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Reeder NK, Reneker JC. Food insecurity is associated with metabolic syndrome among US adults: NHANES 2005-2016. Nutr Res 2024; 126:159-166. [PMID: 38718433 PMCID: PMC11179963 DOI: 10.1016/j.nutres.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 06/16/2024]
Abstract
The primary objective of this study was to examine the association between food security status and metabolic syndrome (MetS) using a nationally representative dataset. We hypothesized that food insecurity would be associated with an increased odds of having MetS. This was a cross-sectional analysis of data from the 2005-2006 to 2015-2016 National Health and Nutrition Examination Survey data collection cycles. Food security was measured using the US Food Security Survey Module. Presence of MetS was determined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The association between food insecurity and MetS was examined using logistic regression models stratified by sex and adjusted for poverty to income ratio, age, race, marital status, educational attainment, smoking status, and body mass index. After adjusting for covariates, men with marginal (odds ratio, 1.64; 95% confidence interval [CI], 1.22-2.20) and low (odds ratio, 1.33; 95% CI, 1.02-1.73) food security had a higher odds of having MetS than men with full food security; however, this association was lost among men with very low food security. For women, very low food security was associated with a 1.61 times greater odds of having MetS (95% CI, 1.16-2.25). These results suggest that food insecurity is generally associated with an increased prevalence of MetS for women, but not necessarily for men. These findings highlight the need to address rising food insecurity rates, while also highlighting the need for further research to fully elucidate the role of gender and sex in food insecurity and chronic disease.
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Affiliation(s)
- Nicole K Reeder
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, Mississippi, USA.
| | - Jennifer C Reneker
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA
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2
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Saelee R, Alexander DS, Onufrak S, Imperatore G, Bullard KM. Household Food Security Status and Allostatic Load among United States Adults: National Health and Nutrition Examination Survey 2015-2020. J Nutr 2024; 154:785-793. [PMID: 38158187 PMCID: PMC10922609 DOI: 10.1016/j.tjnut.2023.12.041] [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: 10/05/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Household food insecurity has been linked to adverse health outcomes, but the pathways driving these associations are not well understood. The stress experienced by those in food-insecure households and having to prioritize between food and other essential needs could lead to physiologic dysregulations [i.e., allostatic load (AL)] and, as a result, adversely impact their health. OBJECTIVE To assess the association between household food security status and AL and differences by gender, race and ethnicity, and Supplemental Nutrition Assistance Program (SNAP) participation. METHODS We used data from 7640 United States adults in the 2015-2016 and 2017-March 2020 National Health and Nutrition Examination Survey to estimate means and prevalence ratios (PR) for AL scores (based on cardiovascular, metabolic, and immune biomarkers) associated with self-reported household food security status from multivariable linear and logistic regression models. RESULTS Adults in marginally food-secure [mean = 3.09, standard error (SE) = 0.10] and food-insecure households (mean = 3.05; SE = 0.08) had higher mean AL than those in food-secure households (mean = 2.70; SE = 0.05). Compared with adults in food-secure households in the same category, those more likely to have an elevated AL included: SNAP participants [PR = 1.12; 95% confidence interval (CI): 1.03, 1.22] and Hispanic women (PR = 1.20; 95% CI: 1.05, 1.37) in marginally food-secure households; and non-Hispanic Black women (PR = 1.14; 95% CI: 1.03, 1.26), men (PR = 1.13; 95% CI: 1.02, 1.26), and non-SNAP non-Hispanic White adults (PR = 1.22; 95% CI: 1.08, 1.39) in food-insecure households. CONCLUSIONS AL may be one pathway by which household food insecurity affects health and may vary by gender, race and ethnicity, and SNAP participation.
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Affiliation(s)
- Ryan Saelee
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Dayna S Alexander
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Stephen Onufrak
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kai McKeever Bullard
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
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3
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Shi S, Huang H, Huang Y, Zhong VW, Feng N. Lifestyle Behaviors and Cardiometabolic Diseases by Race and Ethnicity and Social Risk Factors Among US Young Adults, 2011 to 2018. J Am Heart Assoc 2023; 12:e028926. [PMID: 37608770 PMCID: PMC10547329 DOI: 10.1161/jaha.122.028926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023]
Abstract
Background Cardiometabolic health has been worsening among young adults, but the prevalence of lifestyle risk factors and cardiometabolic diseases is unclear. Methods and Results Adults aged 18 to 44 years were included from the National Health and Nutrition Examination Survey, 2011 to 2018. Age-standardized prevalence of lifestyle risk factors and cardiometabolic diseases was estimated overall and by demographic and social risk factors. A set of multivariable logistic regressions was sequentially performed by adjusting for age, sex, social risk factors, and lifestyle factors to determine whether racial and ethnic disparities in the prevalence of cardiometabolic diseases may be attributable to differences in social risk factors and lifestyle factors. Appropriate weights were used to ensure national representativeness of the estimates. A total of 10 405 participants were analyzed (median age, 30.3 years; 50.8% women; 32.3% non-Hispanic White). The prevalence of lifestyle risk factors ranged from 16.3% for excessive drinking to 49.3% for poor diet quality. The prevalence of cardiometabolic diseases ranged from 4.3% for diabetes to 37.3% for dyslipidemia. The prevalence of having ≥2 lifestyle risk factors was 45.2% and having ≥2 cardiometabolic diseases was 22.0%. Racial and ethnic disparities in many cardiometabolic diseases persisted but were attenuated after adjusting for social risk factors and lifestyle factors. Conclusions The prevalence of lifestyle risk factors and cardiometabolic diseases was high among US young adults and varied by race and ethnicity and social risk factors. Racial and ethnic disparities in the prevalence of cardiometabolic diseases were not fully explained by differences in social risk factors and lifestyle factors.
