An ecological analysis of factors associated with food insecurity in South Australia, 2002–7

Loneliness Among Older Indian Workers: Findings From the Longitudinal Ageing Study in India

The number of adults aged 60 years and over who work is growing. However, there has been relatively limited research assessing the determinants of wellbeing in this cohort. Given the known relationship between loneliness and socioeconomic disadvantage, the present analysis assessed the role of working conditions and food security on loneliness among employed Indians aged 60 years and over (N = 9035), using data from wave 1 of the Longitudinal Ageing Study in India. Just over 11% of participants reported being lonely most or all of the time. Food insecurity and work that involved exposure to unpleasant conditions was associated with increased loneliness, while work requiring more mental effort was associated with lower loneliness. Policies that ensure skills training to support job transitions for older adults working in unpleasant conditions, and greater food security in later life are important to ensure wellbeing in this group.

Harnessing community expertise in understanding food insecurity to inform responses in a local government area in Victoria, Australia: a mixed methods photovoice study

BACKGROUND

Local food systems which support affordable, equitable, accessible, and sustainable food are important to enhance food access and reduce food insecurity. Cardinia Shire Council, a local government in Victoria, Australia has developed and endorsed a 'Community Food Strategy' to support their local food system and food security. This study aimed to explore local government community member perspectives regarding food access within their local food environment, and suggested areas to be addressed to better support access.

METHODS

A sequential mixed methods photovoice methodology was implemented. Participants aged over 18 years, who resided in Cardinia Shire, completed an online quantitative survey to explore demographics, food access and food security status and severity (18-item USDA Household Food Security Survey Module). The qualitative photovoice method was used, whereby participants were asked to take photographs that represent their experiences of food access. These photographs were used as prompts in a semi-structured interview Interview data were thematically analysed.

RESULTS

Seventeen participants completed the study, of which five participants experienced varied severity levels of food insecurity. From the photovoice interviews four themes were developed: 1) Food: a connector to self, people and place, 2) Influencers of food access and triggers for food insecurity, 3) Savvy food literacy skills to support access to food, 4) Consequences of and struggles with food insecurity. Participants suggested recommendations for action to support future food access in their community.

CONCLUSIONS

While food choice is influenced by a range of determinants, the local food environment greatly impacts both food access and food choice. A supportive local food system which promotes inclusion of a community voice, community connectedness, food literacy and physical and economic access to local produce is crucial to support food security.

Changes in household food grocery shopping patterns in Melbourne, Australia during COVID-19 restrictions in 2020

OBJECTIVE

To investigate the impact of COVID-19 restrictions in Melbourne, 2020, on food grocery purchases.

METHODS

Grocery purchase data for 2019 and 2020 were accessed for 1,413 Melbourne households (NielsenIQ Homescan Consumer Panel) and linked to a nutrition composition database (FoodSwitch).

RESULTS

Per capita expenditure and dietary energy from groceries increased by 21.2% and 17.7%, respectively, during lockdowns, with marginally larger increases in expenditure and energy purchases from unhealthy products than healthy products (21.9% and 18.0% v 20.2% and 17.5%). The most socioeconomically disadvantaged households spent the least on but purchased the most energy from unhealthy products during lockdowns ($108 and 109MJ per capita per month), with the inverse found for the most advantaged households ($121 and 102MJ per capita per month). An increase in the overall proportion of total expenditure from unhealthy products during lockdowns was identified (+0.7%); however, there was no evidence of a difference in the proportion of energy purchased from unhealthy products. For most quintiles of household socioeconomic disadvantage/advantage, there were no statistically significant changes in the contribution of unhealthy products to total expenditure and energy purchases.

CONCLUSIONS

There was no substantial deterioration in the healthiness of grocery purchases during COVID-19 lockdowns in Melbourne. However, any additional purchases of unhealthy products are a concern. Further research on other sources of foods and drinks is also required to ascertain impacts on broader dietary patterns.

IMPLICATIONS FOR PUBLIC HEALTH

The increase in energy purchased may have implications for overweight and obesity as a risk factor for COVID-19 and chronic diseases. Governments and retailers may need to consider measures to encourage improved diet quality during future crises.

Prevalence of household food insecurity in the marginal area of Birjand, Iran

Introduction

The right to food is a human right. Food insecurity refers to the inability to prepare proper and healthy food. Food insecurity is associated with adverse outcomes among households. To determine the prevalence of food insecurity, its level, and the factors affecting it among households covered by health centers in marginalized areas of Birjand city.

Methods

This descriptive-analytical cross-sectional study was performed on 396 households aged 20-60 years covered by health centers in the marginal areas of Birjand in 2019. We used a 9-item Household Food Insecurity Access Scale (HFIAS) questionnaire. Chi-square, Fisher, and logistic regression analyses were performed using SPSS 22 software at a significance level of less than 0.05.

Results

The mean age of the subjects was 34.04 ± 9.41 years. In total, 48% of the subjects had a level of food insecurity, of which 7.6% had severe, 12.6% moderate, and 27.5% mild insecurity. The prevalence of food insecurity in families with low members and higher levels of education is significantly lower (p < 001). Backward Logistic regression showed that illiteracy (OR: 8.26) and primary education (OR: 2.65), rental housing status (OR: 1.69), lower-income levels being covered by support organizations (OR: 3.13), employed members between 3-4 and more than five (OR: 2.73 and 2.93, respectively), and low weight (OR: 2.55) were associated with food insecurity. The prevalence of food insecurity in this study was high.

Conclusion

The high prevalence of insecurity in studied households is an alarm for the authorities, which can be due to poverty and the low level of nutritional literacy of households' heads and mothers. Helping to improve the quality of life of families and food insecurity of households by improving physical and economic access, increasing literacy and nutritional culture, and reducing the burden of non-communicable diseases related to nutrition is a suggested solution.

Association between Quality of Maternal Prenatal Food Source and Preparation and Breastfeeding Duration in the Environmental Influences on Child Health Outcome (ECHO) Program

This study examined the relationship between maternal food source and preparation during pregnancy and the duration of breastfeeding among 751 mother-child dyads in the United States. The data collected from the Environmental influences on Child Health Outcomes (ECHO) Program included twelve cohorts of mothers (age ≥ 18) who delivered infant(s). Three categories of maternal food source and preparation including, High, Moderate, or Low Food Source Quality were derived from the mother report. The mean duration of breastfeeding differed strongly across the three categories. The High Food Source Quality group breastfed an average of 41 weeks, while shorter durations were observed for the Moderate (26 weeks) and Low (16 weeks) Food Source Quality groups. Cox proportional hazards models were used to estimate the relative hazard of time to breastfeeding cessation for each participant characteristic. The full model adjusted for clustering/cohort effect for all participant characteristics, while the final model adjusted for the subset of characteristics identified from variable reduction modeling. The hazard of breastfeeding cessation for those in the High Food Source Quality group was 24% less than the Moderate group (RH = 0.76; 95% CI, 0.63-0.92). Pregnant women in the High Food Source Quality group breastfed longer than the Moderate and Low groups. We encourage more detailed studies in the future to examine this relationship longitudinally.

