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Fulay AP, Farsijani S, Freeland K, Roberts J, Rosso AL, Houston DK, Strotmeyer ES. Development of an older adult Nutrition Equity Index (NEI) and association with the Healthy Eating Index (HEI) in older Black and White U.S. adults. J Nutr Health Aging 2024; 28:100343. [PMID: 39326090 DOI: 10.1016/j.jnha.2024.100343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/18/2024] [Accepted: 08/15/2024] [Indexed: 09/28/2024]
Abstract
OBJECTIVES We developed a novel measure for older U.S. adults called the Nutrition Equity Index (NEI), which includes functional ability. We compared both the NEI and food insufficiency with Healthy Eating Index (HEI) scores. DESIGN The Health, Aging, and Body Composition Study is a prospective, longitudinal cohort of Medicare-eligible, community-dwelling Black and White men and women. SETTING Pittsburgh, PA and Memphis, TN. PARTICIPANTS Participants (N = 2468, aged 74.7 ± 2.9 years) had baseline (1997-98) and 1-year follow-up NEI data; and 1 year follow-up for food insufficiency, key covariates, and the HEI (diet quality measure) from a 108-item interviewer-administered food frequency questionnaire. MEASUREMENTS Food insufficiency was defined from a modified validated question on ample food amount/variety from the U.S. Department of Agriculture. NEI was constructed from 8 questions in three subdomains: food insecurity (food insufficiency, hunger, anxiety about limited food, limited money for food), food access (groceries), and food acquisition (difficulty shopping, preparing meals, carrying groceries). Final NEI categories were low nutrition equity (0), moderate nutrition equity (1), and high nutrition equity (2). Multivariable linear regression compared both NEI and food insufficiency with HEI, adjusted for sociodemographic, lifestyle and comorbidity factors. RESULTS Of participants, 13.5% had food insufficiency, 12.1% had low NEI, and 32.5% had moderate NEI. Participants with food insufficiency (vs. food sufficiency) or low NEI (vs. high NEI) were more likely to be Black and have < high school education (both p < 0.0001). In minimally adjusted models, food insufficiency was associated with 2.2 point lower HEI score (p = 0.001), low NEI with 2.6 point lower HEI score (p = 0.001), and moderate NEI with 1.0 point lower HEI score (p < 0.05). Adjusting for race attenuated NEI associations with HEI to non-significance. After multivariable adjustment, food insufficiency was associated with 1.5 point lower HEI score (p = 0.03). CONCLUSION Food insufficiency was associated with lower dietary quality in this sample of older Black and White U.S. adults. NEI performed similarly to food insufficiency for HEI associations prior to multivariable adjustment and identified more older adults with nutrition inequity, who may be at risk for poor health outcomes.
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Affiliation(s)
- Aarohee P Fulay
- Department of Epidemiology, University of Pittsburgh School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, United States.
| | - Samaneh Farsijani
- Department of Epidemiology, University of Pittsburgh School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, United States
| | - Kerri Freeland
- Department of Epidemiology, University of Pittsburgh School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, United States
| | - Jimmie Roberts
- Department of Epidemiology, University of Pittsburgh School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, United States
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, United States
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, 475 Vine St., Winston-Salem, NC, 27101, United States
| | - Elsa S Strotmeyer
- Department of Epidemiology, University of Pittsburgh School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, United States
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Zhang Y, Jiang J, Yin D. Impact of food insecurity on cognitive health in older adults: insights from the NHANES 2011-2014 data. Front Nutr 2024; 11:1421970. [PMID: 39021595 PMCID: PMC11252057 DOI: 10.3389/fnut.2024.1421970] [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: 04/23/2024] [Accepted: 05/31/2024] [Indexed: 07/20/2024] Open
Abstract
Purpose To investigate the relationship between food insecurity and cognitive decline among elderly Americans. Methods Utilizing NHANES 2011-2014 data, we examined cognitive function via the Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), Digit Symbol Substitution Test (DSST) and assessed food security through the US Food Security Survey Module. Multiple regression models were used to adjust for demographic and health variables. Results Food insecurity demonstrated a significant association with lower cognitive function scores. The effects of food insecurity on cognitive function were moderated by factors such as smoking and alcohol use, indicating a direct influence of food insecurity on cognitive decline. Conclusion This study underscores the importance of food security for cognitive health in the elderly and advocates for targeted interventions to address nutritional disparities and enhance cognitive functioning in aging populations.
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Affiliation(s)
- Yanwei Zhang
- Department of Anesthesiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - JiaWen Jiang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Dekun Yin
- Department of Anesthesiology, Funing People’s Hospital of Jiangsu, Yancheng, Jiangsu, China
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Maino Vieytes CA, Zhu R, Gany F, Koester BD, Arthur AE. Dietary patterns among U.S. food insecure cancer survivors and the risk of mortality: NHANES 1999-2018. Cancer Causes Control 2024; 35:1075-1088. [PMID: 38532045 PMCID: PMC11217055 DOI: 10.1007/s10552-024-01868-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Food insecurity-the lack of unabated access to nutritious foods-is a consequence many cancer survivors face. Food insecurity is associated with adverse health outcomes and lower diet quality in the general public. The goal of this analysis was to extract major and prevailing dietary patterns among food insecure cancer survivors from observed 24-h recall data and evaluate their relationship to survival after a cancer diagnosis. METHODS We implemented two dietary patterns analysis approaches: penalized logistic regression and principal components analysis. Using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) study, we extracted three dietary patterns. Additionally, we evaluated the HEI-2015 for comparison. Cox proportional hazards models assessed the relationship between the diet quality indices and survival after a cancer diagnosis. RESULTS There were 981 deaths from all causes and 343 cancer-related deaths. After multivariable adjustment, we found higher risks of all-cause mortality associated with higher adherence to Pattern #1 (HR 1.25; 95% CI 1.09-1.43) and Pattern #2 (HR 1.15; 95% CI 1.01-1.31) among cancer survivors. CONCLUSION Among all cancer survivors, higher adherence to major and prevailing dietary patterns from the U.S. food insecure cancer survivor population may lead to worse survival outcomes.
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Affiliation(s)
- Christian A Maino Vieytes
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 386 Bevier Hall, 905 S Goodwin Ave, Urbana, IL, 61801, USA.
| | - Ruoqing Zhu
- Department of Statistics, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Brenda D Koester
- Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Anna E Arthur
- Department of Dietetics and Nutrition, Medical Center, University of Kansas, Kansas City, KS, 66160, USA
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Quintero Arias C, Rony M, Jensen E, Patel R, O'Callaghan S, Koziatek CA, Doran KM, Anthopolos R, Thorpe LE, Elbel B, Lee DC. Food insecurity in high-risk rural communities before and during the COVID-19 pandemic. Heliyon 2024; 10:e31354. [PMID: 38807877 PMCID: PMC11130676 DOI: 10.1016/j.heliyon.2024.e31354] [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: 07/24/2023] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
Objective To perform a geospatial analysis of food insecurity in a rural county known to have poor health outcomes and assess the effect of the COVID-19 pandemic. Methods In 2020, we mailed a comprehensive cross-sectional survey to all households in Sullivan County, a rural county with the second-worst health outcomes among all counties in New York State. Surveys of households included validated food insecurity screening questions. Questions were asked in reference to 2019, prior to the pandemic, and for 2020, in the first year of the pandemic. Respondents also responded to demographic questions. Raking adjustments were performed using age, sex, race/ethnicity, and health insurance strata to mitigate non-response bias. To identify significant hotspots of food insecurity within the county, we also performed geospatial analysis. Findings From the 28,284 households surveyed, 20% of households responded. Of 4725 survey respondents, 26% of households reported experiencing food insecurity in 2019, and in 2020, this proportion increased to 35%. In 2020, 58% of Black and Hispanic households reported experiencing food insecurity. Food insecurity in 2020 was also present in 58% of unmarried households with children and in 64% of households insured by Medicaid. The geospatial analyses revealed that hotspots of food insecurity were primarily located in or near more urban areas of the rural county. Conclusions Our countywide health survey in a high-risk rural county identified significant increases of food insecurity in the first year of the COVID-19 pandemic, despite national statistics reporting a stable rate. Responses to future crises should include targeted interventions to bolster food security among vulnerable rural populations.
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Affiliation(s)
- Carolina Quintero Arias
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, 10016, USA
| | - Melissa Rony
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, 10016, USA
| | - Erica Jensen
- Touro College of Osteopathic Medicine, New York, NY, 10027, USA
| | - Rahi Patel
- Northeast Ohio Medical University, Rootstown, OH, 44272, USA
| | - Stasha O'Callaghan
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, 10016, USA
| | - Christian A. Koziatek
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, 10016, USA
| | - Kelly M. Doran
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, 10016, USA
- Department of Population Health, NYU School of Medicine, New York, NY, 10016, USA
| | - Rebecca Anthopolos
- Department of Population Health, NYU School of Medicine, New York, NY, 10016, USA
| | - Lorna E. Thorpe
- Department of Population Health, NYU School of Medicine, New York, NY, 10016, USA
| | - Brian Elbel
- Department of Population Health, NYU School of Medicine, New York, NY, 10016, USA
| | - David C. Lee
- Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, 10016, USA
- Department of Population Health, NYU School of Medicine, New York, NY, 10016, USA
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Flores AC, Sarpong C, Dou N, Na M. Food sufficiency status and sleep outcomes in older adults: the National Health and Aging Trends Study (NHATS). Nutr J 2024; 23:25. [PMID: 38414001 PMCID: PMC10898009 DOI: 10.1186/s12937-024-00918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 01/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Studies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and sleep outcomes in a nationally representative sample of older adults. METHODS Our study included 1,665 older adults (≥ 65 years), using data from the 2013 and 2014 National Health and Aging Trends Study (NHATS). Food insufficiency was determined via participants' experience and utilization of food assistance programs (FAP). Sleep outcomes, including nighttime and total sleep hours, sleep latency, and sleep quality, were derived from self-reported data. Multivariable linear regression and logistic regression models were used to estimate the associations between food sufficiency status and sleep outcomes. RESULTS In 2013-2014, 86.1% of older adults were classified as food sufficient without FAP, 9.85% as food sufficient with FAP, and 4.08% as food insufficient. Adjusting for sociodemographic characteristics, food sufficient older adults with FAP reported more total sleep hours (𝛽 = 0.31, 95% CI: -0.02, 0.64) than those participants who are food sufficient without FAP. Further adjusting for health factors, food sufficient participants with FAP had more nighttime sleep hours and greater total sleep hours compared to those participants food sufficient without FAP. Compared to those deemed as food sufficient without FAP, food sufficient participants with FAP had lower odds of having longer sleep latency (OR = 0.50, 95% CI: 0.28, 0.89), after further adjusting for physical function performance. CONCLUSIONS Among older adults, food sufficiency with FAP is associated with greater total sleep hours, greater nighttime sleep hours, and lower odds of longer sleep latency. Our findings may help inform nutrition food assistance programs targeting older populations.
