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Nguyen G, Bell Z, Andreae G, Scott S, Sermin-Reed L, Lake AA, Heslehurst N. Food insecurity during pregnancy in high-income countries, and maternal weight and diet: A systematic review and meta-analysis. Obes Rev 2024; 25:e13753. [PMID: 38693587 DOI: 10.1111/obr.13753] [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: 03/17/2023] [Revised: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Food insecurity is a well-established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42 kg 95%CI -0.62, -0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.
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Affiliation(s)
- Giang Nguyen
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Zoë Bell
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Department of Nutritional Sciences, King's College London, London, UK
| | - Gemma Andreae
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Stephanie Scott
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - Letitia Sermin-Reed
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Amelia A Lake
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Nicola Heslehurst
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
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Sparks JR, Myers CA, Phelan S, Newton RL, Yang S, Redman LM. Influence of Food Security Status and Diet Quality on Maternal Gestational Weight Gain. J Midwifery Womens Health 2024; 69:394-402. [PMID: 38553830 PMCID: PMC11150105 DOI: 10.1111/jmwh.13622] [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] [Revised: 12/07/2023] [Indexed: 04/07/2024]
Abstract
BACKGROUND Recommended gestational weight gain (GWG) is crucial for health of women and their offspring. Food security status is hypothesized to influence diet quality and GWG. Therefore, we examined the relationship between diet quality and GWG by food security status. METHODS Participants (n = 679) were enrolled in the Initial Vanguard Study of the National Children's Study. GWG was calculated as third trimester weight minus prepregnancy weight. Food security status and diet quality (Healthy Eating Index [HEI]-2015) were assessed using the Household Food Security Survey and a Diet History Questionnaire, respectively. General linear models evaluated the relationship between GWG and HEI-2015 by food security status. RESULTS A greater proportion of women experienced food security (81.3%) compared with food insecurity (18.7%). In women with food security, GWG was negatively associated with HEI-2015 in women having overweight (r = -0.421, P = .003) and positively associated with HEI-2015 in women with inadequate GWG (r = 0.224, P = .019). Conversely, no significant relationships were found between GWG and HEI-2015 in women with food insecurity. DISCUSSION Improved diet quality potentially lowers GWG in women with food security. However, in vulnerable populations, including women with food insecurity, improvements in diet quality may not effectively enhance GWG.
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Affiliation(s)
- Joshua R Sparks
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Candice A Myers
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Suzanne Phelan
- Kinesiology and Public Health Department, California Polytechnic State University, San Luis Obispo, California
| | - Robert L Newton
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Shengping Yang
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Leanne M Redman
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
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Whiteoak B, Dawson SL, Callaway L, de Jersey S, Eley V, Evans J, Kothari A, Navarro S, Gallegos D. Food Insecurity Is Associated with Diet Quality in Pregnancy: A Cross-Sectional Study. Nutrients 2024; 16:1319. [PMID: 38732568 PMCID: PMC11085356 DOI: 10.3390/nu16091319] [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: 03/24/2024] [Revised: 04/10/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Household food insecurity (HFI) and poorer prenatal diet quality are both associated with adverse perinatal outcomes. However, research assessing the relationship between HFI and diet quality in pregnancy is limited. A cross-sectional online survey was conducted to examine the relationship between HFI and diet quality among 1540 pregnant women in Australia. Multiple linear regression models were used to examine the associations between HFI severity (marginal, low, and very low food security compared to high food security) and diet quality and variety, adjusting for age, education, equivalised household income, and relationship status. Logistic regression models were used to assess the associations between HFI and the odds of meeting fruit and vegetable recommendations, adjusting for education. Marginal, low, and very low food security were associated with poorer prenatal diet quality (adj β = -1.9, -3.6, and -5.3, respectively; p < 0.05), and very low food security was associated with a lower dietary variety (adj β = -0.5, p < 0.001). An association was also observed between HFI and lower odds of meeting fruit (adjusted odds ratio [AOR]: 0.61, 95% CI: 0.49-0.76, p < 0.001) and vegetable (AOR: 0.40, 95% CI: 0.19-0.84, p = 0.016) recommendations. Future research should seek to understand what policy and service system changes are required to reduce diet-related disparities in pregnancy.