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Affiliation(s)
- Shuxiao Shi
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Hengye Huang
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yue Huang
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Victor W. Zhong
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Nannan Feng
- Department of Epidemiology and Biostatistics, School of Public HealthShanghai Jiao Tong University School of MedicineShanghaiChina
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4
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Liang JH, Pu YQ, Liu ML, Hu LX, Bao WW, Zhang YS, Kakaer A, Zhao Y, Chen YC, Pu XY, Huang SY, Jiang N, Huang S, Dong GH, Chen YJ. Joint effect of whole blood metals exposure with dyslipidemia in representative US adults in NHANES 2011-2020. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:96604-96616. [PMID: 37578581 DOI: 10.1007/s11356-023-28903-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023]
Abstract
With little knowledge on the joint effects of metal exposure on dyslipidemia, we aimed to investigate the relationship between exposure to metal and dyslipidemia among US adults based on the National Health and Nutrition Examination Survey (NHANES). Based on the five NHANES waves (2011-2020), we selected five metals in blood as exposure, namely, cadmium (Cd), lead (Pb), total mercury (Hg), manganese (Mn), and selenium (Se), which were detected by inductively coupled plasma mass spectrometry. Survey-multivariable logistic regression, generalized weighted quantile sum (WQS), and Bayesian kernel machine regression (BKMR) were performed to determine whether dyslipidemia was associated with single metals or mixed metals. Our study included 12,526 participants aged from 20 to 80, representing 577.1 million non-institutionalized US adults. We found a positive association between several metals including Pb [adjusted odds ratio (AOR) = 1.332, 95%CI: 1.165, 1.522], total Hg (AOR = 1.264, 95%CI: 1.120, 1.427), Mn (AOR = 1.181, 95%CI: 1.046, 1.334), and Se (AOR = 1.771, 95%CI: 1.576, 1.992) and dyslipidemia. According to the WQS approach, metal mixtures were positively associated with dyslipidemia (AOR: 1.310, 95%CI: 1.216, 1.411) after a full-model adjustment. As is shown in the BKMR model, mixed metals tended to be positively associated with dyslipidemia ratios in a significant manner. Females, non-Hispanic White populations, people aged over 60, and those who did a little physical activity had a greater risk for dyslipidemia. Our findings suggest metals including Cd, Pb, Hg, Mn, and Se and their combinations may adversely affect dyslipidemia among US adults. Due to the cross-sectional nature of the study, it is possible that reverse causation may exist.
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Affiliation(s)
- Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Ying-Qi Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Mei-Ling Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Li-Xin Hu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Yu-Shan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Aerziguli Kakaer
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Yi-Can Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Xue-Ya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Shao-Yi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No.74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, People's Republic of China, 510080.
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Krasnovsky L, Crowley AP, Naeem F, Wang LS, Wu GD, Chao AM. A Scoping Review of Nutritional Biomarkers Associated with Food Security. Nutrients 2023; 15:3576. [PMID: 37630766 PMCID: PMC10459650 DOI: 10.3390/nu15163576] [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: 07/19/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Food insecurity affects more than 40 million individuals in the United States and is linked to negative health outcomes due, in part, to poor dietary quality. Despite the emergence of metabolomics as a modality to objectively characterize nutritional biomarkers, it is unclear whether food security is associated with any biomarkers of dietary quality. This scoping review aims to summarize studies that examined associations between nutritional biomarkers and food security, as well as studies that investigated metabolomic differences between people with and without food insecurity. PubMed, Embase, Scopus, and AGRICOLA were searched through August 2022 for studies describing food insecurity and metabolic markers in blood, urine, plasma, hair, or nails. The 78 studies included consisted of targeted assays quantifying lipids, dietary nutrients, heavy metals, and environmental xenobiotics as biochemical features associated with food insecurity. Among those biomarkers which were quantified in at least five studies, none showed a consistent association with food insecurity. Although three biomarkers of dietary quality have been assessed between food-insecure versus food-secure populations, no studies have utilized untargeted metabolomics to characterize patterns of small molecules that distinguish between these two populations. Further studies are needed to characterize the dietary quality profiles of individuals with and without food insecurity.
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Affiliation(s)
- Lev Krasnovsky
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Aidan P. Crowley
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Fawaz Naeem
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Lucy S. Wang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Gary D. Wu
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Ariana M. Chao
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA;
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6
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Malecki KMC, Nikodemova M, Schultz AA, LeCaire TJ, Bersch AJ, Cadmus-Bertram L, Engelman CD, Hagen E, McCulley L, Palta M, Rodriguez A, Sethi AK, Walsh MC, Nieto FJ, Peppard PE. The Survey of the Health of Wisconsin (SHOW) Program: An Infrastructure for Advancing Population Health. Front Public Health 2022; 10:818777. [PMID: 35433595 PMCID: PMC9008403 DOI: 10.3389/fpubh.2022.818777] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction The Survey of the Health of Wisconsin (SHOW) was established in 2008 by the University of Wisconsin (UW) School of Medicine and Public Health (SMPH) with the goals of (1) providing a timely and accurate picture of the health of the state residents; and (2) serving as an agile resource infrastructure for ancillary studies. Today, the SHOW program continues to serve as a unique and vital population health research infrastructure for advancing public health. Methods SHOW currently includes 5,846 adult and 980 minor participants recruited between 2008 and 2019 in four primary waves. WAVE I (2008–2013) includes annual statewide representative samples of 3,380 adults ages 21 to 74 years. WAVE II (2014–2016) is a triannual statewide sample of 1,957 adults (age ≥18 years) and 645 children (age 0–17). WAVE III (2017) consists of follow-up of 725 adults from the WAVE I and baseline surveys of 222 children in selected households. WAVEs II and III include stool samples collected as part of an ancillary study in a subset of 784 individuals. WAVE IV consists of 517 adults and 113 children recruited from traditionally under-represented populations in biomedical research including African Americans and Hispanics in Milwaukee, Wisconsin. Findings to Date The SHOW resource provides unique spatially granular and timely data to examine the intersectionality of multiple social determinants and population health. SHOW includes a large biorepository and extensive health data collected in a geographically diverse urban and rural population. Over 60 studies have been published covering a broad range of topics including, urban and rural disparities in cardio-metabolic disease and cancer, objective physical activity, sleep, green-space and mental health, transcriptomics, the gut microbiome, antibiotic resistance, air pollution, concentrated animal feeding operations and heavy metal exposures. Discussion The SHOW cohort and resource is available for continued follow-up and ancillary studies including longitudinal public health monitoring, translational biomedical research, environmental health, aging, microbiome and COVID-19 research.