The bad, the ugly and the monster behind the mirror - Food insecurity, mental health and socio-economic determinants

INTRODUCTION

Food insecurity is associated with poor mental health outcomes, including depression and anxiety and COVID-19 could increase these relations. In this sense, we aimed to explore the relationship between food insecurity and mental health features and behaviors in adults from Portugal.

METHODOLOGY

We conducted a cross-sectional online snowball study from November 2020 until February 2021. A total of 882 Portuguese residents 18 years of age or older with food security data were included. Data on socio-demographics, food security status, and anxiety and depression symptoms were collected. Crude and adjusted logistic regression models were performed. Odds ratio (OR) and respective 95% confidence intervals (CI) were estimated.

RESULTS

Most participants were women (71.3%), with a mean (SD) age of 36.8 (10.9) years, three-thirds had a university degree (76.7%), and 65.3% lived in the country's northern region. Regarding the characteristics associated with food insecurity, we observed that less-educated participants (OR = 7.84; 95% CI: 3.67-16.73), with depression symptoms (OR = 5.91; 95% CI: 3.12-11.19) and with anxiety symptoms (OR = 6.41; 95% CI: 3.02-13.59), had a higher odds of belonging to a food-insecure household. After adjustments less educated individuals (OR = 8.37; 95% CI: 3.81-18.35), those who faced a reduction in income (OR = 0.27; 95% CI: 0.13-0.53) and, presenting anxiety symptoms (OR = 7.32; 95% CI: 3.53-15.17) had a higher odds of belonging to a food-insecure household.

CONCLUSIONS

Approaching food insecurity without addressing mental health, and the opposite is making partial and reductive interventions. It is important to have an integrative approach.

Prevalence of food insecurity and related factors among slum households in Kerman, south of Iran

INTRODUCTION

Household food insecurity (FI) is defined as limited or uncertain access to nutritionally adequate and safe food or limited ability to obtain foods in socially acceptable ways has become a global issue in recent decades.

METHODS

This cross-sectional study was conducted in Kerman, southeast of Iran in 2019, covering 559 marginalised households. United States Department of Agriculture food security measure was used for data collection. Finally, data were analysed using t-test, χ ² , Mann-Whitney tests and logistic regression.

RESULTS

The prevalence of FI was 82% among slums households. The most important experience of FI in households was reliance on low-cost foods. There was a significant relationship between slums FI and gender of head of household, household size, household income, household education level and marital status (p ˂ 0.05). According to the results of the multivariate regression the variables of education, household income level and household size significantly determined FI (p ˂ 0.05).

CONCLUSION

The most important determinant of FI was low socioeconomic status (income, education, household size). Hence, public policies targeting socioeconomic factors should be made to improve the socioeconomic status of slum dwellers.

The role of foodbanks in the context of food insecurity: Experiences and eating behaviours amongst users

The study aim was to investigate the role of foodbanks in the context of food insecurity and explore food choices and eating behaviours amongst users. Food insecurity is associated with poor diet quality and obesity; however, the dimensions that influence food choices and eating behaviour remain unclear. Face-to-face interviews were conducted with individuals who had visited a faith-based foodbank in Perth, Western Australia. Participants were thirty-three service users who had collected a food hamper from the foodbank. Interview transcripts were analyzed using thematic analysis. Four main themes emerged: Ties you over until pay day; Food hamper supporting meals and fruit and vegetable consumption; Food choices supplementing hamper; Household gatekeeping and food control. Participants were complimentary about the content of the food hamper received which included a variety of fresh produce. A key new finding was the frequent purchase and consumption of meat and processed meat to supplement the food hamper provision. Future work and interventions to improve eating behaviour and reduce food-related financial pressure for those vulnerable to food insecurity include further exploration of the dimensions influencing food choices (i.e., cultural norms, habits, symbols); exposure to healthy and tasty plant-based meals, (i.e., tasting low-cost and tasty vegetable-based meals); parenting training focused on handling child/partner food choice influences, and, enforcing household rules governing food.

Prevalence and Socio-Demographic Predictors of Food Insecurity in Australia during the COVID-19 Pandemic

The COVID-19 pandemic has exacerbated economic vulnerabilities and disrupted the Australian food supply, with potential implications for food insecurity. This study aims to describe the prevalence and socio-demographic associations of food insecurity in Tasmania, Australia, during the COVID-19 pandemic. A cross-sectional survey (deployed late May to early June 2020) incorporated the U.S. Household Food Security Survey Module: Six-Item Short Form, and fifteen demographic and COVID-related income questions. Survey data (n = 1170) were analyzed using univariate and multivariate binary logistic regression. The prevalence of food insecurity was 26%. The adjusted odds of food insecurity were higher among respondents with a disability, from a rural area, and living with dependents. Increasing age, a university education, and income above $80,000/year were protective against food insecurity. Food insecurity more than doubled with a loss of household income above 25% (Adjusted Odds Ratio (AOR): 2.02; 95% CI: 1.11, 3.71; p = 0.022), and the odds further increased with loss of income above 75% (AOR: 7.14; 95% CI: 2.01, 24.83; p = 0.002). Our results suggest that the prevalence of food insecurity may have increased during the COVID-19 pandemic, particularly among economically vulnerable households and people who lost income. Policies that support disadvantaged households and ensure adequate employment opportunities are important to support Australians throughout and post the COVID-19 pandemic.

The development of the gluten free healthy food basket in Cyprus. Is it affordable among low-income adults diagnosed with celiac disease?

BACKGROUND

Gluten free (GF) diets are not only restrictive but also costly. The main aim of this study was to evaluate the acceptability, cost and affordability of a Gluten Free Healthy Food Basket (GFHFB) and further examine whether low-income Cypriots diagnosed with celiac disease (CD) experience food stress.

METHODS

GFΗFBs were constructed for adult women and adult men (±40 years) diagnosed with CD. Feasibility and acceptability was tested through three focus groups. Affordability was defined as the cost of the GFΗFB as a percentage of the Guaranteed Minimum Income (GMI).

RESULTS

The GFΗFB was 33.6 and 47 euros/month more expensive compared to the HB (Healthy Basket) for women and men, respectively. The total budget for GF-manufactured products were 27.81 and 28.5% of the total food budget, for women and men, respectively. For low-income people receiving the GMI, the proportion of income that would need to be spent on the GFHFB ranges from around 42 to 60%.

CONCLUSIONS

The GFΗFB is costly and not affordable among low-income Cypriots diagnosed with CD; thus, they are likely to suffer from food stress. As such, the risk of reducing their adherence to a GF diet is high and thus compromises their long-term health.

