Household food insufficiency is associated with dietary intake in Korean adults

Associations of Food Insecurity with Dietary Inflammatory Potential and Risk of Low Muscle Strength

Food insecurity refers to the uncertain availability of or limited access to nutritious food. Poor diets prevalent among food insecure populations may incite an inflammatory state and subsequently negatively affect skeletal muscle metabolism. To examine the inflammatory mechanistic potential of the association between food insecurity and the risk of low muscle strength, we analyzed cross-sectional data from 8624 adults aged ≥20 years from the Korean National Health and Nutrition Examination Survey 2014-2015. Household food security status was assessed using an 18-item food security survey module. The inflammatory potential of diets was estimated by the dietary inflammation index (DII). Low muscle strength was ascertained using hand grip strength. In the multivariable-adjusted model, greater food insecurity was significantly associated with a higher DII score and risk of low muscle strength. The multivariable-adjusted mean difference (95% confidence interval) on the DII, comparing the "moderate-to-severe" food insecurity group with the "food secure" group, was 0.43 (0.06-0.80) (P-trend: <0.001) and the odds ratio (95% confidence intervals) of low muscle strength for the same comparison groups was 2.06 (1.07-3.96) (P-trend: 0.005). Our results suggest that individuals with greater food insecurity may be susceptible to diets with greater inflammatory potential, which may contribute to a loss of muscle strength.

Moderate and Severe Level of Food Insecurity Is Associated with High Calorie-Dense Food Consumption of Filipino Households

Food insecurity is often deeply rooted in poverty. Hence, accessibility and the quality of foods consumed may affect the dietary pattern. The study aims to assess the relationship between food insecurity and dietary consumption. This investigation analyzed the data from the 2015 Updating of Nutritional Nutrition Survey. The Household Food Insecurity Access Scale (HFIAS) was used to determine household food security status and the prevalence of food insecurity. Food weighing, food inventory, and food recall were the methods used to collect food consumption data of sampled households. The study revealed poor nutrient quality and a greater likelihood of inadequacy of nutrients among moderate and severe food insecure households. Mild, moderate, and severe levels of food insecurity were found to affect 12%, 32%, and 22% of the population, respectively. The test showed that both moderate and severe food insecure families have significantly lower mean consumption of meat, milk, and fats and oils in contrast to food secure households. In comparison with food secure households, moderate and severe food insecure households consume higher amounts of cereals and cereal products, rice, and vegetables. Moderate and severe food insecure households have higher consumption of total carbohydrates but have significantly lower average intake of vitamin A, riboflavin, niacin, and total fat related to food stable households. Moreover, the results of the multiple logistic regression revealed that food insecure households have a higher likelihood to be deficient in energy, protein, calcium, vitamin A, thiamin, riboflavin, niacin, and vitamin C intakes, but except for iron (p value <0.05). Indeed, household food insecurity was associated with the higher consumption of calorie-dense food among Filipino households. This explains a lower nutrient quality and a higher likelihood of inadequacy of nutrients among moderate and severe food insecure households.

Nutritional Education and Its Effects on Household Food Insecurity in Southeastern Iran

Background:

Food insecurity can affect health directly or indirectly through its impact on nutritional status. We aimed at determining the effects of nutrition education intervention on household food insecurity in Zahedan, southeast Iran.

Methods:

The study was conducted using multi-stage sampling method. The first stage was a cross-sectional investigation whereby 2,160 households were studied in Zahedan in 2015. The prevalence of food insecurity was determined and food-insecure households were identified. Household food security status was assessed through the 18-item US Household Food Security Survey Module. In the second stage, based on the determined sample size of 150 households in each group, eligible households were randomly divided into the intervention and control groups. Before the educational intervention, questionnaires including demographic and socioeconomic information were completed for both groups. Then, data analysis was performed and the intervention was conducted on the intervention group. Six months post-intervention, a final assessment was made by interviewing the two groups to complete demographic, socioeconomic, and household food security questionnaires.

Results:

The prevalence of food insecurity in the 2,160 households was 58.8%. After the intervention, the number of food-insecure households diminished by 22% in the intervention group, and these households were assigned to the food secure category. After controlling the confounding variables, the educational intervention was significantly effective in reducing food insecurity score (P<0.001).

Conclusion:

The findings demonstrated the beneficial role of nutritional education and the skills of resource management in modifying nutritional behaviors and improving food security in the study population.

Is It What They Eat or How Much They Eat That Matters More in Adults with Food Insecurity in a Wealthy-Country Context?