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Affiliation(s)
- Ashley C Flores
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA
| | - Christopher Sarpong
- Department of Biology, The Pennsylvania State University, University Park, PA, USA
| | - Nan Dou
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA
| | - Muzi Na
- Department of Nutritional Sciences, 108C Chandlee Laboratory, The Pennsylvania State University, University Park, University Park, PA, 16802, USA.
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Pourebrahim F, Omidvar N, Rezazadeh A, Eini-Zinab H, Shirani P, Ghodsi D. Food security and its association with socioeconomic status and dietary diversity in free living older people in Tehran, Iran. BMC Geriatr 2024; 24:128. [PMID: 38308219 PMCID: PMC10836019 DOI: 10.1186/s12877-024-04705-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 01/11/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Food security is a function of food access and dietary diversity. Older age is a period when adequate and diverse dietary intake is a challenge. This study aimed to investigate the association between food security on the one hand and dietary diversity and socioeconomic factors on the other hand among the free-living older people in the city of Tehran. METHODS In this cross-sectional study, 583 older people, aged 60-80 years living in Tehran city, were selected through the systematic cluster sampling method. Food security was determined by the United States Household Food Security Survey Module (US-HFSSM (.Socioeconomic status (SES) and two 24-h recalls were obtained. Dietary Diversity Score (DDS) was calculated using the FAO 2010 guideline. Multinomial logistic regression was applied. RESULTS The average age of participants was 67.87 ± 5.86 years. Based on US-HFSSM, 56.9% of older people were food secure; while 25.7%, 14.2% and 3.2% suffered from food insecurity (FI) without hunger, with moderate hunger, and with severe hunger, respectively. There was no association between FI and DDS, even after controlling for confounders. FI with mild hunger was associated with household income (OR = 2.744, 95% CI = 1.100-6.846), while FI with severe hunger was associated with Fars ethnicity (OR = 0.146, 95% CI = 0.051-0.424). CONCLUSIONS Overall, socio-economic status and demographic characteristics were the predictors of FI among older people. The findings can have implication in design and targeting of interventions directed at older people.
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Affiliation(s)
- Fatemeh Pourebrahim
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran.
| | - Arezoo Rezazadeh
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Pedram Shirani
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No 46, Hafezi Street, Farahzadi Boulevard, Sharak Ghods, P.O. Box: 1981619573, Tehran, Iran
| | - Delaram Ghodsi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Aljahdali AA, Na M, Leung CW. Food insecurity and health-related quality of life among a nationally representative sample of older adults: cross-sectional analysis. BMC Geriatr 2024; 24:126. [PMID: 38302907 PMCID: PMC10835917 DOI: 10.1186/s12877-024-04716-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Food insecurity is a significant health issue among older adults and contributes to poorer quality of life and mental health. However, limited evidence is available among older adults. Thus, the study evaluated the associations between food security and multiple outcomes related to health-related quality of life. We examined whether participants' sex and participation in the federal Supplemental Nutrition Assistance Program (SNAP)/or receiving the Food Stamp program might modify these associations. METHODS Cross-sectional analysis of the 2007-2012 National Health and Nutrition Examination Surveys (NHANES). A sample of 3,375 adults aged ≥ 60 years with household incomes ≤ 300% of the federal poverty level (FPBL). Food security was assessed using the 18-item US Household Food Security Survey Module and categorized as food security, marginal food security, and food insecurity. Outcomes were the CDC Health-Related Quality of Life measures (HRQOL-4). RESULTS Approximately 8% experienced marginal food security and 12% experienced food insecurity. Over the past month, food insecurity was significantly associated with ≥ 16 days of poor physical health (OR 1.88, 95% CI 1.23, 2.85, P-trend = 0.005), ≥ 16 days of poor mental health (OR 2.22, 95% CI 1.50, 3.28, P-trend < 0.0001), and ≥ 16 days of feeling anxious (OR 3.33, 95% CI 2.30, 4.81, P-trend < 0.0001) after multivariate adjustment. The association between food insecurity and poor physical health was stronger in females (P-interaction = 0.02). There was no evidence for effect modification in any of these associations among those receiving benefits from the federal SNAP/Food Stamp program. CONCLUSIONS Food insecurity was positively associated with multiple adverse health outcomes. Public health programs and policies targeted for older adults are needed to mitigate the extent of food insecurity to promote overall health and well-being.
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Affiliation(s)
- Abeer A Aljahdali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences , King Abdulaziz University, 21589, Jeddah, Saudi Arabia.
- Department of Nutritional Sciences, University of Michigan, 48109, Ann Arbor, MI, USA.
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences , King Abdulaziz University, 21589, Jeddah, Saudi Arabia.
| | - Muzi Na
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan, 48109, Ann Arbor, MI, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 02115, Boston, MA, USA
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Aytekin Sahin G, Mengi Celik O. Evaluation of food insecurity and associated factors in women of childbearing age: A community-based study from Turkey. Food Sci Nutr 2024; 12:154-161. [PMID: 38323300 PMCID: PMC10846561 DOI: 10.1002/fsn3.3743] [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: 06/15/2023] [Revised: 08/25/2023] [Accepted: 09/23/2023] [Indexed: 02/08/2024] Open
Abstract
Food security is an important factor in ensuring a healthy diet. However, it has been reported that women are more vulnerable to food insecurity than men in many countries. In addition, there is little evidence that Mediterranean diet (MD) adherence is associated with a lower risk of food insecurity. Therefore, this study aimed to evaluate food insecurity and associated factors in women of childbearing age. In addition, women's adherence to MD and its relationship with food insecurity were evaluated. This descriptive and cross-sectional study was conducted with 2675 adult women aged 18-49. The demographic characteristics, anthropometric measurements, nutritional habits, compliance with the MD, and the level of food insecurity were evaluated using the structured, self-administered, web-based questionnaire form. The mean age of the individuals was 29.5 ± 10.35 years. 21.6% of individuals had food insecurity, and 5.2% had severe food insecurity. 36.4% of the individuals adhere to the MD. There was a statistically significant difference between the individuals with and without food security regarding age, marital status, and income status (p < .05). However, there was no statistically significant difference in terms of the Mediterranean diet adherence score (MEDAS) and MEDAS classification between individuals with and without food security (p > .05). It was determined that age, marital status, and income status affected food insecurity (R 2 = 0.374; p < .001). Also, it was determined that age, number of main meals and snacks, and income status affected adherence to MD (R 2 = 0.286; p < .001). In conclusion, considering the fragility of women in food insecurity, more comprehensive studies should be conducted in this area to better define the factors associated with food insecurity in women and inform policymakers. In addition, the results of this study can shed light on comprehensive intervention studies in this area.
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Affiliation(s)
- Gizem Aytekin Sahin
- Department of Nutrition and Dietetics, Faculty of Health SciencesNuh Naci Yazgan UniversityKayseriTurkey
| | - Ozge Mengi Celik
- Department of Nutrition and Dietetics, Gulhane Faculty of Health SciencesUniversity of Health SciencesAnkaraTurkey
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Kibe LW, Schrode K, Bazargan M, Shaheen M. Impact of food insecurity and food environment on the diet quality of older African Americans during the COVID-19 pandemic. Front Public Health 2023; 11:1268961. [PMID: 38035278 PMCID: PMC10682682 DOI: 10.3389/fpubh.2023.1268961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction A high quality diet is vital in promoting wellbeing and ensuring good health, particularly for those living with chronic conditions. Older African Americans, already burdened with a higher prevalence of chronic conditions, also face a higher risk for suboptimal diets. The COVID-19 pandemic had lasting effects on access to healthy food for all Americans, but some demographic groups were disproportionately affected. Older African Americans, who already experienced reduced access to healthy food pre-pandemic, were particularly afflicted, but the full extent of the pandemic's impact on their food insecurity and food environment remains unclear. Methods To address this gap, we conducted a study among 102 older African Americans in South Los Angeles between October 2021 and July 2022 during the COVID-19 pandemic. Participants completed surveys on dietary intake, food insecurity, and neighborhood food environment. We measured dietary quality using the healthy eating index (HEI)-2015. The analysis included descriptive, bivariate chi-square, t-tests, analysis of variance, and multiple linear and logistic regression. Results While overall dietary quality was suboptimal, most participants met the guidelines for fruit and vegetable consumption. Food insecurity was associated with lower overall diet quality and lower total fruit and whole fruit intake. However, there was no association between food environment and diet quality. Discussion In light of our findings, further intervention is critical to improving diet quality, especially among older African Americans living with chronic conditions in the post-pandemic era.
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Affiliation(s)
- Lucy W. Kibe
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Katrina Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Mohsen Bazargan
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Magda Shaheen
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
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Croxford S. Role of food in our teaching and practice. Nutr Diet 2023; 80:448-451. [PMID: 37952932 DOI: 10.1111/1747-0080.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Sharon Croxford
- Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
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Zoellner ER, Patterson MA, Sharrief AZ, Savitz SI, Tucker WJ, Miketinas DC. Dietary Intake and Quality among Stroke Survivors: NHANES 1999-2018. J Nutr 2023; 153:3032-3040. [PMID: 37598751 DOI: 10.1016/j.tjnut.2023.08.015] [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: 04/17/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Nutrition is an important modifiable risk factor for prevention and treatment of stroke. However, examination of nutrient intake and diet quality in stroke survivors is limited. OBJECTIVES The aim of the study was to estimate usual nutrient intake and diet quality in US adults with and without a history of self-reported stroke. METHODS Using US National Health and Nutrition Examination Survey (NHANES) 1999-2018, we analyzed demographics, health history, and dietary intake data in 1626 individuals with a history of stroke matched for age, gender, and survey cycle to respective controls (n=1621) with no history of stroke. A minimum of one 24-h dietary recall was used to assess dietary intake. Diet quality was determined using Healthy Eating Index 2015 (HEI-2015) scores. Adult food security was assessed based on responses to the US Department of Agriculture Household Food Security Survey Module. Physical and mental limitations were assessed from responses to the NHANES Physical Functioning Questionnaire. Estimates were reported as mean (standard error). RESULTS In comparison to controls, stroke survivors were more likely to be food insecure, experience poverty, and report physical and mental limitations (P < .001, all comparisons). Stroke survivors were more likely to report excessive (% > acceptable macronutrient distribution range) intake for total fat (50.9 [2.7]% vs. 40.4 [2.2]%, P < .001) and inadequate intake (% < estimated average requirement) for calcium (54.6 [1.8]% vs. 43.5 [2.4]%, P = .001) and magnesium (66 [1.8] vs. 53.6 [1.8]%, P < .001). In addition, stroke survivors reported lower HEI-2015 total scores than controls (49.8 vs. 51.9, P < .001). Finally, HEI-2015 total scores were lower in stroke survivors who were food insecure and those with a lower income-to-poverty ratio (< 185%) (P = .001). CONCLUSIONS Dietary intake in stroke survivors was nutritionally poor, with suboptimal nutrient intake and lower overall diet quality compared with age- and gender-matched controls. Furthermore, poverty and food insecurity were more prevalent in stroke survivors and associated with worse diet quality.
