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Bartoskova Polcrova A, Ksinan Jiskrova G, Bobak M, Pikhart H, Klánová J, Ksinan AJ. Early life social conditions and adverse experiences are associated with childhood BMI and perceived overeating. Pediatr Obes 2024:e13179. [PMID: 39379172 DOI: 10.1111/ijpo.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 08/22/2024] [Accepted: 09/13/2024] [Indexed: 10/10/2024]
Abstract
BACKGROUND Early life socioeconomic disadvantage and adverse experiences may lead to overeating, which is in turn associated with increased body mass index (BMI). However, recent evidence indicated that the association between childhood BMI and overeating might be bidirectional. This bidirectionality prompts the need for further investigation of early life predictors of BMI in childhood. OBJECTIVES To longitudinally assess the directionality of the association between childhood BMI and perceived overeating and to investigate their antecedent early life predictors. METHODS The sample included data from 5151 children from the ELSPAC study, collected between 18 months and 11 years of child age. The outcomes were child BMI and mother-reported overeating, assessed at the age of 3, 5, 7 and 11 years. Predictors included maternal BMI, maternal education, single parenthood, financial difficulties and adverse childhood experiences (ACEs) reported by parents and paediatricians. The random intercept cross-lagged panel model was applied. RESULTS The mean child's BMI at age 3 was 15.59 kg/m2 and increased to 17.86 kg/m2 at age 11. The percentage of parent-reported overeating increased in the following period, from about 12% at age 3 to 17% at age 11. The results showed temporal stability in perceived overeating and BMI, with a bidirectional relationship strengthening over time. The child's BMI was associated with maternal BMI. Maternal BMI was positively associated with child-perceived overeating, but a stronger effect was found for ACEs. ACEs mediated the impact of maternal education, financial difficulties and single parenthood on overeating. CONCLUSIONS We observed stable bidirectional associations between BMI and perceived overeating. The results indicated two main pathways: one linked to maternal BMI and early childhood BMI increase followed by perceived overeating and the second associated with ACEs mediating the effect of early childhood social factors on perceived overeating, leading to gradual BMI gain.
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Affiliation(s)
| | | | - Martin Bobak
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jana Klánová
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Albert J Ksinan
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
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Saad A, Brandt EJ, Faridi KF, Paster JW, Sheth S, Freeman AM, Ramirez V, Aggarwal M. Rethinking Our Roots: The Ground-Up Approach to Heart Health & Planetary Sustainability. Am J Med 2024:S0002-9343(24)00625-9. [PMID: 39383927 DOI: 10.1016/j.amjmed.2024.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 09/24/2024] [Accepted: 09/24/2024] [Indexed: 10/11/2024]
Abstract
Cardiovascular disease is the leading cause of death in the United States. Poor dietary habits are not only a major modifiable risk factor for cardiovascular disease and other chronic illnesses, but they also harm planetary health. Our food system is complex, shaped by agricultural practices and human behaviors. To change it, we need to understand why current agricultural practices exist and address nutrition education, food insecurity, and nutritional security. There are effective ways to make our food system healthier, more equitable, and more sustainable. The best available evidence points to plant-forward diets as the keystone to this complex issue. This manuscript reviews how human and planetary health are connected through our food system and suggests solutions for diets that prevent and treat cardiovascular disease while promoting planetary health.
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Affiliation(s)
- Ali Saad
- Climate and Health Program, University of Colorado, Denver, CO, USA
| | - Eric J Brandt
- Division of Cardiovascular Medicine, Department of Internal Medicine and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Kamil F Faridi
- Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven CT, USA
| | | | - Sohum Sheth
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver CO, USA
| | - Verity Ramirez
- Division of Cardiology, Brown University, Providence, RI, USA
| | - Monica Aggarwal
- Division of Cardiology, University of Florida, Gainesville, FL, USA.
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Pitman SA, Pasch KE, Poulos NS, Velazquez CE. Food insecurity and substance use among young adults in the United States. Prev Med 2024; 189:108148. [PMID: 39369996 DOI: 10.1016/j.ypmed.2024.108148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 09/30/2024] [Accepted: 10/01/2024] [Indexed: 10/08/2024]
Abstract
PURPOSE The purpose of this study was to examine the association between food insecurity and substance use among young adults aged 18-25 in the U.S. METHODS A cross-sectional online survey was completed by a diverse sample of 1024 young adults (50.2 % female; 62 % non-white; m age = 21.7[SD = 2.26]) between January-April 2022. Logistic regression analyses were used to examine the association between food insecurity and current cigarette use, Electronic Nicotine Delivery System (ENDS) use, cannabis use, alcohol use, and binge drinking controlling for socio-demographic and economic factors, mental health, and experiences of discrimination. RESULTS Nearly 70 % of participants reported being food insecure over the past year. Substance use was also common: 45.9 % of participants reported current cigarette use, 50.9 % ENDS use, 57 % cannabis use, 65.9 % alcohol use, and 50.4 % engaged in binge drinking in the past two weeks. Being food insecure was associated with greater odds of cigarette use (OR = 2.49, 95 % CI = [1.77, 3.50]), ENDS use (OR = 2.18, 95 % CI = [1.58, 3.01]), cannabis use (OR = 1.73, 95 % CI = [1.26, 2.37]), alcohol use (OR = 1.60, 95 % CI = [1.16, 2.19]) and binge drinking (OR = 1.98, 95 % CI = [1.44, 2.72]), controlling for all other factors. CONCLUSION Food insecurity may serve as an important indicator of substance use among young adults. Practitioners should consider screening for food insecurity, providing information about food access, and developing interventions to address food insecurity among the young adults with whom they work. Future research should examine these associations prospectively to better understand how food insecurity may contribute to the initiation and/or escalation of substance use.
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Affiliation(s)
- Sarah A Pitman
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA.
| | - Natalie S Poulos
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Cayley E Velazquez
- Department of Biological and Health Sciences, Kwantlen Polytechnic University, Surrey, BC, Canada
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Lee J, Helgeson E, Horning ML, Elgesma KM, Kubik MY, Fulkerson JA. Food Insecurity and Changes in Diet Quality and Body Mass Index z-Scores Among Elementary School Students. Child Obes 2024; 20:508-516. [PMID: 38546529 DOI: 10.1089/chi.2023.0185] [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] [Indexed: 07/19/2024]
Abstract
Background: Previous research has identified food insecurity as a risk factor for obesity but those studies employed cross-sectional designs and were largely focused on adults and young children. In addition, there is a paucity of studies examining the association between food insecurity and changes in children's overall diet quality. This study aimed to assess whether food insecurity is associated with subsequent changes in diet quality and BMI z-scores over 2 years among 7- to 12-year-old children. Methods: We used 2011-2019 secondary data (n = 404) from three randomized controlled trials in Minnesota. Food insecurity was identified using the U.S. Household Food Security Survey Module at baseline (Time 0). Diet quality was determined using the Healthy Eating Index (HEI)-2015 from 24-hour recalls, and BMI z-scores were calculated using measured height and weight. These two outcomes were measured at Time 0, Time 1 (10-12 months from Time 0), and Time 2 (15-24 months from Time 0). Results: Compared with children from food-secure households, those from food-insecure households experienced a 0.13 greater increase in BMI z-scores from Time 0 to Time 2 [95% confidence interval (CI): 0.04 to 0.21] and a 4.5 point increase in HEI-2015 from Time 0 to Time 1 (95% CI: 0.99 to 8.01). Conclusion: Household food insecurity may widen weight disparities among elementary school-aged children. Further studies are needed to identify the role of diet quality in weight changes among children with food insecurity. Clinical Trial Registration Number: NCT01538615, NCT02029976, NCT02973815.
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Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Erika Helgeson
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Martha Y Kubik
- School of Nursing, College of Public Health, George Mason University, Fairfax, VA, USA
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Zelber-Sagi S, Carrieri P, Pericàs JM, Ivancovsky-Wajcman D, Younossi ZM, Lazarus JV. Food inequity and insecurity and MASLD: burden, challenges, and interventions. Nat Rev Gastroenterol Hepatol 2024; 21:668-686. [PMID: 39075288 DOI: 10.1038/s41575-024-00959-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/31/2024]
Abstract
Liver disease prevalence, severity, outcomes and hepatic risk factors (for example, unhealthy diet) are heavily affected by socioeconomic status and food insecurity. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver disease globally and is likely to co-occur with other liver diseases associated with food insecurity. Though weight reduction and adopting a healthy diet can reverse the course of MASLD, gaps between recommendations and practice transcend individual responsibility and preference. Broader sociocultural determinants of food choices (social nutrition) include food insecurity, community and social norms and the local environment, including commercial pressures that target people experiencing poverty, ethnic minorities and children. Food insecurity is a barrier to a healthy diet, as a low-quality diet is often less expensive than a healthy one. Consequently, food insecurity is an 'upstream' risk factor for MASLD, advanced fibrosis and greater all-cause mortality among patients with liver disease. Intervening on food insecurity at four major levels (environment, policy, community and health care) can reduce the burden of liver disease, thereby reducing social and health inequities. In this Review, we report on the current research in the field, the need for implementing proven interventions, and the role liver specialists can have.
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Affiliation(s)
- Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
- The Global NASH Council, Washington, DC, USA.
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Juan M Pericàs
- Liver Unit, Vall d'Hebron University Hospital, Vall d'Hebron Institute for Research, Universitat Autònoma de Barcelona, CIBERehd, Barcelona, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center, Barcelona, Spain
| | - Dana Ivancovsky-Wajcman
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Zobair M Younossi
- The Global NASH Council, Washington, DC, USA
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington, DC, USA
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
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Berge JM, Hazzard VM, Arlinghaus KR, Larson N, Hahn SL, Neumark-Sztainer D. Do parents engage in weight- and health-focused conversations with their emerging adult children and are there cross-sectional associations with weight and well-being outcomes? Prev Med 2024; 186:108066. [PMID: 39004315 PMCID: PMC11405058 DOI: 10.1016/j.ypmed.2024.108066] [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: 05/07/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Research indicates harmful associations between parental weight-focused conversations and markers of pediatric health and well-being. However, little is known about the prevalence and consequences of parent conversations focused on weight or health behaviors (i.e., physical activity or nutrition) with emerging adult children. METHODS Data are from the 2018 follow-up survey of the population-based EAT 2010-2018 (Eating and Activity over Time) in cohort from Minneapolis-St. Paul, MN. Participants were emerging adults at follow-up with ages 18-26. Regression models adjusted for sociodemographic characteristics were conducted. RESULTS Over two-thirds (68%) of mothers and 44% of fathers engaged in weight-focused conversations with their emerging adult children; 25% of both parents reported engaging in conversations focused only on health behaviors; and 8% of mothers and 26% of fathers reported not engaging in either type of conversation. Health-focused conversations by both parents were associated with lower body mass index (BMI) and disordered eating behaviors, higher intake of fruit and vegetables, and psychosocial well-being in emerging adult children. Weight-focused conversations with both parents were associated with higher BMI and disordered eating behaviors in emerging adults. There were gender moderated associations of paternal conversations about weight and health with vegetable intake, binge eating, and depressive symptoms. DISCUSSION The high prevalence and negative health outcomes associated with weight-focused conversations coupled with the low prevalence and positive health outcomes associated with health-focused conversations by parents suggests the need for public health messaging and intervention development aimed at reducing parental weight talk with emerging adult children.
