioral implications of this prevalent social determinant of health have not been comprehensively elucidated. This systematic review aims to examine the association between FI and childhood developmental and behavioral outcomes in western industrialized countries. METHOD This review provides a critical summary of 23 peer reviewed articles from developed countries on the associations between FI and adverse childhood developmental behavioral outcomes including early cognitive development, academic performance, inattention, externalizing behaviors, and depression in 4 groups-infants and toddlers, preschoolers, school age, and adolescents. Various approaches to measuring food insecurity are delineated. Potential confounding and mediating variables of this association are compared across studies. Alternate explanatory mechanisms of observed effects and need for further research are discussed. RESULTS This review demonstrates that household FI, even at marginal levels, is associated with children's behavioral, academic, and emotional problems from infancy to adolescence across western industrialized countries - even after controlling for confounders. CONCLUSIONS While the American Academy of Pediatrics already recommends routine screening for food insecurity during health maintenance visits, the evidence summarized here should encourage developmental behavioral health providers to screen for food insecurity in their practices and intervene when possible. Conversely, children whose families are identified as food insecure in primary care settings warrant enhanced developmental behavioral assessment and possible intervention.
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Lazaratou H, Kalogerakis Z, Economou M, Xenitidis K. Socioeconomic crisis and aggressive behaviour of Greek adolescents. Int J Soc Psychiatry 2017; 63:488-491. [PMID: 28805156 DOI: 10.1177/0020764017719737] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Aggressive behaviours are common during adolescence. In Greece, adolescents and their families experience a severe and enduring recession with potentially adverse impact on mental health. AIM This study aimed to examine the correlation between adolescents' aggressive behaviour and economic factors. METHODS The Buss-Perry Aggression Questionnaire (AQ) was used to measure aggression. Reduction in pocket money and three items of the Household Food Insecurity Access Scale were used to measure material deprivation as a result of the economic crisis. The questionnaires were administrated to a sample of 2,159 adolescent students of the Greater Athens Metropolitan Area. RESULTS Students who during the previous 4 weeks had experienced household food insecurity (anxiety/uncertainty about food, insufficient food quality or insufficient food intake) or had their pocket money decreased within the last 6 months scored on average significantly higher in the AQ compared to their counterparts who did not. CONCLUSION The shortage in basic goods due to the actual Greek economic crisis seems to be related to aggressive behaviours during adolescence and we should take this into account in clinical practice.
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Affiliation(s)
- Helen Lazaratou
- 1 First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Zacharias Kalogerakis
- 1 First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Marina Economou
- 1 First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Kiriakos Xenitidis
- 2 The Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
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Hunger and Psychobehavioural Problems Among Adolescents in the Association of Southeast Asian Nations (ASEAN) Member Countries. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2017. [DOI: 10.5812/ijpbs.8185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jackson DB, Vaughn MG. Parental History of Disruptive Life Events and Household Food Insecurity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:554-560.e1. [PMID: 28689609 DOI: 10.1016/j.jneb.2017.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate whether a history of disruptive life events (ie, school suspension or expulsion, job termination, hospitalization for mental health, and/or criminal justice involvement) among parents is positively associated with household food insecurity. DESIGN Structured interviews and self-report surveys. SETTING Households across all 50 states in the US. PARTICIPANTS Subsample of 6,270 households that participated in the Early Childhood Longitudinal Study-Birth Cohort with valid maternal and paternal data. MAIN OUTCOME MEASURES Food insecurity was measured when children were aged 9 months (wave 1), 2 years (wave 2), and 4 years (wave 3). Parental history of disruptive life events was measured at wave 1. ANALYSIS Logistic regression was used to carry out the analyses. RESULTS Each examined disruptive life event was associated with a significant increase in the odds of persistent household food insecurity (P < .05). The probability of persistent household food insecurity was >6 times as large in households with 1 or both parents reporting the occurrence of each of the disruptive life events, relative to households with none of these parental risk factors. CONCLUSIONS AND IMPLICATIONS Practitioners may want to consider parental history of various disruptive life events in their assessment of familial risk of household food insecurity. Future policy efforts might include a cost-benefit estimate analysis of intervening earlier in the food insecurity-disruptive life events nexus to advocate for savings to the taxpayer for prevention services. Moreover, future research could evaluate these practice and policy-driven efforts using quasi-experimental designs.
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Affiliation(s)
- Dylan B Jackson
- Department of Criminal Justice, University of Texas at San Antonio, San Antonio, TX.
| | - Michael G Vaughn
- College for Public Health and Social Justice, Saint Louis University, St Louis, MO
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Burke MP, Martini LH, Çayır E, Hartline-Grafton HL, Meade RL. Severity of Household Food Insecurity Is Positively Associated with Mental Disorders among Children and Adolescents in the United States. J Nutr 2016; 146:2019-2026. [PMID: 27581581 DOI: 10.3945/jn.116.232298] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/12/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Household food insecurity and mental disorders are both prevalent conditions among children and adolescents (i.e., youth) in the United States. Although some research has examined the association between the 2 conditions, it is not known whether more severe food insecurity is differently associated with mental disorders in youth. OBJECTIVE We investigated the association between severity of household food insecurity and mental disorders among children (aged 4-11 y) and adolescents (aged 12-17 y) using valid and reliable measures of both household food security status and mental disorders. METHODS We analyzed cross-sectional data on 16,918 children and 14,143 adolescents whose families participated in the 2011-2014 National Health Interview Survey. The brief Strengths and Difficulties Questionnaire and the 10-item USDA Household Food Security Survey Module were used to measure mental disorders and food security status, respectively. Multinomial logistic regressions were used to test the association between household food security status and mental disorders in youth. RESULTS There was a significant linear trend in ORs, such that as severity of household food insecurity increased so did the odds of youth having a mental disorder (P < 0.001). Other selected results included the following: compared with food-secure households, youth in marginally food-secure households had higher odds of having a mental disorder with impairment [child OR: 1.26 (95% CI: 1.05, 1.52); adolescent OR: 1.33 (95% CI: 1.05, 1.68)]. In addition, compared with food-secure households, youth in very-low-food-secure households had higher odds of having a mental disorder with severe impairment [child OR: 2.55 (95% CI: 1.90, 3.43); adolescent OR: 3.44 (95% CI: 2.50, 4.75)]. CONCLUSIONS The severity of household food insecurity is positively associated with mental disorders among both children and adolescents in the United States. These results suggest that improving household food security status has the potential to reduce mental disorders among US youth.