This study aimed to investigate whether dietary quantity and/or quality differ according to food security levels in the Korean adult population. Dietary adequacy and quality were evaluated by the Korean Dietary Reference Intake and the Korean Healthy Eating Index (KHEI) for adults, respectively, according to three food security levels, i.e., food security, low food security, and very low food security. A total of 7144 Korean adults (aged 19 to 64 years) were selected from cross-sectional data from the 2013-2015 Korean National Health and Nutrition Examination Surveys. The risk of inadequate nutrient intakes of protein (p trend = 0.021) and phosphorus (p trend = 0.002) increased according to food insecurity levels after adjustment for putative risk factors. The total KHEI scores (p < 0.001) as well as scores of having breakfast (p < 0.001) were lowest in the very low food security group. Among KHEI components, adults with food insecurity were less likely to get full scores from intakes of mixed grains (p trend = 0.016), total fruit (p trend = 0.039), fresh fruit (p trend = 0.043), and breakfast (p trend < 0.001). In addition, food-insecure adults were more likely to get zero score from intakes of fresh fruit (p trend = 0.020), milk and dairy products (p trend = 0.049), breakfast (p trend < 0.001), % of energy from sweets and beverages (p trend = 0.002), and total energy (p trend = 0.033). In conclusion, food security levels were associated with how much they ate, as well what they ate, in adults in South Korea. These results implied that the diet adequacy as well as moderation and balance could be carefully treated with food assistance or nutrition intervention once nutritional adequacy has mostly been met. In addition, targeted intervention programs tailored to diverse contexts for improving food insecurity may prevent unintended consequences due to easy access to inexpensive obesogenic foods in adults with food insecurity.

Household food insecurity and preschool suspension/expulsion in the United States

Food insecurity is a serious public health concern, affecting approximately 15 million children in the U.S. alone. Exposure to household food insecurity has been linked to a host of deleterious outcomes among infants and children, including mental and behavioral health outcomes. Even so, scholars have yet to examine the connection between household food insecurity and early experiences of school punishment among preschool-aged children. The current study employs a nationally representative sample of 6100 preschool-aged children from the 2016 National Survey of Children's Health. Difference-of-means t-tests and multivariate logistic regression models examining the link between mild and moderate-to-severe household food insecurity and suspension/expulsion among preschool-aged children were conducted in 2020. All estimates were calculated using sample weights that adjust for nonresponse, probability of selection, and the demographic distribution of the target population (i.e., U.S. children attending preschool in 2016). The findings indicate a robust association between moderate-to-severe household food insecurity and suspension/expulsion among preschool-aged children. This association emerged only among male children, as their risk of suspension/expulsion increased more than 11-fold in the presence of moderate-to-severe food insecurity. Additional analyses revealed that a large portion of this association was attenuated upon accounting for parenting stress and child mental health. Trauma-informed nutrition assistance programming as well as early mental health assessment and consultation may yield collateral benefits in the form of reductions in preschool suspension/expulsion. Given the findings, moreover, future research should consider the role of household food insecurity in contributing to health inequities that perpetuate the school-to-prison pipeline.

A bibliometric analysis of multimorbidity from 2005 to 2019

Context:

Multimorbidity is frequently seen in primary care. We aimed to identify and analyze publications on multimorbidity, including those that most influenced this field.

Method:

A bibliometric analysis of publications from 2005 to 2019 in the PubMed database containing “multimorbidity” or “multi-morbidity” identified with the tool iCite. We analyzed the number of publications, total citations, the article-level metric Relative Citation Ratio (RCR), type of study, and journals with the most cited articles.

Results:

The number of publications using “multimorbidity” has continuously increased since 2005 (2005–2009: 138; 2010–2014: 823; 2015–2019: 3068). The median number of total citations per article was 3. The median RCR was 1.04. Articles with RCR at or above the 97th percentile (RCR = 7.43) were analyzed in detail (n = 104). In 34 publications of this subgroup (33%), the word multimorbidity was used but was not the subject of study. The remaining top 70 publications included 32 observational studies, 22 reviews, five guideline statements, three analysis papers, two randomized trials, three qualitative studies, two measurement development reports, and one conceptual framework development report. The publications were produced by authors from 32 countries. They were published in 37 different journals, ranging from one to four articles in the same journal.

Conclusions:

We found a continuous increase in the number of publications about multimorbidity since 2005. However, our study suggests that the numbers should be considered only a general trend because multimorbidity was not the main subject in 33% of publications in a subgroup of 104 analyzed in detail.

Adverse childhood experiences and household food insecurity among children aged 0–5 years in the USA

Objective:

Although studies have examined the association between adverse childhood experiences (ACE) and health and mental health outcomes, few studies have investigated the association between ACE and household food insecurity among children aged 0–5 years in the USA. The objective of this study is to investigate the association between ACE and household food insecurity among children aged 0–5 years.

Design:

The data used in this study came from the 2016–2017 National Survey of Children’s Health. Data were analysed using multinomial logistic regression with household food insecurity as the outcome variable.

Setting:

United States.

Participants:

An analytic sample of 17 543 children aged 0–5 years (51·4% boys).

