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Myers KP, Temple JL. Translational science approaches for food insecurity research. Appetite 2024; 200:107513. [PMID: 38795946 PMCID: PMC11227396 DOI: 10.1016/j.appet.2024.107513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
Food insecurity is a pervasive problem that impacts health and well-being across the lifespan. The human research linking food insecurity to poor metabolic and behavioral health outcomes is inherently correlational and suffers from a high degree of variability both between households and even within the same household over time. Further, food insecurity is impacted by societal and political factors that are largely out of the control of individuals, which narrows the range of intervention strategies. Animal models of food insecurity are being developed to address some of the barriers to mechanistic research. However, animal models are limited in their ability to consider some of the more complex societal elements of the human condition. We believe that understanding the role that food insecurity plays in ingestive behavior and chronic disease requires a truly translational approach, and that understanding the health impacts of this complex social phenomenon requires understanding both its psychological and physiological dimensions. This brief review will outline some key features of food insecurity, highlighting those that are amenable to investigation with controlled animal models and identifying areas where integrating animal and human studies can improve our understanding of the psychological burden and health impacts of food insecurity. In the interest of brevity, this review will largely focus on food insecurity in the United States, as the factors that contribute to food insecurity vary considerably across the globe.
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Affiliation(s)
- Kevin P Myers
- Department of Psychology, Animal Behavior & Neuroscience Programs, Bucknell University, Lewisburg, PA, USA.
| | - Jennifer L Temple
- Departments of Exercise and Nutrition Sciences, Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
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Burns J, Norton DM, Cooper PN, Day PE, Rao MY, Sanchez Parra CA, Kiener AJ. Food insecurity in children with heart disease. Curr Opin Pediatr 2024; 36:473-479. [PMID: 38655802 DOI: 10.1097/mop.0000000000001348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW This review discusses the epidemiology of food insecurity (FI) and its consequences in children with congenital heart disease. We aimed to highlight current interventions to screen and address food insecurity in the context of pediatric cardiology and to offer strategies for providers to engage in this meaningful work. RECENT FINDINGS Food insecurity is consistently associated with poor health outcomes in children. In the United States, 17.3% of households with children experience FI. Nonwhite and single-parent families are disproportionately affected. Interestingly, because of a low-quality diet, FI is associated with childhood obesity, putting affected children at increased risk for cardiovascular morbidity and mortality over time. Children with congenital heart disease are susceptible to poor outcomes due to unique altered metabolic demands, increased risk for growth impairment, frequent need for specialized feeding regimens, and additional morbidity associated with heart surgery in underweight children. SUMMARY Today, the burden of screening for FI is most commonly placed on general pediatricians. Considering the importance of nutrition to cardiovascular health and general wellbeing, and the ease with which screening can be performed, pediatric cardiologists and other subspecialists should take a more active role in FI screening.
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Affiliation(s)
- Joseph Burns
- Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
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Batioja K, Elenwo C, Hendrix-Dicken A, Ali L, Wetherill MS, Hartwell M. Associations of social determinants of health and childhood obesity: a cross-sectional analysis of the 2021 National Survey of Children's Health. J Osteopath Med 2024; 124:231-239. [PMID: 38190347 DOI: 10.1515/jom-2023-0239] [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: 10/20/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
CONTEXT Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Families who are of low socioeconomic status (SES) have also been shown to be more likely to experience food insecurity. OBJECTIVES Our primary objective was to utilize the National Survey of Children's Health (NSCH) 2021 data to determine the current associations between childhood obesity and SDOH. Secondarily, we estimated the prevalence of select SDOH among children with obesity. METHODS We conducted a cross-sectional analysis of 2021 NSCH to extract data related to the SDOH domains. We extracted sociodemographic variables to utilize as controls and constructed logistic regression models to determine associations, via odds ratios, between SDOH and childhood obesity. RESULTS Within the binary regression models, children with obesity (≥95th percentile) were more likely than children without obesity to experience SDOH in all domains. After controlling for sociodemographic variables, children with obesity were significantly more likely to experience food insecurity when compared to children without obesity (adjusted odds ratio [AOR]=1.39; 95 % confidence interval [CI]: 1.13-1.17). CONCLUSIONS In line with the current American Academy of Pediatrics (AAP) Clinical Practice Guidelines (CPG), improving policies for nutrition programs and addressing the lack of access to nutritious foods may alleviate some food insecurity. Ensuring that children have access to sufficient nutritious foods is critical in addressing childhood obesity and thus decreasing risk of chronic disease.
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Affiliation(s)
- Kelsi Batioja
- Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA
| | - Covenant Elenwo
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Tahlequah, OK, USA
| | - Amy Hendrix-Dicken
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Lamiaa Ali
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Marianna S Wetherill
- College of Public Health - Schusterman Center, University of Oklahoma Health Sciences Center, Tulsa, OK, USA
| | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Cope AL, Chestnutt IG. A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries. Community Dent Oral Epidemiol 2024. [PMID: 38571289 DOI: 10.1111/cdoe.12959] [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: 08/04/2023] [Revised: 12/08/2023] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. METHODS A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. RESULTS Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. CONCLUSIONS This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.
