1
|
Whiteoak B, Dawson SL, Callaway L, de Jersey S, Eley V, Evans J, Kothari A, Navarro S, Gallegos D. Food Insecurity Is Associated with Diet Quality in Pregnancy: A Cross-Sectional Study. Nutrients 2024; 16:1319. [PMID: 38732568 PMCID: PMC11085356 DOI: 10.3390/nu16091319] [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: 03/24/2024] [Revised: 04/10/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Household food insecurity (HFI) and poorer prenatal diet quality are both associated with adverse perinatal outcomes. However, research assessing the relationship between HFI and diet quality in pregnancy is limited. A cross-sectional online survey was conducted to examine the relationship between HFI and diet quality among 1540 pregnant women in Australia. Multiple linear regression models were used to examine the associations between HFI severity (marginal, low, and very low food security compared to high food security) and diet quality and variety, adjusting for age, education, equivalised household income, and relationship status. Logistic regression models were used to assess the associations between HFI and the odds of meeting fruit and vegetable recommendations, adjusting for education. Marginal, low, and very low food security were associated with poorer prenatal diet quality (adj β = -1.9, -3.6, and -5.3, respectively; p < 0.05), and very low food security was associated with a lower dietary variety (adj β = -0.5, p < 0.001). An association was also observed between HFI and lower odds of meeting fruit (adjusted odds ratio [AOR]: 0.61, 95% CI: 0.49-0.76, p < 0.001) and vegetable (AOR: 0.40, 95% CI: 0.19-0.84, p = 0.016) recommendations. Future research should seek to understand what policy and service system changes are required to reduce diet-related disparities in pregnancy.
Collapse
Affiliation(s)
- Bree Whiteoak
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD 4059, Australia;
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD 4101, Australia;
- QIMR Berghofer Medical Research Institute, 300 Herston Rd., Herston, QLD 4006, Australia
| | - Samantha L. Dawson
- Food & Mood Centre, IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3220, Australia;
| | - Leonie Callaway
- Women’s and Newborns Services, Royal Brisbane and Women’s Hospital, Herston, QLD 4006, Australia;
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
| | - Susan de Jersey
- Department of Dietetics and Foodservices, Royal Brisbane and Women’s Hospital, Herston, QLD 4006, Australia;
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia
| | - Victoria Eley
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, Herston, QLD 4006, Australia
| | - Joanna Evans
- Maternity Services, Caboolture Hospital, McKean Street, Caboolture, QLD 4510, Australia;
| | - Alka Kothari
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
- Redcliffe Hospital, Anzac Avenue, Redcliffe, QLD 4020, Australia
| | - Severine Navarro
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD 4101, Australia;
- QIMR Berghofer Medical Research Institute, 300 Herston Rd., Herston, QLD 4006, Australia
- Faculty of Medicine, The University of Queensland, 288 Herston Rd., Herston, QLD 4006, Australia; (V.E.); (A.K.)
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD 4059, Australia;
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD 4101, Australia;
| |
Collapse
|
2
|
Murray S, Gale F, Adams D, Dalton L. Evolution of Food and Nutrition Policy: A Tasmanian Case Study from 1994 to 2023. Nutrients 2024; 16:918. [PMID: 38612952 PMCID: PMC11013732 DOI: 10.3390/nu16070918] [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: 01/30/2024] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
Food security is a concept with evolving definitions and meanings, shaped by contested knowledge and changing contexts. The way in which food security is understood by governments impacts how it is addressed in public policy. This research investigates the evolution of discourses and practices in Tasmanian food and nutrition policies from 1994 to 2023. Four foundational documents were analysed using qualitative document analysis, revealing persistent food insecurity issues over three decades. The analysis identified a duality in addressing the persistent policy challenges of nutrition-related health issues and food insecurity: the balancing act between advancing public health improvements and safeguarding Tasmania's economy. The research revealed that from 1994 to 2023, Tasmania's food and nutrition policies and strategies have been characterised by various transitions and tensions. Traditional approaches, predominantly emphasising food availability and, to a limited extent, access, have persisted for over thirty years. The transition towards a more contemporary approach to food security, incorporating dimensions of utilisation, stability, sustainability, and agency, has been markedly slow, indicating systemic inertia. This points to an opportunity for future policy evolution, to move towards a dynamic and comprehensive approach. Such an approach would move beyond the narrow focus of food availability to address the complex multi-dimensional nature of food security.