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Affiliation(s)
- Jerica M Berge
- University of Colorado Anschutz Medical Campus, Department of Family Medicine, and Adult and Child Center for Outsomes Research and Delivery Science (ACCORDS), Aurora, CO, USA.
| | - Vivienne M Hazzard
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Katherine R Arlinghaus
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Nicole Larson
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Samantha L Hahn
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Dianne Neumark-Sztainer
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
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Mmari K, Harper K, Kawatachi J, Jenkins M, Gross S, Lu S, Skinner R, Marshall B. The Association between Federal Nutrition Assistance Programs and Adolescent Food Security during the COVID-19 Pandemic: Evidence from Baltimore, Maryland. Nutrients 2024; 16:2876. [PMID: 39275192 PMCID: PMC11397004 DOI: 10.3390/nu16172876] [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: 07/23/2024] [Revised: 08/20/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
Given the lack of attention on adolescent food insecurity, the primary objective of this study was to assess the association of household participation in federal food assistance programs with food security status among adolescents in Baltimore during the COVID-19 pandemic. Adolescents, ages 14-19 years, were invited to participate in two online surveys. The baseline was implemented between October 2020 and January 2021, while the follow-up took place one year later from November 2021 to January 2022 after schools had re-opened. We then matched survey participants with household participation in food nutrition assistance programs using data obtained from the Maryland Department of Social Services. We used logistic regression to examine the association between food assistance program participation status and food insecurity. Additionally, to examine whether the impact of program participation on food insecurity changed between the baseline survey and one year later at follow-up when schools re-opened, a difference-in-differences analysis was conducted. The results showed no significant associations between adolescent food security and participation in any of the federal nutrition assistance programs. Increased attention on how best to improve adolescent food security in low-income households that can respond to the unique needs of adolescents is clearly warranted.
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Affiliation(s)
- Kristin Mmari
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Kaitlyn Harper
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Jon Kawatachi
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Marina Jenkins
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Susan Gross
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Stacy Lu
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Rebecca Skinner
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Beth Marshall
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Loomba P, Raber MR, Aquino M, Rincon N, Rumfield L, Basen‐Engquist KM, Rechis R. Enhancing food access in a comprehensive cancer center area of influence through local partner capacity building. Cancer Med 2024; 13:e70070. [PMID: 39152705 PMCID: PMC11329840 DOI: 10.1002/cam4.70070] [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: 05/03/2024] [Revised: 06/28/2024] [Accepted: 07/23/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Food insecurity, an economic and social condition of limited food access, is associated with poor diet quality-a risk factor for several common cancers. The University of Texas MD Anderson Cancer Center supports healthy food access through community-led evidence translation by actively partnering with community-based organizations (CBOs). These partnerships aim to enhance the capacity of food assistance CBOs to effectively implement evidence-based food insecurity mitigation programs in the cancer center's area of influence. METHODS This case study aims to describe the cancer center's model for local food access capacity building and detail operationalization in the context of a whole-community cancer prevention effort (Be Well Baytown) in Baytown, Texas. RESULTS Elements central to the capacity building model include (i) assessment of baseline needs and capacity, (ii) empowering a community champion within a relevant CBO, (iii) mapping inter-sectoral community partnerships, collaborations, and linkages, and (iv) leveraging systems, connections, and resources to provide an enabling environment for overall food access systems growth. Through this process, Be Well Baytown enhanced the capacity of a local food pantry leading to increases in total reach, pounds of food distributed, and number of food distribution events in collaboration with intersectoral partners from 2018 to 2023. CONCLUSION This case study highlights the model's implementation as a co-benefit community partnership strategy to maximize the impact of food security programs integrated with comprehensive cancer center prevention efforts.
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Affiliation(s)
- Preena Loomba
- Department of Health Disparities ResearchUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Margaret R. Raber
- Department of Health Disparities ResearchUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Mayra Aquino
- Cancer Prevention and Control PlatformUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | | | - Lori Rumfield
- Goose Creek Consolidated Independent School DistrictBaytownTexasUSA
| | - Karen M. Basen‐Engquist
- Department of Health Disparities ResearchUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Ruth Rechis
- Cancer Prevention and Control PlatformUniversity of Texas MD Anderson Cancer CenterHoustonTexasUSA
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Royer MF, Hauser ME, Zamora AN, Campero MI, Garcia D, Gabaray M, Sheats JL, King AC. Serving up FLAN. a food literacy and nutrition intervention to fend off food insecurity. BMC Nutr 2024; 10:102. [PMID: 39044224 PMCID: PMC11264464 DOI: 10.1186/s40795-024-00909-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 07/09/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Food insecurity, an ongoing and accelerating problem in the U.S., is an economic and social condition involving limited or uncertain access to adequate food. Some of the highest rates of food insecurity in 2022 were found among individuals who were Hispanic/Latinx (20.8%), a population that already faces disproportionate health and socioeconomic disadvantages. There remains an urgent health-related need to identify sustainable strategies to prevent food insecurity in the Latinx population. METHODS A first-generation pilot investigation was conducted using data derived from a sub-study connected to the Computerized Physical Activity Support for Seniors (COMPASS) Trial, a 12-month cluster-randomized controlled trial among older Latinx adults. The sub-study focused on two nutrition interventions that included (1) the Food Literacy and Nutrition (FLAN) curriculum, and (2) a nutrition information-only control. Research hypotheses aimed to determine whether the FLAN intervention reduced food insecurity and increased daily fruit and vegetable servings. RESULTS On average, participants (n = 39) were 61.5 years of age (SD = 6.7), mostly female (69%), and reported Spanish as their primary language (69%). The FLAN intervention was associated with decreased odds of food insecurity at 12 months (AOR = 0.71, 95% CI = 0.54, 0.95; p = 0.03) when compared to the nutrition-information only control intervention. Although no between-group differences in daily fruit and vegetable servings were found, there was a significant correlation between changes in daily fruit and vegetable servings from baseline to six months and changes in food insecurity from baseline to 12 months (r = -0.51, p = 0.01). CONCLUSIONS The FLAN intervention, a bilingual and culturally tailored educational curriculum, yielded 12-month improvements in food security among a small sample of older Latinx adults. Evidence from this investigation highlights the potential utility of implementing the FLAN curriculum among individuals who are at an increased risk of food insecurity. Further investigation in a larger sample is merited to determine whether the 12-month decreases in food insecurity that were produced by the FLAN intervention can be replicated. TRIAL REGISTRATION ClinicalTrials gov Identifier: NCT02111213. Registered on 04/02/2014.
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Affiliation(s)
- Michael F Royer
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Michelle E Hauser
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA, USA
- Palo Alto Veterans Affairs Health Care System, Internal Medicine-Obesity Medicine, Palo Alto, CA, USA
| | - Astrid N Zamora
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Maria Ines Campero
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Dulce Garcia
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Martha Gabaray
- Stanford Medicine Children's Health, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Jylana L Sheats
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, LA, USA
- The Aspen Institute Science & Society Program, District of Columbia, 2300 N St NW, Washington, USA
| | - Abby C King
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
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Hammad NM, Zimmer M, Chen JT, Tobias DK, Willett WC, Leung CW. Associations Between Food Insecurity and Diet Quality Among Graduate Students and Postdoctoral Trainees in the Health Sciences at a Private University in Boston: A Cross-Sectional Study. Curr Dev Nutr 2024; 8:102157. [PMID: 39035701 PMCID: PMC11258709 DOI: 10.1016/j.cdnut.2024.102157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/29/2024] [Accepted: 04/06/2024] [Indexed: 07/23/2024] Open
Abstract
Background Food insecurity is a pivotal determinant of health outcomes. Little evidence exists on the association between food insecurity and health behaviors and outcomes, including diet quality, among graduate students or postdoctoral trainees. Objectives This study aimed to examine the association between food insecurity and diet quality among graduate students and postdoctoral trainees at 3 health-focused graduate schools (public health, medical, and dental medicine) within Harvard University. Methods Between April and June 2023, 1287 graduate students and 458 postdoctoral trainees at the health-focused schools within Harvard University completed a web-based survey. The primary exposure was food security status, assessed using the United States Household Food Security Survey Module. The primary outcome was diet quality, measured using the 30-day Prime Diet Quality Score screener (ranges from 0 to 126, with higher scores indicating healthier diets). The associations between food insecurity and diet quality were examined using multivariable regression models, adjusting for sociodemographic covariates. Results Among graduate students, compared with those with high food security, diet quality was significantly lower among those experiencing marginal food security [β: -4.7; 95% confidence interval (CI): -6.5, -2.9], low food security (β: -5.4; 95% CI: -7.6, -3.3), and very low food security (β: -4.4; 95% CI: -7.4, -1.4). Poor diet quality included lower intake frequencies of vegetables, fruits, beans/peas/soy products, nuts/seeds, poultry, fish, low-fat dairy, and liquid oils, and higher intake frequencies of refined grains/baked products, sugar-sweetened beverages, and fried foods. Among postdoctoral trainees, compared with those with high food security, diet quality was significantly lower among those experiencing low food security (β: -5.1; 95% CI: -8.8, -1.4), and very low food security (β: -5.2; 95% CI: -10.2, -0.2). Poor diet quality included lower intake frequencies of dark green leafy vegetables, other fruits, and whole grains. Conclusions Graduate students and postdoctoral trainees who experienced degrees of food insecurity reported lower diet quality. These observations underscore the need for policies and interventions to simultaneously reduce food insecurity and improve diet quality.
