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Thomson JL, Landry AS, Walls TI. Direct and Indirect Effects of Food and Nutrition Security on Dietary Choice and Healthfulness of Food Choice: Causal Mediation Analysis. Curr Dev Nutr 2024; 8:102081. [PMID: 38328776 PMCID: PMC10847738 DOI: 10.1016/j.cdnut.2024.102081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
Background Links between diet and food security are well established, but less is known about how food and nutrition security affect a household's ability to decide what to consume. Objectives This study's purpose was to quantify and compare causal pathways from 1) food and nutrition security to perceived dietary choice and 2) food and nutrition security to perceived healthfulness of food choice while testing for mediation by perceived limited availability of foods and utilization barriers to healthful meals. Methods Causal mediation analysis was conducted using an observational data set. Exposures included food insecurity and nutrition insecurity; mediators included perceived limited availability and utilization barriers; outcomes included perceived dietary choice and healthfulness choice; covariates included income and education. Results Dietary choice (range 0-4) was 0.9 to 1.1 points lower for participants with food/nutrition insecurity compared with participants with food/nutrition security (direct effects). Neither mediation nor moderation by perceived limited availability were present. Seventeen percent and 11 %, respectively, of the effects of food and nutrition security on dietary choice could be contributed to utilization barriers (mediation). Moderation by utilization barriers was present only for nutrition security (differences in dietary choice only present when barriers were low). Healthfulness choice (range 0-4) was 0.6 to 0.7 points lower for participants with food/nutrition insecurity compared with participants with food/nutrition security (direct effects). Mediation by perceived limited availability and utilization barriers was not present. Moderation was present only for nutrition security (differences in healthfulness choice only present when perceived limited availability was low; differences in healthfulness choice only present when barriers were low). Conclusions Food and nutrition security affect food choices, with utilization barriers acting as an intermediary step. When environmental and household utilization barriers to healthful food purchasing and preparation are high, the ability to decide what to consume does not differ between households with nutrition security and those with nutrition insecurity.
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Affiliation(s)
- Jessica L Thomson
- Delta Human Nutrition Research Program, USDA Agricultural Research Service, Stoneville, MS, United States
| | - Alicia S Landry
- Department of Nutrition and Family Sciences, University of Central Arkansas, Conway, AR, United States
| | - Tameka I Walls
- Delta Human Nutrition Research Program, USDA Agricultural Research Service, Stoneville, MS, United States
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Myers CA. Impact of the Neighborhood Food Environment on Dietary Intake and Obesity: a Review of the Recent Literature. Curr Diab Rep 2023; 23:371-386. [PMID: 38008848 DOI: 10.1007/s11892-023-01529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE OF REVIEW The built environment impacts obesogenic behaviors and in turn body weight outcomes. This review summarizes recent research demonstrating environmental impacts on dietary intake and obesity with a specific focus on the neighborhood food environment. RECENT FINDINGS In the previous five years, an abundance of reviews and research studies have been undertaken to elucidate how the neighborhood food environment impacts diet and obesity. This includes studies using primary data collection and secondary data analyses in various populations across the globe. Taken together, current research presents mixed evidence on the impact of the neighborhood food environment on both dietary intake and obesity. While there is some evidence that certain features of the neighborhood food environment influence health behaviors and outcomes in particular populations, it is imperative to acknowledge the complexity of how neighborhood features interact and constantly evolve when considering place-based influences on health behaviors and outcomes.