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Affiliation(s)
- Kristen M C Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Maria Nikodemova
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Amy A Schultz
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Tamara J LeCaire
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States.,School of Medicine and Public Health, Wisconsin Alzheimer's Institute, University of Wisconsin, Madison, WI, United States
| | - Andrew J Bersch
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Lisa Cadmus-Bertram
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States.,Department of Kinesiology, School of Education, University of Wisconsin, Madison, WI, United States
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Erika Hagen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Laura McCulley
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Mari Palta
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Allison Rodriguez
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Ajay K Sethi
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Matt C Walsh
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - F Javier Nieto
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States.,School of Medicine and Public Health, Wisconsin Alzheimer's Institute, University of Wisconsin, Madison, WI, United States.,College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Paul E Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
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7
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Design of a clinical trial to isolate the experience of food insecurity and elucidate the biological mechanisms of risk for childhood health outcomes. Contemp Clin Trials 2022; 117:106751. [DOI: 10.1016/j.cct.2022.106751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/29/2022] [Indexed: 11/23/2022]
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8
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Jin X, Ezeonwu M, Ayad A, Bowman K. Using a Food Bank as a Platform for Educating Communities during the COVID-19 Pandemic. J Community Health Nurs 2022; 39:50-57. [PMID: 35191787 DOI: 10.1080/07370016.2022.2037052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe a partnership between a public university and a regional foodbank aimed to promote health in food insecure communities, and to support nursing students' learning experiences in community health. DESIGN A single setting case study. METHODS A comprehensive health needs assessment conducted through a windshield survey and key informant interviews was used to identify the community's priorities. FINDINGS Nursing interventions were tailored to the community's needs by creating healthy recipes and providing education on food safety, lower back injury prevention, and chronic disease prevention and 15 management. CONCLUSION During pandemics, nursing program partnerships with food banks could play pivotal roles in community health promotion. CLINICAL EVIDENCE Food banks can serve as clinical platforms for nursing education and community wellness activities.
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Affiliation(s)
- Xianglan Jin
- PhD Student, University of Washington, Seattle, USA
| | - Mabel Ezeonwu
- Associate Professor, School of Nursing and Health Studies, University of Washington Bothell, USA
| | - Andreka Ayad
- Staff RN, Swedish Medical Center, First Hill, Seattle, USA
| | - Karen Bowman
- CEO, Karen Bowman & Associates, Inc, Seattle, USA; Volunteer, Des Moines Regional Food Bank, Des Moines, USA
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9
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Miguel EDS, Lopes SO, Araújo SP, Priore SE, Alfenas RDCG, Hermsdorff HHM. Association between food insecurity and cardiometabolic risk in adults and the elderly: A systematic review. J Glob Health 2021; 10:020402. [PMID: 33110569 PMCID: PMC7568919 DOI: 10.7189/jogh.10.020402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Food insecurity is a public health concern that affects health and quality of life, but its association with cardiometabolic risk is not well established. Thus, this systematic review evaluated the association between food insecurity and cardiometabolic risk factors in adults and the elderly. Methods Search was conducted according to the PRISMA protocol using Scielo, LILACS and PubMed databases. We included original articles published in Portuguese, English, and Spanish, which assessed the association between food insecurity and cardiometabolic risk factors in adults and the elderly. The search identified 877 articles but only 11 were included in the review. Results Food insecurity was directly associated with cardiometabolic risk (excess weight, hypertension, dyslipidemias, diabetes, and stress) after adjusting for interfering factors. A limitation of the cross-sectional study design is that the cause-effect relation between food insecurity and cardiometabolic risk cannot be established. Conclusions We conclude that food insecurity has a direct relationship with cardiometabolic risk factors, especially excess weight, hypertension, and dyslipidemias. The identification of food insecurity as health problems can contribute to the implementation of efficient public policies for the prevention and control of chronic diseases. Protocol registration This review was registered on PROSPERO-International Prospective Register of Systematic Reviews – CRD4201911549.
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Affiliation(s)
| | - Sílvia Oliveira Lopes
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa-Minas Gerais, Brazil
| | - Susilane Pereira Araújo
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa-Minas Gerais, Brazil
| | - Silvia Eloiza Priore
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa-Minas Gerais, Brazil
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Horning ML, Alver B, Porter L, Lenarz-Coy S, Kamdar N. Food insecurity, food-related characteristics and behaviors, and fruit and vegetable intake in mobile market customers. Appetite 2021; 166:105466. [PMID: 34139297 DOI: 10.1016/j.appet.2021.105466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/20/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
Mobile markets (MM) bring affordable, quality, healthy foods to high-need, low-food access communities. However, little is known about food insecurity of MM customers. This manuscript evaluates food insecurity prevalence in MM customers and assesses associations between food insecurity and MM use, food-related characteristics and behaviors, and fruit and vegetable (FV) intake. Customers (N = 302) completed cross-sectional surveys in summer 2019 that assessed: food security, food availability, cooking attitude, self-efficacy for healthy cooking, self-efficacy for cooking and eating FV, social connectedness, and FV intake. Descriptive and multivariate analyses were used to describe and assess associations with food insecurity and FV intake. Results show most MM customers were food insecure (85%). In logistic regression models adjusted for sociodemographic characteristics, long-term MM use (OR = 0.77, CI = 0.60-0.997), access to affordable, quality foods (OR = 0.81, CI = 0.71-0.93), and self-efficacy for both cooking healthy foods (OR = 0.88, CI = 0.80-0.97) and cooking and eating FV (OR = 0.90, CI = 0.82-0.98) were associated with lower odds of food insecurity; negative cooking attitudes (OR = 1.12, CI = 1.02-1.24) were associated with higher odds of food insecurity. Being food insecure (β = -1.37, SE=0.43, p < 0.01) was associated with poorer FV intake; this association attenuated slightly (β = -1.22, SE=0.43, p < 0.01) when length of MM use was added to the general linear model, which was also associated with higher fruit and vegetable intake (β = 0.26, SE=0.10, p = 0.01). Results suggest the MM reaches customers experiencing high levels of food insecurity and long-term MM use is associated with lower food insecurity and higher FV intake. Relationships between food insecurity and several food characteristics/behaviors provide insight for potential targets for wrap-around interventions to address food insecurity among customers. Findings suggest longitudinal evaluation of the MM's impact on food security and other food-related characteristics/behaviors is warranted.
