1
|
Inoue M, Masa R, Prieto L, Baruah D, Kellermeyer K, Booker E, Sweeney G. Prevalence and Correlates of Food Insecurity Among Older Adults in the United States. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:738-755. [PMID: 38739384 DOI: 10.1080/01634372.2024.2339975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 04/03/2024] [Indexed: 05/14/2024]
Abstract
This study analyzed the 2021 National Health Interview Survey (NHIS) to assess food insecurity among adults aged 65 and older. Among 8,877 older adults, 4 percent (N=287) reported low or very low food security levels. Those who identified as Black or African American and Hispanic or Latino were more likely to experience food insecurity compared to White individuals. The study found that merely surpassing the poverty threshold might not be sufficient to protect against food insecurity. It also underscored socioemotional support's protective role in older adults' food security. Social workers must recognize various factors influencing food security among older adults.
Collapse
Affiliation(s)
- Megumi Inoue
- Department of Social Work, George Mason University, Virginia, USA
| | - Rainier Masa
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lucas Prieto
- Department of Social Work, George Mason University, Virginia, USA
| | - Dicky Baruah
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Emma Booker
- Department of Social Work, George Mason University, Virginia, USA
| | - Grace Sweeney
- Department of Social Work, George Mason University, Virginia, USA
| |
Collapse
|
2
|
Aljahdali AA, Ludwig-Borycz E, Leung CW. Food insecurity, inflammation, and immune function among older US adults: Findings from the health and Retirement study. Brain Behav Immun 2024; 119:28-35. [PMID: 38552920 PMCID: PMC11162895 DOI: 10.1016/j.bbi.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/10/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Food insecurity (FI) is a pressing public health concern among older adults and has been associated with adverse cardiovascular outcomes. Greater systemic inflammation may provide a pathway to explain these associations, but few studies have examined the link between FI and markers of inflammation. Thus, the objective of the present study was to evaluate the associations between FI and multiple inflammatory and immune functioning biomarkers using a nationally representative study of US adults aged > 50 years. METHOD Participants (n = 3,924) were drawn from the longitudinal Health and Retirement Study (HRS). Household FI was assessed using the six-item Short Form Food Security Survey Module from the 2013 HRS Health Care and Nutrition Study. Markers of inflammation (neutrophil-lymphocyte ratio, albumin, hs-CRP, IL6, IL10, IL-1Ra, sTNFR-1, and TGFβ-1) and immune functioning (CMV) were collected during the 2016 HRS Venous Blood Study. Multivariate logistic and linear regression models were used to evaluate associations between household FI and inflammatory and immune functioning biomarkers, adjusting for individual and household sociodemographic characteristics. RESULTS The weighted prevalence of FI was 18.8 %. Age and sex-adjusted mean showed that FI was associated with higher levels of inflammation and impaired immune functioning (Ps-value < 0.05). Older adults with FI had higher mean levels of albumin, hs-CRP, IL6, IL10, IL-1Ra, TGFß-1, and CMV seronegative and borderline (Ps-value < 0.05). Multivariate-adjusted regression model showed that FI was associated with high-risk categories of hs-CRP (OR 1.34, 95 % CI 1.06, 1.68), IL-6 (OR 1.66, 95 % CI 1.28, 2.14), IL-1Ra (OR 0.67, 95 % CI 0.48, 0.93), TGFß-1 (OR 1.87, 95 % CI 1.45, 2.42), seronegativity for CMV (OR 0.48, 95 % CI 0.35, 0.64). CONCLUSION In this nationally representative sample of older adults, FI was positively associated with multiple markers of systemic inflammation and impaired immune functioning. Public health efforts that directly work to reduce FI among older adults are warranted and may result in further improvements in their health and well-being.
Collapse
Affiliation(s)
- Abeer A Aljahdali
- Department of Clinical Nutrition, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Department of Nutritional Sciences, University of Michigan, Ann Arbor MI 48109, USA.
| | | | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan, Ann Arbor MI 48109, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston MA 02115, USA.
| |
Collapse
|
3
|
Almohamad M, Dave JM, Calloway EE, Li R, Sharma S. Relationship between Food Security, Nutrition Security, and Diabetes: The Role of Supplemental Nutrition Assistance Program Participation. Curr Dev Nutr 2024; 8:102153. [PMID: 38693968 PMCID: PMC11061707 DOI: 10.1016/j.cdnut.2024.102153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 05/03/2024] Open
Abstract
Background Inadequate nutrition and poor diet quality are associated with a heightened risk of diabetes. The connection between food insecurity measures and diabetes has been established, with evidence indicating that Supplemental Nutrition Assistance Program (SNAP) participation contributes to reductions in food insecurity. Recently developed nutrition security measures, defined as the ability to acquire healthful foods to prevent diseases, and their association with diabetes and SNAP participation are not yet understood. Objectives This study aimed to assess the relationship between food security and nutrition security in relation to diabetes overall and by SNAP participation and nutrition security as potential modifiers. Methods Secondary data analysis of cross-sectional pilot study data collected from adults in 5 US states (N = 517). Logistic regression mixed models included moderation analysis and clustering effects by state to address site-level confounding. Results Higher nutrition security scores among adults, after adjusting for confounders, were significantly associated with lower odds of diabetes risk (adjusted odds ratio = 0.59; 95% confidence interval: 0.40, 0.87; P value = 0.008). Statistically significant interaction effect of differences according to SNAP participation was observed for nutrition security (Phomogeneity/interaction = 0.021), adjusting for age, gender, race/ethnicity, education, employment, National School Lunch Program, Special Supplemental Nutrition Program for Women, Infants, and Children, food pantry use, household with children, survey mode, and food security. The association between food security and diabetes was not statistically significant overall. However, statistically significant interaction effect of differences according to SNAP participation was observed for food security (Phomogeneity/interaction = 0.047). Further, no interaction effect of differences in nutrition security was found between food security and self-reported diabetes/prediabetes (Phomogeneity/interaction = 0.250). Conclusions This study sheds light on the early exploration of the intricate relationship between nutrition security and diabetes. The findings suggest that a higher nutrition security score, after adjusting for confounders, was significantly associated with lower odds of diabetes risk. Notably, there were statistically significant interaction effects in these associations based on SNAP participation.
Collapse
Affiliation(s)
- Maha Almohamad
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, United States
| | - Jayna M Dave
- US Department of Agriculture/ Agricultural Research Service Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Eric E Calloway
- Gretchen Swanson Center for Nutrition, Omaha, NE, United States
| | - Ruosha Li
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, United States
| | - Shreela Sharma
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, United States
| |
Collapse
|
4
|
Xu L, Plakias Z, Hanks AS, Garner J. Food insecurity, fruit and vegetable consumption, and use of the Supplemental Nutrition Assistance Program (SNAP) in Appalachian Ohio. PLoS One 2024; 19:e0295171. [PMID: 38329953 PMCID: PMC10852251 DOI: 10.1371/journal.pone.0295171] [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: 04/10/2023] [Accepted: 11/16/2023] [Indexed: 02/10/2024] Open
Abstract
Food insecurity and inadequate nutrition are two major challenges that contribute to poor health conditions among U.S. households. Ohioans continue to face food insecurity, and rates of food insecurity in rural Southeast Ohio are higher than the state average. The main purpose of this project is to evaluate the associations between Supplemental Nutrition Assistance Program (SNAP) participation and food security in rural Ohio, and to explore the association between SNAP participation and fruit/vegetable consumption. We control for food shopping patterns, such as shopping frequency, because previous research reports a significant relationship between shopping patterns and food security. To achieve our purpose, we use novel household-level data on food insecurity and SNAP participation in rural Southeast Ohio, collected during the COVID-19 pandemic. We find that people who experience higher levels of food insecurity than others are more likely to participate in SNAP, though this is likely a function of selection bias. To correct for the bias, we employ the nearest neighbor matching method to match treated (SNAP participant) and untreated (similar SNAP nonparticipant) groups. We find that participating in SNAP increases the probability of being food secure by around 26 percentage points after controlling for primary food shopping patterns. We do not find any significant association between SNAP participation and estimated intake of fruits and vegetables. This study provides policymakers with suggestive evidence that SNAP is associated with food security in rural Southeast Ohio during the pandemic, and what additional factors may mediate these relationships.