Collapse
Affiliation(s)
- Sandra Murray
- School of Health Science, University of Tasmania, Launceston, TAS 7250, Australia
| | - Fred Gale
- School of Social Sciences, University of Tasmania, Launceston, TAS 7250, Australia;
| | - David Adams
- Tasmanian School of Business and Economics, University of Tasmania, Launceston, TAS 7250, Australia;
| | - Lisa Dalton
- School of Health Science, University of Tasmania, New Norfolk, TAS 7140, Australia;
| |
Collapse
|
3
|
Molenaar A, Bucello P, Kleve S. Harnessing community expertise in understanding food insecurity to inform responses in a local government area in Victoria, Australia: a mixed methods photovoice study. BMC Public Health 2023; 23:1996. [PMID: 37833654 PMCID: PMC10571378 DOI: 10.1186/s12889-023-16796-0] [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: 03/28/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Local food systems which support affordable, equitable, accessible, and sustainable food are important to enhance food access and reduce food insecurity. Cardinia Shire Council, a local government in Victoria, Australia has developed and endorsed a 'Community Food Strategy' to support their local food system and food security. This study aimed to explore local government community member perspectives regarding food access within their local food environment, and suggested areas to be addressed to better support access. METHODS A sequential mixed methods photovoice methodology was implemented. Participants aged over 18 years, who resided in Cardinia Shire, completed an online quantitative survey to explore demographics, food access and food security status and severity (18-item USDA Household Food Security Survey Module). The qualitative photovoice method was used, whereby participants were asked to take photographs that represent their experiences of food access. These photographs were used as prompts in a semi-structured interview Interview data were thematically analysed. RESULTS Seventeen participants completed the study, of which five participants experienced varied severity levels of food insecurity. From the photovoice interviews four themes were developed: 1) Food: a connector to self, people and place, 2) Influencers of food access and triggers for food insecurity, 3) Savvy food literacy skills to support access to food, 4) Consequences of and struggles with food insecurity. Participants suggested recommendations for action to support future food access in their community. CONCLUSIONS While food choice is influenced by a range of determinants, the local food environment greatly impacts both food access and food choice. A supportive local food system which promotes inclusion of a community voice, community connectedness, food literacy and physical and economic access to local produce is crucial to support food security.
Collapse
Affiliation(s)
- Annika Molenaar
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | | | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.
| |
Collapse
|
4
|
McKay FH, McKenzie H, Lindberg R. The coping continuum and acts reciprocity - a qualitative enquiry about household coping with food insecurity in Victoria, Australia. Aust N Z J Public Health 2023; 47:100004. [PMID: 36706551 DOI: 10.1016/j.anzjph.2022.100004] [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: 05/11/2022] [Revised: 10/20/2022] [Accepted: 10/30/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Food insecurity exists when a household has limited or uncertain access to food. This paper explores the strategies employed by households who are already accessing emergency and community food assistance to meet their food needs. METHOD Interviews to explore strategies used to mitigate food insecurity of people living in Victoria, Australia, between June 2018 and January 2019. Data were analysed thematically. RESULTS Seventy-eight interviews were conducted. Analysis resulted in two themes highlighting the range of coping strategies employed to mitigate the impacts of food insecurity; broadly described as 1) the coping continuum and 2) coping reciprocity. CONCLUSIONS Food insecure households employ a range of strategies to secure food. Households that engage with the emergency and community food sector are described as in crisis or struggling, often skipping meals or reducing food consumed, or as coping and managing, characterised by bulking meals and growing food. IMPLICATIONS FOR PUBLIC HEALTH Coping with food insecurity exists on a continuum from crisis to management and reciprocity. With the prevalence of food insecurity expected to increase, some of these coping strategies will need to be incorporated into the practice of emergency and community food providers to assist households to meet food needs.