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Affiliation(s)
- Bree Whiteoak
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD 4059, Australia;
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD 4101, Australia;
- QIMR Berghofer Medical Research Institute, 300 Herston Rd., Herston, QLD 4006, Australia
| | - Samantha L. Dawson
- Food & Mood Centre, IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3220, Australia;
| | - Leonie Callaway
- Women’s and Newborns Services, Royal Brisbane and Women’s Hospital, Herston, QLD 4006, Australia;
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
| | - Susan de Jersey
- Department of Dietetics and Foodservices, Royal Brisbane and Women’s Hospital, Herston, QLD 4006, Australia;
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia
| | - Victoria Eley
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, Herston, QLD 4006, Australia
| | - Joanna Evans
- Maternity Services, Caboolture Hospital, McKean Street, Caboolture, QLD 4510, Australia;
| | - Alka Kothari
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
- Redcliffe Hospital, Anzac Avenue, Redcliffe, QLD 4020, Australia
| | - Severine Navarro
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD 4101, Australia;
- QIMR Berghofer Medical Research Institute, 300 Herston Rd., Herston, QLD 4006, Australia
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD 4059, Australia;
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD 4101, Australia;
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Khammarnia M, Ansari-Moghaddam A, Kakhki FG, Clark CCT, Barahouei FB. Maternal macronutrient and energy intake during pregnancy: a systematic review and meta-analysis. BMC Public Health 2024; 24:478. [PMID: 38360655 PMCID: PMC10870573 DOI: 10.1186/s12889-024-17862-x] [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: 07/28/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Nutritional status during pregnancy can have a significant impact on infant and maternal health outcomes. To maintain maternal homeostasis and support fetal growth, adequate macronutrient and energy intake during pregnancy is essential. Therefore, this study sought to systematically review and meta-analyze macronutrient and energy intakes during pregnancy. METHODS A systematic review and meta-analysis was carried out based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The required data were collected from four databases including: Web of Sciences, ProQuest, Scopus, and PubMed, from 1 January 1980 to 30 May 2023, by using a combination of search terms (dietary pattern" OR "diet quality" OR "food habits" OR "nutrition surveys" OR "diet surveys" OR "food-frequency questionnaire" OR "diet record" OR "dietary recall") AND ( "pregnancy" OR "reproduction" OR "maternal health" OR "neonatal outcomes") among interventional and observational studies. Excel and STATA version 11 were used for data analysis. RESULTS Among 7081 published articles, 54 studies were included in the review. Most of the 33 (61%) studies were cohort studies and a total of 135,566 pregnant women were included. The overall average of energy, carbohydrate, fat, and protein intake was 2036.10 kcal/day, 262.17 gr/day, 74.17 gr/day, and 78.21 gr/day, respectively. Also, energy intake during pregnancy was higher in American (2228.31 kcal/day, CI95%: 2135.06-2325.63) and Eastern Mediterranean regions (2226.70 kcal/day, CI95%: 2077.23-2386.92) than other regions (P < 0.001). Energy intake was higher in the third trimester than others (2115.64 kcal/day, CI95%: 1974.15-2267.27). Furthermore, based on the findings, there was a significant difference between energy intake in different World Health Organization (WHO) regions (P < 0.05). CONCLUSIONS According to the results of meta-analysis, the average total energy was below than average total energy required during pregnancy. More efforts are needed to encourage women to adopt healthy eating habits during pregnancy to support healthy fetal and infant development.