Sociodemographic factors associated with food insecurity: data from the 2003-2014 New South Wales Population Health Survey

OBJECTIVE

To determine the prevalence and sociodemographic factors associated with food insecurity in the state of New South Wales (NSW), Australia.

DESIGN

Cross-sectional analysis of food insecurity data collected by the NSW Population Health Survey between 2003 and 2014. Multiple logistic regression was used to examine associations with key sociodemographic variables.

SETTING

NSW, Australia.

PARTICIPANTS

212 608 survey participants responded to the food insecurity survey question between 2003 and 2014. 150 767 of them were aged ≥16 years. The survey sample was randomly selected and weighted to be representative of the NSW population.

RESULTS

On average 6 % of adults aged ≥16 years experienced food insecurity in NSW. The odds of food insecurity appeared to increase from one survey year to the next by a factor of 1·05. Food insecurity was found to be independently associated with age, sex, marital status, household size, education, employment status, household income, smoking status, alcohol intake and self-rated health. The association with income, smoking status and self-rated health appeared to be the strongest among all covariates and showed a gradient effect. Food insecurity appeared to increase significantly between the age of 16 and 19 years.

CONCLUSIONS

The prevalence of food insecurity appears to be rising over time. Given the negative health consequences of food insecurity, more rigorous measurement and monitoring of food insecurity in NSW and nationally is strongly recommended. The findings provide support for interventions targeting low-income and younger population groups.

Food Insecurity and Socioeconomic Disadvantage in Australia

Research on food insecurity in Australia has typically relied on a single-item measure and finds that approximately 5% of the population experiences food insecurity. This research also finds that demographic characteristics such as household composition and marital status affect levels of food insecurity, independent of income level. The present study examines the prevalence and correlates of food insecurity in a cohort (n = 400) of people experiencing entrenched disadvantage in Perth, Western Australia. Using the US Department of Agriculture Household Food Security Survey Module, we find that food insecurity at the household, adult, and child level is at sharply elevated levels, with 82.8% of the sample reporting household food insecurity, 80.8% and 58.3% experiencing food insecurity among adults and children, respectively. Demographic characteristics do not significantly affect levels of food insecurity, and food insecurity is associated with negative physical and mental health outcomes. Food insecurity is positively correlated with access to food emergency relief services, indicating that these services are being used by those most in need, but do not address the root causes of food insecurity. Policy and practice should focus on increasing stable access to adequate quantities and quality of food and addressing the structural causes of food insecurity.

Homeownership status and risk of food insecurity: examining the role of housing debt, housing expenditure and housing asset using a cross-sectional population-based survey of Canadian households

BACKGROUND

Household food insecurity is a potent marker of material deprivation with adverse health consequences. Studies have repeatedly found a strong, independent relationship between owning a home and lower vulnerability to food insecurity in Canada and elsewhere, but the reasons for this relationship are poorly understood. We aimed to examine the influence of housing asset, housing debt and housing expenditure on the relationship between homeownership status and food insecurity in Canada.

METHODS

Cross-sectional data on food insecurity, housing tenure and expenditures, home value, income and sociodemographic characteristics were derived from the 2010 Survey of Household Spending, a population-based survey. Multivariable logistic regression models were conducted to estimate odds ratios of food insecurity among households of all incomes (n = 10,815) and those with lower incomes (n = 5547).

RESULTS

Food insecurity prevalence was highest among market renters (28.5%), followed by homeowners with a mortgage (11.6%) and mortgage-free homeowners (4.3%). Homeowners with a mortgage (OR: 0.51, 95% CI: 0.39-0.68) and those without a mortgage (OR: 0.23, 95% CI: 0.16-0.35) had substantially lower adjusted odds of food insecurity than market renters, and accounting for the burden of housing cost had minimal impact on the association. Mortgage-free homeowners had lower adjusted odds ratios of food insecurity compared to homeowners with a mortgage, but differences in the burden of housing cost fully accounted for the association. When stratifying homeowners based on presence of mortgage and housing asset level, the adjusted odds ratios of food insecurity for market renters were not significant when compared to mortgage holders with low housing asset. Mortgage-free owners with higher housing asset were least vulnerable to food insecurity (adjusted OR: 0.18, 95% CI: 0.11-0.27).

CONCLUSIONS

Substantial disparities in food insecurity exist between households with different homeownership status and housing asset level. Housing policies that support homeownership while ensuring affordable mortgages may be important to mitigate food insecurity, but policy actions are required to address renters' high vulnerability to food insecurity.

Needs and perceptions regarding healthy eating among people at risk of food insecurity: a qualitative analysis

Background

Healthy eating behaviour is an essential determinant of overall health. This behaviour is generally poor among people at risk of experiencing food insecurity, which may be caused by many factors including perceived higher costs of healthy foods, financial stress, inadequate nutritional knowledge, and inadequate skills required for healthy food preparation. Few studies have examined how these factors influence eating behaviour among people at risk of experiencing food insecurity. We therefore aimed to gain a better understanding of the needs and perceptions regarding healthy eating in this target group.

Methods

We conducted a qualitative exploration grounded in data using inductive analyses with 10 participants at risk of experiencing food insecurity. The analysis using an inductive approach identified four core factors influencing eating behaviour: Health related topics; Social and cultural influences; Influences by the physical environment; and Financial influences.

Results

Overall, participants showed adequate nutrition knowledge. However, eating behaviour was strongly influenced by both social factors (e.g. child food preferences and cultural food habits), and physical environmental factors (e.g. temptations in the local food environment). Perceived barriers for healthy eating behaviour included poor mental health, financial stress, and high food prices. Participants had a generally conscious attitude towards their financial situation, reflected in their strategies to cope with a limited budget. Food insecurity was mostly mentioned in reference to the past or to others and not to participants’ own current experiences. Participants were familiar with several existing resources to reduce food-related financial strain (e.g. debt assistance) and generally had a positive attitude towards these resources. An exception was the Food Bank, of which the food parcel content was not well appreciated. Proposed interventions to reduce food-related financial strain included distributing free meals, facilitating social contacts, increasing healthy food supply in the neighbourhood, and lowering prices of healthy foods.

Conclusion

The insights from this study increase understanding of factors influencing eating behaviour of people at risk of food insecurity. Therefore, this study could inform future development of potential interventions aiming at helping people at risk of experiencing food insecurity to improve healthy eating, thereby decreasing the risk of diet-related diseases.