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Affiliation(s)
- Erika R Zoellner
- Department of Nutrition & Food Sciences, Texas Woman's University, Houston, TX, United States
| | - Mindy A Patterson
- Department of Nutrition & Food Sciences, Texas Woman's University, Houston, TX, United States; Institute for Women's Health, College of Health Sciences, Houston, TX, United States
| | - Anjail Z Sharrief
- UTHealth Department of Neurology, McGovern Medical School and Institute for Stroke and Cerebrovascular Disease, Houston, TX, United States
| | - Sean I Savitz
- UTHealth Department of Neurology, McGovern Medical School and Institute for Stroke and Cerebrovascular Disease, Houston, TX, United States
| | - Wesley J Tucker
- Department of Nutrition & Food Sciences, Texas Woman's University, Houston, TX, United States; Institute for Women's Health, College of Health Sciences, Houston, TX, United States
| | - Derek C Miketinas
- Department of Nutrition & Food Sciences, Texas Woman's University, Houston, TX, United States.
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12
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Dufe Turkson RK, Ngounda J, Nel R, Walsh CM. The nutritional status of community-dwelling elderly in Lesotho and factors associated with malnutrition. Nutr Health 2023; 29:513-522. [PMID: 35195475 PMCID: PMC10503240 DOI: 10.1177/02601060221082368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The elderly living in Africa are prone to malnutrition which is complicated by the high prevalence of poverty. This study assessed the nutritional status of the elderly and factors associated with malnutrition. Method: In a cross-sectional survey, the nutritional status of 300 participants aged 65 years and older was determined using the Mini Nutritional Assessment (MNA) questionnaire consisting of 18 questions. Socio-demographic data was obtained using a questionnaire. Results: Sixty-six percent were at risk of malnutrition, while 14.6% (n = 44) were malnourished. Participants that did not use electricity as a fuel for cooking versus those that did, had higher odds of being malnourished/ at risk of malnutrition (OR = 1.85 [1.04; 3.31]). Those that did not experience psychological stress or acute disease versus those that did, had lower odds of being malnourished/at risk of malnutrition (OR = 0.33 [0.12; 0.90]). Participants that did not perceive nutritional problems versus those that did, had lower odds of being malnourished/at risk of malnutrition (OR = 0.18 [0.09; 0.34]). Similarly, those that did not perceive their health status as poor versus those that did, had lower odds of being malnourished/at risk of malnutrition (OR = 0.17 [0.08; 0.34]). Discussion: The findings indicate that the elderly with more resources, less stress, and better actual and perceived health were less likely to be malnourished. In such communities, routine screening in the elderly is required to identify those with compromised health and nutritional status.
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Affiliation(s)
- Rose Kokui Dufe Turkson
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
| | - Jennifer Ngounda
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
| | - Riette Nel
- Department of Biostatistics, University of the Free State, Bloemfontein, South Africa
| | - Corinna May Walsh
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
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13
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Carrillo-Álvarez E. Perspective: Food and Nutrition Insecurity in Europe: Challenges and Opportunities for Dietitians. Adv Nutr 2023; 14:995-1004. [PMID: 37543145 PMCID: PMC10509433 DOI: 10.1016/j.advnut.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023] Open
Abstract
In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.
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Affiliation(s)
- Elena Carrillo-Álvarez
- Public Health Specialist Network (ESDN PH), European Federation of Association of Dietetics (EFAD), Europe; Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences, Universitat Ramon Lull, Barcelona, Spain.
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14
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Rigling M, Schuetz P, Kaegi-Braun N. Is food insecurity contributing to malnutrition in older adults in Switzerland? - A cross-sectional study. Front Nutr 2023; 10:1228826. [PMID: 37654475 PMCID: PMC10466426 DOI: 10.3389/fnut.2023.1228826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
Background Food insecurity has been defined as "limited access to food, at the level of individuals or households, due to lack of money or other resources" and may increase the nutritional risk, which in turn leads to poor health, development of chronic diseases, poor psychological and cognitive functioning, and substandard academic achievements. There is limited data on the importance of food insecurity in a rich country such as Switzerland. Methods This is a cross-sectional analysis of data from a structured survey in an elderly population of Switzerland. The data was assessed between June and August 2021 in the course of a 7-year phone call follow-up from the EFFORT trial, which included medical inpatients at nutritional risk from 2014 to 2018. A validated questionnaire (Six-Item Short Form 2012 of the U.S: Household Food Security Survey Module) was used to assess food security status. Results Of the 433 included patients, 30 (6.9%) were food insecure. A significant association between food insecurity and age, governmental financial support and self-reported loneliness was found. When compared with the food secure group, there was a significant lower quality of life measured by the EQ-5D VAS. Conclusion In an older Swiss population of patients at nutritional risk, food insecurity was named as a contributing factor for malnutrition in about 7% of patients, particularly younger individuals with financial support, and self-reported loneliness. In the assessment of malnutrition, physician and dieticians should ask for food insecurity and if detect take appropriate actions.
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Affiliation(s)
- Maurus Rigling
- Division of General Internal and Emergency Medicine, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Philipp Schuetz
- Division of General Internal and Emergency Medicine, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Nina Kaegi-Braun
- Division of General Internal and Emergency Medicine, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
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15
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Tapper EB, Mehta M, Leung CW. Food Insecurity Is Associated With Chronic Liver Disease Among US Adults. J Clin Gastroenterol 2023; 57:737-742. [PMID: 36812254 PMCID: PMC9977268 DOI: 10.1097/mcg.0000000000001741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/19/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Food insecurity is associated with many poor health outcomes. Most contemporary liver disease is metabolic and impacted by nutritional status. Data regarding the association between food insecurity and chronic liver disease are limited. We evaluated the linkage between food insecurity and liver stiffness measurements (LSMs), a key measure of liver health. METHODS A cross-sectional analysis of 3502 subjects aged 20 years and older from the 2017 to 2018 National Health and Nutrition Examination Survey. Food security was measured using the US Department of Agriculture's Core Food Security Module. Models were adjusted using age, sex, race/ethnicity, education, poverty-income ratio, smoking, physical activity, alcohol intake, sugary beverage intake, Healthy Eating Index-2015 score. All subjects underwent vibration-controlled transient elastography, which provides LSMs (kPa) and a measure of hepatic steatosis (controlled attenuation parameter, dB/m). LSM was stratified: <7, 7 to 9.49, 9.5 to 12.49 (advanced fibrosis), and ≥12.5 (cirrhosis) in the whole-study population and stratified by age (20 to 49 y and 50 y and older). RESULTS There were no significant differences in mean controlled attenuation parameter, alanine aminotransferase, or aspartate aminotransferase values by food security status. However, food insecurity was associated with a higher mean LSM (6.89±0.40 kPa vs. 5.77±0.14 kPa, P =0.02) for adults 50 years and older. After multivariate adjustment, food insecurity was associated with higher LSMs across all risk stratifications for adults 50 years and older: LSM≥7 kPa [odds ratio (OR): 2.06, 95% CI, 1.06 to 4.02]; LSM≥9.5 kPa (OR: 2.50, 95% CI, 1.11 to 5.64); LSM≥12.5 kPa (OR: 3.07, 95% CI, 1.21 to 7.80). CONCLUSIONS Food insecurity is associated with liver fibrosis and an increased risk of advanced fibrosis and cirrhosis in older adults.
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Affiliation(s)
| | - Manaav Mehta
- Division of Gastroenterology, Department of medicine
| | - Cindy W Leung
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
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16
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Vaudin A, Dean W, Chen J, Sahyoun NR. Service Awareness Among Older Adults Experiencing Barriers to Food and Eating. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:564-574. [PMID: 37389500 DOI: 10.1016/j.jneb.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE To explore (1) the services older adults use to address the barriers to food access they face and (2) how they found out about these services. DESIGN Semistructured, basic descriptive qualitative in-person interviews. SETTING Senior center and participants' homes. PARTICIPANTS A convenience sample of 24 older adults recruited from suburban and urban settings. Primarily Black females, living alone, and able to leave home without help. PHENOMENON OF INTEREST Financial and nonfinancial barriers to food access, awareness of services available. ANALYSIS Codes were assigned to portions of the text in which participants described how they learned about a service. These codes were categorized into one of the 3 larger themes that emerged: (1) intentionally sought by the participant, (2) intentional outreach by the service, and (3) encounters in daily life and environment. RESULTS Most connections to services were made through encounters in participants' daily life and environment; for example, word of mouth from family, friends or neighbors; connection through other services; referral from health care professionals; and seeing the service in their neighborhood. CONCLUSIONS AND IMPLICATIONS Robust social networks, medical screening, and referral may promote awareness of food assistance services. Future research and outreach should target those who are most isolated.
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Affiliation(s)
- Anna Vaudin
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD
| | - Wesley Dean
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - Jie Chen
- Department of Health Policy and Management, School of Public Health, University of Maryland College Park, College Park, MD
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD.
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17
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Li J, Zuo D, Heflin CM. Adoption Of Standard Medical Deduction Increased SNAP Enrollment And Benefits In 21 Participating States. Health Aff (Millwood) 2023; 42:1173-1181. [PMID: 37549333 PMCID: PMC10500947 DOI: 10.1377/hlthaff.2022.01575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The Supplemental Nutrition Assistance Program (SNAP) reduces food insecurity but is underused among many households. To increase SNAP participation, twenty-one states have adopted the standard medical deduction (SMD), which simplifies administrative requirements for eligible households (those with older adults or people with disabilities). However, to offset the costs of the SMD, states have reduced SNAP benefits elsewhere, raising concerns of negative spillover effects. Using national data from the period 2004-19 and a fixed-effects estimator, we found that the SMD was associated with increased SNAP participation among SMD-eligible households, in terms of aggregate household counts (20 percent) and as a share of households receiving SNAP (5 percentage points). Moreover, estimated annual SNAP benefits per state increased for SMD-eligible households but decreased (although not statistically significantly) for ineligible households. Offsetting SNAP costs may have benefited households with older adults and households with people with disabilities at the expense of others.
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Affiliation(s)
- Jun Li
- Jun Li , Syracuse University, Syracuse, New York
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18
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Gajda R, Jeżewska-Zychowicz M. Relationship between Food Insecurity and Nutritional Risk among Older Adults in Poland-A Preliminary Study. Nutrients 2023; 15:3232. [PMID: 37513650 PMCID: PMC10385899 DOI: 10.3390/nu15143232] [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: 06/16/2023] [Revised: 07/06/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Aging populations may be associated with increased nutritional risk, malnutrition, and food insecurity. This study aims to examine the relationship between food insecurity and nutritional risk, taking into account selected characteristics of the study group, and factors describing nutritional risk. It was conducted between May and July 2021, among 417 people aged 60 and older, in two regions of Poland. Questions from the SCREEN-14 questionnaire were used to assess nutritional risk. Selected questions from the HFSS questionnaire (U.S. Household Food Security Survey Module) concerning the elderly were used to assess food insecurity. A K-means cluster analysis was used to separate homogeneous clusters into food security indicators and nutritional risk factors. The Mann-Whitney U test and Kruskal-Wallis test were used to compare mean values between groups, and the Chi-square test was used to verify the differences. Two clusters were distinguished: I-"low food security and high nutritional risk" and II-"high food security and low nutritional risk". Cluster I included people aged 60-65, and over 75, living in urban areas, living alone or with family, with unfavorable economic situations and family relationships. Cluster II was composed of people aged 71-75, who were rural residents, living with a partner, with favorable economic situations and family relations. The vast majority of nutritional risk factors were found in Cluster I and among those at high nutritional risk. The largest number of people were affected by such nutritional risk factors such as difficulty in chewing or biting, loss in appetite, skipping meals, and perceiving one's weight as abnormal. Moreover, the group of people most significantly affected by high nutritional risk were in unfavorable economic situations, had poor family relationships, lived alone or with family, rated their health as worse than their peers, were overweight and obese, had metabolic disease, or impeding mobility. The results obtained can be applied to the planning of social and health policies for the elderly in Poland.