Collapse
Affiliation(s)
- Lei Xu
- Department of Agricultural, Environmental, and Development Economics, The Ohio State University, Columbus, OH, United States of America
| | - Zoë Plakias
- Department of Economics, Western Washington University, Bellingham, Washington, United States of America
| | - Andrew S. Hanks
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States of America
| | - Jennifer Garner
- Department of Nutritional Sciences, University of Michigan School of Public Health, Columbus, OH, United States of America
| |
Collapse
|
5
|
Kibe LW, Schrode K, Bazargan M, Shaheen M. Impact of food insecurity and food environment on the diet quality of older African Americans during the COVID-19 pandemic. Front Public Health 2023; 11:1268961. [PMID: 38035278 PMCID: PMC10682682 DOI: 10.3389/fpubh.2023.1268961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction A high quality diet is vital in promoting wellbeing and ensuring good health, particularly for those living with chronic conditions. Older African Americans, already burdened with a higher prevalence of chronic conditions, also face a higher risk for suboptimal diets. The COVID-19 pandemic had lasting effects on access to healthy food for all Americans, but some demographic groups were disproportionately affected. Older African Americans, who already experienced reduced access to healthy food pre-pandemic, were particularly afflicted, but the full extent of the pandemic's impact on their food insecurity and food environment remains unclear. Methods To address this gap, we conducted a study among 102 older African Americans in South Los Angeles between October 2021 and July 2022 during the COVID-19 pandemic. Participants completed surveys on dietary intake, food insecurity, and neighborhood food environment. We measured dietary quality using the healthy eating index (HEI)-2015. The analysis included descriptive, bivariate chi-square, t-tests, analysis of variance, and multiple linear and logistic regression. Results While overall dietary quality was suboptimal, most participants met the guidelines for fruit and vegetable consumption. Food insecurity was associated with lower overall diet quality and lower total fruit and whole fruit intake. However, there was no association between food environment and diet quality. Discussion In light of our findings, further intervention is critical to improving diet quality, especially among older African Americans living with chronic conditions in the post-pandemic era.
Collapse
Affiliation(s)
- Lucy W. Kibe
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Katrina Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Mohsen Bazargan
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Magda Shaheen
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| |
Collapse
|
6
|
Fong JH. Risk Factors for Food Insecurity among Older Adults in India: Study Based on LASI, 2017-2018. Nutrients 2023; 15:3794. [PMID: 37686826 PMCID: PMC10490409 DOI: 10.3390/nu15173794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Food security is linked to the nutritional status and well-being of older adults. India is a rapidly aging nation that ranks highly on the 2022 Global Hunger Index. This paper examines the prevalence and risk factors of food insecurity in India's older population. METHODS We used data from the 2017-2018 Longitudinal Aging Study in India. The sample size was 31,532 adults aged 60 years and above. Food insecurity was measured using a four-item version of the Food Insecurity Experience scale. Multivariable logistic regressions using individual-level weights were implemented to assess the risk factors of food insecurity. RESULTS The prevalence of food insecurity was 10.5% in the weighted sample. Sociodemographic factors were important in explaining food insecurity. Older adults who were male, younger, lowly educated, socially disadvantaged, in rural areas, and outside the Northern region were most vulnerable to food insecurity, controlling for various confounders. Additionally, low economic status, no occupational pension, currently working, social isolation, physical impairment, functional disabilities, poor self-rated health, and arthritis were associated with an increased risk of food insecurity. CONCLUSIONS More active food assistance programs catering to older adults and a better provision of economic and social security are warranted to establish a food-secure environment for rapidly aging India.
Collapse
Affiliation(s)
- Joelle H Fong
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore 259771, Singapore
| |
Collapse
|
7
|
Pengpid S, Peltzer K. Food insecurity and health outcomes among community-dwelling middle-aged and older adults in India. Sci Rep 2023; 13:1136. [PMID: 36670204 PMCID: PMC9859825 DOI: 10.1038/s41598-023-28397-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
The study assessed associations between food insecurity and mental, physical, and behavioural health outcomes in India. The study analysed national cross-sectional population-based data (N = 72,262; ≥ 45 years) from in India in 2017-2018. The overall prevalence of food insecurity was 9.7%. Food insecurity was significantly positively associated with poor mental health [low life satisfaction (AOR: 2.75, 95% CI 2.35-3.23), low self-reported health (AOR: 1.61, 95% CI 1.11-1.42), insomnia symptoms (AOR: 1.64, 95% CI 1.45-1.85), depressive symptoms (AOR: 2.21, 95% CI 1.97-2.48), major depressive disorder (AOR: 2.37, 95% CI 2.03-2.77), Alzheimer's/dementia (AOR: 1.75, 95% CI 1.13-2.69), and poorer cognitive functioning (AOR: 0.68, 95% CI 0.49-0.93)], poor physical health [bone or joint disease (AOR: 1.18, 95% CI 1.04-1.34), angina (AOR: 1.80, 95% CI 1.58-2.06), underweight (AOR: 1.28, 95% CI 1.16-1.40), chronic lung disease (AOR: 1.22, 95% CI 1.03-1.45), and functional disability (AOR: 1.68, 95% CI 1.47-1.92)], and health risk behaviour [tobacco use (AOR: 1.13, 95% CI 1.01-1.25), heavy episodic drinking (AOR: 1.45, 95% CI 1.10-1.91) and physical inactivity (AOR: 1.42, 95% CI 1.21-1.67)]. Furthermore, food insecurity was negatively associated with overweight/obesity (AOR: 0.80, 95% CI 0.73-0.88). Food insecurity was associated with seven poor mental health indicators, five poor physical health conditions, and three health risk behaviours. Programmes and policies that improve food availability may help improve mental and physical health among middle-aged and older adults in India.
Collapse
Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand. .,Department of Psychology, University of the Free State, Bloemfontein, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Wufeng, Taichung, 41354, Taiwan.
| |
Collapse
|
8
|
Muhammad T, Saravanakumar P, Sharma A, Srivastava S, Irshad CV. Association of food insecurity with physical frailty among older adults: study based on LASI, 2017-18. Arch Gerontol Geriatr 2022; 103:104762. [PMID: 35841798 DOI: 10.1016/j.archger.2022.104762] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Food security can be directly linked to nutritional status and either directly or indirectly, it has an impact on health status and well-being of the population. Physical frailty is one of the most important phenotypes used to understand the vulnerable nature of older adults. This paper examined the association between food security and physical frailty in older adults. METHODS We used data from the Longitudinal Ageing Study in India (LASI, 2017-18), wave-1. The sample size was 31,464 older adults aged 60 years and above. Physical frailty was assessed using the modified version of frailty phenotype proposed by Fried and colleagues. Multivariable logistic regression was used to establish the association between food insecurity with physical frailty. RESULTS A proportion of 30.65% of older adults were frail in this study. Older adults with food insecurity had higher prevalence of exhaustion (12.1% vs 6.5%), unintentional weight loss (65.5% vs 5.1%), and weak grip strength (8.6% vs 7.9%) in comparison to their food secure counterparts. After adjusting for a large number of confounders, older adults who reported food insecurity had significantly higher odds of being frail [AOR: 2.68; CI: 2.26-3.19] in comparison to older adults with no food insecurity. CONCLUSION The study showed that food insecurity is associated with physical frailty among older adults in India. It is suggested that food security programs in the country may be considered as an effective strategy to prevent physical frailty among older adults.
Collapse
Affiliation(s)
- T Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
| | - Priya Saravanakumar
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Building 10, Level 7, 235 Jones St, Ultimo, Sydney, NSW 2007, Australia
| | - Abhishek Sharma
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
| | - C V Irshad
- Department of Humanities and Social Sciences, Indian Institute of Technology, Madras, 600036 India.
| |
Collapse
|
9
|
Brady PJ, Harnack L, Widome R, Berry KM, Valluri S. Use of the Emergency Food System among Food Insecure, Low-income Households in the United States 2015 to 2020. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022; 18:145-163. [PMID: 36910336 PMCID: PMC10002470 DOI: 10.1080/19320248.2022.2131497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
The emergency food system (EFS) is a critical part of the United States' social safety net. Using 2015-2020 Current Population Survey Food Security Supplement data, we identified trends in EFS use among food insecure, low-income households by estimating the probability of EFS use adjusting for demographics using multivariable logistic regression. From 2015-2019, between 31.0% and 34.4% of households received emergency food, while 42.4% did in 2020. EFS use did not increase in 2020 compared to prior years for older adults and non-metropolitan households. Targeted outreach should be used to expand the reach of this resource to underserved and marginalized populations."