The Relation Between Household Food Insecurity and Children's Height in Canada and the United States: A Scoping Review

Household food insecurity is a determinant of health and marker of material deprivation. Although research has shown that food insecurity is associated with numerous adverse health, developmental and nutritional outcomes among children in high-income countries, little is known about its impact on children's height, an important marker of nutritional status and physical development. We reviewed evidence on the relation between experience-based measures of food insecurity and the height of children aged 0-18 y in Canada and the United States. The search, conducted in Embase, Medline, CINAHL, ProQuest, Web of Science, and EconLit from the inception of the databases to October 2017, identified 811 records that were screened for relevance. A total of 8 peer-reviewed studies, 2 from Canada and 6 from the United States, met the inclusion criteria and were summarized. Five studies found no association between food insecurity and children's height. One study found that having taller children in the household predicted more severe food insecurity, whereas 2 studies found that more severe experiences of food insecurity were associated with shorter height among children from ethnic minority populations. These results suggest that household food insecurity may not be associated with height inequalities among children in Canada and the United States, except perhaps in certain high-risk populations. However, the few studies identified for review provide insufficient evidence to determine whether food insecurity is or is not associated with children's height in these countries. Given the importance of optimal linear growth for current and future well-being, it is critical to understand how different modifiable environmental circumstances relate to children's height to help establish priorities for intervention. Families with children are disproportionately affected by food insecurity, and more research explicitly designed to examine the association between household food insecurity and children's height in high-income countries is needed.

Putting urban Aboriginal and Torres Strait Islander food insecurity on the agenda

Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.

Measuring and Understanding Food Insecurity in Australia: A Systematic Review

The number of Australians seeking food aid has increased in recent years; however, the current variability in the measurement of food insecurity means that the prevalence and severity of food insecurity in Australia is likely underreported. This is compounded by infrequent national health surveys that measure food insecurity, resulting in outdated population-level food insecurity data. This review sought to investigate the breadth of food insecurity research conducted in Australia to evaluate how this construct is being measured. A systematic review was conducted to collate the available Australian research. Fifty-seven publications were reviewed. Twenty-two used a single-item measure to examine food security status; 11 used the United States Department of Agriculture (USDA) Household Food Security Survey Module (HFSSM); two used the Radimer/Cornell instrument; one used the Household Food and Nutrition Security Survey (HFNSS); while the remainder used a less rigorous or unidentified method. A wide range in prevalence and severity of food insecurity in the community was reported; food insecurity ranged from 2% to 90%, depending on the measurement tool and population under investigation. Based on the findings of this review, the authors suggest that there needs to be greater consistency in measuring food insecurity, and that work is needed to create a measure of food insecurity tailored for the Australian context. Such a tool will allow researchers to gain a clear understanding of the prevalence of food insecurity in Australia to create better policy and practice responses.

Using Cross-Sectional Data to Identify and Quantify the Relative Importance of Factors Associated with and Leading to Food Insecurity

Australian governments routinely monitor population household food insecurity (FI) using a single measure-'running out of food at least once in the previous year'. To better inform public health planning, a synthesis of the determinants and how they influence and modify each other in relation to FI was conducted. The analysis used data from the Health & Wellbeing Surveillance System cross-sectional dataset. Weighted means and multivariable weighted logistic regression described and modelled factors involved in FI. The analysis showed the direction and strength of the factors and a path diagram was constructed to illustrate these. The results showed that perceived income, independent of actual income was a strong mediator on the path to FI as were obesity, smoking and other indicators of health status. Eating out three or more times a week and eating no vegetables more strongly followed FI than preceded it. The analysis identified a range of factors and demonstrated the complex and interactive nature of them. Further analysis using propensity score weighted methods to control for covariates identified hypothetical causal links for investigation. These results can be used as a proof of concept to assist public health planning.

The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia

A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. Using nationally representative data from the 2014 General Social Survey and multivariable logistic regression, this paper reports on the association between 18 discrete stressors and the likelihood of reporting food insecurity in Australia. The results, adjusted for known correlates of food insecurity and complex survey design, show that exposure to stressors significantly increased the likelihood of experiencing food insecurity. Importantly, stressors related to employment and health approximately doubled the odds of experiencing food insecurity. The results underscore the complex correlates of food insecurity and indicates that conceptually it interacts with many important social and economic problems in contemporary Australia. There is no simple fix to food insecurity and solutions require co-ordination across a range of social and economic policies.

Walking the Food Security Tightrope-Exploring the Experiences of Low-to-Middle Income Melbourne Households

There is limited evidence of how Australian low-to-middle income (AUD $40,000⁻$80,000) households maintain food security. Using a sequential explanatory mixed methods methodology, this study explored and compared the food security (FS) and insecurity (FIS) experiences of these households. An initial quantitative survey categorised participants according to food security status (the 18-item United States Department of Agriculture Household Food Security Survey Module) and income level to identify and purposefully select participants to qualitatively explore food insecurity and security experiences. Of the total number of survey participants (n = 134), 42 were categorised as low-to-middle income. Of these, a subset of 16 participants (8 FIS and 8 FS) was selected, and each participant completed an in-depth interview. The interviews explored precursors, strategies to prevent or address food insecurity, and the implications of the experience. Interview data were analysed using a thematic analysis approach. Five themes emerged from the analysis: (i) food decision experiences, (ii) assets, (iii) triggers, (iv) activation of assets, and (v) consequences and emotion related to walking the food security tightrope. The leverage points across all themes were more volatile for FIS participants. Low-to-middle income Australians are facing the challenges of trying to maintain or improve their food security status, with similarities to those described in lower income groups, and should be included in approaches to prevent or address food insecurity.

Association of food security status with overweight and dietary intake: exploration of White British and Pakistani-origin families in the Born in Bradford cohort

BACKGROUND

Food insecurity has been associated with dietary intake and weight status in UK adults and children although results have been mixed and ethnicity has not been explored. We aimed to compare prevalence and trajectories of weight and dietary intakes among food secure and insecure White British and Pakistani-origin families.

METHODS

At 12 months postpartum, mothers in the Born in Bradford cohort completed a questionnaire on food security status and a food frequency questionnaire (FFQ) assessing their child's intake in the previous month; at 18 months postpartum, mothers completed a short-form FFQ assessing dietary intake in the previous 12 months. Weights and heights of mothers and infants were assessed at 12-, 24-, and 36-months postpartum, with an additional measurement of children taken at 4-5 years. Associations between food security status and dietary intakes were assessed using Wilcoxon-Mann-Whitney for continuous variables and χ2 or Fisher's exact tests for categorical variables. Quantile and logistic regression were used to determine dietary intakes adjusting for mother's age. Linear mixed effects models were used to assess longitudinal changes in body mass index (BMI) in mothers and BMI z-scores in children.