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Affiliation(s)
- Candice A Myers
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
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Sassine AJ, Rabbitt MP, Coleman-Jensen A, Moshfegh AJ, Sahyoun NR. Development and Validation of a Physical Food Security Tool for Older Adults. J Nutr 2023; 153:1273-1282. [PMID: 36868513 DOI: 10.1016/j.tjnut.2023.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Current measures of food insecurity focus on economic access to food, but not on the physical aspect of food insecurity that captures the inability to access food or prepare meals. This is particularly relevant among the older adult population who are at a high risk of functional impairments. OBJECTIVES To develop a short-form physical food security (PFS) tool among older adults using statistical methods based on the Item Response Theory (Rasch) model. METHODS Pooled data from adults aged ≥60 y of the NHANES (2013-2018) (n = 5892) were used. The PFS tool was derived from the physical limitation questions included in the physical functioning questionnaire of NHANES. Item severity parameters, fit and reliability statistics, and residual correlation between items were estimated using the Rasch model. The construct validity of the tool was assessed by examining associations with the Healthy Eating Index (HEI)-2015 scores, self-reported health, self-reported diet quality, and economic food insecurity, using weighted multivariable linear regression analysis, controlling for potential confounders. RESULTS A 6-item scale was developed, which had adequate fit statistics and high reliability (0.62). It was categorized based on raw score severity into high, marginal, low, and very low PFS. Very low PFS was associated with respondent's self-reported poor health (OR = 23.8; 95% CI: 15.3, 36.9; P < 0.0001), self-reported poor diet (OR = 3.9; 95% CI: 2.8, 5.5; P < 0.0001), low and very low economic food security (OR = 6.08; 95% CI: 4.23, 8.76; P < 0.0001), and with lower mean HEI-2015 index score, in comparison to older adults with high PFS (54.5 compared with 57.5, P = 0.022). CONCLUSIONS The proposed 6-item PFS scale captures a new dimension of food insecurity that can inform on how older adults experience food insecurity. The tool will require further testing and evaluation in larger and different contexts to demonstrate its external validity.
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Affiliation(s)
- AnnieBelle J Sassine
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States
| | | | | | - Alanna J Moshfegh
- Beltsville Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States.
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Avelino DC, Duffy VB, Puglisi M, Ray S, Lituma-Solis B, Nosal BM, Madore M, Chun OK. Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments? Nutrients 2023; 15:nu15040862. [PMID: 36839221 PMCID: PMC9964317 DOI: 10.3390/nu15040862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 01/29/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in Northeastern Connecticut during the pandemic. Via online survey, adults (n = 276) reported their perceived home and store food environments, food assistance participation, whether they ordered groceries online, and consumption frequency and liking of foods/beverages to calculate diet quality indices. Those who ordered groceries online (44.6%) were more likely to participate in food assistance programs and report greater diet quality. Perceived healthiness of store and home food environments was variable, with the ease of obtaining and selecting unhealthy foods in the neighborhood significantly greater than healthy foods. Healthier perceived home food environments were associated with significantly higher diet qualities, especially among individuals who participated in multiple food assistance programs. Ordering groceries online interacted with multiple measures of the food environment to influence diet quality. Generally, the poorest diet quality was observed among individuals who perceived their store and home food environments as least healthy and who did not order groceries online. Thus, ordering groceries online may support higher diet quality among adults who can use their food assistance for purchasing groceries online and who live in low-income, low-access food environments.
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Affiliation(s)
- Daniela C. Avelino
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
- Correspondence: (V.B.D.); (O.K.C.); Tel.: +860-486-1997 (V.B.D.); +860-486-6275 (O.K.C.)
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Snehaa Ray
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Brenda Lituma-Solis
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Briana M. Nosal
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Matthew Madore
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
- Correspondence: (V.B.D.); (O.K.C.); Tel.: +860-486-1997 (V.B.D.); +860-486-6275 (O.K.C.)