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Affiliation(s)
- A L Cope
- Dental Public Health, School of Dentistry, Cardiff University, Cardiff, UK
| | - I G Chestnutt
- Dental Public Health, School of Dentistry, Cardiff University, Cardiff, UK
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Kohanmoo A, Hashemzadeh M, Teymouri M, Zare M, Akhlaghi M. Food insecurity is associated with low diet quality and unhealthy cooking and eating habits in Iranian women. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:42. [PMID: 38486251 PMCID: PMC10941397 DOI: 10.1186/s41043-024-00533-3] [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: 12/19/2022] [Accepted: 03/02/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Food insecurity affects diet and nutrition intakes. We explored the relationship between food insecurity and dietary intakes in a group of Iranian women. METHODS The cross-sectional study was performed on 190 healthy females aged 20-55 years attending primary healthcare centers in Shiraz. Food insecurity was evaluated by Household Food Insecurity Access Scale, which is a validated tool for assessing food insecurity in developing countries. Diet was assessed using a food frequency questionnaire. The association of dietary patterns and food insecurity was assessed by linear regression. RESULTS Assessment of dietary intakes revealed that consumption of red meat, poultry, fish, dairy, fruits, non-starchy vegetables, and nuts decreased whereas that of grains, processed meats, potato, and sugary foods increased with increasing food insecurity. Among nutrients, carbohydrates, fiber, vitamin A, vitamin C, folic acid, potassium, calcium, and magnesium decreased while fat and sodium increased as food insecurity increased. Three major dietary patterns were detected. Healthy dietary patterns showed inverse associations with food insecurity in the crude (β = -0.422 and - 0.435, P < 0.001) and adjusted (adjusted for age, marital status, and educational level) (β = -0.475 and - 0.341, P < 0.001) models of regression analysis but unhealthy pattern did not show an association with food insecurity. Compared to food secure participants, a higher percentage of food insecure individuals indicated unhealthy eating habits, such as skipping breakfast, lower snack ingestion, more fast and fried food consumption, and using unhealthy cooking methods. CONCLUSION Overall, this study showed that food insecurity was associated with less healthy diet and unhealthy cooking and eating habits.
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Affiliation(s)
- Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maral Hashemzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Teymouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Blasingame M, Samuels LR, Heerman WJ. The Combined Effects of Social Determinants of Health on Childhood Overweight and Obesity. Child Obes 2024; 20:107-118. [PMID: 36989504 DOI: 10.1089/chi.2022.0222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Background: To characterize the association between multiple social determinants of health (SDOH) and overweight and obesity among US children. Methods: We conducted a cross-sectional analysis using the 2016-2020 National Survey of Children's Health. SDOH domains consisted of Economic Stability, Social and Community Context, Neighborhood and Built Environment, and Health Care Access and Quality. We used ordinal logistic regression to model associations between SDOH and weight status and calculate predicted probabilities of having overweight or obesity for various SDOH profiles. Results: Data from 81,716 children represented a weighted sample of 29,415,016 children ages 10-17 years in the United States. Of these, 17% had overweight and 17% had obesity. Compared with children with the theoretically lowest-risk SDOH profile, children with the highest-risk SDOH profiles in all four domains had an odds ratio of having a higher BMI category of 4.38 (95% confidence interval 1.67-7.09). For the lowest risk profile, the predicted probability of obesity varied from 8% to 11%, depending on race. For the highest risk profile, the predicted probability of obesity varied from 26% to 34%, depending on race. Conclusions: While high-risk values in each SDOH domain were associated with higher predicted probability of overweight and obesity, it was the combination of highest risk values in all the SDOH domains that led to greatest increases. This suggests a complex and multilayered relationship between the SDOH and childhood obesity, necessitating a comprehensive approach to addressing health equity to reduce childhood obesity.
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Affiliation(s)
| | - Lauren R Samuels
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
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Dubois L, Bédard B, Goulet D, Prud'homme D, Tremblay RE, Boivin M. Experiencing food insecurity in childhood: influences on eating habits and body weight in young adulthood. Public Health Nutr 2023; 26:2396-2406. [PMID: 37665116 DOI: 10.1017/s1368980023001854] [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: 09/05/2023]
Abstract
OBJECTIVE To examine how food insecurity in childhood up to adolescence relates to eating habits and weight status in young adulthood. DESIGN A longitudinal study design was used to derive trajectories of household food insecurity from age 4·5 to 13 years. Multivariable linear and logistical regression analyses were performed to model associations between being at high risk of food insecurity from age 4·5 to 13 years and both dietary and weight outcomes at age 22 years. SETTING A birth cohort study conducted in the Province of Quebec, Canada. PARTICIPANTS In total, 698 young adults participating in the Québec Longitudinal Study of Child Development. RESULTS After adjusting for sex, maternal education and immigrant status, household income and type of family, being at high risk (compared with low risk) of food insecurity in childhood up to adolescence was associated with consuming higher quantities of sugar-sweetened beverages (ßadj: 0·64; 95 % CI (0·27, 1·00)), non-whole-grain cereal products (ßadj: 0·32; 95 % CI (0·07, 0·56)) and processed meat (ßadj: 0·14; 95 % CI (0·02, 0·25)), with skipping breakfast (ORadj: 1·97; 95 % CI (1·08, 3·53)), with eating meals prepared out of home (ORadj: 3·38; 95 % CI (1·52, 9·02)), with experiencing food insecurity (ORadj: 3·03; 95 % CI (1·91, 4·76)) and with being obese (ORadj: 2·01; 95 % CI (1·12, 3·64)), once reaching young adulthood. CONCLUSION Growing up in families experiencing food insecurity may negatively influence eating habits and weight status later in life. Our findings reinforce the importance of public health policies and programmes tackling poverty and food insecurity, particularly for families with young children.