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Affiliation(s)
- Nour M Hammad
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Meghan Zimmer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Royer MF, Hauser ME, Zamora AN, Campero MI, Garcia D, Gabaray M, Sheats JL, King AC. Serving Up FLAN. A Food Literacy and Nutrition Intervention to Fend Off Food Insecurity. RESEARCH SQUARE 2024:rs.3.rs-4331290. [PMID: 38766254 PMCID: PMC11100874 DOI: 10.21203/rs.3.rs-4331290/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background Food insecurity, an ongoing and accelerating problem in the U.S., is an economic and social condition involving limited or uncertain access to adequate food. Some of the highest rates of food insecurity in 2022 were found among individuals who were Hispanic-Latinx (20.8%), a population that already faces disproportionate health and socioeconomic disadvantages. There remains an urgent health-related need to identify sustainable strategies to prevent food insecurity in the Latinx population. Methods A first-generation pilot investigation was conducted using data derived from a sub-study connected to the Computerized Physical Activity Support for Seniors (COMPASS) Trial, a 12-month cluster-randomized controlled trial among older Latinx adults. The sub-study focused on two nutrition interventions that included 1) the Food Literacy and Nutrition (FLAN) curriculum, and 2) a nutrition information-only control. Research hypotheses aimed to determine whether the FLAN intervention reduced food insecurity and increased daily fruit and vegetable servings. Results On average, participants (n = 39) were 61.5 years of age (SD = 6.7), mostly female (69%), and reported Spanish as their primary language (69%). The FLAN intervention was associated with decreased odds of food insecurity at 12 months (AOR = 0.71, 95% CI = 0.54, 0.95; p = 0.03) when compared to the nutrition-information only control intervention. Although no between-group differences in daily fruit and vegetable servings were found, there was a significant correlation between changes in daily fruit and vegetable servings from baseline to six months and changes in food insecurity from baseline to 12 months (r = -0.51, p = 0.01). Conclusions The FLAN intervention, a bilingual and culturally tailored educational curriculum, yielded 12-month improvements in food security among a small sample of older Latinx adults. Evidence from this investigation suggests the potential utility of implementing the FLAN curriculum among individuals who are at an increased risk of food insecurity. Further investigation in a larger sample is merited to determine whether the 12-month decreases in food insecurity that were produced by the FLAN intervention can be replicated. Trial Registration ClinicalTrials.gov Identifier: NCT02111213.
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Affiliation(s)
- Michael F Royer
- Stanford Prevention Research Center, Stanford University School of Medicine
| | - Michelle E Hauser
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine
| | - Astrid N Zamora
- Stanford Prevention Research Center, Stanford University School of Medicine
| | - Maria Ines Campero
- Department of Epidemiology and Population Health, Stanford University School of Medicine
| | - Dulce Garcia
- Department of Epidemiology and Population Health, Stanford University School of Medicine
| | - Martha Gabaray
- Stanford Medicine Children's Health, Lucile Packard Children's Hospital Stanford
| | - Jylana L Sheats
- Tulane University School of Public Health and Tropical Medicine
| | - Abby C King
- Stanford Prevention Research Center, Stanford University School of Medicine
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Slotnick MJ, Ansari S, Parnarouskis L, Gearhardt AN, Wolfson JA, Leung CW. Persistent and Changing Food Insecurity Among Students at a Midwestern University is Associated With Behavioral and Mental Health Outcomes. Am J Health Promot 2024; 38:483-491. [PMID: 38130004 PMCID: PMC11044134 DOI: 10.1177/08901171231224102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE To assess associations between persistent and changing food insecurity and behavioral and mental health outcomes in college students. DESIGN Online surveys conducted November 2018 and March 2019 (freshman year), and March 2020 (sophomore year) were used to assess food insecurity, which was then used to create 4 food security transitions: persistent food insecurity, emergent food insecurity, emergent food security, and persistent food security. SETTING Large Midwestern university. SAMPLE 593 students completing all 3 surveys. MEASURES Dietary intake and behavioral and mental health outcomes (eating disorders, anxiety, depression, sleep quality) were assessed using validated instruments. ANALYSIS Associations between food security transitions and dietary intake, behavioral, and mental health outcomes were examined using generalized linear models. RESULTS Compared to persistent food security, emergent and persistent food insecurity was associated with lower (7% and 13% respectively) intake of fruits and vegetables combined; persistent food insecurity was associated with 17% lower intake of fruits, 6% lower intake of fiber and 10% higher intake of added sugar from beverages. Compared to persistent food secure students, eating disorder symptom risk was higher for emergent food insecure (OR = 7.61, 95% CI: 3.32, 17.48), and persistent food insecure (OR = 6.60, 95% CI: 2.60, 16.72) students; emergent (OR = 2.05, 95% CI: 1.14, 3.71) and persistent (OR = 2.55, 95% CI: 1.34, 4.87) food insecure students had higher odds of poor sleep quality, and persistent food insecure, emergent food insecure, and emergent food secure students had higher odds of anxiety and depression (OR range 2.35-2.85). CONCLUSION Food security transitions were associated with aspects of low diet quality and poorer behavioral and mental health outcomes among college students.
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Affiliation(s)
- Melissa J Slotnick
- Department of Nutritional Sciences, School of Public Health, The University of Michigan, Ann Arbor, MI, USA
| | - Saba Ansari
- Department of Health Management and Policy, School of Public Health, The University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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13
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Tucker JS, Perez LG, Klein DJ, D'Amico EJ. Homelessness and Food Insecurity During Emerging Adulthood: Associations With Changes in Behavioral and Physical Health Over a Two-Year Period. J Adolesc Health 2024; 74:1006-1011. [PMID: 38323969 PMCID: PMC11031281 DOI: 10.1016/j.jadohealth.2023.12.007] [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: 04/21/2023] [Revised: 09/22/2023] [Accepted: 12/02/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE For emerging adults in the United States, economic instability is a widespread problem with implications for the successful transition to adulthood. This study examines how two indicators of economic instability, homelessness and food insecurity, are associated with changes in health-related outcomes over a two-year period. METHODS The analytic sample (N = 2,182) completed online surveys in 2019-2020 (mean age 23 years) and 2021-2022 (mean age 25 years). Regression analyses were conducted for the full sample, as well as by sexual or gender diverse (SGD) identity (17.8% of sample identified as SGD) and race/ethnicity (76.3% identified as non-White). RESULTS At age 23, 8.2% of participants reported homelessness and 31.2% reported food insecurity. In the full sample, homelessness and food insecurity were associated with increased depression, anxiety, physical ailments, and drug problems two years later. A similar pattern emerged for those identifying as non-SGD. The only associations for SGD-identifying participants were food insecurity with increased anxiety, depression, and physical ailments. Racial/ethnic differences indicated that homelessness was associated with increased depression and anxiety among Hispanics, and physical ailments and drug consequences among Asians, but fewer drug problems among Whites. Food insecurity was associated with increased depression in all racial/ethnic groups, anxiety among Hispanics and Asians, physical ailments among Whites and Asians, and drug problems among Asians. DISCUSSION Homelessness and food insecurity predicted worse health outcomes during the transition to adulthood, with varying results across SGD and racial/ethnic subgroups. It is important for future research to continue examining long-term effects of economic instability on health disparities during this important developmental period.
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14
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Hammad NM, Wolfson JA, de Ferranti SD, Willett WC, Leung CW. Food Insecurity and Ideal Cardiovascular Health Risk Factors Among US Adolescents. J Am Heart Assoc 2024; 13:e033323. [PMID: 38591328 PMCID: PMC11262504 DOI: 10.1161/jaha.123.033323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/08/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Food insecurity, a social and economic condition of limited availability of healthy food, is a risk factor for adverse cardiovascular health outcomes among adults; few studies have been conducted in adolescents. This study explores the association between food insecurity and cardiovascular health risk factors among a nationally representative sample of US adolescents, adopting the American Heart Association's Life's Essential 8 metric. METHODS AND RESULTS We analyzed data from 2534 adolescents aged 12 to 19 years from the 2013 to 2018 National Health and Nutrition Examination Surveys. In the sample, 24.8% of adolescents lived in food-insecure households. After multivariable adjustment, food insecurity was associated with a 3.23-unit lower total Life's Essential 8 score (95% CI, -6.32, -0.15) and lower scores on diet quality (β=-5.39 [95% CI, -8.91, -1.87]) and nicotine exposure (β=-4.85 [95% CI, -9.24, -0.45]). Regarding diet, food insecurity was associated with 5% lower Healthy Eating Index-2015 scores [95% CI, -7%, -2%], particularly lower intakes of whole grains and seafood/plant proteins and marginally higher intake of added sugar. Regarding nicotine exposure, food insecurity was associated with ever use of a tobacco product among m (odds ratio, 1.74 [95% CI, 1.20-2.53]). Compared with their food-secure counterparts, food-insecure male (odds ratio, 1.98 [95% CI, 1.07-3.65]) and female (odds ratio, 3.22 [95% CI, 1.60-6.45]) adolescents had higher odds of living with a current indoor smoker. CONCLUSIONS In this nationally representative sample of adolescents, food insecurity was associated with multiple indicators of cardiovascular health risk. These findings underscore the need for public health interventions and policies to reduce food insecurity and improve cardioprotective behaviors during adolescence, with particular efforts targeting diet quality and nicotine exposure.