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Affiliation(s)
- Robert Gajda
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland
| | - Marzena Jeżewska-Zychowicz
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland
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19
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Brady PJ, Askelson NM, Thompson H, Ashida S, Nothwehr F, Janssen B, Frisvold D. Perceptions of the Right to Food Among Adults Aged 60 Years and Older. Ecol Food Nutr 2023; 62:165-180. [PMID: 37382355 PMCID: PMC10426768 DOI: 10.1080/03670244.2023.2228702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
This study explores perceptions of the right to food and issues around food assistance and access among older adults. We conducted 20 semi-structured interviews with adults aged 60+ in Iowa, half of whom were food insecure. Most respondents expressed the right to food concerns freedom of choice rather than physical and financial access. The respondents said poor food access was due to improper choices or not accessing food assistance. While respondents believed food insecurity was morally wrong, they also believed current food assistance services are sufficient. These results have important implications for understanding how older adults think about food access.
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Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 420 Delaware Street SE, Minneapolis, MN, 55455
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
- University of Iowa Public Policy Center, 310 S Grand Ave, Iowa City, IA 52242
| | - Helaina Thompson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Faryle Nothwehr
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Brandi Janssen
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - David Frisvold
- University of Iowa Public Policy Center, 310 S Grand Ave, Iowa City, IA 52242
- Department of Economics, Tippie College of Business, University of Iowa, 21 E Market Street, Iowa City, IA, 52242
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20
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El Shikieri AB. Impact of food insecurity and its influencing factors on the risk of malnutrition among COVID-19 patients. PLoS One 2023; 18:e0287311. [PMID: 37319179 PMCID: PMC10270634 DOI: 10.1371/journal.pone.0287311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 06/02/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Few studies focused on the impact of food insecurity severity on the risk of malnutrition among COVID-19 patients in Saudi Arabia. OBJECTIVES This study described the prevalence of food insecurity among COVID-19 patients, its severity, and its associated factors. Additionally, the impact of the severity of food insecurity on the risk of malnutrition was determined. It is hypothesized that food insecurity is associated with an increased risk of malnutrition among COVID-19 patients. METHOD A cross-sectional study was conducted in Al Madinah Al Munawarah in Saudi Arabia. Patients with confirmed COVID-19 and acute severe or nonsevere illness were enrolled. The Food Insecurity Experience Scale was used to determine the severity of food insecurity, and risk of malnutrition was assessed using the Malnutrition Screening Tool. Demographic characteristics, history of medical conditions, food intake, and body mass index (BMI) were assessed. RESULTS A total of 514 patients were enrolled, with 391 (76%) having acute nonsevere COVID-19 symptoms. A total of 14.2% of patients suffered from food insecurity. Of these, 17% had severe symptoms. The severity of food insecurity was influenced by patients' education (P = 0.02, 95% CI 0.019-0.225), weight loss (P = 0.0001, 95% CI 0.252-0.752), and loss of appetite (P = 0.0001, 95% CI 0.293-0.604). Fifteen percent of patients were at risk of malnutrition. Many obese patients suffered from severe COVID-19 symptoms (P = 0.029, 95% CI 0.02-0.539). The risk of malnutrition was associated with the severity of food insecurity (P = 0.001, 95% CI -0.056- -0.014), BMI (P = 0.049, 95% CI 0.000-0.042), and employment status (P = 0.034, 95% CI 0.002-0.048). CONCLUSION Food insecurity and the risk of malnutrition among COVID-19 patients should be assessed to prevent adverse health outcomes.
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Affiliation(s)
- Ahlam Badreldin El Shikieri
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Al Madinah Al Munawarah, Saudi Arabia
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21
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Lee J, Pak TY. Longitudinal Associations Between Food Insecurity and Suicidal Ideation Among Adults Aged ≥65 in the Korean Welfare Panel Study. Int J Public Health 2023; 68:1605618. [PMID: 37342679 PMCID: PMC10277513 DOI: 10.3389/ijph.2023.1605618] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives : This study aimed to explore longitudinal associations between food insecurity and suicidal ideation, and the moderating roles of intervention programs. Methods: Data were derived from the 2012-2019 waves of the Korean Welfare Panel Study. Participants aged ≥65 at baseline (n = 4,425) and their annual follow-up measurements for a mean of 6.58 years were included. Conditional fixed effects logistic regressions were used to test 1) associations between food insecurity and the onset of suicidal ideation; 2); whether associations were attenuated by food assistance and income support programs. Results: Food insecurity was associated with higher odds of suicidal ideation in the full sample (OR, 1.77; 95% CI, 1.37-2.29), among women (OR, 1.67; 95% CI, 1.24-2.26) and men (OR, 2.06; 95% CI, 1.25-3.40). The association between food insecurity and suicidal ideation was attenuated by participation in home-delivered meal services (OR, 0.43; 95% CI, 0.21-0.88). Conclusion: Food insecure older adults were more likely to consider committing suicide than their food secure counterparts. Food assistance through home-delivered meal services, but not other intervention programs, could weaken this link.
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22
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Ganhão-Arranhado S, Poínhos R, Pinhão S. Determinants of Nutritional Risk among Community-Dwelling Older Adults with Social Support. Nutrients 2023; 15:nu15112506. [PMID: 37299469 DOI: 10.3390/nu15112506] [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: 04/28/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND It is well established that older adults are at risk for malnutrition due to several social and non-social determinants, namely physiological, psychosocial, dietary and environmental determinants. The progression to malnutrition is often insidious and undetected. Thus, nutritional assessment should consider a complex web of factors that can impact nutritional status (NS). The primary objective of this study was to assess the NS of older adults attending senior centres (SCs) and to identify its predictors. METHODS This cross-sectional study enrolled a sample of community-dwelling older adults in Lisbon. NS was assessed using Mini Nutritional Assessment (MNA®). Malnutrition or malnutrition risk (recategorised into a single group) was predicted using binary logistic regression models, considering those participants classified as having a normal NS as the reference group. Data were collected through face-to-face interviews and anthropometric indices were measured according to Isak procedures. RESULTS A sample of 337 older adults, with an average age of 78.4 years old (range 66-99), mostly women (n = 210; 62.3%), were enrolled. Older adults at risk of malnutrition accounted for 40.7% of the sample. Being older (OR = 1.045, CI 95% [1.003-1.089], p = 0.037), having a worse perception of health status (OR = 3.395, CI 95% [1.182-9.746], p = 0.023), having or having had depression (OR = 5.138, CI 95% [2.869-9.201], p < 0.001), and not having or having had respiratory tract problems (OR = 0.477, CI 95% [0.246-0.925], p = 0.028) were independent predictors of malnutrition or malnutrition risk. An intermediate time of SC attendance was associated with a lower probability of malnutrition or risk (OR = 0.367, CI 95% [0.191-0.705], p = 0.003). CONCLUSIONS NS among older adults has a multifactorial aetiology, with a strongly social component and is related to health circumstances. Further research is needed to timely identify and understand nutritional risk among this population.
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Affiliation(s)
- Susana Ganhão-Arranhado
- CINTESIS, Centre for Health Technology and Services Research, 4200-450 Porto, Portugal
- Atlântica, Instituto Universitário, Fábrica da Pólvora de Barcarena, 2730-036 Barcarena, Portugal
| | - Rui Poínhos
- Faculty of Nutrition and Food Sciences, Universidade do Porto, 4150-180 Porto, Portugal
| | - Sílvia Pinhão
- Faculty of Nutrition and Food Sciences, Universidade do Porto, 4150-180 Porto, Portugal
- Serviço de Nutrição do Centro Hospitalar Universitário de São João, E.P.E, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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23
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Carlson SM, Giovanni ME, Neyman Morris M. The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults. J Nutr Gerontol Geriatr 2023:1-19. [PMID: 37211756 DOI: 10.1080/21551197.2023.2202157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions.
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Affiliation(s)
- S M Carlson
- Montefiore Health System, Bronx, New York, USA
| | - M E Giovanni
- Department of Nutrition and Food Science, California State University, Chico, California, USA
| | - M Neyman Morris
- Department of Nutrition and Food Science, California State University, Chico, California, USA
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Azhar S, Ross AM, Keller E, Weed J, Acevedo G. Predictors of Food Insecurity and Childhood Hunger in the Bronx During the COVID-19 Pandemic. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2023:1-14. [PMID: 37363071 PMCID: PMC10183692 DOI: 10.1007/s10560-023-00927-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
Using a community-based participatory research approach, we conducted a survey of 218 food pantry recipients in the south Bronx to determine predictors of food insecurity and childhood hunger. In adjusted multiple regression models, statistically significant risk factors for food insecurity included: having one or more children and not having health insurance. Statistically significant protectors against childhood hunger were: having a graduate degree, having health insurance and Spanish being spoken at home. Experiencing depression symptoms was positively associated with both food insecurity and childhood hunger. Frequency of food pantry use was not significantly associated with either food insecurity nor childhood hunger. This study suggests that targeting families with multiple children and without insurance will best help to promote food security among residents of the south Bronx. Social policy implications related to food security and benefit provision through the COVID-19 pandemic are also provided.