Collapse
Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Suite 300 1300 S. 2 Street, Minneapolis, MN, 55455
| | - Lisa Harnack
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Suite 300 1300 S. 2 Street, Minneapolis, MN, 55455
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Suite 300 1300 S. 2 Street, Minneapolis, MN, 55455
| | - Kaitlyn M. Berry
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Suite 300 1300 S. 2 Street, Minneapolis, MN, 55455
| | - Sruthi Valluri
- University of Minnesota Medical School, 420 Delaware Street SE, Minneapolis, MN, 55455
| |
Collapse
|
10
|
Ajabshir S, Stumbar S, Lachica I, Gates K, Qureshi Z, Huffman F. Rate of Nutrition-Related Chronic Diseases Among a Multi-Ethnic Group of Uninsured Adults. Cureus 2022; 14:e28802. [PMID: 36225455 PMCID: PMC9534339 DOI: 10.7759/cureus.28802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/26/2022] Open
Abstract
The prevalence of nutrition-related chronic diseases, such as obesity, cardiovascular disease, and type 2 diabetes, among adults in the U.S. is of increasing importance. These conditions adversely affect the overall public health, health care systems, and economy. Marginalized minority groups have been disproportionally affected by these conditions. Lack of or inadequate health insurance limits access to health care, which contributes to poor health outcomes among individuals with these conditions. South Florida is home to diverse racial/ethnic minority groups, many of whom are uninsured and do not have access to expert-delivered nutrition education services. It is imperative to thoroughly study the health needs of these underserved patient populations and examine the rate of nutrition-related conditions among them in order to develop medically and culturally tailored nutrition education programs for them. Therefore, the aim of this study was to assess the prevalence of nutrition-related diseases among multi-racial/ethnic uninsured individuals living in South Florida. A four-week electronic health record of adult patients (N=272) from a free clinic in South Florida was analyzed. Spearman`s correlation and binary regression models were used to assess the relationship between the variables. The sample included females (65%) and males (35%). The mean age was 49.08±14.56 years. Overall, 87% had at least one nutrition-related condition, with overweight/obesity being the most observed (75.2%), followed by hypertension (39%), dyslipidemia (27.2%), and diabetes (23.9%). BMI was a significant predictor of the prevalence of hypertension among Whites (p=0.008) and Blacks (p=0.002) but not Asians (p=0.536). Overall, a high rate of nutrition-related chronic diseases was found among uninsured adults in this study. This supports the need for increased medically, culturally, and economically tailored nutrition education programs in free clinic settings.
Collapse
|
11
|
Abstract
Sex differences are an important consideration when researching and establishing policies for nutrition and optimal health. For women's health, there are important physiologic, neurologic, and hormonal distinctions throughout the lifecycle that impact nutritional needs. Distinct from those for men, these nutritional needs must be translated into appropriate nutrition policy that aims to not only avoid overt nutritional deficiency, but also to promote health and minimize risk for chronic disease. Through a series of webinars, scientific experts discussed the advances in the understanding of the unique nutritional needs, challenges and opportunities of the various life stages for women across the life course and identified emerging nutritional interventions that may be beneficial for women. Nevertheless, there is concern that existing nutrition policy intended for women's health is falling short with examples of programs that are focused more on delivering calories than achieving optimal nutrition. To be locally effective, targeted nutrition needs to offer different proposals for different cultural, socio-economic, and geographic communities, and needs to be applicable at all stages of growth and development. There must be adequate access to nutritious foods, and the information to understand and implement proven nutritional opportunities. Experts provided recommendations for improvement of current entitlement programs that will address accessibility and other social and environmental issues to support women properly throughout the lifecycle.
Collapse
|
12
|
John JC, Kaleemullah T, McPherson H, Mahata K, Morrow RB, Bujnowski D, Johnston A, Danho M, Siddiqui N, Walsh MT, Haley SA, Sirajuddin AM, Schauer T, Wu MJ, Rechis R, Galvan E, Correa N, Browning N, Ganelin D, Gonzalez J, Lofton S, Banerjee D, Sharma SV. Building and Advancing Coalition Capacity to Promote Health Equity: Insights from the Health Equity Collective's Approach to Addressing Social Determinants of Health. Health Equity 2022; 5:872-878. [PMID: 35018321 PMCID: PMC8742293 DOI: 10.1089/heq.2021.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/12/2022] Open
Abstract
This article presents the structure and function of the Health Equity Collective in developing a systemic approach to promoting health equity across the Greater Houston area. Grounded in Kania and Kramer's five phases of collective impact for coalition building, The Collective operationalizes its mission through its backbone team, steering committees, and eight workgroups; each has goals that mutually reinforce and advance its vision. To date, Phase I (generating ideas), Phase II (initiating action), and Phase III (organizing for impact) have been completed. Phases IV (implementation) and Phase V (sustainability) are currently underway.
Collapse
Affiliation(s)
- Jemima C John
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | | | | | - Kallol Mahata
- Patient Care Intervention Center, Houston, Texas, USA
| | - Robert B Morrow
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | | | | | - Melisa Danho
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | | | - Michael T Walsh
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sean A Haley
- Center for Civic and Public Policy Improvement, Houston, Texas, USA
| | | | | | - Mon-Ju Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ruth Rechis
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | | | | | | | | | - Staci Lofton
- Harris County Public Health, Houston, Texas, USA
| | - Deborah Banerjee
- City of Houston Department of Health and Human Services, Houston, Texas, USA
| | - Shreela V Sharma
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| |
Collapse
|
13
|
Long CR, Narcisse MR, Bailey MM, Rowland B, English E, McElfish PA. Food insecurity and chronic diseases among Native Hawaiians and Pacific Islanders in the US: results of a population-based survey. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022; 17:53-68. [PMID: 35432687 PMCID: PMC9012098 DOI: 10.1080/19320248.2021.1873883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Data from the 2014 Native Hawaiian and Pacific Islander (NHPI) National Health Interview Survey were used to examine associations between food security and individual chronic diseases, total number of chronic diseases, and general health status among 637 NHPI adults with income below 200 percent federal poverty level. Very low food security was associated with hypertension, diabetes, and asthma. Very low food security and marginal food security were associated with having any chronic disease and with having a higher number of chronic diseases. Risk for food insecurity increased as health status decreased. These associations had not previously been documented for NHPI.
Collapse
Affiliation(s)
- Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Mary M. Bailey
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Emily English
- Department of Pediatrics, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| |
Collapse
|
14
|
Abstract
Food insecurity has emerged as a significant problem for older adults in the United States. Older adults with chronic conditions are particularly vulnerable, as they face a number of physical, psychological, social, and economic barriers related to food purchasing options. The purpose of the current article is to examine the significance of food insecurity in older adults with chronic disease, highlight the barriers and determinates that contribute to the problem, and offer interventions to impact the disparity of food insecurity in this population. [Journal of Gerontological Nursing, 47(12), 7-11.].