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Jalata DD, Mekonnen SA, Taddese HY, Workeneh MZ. Food consumption patterns in employees of Ethiopian institute of agricultural research. Heliyon 2023; 9:e12915. [PMID: 36704267 PMCID: PMC9871231 DOI: 10.1016/j.heliyon.2023.e12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023] Open
Abstract
In developing countries, including Ethiopia, diet-related non-communicable diseases are prevalent among the working population. Understanding this active group's dietary diversity and food consumption patterns is essential to devise alternative solutions and recommend possible improvements. This study investigates the food consumption patterns of employees of the Ethiopian Institute of Agricultural Research. A cross-sectional survey was conducted from January 1 to March 31, 2022, involving 13 different research centers of the institute situated in different agro-ecological regions of the country. A validated food frequency questionnaire and a 24-h food recall were administered to a total sample size of 355 employees. A systematic random sampling was used for data collection. Stata survey commands version 16.0 and multiple logistic regression were used to analyze the data. The research confirmed that socio-demographic determinants, income, and educational level affect the food consumption patterns of employees. The majority of employees have low consumption of foods like fish, fruits, vegetables, and animal products. Consumption of all kinds of animal products was very low on Wednesday and Friday. This result will help employees to give more attention to low-cost healthier food items, as well as institutional management bodies in designing awareness-creation campaigns and government programs to encourage the production and access of nutritious food.
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Affiliation(s)
- Dassalegn Daraje Jalata
- Department of Food Science and Nutrition Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
- Corresponding author.
| | - Solomon Abate Mekonnen
- Department of Food Science and Nutrition Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Hana Yeshitila Taddese
- Department of Agricultural Extension and Communication Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Mulate Zerihun Workeneh
- Department of Food Science and Nutrition Research, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
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Sankavaram K, Roe AJ, Whiteley J, Price WJ. Diet Quality and Nutrition Behavior of Federal Nutrition Education Program Participants before and during the COVID-19 Pandemic. Nutrients 2022; 15:nu15010141. [PMID: 36615798 PMCID: PMC9824662 DOI: 10.3390/nu15010141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Despite challenges due to the COVID-19 pandemic, reports from regional and national meetings of the Expanded Food and Nutrition Education program (EFNEP) have provided anecdotal evidence that the program has persevered, pivoted, and continued to positively impact the lives of some of the nation's most vulnerable populations. However, there have been necessary changes to program delivery, inevitable changes in the lives of participants, and changes in the food environment that may have impacted program outcomes. This study compares national EFNEP data (demographics, behavior change data, and 24 h dietary recall data) of participants from two federal fiscal years, before the COVID-19 pandemic and during the pandemic. Linear mixed model analysis of variance and covariance were used to assess the effects of year on program outcomes. Results of this study provide quantitative evidence of the resiliency of EFNEP to facilitate positive behavior changes related to diet quality, physical activity, food safety, food resource management, and food security. Amidst changes in the food environment during the COVID-19 pandemic, these results emphasize the importance and value of federal nutrition education programs in any food environment.
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Affiliation(s)
- Kavitha Sankavaram
- Department of Nutrition and Food Science, University of Maryland, College Park, MD 20742, USA
| | - Annie J. Roe
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA
- Correspondence: ; Tel.: +208-885-1709
| | - Jolene Whiteley
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA
| | - William J. Price
- Statistical Programs, College of Agricultural and Life Sciences, University of Idaho, Moscow, ID 83844, USA
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Anaemia and associated factors among children aged 6-23 months in agrarian community of Bale zone: a cross-sectional study. J Nutr Sci 2022; 11:e96. [PMID: 36405097 PMCID: PMC9641524 DOI: 10.1017/jns.2022.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022] Open
Abstract
Anaemia remains among the most prevalent nutritional problems among children in developing countries. In Ethiopia, more than half of children <5 years of age are anaemic. In the early stages of life, it leads to poor cognitive performance, delay psychomotor development and decreases working capacity in later life. The present study aimed to assess the prevalence and associated factors of anaemia among children aged 6-23 months in the Bale zone. A community-based cross-sectional study was conducted from 1 to 30 June 2021. Multistage stratified sampling and simple random sampling techniques were employed to select 770 samples. An interviewer-administered questionnaire was used to collect data on socio-demographic, child health and feeding practices. Haemoglobin levels were estimated using a portable Hemosmart machine. Children with haemoglobin values below 11 g/dl were considered anaemic. Binary logistic regression analysis was performed to identify factors associated with anaemia. Statistical significance was set at P < 0⋅05. The prevalence of anaemia was 47⋅9 % (95 % CI (44⋅4, 51⋅5)). The multivariate analysis showed that child age (6-11 months) (AOR 1⋅47; 95 % CI (1⋅06, 2⋅03)), household food insecurity (AOR 1⋅44; 95 % CI (1⋅01, 2⋅04)), having diarrhoea and cough in the past 2 weeks (AOR 1⋅70; 95 % CI (1⋅18, 2⋅44)) and (AOR 1⋅97; 95 % CI (1⋅28, 3⋅04), respectively), not consuming the recommended dietary diversity (AOR 2⋅72; 95 % CI (1⋅96, 3⋅77)) and stunting (AOR 1⋅88; 95 % CI (1⋅31, 2⋅70)) were significantly associated with anaemia. Anaemia in children aged 6-23 months was a severe public health problem in the study area. Integrated nutritional interventions combined with iron fortification and supplementation is recommended.