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Affiliation(s)
- Sameena Azhar
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
| | - Abigail M. Ross
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
| | - Eve Keller
- Fordham University, Fordham College at Rose Hill, New York, USA
| | | | - Gregory Acevedo
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
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Wiesmann D, Goldsmith R, Shimony T, Nitsan L, Keinan-Boker L, Shohat T. Food Insecurity in Israeli Elderly is Associated with Sociodemographic Characteristics, Disability, and Depression: Policy Implications. Curr Dev Nutr 2023; 7:100006. [PMID: 37180079 PMCID: PMC10111608 DOI: 10.1016/j.cdnut.2022.100006] [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: 04/28/2022] [Revised: 09/26/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background Food insecurity (FI) and poor health can turn into a vicious cycle with detrimental effects, especially in the elderly, however, few studies have examined the relationship between FI and health in this age group. Objectives We investigated associations of FI with physical and mental health and health behaviors among community-dwelling elderly. Methods We used nationally representative, cross-sectional data from the 2014-2015 Israel National Health and Nutrition Survey of the Elderly (Rav Mabat Zahav) on FI, sociodemographic characteristics, noncommunicable diseases (NCDs), disability, self-assessed physical, oral, and mental health for 1006 individuals aged ≥65 y. Results FI affected 12.3% of all households with elderly and was significantly higher among late immigrants and Arabs. Bivariate associations of FI with the number of NCDs, depression, disability in all 6 domains (vision, hearing, mobility, self-care, remembering, communication), poor self-assessed physical and oral health, chewing and swallowing problems, feelings of loneliness, insufficient physical activity, and smoking were significant (P < 0.05). In a multivariable logistic regression controlling for population group, household size, age and sex, FI was significantly associated (P < 0.05) with lack of formal education (OR: 6.26; 95% CI: 1.66, 23.65), being in the lowest (OR: 23.56; 95% CI: 3.71, 149.76) or second-lowest (OR: 16.75; 95% CI: 2.68, 104.52) per capita household income quartile, having one (OR: 2.11; 95% CI: 1.05, 4.23) or several disabilities (OR: 4.04; 95% CI: 1.72, 9.45), and having ever been diagnosed with depression (OR: 3.34; 95% CI: 1.35, 8.28). Conclusions FI is associated with physical and mental health problems, multiple disabilities, and loneliness among Israeli elderly. Providing income support could reduce FI, and subsidized congregate and home-delivered meal services could be expanded to meet the needs of elderly with disabilities and counter social isolation. Because low education, disability, and depression are particularly prevalent among the food insecure and vulnerable groups face language barriers, assistance with applications for these services should be increased.
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Affiliation(s)
| | - Rebecca Goldsmith
- School of Public Health, The Hebrew University in Jerusalem, Ein Karem, Jerusalem, Israel
| | - Tal Shimony
- Israel Center for Disease Control (ICDC), Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Lesley Nitsan
- Israel Center for Disease Control (ICDC), Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control (ICDC), Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Israel
- School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel
| | - Tamy Shohat
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Tai‐Seale M, Cheung MW, Kwak J, Harris V, Madonis S, Russell L, Haley E, Agnihotri P. Unmet needs for food, medicine, and mental health services among vulnerable older adults during the COVID-19 pandemic. Health Serv Res 2023; 58 Suppl 1:69-77. [PMID: 36214725 PMCID: PMC9843077 DOI: 10.1111/1475-6773.14084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To examine sociodemographic factors associated with having unmet needs in medications, mental health, and food security among older adults during the COVID-19 pandemic. DATA SOURCES AND STUDY SETTING Primary data and secondary data from the electronic health records (EHR) in an age-friendly academic health system in 2020 were used. STUDY DESIGN Observational study examining factors associated with having unmet needs in medications, food, and mental health. DATA COLLECTING/EXTRACTION METHODS Data from a computer-assisted telephone interview and EHR on community-dwelling older patients were analyzed. PRINCIPLE FINDINGS Among 3400 eligible patients, 1921 (53.3%) (average age 76, SD 11) responded, with 857 (45%) of respondents having at least one unmet need. Unmet needs for medications were present in 595 (31.0%), for food in 196 (10.2%), and for mental health services in 292 (15.2%). Racial minorities had significantly higher probabilities of having unmet needs for medicine and food, and of being referred for services related to medications, food, and mental health. Patients living in more resource-limited neighborhoods had a higher probability of being referred for mental health services. CONCLUSIONS Age-friendly health systems (AFHS) and their recognition should include assessing and addressing social risk factors among older adults. Proactive efforts to address unmet needs should be integral to AFHS.
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Affiliation(s)
- Ming Tai‐Seale
- University of California San Diego School of Medicine, Department of Family MedicineSan DiegoCaliforniaUSA,UC San Diego Health Population Health Services OrganizationSan DiegoCaliforniaUSA,UC San Diego Health Center for Health InnovationSan DiegoCaliforniaUSA
| | - Michael W. Cheung
- University of California San Diego School of Medicine, Department of Family MedicineSan DiegoCaliforniaUSA
| | - Jamie Kwak
- UC San Diego Health Population Health Services OrganizationSan DiegoCaliforniaUSA,UC San Diego Health Center for Health InnovationSan DiegoCaliforniaUSA
| | - Victoria Harris
- UC San Diego Health Population Health Services OrganizationSan DiegoCaliforniaUSA
| | - Samantha Madonis
- UC San Diego Health Population Health Services OrganizationSan DiegoCaliforniaUSA
| | - Lc Russell
- UC San Diego Health Population Health Services OrganizationSan DiegoCaliforniaUSA
| | - Eileen Haley
- UC San Diego Health Population Health Services OrganizationSan DiegoCaliforniaUSA
| | - Parag Agnihotri
- UC San Diego Health Population Health Services OrganizationSan DiegoCaliforniaUSA
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Calloway EE, Carpenter LR, Gargano T, Sharp JL, Yaroch AL. Development of three new multidimensional measures to assess household food insecurity resilience in the United States. Front Public Health 2022; 10:1048501. [PMID: 36589949 PMCID: PMC9794863 DOI: 10.3389/fpubh.2022.1048501] [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: 09/19/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction This study aimed to develop and test novel self-administered measures (Absorptive capacity, Adaptive capacity, and Transformative capacity) of three aspects of a household's resilience to financial shocks (e.g., job loss) that can increase food insecurity risk. Methods Measures were piloted in a convenience sample of households at risk for food insecurity in the United States. The survey included the new measures, validation variables (financial shock, household food security, general health, personal resilience to challenges, and financial wellbeing), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal consistency was assessed [Cronbach's alpha (CA)], and construct validity was assessed (Spearman's correlation). Also, brief screener versions of the full measures were created. Results Participants in the analytic samples (n = 220-394) averaged 44 years old, 67% experienced food insecurity, 47% had a high school diploma or less, 72% were women, and the sample was racially/ethnically diverse. Scores for Absorptive capacity [one factor; CA = 0.70; Mean = 1.32 (SD = 0.54)], Adaptive capacity [three factors; CAs 0.83-0.90; Mean = 2.63 (SD = 0.85)], and Transformative capacity [three factors; CAs 0.87-0.95; Mean = 2.70 (SD = 1.10)] were negatively associated with financial shocks (-0.221 to -0.307) and positively associated with food insecurity (0.310-0.550) general health (0.255-0.320), personal resilience (0.231-0.384), and financial wellbeing (0.401-0.474). Discussion These findings are encouraging and support reliability and validity of these new measures within this sample. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may prove useful for needs assessments, program evaluation, intake screening, and research/surveillance. Widespread adoption in the future may promote a more comprehensive understanding of the food insecurity experience and facilitate development of tailored interventions on upstream causes of food insecurity.
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Affiliation(s)
- Eric E. Calloway
- The Gretchen Swanson Center for Nutrition, Omaha, NE, United States,*Correspondence: Eric E. Calloway
| | | | - Tony Gargano
- The Gretchen Swanson Center for Nutrition, Omaha, NE, United States
| | - Julia L. Sharp
- Graybill Statistical Laboratory, Colorado State University, Fort Collins, CO, United States
| | - Amy L. Yaroch
- The Gretchen Swanson Center for Nutrition, Omaha, NE, United States
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28
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Chai X, Mei J. Investigating food insecurity, health lifestyles, and self-rated health of older Canadians living alone. BMC Public Health 2022; 22:2264. [PMID: 36464679 PMCID: PMC9720941 DOI: 10.1186/s12889-022-14467-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is a large number of older of this demographic fact. Although many studies have investigated the association between living arrangements and health, little is known about potential underlying mechanisms regarding how living alone may predict older Canadians' health. In this study, we address this research gap intending to contribute to offering policy suggestions for older Canadians who live alone. RESEARCH DESIGN AND METHODS We applied Cockerham's health lifestyle theory to explore to what degree living alone predicts worse health lifestyles and, further, to what degree these lifestyles can explain the association between living alone and older Canadians' health. We used the 2017-2018 Canadian Community Social Survey (Annual Component) which has a response rate of 58.8%. We focused on respondents aged 60 and above, and the analytical sample size is 39,636. RESULTS Older Canadians living alone are more likely to have food insecurity problems and higher possibilities of smoking cigarettes compared to those living with spouses/partners with or without children. Compared to those living with spouses/partners only, the odds of solo-living older Canadians drinking regularly is significantly lower. There also exists a significant difference between older Canadians living alone and their counterparts living with spouses/partners that the former reported lower self-rated health compared to the latter. Moreover, food insecurity and the three health lifestyle variables are significantly associated with respondents' self-rated health; food insecurity, cigarette smoking, and alcohol drinking can partially explain the difference in self-rated health due to living arrangements. DISCUSSION AND IMPLICATIONS According to our findings, health officials are recommended to pay more attention to food insecurity and heavy smoking problems facing older Canadians who live by themselves. Local communities and other stakeholders are suggested to provide older adults living alone with more opportunities for social engagement and involvement since regular drinking may have played such a role in enhancing social life quality of the aged.
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Affiliation(s)
- Xiangnan Chai
- grid.41156.370000 0001 2314 964XSociology Department, School of Social and Behavioral Sciences, Nanjing University, He’ren Building 359, Xianlin Street, Qixia District, Nanjing, Jiangsu Province People’s Republic of China
| | - Junyi Mei
- grid.41156.370000 0001 2314 964XSociology Department, School of Social and Behavioral Sciences, Nanjing University, He’ren Building 359, Xianlin Street, Qixia District, Nanjing, Jiangsu Province People’s Republic of China
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Maino Vieytes CA, Zhu R, Gany F, Burton-Obanla A, Arthur AE. Empirical Dietary Patterns Associated with Food Insecurity in U.S. Cancer Survivors: NHANES 1999-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14062. [PMID: 36360938 PMCID: PMC9656362 DOI: 10.3390/ijerph192114062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Food insecurity (FI) is a public health and sociodemographic phenomenon that besets many cancer survivors in the United States. FI in cancer survivors may arise as a consequence of financial toxicity stemming from treatment costs, physical impairment, labor force egress, or a combination of those factors. To our knowledge, an understanding of the dietary intake practices of this population has not been delineated but is imperative for addressing the needs of this vulnerable population; (2) Methods: Using data from NHANES, 1999-2018, we characterized major dietary patterns in the food insecure cancer survivor population using: i. penalized logistic regression (logit) and ii. principal components analysis (PCA). We validated these patterns by examining the association of those patterns with food insecurity in the cancer population; (3) Results: Four dietary patterns were extracted with penalized logit and two with PCA. In the pattern validation phase, we found several patterns exhibited strong associations with FI. The FI, SNAP, and Household Size patterns (all extracted with penalized logit) harbored the strongest associations and there was evidence of stronger associations in those moderately removed from a cancer diagnosis (≥2 and <6 years since diagnosis); (4) Conclusions: FI may play an influential role on the dietary intake patterns of cancer survivors in the U.S. The results highlight the relevance of FI screening and monitoring for cancer survivors.