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Affiliation(s)
- Nour M. Hammad
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMA
| | - Julia A. Wolfson
- Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | | | - Walter C. Willett
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMA
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
| | - Cindy W. Leung
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMA
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15
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Kohanmoo A, Hashemzadeh M, Teymouri M, Zare M, Akhlaghi M. Food insecurity is associated with low diet quality and unhealthy cooking and eating habits in Iranian women. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:42. [PMID: 38486251 PMCID: PMC10941397 DOI: 10.1186/s41043-024-00533-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/02/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Food insecurity affects diet and nutrition intakes. We explored the relationship between food insecurity and dietary intakes in a group of Iranian women. METHODS The cross-sectional study was performed on 190 healthy females aged 20-55 years attending primary healthcare centers in Shiraz. Food insecurity was evaluated by Household Food Insecurity Access Scale, which is a validated tool for assessing food insecurity in developing countries. Diet was assessed using a food frequency questionnaire. The association of dietary patterns and food insecurity was assessed by linear regression. RESULTS Assessment of dietary intakes revealed that consumption of red meat, poultry, fish, dairy, fruits, non-starchy vegetables, and nuts decreased whereas that of grains, processed meats, potato, and sugary foods increased with increasing food insecurity. Among nutrients, carbohydrates, fiber, vitamin A, vitamin C, folic acid, potassium, calcium, and magnesium decreased while fat and sodium increased as food insecurity increased. Three major dietary patterns were detected. Healthy dietary patterns showed inverse associations with food insecurity in the crude (β = -0.422 and - 0.435, P < 0.001) and adjusted (adjusted for age, marital status, and educational level) (β = -0.475 and - 0.341, P < 0.001) models of regression analysis but unhealthy pattern did not show an association with food insecurity. Compared to food secure participants, a higher percentage of food insecure individuals indicated unhealthy eating habits, such as skipping breakfast, lower snack ingestion, more fast and fried food consumption, and using unhealthy cooking methods. CONCLUSION Overall, this study showed that food insecurity was associated with less healthy diet and unhealthy cooking and eating habits.
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Affiliation(s)
- Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maral Hashemzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Teymouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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16
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Yoon CY, Arlinghaus KR, Ledoux TA, Johnston CA, Larson N, Neumark-Sztainer D. Associations of regular consumption of breakfast, lunch and dinner with Body Mass Index during adolescence: longitudinal findings by weight status among the Eating and Activity over Time 2010-2018 cohort. Public Health Nutr 2024; 27:e95. [PMID: 38384116 PMCID: PMC10993067 DOI: 10.1017/s1368980024000454] [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: 09/21/2022] [Revised: 12/18/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE To examine how the associations between meal consumption and BMI over 8 years differ by weight status in a sample of adolescents. DESIGN Longitudinal, population-based study. Breakfast, lunch and dinner consumption and BMI were self-reported. Linear regressions were used to examine how the associations between meal consumption and BMI differed by weight status. SETTING Adolescents in the Minneapolis/St. Paul metropolitan area. PARTICIPANTS Adolescents (n 1,471) were surveyed as part of the EAT 2010-2018 in 2009-2010 (Mage = 14·3 years) and 2017-2018 (Mage = 22·0 years). RESULTS The prevalence of regular breakfast, lunch and dinner consumption (≥ 5 times/week) ranged from 45 to 65 %, 75 to 89 % and 76 to 94 %, respectively, depending on weight status category. Among adolescents with a sex- and age-specific BMI < 15th percentile, regular consumptions of breakfast, lunch and dinner during adolescence were positively associated with BMI in emerging adulthood compared with irregular consumption of breakfast, lunch and dinner (<5 times/week) after adjustment for socio-demographic characteristics (β = 5·43, β = 5·39 and β = 6·46, respectively; all P-values <0·01). Among adolescents in the BMI 15-85th and 85-95th percentiles, regular consumptions of breakfast, lunch and dinner were positively associated with BMI but to a lesser extent (P-values <0·01). For participants with a BMI ≥ 95th percentile, regular consumptions of breakfast, lunch and dinner were positively associated with BMI, but the associations were not statistically significant (P-values > 0·05). CONCLUSIONS The relationship between meal consumption during adolescence and BMI in emerging adulthood differs by adolescent weight status. Future studies should investigate underlying factors related to meal consumption routines and BMI.
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Affiliation(s)
- Cynthia Y Yoon
- Department of Health and Human Performance, College of Liberal Arts and
Social Sciences, University of Houston, 3875 Holman Street, Room
104, Houston, TX, USA
| | - Katherine R Arlinghaus
- Division of Epidemiology and Community Health, University of
Minnesota School of Public Health, 1300 S 2nd St Suit 300,
Minneapolis, MN, USA
| | - Tracey A Ledoux
- Department of Health and Human Performance, College of Liberal Arts and
Social Sciences, University of Houston, 3875 Holman Street, Room
104, Houston, TX, USA
| | - Craig A Johnston
- Department of Health and Human Performance, College of Liberal Arts and
Social Sciences, University of Houston, 3875 Holman Street, Room
104, Houston, TX, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of
Minnesota School of Public Health, 1300 S 2nd St Suit 300,
Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of
Minnesota School of Public Health, 1300 S 2nd St Suit 300,
Minneapolis, MN, USA
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17
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Byrne SM, Fursland A. New understandings meet old treatments: putting a contemporary face on established protocols. J Eat Disord 2024; 12:26. [PMID: 38336928 PMCID: PMC10854196 DOI: 10.1186/s40337-024-00983-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
In the twenty years since the publication of the most widely used treatment manuals describing evidence-based therapies for eating disorders, there have been some substantial advances in the field. New methods of delivering treatments have been trialled and our perception of mental health has advanced; significant cultural changes have led to shifts in our societal landscape; and new technologies have allowed for more in-depth research to be conducted. As a result, our understanding of eating disorders and their treatment has broadened considerably. However, these new insights have not necessarily been translated into improved clinical practice. This paper highlights the changes we consider to have had the greatest impact on our work as experienced clinical psychologists in the field and suggests a list of new learnings that might be incorporated into clinical practice and research design.
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Affiliation(s)
- Susan M Byrne
- University of Western Australia, Perth, WA, Australia.
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18
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Kent K, Schumacher T, Kocar S, Seivwright A, Visentin D, Collins CE, Lester L. Increasing food insecurity severity is associated with lower diet quality. Public Health Nutr 2024; 27:e61. [PMID: 38311345 PMCID: PMC10897580 DOI: 10.1017/s1368980024000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Food insecurity may reduce diet quality, but the relationship between food insecurity severity and diet quality is under-researched. This study aimed to examine the relationship between diet quality and severity of household food insecurity. DESIGN A cross-sectional, online survey used the United States Department of Agriculture Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately or severely food insecure. The Australian Recommended Food Score (ARFS; scored 0–73) determined diet quality (ARFS total and sub-scale scores). Survey-weighted linear regression (adjusted for age, sex, income, education, location and household composition) was conducted. SETTING Tasmania, Australia. PARTICIPANTS Community-dwelling adults (aged 18 years and over). RESULTS The mean ARFS total for the sample (n 804, 53 % female, 29 % aged > 65 years) was 32·4 (sd = 9·8). As the severity of household food insecurity increased, ARFS total decreased. Marginally food-insecure respondents reported a mean ARFS score three points lower than food-secure adults (B = –2·7; 95 % CI (–5·11, –0·34); P = 0·03) and reduced by six points for moderately (B = –5·6; 95 % CI (–7·26, –3·90); P < 0·001) and twelve points for severely food-insecure respondents (B = –11·5; 95 % CI (–13·21, –9·78); P < 0·001). Marginally food-insecure respondents had significantly lower vegetable sub-scale scores, moderately food-insecure respondents had significantly lower sub-scale scores for all food groups except dairy and severely food-insecure respondents had significantly lower scores for all sub-scale scores. CONCLUSIONS Poorer diet quality is evident in marginally, moderately and severely food-insecure adults. Interventions to reduce food insecurity and increase diet quality are required to prevent poorer nutrition-related health outcomes in food-insecure populations in Australia.
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Affiliation(s)
- Katherine Kent
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong. Wollongong, NSW2522, Australia
| | - Tracy Schumacher
- Department of Rural Health, University of Newcastle, Tamworth, NSW2340, Australia
| | - Sebastian Kocar
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Ami Seivwright
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Denis Visentin
- School of Health Sciences, University of Tasmania, Launceston, Tasmania7250, Australia
| | - Clare E Collins
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW2305, Australia
| | - Libby Lester
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
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Spaulding MO, Hoffman JR, Madu GC, Lord MN, Iizuka CS, Myers KP, Noble EE. Adolescent food insecurity in female rodents and susceptibility to diet-induced obesity. Physiol Behav 2024; 273:114416. [PMID: 38000529 PMCID: PMC10790603 DOI: 10.1016/j.physbeh.2023.114416] [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: 09/26/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 11/26/2023]
Abstract
Food insecurity is defined as having limited or uncertain access to nutritious foods, and adolescent food insecurity is associated with obesity and disordered eating behaviors in humans. We developed a rodent model of adolescent food insecurity to determine whether adolescent food insecurity per se promotes increased susceptibility to diet-induced obesity and altered eating behaviors during adulthood. Female juvenile Wistar rats were singly housed and assigned to three experimental diets: food-secure with standard chow (CHOW), food-secure with a high-fat/sugar Western diet (WD), and food-insecure with WD (WD-FI). Food-secure rats (CHOW and WD) received meals at fixed feeding times (9:00, 13:00, and 16:00). WD-FI rats received meals at unpredictable intervals of the above-mentioned feeding times but had isocaloric amounts of food to WD. We investigated the impact of adolescent food insecurity on motivation for sucrose (Progressive Ratio), approach-avoidance behavior for palatable high-fat food (Approach-Avoidance task), and susceptibility to weight gain and hyperphagia when given an obesogenic choice diet. Secondary outcomes were the effects of food insecurity during development on anxiety-like behaviors (Open Field and Elevated Plus Maze) and learning and memory function (Novel Location Recognition task). Rodents with adolescent food insecurity showed a greater trend of weight gain and significantly increased fat mass and liver fat accumulation on an obesogenic diet in adulthood, despite no increases in motivation for sucrose or high-fat food. These data suggest that adolescent unpredictable food access increases susceptibility to diet-induced fat gain without impacting food motivation or food intake in female rodents. These findings are among a small group of recent studies modeling food insecurity in rodents and suggest that adolescent food insecurity in females may have long-term implications for metabolic physiology later in life.
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Affiliation(s)
- Mai O Spaulding
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, Athens, GA 30602, United States
| | - Jessica R Hoffman
- Neuroscience Graduate Program, University of Georgia, Athens, GA, United States
| | - Grace C Madu
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, Athens, GA 30602, United States
| | - Magen N Lord
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, Athens, GA 30602, United States
| | - Caroline Soares Iizuka
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, Athens, GA 30602, United States
| | - Kevin P Myers
- Department of Psychology, Bucknell University, Lewisburg, PA, United States
| | - Emily E Noble
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, Athens, GA 30602, United States.