Collapse
Affiliation(s)
- Fiona H McKay
- The School of Health and Social Development and the Institute for Health Transformation, Deakin University, Locked Bag 20,000 Geelong, Victoria, 3220, Australia.
| | - Hayley McKenzie
- The School of Health and Social Development and the Institute for Health Transformation, Deakin University, Locked Bag 20,000 Geelong, Victoria, 3220, Australia
| | - Rebecca Lindberg
- The Institute for Physical Activity and Nutrition Science (IPAN) and the School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 20,000 Geelong, Victoria, 3220, Australia
| |
Collapse
|
5
|
McKay FH, Zinga J, van der Pligt P. Consensus from an expert panel on how to identify and support food insecurity during pregnancy: A modified Delphi study. BMC Health Serv Res 2022; 22:1231. [PMID: 36199090 PMCID: PMC9533284 DOI: 10.1186/s12913-022-08587-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/29/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background Food insecurity and hunger during pregnancy have significant implications for the health of the mother and baby. Assisting clinicians when they encounter women who are experiencing hunger or food insecurity during their pregnancy will increase the opportunity for better birth and pregnancy outcomes. At present there are no guidelines for Australian clinicians on how to do this. Methods This study uses a modified Delphi technique, allowing diverse participation in the process, to create consensus on the ways to address and respond to food insecurity during pregnancy. This modified Delphi collected data via two rounds of consensus. The opinions collected from the first round were thematically categorised and grouped. The topics were integrated into the survey for the second round and circulated to participants. During the second round, priorities were scored by giving five points to the topic considered most important, and one point to the least important. Results Through two rounds of consultation, the panel achieved consensus on how to identify food insecurity during pregnancy, with some clear items of consensus related to interventions that could be implemented to address food insecurity during pregnancy. Experts achieved consensus on items that have importance at the institution and policy level, as well as services that exist in the community. The consensus across the spectrum of opportunities for assistance, from the clinical, to community-provided assistance, and on to government policy and practice demonstrate the complexity of this issue, and the multipronged approach that will be required to address it. Conclusion This is the first time such a consultation with experts on hunger and food insecurity during pregnancy has been conducted in Australia. Items that achieved consensus and the importance of the issue suggest several ways forward when working with pregnant women who are hungry and/or food insecure. Supplementary information The online version contains supplementary material available at 10.1186/s12913-022-08587-x.
Collapse
Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Deakin University, 3220, Geelong, VIC, Australia.
| | - Julia Zinga
- School of Health and Social Development, Institute for Health Transformation, Faculty of Health, Deakin University, 3220, Geelong, VIC, Australia.,Department of Nutrition and Dietetics, Royal Women's Hospital, Parkville, VIC, Australia
| | - Paige van der Pligt
- The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, 3220, Geelong, VIC, Australia.,Department of Nutrition Western Health, Footscray, Australia
| |
Collapse
|
6
|
Dawson N, Lawlis T. Exploring Food Charity Managers Perceived Barriers to Food Security for Vulnerable Women in the Australian Capital Territory Region: A Qualitative Study. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2107414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Nicole Dawson
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Tanya Lawlis
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| |
Collapse
|
7
|
A Food Relief Charter for South Australia-Towards a Shared Vision for Pathways Out of Food Insecurity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127080. [PMID: 35742343 PMCID: PMC9222515 DOI: 10.3390/ijerph19127080] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023]
Abstract
Chronic food insecurity persists in high-income countries, leading to an entrenched need for food relief. In Australia, food relief services primarily focus on providing food to meet immediate need. To date, there has been few examples of a vision in the sector towards client outcomes and pathways out of food insecurity. In 2016, the South Australian Government commissioned research and community sector engagement to identify potential policy actions to address food insecurity. This article describes the process of developing a co-designed South Australian Food Relief Charter, through policy–research–practice collaboration, and reflects on the role of the Charter as both a policy tool and a declaration of a shared vision. Methods used to develop the Charter, and resulting guiding principles, are discussed. This article reflects on the intentions of the Charter and suggests how its guiding principles may be used to guide collective actions for system improvement. Whilst a Charter alone may be insufficient to create an integrated food relief system that goes beyond the provision of food, it is a useful first step in enabling a culture where the sector can have a unified voice to advocate for the prevention of food insecurity.