Results:

Of the 17 543 respondents, 83·7% experienced no childhood adversity. About one in twenty (4·8%) children experienced moderate-to-severe food insecurity. Controlling for other factors, children with one adverse childhood experience had 1·43 times the risk of mild food insecurity (95 % CI 1·25, 1·63) and 2·33 times the risk of moderate-to-severe food insecurity (95 % CI 1·84, 2·95). The risk of mild food insecurity among children with two or more ACE was 1·5 times higher (95 % CI 1·24, 1·81) and that of moderate-to-severe food insecurity was 3·96 times higher (95 % CI 3·01, 5·20), when compared with children with no childhood adversity.

Conclusion:

Given the critical period of development during the first few years of life, preventing ACE and food insecurity and early intervention in cases of adversity exposure is crucial to mitigate their negative impact on child development.

Diet quality of Japanese adults with respect to age, sex, and income level in the National Health and Nutrition Survey, Japan

Objective:

Although several studies in Western countries show that higher socioeconomic status is associated with higher diet quality, no study has observed this association in Japan. In the current study, we examined the association between diet quality and the combinations of age, sex, and household income, and also compared the dietary intake between diet quality levels according to household income.

Design:

Cross-sectional study.

Setting:

National Health and Nutrition Survey, Japan in 2014.

Participants:

2785 men and 3215 women.

Results:

Higher Japanese Food Guide Spinning Top scores (better diet quality) were observed in older women, especially those with higher household income, whereas lower scores were observed in younger men with lower household income. Those having low quality diet, especially in low income households, had higher odds of not meeting the recommended amounts of the Japanese dietary guidelines, than those having high quality diet.

Conclusions:

Diet quality in Japanese adults differed by age and sex as well as by household income level. A different approach to diet quality improvement is needed according to population characteristics including not only age and sex but also social economic status.

Adverse Childhood Experiences and Household Food Insecurity: Findings From the 2016 National Survey of Children's Health

INTRODUCTION

Research has linked adverse childhood experiences to a host of negative health outcomes. The present study examines the link between individual and cumulative adverse childhood experience exposure and household food insecurity in a recent, nationally representative sample of children, and whether parent self-rated well-being attenuates these associations.

METHODS

Data from the 2016 National Survey of children's Health were analyzed in 2018 (n=50,212). Information concerning children's exposure to multiple forms of adversity, household availability of food, and parent self-rated well-being were available in the data. Multinomial logistic regression was performed to analyze the data.

RESULTS

Findings suggest that the accumulation of adverse childhood experiences is associated with higher odds of food insecurity, with stronger associations between adverse childhood experience accumulation and moderate-to-severe food insecurity. Compared with no adverse childhood experience exposure, exposure to 3 or more adverse experiences corresponded to an 8.14-fold increase in the RR of moderate-to-severe food insecurity. Self-rated parent physical and mental well-being partially attenuated these associations.

CONCLUSIONS

Policies aimed at minimizing adverse childhood experience exposure among children may have important collateral benefits in the form of reduced household hunger. Existing nutrition assistance programs may be enhanced by linking children and families to programs that bolster parent and child well-being; addressing community and family violence; and providing support for caregivers to prevent abuse, hardship, and exposure to the criminal justice system.

Comparison of Health Status and Nutrient Intake by Household Type in the Elderly Population

Background

The health condition of old age is affected by various factors such as economic level, disease condition, and nutrition. With the aging population in Korea, the ratio of single-person households increased rapidly. Research on the health status and nutrition of the elderly in the single-person household is very insufficient. In this study, we compared the health and nutritional status of the elderly by the household type.

Methods

Data from the 2013 to 2014 Korea National Health and Nutrition Examination Survey were used. A total of 2,730 patients were classified into 2 groups (single-person, with family), and general, chronic disease, health behavior, nutrient intake, and food insecurity status were compared by the statistical analysis.

Results

Single-person households had a low economic and educational level and a higher percentage of women. In addition, obesity, hypertension, dyslipidemia, stroke, myocardial infarction disease rate was significantly higher. Sing-person households answered that their subjective health status was bad, and their quality of life was low. As a result of analysis of the quality of the diet in the single-person, the intake of protein, calcium, iron, vitamin B2, niacin, and vitamin C was significantly lower. In particular, the intake of calcium was the most insufficient. Food insecurity has also been observed, including the inability to consume diverse and sufficient foods due to economic difficulties.

Conclusions

More attention should be paid to the health of single-person households in elderly population and various policies should be prepared.

Household Food Insufficiency and Children Witnessing Physical Violence in the Home: Do Family Mental Illness and Substance Misuse Moderate the Association?