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Affiliation(s)
- Mohammad Khammarnia
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Shriver LH, Eagleton SG, Hosseinzadeh M, Buehler C, Wideman L, Leerkes EM. Associations among eating behaviors, food security status, and dietary intake during pregnancy. Appetite 2023; 191:107062. [PMID: 37742786 PMCID: PMC10957504 DOI: 10.1016/j.appet.2023.107062] [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: 05/04/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 09/26/2023]
Abstract
Dietary intake of certain food groups and/or nutrients during pregnancy has been associated with maternal and infant pregnancy-related outcomes. Few studies have examined how behavioral and environmental factors interact to influence prenatal diet. We examined associations between eating behaviors (dietary restraint, emotional eating, external eating) and food security status regarding dietary intake of selected nutrients/food groups during pregnancy. Participants (N = 299; 29% Non-Hispanic Black; 16% ≤ high school education; 21% food insecure) completed validated questionnaires to assess estimated daily intake of food groups/nutrients during pregnancy [e.g., added sugars from sugar-sweetened beverages (SSBs), % of energy from fat, fruit and vegetable (FV) intake] via National Cancer Institute Dietary Screener Questionnaires); eating behaviors (Dutch Eating Behavior Questionnaire); and food security status (6-item USDA Food security Module). Separate hierarchical multiple regressions for each dietary outcome were conducted controlling for maternal age, education, income-to-needs, race/ethnicity, pre-pregnancy BMI, and gestational diabetes. A significant interaction was found between dietary restraint and food security status on added sugar intake from SSBs (β = -0.15, p = 0.02). The negative association between restraint and added sugar from SSBs was stronger among food insecure participants (β = -0.47, p < 0.001 vs. β = -0.15, p = 0.03). Higher external eating (β = 0.21, p < 0.01) and lower restraint (β = -0.13, p = 0.03) were associated with higher % of energy from fat and living in a food insecure household (β = -0.15, p = 0.01) was associated with lower FV intake. Understanding dietary intake during pregnancy requires consideration of the broader context in which eating behaviors occur.
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Affiliation(s)
- Lenka H Shriver
- Nutrition, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Sally G Eagleton
- Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - Mali Hosseinzadeh
- Nutrition, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Cheryl Buehler
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Laurie Wideman
- Kinesiology, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Esther M Leerkes
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
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Venkatesh KK, Walker DM, Yee LM, Wu J, Garner J, McNeil B, Haas DM, Mercer B, Reddy UM, Silver R, Wapner R, Saade G, Parry S, Simhan H, Lindsay K, Grobman WA. Association of Living in a Food Desert and Poor Periconceptional Diet Quality in a Cohort of Nulliparous Pregnant Individuals. J Nutr 2023; 153:2432-2441. [PMID: 37364682 PMCID: PMC10447609 DOI: 10.1016/j.tjnut.2023.06.032] [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: 02/21/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND A poor diet can result from adverse social determinants of health and increases the risk of adverse pregnancy outcomes. OBJECTIVE We aimed to assess, using data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be prospective cohort, whether nulliparous pregnant individuals who lived in a food desert were more likely to experience poorer periconceptional diet quality compared with those who did not live in a food desert. METHODS The exposure was living in a food desert based on a spatial overview of food access indicators by income and supermarket access per the Food Access Research Atlas. The outcome was periconceptional diet quality per the Healthy Eating Index (HEI)-2010, analyzed by quartile (Q) from the highest or best (Q4, reference) to the lowest or worst dietary quality (Q1); and secondarily, nonadherence (yes or no) to 12 key aspects of dietary quality. RESULTS Among 7,956 assessed individuals, 24.9% lived in a food desert. The mean HEI-2010 score was 61.1 of 100 (SD: 12.5). Poorer periconceptional dietary quality was more common among those who lived in a food desert compared with those who did not live in a food desert (Q4: 19.8%, Q3: 23.6%, Q2: 26.5%, and Q1: 30.0% vs. Q4: 26.8%, Q3: 25.8%, Q2: 24.5%, and Q1: 22.9%; overall P < 0.001). Individuals living in a food desert were more likely to report a diet in lower quartiles of the HEI-2010 (i.e., poorer dietary quality) (aOR: 1.34 per quartile; 95% CI: 1.21, 1.49). They were more likely to be nonadherent to recommended standards for 5 adequacy components of the HEI-2010, including fruit, total vegetables, greens and beans, seafood and plant proteins, and fatty acids, and less likely to report excess intake of empty calories. CONCLUSIONS Nulliparous pregnant individuals living in a food desert were more likely to experience poorer periconceptional diet quality compared with those who did not live in a food desert.