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Affiliation(s)
- Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | - Brigitte Bédard
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | - Danick Goulet
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | | | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montréal, Montréal, QC, Canada
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Michel Boivin
- École de Psychologie, Université Laval, Québec, QC, Canada
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Zhou C, Miao H, Zhao Y, Wan X. Food insecurity increases the risk of overweight and chronic diseases in adolescents: a systematic review and meta-analysis. FOOD SCIENCE AND HUMAN WELLNESS 2023. [DOI: 10.1016/j.fshw.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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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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Ghani F, Wang H, Manning SE, Sambamoorthi U. Interactive association of chronic illness and food insecurity with emergency department utilization among school-age children in the United States: A cross-sectional study. Health Sci Rep 2023; 6:e1123. [PMID: 36814967 PMCID: PMC9940462 DOI: 10.1002/hsr2.1123] [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: 09/29/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 02/23/2023] Open
Abstract
Background and Aims Food insecurity combined with chronic disease conditions is a risk factor for Emergency Department (ED) utilization, an indicator of poor quality of care. However, such an association is not certain among school-age children with chronic conditions. Therefore, we aim to determine the association of food insecurity, chronic conditions, and ED utilization among school-age children in the United States. Methods We analyzed the data from the 2017 Medical expenditure panel survey (MEPS) among children aged 6-17 years (N = 5518). MEPS data was released electronically by the Agency for Healthcare Research and Quality (AHRQ). We identified four groups of school-age children based on the presence of food security and chronic conditions: 1) with food insecurity and chronic conditions; 2) no food insecurity and chronic conditions; 3) with food insecurity and no chronic conditions; and 4) no food insecurity and no chronic conditions. We compared ED utilization among these four groups using incidence rate ratios (IRR) after adjusting children's age, sex, race and ethnicity, household income, insurance coverage, obesity, and geographic region using count data model, specifically multivariable Poison regression. We used SAS 9.4 and STATA 14.2 for all the data analyses. Results There were unweighted 5518 school-age children who represented weighted 50,479,419 school-age children in the final analysis. Overall, 6.0% had food insecurity with chronic conditions. These children had higher ED utilization (19.7%) than the other three groups (13.3%, 8.8%, and 7.2%, p < 0.001). The adjusted IRR of ED utilization among school-age children with food insecurity and chronic conditions was 1.90 (95% confidence interval 1.20-3.01, p = 0.007) compared with those with food security and chronic conditions. Conclusion One in 16 school-age children has both food insecurity and chronic conditions. Food insecurity was positively associated with frequent ED visits in the presence of chronic conditions. Therefore, addressing food insecurity may reduce the risk of ED visits.
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Affiliation(s)
- Farheen Ghani
- Department of Pharmacotherapy, College of PharmacyUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Hao Wang
- Department of Emergency MedicineJPS Health NetworkFort WorthTexasUSA
| | | | - Usha Sambamoorthi
- Department of Pharmacotherapy, College of PharmacyUniversity of North Texas Health Science CenterFort WorthTexasUSA
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Salinas LMB, Machiorlatti M, Romero Z, Wang L, Alanis E, Treviño-Peña R. The Relationship Between Food Insecurity and Food Assistance Program Participation in Families of Preschool Children in the Rio Grande Valley. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2023. [DOI: 10.1080/19320248.2023.2166802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Lisa Michelle Belzer Salinas
- Department of Health & Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Michael Machiorlatti
- Department of Population Health and Biostatistics, School of Medicine, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Zasha Romero
- Department of Health & Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Lin Wang
- Department of Health & Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Elizabeth Alanis
- Department of Health & Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Roberto Treviño-Peña
- Department of Health & Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, Texas, USA
- Social & Health Research Center, San Antonio, Texas, USA
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Ortiz-Marrón H, Ortiz-Pinto MA, Urtasun Lanza M, Cabañas Pujadas G, Valero Del Pino V, Belmonte Cortés S, Gómez Gascón T, Ordobás Gavín M. Household food insecurity and its association with overweight and obesity in children aged 2 to 14 years. BMC Public Health 2022; 22:1930. [PMID: 36253730 PMCID: PMC9578200 DOI: 10.1186/s12889-022-14308-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective was to estimate the prevalence of household food insecurity (HFI) depending on sociodemographic factors and its association with lifestyle habits and childhood overweight and obesity. METHODS Data was collected from 1,938 children aged 2 to 14 years who participated in the "Study about Malnutrition" of the Community of Madrid. Weight and height were obtained through physical examination. Body mass index was calculated as weight/height2 (kg/m2) and the criteria of the WHO were used for determining conditions of overweight and obesity. The participants' parents answered a structured questionnaire about their diet, lifestyle (physical activity and screen time), and food insecurity. The diet quality was assessed with the Healthy Eating Index in Spain and food insecurity, defined as the lack of consistent access to sufficient food for a healthy life, was measured via three screening questions and the Household Food Insecurity Access Scale (HFIAS). Odds Ratios (ORs) and Relative Risk Ratios (RRRs) were estimated using logistic regression models and adjusted for confounding variables. RESULTS The overall prevalence of HFI was 7.7% (95% CI: 6.6‒9.0), with lower values in children 2 to 4 years old (5.7%, 95% CI: 4.0‒8.1) and significantly higher values in households with low family purchasing power [37.3%; OR: 8.99 (95% CI: 5.5‒14.6)]. A higher prevalence of overweight (33.1%) and obesity (28.4%) was observed in children from families with HFI, who presented a lower quality diet and longer screen time compared to those from food-secure households (21.0% and 11.5%, respectively). The RRR of children in families with HFI relative to those from food-secure households was 2.41 (95% CI: 1.5‒4.0) for overweight and 1.99 (95% CI: 1.2‒3.4) for obesity. CONCLUSION The prevalence of HFI was high in the paediatric population, especially in households with low family purchasing power. HFI was associated with lower diet quality and higher prevalence of childhood overweight and obesity. Our results suggest the need for paediatric services to detect at-risk households at an early stage to avoid this dual burden of child malnutrition.
