Food insecurity: A key determinant of health

Nutrition and Food Security Among Veterans: Operationalizing Nutritional Functioning

OBJECTIVE

To assess injured military veterans' experiences, beliefs, and daily physical and psychosocial functioning in relation to food and nutrition.

DESIGN

We used a convergent mixed-methods study design and the International Classification of Functioning, Disability, and Health to operationalize the core constructs and influencing factors related to physical and psychosocial functioning, food, and nutrition.

SETTING

Three Veterans Affairs polytrauma rehabilitation centers.

PARTICIPANTS

Veterans who served in the United States military on or after September 11, 2001, and whose medical diagnoses met the criteria for polytrauma; at least 1 mild traumatic brain injury and at least 1 associated comorbidity (eg, posttraumatic stress disorder, chronic musculoskeletal pain, vestibular disturbances), for a total N of 43.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Themes from survey responses and semistructured interview data were pooled into core constructs and influencing factors.

RESULTS

Thirty-seven veterans completed all surveys and participated in recorded interviews. Based on qualitative and quantitative data, veterans' relation to food and nutrition (ie, nutritional functioning) was found to be characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning was found to be shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relations, current beliefs, and current behaviors.

CONCLUSIONS

Nutritional functioning (food background, nutrition knowledge, meal aptitude, resource navigation, navigation to/of food spaces) among injured veterans is complex and shaped by multiple physical, psychosocial, economic, and cultural factors.

Food insecurity and body dissatisfaction in a sample of Canadian adults

Food insecurity may predict poorer body image, which is associated with increased risk of mental health problems. However, minimal attention has been given to the food insecurity-body image link and to factors that may influence this link, such as assigned sex; importantly, females are more likely to experience both food insecurity and body dissatisfaction. The present study used data from the 2017 to 2018 Canadian Community Health Survey (N = 32,017) to investigate the effects of food insecurity and sex on body satisfaction via generalized ordered logistic regression. Results indicated: (1) Food insecurity predicted lower odds of body satisfaction, (2) Males were more likely than females to be satisfied with their bodies, and (3) Food insecurity no longer predicted body satisfaction following the inclusion of sex. Findings suggest the association between food insecurity and body satisfaction may largely be driven by the link between food insecurity and sex. Further investigation is warranted.

Artificial neural network approaches to identify maternal and infant risk and asset factors using Peridata.Net: a WI-MIOS study

Objective

To analyze PeriData.Net, a clinical registry with linked maternal-infant hospital data of Milwaukee County residents, to demonstrate a predictive analytic approach to perinatal infant risk assessment.

Materials and Methods

Using unsupervised learning, we identified infant birth clusters with similar multivariate health indicator patterns, measured using perinatal variables from 2008 to 2019 from n = 43 969 clinical registry records in Milwaukee County, WI, followed by supervised learning risk-propagation modeling to identify key maternal factors. To understand the relationship between socioeconomic status (SES) and birth outcome cluster assignment, we recoded zip codes in Peridata.Net according to SES level.

Results

Three self-organizing map clusters describe infant birth outcome patterns that are similar in the multivariate space. Birth outcome clusters showed higher hazard birth outcome patterns in cluster 3 than clusters 1 and 2. Cluster 3 was associated with lower Apgar scores at 1 and 5 min after birth, shorter infant length, and premature birth. Prediction profiles of birth clusters indicate the most sensitivity to pregnancy weight loss and prenatal visits. Majority of infants assigned to cluster 3 were in the 2 lowest SES levels.

Discussion

Using an extensive perinatal clinical registry, we found that the strongest predictive performance, when considering cluster membership using supervised learning, was achieved by incorporating social and behavioral risk factors. There were inequalities in infant birth outcomes based on SES.

Conclusion

Identifying infant risk hazard profiles can contribute to knowledge discovery and guide future research directions. Additionally, presenting the results to community members can build consensus for community-identified health and risk indicator prioritization for intervention development.

Machine learning techniques for the identification of risk factors associated with food insecurity among adults in Arab countries during the COVID-19 pandemic

BACKGROUND

A direct consequence of global warming, and strongly correlated with poor physical and mental health, food insecurity is a rising global concern associated with low dietary intake. The Coronavirus pandemic has further aggravated food insecurity among vulnerable communities, and thus has sparked the global conversation of equal food access, food distribution, and improvement of food support programs. This research was designed to identify the key features associated with food insecurity during the COVID-19 pandemic using Machine learning techniques. Seven machine learning algorithms were used in the model, which used a dataset of 32 features. The model was designed to predict food insecurity across ten Arab countries in the Gulf and Mediterranean regions. A total of 13,443 participants were extracted from the international Corona Cooking Survey conducted by 38 different countries during the COVID -19 pandemic.