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Tamargo JA, Strath LJ, Karanth SD, Spector AL, Sibille KT, Anton S, Cruz-Almeida Y. Food insecurity is associated with chronic pain and high-impact chronic pain in the USA. Public Health Nutr 2023; 27:e7. [PMID: 38087858 PMCID: PMC10830368 DOI: 10.1017/s1368980023002732] [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: 08/29/2023] [Accepted: 12/08/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE This study evaluated whether food insecurity (US Adult Food Security Survey) was associated with chronic pain (≥ 3 months) and high-impact chronic pain (i.e. pain that limits work and life) among US adults. DESIGN Cross-sectional analysis. SETTING Nationally representative sample of non-institutionalised adults in the USA. PARTICIPANTS 79 686 adults from the National Health Interview Survey (2019-2021). RESULTS Marginal, low and very low food security were associated with increased prevalence odds of chronic pain (OR: 1·58 (95 % CI 1·44, 1·72), 2·28 (95 % CI 2·06, 2·52) and 3·37 (95 % CI 3·01, 3·78), respectively) and high-impact chronic pain (OR: 1·28 (95 % CI 1·14, 1·42), 1·55 (95 % CI 1·37, 1·75) and 1·90 (95 % CI 1·65, 2·18), respectively) in a dose-response fashion (P-trend < 0·0001 for both), adjusted for sociodemographic, socio-economic and clinically relevant factors. Participation in Supplemental Nutrition Assistance Program (SNAP) and age modified the association between food insecurity and chronic pain. CONCLUSIONS These findings illustrate the impact of socio-economic factors on chronic pain and suggest that food insecurity may be a social determinant of chronic pain. Further research is needed to better understand the complex relationship between food insecurity and chronic pain and to identify targets for interventions. Moreover, the consideration of food insecurity in the clinical assessment of pain and pain-related conditions among socio-economically disadvantaged adults may be warranted.
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Affiliation(s)
- Javier A Tamargo
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Institute on Aging, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Larissa J Strath
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Shama D Karanth
- University of Florida Health Cancer Center, University of Florida, Gainesville, FL, USA
| | - Antoinette L Spector
- College of Health Professions and Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Kimberly T Sibille
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Stephen Anton
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Institute on Aging, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Institute on Aging, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
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21
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Bach R, Hui A, Chao AM. A Systematic Review of Interventions for Obesity Among Adults With Food Insecurity. J Cardiovasc Nurs 2023:00005082-990000000-00156. [PMID: 38048488 PMCID: PMC11147955 DOI: 10.1097/jcn.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
OBJECTIVE Food insecurity is associated with reduced dietary quality and excess weight gain. However, interventions that are effective for obesity among individuals with food insecurity are unclear. The purpose of this systematic review was to synthesize studies in which authors examined interventions for obesity among adults with food insecurity. METHODS PubMed, PsycINFO, CINAHL, and EMBASE were searched from inception to October 2022. Studies were included if their authors reported on nonpharmacological and nonsurgical interventions that focused on adults with food insecurity and overweight/obesity and reported weight loss. RESULTS A total of 1360 titles were reviewed during the electronic search, and only 5 studies met inclusion criteria. There were 2 primary types of interventions that have been tested: first, behavioral weight loss counseling with or without tailoring for individuals with food insecurity and, second, subsidies for food. Findings of the benefits of one type of intervention over another are mixed. CONCLUSIONS This systematic review highlights that the current evidence for interventions that address food insecurity and obesity is mixed and limited in scope. There is a need for rigorous controlled trials to examine the effectiveness and cost-effectiveness of interventions for weight management among individuals with food insecurity and obesity while considering sustainability.
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Silva P, Araújo R, Lopes F, Ray S. Nutrition and Food Literacy: Framing the Challenges to Health Communication. Nutrients 2023; 15:4708. [PMID: 38004102 PMCID: PMC10674981 DOI: 10.3390/nu15224708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/20/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Nutrition and food literacy are two important concepts that are often used interchangeably, but they are not synonymous. Nutrition refers to the study of how food affects the body, while food literacy refers to the knowledge, skills, and attitudes necessary to make informed decisions about food and its impact on health. Despite the growing awareness of the importance of food literacy, food illiteracy remains a global issue, affecting people of all ages, backgrounds, and socioeconomic status. Food illiteracy has serious health implications as it contributes to health inequities, particularly among vulnerable populations. In addition, food literacy is a complex and multidisciplinary field, and there are numerous challenges to health communication that must be addressed to effectively promote food literacy and improve health outcomes. Addressing food illiteracy and the challenges to health communication is essential to promote health equity and improve health outcomes for all populations.
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Affiliation(s)
- Paula Silva
- Laboratory of Histology and Embryology, Department of Microscopy, School of Medicine and Biomedical Sciences (ICBAS), University of Porto (U.Porto), Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- iNOVA Media Lab, ICNOVA-NOVA Institute of Communication, NOVA School of Social Sciences and Humanities, Universidade NOVA de Lisboa, 1069-061 Lisbon, Portugal
| | - Rita Araújo
- Departamento de Artes e Humanidades, Escola Superior de Comunicação, Administração e Turismo, Instituto Politécnico de Bragança, Campus do Cruzeiro—Avenida 25 de Abril, Cruzeiro, Lote 2, Apartado 128, 5370-202 Mirandela, Portugal;
| | - Felisbela Lopes
- Centro de Estudos de Comunicação e Sociedade, Instituto de Ciências Sociais, Universidade do Minho, Campus de Gualtar, 4710-057 Braga, Portugal;
| | - Sumantra Ray
- NNEdPro Global Institute for Food, Nutrition & Health, Cambridge CB4 0WS, UK;
- School of Biomedical Sciences, Ulster University at Coleraine, Coleraine BT52 1SA, UK
- Fitzwilliam College, University of Cambridge, Cambridge CB3 0DG, UK
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23
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Larson N, Mason SM, Bruening M, Laska MN, Hazzard VM, Neumark-Sztainer D. Adverse childhood experiences and food insecurity in emerging adulthood: findings from the EAT 2010-2018 study. Public Health Nutr 2023; 26:2343-2354. [PMID: 37431646 DOI: 10.1017/s1368980023001349] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
OBJECTIVE Low childhood socio-economic status (SES) and adverse childhood experiences (ACE) are associated with poor health outcomes in adulthood. Determining how ACE may be linked to food insecurity among young people from socio-economically diverse households can inform health-protective strategies. This study examined if ACE are associated with food insecurity during the transition to adulthood and investigated prevalence differences across SES strata. SETTING Participants were recruited from twenty secondary schools in Minneapolis-St. Paul, Minnesota. PARTICIPANTS The analytic sample (n 1518) completed classroom surveys in 2009-2010 (mean age = 14·5 years) and follow-up surveys in 2017-2018 (mean age = 22·0 years). DESIGN Past-year food insecurity was reported at both time points, and ACE were reported at follow-up. Logistic regression models were used to estimate emerging adult food insecurity prevalence by ACE exposure; models were stratified by childhood SES (low, middle and high). RESULTS The adjusted prevalence of food insecurity was 45·3 % among emerging adults who reported three or more ACE compared with 23·6 % among those with one or two ACE and 15·5 % among those with no ACE (P < 0·001). All forms of ACE were related to an elevated prevalence of food insecurity in emerging adulthood. ACE-food insecurity associations were strongest for emerging adults from lower and middle SES households. Among emerging adults from low SES households, childhood experiences of emotional abuse and substance use by a household member were associated with the largest prevalence differences in food insecurity. CONCLUSIONS Findings suggest a need for trauma-informed services within food assistance programs to better serve individuals with a history of ACE.
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Susan M Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Meg Bruening
- Department of Nutritional Sciences, College of Health and Human Development, Penn State, 110 Chandlee Lab, University Park, PA16802, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Suite 300, 1300 South Second Street, Minneapolis, MN55454, USA
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24
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Marshall TA, Laurence B, Qian F, Robinson-Warner G, Handoo N, Anderson C. Food insecurity is associated with lower diet quality among dental students. J Dent Educ 2023; 87:1574-1584. [PMID: 37537836 DOI: 10.1002/jdd.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/10/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE Food insecurity is associated with lower diet quality, adverse health outcomes, and academic difficulty among undergraduate students. The objective was to identify the relationship between food security status and diet quality in dental students. METHODS All dental students attending Howard University (n = 286) or the University of Iowa (n = 326) during the fall 2021 semester were invited to complete a cross-sectional survey designed to query demographics, food security status (i.e., United States Department of Agriculture's ten item Adult Food Security Module), and diet quality (i.e., short Healthy Eating Index). The survey was administered using the Qualtrics platform. RESULTS Response rates were similar for Howard (32.5%) and Iowa (29.4%). Students with food insecurity (46.0%) were slightly older and more likely to be Black or other, first generation professional/graduate students, and receive financial aid than peers with food security (p < 0.050). Food insecurity was associated with lower intakes of fruits and vegetables (p ≤ 0.005), higher intakes of added sugars (p < 0.001), and lower diet quality (p = 0.003). In linear regression analyses that controlled for other variables, food insecurity (p = 0.012), school site (p = 0.027), and gender (p = 0.039) were predictive of lower diet quality. CONCLUSIONS The inability to procure adequate and appropriate foods was associated with marginal dietary habits (i.e., less than ideal food choices and eating behaviors) and lower diet quality in dental students. Both marginal dietary habits and lower diet quality increase chronic disease risk and may present a barrier to academic success. Addressing food insecurity among dental students is necessary to ensure equitable opportunities for a healthy workforce in the future.