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Affiliation(s)
- Honorato Ortiz-Marrón
- Epidemiology Service. General Directorate of Public Health, Department of Health, Community of Madrid, C/ San Martín de Porres nº 6, 28035, Madrid, Spain.
| | - Maira Alejandra Ortiz-Pinto
- Epidemiology Service. General Directorate of Public Health, Department of Health, Community of Madrid, C/ San Martín de Porres nº 6, 28035, Madrid, Spain
| | - María Urtasun Lanza
- Group of Epidemiology and Public Health, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain.,APLICA Cooperative, Madrid, Spain
| | - Gloria Cabañas Pujadas
- Epidemiology Service. General Directorate of Public Health, Department of Health, Community of Madrid, C/ San Martín de Porres nº 6, 28035, Madrid, Spain
| | - Virginia Valero Del Pino
- Epidemiology Service. General Directorate of Public Health, Department of Health, Community of Madrid, C/ San Martín de Porres nº 6, 28035, Madrid, Spain
| | - Susana Belmonte Cortés
- Nutrition Service, Department of Health, Community of Madrid, General Directorate of Public Health, Madrid, Spain
| | - Tomás Gómez Gascón
- Foundation for Biosanitary Research and Innovation in Primary Care ES Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain Faculty of Medicine. Universidad Complutense de Madrid, Madrid, Spain
| | - María Ordobás Gavín
- Epidemiology Service. General Directorate of Public Health, Department of Health, Community of Madrid, C/ San Martín de Porres nº 6, 28035, Madrid, Spain
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Al-Bazz SA, Béland D, Lane GL, Engler-Stringer RR, White J, Vatanparast H. Food Security of Temporary Foreign Farm Workers under the Seasonal Agricultural Worker Program in Canada and the United States: A Scoping Review. Adv Nutr 2022; 13:1603-1627. [PMID: 35325019 PMCID: PMC9526858 DOI: 10.1093/advances/nmac027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/20/2022] [Accepted: 03/18/2022] [Indexed: 01/28/2023] Open
Abstract
Temporary foreign farm workers (TFWs) are among the most vulnerable and exploitable groups. Recent research shows alarming rates of food insecurity among them. This review explores research focussing on food security of TFWs in Canada and the United States, summarizes findings, and identifies research gaps. Online databases, including MEDLINE, Web of Science, Scopus, Google Scholar, and government and nongovernment websites, and websites of migrant worker-supporting organizations were searched for peer-reviewed and non-peer-reviewed papers and reports published between 1966 and 2020 regarding food security of TFWs. Articles reviewed were analyzed to determine publication type, country, year, target population, and main findings. Content analysis was performed to identify major themes. Of 291 sources identified, 11 met the inclusion criteria. Most articles (n = 10) were based on studies conducted in the United States. The prevalence of food insecurity among TFWs ranged between 28% and 87%. From the content analysis, we formulated 9 themes, representing a diversity of perspectives, including access to resources, income, housing and related facilities, food access, dietary pattern and healthy food choices, and migrant's legal status. Instruments reported for the measurement of food security include USDA Household Food Security Survey Module (HFSSM; n = 8, 72.7%), the modified version of the USDA HFSSM (n = 1, 9%), hunger measure (n = 1, 9%), the modified CDC's NHANES (n = 1, 9%), and 24-h recall, diet history, and/or food-frequency questionnaire (n = 3, 27.3%). Factors impacting food security of TFWs working under the Seasonal Agricultural Worker Programs (SAWPs) in North America are understudied. There is a need to advance research looking particularly at policies and regulatory and administrative aspects of the SAWPs to improve the food security of this cohort. There is also a need for qualitative studies that explore lived experiences and perspectives of TFWs and key informants. Longitudinal studies may be useful to examine various factors, including policy-related, contributing to food insecurity of TFWs over time.
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Affiliation(s)
- Samer A Al-Bazz
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Daniel Béland
- Department of Political Science, McGill University, Montreal, Quebec, Canada
| | - Ginny L Lane
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA
| | - Rachel R Engler-Stringer
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Judy White
- Faculty of Social Work, University of Regina, Regina, Saskatchewan, Canada
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De-Jongh González O, Ojeda García A, Turnbull B, Cruz Torres CE, León Elizalde MA, Escalante Izeta EI. Don't take the context out of the picture: Contextually shaped parents' and children's obesogenic behaviors in a marginalized area of Mexico City. Appetite 2022; 171:105915. [PMID: 35007664 DOI: 10.1016/j.appet.2022.105915] [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: 08/02/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/26/2022]
Abstract
Santa Fe Gully zone is a marginalized area of Mexico City where nearly 39% of children live with either overweight or obesity. Despite the extensive research on obesogenic behaviors, studies frequently overlook the contexts where such behaviors occur. This qualitative study described individual and familial obesogenic behaviors among children with obesity from Santa Fe Gully, and explained how these behaviors might be contextually shaped. We used a grounded theory approach to investigate the process of development/maintenance of obesity in our sample. Fifteen participants (seven 10-year-olds with overweight or obesity and their parents) participated in nine art-based focus groups, and parents completed individual semi-structured interviews. Data were analyzed using a structured thematic content analysis. Results showed children's weight status was part of their identity, providing children with a familial 'fitting' sense while increasing psychosocial difficulties, leading to emotional overeating as a coping strategy. Parents' use of controlling and low-structured parenting practices reinforced children's emotional overeating and failed to regulate children's dietary and physical activity behaviors. Some low-structured parenting practices were guilt-motivated or fostered by socioeconomic and cultural factors (e.g., limited food access, unhealthy food exposure, community unsafety). Future interventions in Santa Fe Gully aimed at modifying obesogenic behaviors should incorporate systemic and ecological approaches to help participants navigate through contextual obstacles, as their behaviors should be analized considering the context where they occur.