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Key Words
- AOR, adjusted odds ratio
- Anaemia
- CI, confidence interval
- COR, crude odds ratio
- Child
- Cross-sectional
- EDHS, Ethiopian Demographic and Health Survey
- FANTA, Food and Nutritional Technical Assistance
- GPS, global positioning system
- HAZ, height-for-age Z-score
- HFIAS, Household Food Insecurity Access Scale
- HHFSS, household food security status
- Haemoglobin
- Hb, haemoglobin
- IDA, iron deficiency anaemia
- INNP, National Nutritional Program
- IYCF, Infant and Young Child Feeding
- Infant
- OR, odds ratio
- PCA, principal component analysis
- WAZ, weight-for-age Z-score
- WHO, World Health Organization
- WHZ, weight-for-height Z-score
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Wolfson JA, Posluszny H, Kronsteiner-Gicevic S, Willett W, Leung CW. Food Insecurity and Less Frequent Cooking Dinner at Home Are Associated with Lower Diet Quality in a National Sample of Low-Income Adults in the United States during the Initial Months of the Coronavirus Disease 2019 Pandemic. J Acad Nutr Diet 2022; 122:1893-1902.e12. [PMID: 35569728 PMCID: PMC9186786 DOI: 10.1016/j.jand.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Food insecurity is a critical public health problem in the United States that has been associated with poor diet quality. Cooking dinner more frequently is associated with better diet quality. OBJECTIVE This study aimed to examine how food insecurity and dinner cooking frequency are associated with diet quality during the initial months of the coronavirus disease 2019 pandemic. DESIGN This cross-sectional study analyzed data from a national web-based survey (June 23 to July 1, 2020). PARTICIPANTS/SETTING Participants were 1,739 low-income (<250% of the federal poverty level) adults in the United States. MAIN OUTCOME MEASURES The outcome was diet quality, measured by the Prime Diet Quality Score (PDQS-30D). The PDQS-30D is a food frequency questionnaire-based, 22-component diet quality index. STATISTICAL ANALYSES PERFORMED Food security status (high, marginal, low, or very low) and frequency of cooking dinner (7, 5 to 6, 3 to 4, or 0 to 2 times/week) were evaluated in relation to PDQS-30D scores (possible range = zero to 126) in age- and sex and gender-, and fully adjusted linear regression models. Postestimation margins were used to predict mean PDQS-30D score by food security status and dinner cooking frequency. The interaction between food security status and frequency of cooking dinner was also tested. RESULTS Overall, the mean PDQS-30D score was 51.9 ± 11 points (possible range = zero to 126). The prevalence of food insecurity (low/very low) was 43%, 37% of the sample cooked 7 times/week and 15% cooked 0 to 2 times/week. Lower food security and less frequent cooking dinner were both associated with lower diet quality. Very low food security was associated with a 3.2-point lower PDQS-30D score (95% CI -4.6 to -1.8) compared with those with high food security. Cooking dinner 0 to 2 times/week was associated with a 4.4-point lower PDQS-30D score (95% CI -6.0 to -2.8) compared with cooking 7 times/week. The relationship between food insecurity and diet quality did not differ based on cooking dinner frequency. CONCLUSIONS During the initial months of the coronavirus disease 2019 pandemic food insecurity and less frequently cooking dinner at home were both associated with lower diet quality among low-income Americans. More research is needed to identify and address barriers to low-income households' ability to access, afford and prepare enough nutritious food for a healthy diet.