RESULTS

At 12 months postpartum, White British mothers reported more food insecurity than Pakistani-origin mothers (11% vs 7%; p < 0.01) and more food insecure mothers were overweight. Between 12 and 36 months postpartum, BMI increased more among food insecure Pakistani-origin mothers (β = 0.77 units, [95% Confidence Interval [CI]: 0.40, 1.10]) than food secure (β = 0.44 units, 95% CI: 0.33, 0.55). This was also found in Pakistani-origin children (BMI z-score: food insecure β = 0.40 units, 95% CI: 0.22, 0.59; food secure β = 0.25 units, 95% CI: 0.20, 0.29). No significant increases in BMI were observed for food secure or insecure White British mothers while BMI z-score increased by 0.17 (95% CI: 0.13, 0.21) for food secure White British children. Food insecure mothers and children had dietary intakes of poorer quality, with fewer vegetables and higher consumption of sugar-sweetened drinks.

CONCLUSIONS

Food security status is associated with body weight and dietary intakes differentially by ethnicity. These are important considerations for developing targeted interventions.

Prevalence and socio-demographic predictors of food insecurity among regional and remote Western Australian children

OBJECTIVE

Inequities can negatively impact the health outcomes of children. The aims of this study were to: i) ascertain the prevalence of food insecurity (FI) among regional and remote Western Australian (WA) children; and ii) determine which socio-demographic factors predicted child FI.

METHODS

Caregiver-child dyads (n=219) completed cross-sectional surveys. Descriptive statistics and logistic regression analyses were conducted using IBM SPSS version 23.

RESULTS

Overall, 20.1% of children were classified as FI. Children whose family received government financial assistance were more likely to be FI (OR 2.60; CI 1.15, 5.91; p=0.022), as were children living in a Medium disadvantage area (OR 2.60; CI 1.18, 5.72; p=0.017), compared to High or Low SEIFA ratings.

CONCLUSIONS

Study findings are suggestive of the impact low income has on capacity to be food secure. The higher FI prevalence among children from families receiving financial assistance and living in medium disadvantage areas indicates more support for these families is required. Recommendations include: ensuring government plans and policies adequately support disadvantaged families; increasing employment opportunities; establishing evidence on the causes and the potential impact of FI on children's health. Implications for public health: One in five children were FI, demonstrating that FI is an issue in Western Australia.

Do low-income Cypriots experience food stress? The cost of a healthy food basket relative to guaranteed minimum income in Nicosia, Cyprus

AIM

The aim of the present study was to assess the cost, acceptability and affordability of the healthy food basket (HFB) among low-income families in Cyprus.

METHODS

HFBs were constructed based on the National Guidelines for Nutrition and Exercise for six different types of households. Acceptability was tested through focus groups. Affordability was defined as the cost of the HFB as a percentage of the guaranteed minimum income (GMI). The value of the GMI is set to be equal to €480 for a single individual and increases with the size of the recipient unit in accordance with the Organization for Economic Co-operation and Development equivalence scales. The Ministry of Labour estimates that, on average, nearly 50% of the GMI is required for food.

RESULTS

The total monthly budget for HFB is 0.80, 1.11, 1.27, 1.28, 1.44 and 1.48 times higher than the GMI budget for food among different types of households in Cyprus (a single woman, a single man, a couple, a single woman with two children, a single man with two children and a couple with two children, respectively). In particular, a family with two children on GMI would need to spend a large proportion of their income on the HFB (71.68%).

CONCLUSIONS

The GMI scheme appears not to consider the cost of healthy food, and thus, families on welfare payments in Cyprus are at a high risk of experiencing food stress. Therefore, additional research is required to measure the cost of the six HFBs in various settings.

Developing a food basket for fulfilling physical and non-physical needs in Cyprus. Is it affordable?

Background

An acceptable and affordable food basket (FB) is necessary to meet not only physical (healthy) needs but also the non-physical needs of individuals and communities. FBs were developed based on the Cypriot national food-based dietary guidelines for six types of household: single woman (±40 years), single man (±40 years), a couple (±40 years) without children, single woman (±40 years) with two children (10-year-old boy and 14-year-old girl), single man (±40 years) with two children and a couple (±40 years) with two children. Non-physical needs (kitchen equipment, physical activity and other related functions of food) were added to the baskets. The cost, acceptability and feasibility of FB were examined through the focus group discussions. Affordability was defined as the cost of the each basket as a percentage of household income (Guaranteed Minimum Income [GMI]). The budget for healthy food has the highest proportion in the total food budget (83-89%) compared with the other components. The part of the budget required for other functions of food is small compared with that of healthy food and ranged between 4.7 and 6.7% of the total monthly budget. For low-income families, the proportion of income that needs to be spent on the FB for physical needs and FB for physical and non-physical needs ranged from around 39 to 72% and 47 to 81%, respectively. The FB fulfilling physical and non-physical needs is not affordable among the low-income families (mainly with children) receiving the GMI scheme in Cyprus.

What are the determinants of food security among regional and remote Western Australian children?

OBJECTIVE

To explore how determinants of food security affect children in regional and remote Western Australia (WA), across food availability, access and utilisation dimensions.

METHODS

The Determinants of Food Security framework guided the thematic analysis (using NVivo 10) of semi-structured interviews with 20 key informants.

RESULTS

Food availability factors included availability, price, promotion, quality, location of outlets and variety. Food access factors included social support, financial resources, transport to food outlets, distance to food outlets and mobility. Food utilisation factors included nutrition knowledge and skills, children's food preferences, storage facilities, preparation and cooking facilities and time to purchase food.

CONCLUSIONS

Key food availability recommendations include increasing local food supply options. Food access recommendations include ensuring equitable formal social support and empowering informal support options. Food utilisation recommendations include prioritising food literacy programs focusing on quick, healthy food preparation and budgeting skills. Implications for public health: Policymakers should invest in local food supply options, equitable social support services and experiential food literacy programs. Practitioners should focus child/parent programs on improving attitude, knowledge and skills.

Around the Table: Food Insecurity, Socioeconomic Status, and Instrumental Social Support among Women Living in a Rural Kenyan Island Community

The objective of this study was to investigate the relationship among socioeconomic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample of 111 female heads of households representing 583 household members were surveyed in Mfangano Island, Kenya from August to October 2010 using adaptations of the Household Food Insecurity Access Scale and the Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental social support, defined as concrete direct ways people help others (B = -0.81; 95% confidence interval [CI] -1.45 to -0.17), and decreased ownership scale based on owning material assets (B = -2.93; 95% CI -4.99 to -0.86) were significantly associated with increased food insecurity, controlling for age, education, marital status, and household size. Social support interventions geared at group capacity and resilience may be crucial adjuncts to improve and maintain the long term food security and health of persons living in low-resource regions.