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Affiliation(s)
- Olivia De-Jongh González
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico; School of Population and Public Health, University of British Columbia, BC Children's Hospital Research Institute, F514-4490 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
| | - Angélica Ojeda García
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico.
| | - Bernardo Turnbull
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico.
| | - Christian E Cruz Torres
- Psychology Department, Universidad de Guanajuato Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos, CP 37670, Guanajuato, México.
| | - M Angélica León Elizalde
- School of Population and Public Health, University of British Columbia, BC Children's Hospital Research Institute, F514-4490 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
| | - Ericka I Escalante Izeta
- Health Department, Universidad Iberoamericana of Puebla. 2901 Blvd. del Niño Poblano, Reserva Territorial Atlixcáyotl, San Andrés Cholula, Puebla, CP 72820, Mexico.
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15
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Silva MRG, Machado-Rodrigues AM, Rodrigues D, Nogueira H, Rosado-Marques V, Gama A, Padez C. Household Food Security and Associated Factors among Portuguese Children. Ecol Food Nutr 2021; 61:407-421. [PMID: 34936530 DOI: 10.1080/03670244.2021.2018311] [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: 10/19/2022]
Abstract
This study investigated the household food insecurity (HFI) among Portuguese children following the last world financial crisis. A cross-sectional study was conducted on 4737 Portuguese children (3-11 yrs). Socio-demographics, food insecurity, and household geographic location were assessed via questionnaire. Nutritional status was measured. Following the economic crisis, 14.2% of school children and 12.0% of preschool children experienced HFI. Preschool children having parents with low and medium parental education (paternal: OR = 4.4; 95% CI 2.7-7.1 and OR = 2.4; 95% CI 1.5-3.6; maternal: OR = 2.2; 95% CI 1.4-3.5 and OR = 1.6; 95% CI 1.1-2.3), living in the south (OR = 1.4; 95% CI 1.0-2.0) and being overweight/obese (OR = 1.1; 95% CI 0.7-1.3) were more likely to experience HFI than food secure household peers. Higher OR of belonging to a food insecure household were observed in school-aged children with low and medium parental education (paternal: OR = 2.9; 95% CI 1.9-4.6 and OR = 1.7; 95% CI 1.1-2.5; maternal: OR = 2.5; 95% CI 1.6-3.9 and OR = 2.3; 95% CI 1.6-3.3), living in Coimbra (OR = 1.7; 95% CI 1.1-2.6) and being overweight/obese (OR = 1.3; 95% CI 0.8-1.5) compared to food secure household peers. Data are instructive and support the need to increase awareness of HFI, reduce its incidence in overweight/obese children from low socio-economic status families and specific geographic areas, and increase food availability based on local ecology.
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Affiliation(s)
- Maria-Raquel G Silva
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.,CHRC - Comprehensive Health Research Centre-Group of Sleep, Chronobiology and Sleep Disorders-Nova Medical School, University of Lisbon, Lisbon, Portugal
| | - Aristides M Machado-Rodrigues
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,High School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Daniela Rodrigues
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Portugal, Coimbra, Portugal
| | - Helena Nogueira
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal
| | - Vítor Rosado-Marques
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Augusta Gama
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Department of Animal Biology, Faculty of Sciences of the University of Lisbon, Portugal
| | - Cristina Padez
- CIAS - Research Centre for Anthropology and Health - Human Biology, Health and Society, University of Coimbra, Coimbra, Portugal.,Department of Life Sciences, University of Portugal, Coimbra, Portugal
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16
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Household food insecurity and children's physical activity and sedentary behaviour in the United States: the Healthy Communities Study. Public Health Nutr 2021; 25:381-388. [PMID: 34108064 PMCID: PMC8660938 DOI: 10.1017/s1368980021002536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: To examine associations between household food insecurity and children’s physical activity and sedentary behaviours. Design: Secondary analysis was conducted on the Healthy Communities Study, an observational study from 2013 to 2015. Household food insecurity was assessed by two items from the US Department of Agriculture’s 18-item US Household Food Security Survey Module. Physical activity was measured using the 7-d Physical Activity Behaviour Recall instrument. Data were analysed using multilevel statistical modelling. Setting: A total of 130 communities in the USA. Participants: In sum, 5138 US children aged 4–15 years. Results: No associations were found for the relationship between household food insecurity and child physical activity. A significant interaction between household food insecurity and child sex for sedentary behaviours was observed (P = 0·03). Conclusions: Additional research capturing a more detailed assessment of children’s experiences of food insecurity in relation to physical activity is warranted. Future studies may consider adopting qualitative study designs or utilising food insecurity measures that specifically target child-level food insecurity. Subsequent research may also seek to further explore sub-group analyses by sex.