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Affiliation(s)
- Melissa L Horning
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN, 55414, USA.
| | - Bonnie Alver
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN, 55414, USA.
| | | | | | - Nipa Kamdar
- VA Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety (CIN 13-413), Michael E. DeBakey VA Medical Center, Houston, TX, USA.
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11
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Walker S, Baum JI. Eggs as an affordable source of nutrients for adults and children living in food-insecure environments. Nutr Rev 2021; 80:178-186. [PMID: 34027973 DOI: 10.1093/nutrit/nuab019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/10/2021] [Accepted: 03/02/2021] [Indexed: 01/03/2023] Open
Abstract
Food insecurity affects an estimated 12% of households in the United States. Adults and children who experience food insecurity are increased risk for development of metabolic diseases such as type 2 diabetes, obesity, and cardiovascular disease. The negative health outcomes associated with food insecurity are multifactorial; however, many of them may be caused by limited nutritional intake and poor diet quality. Dietary intake of eggs may be an applicable solution for food-insecure families who are challenged by limited nutritional intake. Eggs contain a variety of nutrients that support metabolic health. For instance, eggs are a complete source of high-quality protein and contain 16 vitamins and minerals. Furthermore, eggs are cost efficient. When comparing the relationship between foods on the basis of calories and unit cost, the energy cost of eggs is significantly less when compared with that of other animal-protein foods such as meat, poultry, and fish. However, dietary intake of eggs is controversial in regard to cardiovascular health. Thus, the aim of this review is to summarize the role of eggs in the diet and the impact eggs have on health for adults and children living in a food-insecure environment.
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Affiliation(s)
- Sam Walker
- S. Walker and J.I. Baum are with the Department of Food Science, University of Arkansas. S. Walker and J.I. Baum are with the Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, Arkansas, USA
| | - J I Baum
- S. Walker and J.I. Baum are with the Department of Food Science, University of Arkansas. S. Walker and J.I. Baum are with the Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, Arkansas, USA
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Malecki KM, Nikodemova M, Schultz AA, LeCaire TJ, Bersch AJ, Cadmus-Bertram L, Engelman CD, Hagen E, Palta M, Sethi AK, Walsh MC, Nieto FJ, Peppard PE. The Survey of the Health of Wisconsin (SHOW) Program: An infrastructure for Advancing Population Health Sciences. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.15.21253478. [PMID: 33851173 PMCID: PMC8043470 DOI: 10.1101/2021.03.15.21253478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE The Survey of the Health of Wisconsin (SHOW) was established in 2008 by the University of Wisconsin (UW) School of Medicine and Public Health (SMPH) with the goals of 1) providing a timely and accurate picture of the health of the state residents; and 2) serving as an agile resource infrastructure for ancillary studies. Today SHOW continues to serve as a vital population health research infrastructure. PARTICIPANTS SHOW currently includes 5,846 adult and 980 minor participants recruited between 2008-2019 in four primary waves. WAVE I (2008-2013) includes annual statewide representative samples of 3,380 adults ages 21 to 74 years. WAVE II (2014-2016) is a triannual statewide sample of 1957 adults (age ≥18 years) and 645 children. WAVE III (2017) consists of follow-up of 725 adults from the WAVE I and baseline surveys of 222 children in selected households. WAVEs II and III include stool samples collected as part of an ancillary study in a subset of 784 individuals. WAVE IV consist of 517 adults and 113 children recruited from traditionally under-represented populations in biomedical research including African Americans and Hispanics in Milwaukee county, WI. FINDINGS TO DATE The SHOW provides extensive data to examine the intersectionality of multiple social determinants and population health. SHOW includes a large biorepository and extensive health data collected in a geographically diverse urban and rural population. Over 60 studies have been published covering a broad range of topics including, urban and rural disparities in cardio-metabolic disease and cancer, objective physical activity, sleep, green-space and mental health, transcriptomics, the gut microbiome, antibiotic resistance, air pollution, concentrated animal feeding operations and heavy metal exposures. FUTURE PLANS The SHOW cohort is available for continued longitudinal follow-up and ancillary studies including genetic, multi-omic and translational environmental health, aging, microbiome and COVID-19 research. ARTICLE SUMMARY Strengths and limitations: The Survey of the Health of Wisconsin (SHOW) is an infrastructure to advance population health sciences including biological sample collection and broader data on individual and neighborhood social and environmental determinants of health.The extensive data from diverse urban and rural populations offers a unique study sample to compare how socio-economic gradients shape health outcomes in different contexts.The objective health data supports novel interdisciplinary research initiatives and is especially suited for research in causes and consequences of environmental exposures (physical, chemical, social) across the life course on cardiometabolic health, immunity, and aging related conditions.The extensive biorepository supports novel omics research into common biological mechanisms underlying numerous complex chronic conditions including inflammation, oxidative stress, metabolomics, and epigenetic modulation.Ancillary studies, such as the Wisconsin Microbiome Study, have expanded the utility of the study to examine human susceptibility to environmental exposures and opportunities for investigations of the role of microbiome in health and disease.Long-standing partnerships and recent participation among traditionally under-represented populations in biomedical research offer numerous opportunities to support community-driven health equity work.No biological samples were collected among children.The statewide sampling frame may limit generalizability to other regions in the United States.