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Affiliation(s)
| | - Ruoqing Zhu
- Department of Statistics, The University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Amirah Burton-Obanla
- Division of Nutritional Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Anna E. Arthur
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, Kansas City, KS 66160, USA
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30
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Eckert CD, Tarleton EK, Pellerin J, Mooney N, Gell NM. Nutrition Risk is Associated With Falls Risk in an Observational Study of Community-Dwelling, Rural, Older Adults. J Aging Health 2022; 34:1125-1134. [PMID: 35487237 PMCID: PMC10370346 DOI: 10.1177/08982643221096944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Poor nutritional status is a risk factor for falls and impedes recovery from falls in older adults. The primary objective of this study was to investigate the relationship between nutrition status and fall risk over time in a cohort of older adults. METHODS Using an observational analytic study design, we collected demographic, fall risk, nutrition risk, food insecurity, and incident falls data from community-dwelling older Vermonters. RESULTS Data from 708 participants (70.3 years ± 6.6; 82% female) indicate a significant association between fall risk and nutrition risk (p < 0.001), fall risk and food insecurity (p < 0.001), and food insecurity and nutrition risk (p < 0.001). After adjusting for potential confounders, elevated nutrition risk was significantly associated with an incident fall over the next 6 months (p < 0.05). CONCLUSION Given the evidence for an association between nutrition status and falls, additional research, in a more diverse population, is needed to understand the nuances of these relationships.
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Affiliation(s)
- Caitlin D Eckert
- Department of Environmental and Health Sciences, 40909Northern Vermont University, Johnson, VT, USA
| | - Emily K Tarleton
- Department of Environmental and Health Sciences, 40909Northern Vermont University, Johnson, VT, USA
| | - Jocelyn Pellerin
- Department of Environmental and Health Sciences, 40909Northern Vermont University, Johnson, VT, USA
| | - Nicole Mooney
- Department of Environmental and Health Sciences, 40909Northern Vermont University, Johnson, VT, USA
| | - Nancy M Gell
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
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31
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Bhatia S, Johnston CD, Derry-Vick H, Brennan-Ing M, Burchett CO, Siegler EL, Glesby MJ. Food Insecurity Is Associated with Key Functional Limitations and Depressive Symptoms in Older People Living with HIV. AIDS Patient Care STDS 2022; 36:375-378. [PMID: 36201225 PMCID: PMC9595635 DOI: 10.1089/apc.2022.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Sanam Bhatia
- Weill Cornell Medical College, New York, New York, USA
| | - Carrie D. Johnston
- Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA
| | - Heather Derry-Vick
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, New York, USA
| | - Chelsie O. Burchett
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Eugenia L. Siegler
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Marshall J. Glesby
- Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA
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32
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Choi YJ, Crimmins EM, Ailshire JA. Food insecurity, food environments, and disparities in diet quality and obesity in a nationally representative sample of community-dwelling older Americans. Prev Med Rep 2022; 29:101912. [PMID: 35911578 PMCID: PMC9326331 DOI: 10.1016/j.pmedr.2022.101912] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
Food insecurity, reflecting a household's low ability to purchase healthy food, is a public health concern that is associated with poor diet and obesity. Poor food environments, characterized as a neighborhood with low access to healthy, affordable food, may amplify the negative impact of food insecurity on diet and obesity. This study aims to investigate whether food insecurity and food environments are jointly associated with an increased risk of poor diet quality and obesity. We used data from a nationally representative sample of community-dwelling older adults in the Health and Retirement Study Health Care and Nutrition Survey and the National Neighborhood Data Archive to investigate the role of household and neighborhood characteristics on diet and obesity. Weighted regression models were estimated to examine the relationship between food insecurity and food environments as well as their interaction with diet quality and obesity. Food insecure respondents had lower Healthy Eating Index scores and were more likely to be obese than food secure respondents. Living in a poor food environment was associated with lower Healthy Eating Index scores, but not with obesity. We did not find any interaction between food insecurity and food environment in determining either healthy eating or obesity. Reducing food insecurity and increasing access to healthy food environments may encourage healthier eating among older adults, while alleviating food-related hardship may also reduce their obesity risk.
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Affiliation(s)
- Yeon Jin Choi
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
| | - Eileen M. Crimmins
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
| | - Jennifer A. Ailshire
- Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue #218, Los Angeles, CA, USA
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33
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Lee JS. Food Insecurity in Older Adults. J Nutr 2022; 152:1808-1809. [PMID: 35732466 DOI: 10.1093/jn/nxac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jung Sun Lee
- Department of Nutritional Sciences, University of Georgia, Athens, GA, USA
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34
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Vaudin AM, Moshfegh AJ, Sahyoun NR. Measuring Food Insecurity in Older Adults Using Both Physical and Economic Food Access, NHANES 2013-18. J Nutr 2022; 152:1953-1962. [PMID: 35285903 DOI: 10.1093/jn/nxac058] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/17/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Economic food insecurity tools are used to detect need for assistance in the general population. However, in older adults, food insecurity can also be due to factors other than economic, such as physical inability to shop or cook. OBJECTIVES We determined: 1) the proportion of older adults in the United States who experience physical and/or economic food insecurity; 2) differences in characteristics, diet quality, chronic conditions, and depression by economic and/or physical food insecurity; and 3) the relation of physical and economic food insecurity with diet quality and with depression. METHODS Data from adults aged ≥60 y of the NHANES (2013-2018) were used. Groups were created based on economic food security [measured using the USDA's Household Food Security Survey Module (HFSSM)] and physical food security (measured using questions evaluating ability to shop and cook). Depression, Healthy Eating Index (HEI-2015) score, and socioeconomic characteristics were compared by food security group. Rao-Scott χ2 tests were used to test for significant differences between categorical variables, and t tests for continuous variables. Associations between food security status, HEI-2015, and depression score were examined using linear regression analysis. RESULTS One-quarter (25.0%) of older adults had physical difficulty accessing food but were not living in economically food insecure households. Those who lived in economically food insecure households and also had physical difficulties accessing food had the lowest mean HEI-2015 score (51.7) and highest mean depression score (6.9); both were significantly lower than the mean scores of those who lived in food secure households (HEI-2015 = 57.3; depression = 2.1; P < 0.01). CONCLUSIONS Considering physical ability to shop for and prepare food when measuring food insecurity in older adults can help identify those who might need dietary and mental health support the most, and those who need food assistance but would otherwise be missed if only measuring economic access.
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Affiliation(s)
- Anna M Vaudin
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, USA
| | - Alanna J Moshfegh
- Agriculture Research Service, Food Surveys Research Group, U.S. Department of Agriculture, Beltsville, Maryland, USA
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, USA
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Kandapan B, Pradhan I, Pradhan J. Food Insecurity and Malnutrition among Indian Older Adults: Findings from Longitudinal Ageing Study in India, 2017-18. JOURNAL OF POPULATION AGEING 2022; 16:1-21. [PMID: 35965640 PMCID: PMC9361951 DOI: 10.1007/s12062-022-09378-2] [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: 03/30/2022] [Accepted: 06/28/2022] [Indexed: 10/28/2022]
Abstract
The study aims to assess the prevalence of food insecurity and malnutrition and to investigate the association between food insecurity, sociodemographic characteristics, and malnutrition among Indian older adults. Data for 28,004 older adults (60 + years) was extracted from Wave-1 of the Longitudinal Aging Study in India, 2017-18. Bivariate analysis was used for prevalence estimates. Multinomial logistic regression provided relative risk ratios (RRR) to determine the association. About 45% of older adults were food insecure and nearly half were malnourished (underweight - 26.7%, overweight - 22.2%). Overweight was widespread in southern, western, and northern India, while underweight and food insecurity were widespread in central, eastern, and north-eastern India. Food insecure older adults were significantly more likely to be underweight (mild: RRR = 1.105, 95% CI = 1.038-1.176; severe: RRR = 1.327, 95% CI = 1.186-1.485). Rather than severe food insecurity, those with moderate food insecurity have the least likelihood of being overweight. Being the oldest, male, widowed, divorced/separated/deserted, having fewer years of schooling, living in a ST or SC household, and in rural areawere associated with higher risk of being underweight; while their other counterparts were of being overweight. No association was found between working status and underweight, meanwhile the non-working older adults were less likely to be overweight (RRR = 0.804, 95% CI = 0.744-0.868). Underweight is strongly linked to food insecurity. In terms of food insecurity and malnutrition, the most vulnerable categories identified include oldest old, widowed, divorced/separated/deserted, SC, ST, economically weaker, and persons without or with only a few years of formal education.
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Affiliation(s)
- Binayak Kandapan
- Department of Humanities and Social Sciences, National Institute of Technology (NIT), 769008 Rourkela, Odisha India
| | - Itishree Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology (NIT), 769008 Rourkela, Odisha India
| | - Jalandhar Pradhan
- Department of Humanities and Social Sciences, National Institute of Technology (NIT), 769008 Rourkela, Odisha India
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Calloway EE, Carpenter LR, Gargano T, Sharp JL, Yaroch AL. Development of new measures to assess household nutrition security, and choice in dietary characteristics. Appetite 2022; 179:106288. [DOI: 10.1016/j.appet.2022.106288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/15/2022] [Accepted: 08/24/2022] [Indexed: 11/02/2022]
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Brady PJ, Askelson NM, Thompson H, Ashida S, Nothwehr F, Janssen B, Frisvold D. Perceived Food-Related Responsibilities Among Adults Aged 60 Years and Older. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022; 19:571-586. [PMID: 39355272 PMCID: PMC11441630 DOI: 10.1080/19320248.2022.2088264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Food citizenship states individuals, organizations, and governments have responsibilities for their actions and policies around food. We conducted twenty semi-structured interviews with older adults as an exploratory study about perceived food-related responsibilities. The government and agribusiness were seen as responsible for food safety and how healthy foods are. The government, agribusiness, and emergency food providers were seen as responsible for availability and accessibility. Individuals were seen as having a personal responsibility to access and choose healthy, safe foods. These results have important implications for understanding how older adults think about the roles themselves and others play in the food system.
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Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2 Street Suite 300, Minneapolis, MN, 55455
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
- University of Iowa Public Policy Center, 310 S Grand Ave, Iowa City, IA 52242
| | - Helaina Thompson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Faryle Nothwehr
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Brandi Janssen
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - David Frisvold
- University of Iowa Public Policy Center, 310 S Grand Ave, Iowa City, IA 52242
- Department of Economics, Tippie College of Business, University of Iowa, 21 E Market Street, Iowa City, IA, 52242
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Levy H. The Long-Run Prevalence of Food Insufficiency among Older Americans. APPLIED ECONOMIC PERSPECTIVES AND POLICY 2022; 44:575-590. [PMID: 36148327 PMCID: PMC9491516 DOI: 10.1002/aepp.13229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 01/10/2022] [Indexed: 06/02/2023]
Abstract
The prevalence of food insufficiency among seniors in any given year is well-documented, but the prevalence of this hardship over a longer time period in later life is unknown. Using panel data from the Health and Retirement Study, I find that about 8% of seniors report food insufficiency over a two-year recall window, while 22% experience it at some point over the two decades of their sixties and seventies. Food insufficiency is not concentrated among a small group of persistently disadvantaged elderly, but is instead a surprisingly common feature of the later life course.