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Affiliation(s)
- Michael P Burke
- Food and Nutrition Service, USDA, Alexandria, VA; Center for Research in Nutrition and Health Disparities and Departments of
| | - Lauren H Martini
- Center for Research in Nutrition and Health Disparities and Departments of Epidemiology and Biostatistics and
| | - Ebru Çayır
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Randa L Meade
- Department of Nutrition, University of Tennessee, Knoxville, TN
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Wu J, Dal Grande E, Winefield H, Broderick D, Pilkington R, Gill TK, Taylor AW. Parent-reported Mental Health Problems and Mental Health Services Use in South Australian School-aged Children. AIMS Public Health 2016; 3:750-768. [PMID: 29546193 PMCID: PMC5690403 DOI: 10.3934/publichealth.2016.4.750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Monitoring and reporting childhood mental health problems and mental health services utilization over time provide important information to identify mental health related issues and to guide early intervention. This paper aims to describe the recent prevalence of parent-reported mental health problems among South Australian (SA) children; to identify mental health problems associated characteristics; and to describe mental health services utilization and its related characteristics among this population. METHODS Parent-reported mental health problems were assessed against the first item of the Strength and Difficulties Questionnaire. School-aged children were randomly sampled monthly and data were collected using a surveillance system between 2005 and 2015. Associations between mental health problems and various factors were analysed using univariable analysis and multivariable logistic regression modelling. RESULTS Prevalence of parent-reported mental health problems among children was 9.1% and 9.3% for children aged 5 to 11 years and children aged 12 to 15 years, respectively. No change in prevalence was observed during the past decade. Mental health problems were associated with male sex, long-term illness or pain, negative school experiences, not living with biological parents, and living in a rental dwelling. Less than half (48.7%) of the children with mental health problems received professional help. An increasing trend was found in mental health services utilisation among children aged 5 to 15 years. Utilization of mental health services was associated with male sex, older age, long-term illness or pain, and feeling unhappy at school. CONCLUSION This study reports the prevalence of parent-reported mental and mental health services utilisation among SA school-aged children. Identified characteristics associated with mental health problems and mental health services utilisation provide useful information for the planning of catered population initiatives.
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Affiliation(s)
- Jing Wu
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
| | - Eleonora Dal Grande
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
| | - Helen Winefield
- School of Psychology, University of Adelaide, South Australia 5005
| | | | | | - Tiffany K Gill
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
| | - Anne W Taylor
- Population Research and Outcome Studies (PROS), School of Medicine, University of Adelaide, PO Box 498, Adelaide, South Australia 5001
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Romo ML, Abril-Ulloa V, Kelvin EA. The relationship between hunger and mental health outcomes among school-going Ecuadorian adolescents. Soc Psychiatry Psychiatr Epidemiol 2016; 51:827-37. [PMID: 27083901 DOI: 10.1007/s00127-016-1204-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 03/16/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Mental health and food insecurity are major public health issues among adolescents in Ecuador. Our objective was to determine the relationship between hunger, symptoms of depression, and suicidal ideation among school-going Ecuadorian adolescents. METHODS We conducted crude and multivariable logistic regression models using data from the 2007 Global School-based Student Health Survey from Quito, Guayaquil, and Zamora, Ecuador (N = 5524). Hunger was defined as having gone hungry in the past 30 days due to lack of food in the home. Outcomes of interest were symptoms of depression and suicidal ideation with or without planning in the past year. RESULTS Overall, 41.2 % (2200/5467) of students reported experiencing hunger. In multivariable logistic regression models, hunger had an increasing exposure-response relationship with symptoms of depression [sometimes hungry odds ratio (OR) 1.80, P = 0.0001; most of the time or always hungry OR 2.01, P < 0.0001] and suicidal ideation with planning (sometimes hungry OR 1.55, P = 0.04; most of the time or always hungry OR 2.63, P = 0.001). CONCLUSION Hunger was associated with increased odds of symptoms of depression and suicidal ideation with planning. Strategies to improve mental health among adolescents in Ecuador should consider the potential contribution of hunger and food insecurity.
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Affiliation(s)
- Matthew L Romo
- Epidemiology and Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, NY, 10035, USA.,CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA.,Dirección de Investigación, Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca, Ecuador
| | - Victoria Abril-Ulloa
- Dirección de Investigación, Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca, Ecuador
| | - Elizabeth A Kelvin
- Epidemiology and Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, NY, 10035, USA. .,CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA. .,Doctor of Public Health Program, The Graduate Center, City University of New York, New York, NY, USA.
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