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Affiliation(s)
- Kristen M.C. Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Maria Nikodemova
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Amy A. Schultz
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Tamara J. LeCaire
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Andrew J. Bersch
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Lisa Cadmus-Bertram
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
- Department of Kinesiology, School of Education, University of Wisconsin, Madison
| | - Corinne D. Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Erika Hagen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Mari Palta
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Ajay K. Sethi
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | | | - F. Javier Nieto
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
- Department of Kinesiology, School of Education, University of Wisconsin, Madison
| | - Paul E. Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
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Xu H, Mao Y, Xu B, Hu Y. Low-level environmental lead and cadmium exposures and dyslipidemia in adults: Findings from the NHANES 2005-2016. J Trace Elem Med Biol 2021; 63:126651. [PMID: 33035812 DOI: 10.1016/j.jtemb.2020.126651] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/13/2020] [Accepted: 09/16/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Previous experimental and occupational health studies have shown the toxic effects of relatively high-level cadmium and lead on lipid metabolism. However, limited studies investigated the relationships between serum lipid levels and exposure to low-level lead and cadmium in adults. OBJECTIVE To investigate the associations between lead and cadmium levels in blood and dyslipidemia in adults. METHODS A retrospective cross-sectional study of 7,457 adults aged 20-79 years who were recruited in the National Health and Nutrition Examination Survey (NHANES, 2005-2016) was conducted. Multivariate linear and logistic regressions were used to examine the associations of blood lead and cadmium levels with serum lipid profiles and risk of dyslipidemia, respectively. RESULTS The weighted geometric means [95% confidence intervals (CIs)] of lead and cadmium in blood were 1.23 (1.21, 1.25) μg/dL and 0.36 (0.35, 0.37) μg/L, respectively. Blood lead was significantly associated with serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (Apo B) levels after adjusting for covariates. Compared with the adults in the lowest blood lead quartile (≤0.76 μg/dL), those in the highest lead quartile (>1.90 μg/dL) had higher risks of elevated TC (OR = 1.88, 95% CI: 1.59-2.22), non-HDL-C (OR = 1.59, 95% CI: 1.33-1.91), LDL-C (OR = 1.68, 95% CI: 1.41-1.99) and Apo B (OR = 2.00, 95% CI: 1.46-2.73). However, the single effect of cadmium exposure and the joint effect of lead and cadmium exposures on dyslipidemia were not observed. CONCLUSION Blood lead well below the current recommended level was positively associated with the risk of dyslipidemia in adults, while the low-level cadmium exposure currently observed in adults did not show any significant associations with lipid levels.
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Affiliation(s)
- Huadong Xu
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Yu Mao
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Bucai Xu
- The Longgang People's Hospital, Wenzhou Medical University, No. 238 Longxiang Road, Longgang City, Zhejiang, 325800, China
| | - Yanan Hu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 288 Nanjing Road, Heping District, Tianjin, 300020, China.
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Lee JW, Shin WK, Kim Y. Food Security Status is not Associated with Increased Risk of Metabolic Syndrome in Korean Adults. Metab Syndr Relat Disord 2020; 19:192-199. [PMID: 33373532 DOI: 10.1089/met.2020.0101] [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: 12/28/2022] Open
Abstract
Background: It is still uncertain whether food insecurity increases the risk of metabolic syndrome. Recent reports from the United States and developing countries have shown conflicting results on this issue. This study aimed to investigate the association between food security status and metabolic syndrome in Korean adults. Methods: We performed a nationwide population study using data for 18,782 adults obtained from the 2012 to 2015 Korean National Health and Nutrition Examination Surveys. The 18-item Food Security Survey Module was utilized to assess household food security status. We used multiple logistic regression models to determine the association between food security status and metabolic syndrome. Results: The overall prevalence of food insecurity was 8.2% and that of metabolic syndrome was 27.3%. The prevalences of metabolic syndrome were 26.2%, 32.3%, 30.2%, and 28.8% in the high, marginal, low, and very low food security groups, respectively. Food-insecure participants (participants in the low food security and very low food security groups) were significantly more likely to be female, divorced/widowed/separated, and current smokers compared to food-secure participants. Food-insecure participants also had lower incomes, lower education attainments, and lower physical activities (P < 0.05). Compared with the high food security group, the marginal (odds ratio [OR]: 1.34, 95% confidence interval [95% CI]: 1.19-1.50, P < 0.001) and low food security groups (OR: 1.22, 95% CI: 1.04-1.42, P = 0.01) had increased odds of metabolic syndrome in the unadjusted models. However, after controlling for covariates, including age, sex, marital status, education attainment, household income, smoking, alcohol intake, and physical activity, neither marginal food security (adjusted odds ratio [aOR]: 1.02, 95% CI: 0.87-1.19, P = 0.86) nor low food security (aOR: 0.88, 95% CI: 0.71-1.08, P = 0.22) was significantly associated with an increased risk of metabolic syndrome. Conclusions: Contrary to a prior report from the United States, food security status was not significantly associated with the risk of metabolic syndrome in Korean adults.