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Affiliation(s)
- Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Hannah Posluszny
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Walter Willett
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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Sleboda P, Bruine de Bruin W, Arangua L, Gutsche T. Associations of Eating Identities With Self-Reported Dietary Behaviors and Body Mass Index. Front Nutr 2022; 9:894557. [PMID: 35911121 PMCID: PMC9330157 DOI: 10.3389/fnut.2022.894557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: To inform dietary interventions, it is important to understand antecedents of recommended (henceforth: healthy) dietary behaviors, beyond dietary beliefs and self-efficacy. We used the validated “Eating Identity Type Inventory” to assess the extent to which participants identified as healthy eaters, meat eaters, emotional eaters or picky eaters. We examined correlations between participants' race/ethnicity and other socio-demographic characteristics and affinity with these eating identities, how affinity with these eating identities correlated with self-reports of dietary beliefs, self-efficacy, dietary behaviors and Body Mass Index (BMI), and how well affinity with these eating identities predicted self-reported dietary behaviors and BMI, as compared to self-reported dietary beliefs and self-efficacy. Methods In an online survey, a diverse sample of 340 Los Angeles County adults reported eating identities, dietary beliefs, and self-efficacy, dietary behaviors and BMI. Results Pearson correlations revealed that identifying more as a healthy eater was positively associated with self-reports of being non-Hispanic White, non-Hispanic mixed race, older, and college-educated, while identifying more as a meat eater was positively associated with self-reports of being non-Hispanic Black, younger, and male (α = 0.05). Pearson correlations also showed that healthy eaters had more accurate dietary beliefs and self-efficacy, and emotional eaters had lower self-efficacy (α = 0.05). In linear regressions, identifying more as a healthy eater was associated with self-reporting healthier dietary behaviors and lower BMI, and identifying more as a meat eater and emotional eater was associated with reporting less healthy dietary behaviors and higher BMI, even after accounting for correlations with socio-demographics, dietary beliefs, and self-efficacy (α = 0.05). Conclusions Our findings highlight the importance of eating identities in understanding dietary behaviors and outcomes, with implications for dietary interventions.
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Affiliation(s)
- Patrycja Sleboda
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Patrycja Sleboda
| | - Wändi Bruine de Bruin
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, United States
- Dornsife Department of Psychology, University of Southern California, Los Angeles, CA, United States
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Lisa Arangua
- Los Angeles County Department of Public Health, Los Angeles, CA, United States
| | - Tania Gutsche
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
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The Evolution of Food Security: Where Are We Now, Where Should We Go Next? SUSTAINABILITY 2022. [DOI: 10.3390/su14063634] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Food security is one of the most challenging topics globally; however, the concept of food security has taken on additional dimensions that are general and are less detailed. This study aims to identify the intellectual structure of food security research and the changes in this structure. This paper analyzed 3169 documents from the Web of Science database through a bibliometric review. A review of the published documents shows an increasing trend over the past 46 years. In accordance with co-occurrence analysis, 125 keywords were grouped into five clusters: food security and sustainable development; food security and socioeconomic factors; food security policy and governance; coping strategies for poverty, inequality, and hunger; and modern food security management. This study identifies four streams within food security research: sustainability and environmental, socioeconomic, cultural, and political factors. The paper concludes that even though food security might investigate many significant areas, other new dimensions should still be considered. Further gaps in the literature emerge that present avenues for future research directions. Reviewing indicators and techniques of food security assessment and identifying high-risk groups should be a priority.
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