RESULTS

The findings indicate that Jordanian, Palestinian, Lebanese, and Saudi Arabian respondents reported the highest rates of food insecurity in the region (15.4%, 13.7%, 13.7% and 11.3% respectively). On the other hand, Oman and Bahrain reported the lowest rates (5.4% and 5.5% respectively). Our model obtained accuracy levels of 70%-82% in all algorithms. Gradient Boosting and Random Forest techniques had the highest performance levels in predicting food insecurity (82% and 80% respectively). Place of residence, age, financial instability, difficulties in accessing food, and depression were found to be the most relevant features associated with food insecurity.

CONCLUSIONS

The ML algorithms seem to be an effective method in early detection and prediction of food insecurity and can profoundly aid policymaking. The integration of ML approaches in public health strategies could potentially improve the development of targeted and effective interventions to combat food insecurity in these regions and globally.

Is intuitive eating a privileged approach? Cross-sectional and longitudinal associations between food insecurity and intuitive eating

OBJECTIVE

To examine: (1) cross-sectional and longitudinal associations between measures of food insecurity (FI; household status and youth-reported) and intuitive eating (IE) from adolescence to emerging adulthood; and (2) the association between FI persistence and IE in emerging adulthood.

DESIGN

Longitudinal population-based study. Young people reported IE and FI (two items from the US Household Food Security Module) in adolescence and emerging adulthood. Parents provided data on household FI via the six-item US Household Food Security Module in adolescence.

SETTING

Adolescents (Mage = 14·3 ± 2 years) and their parents, recruited from Minneapolis/St. Paul public schools in 2009-2010 and again in 2017-2018 as emerging adults (Mage = 22·1 ± 2 years).

PARTICIPANTS

The analytic sample (n 1372; 53·1 % female, 46·9 % male) was diverse across race/ethnicity (19·8 % Asian, 28·5 % Black, 16·6 % Latinx, 14·7 % Multiracial/Other and 19·9 % White) and socio-economic status (58·6 % low/lower middle, 16·8 % middle and 21·0 % upper middle/high).

RESULTS

In cross-sectional analyses, youth-reported FI was associated with lower IE during adolescence (P = 0·02) and emerging adulthood (P < 0·001). Longitudinally, household FI, but not adolescent experience of FI, was associated with lower IE in emerging adulthood (P = 0·01). Those who remained food-insecure (P = 0·05) or became food-insecure (P = 0·02) had lower IE in emerging adulthood than those remaining food-secure. All effect sizes were small.

CONCLUSIONS

Results suggest FI may exert immediate and potentially lasting impacts on IE. As evidence suggests IE is an adaptive approach conferring benefits beyond eating, it would be valuable for interventions to address social and structural barriers that could impede IE.

A Descriptive Systematic Review of Food Insecurity and Intimate Partner Violence in Southern Africa

Food insecurity and intimate partner violence are important determinants of health and wellbeing in southern Africa. However, very little research has attempted to investigate the association between them even though food insecurity is anticipated to increase in the region, mostly owing to climate change. The objective of this paper was to descriptively review peer reviewed studies that investigated the relationship between food insecurity and intimate partner violence in southern Africa. Literature searches were carried out in Scopus, Web of Science and PubMed databases without any time restriction. A total of five studies that investigated the association between food insecurity and intimate partner violence were identified in South Africa and Swaziland. Of these four studies used a cross-sectional design, and one employed a longitudinal design. Samples varied from 406 to 2479 individuals. No empirical studies were found for the remaining southern African countries of Angola, Botswana, Malawi, Namibia, Zambia, Zimbabwe, Lesotho, and Mozambique. Moreover, the reported findings indicated that there was an association between food insecurity and interpersonal violence (i.e., physical, psychological, and emotional) in the sub-region regardless the fact that the five studies used diverse measurements of both food insecurity and intimate partner violence.