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Affiliation(s)
- Jung Woo Lee
- Department of Human Ecology, Graduate School, Korea University, Seoul, Republic of Korea
| | - Woo-Kyoung Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yookyung Kim
- Department of Human Ecology, Graduate School, Korea University, Seoul, Republic of Korea
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15
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Food Insecurity, Food Deserts, and Waist-to-Height Ratio: Variation by Sex and Race/Ethnicity. J Community Health 2020; 44:444-450. [PMID: 30560310 DOI: 10.1007/s10900-018-00601-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study is to investigate the association between two food-related hardships-food insecurity and living in a food desert-on waist-to-height ratio (WHtR). Data on participants from waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were analyzed. The association between food-related hardships and waist-to-height ratio were examined using logistic regression. Models were stratified by sex and race/ethnicity to examine potential moderating effects. Study results suggest food insecurity has a positive association with WHtR among female respondents (OR = 1.360, p = .017). Living in a food desert has a positive association with WHtR among both females (OR = 1.247, p = .026) and males (OR = 1.245, p = .024). In models stratified by race/ethnicity living in a food desert is positively associated with WHtR among White respondents (OR = 1.279, p = .003). Given the link between food-related hardships and obesity, targeted interventions that alleviate food insecurity and inadequate access to healthy food retailers could be effective in reducing obesity.
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Nagata JM, Palar K, Gooding HC, Garber AK, Bibbins-Domingo K, Weiser SD. Food Insecurity and Chronic Disease in US Young Adults: Findings from the National Longitudinal Study of Adolescent to Adult Health. J Gen Intern Med 2019; 34:2756-2762. [PMID: 31576509 PMCID: PMC6854148 DOI: 10.1007/s11606-019-05317-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/07/2019] [Accepted: 07/23/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Food insecurity, or the limited or uncertain access to food resulting from inadequate financial resources, is associated with a higher prevalence of chronic disease in adulthood. Little is known about these relationships specifically in young adulthood, an important time for the development of chronic disease. OBJECTIVE To determine the association between food insecurity and chronic disease including diabetes, hypertension, obesity, and obstructive airway disease in a nationally representative sample of US young adults. DESIGN Cross-sectional nationally representative data collected from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health was analyzed using multiple logistic regression models. PARTICIPANTS US young adults ages 24-32 years old MAIN MEASURES: Food insecurity and general health; self-reported diabetes, hypertension, hyperlipidemia, "very overweight," and obstructive airway disease; measured obesity derived from body mass index; and inadequate disease control (hemoglobin A1c ≥ 7.0%, blood pressure ≥ 140/90 mmHg) among those with reported diabetes and hypertension. KEY RESULTS Of the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of self-reported poor health (2.63, 95% confidence interval (CI) 1.63-4.24), diabetes (1.67, 95% CI 1.18-2.37), hypertension (1.40, 95% CI 1.14-1.72), being "very overweight" (1.30, 95% CI 1.08-1.57), and obstructive airway disease (1.48, 95% CI 1.22-1.80) in adjusted models compared with young adults who were food secure. Food insecurity was not associated with inadequate disease control among those with diabetes or hypertension. CONCLUSIONS Food insecurity is associated with several self-reported chronic diseases and obesity in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should evaluate the impact of early interventions to combat food insecurity on the prevention of downstream health effects in later adulthood.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94158, USA.
| | - Kartika Palar
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Holly C Gooding
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrea K Garber
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94158, USA
| | - Kirsten Bibbins-Domingo
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Sheri D Weiser
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Johnson CM, Sharkey JR, Lackey MJ, Adair LS, Aiello AE, Bowen SK, Fang W, Flax VL, Ammerman AS. Relationship of food insecurity to women's dietary outcomes: a systematic review. Nutr Rev 2019; 76:910-928. [PMID: 30184168 PMCID: PMC6240001 DOI: 10.1093/nutrit/nuy042] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Context Food insecurity matters for women's nutrition and health. Objective This review sought to comprehensively evaluate how food insecurity relates to a full range of dietary outcomes (food groups, total energy, macronutrients, micronutrients, and overall dietary quality) among adult women living in Canada and the United States. Data sources Peer-reviewed databases (PubMed/MEDLINE, CINAHL, Scopus, Web of Science) and gray literature sources from 1995 to 2016 were searched. Data extraction Observational studies were used to calculate a percentage difference in dietary intake for food-insecure and food-secure groups. Results Of the 24 included studies, the majority found food-insecure women had lower food group frequencies (dairy, total fruits and vegetables, total grains, and meats/meat alternatives) and intakes of macro- and micronutrients relative to food-secure women. Methodological quality varied. Among high-quality studies, food insecurity was negatively associated with dairy, fruits and vegetables, grains, meats/meats alternatives, protein, total fat, calcium, iron, magnesium, vitamins A and C, and folate. Conclusions Results hold practical relevance for selecting nutritional targets in programs, particularly for nutrient-rich foods with iron and folate, which are more important for women's health.