Association of socioeconomic, labor and health variables related to Food Insecurity in workers of the Popular Restaurants in the city of Rio de Janeiro

Objective: This study aimed to analyze the prevalence of perceived food insecurity in households of employees of Popular Restaurants, as well as associate this perception with socioeconomic, labor and health variables. Methods: This is a cross-sectional study of 273 workers from seven restaurants located in the city of Rio de Janeiro, Brazil. We applied a questionnaire with different scales and anthropometric measurements were taken. Assessment of food insecurity was performed using the Brazilian Food Insecurity Scale, classifying individuals in food security and food insecurity. The analyses were performed by calculating the gross and adjusted odds ratio. The logistic regression was performed considering three groups of variables: socio-economic, employment and health. Results: The estimated prevalence of food insecurity was 53.7%. The variables: education (OR=2.39; 95%CI=1.38-4.16), time working in kitchens <29 months (OR=2.72; 95%CI=1.44-5.16) and opinion on the satisfaction with food composition and regularity (OR=2.01; 95%CI=1.12-3.57) were significantly associated with food insecurity. Conclusion: Although the study population find themselves inserted into a social facility to promote food security, food insecurity results are worrying. Additionally, factors like lower education and less time working in restaurants increased the chance to realize their households in food insecurity.

Socio-economic characteristics, living conditions and diet quality are associated with food insecurity in France

OBJECTIVE

To assess the prevalence of household food insecurity (FI) in France and to describe its associations with socio-economic factors, health behaviours, diet quality and cost (estimated using mean food prices).

DESIGN

Cross-sectional nationally representative survey. FI was assessed using an adapted version of the US Department of Agriculture's Food Insufficiency Indicator; dietary intake was assessed using a 7 d open-ended food record; and individual demographic, socio-economic and behavioural variables were assessed using self-administered questionnaires and interviews. Individuals experiencing FI were compared with food-secure individuals, the latter being divided into four categories according to quartiles of their income per consumption unit (FS1 to FS4). Differences among categories were analysed using χ² tests, ANOVA and tests for trend.

SETTING

Individual and National Dietary Survey (INCA2), 2006-2007.

SUBJECTS

Adults aged 18-79 years (n 2624).

RESULTS

Individuals experiencing FI represented 12·2% of the population. They were on average younger, more frequently women and single parents with children compared with those in the other four categories. Their mean income per consumption unit was higher than that in the FS1 category, but they reported poorer material and housing conditions. The prevalence of smoking and the mean daily time spent watching television were also higher in the FI category. No significant difference among categories was found for energy intake, but mean intakes of fruits, vegetables and fish were lower, and diet quality was slightly but significantly poorer in the FI category. Daily diet cost was also lower in the FI category.

CONCLUSIONS

France is not spared by FI. FI should be routinely monitored at the national level and research should be promoted to identify effective strategies to reduce nutrition inequalities in France.

The association of family food security and depression in mothers having primary school children in Ray-Iran

Background

As a major public health problem, food insecurity has adverse social and psychological effects, in addition to the impact on public health. This study aimed to determine the association of household food security and depression in mothers with primary school children in Ray County.

Methods

This descriptive, analytical cross-sectional study was conducted on 430 mothers with primary school children in the spring 2010. During a two-stage cluster sampling, an 18-items food security questionnaire (USDA) and the Beck depression inventory were completed via interviewing mothers. Chi-squared test, one-way analysis of variance, simple regression and stepwise multiple regression were used to describe and analyze data, and to identify related factors using SPSS-16 software.

Results

The prevalence of food insecurity and depression in mothers were 50.2% and 51.4% respectively. Also 34.6% of mothers in the "food secure" group were depressed and 77.8% in "food insecure with hunger" group were depressed and this difference was statistically significant. Twelve out of the 20 examined variables (age, family size, number of children, economic status, home ownership, employment households, educational level of the mother and also the head of household, height, energy intake, and carbohydrate and protein intakes) were significantly associated with food security and depression. Food insecurity and depression in mothers with primary school children in Ray County showed a significant positive correlation (P < 0.001).

Conclusion

The prevalence of household food insecurity and depression in the studied population were high. Since there is a significant relationship between food insecurity and depression, more attention must be paid to this group.

Food insecurity among Dutch food bank recipients: a cross-sectional study

OBJECTIVE

To determine the prevalence of (very) low food security among Dutch food bank recipients, and to identify potential demographic, lifestyle and nutrition-related factors associated with (very) low food security.

SETTING

11 of 135 Dutch food banks were selected throughout the Netherlands.

PARTICIPANTS

251 Dutch food bank recipients participated in the study (93 men and 158 women). Inclusion criteria for participation were: (1) at least 18 years of age, (2) sufficiently fluent in Dutch to participate in oral and written interviews, (3) recipient of a Dutch food bank for at least 1 month and (4) collect own food parcel at the food bank. A single member per household was included.

PRIMARY OUTCOME

Level of food security.

RESULTS

The prevalence of food insecurity was 72.9% (N=183), of which 40.4% (N=74) reported very low food security. Of the very low food secure participants, 56.8% (N=42) reported they were ever hungry but did not eat because they could not afford enough food in the previous 3 months. Adjusted multinomial logistic regression analyses showed that households without children were less likely to experience low food security (OR 0.39 (95% CI 0.18 to 0.88)) and men (OR 0.24 (95% CI 0.11 to 0.51)) were less likely to experience very low food security, while low-educated recipients (OR 5.05 (95% CI 1.37 to 18.61)) were more likely to experience very low food security. Furthermore, recipients with high satisfaction with overall food intake (OR 0.46 (95% CI 0.27 to 0.78)), high perceived healthiness of overall food intake (OR 0.34 (95% CI 0.19 to 0.62)) or high self-efficacy of eating healthy (OR 0.62 (95% CI 0.40 to 0.96)) were less likely to experience very low food security.

CONCLUSIONS

Our study showed high prevalence rates of food insecurity among Dutch food bank recipients, and identified subgroups at increased risk of food insecurity. More research is urgently needed on the underlying determinants of food insecurity and the effectiveness of food assistance by food banks.

Food insecurity among Cambodian refugee women two decades post resettlement

Resettled refugees have high rates of chronic disease, which may be partially due to persistent food insecurity. This study describes food experiences on arrival in the U.S. and current food security status and examines characteristics related to food insecurity in a well-established refugee community. Focus groups and a survey assessed food security status and personal characteristics of Cambodian women in Lowell, MA, USA. Multivariate logistic regression was used to examine relationships with food insecurity. Current rates of food insecurity are high. In multivariate models, food insecurity was positively associated with being depressed and being widowed, and negatively associated with higher income and acculturation. Early arrivers (1980s) had difficulty in the U.S. food system on arrival, while later arrivers (1990s-2000s) did not. Refugee agencies should consider strategically devoting resources to ensure successful early transition to the U.S. food environment and long-term food security of refugees.

Place and food insecurity: a critical review and synthesis of the literature

OBJECTIVE

In some high-income countries, a sizeable proportion of households are estimated to be food insecure. It is well known that food insecurity varies between countries and is strongly tied to household income level. The local environment may be another level of influence, which has been relatively understudied. The present review sought to synthesize and critically appraise the existing literature examining local environmental characteristics in relation to individual/household-level food insecurity in the general population.