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Affiliation(s)
- Kartik K Venkatesh
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States.
| | - Daniel M Walker
- Department of Family and Community Medicine, The Ohio State University, Columbus, OH, United States
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, United States
| | - Jiqiang Wu
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States
| | - Jennifer Garner
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, United States
| | | | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, United States
| | - Brian Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, United States
| | - Uma M Reddy
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States
| | - Robert Silver
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, United States
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States
| | - George Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, United States
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, United States
| | - Hyagriv Simhan
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsbugh, PA, United States
| | - Karen Lindsay
- UCI Susan Samueli Integrative Health Institute, Susan & Henry Samueli College of Health Sciences, University of California, Irvine, CA, United States; Department of Pediatrics, Division of Endocrinology, University of California, Irvine; School of Medicine, Orange, CA, United States
| | - William A Grobman
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, United States
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Nicholas KM, Thompson AL, Wasser HM, Bentley ME. Healthy home food environments of pregnant Black women are shaped by food outlet access and participation in nutrition assistance programs. Am J Hum Biol 2023; 35:e23903. [PMID: 37025042 DOI: 10.1002/ajhb.23903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVES Improving access to healthy food in Black communities is imperative to combat intergenerational health disparities. Pregnant Black women represent an especially vulnerable population to multiple (and overlapping) sources of socioeconomic and political disenfranchisement and thus for whom maternal nutrition is crucial. This study aimed to (1) define household food environment types, (2) determine whether the distribution of community food outlets is associated with these household food environment types, and (3) determine whether the community-household food environment relationship differs by maternal education or participation in nutrition assistance programs. METHODS Cross-sectional data for pregnant Black women in North Carolina (n = 429) come from the Mothers & Others study, an obesity-prevention randomized control trial, with linked spatial data on all community food outlets (n = 6312) in the study area in 2015. Factor analysis was used to define household food environment types. These factor scores were regressed on access metrics to community food outlets. Adjusted linear regressions tested interaction by maternal education and nutrition assistance programs. RESULTS Four household food environment types were defined: Factor 1 (fresh fruits and vegetables (F/V), low snack), Factor 2 (canned F/V, sweet drinks), Factor 3 (dried/frozen F/V, candy), and Factor 4 (low F/V, soda). Having more convenience stores within 0.25 miles was associated with higher Factor 4 scores. No food outlets were associated with higher Factor 1 scores overall. However, SNAP or WIC participating households saw higher Factor 1 scores with increased access to supermarkets, convenience stores, and dollar stores. CONCLUSIONS Nutrition assistance programs play an important role as buffers against unhealthy community food environments which influence household food environments and maternal nutrition.
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Affiliation(s)
- Khristopher M Nicholas
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amanda L Thompson
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Heather M Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret E Bentley
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Zhuang D, Abbas J, Al-Sulaiti K, Fahlevi M, Aljuaid M, Saniuk S. Land-use and food security in energy transition: Role of food supply. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.1053031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Food security in a just energy transition is a growing debate about designing sustainable food secure networks worldwide. Energy transition, land-use change, and food security are crucial factors for food security and provision. The increased demand for food products and customer preferences regarding food safety provide various issues for the current agriculture food supply chain (AFSC). Along with rising sustainability concerns, strict government regulation, food security, and traceability concerns compel managers, business houses, and practitioners working in AFSC to adopt new tools, techniques, and methodologies to model current food supply chain problems. Thus, in turn, design the food logistics network for food security. Hence, this study investigates the core determinants of food security and supply in Egypt, Morocco, Tunisia, and Lebanon over the period of 2010–2019. In order to estimate the objectives of the study, we employ the fully modified ordinary least square (FMOLS) and dynamic ordinary least squares estimators (DOLS) to draw the study findings. However, the estimated results show a negative association of land use with food security and supply. Likewise, energy transition, gross domestic product, and agricultural value added (AVA) contribute to the food security supply. In contrast, urbanization's negative but insignificant contribution to the food supply in selected economies exists. Besides, another core objective of the study is to investigate the moderate role of the energy transition on the gross domestic product, agriculture sector, and land use and find the significant contribution to the food supply. However, the current study also tries forecasting for the next 10 years and employs the impulse response function (IRF) and variance decomposition analysis (VDA). Congruently, this study uses the pairwise panel causality test and finds exciting outcomes. The COVID-19 crisis has posed challenges such as energy consumption and food security issues. On behalf of the results, the current study proposes imperative policies to investigate the desired level of food supply. The findings provide valuable insights for experts, policymakers, and officials to take practical measures for energy use and food security challenges.