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17
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Clemens KK, Le B, Anderson KK, Shariff SZ. Childhood food insecurity and incident diabetes: A longitudinal cohort study of 34 042 children in Ontario, Canada. Diabet Med 2021; 38:e14396. [PMID: 32876966 DOI: 10.1111/dme.14396] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/12/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022]
Abstract
AIM To examine the association between childhood food insecurity and incident diabetes. METHODS Using health administrative databases linked to the Canadian Community Health Survey, we conducted a population-based cohort study of children aged <18 years from Ontario, Canada. Children without diabetes who had a household response to the Canadian Community Health Survey Household Food Security Survey Module were followed for a median of 9.5 years for incident diabetes. Multivariable Cox proportional hazards models were used to examine the association between childhood food insecurity and incident diabetes, adjusted sequentially for important clinical and socio-economic risk factors. RESULTS We included 34 042 children, of whom 5.3% lived in food-insecure households. There were 184 new cases of diabetes, diagnosed at a median age of 16 and 18.5 years in food-secure and food-insecure children, respectively. In unadjusted analysis, childhood food insecurity was associated with an increased risk of incident diabetes (hazard ratio 1.69, 95% CI 1.01 to 2.81). When adjusted for clinical and socio-economic confounders, the relationship was no longer statistically significant (hazard ratio 1.55, 95% CI 0.91 to 2.66, adjusted for clinical confounders; hazard ratio 1.30, 95% CI 0.72 to 2.37, adjusted for clinical/socio-economic confounders). Our results remained robust in sensitivity analyses. CONCLUSIONS Although food-insecure children are a medically and socially vulnerable population, they do not appear to be at increased risk of incident diabetes over a median of 9.5 years.
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Affiliation(s)
- K K Clemens
- Department of Medicine, Division of Endocrinology and Metabolism, London, ON, Canada
- Department of Epidemiology and Biostatistics, London, ON, Canada
- ICES, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Centre for Diabetes, Endocrinology and Metabolism, St Joseph's Hospital, London, ON, Canada
| | | | - K K Anderson
- Department of Epidemiology and Biostatistics, London, ON, Canada
- ICES, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - S Z Shariff
- ICES, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
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18
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Hassink SG, Fairbrother G. Obesity and Hunger Threaten the Foundations of Child Health. Acad Pediatr 2021; 21:396-400. [PMID: 32798724 PMCID: PMC7424333 DOI: 10.1016/j.acap.2020.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/29/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022]
Affiliation(s)
| | - Gerry Fairbrother
- Fairbrother Policy Studies, LLC, Policy and Health Services, Academic Pediatrics (G Fairbrother), Santa Fe, NM
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Pediatric Adapted Liking Survey (PALS) with Tailored Nutrition Education Messages: Application to a Middle School Setting. Foods 2021; 10:foods10030579. [PMID: 33801962 PMCID: PMC8001433 DOI: 10.3390/foods10030579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/23/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022] Open
Abstract
We tested the feasibility of a school-based, liking-based behavioral screener (Pediatric Adapted Liking Survey (PALS)) and message program to motivate healthy diet and activity behaviors. Students, recruited from middle- (n = 195) or low-income (n = 310) schools, online-reported: likes/dislikes of foods/beverages and physical/sedentary activities, scored into healthy behavior indexes (HBI); perceived food insecurity; and sleep indicators. Students received tailored motivating or reinforcing messages (aligned with behavior change theories) and indicated their willingness to improve target behaviors as well as program feasibility (acceptability; usefulness). Although HBIs averaged lower in the lower versus middle-income school, frequencies of food insecurity were similar (39-44% of students). Students in both schools reported sleep concerns (middle-income school-43% reported insufficient hours of sleep/night; low-income school-55% reported excessive daytime sleepiness). Students across both schools confirmed the PALS acceptability (>85% agreement to answering questions quickly and completion without help) and usefulness (≥73% agreed PALS got them thinking about their behaviors) as well as the tailored message acceptability (≥73% reported the messages as helpful; learning new information; wanting to receive more messages) and usefulness (73% reported "liking" to try one behavioral improvement). Neither message type nor response varied significantly by food insecurity or sleep measures. Thus, this program feasibly delivered students acceptable and useful messages to motivate healthier behaviors and identified areas for school-wide health promotion.
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20
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Kreusler P, Vogel M, Willenberg A, Baber R, Dietz Y, Körner A, Ceglarek U, Kiess W. Folate and Cobalamin Serum Levels in Healthy Children and Adolescents and Their Association with Age, Sex, BMI and Socioeconomic Status. Nutrients 2021; 13:546. [PMID: 33562369 PMCID: PMC7915137 DOI: 10.3390/nu13020546] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 01/04/2023] Open
Abstract
This study proposes age- and sex-specific percentiles for serum cobalamin and folate, and analyzes the effects of sex, age, body mass index (BMI), and socioeconomic status (SES) on cobalamin and folate concentrations in healthy children and adolescents. In total, 4478 serum samples provided by healthy participants (2 months-18.0 years) in the LIFE (Leipzig Research Centre for Civilization Diseases) Child population-based cohort study between 2011 and 2015 were analyzed by electrochemiluminescence immunoassay (ECLIA). Continuous age-and sex-related percentiles (2.5th, 10th, 50th, 90th, 97.5th) were estimated, applying Cole's LMS method. In both sexes, folate concentrations decreased continuously with age, whereas cobalamin concentration peaked between three and seven years of age and declined thereafter. Female sex was associated with higher concentrations of both vitamins in 13- to 18-year-olds and with higher folate levels in one- to five-year-olds. BMI was inversely correlated with concentrations of both vitamins, whilst SES positively affected folate but not cobalamin concentrations. To conclude, in the assessment of cobalamin and folate status, the age- and sex-dependent dynamic of the respective serum concentrations must be considered. While BMI is a determinant of both vitamin concentrations, SES is only associated with folate concentrations.