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Affiliation(s)
- Cassandra M Johnson
- School of Family & Consumer Sciences, Texas State University, San Marcos, Texas, USA
| | - Joseph R Sharkey
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Mellanye J Lackey
- Spencer S. Eccles Health Sciences Library, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah K Bowen
- Department of Sociology and Anthropology, College of Humanities and Social Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Wei Fang
- Center for Population Health, University of Massachusetts-Lowell, Lowell, Massachusetts, USA
| | - Valerie L Flax
- RTI International, Research Triangle Park, North Carolina, USA
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Long CR, Rowland B, Steelman SC, McElfish PA. Outcomes of disease prevention and management interventions in food pantries and food banks: a scoping review. BMJ Open 2019; 9:e029236. [PMID: 31439606 PMCID: PMC6707699 DOI: 10.1136/bmjopen-2019-029236] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Food insecurity affects millions of Americans and is associated with a range of adverse health outcomes. Food insecure individuals often obtain food from food pantries/banks, prompting health researchers to implement disease prevention/management interventions at these sites. This review examined the existing peer-reviewed research on disease prevention/management interventions implemented in food pantries/banks. DESIGN Scoping review. DATA SOURCES Databases searched included MEDLINE, Web of Science, CINAHL and Cochrane. Search strategies included Medical Subject Headings and key terms, including food pantry, food bank, food shelf, food aid and related concepts. ELIGIBILITY CRITERIA Studies were included if they described an intervention involving food pantries/banks where at least one biometric indicator was included as an outcome variable. Articles focused solely on the quality of foods distributed, the diet quality of food pantry/bank clients or government food aid programmes were excluded. DATA EXTRACTION AND SYNTHESIS Extracted data included publication details, intervention type, study design, participant characteristics, study outcomes, and barriers and facilitators of intervention implementation. RESULTS A total of 3317 articles were assessed for eligibility. Six studies met the predefined inclusion criteria. The studies employed a range of intervention approaches to manage or prevent a number of chronic diseases, including obesity, type 2 diabetes and HIV. The studies examined a range of biometric outcomes, including body mass index, glycated haemoglobin and blood pressure. Information about the food pantries/banks where the interventions were conducted was lacking. The studies documented multiple barriers and facilitators related to costs, sustainability and organisational capacity. CONCLUSIONS To our knowledge, this is the first review to examine disease prevention and management interventions conducted in food pantries and food banks. Given the high number of households who obtain food from food pantries/banks and the chronic health conditions associated with food insecurity, this review highlights the need for more high-quality research in this setting.
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Affiliation(s)
- Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Susan C Steelman
- Division of Academic Affairs, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
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Juonala M, Sjöholm P, Pahkala K, Ellul S, Kartiosuo N, Davison B, Singh GR. The Australian Aboriginal Birth Cohort study: socio-economic status at birth and cardiovascular risk factors to 25 years of age. Med J Aust 2019; 211:265-270. [PMID: 31329333 DOI: 10.5694/mja2.50285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 04/12/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine whether socio-economic status at birth is associated with differences in risk factors for cardiovascular disease - body mass index (BMI), blood pressure, blood lipid levels - during the first 25 years of life. DESIGN Analysis of prospectively collected data. SETTING, PARTICIPANTS 570 of 686 children born to Aboriginal mothers at the Royal Darwin Hospital during 1987-1990 and recruited for the Aboriginal Birth Cohort Study in the Northern Territory. Participants resided in 46 urban and remote communities across the NT. The analysed data were collected at three follow-ups: Wave 2 in 1998-2001 (570 participants; mean age, 11 years), Wave 3 in 2006-2008 (442 participants; mean age, 18 years), and Wave 4 in 2014-2016 (423 participants; mean age, 25 years). MAIN OUTCOME MEASURES Cardiovascular disease risk factors by study wave and three socio-economic measures at the time of birth: area-level Indigenous Relative Socioeconomic Outcomes (IRSEO) index score and location (urban, remote) of residence, and parity of mother. RESULTS Area-level IRSEO of residence at birth influenced BMI (P < 0.001), systolic blood pressure (P = 0.024), LDL-cholesterol (P = 0.010), and HDL-cholesterol levels (P < 0.001). Remoteness of residence at birth influenced BMI (P < 0.001), HDL-cholesterol (P < 0.001), and triglyceride levels (P = 0.043). Mother's parity at birth influenced BMI (P = 0.039). CONCLUSIONS Our longitudinal life course analyses indicate that area-level socio-economic factors at birth influence the prevalence of major cardiovascular disease risk factors among Indigenous Australians during childhood and early adulthood.
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Affiliation(s)
- Markus Juonala
- Turun Yliopisto (University of Turku), Turku, Finland.,Turku University Hospital, Turku, Finland.,Murdoch Children's Research Institute, Melbourne, VIC
| | | | - Katja Pahkala
- Turun Yliopisto (University of Turku), Turku, Finland
| | - Susan Ellul
- Murdoch Children's Research Institute, Melbourne, VIC
| | - Noora Kartiosuo
- Research Centre of Applied and Preventive Cardiovascular Medicine, Turun Yliopisto, Turku, Finland
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Food Insecurity and Odds of High Allostatic Load in Puerto Rican Adults: The Role of Participation in the Supplemental Nutrition Assistance Program During 5 Years of Follow-Up. Psychosom Med 2018; 80:733-741. [PMID: 30045347 PMCID: PMC6330211 DOI: 10.1097/psy.0000000000000628] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Limited evidence demonstrates pathways linking food insecurity (FI) to chronic disease. Allostatic load (AL) may elucidate potential pathways, capturing both primary (neuroendocrine, inflammation) and secondary (metabolic, cardiovascular) physiological disturbances. We examined the longitudinal association of FI with 5-year AL and primary and secondary subsystem dysregulation and tested moderation by Supplemental Nutrition Assistance Program (SNAP) participation. METHODS We analyzed data from the longitudinal Boston Puerto Rican Health Study among 733 adults aged 45 to 75 years. Participants categorized as food insecure (assessed by US survey module) experienced FI at baseline and/or year 5. AL score comprised 11 biological components (5 primary, 6 secondary). We classified participants as having high scores for AL (≥6 dysregulated components), primary system (≥3), and secondary system (≥4). Multivariate models estimated odds ratios (OR), adjusting for baseline AL, sociodemographic, cultural, and behavioral characteristics. RESULTS By study end, 33.8% had experienced FI, 65.5% had participated in SNAP, and 37.5% had high AL. In adjusted models, FI was not associated with AL (OR [95% confidence intervals] = 1.07 [0.70-1.64]) or secondary system (0.82 [0.48-1.40]) scores, but was associated with high primary system scores (1.71 [1.25-2.36]). SNAP participation seemed to moderate the FI-primary system relationship (p = .06); food-insecure participants never receiving SNAP (mean (SE) = 2.06 (0.14)) had higher scores than food-secure participants receiving (1.72 (0.06], p = .02) or never receiving SNAP (1.64 (0.10), p = .01) and food-insecure participants receiving SNAP (1.80 (0.07), p = .08). CONCLUSIONS FI is associated with dysregulated components of the primary AL system, and this relationship may be stronger for those not receiving SNAP. Research is needed in additional populations to test AL as a plausible pathway connecting FI to chronic disease and SNAP as a moderator.