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Effects of Nutritional and Social Factors on Favorable Fetal Growth Conditions Using Structural Equation Modeling. Nutrients 2022; 14:nu14214642. [PMID: 36364904 PMCID: PMC9656558 DOI: 10.3390/nu14214642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Poor birth outcomes such as low birth weight, low birth length and short gestational age, are public health concern issues in South Africa (SA). This study utilized structural equation modeling (SEM) to explore how nutritional and social factors contribute to favorable fetal growth conditions (FFGC) in pregnant women living with and without human immunodeficiency virus (HIV), in the Free State Province of SA. Sociodemographic characteristics, stress, health and nutrition-related information, and birth outcomes data were collected and analyzed from a subsample of 305 women enrolled in a cohort study from 2018−2020. Descriptive statistics were analyzed in R version 4.1.2 and SEM was conducted in Lavaan version 0.6−5. Higher gestational body mass index (GBMI) and income levels were associated with higher FFGC (p < 0.05). Household incomes were positively associated with dietary micronutrient quality (p = 0.002), GBMI (p = 0.012) and food security (p = 0.001). Low incomes (p = 0.004) and food insecurity (p < 0.001) were associated with higher stress, while social support was positively associated with food security status (p = 0.008). These findings highlight the complex interconnections between the social and nutritional factors that are associated with fetal growth conditions. Multisectoral community-based programs may be a useful strategy to address these challenges.
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Camargo JT, Ramirez M, Gajewski BJ, Sullivan DK, Carlson SE, Gibbs HD. Nutrition Literacy Among Latina/x People During Pregnancy Is Associated With Socioeconomic Position. J Acad Nutr Diet 2022; 122:2097-2105. [PMID: 35589070 DOI: 10.1016/j.jand.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND During pregnancy, Latina/x people experience nutrition and nutrition-related health inequities. Nutrition literacy is a potential factor impacted by these inequities. However, the nutrition literacy level of Latina/x people during pregnancy is not well investigated. OBJECTIVES The study aimed to assess the nutrition literacy level of Latina/x people during pregnancy and explore the association of nutrition literacy with socioeconomic position. DESIGN This was a cross-sectional study of data collected from 2016 to 2018 within the double-blinded, randomized clinical trial Assessment of Docosahexaenoic Acid on Reducing Early Preterm Birth. PARTICIPANTS/SETTING A total of 112 Latina/x people during pregnancy from the Kansas City metro area were included in this study. MAIN OUTCOME MEASURES Nutrition literacy level assessed between 12 and 20 gestational weeks using the Nutrition Literacy Assessment Instrument, both in English and Spanish. STATISTICAL ANALYSES PERFORMED Descriptive measures were used to describe the nutrition literacy level during pregnancy. Multiple logistic regression models were used to examine the association between low nutrition literacy and socioeconomic position, adjusting for age and race. RESULTS In this study, most participants demonstrated low nutrition literacy during pregnancy. Those with low nutrition literacy were 2 times more likely to have low annual household income (odds ratio [OR] = 2.74, 95% confidence interval [CI]: 0.99-7.59), 3 times more likely to prefer Spanish as their primary language of communication (OR = 3.03, 95% CI: 0.95-9.67), and 7 times more likely to be uninsured (OR = 7.47; 95% CI: 1.57-35.64). CONCLUSIONS Nutrition literacy scores during pregnancy were associated with variables of socioeconomic position. Future research should focus on nutrition literacy associations with health outcomes during pregnancy and interventions to improve the nutrition literacy level of primarily Spanish-speaking people who have low household incomes and are uninsured.
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Affiliation(s)
- Juliana T Camargo
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas; Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
| | - Mariana Ramirez
- JUNTOS Center for Advancing Latino Health, Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas
| | - Byron J Gajewski
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas
| | - Heather D Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas.
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