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Affiliation(s)
- Teresa A Marshall
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Brian Laurence
- Department of Comprehensive Care, College of Dentistry, Howard University, Washington, District of Columbia, USA
| | - Fang Qian
- Iowa Institute for Oral Health Research, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Gillian Robinson-Warner
- Restorative Dentistry, College of Dentistry, Howard University, Washington, District of Columbia, USA
| | - Nidhi Handoo
- Department of Oral Pathology and Radiology, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Cari Anderson
- College of Dentistry, University of Iowa, Iowa City, Iowa, USA
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25
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Baltaci A, Laska MN, Horning M, Hearst M, Lee J, Fulkerson JA. Parent meal self-efficacy and practices in households with healthy home food environments in the face of economic hardship. Appetite 2023; 190:107029. [PMID: 37683896 PMCID: PMC10543555 DOI: 10.1016/j.appet.2023.107029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023]
Abstract
Some families who experience economic hardship demonstrate remarkable strength and resourcefulness to sustain a healthy home food environment. This ability to navigate economic barriers could be associated with parent meal practices that promote children's healthful dietary intake. Therefore, this study aimed to examine 1) whether parent meal self-efficacy and practices were associated with economic assistance status and home fruit and vegetable (FV) availability and 2) how parent meal self-efficacy and practices differed by home FV availability and economic assistance status. Analyses utilized baseline data from 274 parent/child dyads from two childhood obesity prevention trials: HOME Plus (urban) and NU-HOME (rural). Parents in households with high FV availability (regardless of economic assistance) had significantly higher self-efficacy in preparing healthy foods, family dinner routines, frequency of child's plate being half filled with FV, frequency of family dinner and breakfast, and lower frequency of purchasing dinner from fast food restaurants. Economic assistance was not associated with parent meal self-efficacy and practices. Four family groups were created and defined by economic assistance (yes/no) and home FV availability (high/low). About 31% of families that received economic assistance and had high home FV availability were food insecure. Families (n = 39) receiving economic assistance and having high home FV availability had greater frequency of family dinners compared to those in households with economic assistance and low home FV availability (n = 47) (p = 0.001); no other parent meal self-efficacy or practices differed between groups. Our findings suggest some families can maintain healthy home food environments despite economic hardship and frequent family dinners may be an important strength for these families. More research is needed to investigate asset-based models to understand the family strengths that enable them to thrive during difficult times.
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Affiliation(s)
- Aysegul Baltaci
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa N Laska
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa Horning
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Mary Hearst
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Jiwoo Lee
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
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26
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Dubois L, Bédard B, Goulet D, Prud'homme D, Tremblay RE, Boivin M. Experiencing food insecurity in childhood: influences on eating habits and body weight in young adulthood. Public Health Nutr 2023; 26:2396-2406. [PMID: 37665116 DOI: 10.1017/s1368980023001854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To examine how food insecurity in childhood up to adolescence relates to eating habits and weight status in young adulthood. DESIGN A longitudinal study design was used to derive trajectories of household food insecurity from age 4·5 to 13 years. Multivariable linear and logistical regression analyses were performed to model associations between being at high risk of food insecurity from age 4·5 to 13 years and both dietary and weight outcomes at age 22 years. SETTING A birth cohort study conducted in the Province of Quebec, Canada. PARTICIPANTS In total, 698 young adults participating in the Québec Longitudinal Study of Child Development. RESULTS After adjusting for sex, maternal education and immigrant status, household income and type of family, being at high risk (compared with low risk) of food insecurity in childhood up to adolescence was associated with consuming higher quantities of sugar-sweetened beverages (ßadj: 0·64; 95 % CI (0·27, 1·00)), non-whole-grain cereal products (ßadj: 0·32; 95 % CI (0·07, 0·56)) and processed meat (ßadj: 0·14; 95 % CI (0·02, 0·25)), with skipping breakfast (ORadj: 1·97; 95 % CI (1·08, 3·53)), with eating meals prepared out of home (ORadj: 3·38; 95 % CI (1·52, 9·02)), with experiencing food insecurity (ORadj: 3·03; 95 % CI (1·91, 4·76)) and with being obese (ORadj: 2·01; 95 % CI (1·12, 3·64)), once reaching young adulthood. CONCLUSION Growing up in families experiencing food insecurity may negatively influence eating habits and weight status later in life. Our findings reinforce the importance of public health policies and programmes tackling poverty and food insecurity, particularly for families with young children.
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Affiliation(s)
- Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | - Brigitte Bédard
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | - Danick Goulet
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand, Ottawa, ONK1G 5Z3, Canada
| | | | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montréal, Montréal, QC, Canada
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Michel Boivin
- École de Psychologie, Université Laval, Québec, QC, Canada
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27
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Slaughter-Acey J, Simone M, Hazzard VM, Arlinghaus KR, Neumark-Sztainer D. More Than Identity: An Intersectional Approach to Understanding Mental-Emotional Well-Being of Emerging Adults by Centering Lived Experiences of Marginalization. Am J Epidemiol 2023; 192:1624-1636. [PMID: 37401016 PMCID: PMC11484611 DOI: 10.1093/aje/kwad152] [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: 08/10/2022] [Revised: 04/12/2023] [Accepted: 06/30/2023] [Indexed: 07/05/2023] Open
Abstract
Understanding social determinants that shape pertinent developmental shifts during emerging adulthood (i.e., ages 18-25 years) and their associations with psychological health requires a nuanced approach. In our exploratory study, we investigated how multiple social identities and lived experiences generated by systems of marginalization and power (e.g., racism, classism, sexism) intersect in connection to the mental-emotional well-being of emerging adults (EAs). Eating and Activity Over Time (EAT, 2010-2018) data were collected from 1,568 EAs (mean age = 22.2 (standard deviation, 2.0) years) recruited initially in 2010 from Minneapolis/St. Paul schools. Conditional inference tree analyses were employed to treat "social location" and systems of marginalization and power as interdependent social factors influencing EAs' mental-emotional well-being outcomes: depressive symptoms, stress, self-esteem, and self-compassion. Conditional inference tree analyses identified EAs' subgroups with differing mean levels of mental-emotional well-being outcomes, distinguished primarily by marginalized social experiences (e.g., discrimination, financial difficulties) rather than social identities themselves. The relative positioning of EAs' experiences of social marginalization (e.g., discrimination) to their social identities (e.g., race/ethnicity) suggests that the social experiences generated by systems of privilege and oppression (e.g., racism) are more adjacent social determinants of mental-emotional well-being than the social identities used in public health research to proxy the oppressive systems that give them social meaning.
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Affiliation(s)
- Jaime Slaughter-Acey
- Correspondence to Dr. Jaime Slaughter-Acey, Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454 (e-mail: )
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28
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Xu T, Tao Y, Chen R, Strachan G, Cai X, Liu C. Effects of a physical activity promotion programme on body composition in emerging adults with physical inactivity: a study protocol of a randomised controlled trial. BMJ Open 2023; 13:e076123. [PMID: 37798029 PMCID: PMC10565148 DOI: 10.1136/bmjopen-2023-076123] [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: 05/29/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION A dramatic decline in physical activity may occur in emerging adulthood because of a major transition over the course of a life. The potential for implementing structured behaviour modification strategies to enhance risk-reducing clinical outcomes is widely recognised. The active participation of clients in the discussion and care process is crucial for optimising intervention outcomes and enhancing individuals' motivation to adopt and maintain healthy behaviours. This study therefore aims to evaluate the effectiveness of a physical activity promotion programme based on the goal attainment theory in relation to emerging adults' body composition, using a face-to-face and e-health blended interventions. METHODS AND ANALYSIS A two-arm, double-blind, randomised, controlled study will be conducted in 114 university students aged 18-25 years with physical inactivity. The intervention assignment will be blind to study participants, outcome assessors and study statisticians. A goal achievement theory-based physical activity promotion programme is developed in this study, which is a 16-week, face-to-face and e-health-blended physical activity promotion intervention. After informed consent, participants will be randomly assigned to either a control group or a treatment group before the start of the study. The primary outcome is body composition (ie, skeletal muscle mass, body fat mass, body mass index and body fat percentage). Other outcomes include physical activity level, goal attainment scale scores, exercise self-efficacy and motivation level, which will be assessed during the intervention (every 4 weeks) and at the 1 month follow-up. Continuous variables have means and SD, while categorical variables have frequencies and percentages. Independent-samples t-tests will be used to compare continuous variable changes. χ2 tests will be used to compare categorical variable changes. Based on the baseline scores, analysis of covariance will compare the follow-up results. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee of Hangzhou Normal University (ratification date: 14 November 2022, 2022059). The results of the study will be submitted for publication and dissemination in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT05697679.
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Affiliation(s)
- Tao Xu
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Yuexian Tao
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Rong Chen
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Garry Strachan
- School of Foreign Languages, Hangzhou Normal University, Hangzhou, China
| | - Xintong Cai
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Chengyi Liu
- School of Nursing, Hangzhou Normal University, Hangzhou, China
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29
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Kehm RD, Lilge L, Walter EJ, White M, Herbstman JB, Perera FP, Miller RL, Terry MB, Tehranifar P. Socioeconomic Status at Birth and Breast Tissue Composition in Adolescence and Adulthood. Cancer Epidemiol Biomarkers Prev 2023; 32:1294-1301. [PMID: 37436425 PMCID: PMC10804240 DOI: 10.1158/1055-9965.epi-23-0444] [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: 04/20/2023] [Revised: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Socioeconomic status (SES) at birth is associated with breast cancer risk. Whether this association is driven by changes in breast tissue composition (BTC) prior to adulthood remains unclear. METHODS We used multivariable linear regression models to examine whether SES at birth is associated with BTC in adolescence and adulthood using data from a New York City cohort of daughters (n = 165, 11-20 years) and mothers (n = 160, 29-55 years). We used maternal-reported data on daughters' household income and maternal education at birth, analyzed individually and in combination (SES index). Women also reported their own mothers' education at birth. We used optical spectroscopy to evaluate BTC measures that positively (water content, collagen content, optical index) and negatively (lipid content) correlate with mammographic breast density, a recognized breast cancer risk factor. RESULTS Being in the highest versus lowest category of the SES index was associated with lower lipid content [βadjusted (βadj) = -0.80; 95% confidence interval (CI), -1.30 to -0.31] and higher collagen content (βadj = 0.54; 95% CI, 0.09-0.99) in adolescence. In women with a body mass index (BMI) <30 kg/m2, higher maternal education at birth (≥ vs. < high school degree) was associated with lower lipid content (βadj = -0.57; 95% CI, -0.97 to -0.17), higher water content (βadj = 0.70; 95% CI, 0.26-1.14), and higher optical index (βadj = 0.53; 95% CI, 0.10-0.95). CONCLUSIONS This study supports that SES at birth is associated with BTC in adolescence and adulthood, although the latter association may depend on adult BMI. IMPACT Further research is needed to identify the socially patterned early life factors influencing BTC.