DESIGN

A systematic search strategy was used to search MEDLINE, MEDLINE In-process and Other Non-indexed, EMBASE, PsychINFO, Social Services Abstracts and Sociological Abstracts databases for studies examining local place characteristic(s) in relation to self-reported food insecurity.

SETTING

Studies could be experimental or observational, but had to be published in a peer-reviewed journal in French or English, and involve individuals from developed countries. 'Place' was defined locally, as ranging from the street to the county level.

SUBJECTS

The target population for the review included non-institutionalized individuals in the general population.

RESULTS

After obtaining full-text articles, eighteen primary studies met the eligibility criteria. Most studies were conducted in the USA and all but one was cross-sectional. Seven of the eleven studies that examined location of residence found that rural living was inversely associated with food insecurity. Mixed results were seen for other place measures such as social capital and distance to food stores.

CONCLUSIONS

Studies were heterogeneous and had various limitations that preclude definitive conclusions from being drawn. Recommendations for future research are provided.

Prevalence and risk factors of food insecurity among a cohort of older Australians

OBJECTIVE

With ongoing national concern about food security, the aim of the study was to estimate the prevalence of food insecurity and to identify associated characteristics in a cohort of older Australians.

DESIGN, SETTING AND PARTICIPANTS

The Blue Mountains Eye Study is a cohort study of community living participants aged 49 + years. The 12-item food security survey was completed by 3068 participants in the cross sectional study which comprised 2335 survivors from baseline and the recruitment of an additional 1174 eligible residents.

MAIN OUTCOME MEASURES

Prevalence of self reported food insecurity was calculated and multivariate logistic regression provided odds ratios with 95% confidence intervals to determine risk factors.

RESULTS

Overall prevalence of food insecurity was 13%. Women (15.7%) compared with men (9.4%) and younger participants, aged <70 years (15.7%) than older participants, ≥70 years (8.4%), were significantly more likely to report being food insecure. Characteristics for reporting food insecurity included participants living in rented accommodation (OR 4.10, 95% CI: 2.83, 5.89) and those living on a pension only (OR 1.90, 95%CI: 1.30, 2.78).

CONCLUSIONS

A relatively high level of food insecurity among this representative population of older Australians should be an issue of concern for policy makers and health and welfare service providers. Addressing food insecurity should be a priority of integrated national food and nutrition policies and this should in turn inform health and welfare service provision to this vulnerable population.

Health outcomes of a subsidised fruit and vegetable program for Aboriginal children in northern New South Wales

OBJECTIVE

To evaluate the impact of a fruit and vegetable subsidy program on short-term health outcomes of disadvantaged Aboriginal children.

DESIGN, SETTING AND PARTICIPANTS

A before-and-after study involving clinical assessments, health record audits and blood testing of all children aged 0-17 2013s (n = 167) from 55 participating families at baseline and after 12 months at three Aboriginal community-controlled health services in New South Wales. All assessments were completed between December 2008 and September 2010.

INTERVENTION

A weekly box of subsidised fruit and vegetables linked to preventive health services and nutrition promotion at an Aboriginal Medical Service.

MAIN OUTCOME MEASURES

Change in episodes of illness, health service and emergency department attendances, antibiotic prescriptions and anthropometry.

RESULTS

There was a significant decrease in oral antibiotics prescribed (- 0.5 prescriptions/2013; 95% CI, - 0.8 to - 0.2) during 12 months of participation in the program compared with the 12 months before the program. The proportion of children classified as overweight or obese at baseline was 28.3% (38/134) and the proportion in each weight category did not change (P = 0.721) after 12 months. A small but significant increase in mean haemoglobin level (3.1 g/L; 95% CI, 1.4-4.8 g/L) was shown, although the proportion with iron deficiency (baseline, 41%; follow-up, 37%; P = 0.440) and anaemia (baseline, 8%; follow-up, 5%; P = 0.453) did not change significantly.

CONCLUSION

it and vegetable subsidy program was associated with improvements in some indicators of short-term health status among disadvantaged Aboriginal children. A controlled trial is warranted to investigate the sustainability and feasibility of healthy food subsidy programs in Australia.

Socio-demographic and health associations with body mass index at the time of enrollment in HIV care in Nyanza Province, Kenya

Low body mass index (BMI) at the time of enrollment into HIV care has been shown to be a strong predictor of mortality independent of CD4 count. This study investigated socio-demographic associations with underweight (BMI < 18.5) among adults in Nyanza Province, Kenya, upon enrollment into HIV care. BMI, socio-demographic, and health data from a cross-sectional sample of 8254 women and 3533 men were gathered upon enrollment in the Family AIDS Care and Education Services (FACES) program in Nyanza Province, Kenya, between January 2005 and March 2010. Overall, 27.4% of adults were underweight upon enrollment in HIV care. Among each women [W] and men [M], being underweight was associated with younger age (W: adjusted odds ratio [AOR], 2.90; 95% confidence interval [CI], 1.85-4.55; M: AOR, 5.87; 95% CI, 2.80-12.32 for those aged 15-19 compared to ≥50 years old), less education (W: AOR, 2.92; 95% CI, 1.83-4.65; M: AOR, 1.55; 95% CI, 1.04-2.31 for primary education compared to some college/university), low CD4 count (W: AOR, 2.13; 95% CI, 1.50-3.03; M: AOR, 1.43; 95% CI, 0.76-2.70 for 0-250 compared to ≥750 cells/mm(3)), and poor self-reported health status (W: AOR, 1.72; 95% CI, 0.89-3.33; M: AOR, 9.78; 95% CI, 1.26-75.73 for poor compared to excellent). Among all enrollees to HIV care, low BMI was associated with male gender, lower educational attainment, younger age, and poor self-reported health. HIV care and treatment programs should consider using socio-demographic and health risk factors associated with low BMI to target and recruit patients with the goal of preventing late enrollment into care.

Food stress in Adelaide: the relationship between low income and the affordability of healthy food

Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a “Healthy Food Basket” methodology, this study costed a week's supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability). It is argued that families that spend more than 30% of household income on food could be experiencing “food stress.” Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt.

Local social environmental factors are associated with household food insecurity in a longitudinal study of children

Background

Food insecurity is a significant public health problem in North America and elsewhere. The prevalence of food insecurity varies by country of residence; within countries, it is strongly associated with household socioeconomic status, but the local environment may also play an important role. In this study, we analyzed secondary data from a population-based survey conducted in Québec, Canada, to determine if five local environmental factors: material and social deprivation, social cohesion, disorder, and living location were associated with changes in household food insecurity over a period of 6 years, while adjusting for household socioeconomic status (SES) and other factors.

Methods

Data from the Québec Longitudinal Study of Child Development, following same-aged children from 4–10 y of age, were analyzed using generalized estimating equations, to determine the longitudinal association between these environmental factors and food insecurity over a period of 6 years.