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Affiliation(s)
- Helen Levy
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48104
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Balistreri KS. Older Adults and the Food Security Infrastructure. APPLIED ECONOMIC PERSPECTIVES AND POLICY 2022; 44:653-670. [PMID: 35685331 PMCID: PMC9173432 DOI: 10.1002/aepp.13238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/02/2022] [Indexed: 06/03/2023]
Abstract
This project explores the correlates of state variation in food security using data from the 2008 to 2018 Current Population Survey's Food Security Supplements. The focus is on the relationship between state-level availability and accessibility of congregate and home-delivered meal programs, the Supplemental Nutrition Assistance Program (SNAP), the Senior Farmer's Market Nutrition Program (SFMNP) and the Commodity Supplemental Food Program (CSFP) on food security among lower-income households headed by older adults (ages 60 and up). Results show evidence that a senior-specific state level food security infrastructure plays a role in the food security status of households headed by older adults.
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Samuel LJ, Dwivedi P, Hladek M, Cudjoe TKM, Drazich BF, Li Q, Szanton SL. The effect of COVID-19 pandemic-related financial challenges on mental health and well-being among U.S. older adults. J Am Geriatr Soc 2022; 70:1629-1641. [PMID: 35393645 PMCID: PMC9115091 DOI: 10.1111/jgs.17808] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022]
Abstract
Background Despite profound financial challenges during the COVID‐19 pandemic, there is a gap in estimating their effects on mental health and well‐being among older adults. Methods The National Health and Aging Trends Study is an ongoing nationally representative cohort study of US older adults. Outcomes included mental health related to COVID‐19 (scores averaged across eight items ranging from one to four), sleep quality during COVID‐19, loneliness during COVID‐19, having time to yourself during COVID‐19, and hopefulness during COVID‐19. Exposures included income decline during COVID‐19 and financial difficulty due to COVID‐19. Propensity score weighting produced covariate balance for demographic, socioeconomic, household, health, and well‐being characteristics that preceded the pandemic to estimate the average treatment effect. Sampling weights accounted for study design and non‐response. Results In weighted and adjusted analyses (n = 3257), both income decline during COVID‐19 and financial difficulty due to COVID‐19 were associated with poorer mental health related to COVID‐19 (b = −0.159, p < 0.001 and b = −0.381, p < 0.001, respectively), poorer quality sleep (OR = 0.63, 95% CI: 0.46, 0.86 and OR = 0.42, 95% CI: 0.30, 0.58, respectively), more loneliness (OR = 1.53, 95% CI: 1.16, 2.02 and OR = 2.72, 95% CI: 1.96, 3.77, respectively), and less time to yourself (OR = 0.54, 95% CI: 0.40, 0.72 and OR = 0.37, 95% CI: 0.27, 0.51, respectively) during COVID‐19. Conclusions Pandemic‐related financial challenges are associated with worse mental health and well‐being regardless of pre‐pandemic characteristics, suggesting that they are distinct social determinants of health for older adults. Timely intervention is needed to support older adults experiencing pandemic‐related financial challenges.
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Affiliation(s)
- Laura J Samuel
- Johns Hopkins University School of Nursing, Baltimore, MD
| | | | - Melissa Hladek
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - Thomas K M Cudjoe
- Johns Hopkins School of Medicine, Department of Medicine, Division of Division of Geriatric Medicine and Gerontology, Baltimore, MD
| | | | - Qiwei Li
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD.,Johns Hopkins Bloomberg School of Public Health Department of Health Policy and Management, Baltimore, MD
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Brady PJ, Askelson NM, Thompson H, Kersten S, Hopkins H. Meeting Older Adults' Food Needs: Interviews with Area Agency on Aging Staff, Food Bank Staff, and Older Adults. J Nutr Gerontol Geriatr 2022; 41:235-255. [PMID: 36016490 PMCID: PMC9679729 DOI: 10.1080/21551197.2022.2114569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Area Agencies on Aging (AAAs) and food banks provide nutritious food for in-need older adults. The objective of this study was to identify successes, challenges, and opportunities associated with meeting the food needs of older adults. We used semi-structured telephone interviews with AAA nutrition staff (n = 5), food bank program coordinators (n = 5) and executives (n = 6), and older adults (n = 60) in Iowa. AAAs and food banks identified providing healthy food and client satisfaction as successes and funding and staff/volunteer capacity as challenges. Before the pandemic, the relationships between these organizations were limited, but both saw opportunities for collaboration. Older adults described coordination between AAAs and food banks during the COVID-19 crisis. AAAs and food banks play an important role in meeting older adults' food needs, but their effectiveness is limited by challenges related to funding and capacity. There is a need to identify feasible and sustainable strategies for collaboration past this crisis.
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Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2 Street Suite 300, Minneapolis, MN, 55455
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
- University of Iowa Public Policy Center, 310 S Grand Ave, Iowa City, IA 52242
| | - Helaina Thompson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Sarah Kersten
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Haley Hopkins
- Iowa Department of Public Health, 321 E. 12 Street, Des Moines, IA, 50319
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Longitudinal Analysis of Food Insufficiency and Cardiovascular Disease Risk Factors in the CARDIA study. Am J Prev Med 2022; 62:65-76. [PMID: 34642058 PMCID: PMC9635889 DOI: 10.1016/j.amepre.2021.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/14/2021] [Accepted: 06/20/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Most previous studies on food insecurity and cardiovascular disease risk factors are cross-sectional. Without longitudinal data, it is unclear whether food insecurity precedes poor health and how exposure timing impacts these relationships. METHODS Data from 2000 to 2001, 2005 to 2006, and 2010 to 2011 of the Coronary Artery Risk Development in Young Adults study were used. Food insufficiency-a screener measure related to food insecurity-was assessed in 2000-2001 and 2005-2006 using a single item. Cardiovascular disease risk factors were objectively assessed in 2010-2011. Impacts of food insufficiency patterns (food sufficient, food insufficient in 2000-2001 only, food insufficient in 2005-2006 only, food insufficient in both 2000-2001 and 2005-2006) on cardiovascular disease risk factors were estimated using inverse probability weighting of marginal structural models. Covariates that change over time were adjusted for using stabilized weights; baseline covariates were adjusted for in the marginal structural models. Analyses were conducted in 2020-2021. RESULTS The baseline sample included 2,596 participants (56% women, 47% White). In unadjusted analyses, all food insufficiency patterns were associated with higher BMI, waist circumference, and blood pressure than food sufficiency. After accounting for covariates, estimates were attenuated but still consistent with adverse effects of food insufficiency, particularly among women. CONCLUSIONS After covariate adjustment, food insufficiency was associated with several cardiovascular disease risk factors. Findings from this study should be replicated in other settings and populations. If verified, this evidence could provide justification for intervening in food insecurity to reduce future cardiovascular disease risk.
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Long CR, Narcisse MR, Bailey MM, Rowland B, English E, McElfish PA. Food insecurity and chronic diseases among Native Hawaiians and Pacific Islanders in the US: results of a population-based survey. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022; 17:53-68. [PMID: 35432687 PMCID: PMC9012098 DOI: 10.1080/19320248.2021.1873883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Data from the 2014 Native Hawaiian and Pacific Islander (NHPI) National Health Interview Survey were used to examine associations between food security and individual chronic diseases, total number of chronic diseases, and general health status among 637 NHPI adults with income below 200 percent federal poverty level. Very low food security was associated with hypertension, diabetes, and asthma. Very low food security and marginal food security were associated with having any chronic disease and with having a higher number of chronic diseases. Risk for food insecurity increased as health status decreased. These associations had not previously been documented for NHPI.
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Affiliation(s)
- Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Mary M. Bailey
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Emily English
- Department of Pediatrics, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
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Brady PJ, Askelson NM, Ashida S, Nothwehr F, Janssen B, Frisvold D. The Relationship between Political, Economic, Social, and Cultural Vulnerability and Food Insecurity among Adults Aged 50 Years and Older. Nutrients 2021; 13:3896. [PMID: 34836150 PMCID: PMC8618552 DOI: 10.3390/nu13113896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Individuals experience food insecurity when they worry about or have limited access to nutritious foods. Food insecurity negatively impacts older adults' health. Social exclusion is a theoretical framework describing how unequal access to rights, resources, and capabilities results in political, economic, social, and cultural vulnerability, which leads to health disparities. We used the Health and Retirement Study to cross-sectionally examine associations between vulnerability and experiencing food insecurity in adults 50 years and older using the social exclusion framework. We tested the association between experiencing food insecurity and indicators of political, economic, social, and cultural vulnerability using logistic regression controlling for demographic and health-related factors. Analyses were performed with all respondents and sub-group of respondents with incomes less than 400% of the federal poverty level (FPL). Assets (OR = 0.97 in both samples), income (OR = 0.85, 0.80 in 400% FPL sub-sample), perceived positive social support from other family (OR = 0.86, 0.84 in 400% FPL sub-sample), and perceived everyday discrimination (OR = 1.68, 1.82 in 400% FPL sub-sample) were significantly associated with food insecurity. Perceived positive social support from spouses, children, or friends and U.S. citizenship status were not significantly associated with food insecurity. Further research is needed to define and measure each dimension of vulnerability in the social exclusion framework. Interventions and policies designed to prevent food insecurity should address these vulnerabilities.
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Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA; (N.M.A.); (S.A.); (F.N.)
- Health Policy Research Program, Public Policy Center, University of Iowa, 310 S Grand Ave., Iowa City, IA 52242, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA; (N.M.A.); (S.A.); (F.N.)
| | - Faryle Nothwehr
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA; (N.M.A.); (S.A.); (F.N.)
| | - Brandi Janssen
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA 52246, USA;
| | - David Frisvold
- Department of Economics, Tippie College of Business, University of Iowa, 21 E Market Street, Iowa City, IA 52242, USA;
- Social and Education Policy Research Program, Public Policy Center, University of Iowa, 310 S Grand Ave., Iowa City, IA 52242, USA
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A lifespan perspective of structural and perceived social relationships, food insecurity, and dietary behaviors during the COVID-19 pandemic. Appetite 2021; 168:105717. [PMID: 34582884 PMCID: PMC8464024 DOI: 10.1016/j.appet.2021.105717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/17/2021] [Accepted: 09/24/2021] [Indexed: 12/29/2022]
Abstract
Physical distancing and economic impacts of the COVID-19 pandemic may influence dietary behaviors. Using a parallel mixed method design, we examined the relationships between structural and perceived social relationships on dietary behaviors across the adult lifespan and by food security status. A representative sample of 360 adults (18-78 years old) living in the United States were recruited through Prolific Academic to complete an online cross-sectional survey. Participants provided data about demographics, food insecurity, structural and perceived social relationships, diet quality, and unhealthy snacking at the onset of the pandemic. Participants responded to open-ended questions about perceived changes in social connections and dietary behavior since COVID-19. Quantitative findings indicated food insecure emerging and older adults were at highest risk for low diet quality and frequent unhealthy snacking. Friend support was associated with higher diet quality. Qualitative findings suggested overall decreases in social connection and changes in dietary behavior, with food insecure adults describing decreases in diet quality. Participants who reported increases in emotional eating also reported decreases in social connection. Findings suggest the pandemic may exacerbate inequalities, particularly among food insecure emerging and older adults. Scaling up preventive interventions to increase social connection and reduce food insecurity during unprecedented challenges may promote healthier dietary behaviors now and in the long-term.