Collapse
|
15
|
Abstract
IMPORTANCE Allostatic overload, a biomarker of wear and tear, could be the potential pathway through which food insecurity leads to increased morbidity risk. OBJECTIVE To assess the association of food insecurity with allostatic load (AL) among US adults aged 50 years or older. DESIGN, SETTING, AND PARTICIPANTS A multiwave longitudinal cohort study was conducted using data from the 2006 to 2014 waves of the Health and Retirement Study in a national cohort study setting. The data comprise 26 509 person-years observations from 14 394 noninstitutionalized individuals aged 50 years or older during the study period. Data were analyzed from September 1 to December 14, 2020. EXPOSURES Moderate food insecurity (not enough money to buy the food needed) and severe food insecurity (reduced food intake due to financial constraints) measured at the household level. MAIN OUTCOMES AND MEASURES The AL score (0-9, with higher scores indicating a greater risk of physiologic dysregulation) and binary indicators of dysregulated inflammatory (C-reactive protein), cardiovascular (systolic and diastolic blood pressure, pulse rate, and cystatin C), and metabolic (hemoglobin A1c, body mass index, waist-to-height ratio, total cholesterol to high-density lipoprotein cholesterol ratio) systems. RESULTS Of 14 394 participants included in the analysis, the median age was 60 (IQR, 56-69) years, 8143 (56.6%) were women, 517 (3.6%) were moderately food insecure, and 804 (5.6%) were severely food insecure. In adjusted models, the incidence rate of AL was 1.05 (95% CI, 1.00-1.09) times higher for the participants with moderate food insecurity and 1.11 (95% CI, 1.07-1.15) times higher for the participants with severe food insecurity, compared with those who were food secure. The increased incidence rate of AL among participants with severe food insecurity was associated with C-reactive protein level (odds ratio [OR], 1.22; 95% CI, 1.04-1.44), cystatin C level (OR, 1.23; 95% CI, 1.01-1.51), hemoglobin A1c level (OR, 1.27; 95% CI, 1.01-1.59), body mass index (OR, 1.84; 95% CI, 1.41-2.40), waist-to-height ratio (OR, 1.54; 95% CI, 1.26-1.88), and total to high-density lipoprotein cholesterol ratio (OR, 1.32; 95% CI, 1.10-1.59) inflated to the high-risk range. The interaction between moderate food insecurity and Supplemental Nutrition Assistance Program (SNAP) enrollment (β = -0.18; P = .001) and the interaction between severe food insecurity and SNAP enrollment (β = -0.09; P = .02) were associated with a reduction in AL. CONCLUSIONS AND RELEVANCE In this national cohort study of US adults aged 50 years or older, food insecurity was associated with higher AL, mainly through dysregulation of the inflammatory and metabolic systems. SNAP enrollment may modify this association between food insecurity and AL.
Collapse
Affiliation(s)
- Tae-Young Pak
- Department of Consumer Science and Convergence Program for Social Innovation, Sungkyunkwan University, Seoul, South Korea
| | - GwanSeon Kim
- College of Agriculture, Arkansas State University, Jonesboro
| |
Collapse
|
16
|
Crook J, Horgas A, Yoon SJ, Grundmann O, Johnson-Mallard V. Insufficient Vitamin C Levels among Adults in the United States: Results from the NHANES Surveys, 2003-2006. Nutrients 2021; 13:nu13113910. [PMID: 34836166 PMCID: PMC8625707 DOI: 10.3390/nu13113910] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 01/08/2023] Open
Abstract
Vitamin C, well-established in immune function and a key factor in epigenetic inflammatory modifications, is only obtained through consistent dietary intake. Identifying individuals at risk for Vitamin C insufficiency may guide prevention and treatment, however, national surveillance has not been evaluated in the United States since 2006. A descriptive, cross-sectional secondary analysis was performed utilizing data from the 2003–2006 National Health and Nutrition Examination Surveys (NHANES) assessing non-institutionalized adults. Five categories of plasma Vitamin C were delineated: deficiency (<11 μmol/L), hypovitaminosis (11–23 μmol/L), inadequate (23–49 μmol/L), adequate (50–69 μmol/L), and saturating (≥70 μmol/L). Results indicated 41.8% of the population possessed insufficient levels (deficiency, hypovitaminosis, and inadequate) of Vitamin C. Males, adults aged 20–59, Black and Mexican Americans, smokers, individuals with increased BMI, middle and high poverty to income ratio and food insecurity were significantly associated with insufficient Vitamin C plasma levels. Plasma Vitamin C levels reveal a large proportion of the population still at risk for inflammatory driven disease with little to no symptoms of Vitamin C hypovitaminosis. Recognition and regulation of the health impact of Vitamin C support the goal of Nutrition and Healthy Eating as part of the Healthy People 2030.
Collapse
Affiliation(s)
- Jennifer Crook
- Center for Health Equity and Community Engagement Research, Mayo Clinic Hospital, Jacksonville, FL 32224, USA
- Correspondence:
| | - Ann Horgas
- Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32610, USA; (A.H.); (S.-J.Y.)
| | - Saun-Joo Yoon
- Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32610, USA; (A.H.); (S.-J.Y.)
| | - Oliver Grundmann
- Entrepreneurial Programs in Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA;
| | | |
Collapse
|
17
|
Walker RJ, Garacci E, Dawson AZ, Williams JS, Ozieh M, Egede LE. Trends in Food Insecurity in the United States from 2011-2017: Disparities by Age, Sex, Race/Ethnicity, and Income. Popul Health Manag 2021; 24:496-501. [PMID: 32941115 PMCID: PMC8403212 DOI: 10.1089/pop.2020.0123] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The number of individuals in the United States who report food insecurity doubled between 2005 and 2012, with little research investigating possible disparities across time in food-insecure populations. The aim of this study was to investigate trends in food insecurity between 2001-2017 by sex, race/ethnicity, income, and age. Adults participating in the National Health Interview Survey (NHIS) between 2011-2017 were included in the study. Food insecurity was dichotomized based on affirmative responses to the Food Security Survey Module. Statistical analysis included logistic regression to investigate trends in food insecurity over time by each demographic variable (age, sex, race/ethnicity, income) adjusted by survey year and demographic variables. After adjustment, those ages ≥65 years were 39% less likely (OR = 0.61, 95% CI [0.57,0.65]) to report food insecurity compared to those ages 18-34; females were 23% more likely to be food insecure than males (OR = 1.23, 95% CI [1.19,1.27]); non-Hispanic blacks were 1.7 times more likely (OR = 1.69, 95% CI [1.62,1.76]) to be food insecure than non-Hispanic whites; and a clear gradient existed by income, with lower incomes more likely to be food insecure. Disparities in food insecurity exist across age, race/ethnicity, sex, and income and were consistent over time. These results suggest that targeted programs may be necessary to decrease food insecurity in particularly vulnerable subpopulations, and barriers to access and use of existing programs need to be investigated.
Collapse
Affiliation(s)
- Rebekah J. Walker
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Emma Garacci
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Aprill Z. Dawson
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Joni S. Williams
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mukoso Ozieh
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Division of Nephrology, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Division of Nephrology, Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin, USA
| | - Leonard E. Egede
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
18
|
Mahdavi-Roshan M, Vakilpour A, Mousavi SM, Ashouri A. Dietary diversity and food security status among heart failure patients in the north of Iran. BMC Nutr 2021; 7:31. [PMID: 34238383 PMCID: PMC8268511 DOI: 10.1186/s40795-021-00438-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022] Open
Abstract
Background Dietary diversity score (DDS) is an indicator for assessing nutritional adequacy. Food security is another important measure in nutrition field which can be associated with several cardiovascular risk factors. Considering the importance of nutrition in heart failure (HF) patients, this study was designed to evaluate the DDS and food security of patients with HF. Methods A total of 200 HF patients were enrolled. DDS was evaluated using valid and reliable food frequency questionnaire and was calculated by scoring food intakes as 5 main groups. Household food insecurity access scale was applied to assess food security status. Data were analyzed using descriptive statistics, Chi-square and Kruskal-Wallis tests and multiple logistic regression models. Results The mean age of patients was 65 (standard deviation: 12) years and 59% of patients were male. Median of DDS was 1.96 (range: 0.29 to 6.12). Adjusted odds of greater DDS (> = median of 2) was 2.58 times higher for patients without hypertension than for patients with hypertension (95%CI: 1.31–5.08, P = 0.006). Also, odds of greater DDS were more in ex-smokers’ patients when compared to non-smokers (adjusted odds ratio (AOR): 2.70, 95%CI: 1.27–5.75, P = 0.010), patients with supplement use (AOR: 2.42, 95%CI: 1.16–5.05, P = 0.019), patients with lower total cholesterol level (AOR: 1.01, 95%CI: 1.00–1.02, P = 0.051), and patients with higher ejection fraction (AOR: 1.03, 95%CI: 1.00–1.05, with borderline. P = 0.073). About 57% of patients had experienced degrees of food insecurity as mild (26%), moderate (16%) and severe (15%). On the other hand, women (AOR: 1.90, 95%CI: 0.90–3.71, with borderline P = 0.061) and patients with middle (AOR: 3.48, 95%CI: 1.79–6.76, P < 0.001) or high (AOR: 20.32, 95%CI: 2.56–161.19, P = 0.004) socio-economic status were more likely to be food secure or mild insecure. Also, no relation between DDS and food security was found (r = − 0.08, P = 0.262). Conclusion This study found that HF patients had a low DDS and more than half of the patients were food insecure to some extents.