Food Security Challenges and Resilience during the COVID-19 Pandemic: Corner Store Communities in Washington, D.C

The COVID-19 pandemic exacerbates the complexities of food inequity. As one of the social determinants of health, food insecurity significantly impacts overall health across the life course. Guided by the Getting to Equity Framework, this qualitative community-engaged participatory project examines the impact of the pandemic on food security among adults in Washington, DC. Semi-structured interviews (n = 79) were conducted by trained community health workers between November 2020 and December 2021 at corner stores. Data analysis was performed using thematic network analysis in NVivo. Results are grouped into four key themes: (1) impact of the pandemic on food access, including expanded services and innovative solutions to meet needs; (2) coping and asset-based strategies at the individual and community level; (3) sources of information and support, and (4) impact of the pandemic on health and well-being. The importance of lived experience research in public health is increasingly recognized as an innovative approach that offers benefits through community engagement and empowerment.

Does a food insecurity intervention improve perinatal outcomes for mother and child? A randomized control study protocol of the Fresh Rx: Nourishing Healthy Starts program

Background

Pregnancy and postpartum periods represent critical times to support nutrition and household food security, especially for families with limited or strained economic resources. The Fresh Rx: Nourishing Healthy Starts study uses a randomized design to examine a comprehensive, holistic “food is medicine” program targeting food insecure expectant mothers in an area with high rates of inequitable adverse maternal and birth outcomes. Participants receive weekly fresh food deliveries from a Combined Community Supported Agriculture partner, cooking and nutrition supports, access to culinary skills education from a trained chef, and counseling and care management. In addition to providing basic cooking tools and pantry staples, the program links participants with locally available community resources and federal food assistance programs such as the Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children.

Design and methods

This study protocol establishes a randomized control design with a control and two treatment groups to isolate distinct program components and examine variation across outcomes including household food security, maternal depressive symptoms, gestational age, and birthweight. The study design and protocol follow Consolidated Standards of Reporting Trials (CONSORT) principles to emphasize transparency and replicability.

Expected impact of the study for Public Health

Guided by the Cycle of Food Insecurity and Chronic Disease, study implications for public health are significant given the program’s potential for improving birth outcomes, reducing per capita healthcare costs, and filling a notable policy and program gap during the critical perinatal period for mother and child alike.

Households' Food Insecurity and Their Association With Dietary Intakes, Nutrition-Related Knowledge, Attitudes and Practices Among Under-five Children in Gaza Strip, Palestine

The present study aimed to determine the households' food insecurity and their association with dietary intakes, nutrition-related knowledge, attitudes and practices (KAP) among under-five children in the Gaza Strip, Palestine. This cross-sectional study was conducted in 2021 among a representative sample of under-five children. A total of 350 children and their proxy were selected from all Gaza strip governorates, using a cluster random sampling method. The Radimer/Cornell food-security scale was used. A 24-h dietary recall was employed for dietary intakes assessment. Nutrition-related KAP for feeding under-five children, anthropometric measurements, and demographic-socioeconomic characteristics were obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 25. The children from food-insecure households had a high prevalence of moderate underweight (30.4%), stunting (32.8%), wasting (9.6%), and acute undernutrition (30.4%). Between food-insecure and food-secure groups there were significant differences in weight, height/length, mid-upper arm circumference, weight-for-age and mid-upper arm circumference z-scores, underweight, acute undernutrition, intakes of protein, fat, vitamin D, zinc, continued breastfeeding, having nutrition-related adequate knowledge, having nutrition-related positive attitudes, and achieved minimum dietary diversity score (P < 0.05 for all). Additionally, about (56.0%) food-insecure households have inadequate nutrition-related knowledge, (77.6%) have nutrition-related negative attitudes, and (95.2%) did not achieve a minimum dietary diversity score. In conclusion, the children from food-insecure households had a high prevalence of moderate underweight, stunting, wasting, and acute undernutrition. Moreover, low economic status, poor dietary intakes, low levels of nutrition-related KAP, and lack of dietary diversity could contribute to the high levels of food insecurity among under-five children.

Older Adults With Chronic Disease and Food Insecurity in the United States

Food insecurity has emerged as a significant problem for older adults in the United States. Older adults with chronic conditions are particularly vulnerable, as they face a number of physical, psychological, social, and economic barriers related to food purchasing options. The purpose of the current article is to examine the significance of food insecurity in older adults with chronic disease, highlight the barriers and determinates that contribute to the problem, and offer interventions to impact the disparity of food insecurity in this population. [Journal of Gerontological Nursing, 47(12), 7-11.].