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Pereira MHQ, Pereira MLAS, Campos GC, Molina MCB. Food insecurity and nutritional status among older adults: a systematic review. Nutr Rev 2021; 80:631-644. [PMID: 34338784 DOI: 10.1093/nutrit/nuab044] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Food insecurity (FI), characterized by difficulty or inability to access adequate food, has become a public health problem. OBJECTIVE To analyze studies relating FI with nutritional status (NS) among older adults and the associated factors. DATA SEARCH Articles published up to June 2020 were investigated in 5 databases: PubMed, Embase, Scopus, LILACS, and Web of Science. The search, selection, extraction, and quality evaluation were carried out by 2 reviewers. DATA EXTRACTION The authors identified characteristics of the studies and the main data regarding the relationship of interest. RESULTS Twenty-two studies were included in the review and their characteristics are summarized and presented using narrative synthesis. In 10 studies (45.4%), a relationship was observed between FI and malnutrition; in another 6 (27.3%), a relationship was observed between FI and being overweight. CONCLUSION A relationship was identified between FI, especially severe forms, and malnutrition, as well as between FI, especially mild forms, and people being overweight. Thus, FI among older adults relates to a 2-fold burden of nutritional outcomes, depending on the level. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020185086.
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Affiliation(s)
- Marlus H Q Pereira
- M.H.Q. Pereira and M.L.A.S. Pereira are with Center of Biological and Health, Science, Federal University of the Western of Bahia, Barreiras, Bahia, Brazil. M.H.Q. Pereira, M.L.A.S. Pereira, and M.C.B. Molina are with the Postgraduate Program in Collective Heath, Federal University of Espírito Santo, Vitória, Brazil. G.C. Campos is with the Federal University of Espírito Santo, Vitória, Brazil. M.C.B. Molina is with the Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Maria L A S Pereira
- M.H.Q. Pereira and M.L.A.S. Pereira are with Center of Biological and Health, Science, Federal University of the Western of Bahia, Barreiras, Bahia, Brazil. M.H.Q. Pereira, M.L.A.S. Pereira, and M.C.B. Molina are with the Postgraduate Program in Collective Heath, Federal University of Espírito Santo, Vitória, Brazil. G.C. Campos is with the Federal University of Espírito Santo, Vitória, Brazil. M.C.B. Molina is with the Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Glaucia C Campos
- M.H.Q. Pereira and M.L.A.S. Pereira are with Center of Biological and Health, Science, Federal University of the Western of Bahia, Barreiras, Bahia, Brazil. M.H.Q. Pereira, M.L.A.S. Pereira, and M.C.B. Molina are with the Postgraduate Program in Collective Heath, Federal University of Espírito Santo, Vitória, Brazil. G.C. Campos is with the Federal University of Espírito Santo, Vitória, Brazil. M.C.B. Molina is with the Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Maria C B Molina
- M.H.Q. Pereira and M.L.A.S. Pereira are with Center of Biological and Health, Science, Federal University of the Western of Bahia, Barreiras, Bahia, Brazil. M.H.Q. Pereira, M.L.A.S. Pereira, and M.C.B. Molina are with the Postgraduate Program in Collective Heath, Federal University of Espírito Santo, Vitória, Brazil. G.C. Campos is with the Federal University of Espírito Santo, Vitória, Brazil. M.C.B. Molina is with the Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
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Mills CM. Food Insecurity in Older Adults in Canada and the United States: A Concept Analysis. CAN J DIET PRACT RES 2021; 82:200-208. [PMID: 34286614 DOI: 10.3148/cjdpr-2021-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified: (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.
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Affiliation(s)
- Christine Marie Mills
- School of Rehabilitation Therapy, Aging and Health, Queen's University, Kingston, ON
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Jung SE, Shin YH, Kim S, Hermann J, Dougherty Henry R. Habit is the Bridge between Intention and Behavior: A Look at Fruit and Vegetable Consumption among Low-Income Older Adults. J Nutr Gerontol Geriatr 2021; 40:215-231. [PMID: 34170212 DOI: 10.1080/21551197.2021.1944423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the influence of habit and theory of planned behavior (TPB) variables in predicting low-income older adults' fruit and vegetable (F&V) consumption. DESIGN Cross-sectional study. SETTING A city in the southeast United States. PARTICIPANTS A total of 372 low-income older adults participated in this study. RESULTS Participants completed a validated survey measuring TPB variables (attitude, subjective norm, perceived behavioral control, and intention), F&V intake using the Block Dietary Fruit-Vegetable Screener, and self-reported habit index to measure F&V consumption. Perceived behavioral control was the largest factor influencing intention to consume F&V, followed by attitude and subjective norm. In addition, there was a significant interaction between habit strength and intention, such that intention influenced F&V consumption only among individuals with average or higher habit strength. CONCLUSIONS Findings from this study suggest health promotion programs aimed at increasing F&V intake among low-income older adults should focus on establishing F&V intake as a habit so that an individual's intentions to consume F&V can be transformed into actual F&V intake. Also, emphasizing how to overcome potential barriers would improve low-income older adults' actual F&V intake by increasing their sense of control over consuming F&V.
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Affiliation(s)
- Seung Eun Jung
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
| | - Yeon Ho Shin
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
| | - Seoyoun Kim
- Department of Sociology, Texas State University, San Marcos, TX, USA
| | - Janice Hermann
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Regan Dougherty Henry
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
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Tan JY, Sheira LA, Frongillo EA, Gustafson D, Sharma A, Merenstein D, Cohen MH, Golub E, Edmonds A, Ofotokun I, Fischl M, Konkle‐Parker D, Neilands T, Tien P, Weiser SD. Food insecurity and frailty among women with and without HIV in the United States: a cross-sectional analysis. J Int AIDS Soc 2021; 24:e25751. [PMID: 34128343 PMCID: PMC8204023 DOI: 10.1002/jia2.25751] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Frailty is frequently observed among people with HIV, and food insecurity is associated with frailty in the general population. Evidence is scarce on the associations between food insecurity and frailty among women with HIV who may be particularly vulnerable to the impacts of food insecurity. The goal of this study was to assess associations between food insecurity and frailty among women with and without HIV. METHODS There were 1265 participants from the Women's Interagency HIV Study who participated in frailty assessments in 2017. Frailty was measured using the Fried Frailty Phenotype, and women were subsequently categorized as robust, pre-frail or frail. Food insecurity was assessed using the U.S. Household Food Security Survey Module, with women categorized as having high, marginal, low or very low food security. Multinomial logistic regression models were conducted to examine cross-sectional associations between food insecurity and frailty while adjusting for socio-demographic, behavioural and HIV status covariates. RESULTS AND DISCUSSION Approximately one-third (31.9%) of the women had marginal, low or very low food security, and the proportions of women who met the criteria for frailty or pre-frailty were 55.6% and 12.4% respectively. In the adjusted model, the relative risk ratio (RRR) of frailty for women with very low food security versus women with high food security was 3.37 (95% CI [1.38 to 8.24], p < 0.01); the corresponding RRR of pre-frailty was 3.63 (95% CI [1.76 to 7.51], p < 0.001). Higher annual household income was associated with lower RRRs of frailty or pre-frailty (p < 0.01). Similarly, older age was associated with more frequent frailty (RRR=1.06, 95% CI [1.03 to 1.09], p < 0.001). HIV serostatus was not significantly associated with either pre-frailty (RRR=0.97, 95% CI [0.71 to 1.31]) or frailty (RRR=0.75, 95% CI [0.48 to 1.16]). CONCLUSIONS Very low food security was associated with more frequent frailty and pre-frailty among women with and without for HIV. HIV serostatus was not associated with frailty.
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Affiliation(s)
- Judy Y Tan
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
| | - Lila A Sheira
- Division of HIV, ID and Global MedicineUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and BehaviorUniversity of South CarolinaColumbiaSCUSA
| | - Deborah Gustafson
- Department of NeurologyState University of New York Downstate Health Sciences UniversityBrooklynNYUSA
| | - Anjali Sharma
- Department of MedicineAlbert Einstein College of MedicineBronxNYUSA
| | - Daniel Merenstein
- Department of Family MedicineGeorgetown University Medical CenterWashingtonDCUSA
| | - Mardge H Cohen
- Department of MedicineStroger Hospital of Cook County HealthChicagoILUSA
| | - Elizabeth Golub
- WIHS Data Management CenterBloomberg School of Public HealthDepartment of EpidemiologyJohns Hopkins UniversityBaltimoreMDUSA
| | - Andrew Edmonds
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Igho Ofotokun
- School of MedicineDepartment of MedicineEmory UniversityAtlantaGAUSA
- Grady Healthcare SystemAtlantaGAUSA
| | - Margaret Fischl
- Miller School of MedicineUniversity of MiamiCoral GablesFLUSA
| | - Deborah Konkle‐Parker
- Department of Medicine/Division of Infectious DiseasesSchool of NursingSchool of Population Health SciencesUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Torsten Neilands
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
| | - Phyllis Tien
- Department of MedicineSan Francisco and Medical ServiceDepartment of Veteran Affairs Medical CenterUniversity of CaliforniaSan FranciscoCAUSA
| | - Sheri D Weiser
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
- Division of HIV, ID and Global MedicineUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
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50
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Walker S, Baum JI. Eggs as an affordable source of nutrients for adults and children living in food-insecure environments. Nutr Rev 2021; 80:178-186. [PMID: 34027973 DOI: 10.1093/nutrit/nuab019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/10/2021] [Accepted: 03/02/2021] [Indexed: 01/03/2023] Open
Abstract
Food insecurity affects an estimated 12% of households in the United States. Adults and children who experience food insecurity are increased risk for development of metabolic diseases such as type 2 diabetes, obesity, and cardiovascular disease. The negative health outcomes associated with food insecurity are multifactorial; however, many of them may be caused by limited nutritional intake and poor diet quality. Dietary intake of eggs may be an applicable solution for food-insecure families who are challenged by limited nutritional intake. Eggs contain a variety of nutrients that support metabolic health. For instance, eggs are a complete source of high-quality protein and contain 16 vitamins and minerals. Furthermore, eggs are cost efficient. When comparing the relationship between foods on the basis of calories and unit cost, the energy cost of eggs is significantly less when compared with that of other animal-protein foods such as meat, poultry, and fish. However, dietary intake of eggs is controversial in regard to cardiovascular health. Thus, the aim of this review is to summarize the role of eggs in the diet and the impact eggs have on health for adults and children living in a food-insecure environment.
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Affiliation(s)
- Sam Walker
- S. Walker and J.I. Baum are with the Department of Food Science, University of Arkansas. S. Walker and J.I. Baum are with the Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, Arkansas, USA
| | - J I Baum
- S. Walker and J.I. Baum are with the Department of Food Science, University of Arkansas. S. Walker and J.I. Baum are with the Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, Arkansas, USA
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