Collapse
Affiliation(s)
- Marjan Mahdavi-Roshan
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran.,Department of Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Azin Vakilpour
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Seyed Mehdi Mousavi
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Asieh Ashouri
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran. .,Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
| |
Collapse
|
19
|
Jung SE, Shin YH, Kim S, Hermann J, Dougherty Henry R. Habit is the Bridge between Intention and Behavior: A Look at Fruit and Vegetable Consumption among Low-Income Older Adults. J Nutr Gerontol Geriatr 2021; 40:215-231. [PMID: 34170212 DOI: 10.1080/21551197.2021.1944423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the influence of habit and theory of planned behavior (TPB) variables in predicting low-income older adults' fruit and vegetable (F&V) consumption. DESIGN Cross-sectional study. SETTING A city in the southeast United States. PARTICIPANTS A total of 372 low-income older adults participated in this study. RESULTS Participants completed a validated survey measuring TPB variables (attitude, subjective norm, perceived behavioral control, and intention), F&V intake using the Block Dietary Fruit-Vegetable Screener, and self-reported habit index to measure F&V consumption. Perceived behavioral control was the largest factor influencing intention to consume F&V, followed by attitude and subjective norm. In addition, there was a significant interaction between habit strength and intention, such that intention influenced F&V consumption only among individuals with average or higher habit strength. CONCLUSIONS Findings from this study suggest health promotion programs aimed at increasing F&V intake among low-income older adults should focus on establishing F&V intake as a habit so that an individual's intentions to consume F&V can be transformed into actual F&V intake. Also, emphasizing how to overcome potential barriers would improve low-income older adults' actual F&V intake by increasing their sense of control over consuming F&V.
Collapse
Affiliation(s)
- Seung Eun Jung
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
| | - Yeon Ho Shin
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
| | - Seoyoun Kim
- Department of Sociology, Texas State University, San Marcos, TX, USA
| | - Janice Hermann
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Regan Dougherty Henry
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL, USA
| |
Collapse
|
20
|
Te Vazquez J, Feng SN, Orr CJ, Berkowitz SA. Food Insecurity and Cardiometabolic Conditions: a Review of Recent Research. Curr Nutr Rep 2021; 10:243-254. [PMID: 34152581 PMCID: PMC8216092 DOI: 10.1007/s13668-021-00364-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 12/26/2022]
Abstract
Purpose of Review To understand recent literature that examines associations between food insecurity and cardiometabolic conditions and risk factors. We included original research, systematic reviews, and meta-analyses on the topic of food insecurity and cardiometabolic risk published from January 1, 2017, to December 31, 2020. Editorials, perspectives, and case reports were excluded. After the initial search, 3 reviewers selected studies for inclusion based on relevance and methods. Ultimately, fifty studies were included. Recent Findings We included 35 studies of adults (20 cross-sectional observational studies, 5 longitudinal observational studies, 5 interventional studies, and 5 meta-analyses/reviews). In adults, food insecurity is associated with greater prevalence of overweight/obesity (especially for women). It is also associated with hypertension, diabetes (including worse glycemic control and more diabetes complications), coronary heart disease, congestive heart failure, stroke, and chronic kidney disease. We included 15 studies of children (11 cross-sectional observational studies and 4 longitudinal observational studies). In children, findings were more nuanced, and in particular, many studies did not find an association between food insecurity and overweight/obesity. However, authors noted that these conditions may not have had time to develop. With notable exceptions, many studies were cross-sectional, and there were few interventions. Summary There is a robust association between food insecurity and cardiometabolic conditions and risk factors in adults, but the picture is less clear in children. Overt cardiometabolic clinical conditions develop more rarely in children, but childhood experiences may set a trajectory for worse health later in life. Detailed life course epidemiologic studies are needed to better understand this relationship. Future interventions should examine how to reduce the prevalence of food insecurity, and how best to improve health for those who experience food insecurity.
Collapse
Affiliation(s)
- Jennifer Te Vazquez
- College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shi Nan Feng
- College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Nutrition Science Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Colin J Orr
- Division of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth A Berkowitz
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 5034 Old Clinic Bldg, CB 7110, Chapel Hill, NC, 27599, USA.
| |
Collapse
|
21
|
Lee S, Deason K, Rancourt D, Gray HL. Disentangling the Relationship between Food Insecurity and Poor Sleep Health. Ecol Food Nutr 2021; 60:580-595. [PMID: 34032535 DOI: 10.1080/03670244.2021.1926245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic has created disruptions in global and national food supply chains. Along with an increase in the unemployment rate, this resulted in a rise in food insecurity at the community-level, threatening individual and family well-being. Food insecurity is associated with inadequate nutrient intakes, weight gain, and psychological distress, including anxiety and depressive symptoms, all of which are known to affect sleep. Yet, little is known about whether and how food insecurity is associated with sleep health, a critical but underrecognized health outcome. This paper reviews literature describing associations between food insecurity and sleep, summarizes key findings based on proposed mechanisms, and discusses directions for future research.
Collapse
Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Karley Deason
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
22
|
Mahmood A, Kim H, Kabir U, Kedia S, Ray M. Food Insecurity and Influenza and Pneumonia Vaccines Uptake Among Community-Dwelling Older Adults in the United States. J Community Health 2021; 45:943-953. [PMID: 32219711 DOI: 10.1007/s10900-020-00812-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Influenza and pneumonia vaccines can reduce morbidities and mortality associated with infectious diseases among older adults. Food security, good nutrition, and high-quality diets are critical for the wellbeing of older adults. However, little is known about the relationship between food insecurity and use of preventive health services, such as influenza and pneumonia vaccinations, among older adults. In this study, we analyzed data on 40,555 adults aged ≥ 65 years from the 2014-2018 National Health Interview Survey in the United States. Through multiple hierarchical logistic regression models, we investigated the associations between food insecurity and influenza and pneumonia vaccines uptake in this population. We found that, during 2014-2018, about 12.6 million (5.3%) adults aged ≥ 65 years lived in food-insecure households in the United States. Of those, 60.6% reported getting an influenza vaccine in the past 12 months, and 54.2% reported ever getting a pneumonia vaccine. Compared to food-secure older adults, food-insecure individuals were not significantly different in terms of influenza vaccine uptake. However, they were 25% less likely to have ever gotten a pneumonia vaccine (adjusted odds ratio = 0.75, 95% CI 0.65-0.86, P < .001). Efforts should be made to develop strategies to improve immunization rates among food-insecure older adults. Healthcare providers could routinely assess their vaccination status and screen them for food insecurity. Also, community level screening and intervention programs should target food-insecure older adults, who often face structural disadvantages. Future studies could explore and identify the underlying predictive factors contributing to low pneumonia vaccination rates among food-insecure older adults.
Collapse
Affiliation(s)
- Asos Mahmood
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Robison Hall, 3825 E DeSoto Avenue, Office #136C, Memphis, TN, 38152-3530, USA.
| | - Hyunmin Kim
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Robison Hall, 3825 E DeSoto Avenue, Office #136C, Memphis, TN, 38152-3530, USA.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Umar Kabir
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Robison Hall, 3825 E DeSoto Avenue, Office #136C, Memphis, TN, 38152-3530, USA
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Meredith Ray
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, TN, USA
| |
Collapse
|
23
|
Abstract
Purpose of Review This review examines the current epidemiological evidence for the relationship between levels of food insecurity and cardiovascular disease (CVD) outcomes among US adults > 17 years. Recent Findings Review of recent literature revealed that reduced food security was associated with decreased likelihood of good self-reported cardiovascular health and higher odds of reporting CVD-related outcomes such as coronary heart disease, angina, heart attack, peripheral arterial disease, and hypertension. Summary Existing evidence suggests a compelling association between each level of reduced food security and CVD risk with a particularly strong association between very low food security and CVD risk. Policies and public health-based strategies are needed to identify the most vulnerable subgroups, strengthen and enhance access to food assistance programs, and promote awareness and access to healthful foods and beverages to improve food security, nutrition, and cardiovascular health.