Collapse
|
8
|
McCann J, Beckford K, Beswick H, Chisholm M, Woods J. Toddler foods and milks don't stack up against regular foods and milks. Nutr J 2022; 21:12. [PMID: 35209925 PMCID: PMC8876127 DOI: 10.1186/s12937-022-00765-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/08/2022] [Indexed: 12/29/2022] Open
Abstract
AIM To compare the cost and nutritional profiles of toddler-specific foods and milks to 'regular' foods and milks. METHODS Cross-sectional audit of non-toddler specific ('regular') foods and milks and secondary analysis of existing audit data of toddler specific (12-36 months) foods and milks in Australia. MAIN FINDINGS The cost of all toddler-specific foods and milks was higher than the regular non-toddler foods. Foods varied in nutritional content, but toddler foods were mostly of poorer nutritional profile than regular foods. Fresh milk cost, on average, $0.22 less per 100 mL than toddler milk. Toddler milks had higher mean sugar and carbohydrate levels and lower mean protein, fat, saturated fat, sodium and calcium levels per 100 mL, when compared to fresh full fat cow's milk. CONCLUSIONS Toddler specific foods and milks cost more and do not represent value for money or good nutrition for young children.
Collapse
Affiliation(s)
- Jennifer McCann
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | | | | | - Julie Woods
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| |
Collapse
|
9
|
Working through Disaster Risk Management to Support Regional Food Resilience: A Case Study in North-Eastern Australia. SUSTAINABILITY 2022. [DOI: 10.3390/su14042466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
As a consequence of disasters such as pandemics and severe weather events, Australian communities often face ‘food shortages’ resulting from the reduced availability of food and reduced access to available food. These food shortages can be acutely felt by vulnerable populations, comprising people in communities who are already dealing with social or economic disadvantages. Despite growing calls to ensure food access for everyone during and following disasters, efforts are still largely ad hoc, champion based and highly variable in their reliability and quality of supply. There is also a disconnect between disaster-related food relief and improving business continuity towards local economic resilience. This study sought to tackle these challenges by exploring how ‘local food access’ could be integrated within disaster management mechanisms, to support the most vulnerable and also contribute to local economic resilience. This paper discusses the findings of a study undertaken in Cairns, a north-eastern Australian regional authority, and involves a review of disaster management planning and policy artifacts, an online survey, and semi-structured interviews with stakeholders providing care and advocacy for vulnerable populations. Synthesizing the findings, we present a disaster-management-focused ‘Local Food Access Model’ that connects shorter food supply chains to improved disaster response, resilience and contingency-planning agendas. Applying this model to Cairns, we conclude the multiple benefits and immediate stakeholder readiness for a virtual (online) food resilience and contingency hub, to enable the connection of local food availability and access information within existing disaster management processes. The research method used, the model, and the case-specific findings provide government decision makers with a useful process, a local food-access schematic and a case study example to support immediate improvements in disaster resilience for vulnerable populations.
Collapse
|
10
|
Lindberg R, McKenzie H, Haines B, McKay FH. An investigation of structural violence in the lived experience of food insecurity. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2021.2019680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Rebecca Lindberg
- The Institute of Physical Activity and Nutrition Sciences (IPAN), Deakin University, Geelong, Australia
| | - Hayley McKenzie
- The School of Health and Social Development, Deakin University, Geelong, Australia
| | - Brontë Haines
- The School of Health and Social Development, Deakin University, Geelong, Australia
| | - Fiona H McKay
- The School of Health and Social Development, Deakin University, Geelong, Australia
| |
Collapse
|