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Affiliation(s)
- Paulina Kreusler
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (M.V.); (R.B.); (Y.D.); (A.K.); (U.C.); (W.K.)
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (M.V.); (R.B.); (Y.D.); (A.K.); (U.C.); (W.K.)
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Anja Willenberg
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Ronny Baber
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (M.V.); (R.B.); (Y.D.); (A.K.); (U.C.); (W.K.)
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Yvonne Dietz
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (M.V.); (R.B.); (Y.D.); (A.K.); (U.C.); (W.K.)
| | - Antje Körner
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (M.V.); (R.B.); (Y.D.); (A.K.); (U.C.); (W.K.)
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Uta Ceglarek
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (M.V.); (R.B.); (Y.D.); (A.K.); (U.C.); (W.K.)
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University Hospital Leipzig, 04103 Leipzig, Germany;
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (M.V.); (R.B.); (Y.D.); (A.K.); (U.C.); (W.K.)
- Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
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21
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Chau S, Oldman S, Smith SR, Lin CA, Ali S, Duffy VB. Online Behavioral Screener with Tailored Obesity Prevention Messages: Application to a Pediatric Clinical Setting. Nutrients 2021; 13:nu13010223. [PMID: 33466705 PMCID: PMC7828782 DOI: 10.3390/nu13010223] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity prevention involves promoting healthy eating and physical activity across all children. Can we leverage technology to feasibly survey children’s health behaviors and deliver theory-based and user-tailored messages for brief clinical encounters? We assessed the acceptability and utility of an online pediatric-adapted liking survey (PALS) and tailored messages among children receiving non-urgent care in a pediatric emergency department (PED). Two hundred and forty-five children (average age = 10 years, racially/ethnically diverse, 34% overweight/obese from measured indices, 25% of families reporting food insecurity) and their parents/caregivers participated. Each reported the child’s activity and behaviors using the online PALS and received two to three messages tailored to the responses (aligned with elaboration likelihood and transtheoretical models) to motivate behavioral improvements or reinforce healthy behaviors. Most children and parents (>90%) agreed the PALS was easy to complete, encouraging thought about their own/child’s behaviors. The child’s PALS responses appeared reasonable (fair-to-good child–parent intraclass correlations). Most children and parents (≥75%) reported the tailored messages to be helpful and favorable for improving or maintaining the targeted behavior. Neither message type (motivating/reinforcing) nor favorability responses varied significantly by the child’s weight or family’s food security status. In summary, children and parents found the PALS with tailored messages acceptable and useful. The message types and responses could help focus brief clinical encounters.
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Affiliation(s)
- Sarah Chau
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
| | - Samantha Oldman
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
| | - Sharon R. Smith
- CT Children’s Medical Center, University of CT School of Medicine, Hartford, CT 06269-1101, USA;
| | - Carolyn A. Lin
- Communications Department, University of CT, Storrs, CT 06269-1101, USA;
| | - Saba Ali
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (S.C.); (S.O.); (S.A.)
- Correspondence: ; Tel.: +1-860-486-1997
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22
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Pourmotabbed A, Moosavian SP, Hadi A, Mohammadi H, Dadfarma A, Rezaei S, Babaei A, Moradi S, Mirzaei K. The Relationship between Food Insecurity and Risk of Overweight or Obesity in under 18 Years Individuals: A Systematic Review and Meta-Analysis. Int J Prev Med 2020; 11:158. [PMID: 33312467 PMCID: PMC7716614 DOI: 10.4103/ijpvm.ijpvm_463_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/23/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Food insecurit (FI) has been considered as reason for childhood and adolescent overweight/obesity (OW/OB). Hence, this study was undertaken to assess these relationships. DESIGN Related articles were found by searching the Web of Science, Scopus, PubMed and Embase databases until October 2019. Odds ratio (OR) was analized by a random-effects model. Standard methods were used for assessment of heterogeneity and publication bias. Data were available from 32 studies. The risk ratios of 139,762 participants were pooled from these articles for the meta-analysis. RESULTS This study domenstrated that children and adolescents in food-insecure condition are not at risk of OW/OB (OR = 1.02 95% CI: 0.99, 1.05). However, subgroup analysis indicated that FI related with inhanced risk of OW/OB in adolescents living in developed countries (OR = 1.14; 95% CI: 1.02, 1.27). Other subgroup analysis indicated that severe FI increased the risk of OW/OB among adolescents (OR = 1.24 95% CI: 1.03-1.49). In addition, we found that lower economic development significantly decreased risk of OW/OB among under 6 year children (OR = 0.88; 95% CI: 0.84, 0.93). CONCLUSIONS Our results showed that higher FI degrees were related with more risks of OW/OB among adolescents (12-18 years). Moreover, the country economic levels had effect on the association between FI and risk of OW/OB.