Collapse
Affiliation(s)
- Yibin Liu
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, 314 Kimball Tower, Buffalo, NY, 14214, USA.
| | | |
Collapse
|
24
|
Beltrán S, Pharel M, Montgomery CT, López-Hinojosa IJ, Arenas DJ, DeLisser HM. Food insecurity and hypertension: A systematic review and meta-analysis. PLoS One 2020; 15:e0241628. [PMID: 33201873 PMCID: PMC7671545 DOI: 10.1371/journal.pone.0241628] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/17/2020] [Indexed: 12/26/2022] Open
Abstract
Background Food insecurity (FIS) is an important public health issue associated with cardiovascular risk. Given the association of FIS with diets of poorer nutritional quality and higher salt intake as well as chronic stress, numerous studies have explored the link between FIS and hypertension. However, no systematic review or meta-analysis has yet to integrate or analyze the existing literature. Methods We performed a wide and inclusive search of peer-reviewed quantitative data exploring FIS and hypertension. A broad-terms, systematic search of the literature was conducted in PubMed, Embase, Scopus, and Web of Science for all English-language, human studies containing primary data on the relationship between FIS and hypertension. Patient population characteristics, study size, and method to explore hypertension were extracted from each study. Effect sizes including odds ratios and standardized mean differences were extracted or calculated based on studies’ primary data. Comparable studies were combined by the random effects model for meta-analyses along with assessment of heterogeneity and publication bias. Results A total of 36 studies were included in the final analyses. The studies were combined into different subgroups for meta-analyses as there were important differences in patient population characteristics, methodology to assess hypertension, and choice of effect size reporting (or calculability from primary data). For adults, there were no significantly increased odds of elevated blood pressures for food insecure individuals in studies where researchers measured the blood pressures: OR = 0.91 [95%CI: 0.79, 1.04; n = 29,781; Q(df = 6) = 7.6; I2 = 21%]. This remained true upon analysis of studies which adjusted for subject BMI. Similarly, in studies for which the standardized mean difference was calculable, there was no significant difference in measured blood pressures between food secure and FIS individuals: g = 0.00 [95%CI: -0.04, 0.05; n = 12,122; Q(df = 4) = 3.6; I2 = 0%]. As for retrospective studies that inspected medical records for diagnosis of hypertension, there were no significantly increased odds of hypertension in food insecure adults: OR = 1.11 [95%CI: 0.86, 1.42; n = 2,887; Q(df = 2) = 0.7; I2 = 0%]. In contrast, there was a significant association between food insecurity and self-reports of previous diagnoses of hypertension: 1.46 [95%CI: 1.13, 1.88; n = 127,467; Q(df = 7) = 235; I2 = 97%]. Only five pediatric studies were identified which together showed a significant association between FIS and hypertension: OR = 1.44 [95%CI: 1.16, 1.79; n = 19,038; Q(df = 4) = 5.7; I2 = 30%]. However, the small number of pediatric studies were not sufficient for subgroup meta-analyses based on individual study methodologies. Discussion In this systematic review and meta-analysis, an association was found between adult FIS and self-reported hypertension, but not with hypertension determined by blood pressure measurement or chart review. Further, while there is evidence of an association between FIS and hypertension among pediatric subjects, the limited number of studies precluded a deeper analysis of this association. These data highlight the need for more rigorous and longitudinal investigations of the relationship between FIS and hypertension in adult and pediatric populations.
Collapse
Affiliation(s)
- Sourik Beltrán
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Marissa Pharel
- Rush Medical College, Rush University, Chicago, Illinois, United States of America
| | - Canada T. Montgomery
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Itzel J. López-Hinojosa
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Daniel J. Arenas
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Horace M. DeLisser
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| |
Collapse
|
25
|
Food Insecurity, Depression, and Race: Correlations Observed Among College Students at a University in the Southeastern United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218268. [PMID: 33182386 PMCID: PMC7664923 DOI: 10.3390/ijerph17218268] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 11/17/2022]
Abstract
Food insecurity is common among college students in the United States and is associated with poorer health-related outcomes and academic performance. The aims of this study were to assess the prevalence of food insecurity at a large, public university in Mississippi, a state with the second highest rate of food insecurity in the nation, and to examine the associations between food insecurity, depression, and race in this group of students. Food security was measured using the United States Department of Agriculture Household Food Security Survey Module: Six-Item Short Form, and depression was measured using the Patient Health Questionnaire-9. In total, 131 students ages 18-24 participated in the study. Food insecurity was present in 38.2% of students surveyed. The odds of food insecurity were higher among African American students compared to Caucasian students (OR = 3.50, 95% CI: 1.38, 8.90). Students with very low food security had 4.52-times greater odds of having depression than food-secure students (p = 0.011, 95% CI: 1.42, 14.36). Neither body mass index nor body fat percentage were associated with food security status. Further research is needed on strategies to address the risk of depression among food-insecure college students and the racial disparity in food insecurity rates present among college students.
Collapse
|
26
|
Diallo AF, Falls K, Hicks K, McQueen Gibson E, Obaid R, Slattum P, Zanjani F, Price E, Parsons P. The Healthy Meal Program: A food insecurity screening and referral program for urban dwelling older adults. Public Health Nurs 2020; 37:671-676. [DOI: 10.1111/phn.12778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Ana F. Diallo
- Virginia Commonwealth University School of Nursing Richmond VA USA
- Virginia Commonwealth University Institute of Inclusion, Inquiry & Innovation Richmond VA USA
| | - Katherine Falls
- Virginia Commonwealth University School of Nursing Richmond VA USA
| | | | | | - Rawan Obaid
- School of Nursing George Washington University Washington DC USA
| | - Patricia Slattum
- School of Pharmacy Virginia Commonwealth University Richmond VA USA
| | - Faika Zanjani
- Virginia Commonwealth University Institute of Inclusion, Inquiry & Innovation Richmond VA USA
- Department of Gerontology College of Health Professions Virginia Commonwealth University Richmond VA USA
| | - Elvin Price
- Virginia Commonwealth University Institute of Inclusion, Inquiry & Innovation Richmond VA USA
- School of Pharmacy Virginia Commonwealth University Richmond VA USA
| | - Pamela Parsons
- Virginia Commonwealth University School of Nursing Richmond VA USA
- Virginia Commonwealth University Institute of Inclusion, Inquiry & Innovation Richmond VA USA
| |
Collapse
|
27
|
Long CR, Rowland B, McElfish PA, Ayers BL, Narcisse MR. Food Security Status of Native Hawaiians and Pacific Islanders in the US: Analysis of a National Survey. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:788-795. [PMID: 32184077 PMCID: PMC8202531 DOI: 10.1016/j.jneb.2020.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/06/2020] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To document food insecurity prevalence among a nationally representative sample of Native Hawaiian and Pacific Islander (NHPI) adults and compare differences in food security status across races/ethnicities in the US. METHODS Using 2014 National Health Interview Survey and 2014 NHPI-National Health Interview Survey data, food insecurity among the NHPI population is described and food security status across racial/ethnic groups is compared using Rao-Scott chi-square and multinomial logistic regression. RESULTS Food insecurity prevalence was 20.5% among NHPI adults, and NHPI had significantly higher odds of experiencing low and very low food security than white individuals. Food insecurity among Hispanic individuals, black people, and other races/ethnicities was also significantly higher than that among white people. Significant variation in food security status was observed by race/ethnicity (P < .001). CONCLUSIONS AND IMPLICATIONS This study provides documentation of food insecurity prevalence among NHPI adults and will inform chronic disease and nutrition research and programs conducted with NHPI communities in the US.
Collapse
Affiliation(s)
- Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR.