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Is Food Insecurity Associated With Lipid Profile and Atherogenic Indices in Iranian Adults? A Population-Based Study. TOP CLIN NUTR 2018. [DOI: 10.1097/tin.0000000000000124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Weaver LJ, Fasel CB. A Systematic Review of the Literature on the Relationships between Chronic Diseases and Food Insecurity. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/fns.2018.95040] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Saiz AM, Aul AM, Malecki KM, Bersch AJ, Bergmans RS, LeCaire TJ, Nieto FJ. Food insecurity and cardiovascular health: Findings from a statewide population health survey in Wisconsin. Prev Med 2016; 93:1-6. [PMID: 27612573 PMCID: PMC6095702 DOI: 10.1016/j.ypmed.2016.09.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 09/01/2016] [Accepted: 09/04/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND The social and economic environment has become a major area of interest regarding the determinants of cardiovascular health. Among markers of economic distress, food insecurity has been found associated with metabolic disorders, dyslipidemia, and obesity, but no previous studies have examined its association with overall cardiovascular health. METHODS AND RESULTS We conducted a cross-sectional analysis among 2935 participants in the Survey of the Health of Wisconsin (SHOW), a statewide population-based representative sample. The presence of food insecurity was determined by an affirmative answer to the question "In the last 12months, have you been concerned about having enough food for you or your family?" Cardiovascular health (CVH) was defined based on the American Heart Association Life's Simple 7 criteria and classified as "poor," "intermediate," or "ideal" using previously published criteria. "Good" CVH was defined as having no poor in any of the seven criteria (any amount of intermediate or ideal). Crude and adjusted odds ratios (OR) of good CVH according to presence of food insecurity were calculated using logistic regression models. Overall, food insecurity was associated with a decreased likelihood of good CVH (OR 0.53; 95% Confidence Interval 0.31 to 0.92; p=0.02). This association persisted in models controlling for age, gender, race, and urbanization. CONCLUSIONS Participants who were food insecure were significantly less likely to have good CVH compared to participants who were food secure. Even though this study cannot confirm causality, these results suggest that food insecurity might be one of several socio-economic barriers contributing to poor CVH.
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Affiliation(s)
- Augustine M Saiz
- University of Wisconsin School of Medicine and Public Health, United States
| | - Allison M Aul
- University of Wisconsin School of Medicine and Public Health, United States
| | - Kristen M Malecki
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States
| | - Andrew J Bersch
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States
| | - Rachel S Bergmans
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States
| | - Tamara J LeCaire
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States
| | - F Javier Nieto
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States.
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Loopstra R, Reeves A, McKee M, Stuckler D. Food insecurity and social protection in Europe: Quasi-natural experiment of Europe's great recessions 2004-2012. Prev Med 2016; 89:44-50. [PMID: 27212071 PMCID: PMC4976834 DOI: 10.1016/j.ypmed.2016.05.010] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 05/12/2016] [Accepted: 05/15/2016] [Indexed: 11/28/2022]
Abstract
Food insecurity rose sharply in Europe after 2009, but marked variation exists across countries and over time. We test whether social protection programs protected people from food insecurity arising from economic hardship across Europe. Data on household food insecurity covering 21 EU countries from 2004 to 2012 were taken from Eurostat 2015 edition and the Organisation for Economic Cooperation and Development. Cross-national first difference models were used to evaluate how rising unemployment and declining wages related to changes in the prevalence of food insecurity and the role of social protection expenditure in modifying observed effects. Economic hardship was strongly associated with greater food insecurity. Each 1 percentage point rise in unemployment rates was associated with an estimated 0.29 percentage point rise in food insecurity (95% CI: 0.10 to 0.49). Similarly, each $1000 decreases in annual average wages was associated with a 0.62 percentage point increase in food insecurity (95% CI: 0.27 to 0.97). Greater social protection spending mitigated these risks. Each $1000 spent per capita reduced the associations of rising unemployment and declining wages with food insecurity by 0.05 percentage points (95% CI: -0.10 to -0.0007) and 0.10 (95% CI: -0.18 to -0.006), respectively. The estimated effects of economic hardship on food insecurity became insignificant when countries spent more than $10,000 per capita on social protection. Rising unemployment and falling wages are strong statistical determinants of increasing food insecurity, but at high levels of social protection, these associations could be prevented.
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Affiliation(s)
- Rachel Loopstra
- Department of Sociology, Oxford University, Manor Road Building, Manor Road, Oxford OX1 3UQ, UK.
| | - Aaron Reeves
- Department of Sociology, Oxford University, Manor Road Building, Manor Road, Oxford OX1 3UQ, UK; International Inequalities Institute, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - David Stuckler
- Department of Sociology, Oxford University, Manor Road Building, Manor Road, Oxford OX1 3UQ, UK
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Tester JM, Laraia BA, Leung CW, Mietus-Snyder ML. Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010. Prev Chronic Dis 2016; 13:E22. [PMID: 26866948 PMCID: PMC4752514 DOI: 10.5888/pcd13.150441] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. METHODS We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. RESULTS Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14-3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11-2.82), and Apo B (OR = 1.98; 95% CI, 1.17-3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14-6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. CONCLUSION In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone.
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Affiliation(s)
- June M Tester
- UCSF Benioff Children's Hospital Oakland, 747 52nd St, Oakland, CA 94609.
| | - Barbara A Laraia
- University of California, Berkeley, School of Public Health, Berkeley, California
| | - Cindy W Leung
- University of California, San Francisco, Center for Health and Community, San Francisco, California
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