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Affiliation(s)
- Rebecca D Kehm
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, NY 10032, USA
| | - Lothar Lilge
- Department of Medical Biophysics, University of Toronto, 101 College St, Toronto, ON M5G 0A3, Canada
- Princess Margaret Cancer Centre, University Health Network, 101 College St, Toronto, ON M5G 0A3, Canada
| | - E Jane Walter
- Princess Margaret Cancer Centre, University Health Network, 101 College St, Toronto, ON M5G 0A3, Canada
| | - Melissa White
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, NY 10032, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Frederica P Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Rachel L Miller
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY 10032, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY 10032, USA
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30
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Chai L. Food Insecurity and Health: Marital Status and Gender Variations. FAMILY & COMMUNITY HEALTH 2023; 46:242-249. [PMID: 37703512 DOI: 10.1097/fch.0000000000000377] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Existing research has established the detrimental effects of food insecurity on health. However, understanding of the social conditions that may moderate this relationship remains limited. To address this gap, the study investigates two questions: First, does marital status moderate the association between food insecurity and self-rated health? Second, if such moderation exists, does its impact vary based on gender? Data from the 2017-2018 Canadian Community Health Survey, a nationally representative survey conducted by Statistics Canada (n =101 647), were utilized for this investigation. The findings demonstrated that individuals living in food-insecure households reported poorer self-rated mental and general health. However, the negative impact of food insecurity on both health outcomes was less pronounced among married individuals than among their unmarried counterparts. Furthermore, the stress-buffering role of marriage was found to be more substantial among men than among women. In light of the significant stress-buffering role of marriage revealed in this study, it is crucial for policies to aim at providing comparable coping resources to unmarried individuals, particularly women.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Canada
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31
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Buettner SA, Pasch KE, Poulos NS. Factors Associated with Food Delivery App use Among Young Adults. J Community Health 2023; 48:840-846. [PMID: 37148460 PMCID: PMC10163566 DOI: 10.1007/s10900-023-01229-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/08/2023]
Abstract
Food delivery apps are popular among young adults and often used to purchase calorie-dense foods. Limited research exists on the use of food delivery apps among young adults. The purpose of this study was to describe food delivery app use among young adults and examine the correlates of food delivery app use. Data are from a panel of U.S. young adults aged 18-25 (n = 1,576) who completed an online survey between January-April 2022. Participants were 51.8% female and 39.3% identified as non-Hispanic white, 24.4% as Hispanic/Latinx, 29.6% as non-Hispanic Black, and 6.8% as another race/ethnicity. Poisson regression was used to examine the relationship between food delivery app use and age, race, ethnicity, sex, SES, food insecurity, living arrangement, financial responsibility, and full-time student status. Young adults used food delivery apps approximately twice a week. Participants who identified as non-Hispanic Black and Hispanic/Latinx used food delivery apps more frequently than participants who identified as white. Having higher perceived subjective social status, food insecurity, financial responsibility, and being a full-time student were significantly associated with using food delivery apps more frequently. Living with someone else was associated with using food delivery apps less frequently. This study provides a first step in understanding the characteristics of young adults who use food delivery apps. Given that food delivery apps are a new technology that can both increase access to unhealthy food options as well as healthy food options, further research is needed to better understand the types of food purchased through food delivery apps.
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Affiliation(s)
- Sarah A Buettner
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd D3700, Austin, TX, 78712, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd D3700, Austin, TX, 78712, USA.
| | - Natalie S Poulos
- Department of Community and Rural Health, University of Texas Health Science Center Tyler, Tyler, TX, USA
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32
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Flórez KR, Albrecht SS, Hwang N, Chambers E, Li Y, Gany FM, Davila M. Household Food Security and Consumption of Sugar-Sweetened Beverages among New York City (NYC) Children: A Cross-Sectional Analysis of 2017 NYC Kids' Data. Nutrients 2023; 15:3945. [PMID: 37764728 PMCID: PMC10537250 DOI: 10.3390/nu15183945] [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: 08/10/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Food insecurity is a stressor associated with adverse health outcomes, including the consumption of sugar-sweetened beverages (SSBs). Our study tests the hypothesis that other socioeconomic vulnerabilities may magnify this effect using cross-sectional data from the 2017 New York City (NYC) Kids Survey. Households providing an affirmative response to one or both food security screener questions developed by the US Department of Agriculture were coded as households with low food security. The number of sodas plus other SSBs consumed was standardized per day and categorized as 1 = none, 2 = less than one, and 3 = one or more. We tested the joint effect of low food security with chronic hardship, receipt of federal aid, and immigrant head of household on a sample of n = 2362 kids attending kindergarten and beyond using ordinal logistic regression and accounting for the complex survey design. Only having a US-born parent substantially magnified the effect of low household food security on SSB consumption (OR = 4.2, 95%CI: 2.9-6.3, p < 0.001) compared to the reference group of high household food security with an immigrant parent. The effect of low food security on SSB consumption among NYC children warrants intersectional approaches, especially to elucidate US-based SSB norms in low-food-security settings.
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Affiliation(s)
- Karen R. Flórez
- Environmental, Occupational and Geospatial Sciences Department, Graduate School of Public Health and Heath Policy, City University of New York, New York, NY 10017, USA
| | - Sandra S. Albrecht
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Neil Hwang
- Business and Information Systems Department, Bronx Community College, City University of New York, Bronx, NY 10453, USA;
| | - Earle Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Francesca M. Gany
- Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Marivel Davila
- Bureau of Health Promotion for Justice-Impacted Populations, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA;
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Loth KA, Huang Z, Wolfson J, Neumark-Sztainer D, Fisher J, Fulkerson JA, Berge JM. Leveraging ecological momentary assessment to understand variability in food parenting practices within a low-income racially/ethnically diverse sample of parents of preschoolers. Appetite 2023; 188:106635. [PMID: 37321277 PMCID: PMC10527935 DOI: 10.1016/j.appet.2023.106635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Abstract
Children's eating behaviors are shaped significantly by their home food environment, including exposure to food parenting practices. The current study leveraged ecological momentary assessment (EMA) to describe how food parenting practices used to feed preschoolers (n = 116) differed across contextual factors around eating, including type of eating occasion (i.e., meals vs. snacks), day of the week (i.e., weekend vs. weekday), who initiated the meal (parent vs. child), emotional climate of the eating occasion. Parent perceptions of how well the eating occasion went, including how well the child ate and whether the food parenting practices worked as intended were also explored. Parent use of specific food parenting practices, situated within four higher-order domains (i.e., structure, autonomy support, coercive control, indulgent), was found to differ by type of eating occasion; parents engaged in a higher proportion of structure practices at meals than at snacks. Use of specific food parenting practices differed by mealtime emotional climate; parent use of structure and autonomy support was associated with eating occasions described as relaxed, enjoyable, neutral, and fun. Finally, parent perception of how well the child ate differed by use of specific food parenting practices; during eating occasions when parent's felt their child ate "not enough", they used less autonomy support and more coercive control compared to eating occasions where the child ate "enough and a good balance." Leveraging EMA allowed for increased understanding of the variability in food parenting practices and contextual factors. Findings may be utilized to inform the development of larger-scale studies seeking to understand why parents choose specific approaches to feeding their children, as well as the impact of various approaches to child feeding on child health outcomes.
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Affiliation(s)
- K A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, 55455, USA.
| | - Z Huang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | - J Wolfson
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | - D Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | - J Fisher
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, 19122, USA
| | - J A Fulkerson
- School of Nursing, University of Minnesota, Minneapolis, MN, 55455, USA
| | - J M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, 55455, USA
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Kisselgoff M, Champagne MR, Dubois R, Turnbull L, LaPlante J, Schultz A, Bombak A, Riediger N. Examining attitudes toward a proposed sugar-sweetened beverage tax among urban Indigenous adults: a qualitative study using a decolonizing lens. CMAJ Open 2023; 11:E922-E931. [PMID: 37816548 PMCID: PMC10569811 DOI: 10.9778/cmajo.20230025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Sugar-sweetened beverage taxation has been proposed as a public health policy to reduce consumption, and compared with other ethnic or racialized groups in Canada, off-reserve Indigenous populations consume sugar-sweetened beverages at higher frequencies and quantities. We sought to explore the acceptability and anticipated outcomes of a tax on sugar-sweetened beverages among Indigenous adults residing in an inner-city Canadian neighbourhood. METHODS Using a community-based participatory research approach, we conducted semistructured interviews (November 2019-August 2020) with urban Indigenous adults using purposive sampling. Interviews were audio-recorded, transcribed verbatim and analyzed using theoretical thematic analysis. RESULTS All 20 participants (10 female, 8 male and 2 two-spirit) consumed sugar-sweetened beverages on a regular, daily basis at the time of the interview or at some point in their lives. Most participants were opposed to and concerned about the prospect of sugar-sweetened beverage taxation owing to 3 interconnected themes: government is not trustworthy, taxes are ineffective and lead to inequitable outcomes, and Indigenous self-determination is critical. Participants discussed government's mismanagement of previous taxes and lack of prioritization of their community's specific needs. Most participants anticipated that Indigenous people in their community would continue to consume sugar-sweetened beverages, but that a tax would result in fewer resources for other necessities, including foods deemed healthy. INTERPRETATION Low support for the tax among urban Indigenous people is characterized by distrust regarding the tax, policy-makers and its perceived effectiveness. Findings underscore the importance of self-determination in informing health policies that are equitable and nonstigmatizing.
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Affiliation(s)
- Maria Kisselgoff
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
| | - Michael Redhead Champagne
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
| | - Riel Dubois
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
| | - Lorna Turnbull
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
| | - Jeff LaPlante
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
| | - Annette Schultz
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
| | - Andrea Bombak
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
| | - Natalie Riediger
- Department of Food and Human Nutritional Sciences (Kisselgoff, Riediger), University of Manitoba; Fearless R2W (Champagne, Dubois); Faculty of Law (Turnbull), University of Manitoba; National Indigenous Diabetes Association (LaPlante); College of Nursing (Schultz), University of Manitoba, Winnipeg, Man.; Department of Sociology (Bombak), University of New Brunswick, Fredericton, NB
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Arlinghaus KR, Hahn SL, Larson N, Eisenberg ME, Berge JM, Neumark-Sztainer D. Helicopter Parenting Among Socio-Economically and Ethnically/Racially Diverse Emerging Adults: Associations with Weight-Related Behaviors. EMERGING ADULTHOOD (PRINT) 2023; 11:909-922. [PMID: 38617057 PMCID: PMC11013951 DOI: 10.1177/21676968231171317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Helicopter parenting, a parenting style defined by over-involvement, may lead to poor health outcomes. However, research has primarily focused on children and adolescents from White, high socio-economic families, with little research examining weight-related health or with emerging adult children. The current study examined associations with emerging adult diet, physical activity, and body mass index (BMI) among a diverse population-based sample of parent and emerging adult dyads (n = 919). Helicopter parenting was highest among lower socioeconomic households and those identifying as Black, Indigenous, or people of color. Helicopter parenting was associated with both healthy and less healthy dietary behaviors across ethnic/racial groups, but was not associated with physical activity or BMI. Greater consideration of the cultural context related to helicopter parenting is needed before making conclusions about its benefits or harms.