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Affiliation(s)
- Ali Pourmotabbed
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyedeh Parisa Moosavian
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Dadfarma
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahabeddin Rezaei
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Babaei
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajjad Moradi
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khadijah Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Thompson HR, Gosliner W, Ritchie L, Wobbekind K, Reed AL, O'Keefe O, Madsen KA. The Impact of a Multipronged Intervention to Increase School Lunch Participation among Secondary School Students in an Urban Public School District. Child Obes 2020; 16:S14-S22. [PMID: 32159376 DOI: 10.1089/chi.2019.0233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction: Schools meals offer a critical opportunity for improving youths' diets, particularly for economically disadvantaged students. We examine the impact of a multipronged intervention to increase middle and high school students' lunch participation in an urban school district. Methods: In school years 2015-2016 through 2017-2018, a quasi-experimental study was conducted in 24 secondary schools, half (n = 12) of which received the following intervention: cafeteria redesign, additional school lunch points-of-sale (mobile carts and vending machines), and teacher education. Results: From baseline to follow-up, lunch participation dropped 4.1% in intervention and 5.1% in comparison schools (difference-in-difference 1.0%, 95% CI 0.5-1.4). The overall decline in lunch participation occurred simultaneously with a drop-in free or reduced-price meal eligibility (from 72% to 58%) across all schools, which is likely related to changing local economic conditions, including a county-wide minimum wage increase that began in summer 2015. Among students eligible for free or reduced-price meals, participation decreased 1.8% in intervention and 4.9% in comparison schools (difference-in-difference 3.1%, 95% CI: 2.5-3.7), with a larger difference-in-difference seen in high schools (5.0%, 95% CI: 4.2-5.9) than middle schools (1.8%, 95% CI: 0.8-2.6). Conclusions: While this intervention demonstrated a modest, but significant relative increase in school lunch participation, the effect was not sufficient to halt large district-wide declines in participation during this study period. Given the significant time, money, and political capital required to implement the intervention, districts should carefully consider similar investments. Broader public policies or other changes to economic conditions that affect eligibility for means-tested benefits-in this case, a strengthening local economy coupled with an increased local minimum wage-may influence school lunch participation more than school-level interventions.
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Affiliation(s)
- Hannah R Thompson
- Division of Community Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
| | - Wendi Gosliner
- Nutrition Policy Institute, UC Agriculture and Natural Resources, Berkeley, CA, USA
| | - Lorrene Ritchie
- Nutrition Policy Institute, UC Agriculture and Natural Resources, Berkeley, CA, USA
| | - Kate Wobbekind
- Student Nutrition Services, San Francisco Unified School District, San Francisco, CA, USA
| | - Annie L Reed
- Division of Community Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
| | - Orla O'Keefe
- Chief of Policy and Operations, San Francisco Unified School District, San Francisco, CA, USA
| | - Kristine A Madsen
- Division of Community Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
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Deal BJ, Huffman MD, Binns H, Stone NJ. Perspective: Childhood Obesity Requires New Strategies for Prevention. Adv Nutr 2020; 11:1071-1078. [PMID: 32361757 PMCID: PMC7490151 DOI: 10.1093/advances/nmaa040] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 02/06/2023] Open
Abstract
The prevalence of obesity among youth in the USA is currently >18% with projections that more than half of today's children will be obese as adults. The growth trajectory of children more likely to become obese is determined by weight in earliest childhood, and childhood body mass index (BMI) tracks through adolescence and adulthood. Childhood consequences of obesity include increased risk of asthma, type 2 diabetes mellitus, orthopedic disorders, and reduced academic performance. Health implications of obesity in adulthood include premature coronary artery disease, hypertension, type 2 diabetes, stroke, and certain cancers, contributing to the leading causes of adult mortality. Early childhood obesity is influenced by prenatal exposure to maternal obesity and environmental obesogens, and is associated with poverty, food insecurity, and poor nutritional quality. New strategies for primordial prevention of early childhood obesity require focusing attention on growth parameters during the first 2 y of life, with support for increasing the duration of breastfeeding, and improvements in dietary quality and availability, particularly the reduced consumption of added sugars. Reducing the prevalence of obesity among adolescent females and reducing exposure to environmental obesogens may reduce the prevalence of transgenerational obesity. The reduction of early childhood obesity could improve population health, quality of life, and longevity throughout the life course.
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Affiliation(s)
| | - Mark D Huffman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA,The George Institute for Global Health, Sydney, Australia
| | - Helen Binns
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Neil J Stone
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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25
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Adolescent Obesity: Diet Quality, Psychosocial Health, and Cardiometabolic Risk Factors. Nutrients 2019; 12:nu12010043. [PMID: 31877943 PMCID: PMC7020092 DOI: 10.3390/nu12010043] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 01/03/2023] Open
Abstract
Obesity is a multifaceted chronic condition with several contributing causes, including biological risk factors, socioeconomic status, health literacy, and numerous environmental influences. Of particular concern are the increasing rates of obesity in children and adolescents, as rates of obesity in youth in the United States have tripled within the last three decades. Youth from historically disadvantaged backgrounds tend to have higher rates of obesity compared to other groups. Adolescents often do not meet intake recommendations for certain food groups and nutrients, which may contribute to a heightened risk of obesity. With obesity disproportionately affecting adolescents (ages 12–19 years), negative effects of excess adiposity may be particularly salient during this critical period of development. The presentation of chronic cardiometabolic disease symptoms typically observed in adults, such as hypertension, hyperglycemia, dyslipidemia, and inflammation, are becoming increasingly common in adolescents with obesity. Additionally, there is dynamic interplay between obesity and psychosocial health, as adolescents with obesity may have increased levels of stress, depressive symptoms, and reduced resilience. To reduce and prevent adolescent obesity, the implementation of theory-driven multicomponent school- and community-based interventions have been suggested. These interventions promote knowledge and self-efficacy for healthful practices that have the potential to progress to sustained behavior change.
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