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR
| | - Britni L Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR
| |
Collapse
|
28
|
Koh K, Kaiser ML, Sweeney G, Samadi K, Hyder A. Explaining Racial Inequality in Food Security in Columbus, Ohio: A Blinder-Oaxaca Decomposition Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5488. [PMID: 32751387 PMCID: PMC7432289 DOI: 10.3390/ijerph17155488] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 12/02/2022]
Abstract
Food insecurity is a leading public health challenge in the United States. In Columbus, Ohio, as in many American cities, there exists a great disparity between Black and White households in relation to food insecurity. This study investigates the degree to which this gap can be attributed to differences in food shopping behavior, neighborhood perception, and socioeconomic characteristics. A Blinder-Oaxaca decomposition method is used to analyze a household survey dataset collected in 2014. We find a 34.2 percent point difference in food security between White and Black households. Variables related to food shopping behavior, neighborhood perception, and socioeconomic characteristics explain 13.8 percent, 11.6 percent, and 63.1 percent of the difference, respectively. These independent variables combined can explain 68.2 percent of the food security gap between White and Black households. Most of this is attributable to socioeconomic variables. Sense of friendship in neighborhood, use of private vehicles, and satisfaction of neighborhood food environment also partially contribute to the food security gap.
Collapse
Affiliation(s)
- Keumseok Koh
- Department of Geography, University of Hong Kong, Hong Kong, China
| | - Michelle L. Kaiser
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
| | - Glennon Sweeney
- Kirwan Institute for the Study of Race and Ethnicity; Department of City and Regional Planning, The Ohio State University, Columbus, OH 43210, USA;
| | - Karima Samadi
- College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH 43210, USA;
| | - Ayaz Hyder
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
| |
Collapse
|
29
|
|
30
|
Palakshappa D, Speiser JL, Rosenthal GE, Vitolins MZ. Food Insecurity Is Associated with an Increased Prevalence of Comorbid Medical Conditions in Obese Adults: NHANES 2007-2014. J Gen Intern Med 2019; 34:1486-1493. [PMID: 31161567 PMCID: PMC6667608 DOI: 10.1007/s11606-019-05081-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/26/2018] [Accepted: 04/23/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Numerous studies have examined if food insecurity (FI) leads to increased weight gain, but little is known about how FI affects obese participants. OBJECTIVE Our objective was to determine if obese, food-insecure adults are more likely to have medical comorbidities than obese, food-secure adults. DESIGN We conducted a cross-sectional study using the 2007-2014 National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS All obese participants (≥ 20 years) in NHANES were eligible. Participants who were pregnant or missing FI data were excluded. MAIN MEASURES The primary exposure was household FI, and the primary outcome was the total number of obesity-related comorbidities. Secondary outcomes evaluated the association between FI and individual comorbidities. Propensity score weighting was used to improve covariate balance. We used negative binomial regression to test the association between FI and the total number of comorbidities. We used logistic regression to test the association between FI and individual comorbidities. KEY RESULTS Of the 9203 obese participants, 15.6% were food insecure. FI (β = 0.09, 95% CI: 0.02, 0.15; p = 0.01) and very low food security (β = 0.17, 95% CI: 0.07, 0.28; p = 0.003) were associated with an increased number of comorbidities. In secondary analyses, FI was associated with increased odds of coronary artery disease (OR: 1.5, 95% CI: 1.1, 2.0) and asthma (OR: 1.3, 95% CI: 1.1, 1.6). Very low food security was associated with increased odds of coronary artery disease, diabetes, and asthma. CONCLUSION Obese adults living in food-insecure households were more likely to have an increased number of comorbid conditions than obese adults living in food-secure households. Clinicians should be aware of the association between FI and comorbid medical conditions when treating patients with obesity.
Collapse
Affiliation(s)
- Deepak Palakshappa
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA. .,Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Jaime L Speiser
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gary E Rosenthal
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mara Z Vitolins
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
31
|
Trego ML, Baba ZM, DiSantis KI, Longacre ML. Food insecurity among adult cancer survivors in the United States. J Cancer Surviv 2019; 13:641-652. [PMID: 31297721 DOI: 10.1007/s11764-019-00783-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to examine the prevalence of food insecurity among US adults with a history of a cancer diagnosis and to understand if socio-demographic factors and cancer characteristics (i.e., time since diagnosis, cancer type) relate to food insecurity. METHODS This was a secondary analysis of cancer survivors drawn from the National Health and Nutrition Examination Surveys (NHANES) 2011-2014. Weighted analyses included descriptive, bivariate, and multinomial logistic regression. RESULTS Of the cancer survivors identified in the sample (n = 1,022), 8.36% were food insecure. In bivariate analysis, several factors were significantly associated with food insecurity among cancer survivors, including female gender, younger age, non-Hispanic black or Hispanic race/ethnicity, lower income, no insurance coverage, lower education, single relationship status, having children at home, having poor health or diet, and cancer characteristics (i.e., non-melanoma skin cancer, female reproductive cancer). In logistic regression analyses, odds of food insecurity decreased with older age and higher income and increased with poor health, although cancer type was no longer significant. CONCLUSIONS Though a low proportion of cancer survivors indicated being food insecure, food insecurity was evident, and this study identified socio-demographic factors related to food insecurity which may be important to consider in clinical and community health settings serving cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Nutrition is essential throughout the cancer care trajectory, including survivorship. Clinicians should consider processes for screening patients, especially younger and lower income patients, for food insecurity through all stages of treatment and particularly as part of survivorship planning. Furthermore, availability and referral to community partners for nutrition and food support is essential.
Collapse
Affiliation(s)
- M L Trego
- Department of Public Health, Arcadia University, 450 S Easton Road, Glenside, PA, 19038, USA.
| | - Z M Baba
- Department of Public Health, Arcadia University, 450 S Easton Road, Glenside, PA, 19038, USA.,Department of Health, West Chester University, 700 S High Street, West Chester, PA, 19383, USA
| | - K I DiSantis
- Department of Public Health, Arcadia University, 450 S Easton Road, Glenside, PA, 19038, USA
| | - M L Longacre
- Department of Public Health, Arcadia University, 450 S Easton Road, Glenside, PA, 19038, USA
| |
Collapse
|
32
|
Martinez SM, Grandner MA, Nazmi A, Canedo ER, Ritchie LD. Pathways from Food Insecurity to Health Outcomes among California University Students. Nutrients 2019; 11:nu11061419. [PMID: 31238534 PMCID: PMC6627945 DOI: 10.3390/nu11061419] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/31/2022] Open
Abstract
The prevalence of food insecurity (FI) among college students is alarmingly high, yet the impact on student health has not been well investigated. The aim of the current study was to examine the simultaneous relationships between food insecurity and health-related outcomes including body mass index (BMI) and overall health in a college student population. Randomly sampled students in the University of California 10 campus system were invited to participate in an online survey in spring 2015. The analytic sample size was 8705 graduate and undergraduate students. Data were collected on FI in the past year, daily servings of fruits and vegetables (FV), number of days in the past week of enough sleep and moderate- to vigorous-intensity physical activity (MVPA), height and weight, self-rated health, and student characteristics. Using path analysis, mediated pathways between FI, BMI, and poor health were examined through FV intake, number of days of MVPA and enough sleep. Analyses controlled for student characteristics. Mean BMI was 23.6 kg/m2 (SD, 5.0), and average self-rated health was good. FI was directly and indirectly related to higher BMI and poor health through three pathways. First, FI was related to fewer days of enough sleep, which in turn was related to increased BMI and poor health. Second, FI was related to fewer days of MVPA, which in turn was related to increased BMI and poor health. Third, FI was related to fewer daily servings of FV, which in turn was related to poor health. FI is associated with poor health behaviors among college students, which may contribute to higher weight status and poor health. These findings highlight the importance of food security for a healthy college experience.