Objectives Research to date indicates that parents and children residing in food insufficient homes incur a host of negative health outcomes. Recently, studies have suggested that these homes are also at risk of violence between family members. Our objective is to examine the link between household food insufficiency and physical violence in the home using a recent, nationally representative sample, and to determine whether family mental illness and/or substance misuse inform this association. Methods A sample of nearly 50,000 children and families from the 2016 National Survey of Children's Health were employed in the study. Information concerning household access to food, experiences of violence between parents/adults, and associated mental health and substance use risk factors were available in the data. Logistic regression, employed in a hierarchical fashion, was utilized to analyze the data. Results Household food insufficiency was associated with an increased risk of children witnessing physical violence in the home, and this was especially pronounced in the case of moderate-to-severe food insufficiency. Findings also indicated that family mental illness and substance misuse partly attenuated this association and that household food insufficiency was more strongly associated with violence in the home in the absence of mental health and substance use risk factors. Conclusions for Practice Polices aimed at diminishing food insufficiency may have important collateral benefits in the form of reductions in family violence, and these benefits appear to extend to families that are otherwise at low risk of family violence.

The role of neighborhoods in household food insufficiency: Considering interactions between physical disorder, low social capital, violence, and perceptions of danger

RATIONALE

Food insecurity is a significant public health concern, with implications for community and individual health and well-being. Although a growing body of literature points to the role of neighborhoods in household food insecurity, studies using nationally representative samples to explore interactions between neighborhood risks - including violence and danger - are lacking.

OBJECTIVE

The present study examines whether interactions between physical disorder, low social capital, and violence/danger in the neighborhood have significant implications for the risk of household food insufficiency using a large, nationally representative sample of U.S. children and their families.

METHOD

Data are from the 2016 National Survey of Children's Health, a survey of a cross-sectional weighted probability sample of U.S. children from 0 to 17 years of age. Multinomial logistic regression techniques were used to analyze the data.

RESULTS

Neighborhood risk factors interacted to predict household food insufficiency, with the confluence of low social capital and violence/danger yielding the strongest effects.

CONCLUSIONS

Our findings suggest that food hardship should be addressed within the context of neighborhood revitalization. The risk of food insufficiency among children and families in especially high-risk ecological contexts might be ameliorated with the provision of informal and formal sources of nutrition assistance and support.

Household Food Insecurity and Mental Health Among Teenage Girls Living in Urban Slums in Varanasi, India: A Cross-Sectional Study

This study was undertaken to investigate the relation between household food insecurity and mental health problems in teenage girls living in urban slums. This community-based cross-sectional study was conducted in 5 urban slums in Varanasi, India, between September 2016 and July 2017. A probability proportion to size (PPS) method was employed to select 5 of 210 urban slums at a first stage, and in the second stage, 418 teenage girls were chosen randomly from selected households. The Household Food Insecurity Access Scale (HFIAS) and mental health inventory tools were employed to assess food insecurity and mental health status. Multivariable logistic regression analysis with at a 95% confidence interval (CI) was used to assess the association between household food insecurity and mental health status. Of 418 respondents, 47.6% were food insecure; 64.1%, 57.7%, and 58.4% had high levels of anxiety, depression, or psychological distress, respectively; and 57.2% exhibited a medium level of loss of behavioral control. Furthermore, teenage girls from food insecure households were more likely to have high levels of anxiety, depression, loss of behavioral control and psychological distress than those living in food secure households. This study shows food insecurity is independently associated with mental health problems among teenage girls. Food insecurity in Indian slums should be addressed by specific public health intervention programs that provide access to sufficient safe, nutritious food.

Dutch food bank parcels do not meet nutritional guidelines for a healthy diet

Nutritional intakes of food bank recipients and consequently their health status largely rely on the availability and quality of donated food in provided food parcels. In this cross-sectional study, the nutritional quality of ninety-six individual food parcels was assessed and compared with the Dutch nutritional guidelines for a healthy diet. Furthermore, we assessed how food bank recipients use the contents of the food parcel. Therefore, 251 Dutch food bank recipients from eleven food banks throughout the Netherlands filled out a general questionnaire. The provided amounts of energy (19 849 (sd 162 615) kJ (4744 (sd 38 866) kcal)), protein (14·6 energy percentages (en%)) and SFA (12·9 en%) in a single-person food parcel for one single day were higher than the nutritional guidelines, whereas the provided amounts of fruits (97 (sd 1441) g) and fish (23 (sd 640) g) were lower. The number of days for which macronutrients, fruits, vegetables and fish were provided for a single-person food parcel ranged from 1·2 (fruits) to 11·3 (protein) d. Of the participants, only 9·5 % bought fruits and 4·6 % bought fish to supplement the food parcel, 39·4 % used all foods provided and 75·7 % were (very) satisfied with the contents of the food parcel. Our study shows that the nutritional content of food parcels provided by Dutch food banks is not in line with the nutritional guidelines. Improving the quality of the parcels is likely to positively impact the dietary intake of this vulnerable population subgroup.