Results

Of the 2120 children originally included in the cohort, 1746 (82%) were included in the present analysis. The prevalence of food insecurity was 9.2% when children were 4 y of age (95% CI: 7.8 – 10.6%) but no significant changes were observed over time. On average over the 6 year period, three environmental factors were positively related to food insecurity: high social deprivation (OR 1.62, 95%CI: 1.16 – 2.26), low social cohesion (OR 1.45 95%CI: 1.10 – 1.92), and high disorder (OR 1.76, 95%CI: 1.37 – 2.27), while living location and material deprivation were not related to food insecurity. These associations were independent of household SES and other social variables.

Conclusion

These results highlight the potential role of the local social environment in preventing and ameliorating food insecurity at the household level. Stakeholders providing food security interventions at the community level should consider interactions with local social characteristics and perhaps changing the social environment itself. Further intervention research also examining interactions with household-level factors could lead to the development of interventions that increase both household and community-level food security.

(In) Segurança alimentar em familias de pré-escolares de uma zona rural do Ceará

OBJETIVOS: Detectar a prevalência da (in) segurança alimentar entre as famílias residentes na zona rural de Maranguape e verificar a associação entre as variáveis socioeconômicas e o grau de (in) segurança alimentar. MÉTODOS: Estudo descritivo, com abordagem quantitativa, realizado no Centro de Saúde da Família (CSF) na zona rural de Maranguape-Ceará em setembro de 2009. A amostra constituiu-se de 200 famílias com crianças pré-escolares atendidas no CSF, sendo aplicada a Escala Brasileira de Insegurança Alimentar (EBIA). RESULTADOS: Das famílias, 12% apresentaram segurança alimentar e 88% insegurança alimentar. Constatou-se associação estatisticamente significante entre a prevalência da (in) segurança alimentar e a escolaridade do responsável (p<0,0001), número de moradores no domicílio (p=0,018) e renda familiar (p<0,0001). CONCLUSÃO: Com a aplicação da EBIA, pôde-se diagnosticar a (in) segurança alimentar, o que possibilita ao enfermeiro propor ações de educação em saúde, visando a melhorar os cuidados relativos à alimentação.

Social determinants, lived experiences, and consequences of household food insecurity among persons living with HIV/AIDS on the shore of Lake Victoria, Kenya

Food insecurity is a considerable challenge in sub-Saharan Africa, disproportionately affecting persons living with HIV/AIDS. This study investigates the lived experience, determinants, and consequences of food insecurity and hunger among individuals living with HIV/AIDS on the shore of Lake Victoria in Suba District, Kenya. Parallel mixed methods included semi-structured interviews and administration of the Household Food Insecurity Access Scale among a systematic sample of 67 persons living with HIV/AIDS (49 of whom were receiving antiretroviral therapy [ART]). All respondents were either severely (79.1%) or moderately (20.9%) food insecure; no respondents were mildly food insecure or food secure. Qualitative data and simple and multiple linear regression models indicated that significant determinants of food insecurity include increased age, a greater number of children, and not being married. A number of themes related to food insecurity and ART emerged, including: (1) an increase in hunger or appetite since initiating ART; (2) exacerbation of ART-related side effects; and (3) non-adherence to ART due to hunger, food insecurity, or agricultural work responsibilities. HIV interventions should address food insecurity and hunger, particularly among at-risk populations, to promote ART adherence and better health outcomes.

Climate change, food insecurity and chronic diseases: sustainable and healthy policy opportunities for Australia

Food provides a link between the population health and climate stabilisation agendas. This paper argues that a broader view of food security for the 21st century in Australia and internationally is needed--one that judges the food system for its nutritional quality, social value and impact on the environment. If done well, climate change mitigation and adaptation policies provide ways to achieve this. This paper focuses on mitigation strategies, and describes how the reduction of greenhouse gas emissions from the agricultural sector through a reduction in consumption of animal source foods can improve food security and reduce the levels of chronic diseases such as cardiovascular diseases and some cancers.

Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity

Diet quality indices reflect overall dietary patterns better than single nutrients or food groups. The study aims were to develop a measure of adherence with dietary guidelines applicable to child and adolescent populations in Australia and determine the association between index scores and food and nutrient intake, socio-demographic characteristics, and measures of adiposity. Data were analyzed from 4- to 16-y-old participants of the 2007 Australian Children's Nutrition and Physical Activity Survey (n = 3416). The Dietary Guideline Index for Children and Adolescents (DGI-CA) comprises 11 components: 5 core food groups, wholegrain bread, reduced-fat dairy foods, extra foods (nutrient poor and high in fat, salt, and added sugar), healthy fats/oils, water, and diet variety (possible score of 100). The index criteria were age specific. The mean DGI-CA score was low (53.6 ± 0.4), similar between boys and girls, and differed by age; the youngest children scored higher than the oldest children (P < 0.0001). Higher DGI-CA scores were associated with lower energy intake, energy density, total and saturated fat, and sugar intake; higher protein, carbohydrate, fiber, calcium, iron, vitamin C, vitamin A, folate, phosphorous, magnesium, zinc, and iodine intakes; and a higher polyunsaturated:saturated fat ratio (P < 0.0001). DGI-CA scores were associated with socio-economic characteristics and measures of family circumstance. Weak positive associations were observed between DGI-CA score and BMI or waist circumference Z-scores in the 4- to 10-y and 12- to 16-y age groups only. This index is the first validated index in Australia and one of the few international indices to describe the diet quality of children and adolescents.

Does living in a food insecure household impact on the diets and body composition of young children? Findings from the Southampton Women's Survey

BACKGROUND

Little is known about food insecurity in the UK. The aims of this study were to assess the prevalence and factors associated with food insecurity in a UK cohort and to examine whether the diets, reported health and anthropometry of young food insecure children differed from those of other children.

METHODS

The Southampton Women's Survey is a prospective cohort study in which detailed information about the diets, lifestyle and body composition of 3000 women was collected before and during pregnancy. Between 2002 and 2006, 1618 families were followed up when the child was 3 years old. Food insecurity was determined using the Household Food Security Scale. The child's height and weight were measured; diet was assessed by food frequency questionnaire.

RESULTS

4.6% of the households were food insecure. Food insecurity was more common in families where the mothers were younger, smokers, of lower social class, in receipt of financial benefits and who had a higher deprivation score (all p<0.05). In comparison with other 3-year-old children, those living in food insecure households were likely to have worse parent-reported health and to have a diet of poorer quality, characterised by greater consumption of white bread, processed meat and chips, and by a lower consumption of vegetables (all p<0.05). They did not differ in height or body mass index.

CONCLUSIONS

Our data suggest that there are significant numbers of food insecure families in the UK. The poorer reported health and diets of young food insecure children have important implications for their development and lifelong health.