Collapse
Affiliation(s)
- Suzanna M Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th St., 2nd Floor, San Francisco, CA 94158, USA.
| | - Michael A Grandner
- Department of Psychiatry, University of Arizona, 2800 E. Ajo Way, Tucson, AZ 85713, USA.
| | - Aydin Nazmi
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Elias Ruben Canedo
- Division of Equity and Inclusion, University of California, Berkeley; 405 Sproul Hall, Berkeley, CA 94720, USA.
| | - Lorrene D Ritchie
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, 2115 Milvia Street, Berkeley, CA 94704, USA.
| |
Collapse
|
33
|
Wright L, Stallings-Smith S, Arikawa AY. Associations between food insecurity and prediabetes in a representative sample of U.S. Adults (NHANES 2005-2014). Diabetes Res Clin Pract 2019; 148:130-136. [PMID: 30500547 DOI: 10.1016/j.diabres.2018.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/06/2018] [Accepted: 11/23/2018] [Indexed: 01/21/2023]
Abstract
AIMS The primary aim of this research was to investigate the association between food insecurity and prediabetes and to identify specific subgroups for early clinical intervention. METHODS Cross-sectional data from 25,814 participants were analyzed from the National Health and Nutrition Examination Survey for years 2005-2014. Multivariable logistic regression was used to explore the association between food security status and laboratory-confirmed prediabetes. All models were adjusted for age, sex, race, and body mass index. RESULTS When compared to participants with full and marginal food security, participants with low/very food security were 1.35 (95% CI: 1.17-1.55) times more likely to have prediabetes. Younger individuals with low/very low food security had a greater likelihood of prediabetes, 1.50 (95% CI: 1.19-1.81), when compared with their food secure counterparts. CONCLUSIONS Food insecurity at any level, whether low or very low, is positively associated with prediabetes in the U.S. general adult population. Food insecure young adults, particularly those aged 20-34 years, should be targeted for early clinical intervention.
Collapse
Affiliation(s)
- Lauri Wright
- Department of Nutrition and Dietetics, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA.
| | - Sericea Stallings-Smith
- Department of Public Health, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA
| | - Andrea Y Arikawa
- Department of Nutrition and Dietetics, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA
| |
Collapse
|
34
|
Atoloye AT, Durward C. Being Motivated by Nutrition Is Associated With Healthy Home Food Environment of Supplemental Nutrition Assistance Program (SNAP) Recipients. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:101-106. [PMID: 30201282 DOI: 10.1016/j.jneb.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/12/2018] [Accepted: 07/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine the relationship between food shopping motivating factors and the home food environment (HFE). METHODS Participants in the Supplemental Nutrition Assistance Program (n = 123) who were taking part in the Utah State Double-Up Food Bucks evaluation program were interviewed about their HFE, factors motivating shopping, and food security status. Composite HFE scores were derived from the Perceived Nutrition Environment Measure Survey questionnaire and food security score from the 6-item US Household Food Security Survey questionnaire. Analysis included multiple linear regression. RESULTS Mean age was 46 ± 16.1 years. Regression models showed significant associations of being motivated by nutrition, education, and food security with HFE (β = 4.70, P = .03; β = 1.44, P = .06; and β = 1.44, P = .06, respectively). CONCLUSION AND IMPLICATIONS In-store interventions to improve perceived nutrition importance among shoppers may be a useful tool to improve home food supplies. Further research is recommended examining the association between food shopping motivators and the HFE in a larger population.
Collapse
Affiliation(s)
- Abiodun T Atoloye
- Department of Nutrition, Dietetics, and Food Science, Utah State University, Logan, UT
| | - Carrie Durward
- Department of Nutrition, Dietetics, and Food Science, Utah State University, Logan, UT.
| |
Collapse
|
35
|
Bishop NJ, Wang K. Food insecurity, comorbidity, and mobility limitations among older U.S. adults: Findings from the Health and Retirement Study and Health Care and Nutrition Study. Prev Med 2018; 114:180-187. [PMID: 30003897 DOI: 10.1016/j.ypmed.2018.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 01/16/2023]
Abstract
Both food insecurity and comorbidity have been identified as precursors to functional limitation in older adults, yet whether food insecurity modifies the progression from chronic disease to disability has not been assessed. We examined 5986 respondents age 50 and older drawn from the 2012-2014 Health and Retirement Study (HRS) and 2013 Health Care and Nutrition Study (HCNS). Mobility limitations reported in 2014 and change in mobility limitations from 2012 to 2014 were regressed on measures of food insecurity, number of chronic conditions, and their interaction terms using Poisson regression. Around 17.3% of the sample was identified as food insecure. In 2012, respondents reported an average of 1.9 (SD = 1.5) chronic conditions and 2.4 mobility limitations (SD = 3.0). In 2014, individuals reported an average of 2.5 (SD = 3.1) mobility limitations. Food insecurity was associated with a greater number of mobility limitations (IRR = 1.20, 95% CI: 1.11-1.29, p < .001) and more rapid increase in mobility limitations over the two-year observational period (IRR = 1.06, 95% CI: 1.00-1.11, p = .047). Food security status also modified the association between comorbidity and both mobility limitation outcomes, with the food secure exhibiting a stronger positive association between chronic conditions and mobility limitations than the food insecure. The food insecure tended to have more mobility limitations than the food secure when few chronic conditions were reported. Our results suggest that food insecurity is associated with prevalence and change in mobility limitations among older adults.
Collapse
Affiliation(s)
- Nicholas J Bishop
- School of Family and Consumer Sciences, College of Applied Arts, Texas State University, 601 University Drive, San Marcos, TX 78666, USA.
| | - Kaipeng Wang
- School of Social Work, College of Applied Arts, Texas State University, 601 University Drive, San Marcos, TX 78666, USA
| |
Collapse
|
36
|
Fernandes SG, Rodrigues AM, Nunes C, Santos O, Gregório MJ, de Sousa RD, Dias S, Canhão H. Food Insecurity in Older Adults: Results From the Epidemiology of Chronic Diseases Cohort Study 3. Front Med (Lausanne) 2018; 5:203. [PMID: 30050904 PMCID: PMC6052142 DOI: 10.3389/fmed.2018.00203] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 06/25/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: The public health problem of food insecurity also affects the elderly population. This study aimed to estimate the prevalence of household food insecurity and its associations with chronic disease and health-related quality of life characteristics in individuals ≥65 years of age living in the community in Portugal. Methods: The data were collected from the Epidemiology of Chronic Diseases Cohort Study 3 (EpiDoC3)-Promoting Food Security Study (2015-2016), which was the third evaluation wave of the EpiDoC and represented the Portuguese adult population. Food insecurity was assessed using a psychometric scale adapted from the Brazilian Food Insecurity Scale. The data on sociodemographic variables, chronic disease, and management of chronic disease were self-reported. Health-related quality of life were assessed using the European Quality of Life Survey (version validated for the Portuguese population). Logistic regression models were used to determine crude and adjusted odds ratios (for age group, gender, region, and education). The dependent variable was the perceived level of food security. Results: Among older adults, 23% were living in a food-insecure household. The odds of living in a food-insecure household were higher for individuals in the 70-74 years age group (odds ratio (OR) = 1.405, 95% confidence interval (CI) 1.392-1.417), females (OR = 1.545, 95% CI 1.534-1.556), those with less education (OR = 3.355, 95% CI 3.306-3.404), low income (OR = 4,150, 95% CI 4.091-4.210), and those reporting it was very difficult to live with the current income (OR = 16.665, 95% CI 16.482-16.851). The odds of having a chronic disease were also greater among individuals living in food-insecure households: diabetes mellitus (OR = 1.832, 95% CI 1.818-1.846), pulmonary diseases (OR = 1.628, 95% CI 1.606-1.651), cardiac disease (OR = 1.329, 95% CI 1.319-1.340), obesity (OR = 1.493, 95% CI 1.477-1.508), those who reduced their frequency of medical visits (OR = 4.381, 95% CI 4.334-4.428), and who stopped taking medication due to economic difficulties (OR = 5.477, 95% CI 5.422-5.532). Older adults in food-insecure households had lower health-related quality of life (OR = 0.212, 95% CI 0.210-0.214). Conclusions: Our findings indicated that food insecurity was significantly associated with economic factors, higher values for prevalence of chronic diseases, poor management of chronic diseases, and decreased health-related quality of life in older adults living in the community.
Collapse
Affiliation(s)
- Simone G. Fernandes
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Ana M. Rodrigues
- CEDOC, EpiDoc Unit – Unidade de Epidemiologia em Doenças Crónicas, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Osvaldo Santos
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Maria J. Gregório
- CEDOC, EpiDoc Unit – Unidade de Epidemiologia em Doenças Crónicas, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Rute Dinis de Sousa
- CEDOC, EpiDoc Unit – Unidade de Epidemiologia em Doenças Crónicas, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Sara Dias
- CEDOC, EpiDoc Unit – Unidade de Epidemiologia em Doenças Crónicas, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Helena Canhão
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
- CEDOC, EpiDoc Unit – Unidade de Epidemiologia em Doenças Crónicas, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| |
Collapse
|