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Affiliation(s)
- Katherine R. Arlinghaus
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Samantha L. Hahn
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Psychiatry & Behavioral Health, University of Minnesota Medical School, Minneapolis, MN, USA
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Marla E. Eisenberg
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Bercaw H, Reid LA, Mendoza JA, Frongillo EA, Sauder KA, Reboussin BA, Mayer-Davis EJ, Dabelea D, Marcovina SM, Mercado C, Liese AD. Food Insecurity and Adequacy of Dietary Intake in Youth and Young Adults With Youth-Onset Type 1 and Type 2 Diabetes. J Acad Nutr Diet 2023; 123:1162-1172.e1. [PMID: 36990427 PMCID: PMC10522799 DOI: 10.1016/j.jand.2023.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/08/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Household food insecurity is associated with poor dietary intake in the general population, but little is known about this association in persons with diabetes. OBJECTIVE We examined the degree of adherence to the dietary reference intakes and 2020-2025 Dietary Guidelines for Americans overall and according to food security status and diabetes type among youth and young adults (YYA) with youth-onset diabetes. DESIGN, PARTICIPANTS, AND SETTING The SEARCH for Diabetes in Youth study includes 1,197 YYA with type 1 diabetes (mean age = 21 ± 5 years) and 319 YYA with type 2 diabetes (25 ± 4 years). Participants (or parents if younger than age 18 years) completed the US Department of Agriculture Household Food Security Survey Module, wherein ≥3 affirmations indicate food insecurity. MAIN OUTCOME MEASURES Diet was assessed via food frequency questionnaire and compared with age- and sex-specific dietary reference intakes for 10 nutrients and dietary components (calcium; fiber; magnesium; potassium; sodium; vitamins C, D, and E; added sugar; and saturated fat). STATISTICAL ANALYSES PERFORMED Median regression models controlled for sex- and type-specific means for age, diabetes duration, and daily energy intake. RESULTS Prevalence of guideline adherence was overarchingly poor, with <40% of participants meeting recommendations for eight of 10 nutrients and dietary components; however, higher adherence (>47%) was observed for vitamin C and added sugars. YYA with type 1 diabetes who were food insecure were more likely to meet recommendations for calcium, magnesium, and vitamin E (P < 0.05), and less likely for sodium (P < 0.05) than those with food security. In adjusted models, YYA with type 1 diabetes who were food secure had closer median adherence to sodium (P = 0.002) and fiber (P = 0.042) guidelines than those food insecure. No associations were observed in YYA with type 2 diabetes. CONCLUSIONS Food insecurity is associated with lesser adherence to fiber and sodium guidelines in YYA with type 1 diabetes, which may lead to diabetes complications and other chronic diseases.
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Affiliation(s)
- Hope Bercaw
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Lauren A Reid
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Jason A Mendoza
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Edward A Frongillo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Elizabeth J Mayer-Davis
- Department of Nutrition University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Carla Mercado
- Office of Minority Health and Health Equity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
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Laboe AA, D'Adamo L, Grammer AC, McGinnis CG, Davison GM, Balantekin KN, Graham AK, Smolar L, Taylor CB, Wilfley DE, Fitzsimmons-Craft EE. The relation of food insecurity to eating disorder characteristics and treatment-seeking among adult respondents to the National Eating Disorders Association online screen. Eat Behav 2023; 50:101776. [PMID: 37390519 PMCID: PMC10542957 DOI: 10.1016/j.eatbeh.2023.101776] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Food insecurity (FI), characterized by limited or uncertain access to adequate food, has been associated with eating disorders (EDs). This study explored whether FI was associated with ED behaviors, ED diagnosis, current treatment status, and treatment-seeking intentions among adults who completed an online ED screen. METHODS Respondents to the National Eating Disorders Association online screening tool self-reported demographics, FI, height and weight, past 3-month ED behaviors, and current treatment status. Respondents were also asked an optional question about treatment-seeking intentions. Hierarchical regressions evaluated relations between FI and ED behaviors, treatment status, and treatment-seeking intentions. Logistic regressions explored differences in probable ED diagnosis by FI status. RESULTS Of 8714 respondents, 25 % screened at risk for FI. FI was associated with greater binge eating (R2Change = 0.006), laxative use (R2Change = 0.001), and presence of dietary restriction (R2Change = 0.001, OR: 1.32) (ps < .05). Having FI was associated with greater odds of screening positive for a probable ED or as high risk for an ED (ps < .05). FI was not associated with current treatment status or treatment-seeking intentions (ps > .05). CONCLUSIONS Findings add to existing literature supporting a relation between FI and EDs. Implications include a need to disseminate EDs screening and treatment resources to populations affected by FI and to tailor treatments to account for barriers caused by FI.
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Affiliation(s)
- Agatha A Laboe
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Laura D'Adamo
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA; Department of Psychological and Brain Sciences, Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Claire G McGinnis
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Genevieve M Davison
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauren Smolar
- National Eating Disorders Association, New York, NY, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA; Center for m(2)Health, Palo Alto University, 5150 El Camino Real, Los Altos, CA 94022, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Ellen E Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
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Coletro HN, de Menezes-Júnior LAA, Mendonça RDD, Meireles AL, Machado-Coelho GLL, de Menezes MC. The combined consumption of fresh/minimally processed food and ultra-processed food on food insecurity: COVID Inconfidentes, a population-based survey. Public Health Nutr 2023; 26:1414-1423. [PMID: 36919847 PMCID: PMC10346086 DOI: 10.1017/s136898002300054x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/11/2022] [Accepted: 03/03/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To investigate whether the combined consumption of fresh/minimally processed and ultra-processed food is associated with food insecurity (FI) during the COVID-19 pandemic. DESIGN Cross-sectional observational study was derived from a survey using a population-based search of a complex sample. FI was assessed using the validated Brazilian Food Insecurity Scale. Food consumption was assessed using a qualitative FFQ and the NOVA classification for fresh/minimally processed food and ultra-processed food. A scoring system was used to evaluate combined food consumption according to the extent and purpose of processing, considering the weekly consumption of the two groups (according to the NOVA classification). Higher punctuation reflects worse diet quality (higher consumption of ultra-processed foods and lower consumption of fresh/minimally processed foods). A theoretical causality model was constructed using a directed acyclic graph, and multivariate analysis was performed using Poisson regression to test the association between FI and food consumption. SETTING Ouro Preto and Mariana, Brazil, between October and December 2020. PARTICIPANTS An epidemiological household survey was conducted with 1753 individuals selected through a stratified and clustered sampling design in three stages. RESULTS Those with food consumption scores in the fourth quartile had a 60 % higher prevalence ratio (PR) for FI (PR: 1·60 and 95 % CI: 1·06 - 2·40). Also, the increased consumption of fresh/minimally processed foods and low consumption of ultra-processed foods presented a 45 % lower prevalence ratio of FI (PR: 0·55 and 95 % CI: 0·40 - 0·80). CONCLUSION These results indicate an inverse association between FI and diet quality.
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Affiliation(s)
- Hillary Nascimento Coletro
- Universidade Federal de Ouro Preto, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Luiz Antônio Alves de Menezes-Júnior
- Universidade Federal de Ouro Preto, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Raquel de Deus Mendonça
- Universidade Federal de Ouro Preto, Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - Adriana Lúcia Meireles
- Universidade Federal de Ouro Preto, Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
| | | | - Mariana Carvalho de Menezes
- Universidade Federal de Ouro Preto, Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Ouro Preto, Minas Gerais, Brazil
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Eicher-Miller HA, Graves L, McGowan B, Mayfield BJ, Connolly BA, Stevens W, Abbott A. A Scoping Review of Household Factors Contributing to Dietary Quality and Food Security in Low-Income Households with School-Age Children in the United States. Adv Nutr 2023; 14:914-945. [PMID: 37182740 PMCID: PMC10334140 DOI: 10.1016/j.advnut.2023.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023] Open
Abstract
Low-income and food-insecure households are at risk of poor dietary quality and even more severe food insecurity. Especially in childhood, consuming a nutritionally adequate diet is an essential driver of health, growth, and development. Household-level factors can present challenges to support the nutritional needs of low-income and food-insecure household members. The aim of this scoping review is to identify the contributing household factors to dietary quality and food security in US households of school-aged children 5 to 19 years and synthesize the evidence around emergent themes for application to future interventions. The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews using search terms addressing food insecurity, low income, and dietary behaviors in the database PubMed. Screening by 3 independent reviewers of the title, abstract, and full study phases identified 44 studies. The 5 themes around which the studies grouped were: parental behaviors, child/adolescent behaviors, food procurement behaviors, food preparation behaviors, and household environment factors. Most studies were cross-sectional (n = 41, 93%) and focused on parental behaviors (n = 31, 70%), followed by food preparation and procurement behaviors. The themes identified were interrelated and suggest that incorporating education on parent and child behaviors that influence food procurement and preparation, along with strengthening organization and planning in the household environment, may hold promise to improve dietary quality and food security among food-insecure and low-income households. The findings can be used to inform future nutrition education interventions aimed at improving dietary quality and food security in households with school-aged children.
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Affiliation(s)
| | - Lisa Graves
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Bethany McGowan
- Libraries and School of Information Studies, Purdue University, West Lafayette, IN, USA
| | | | - Blake A Connolly
- College of Health and Human Sciences, Purdue Extension, Purdue University, West Lafayette, IN, USA
| | - Wanda Stevens
- College of Health and Human Sciences, Purdue Extension, Purdue University, West Lafayette, IN, USA
| | - Angela Abbott
- College of Health and Human Sciences, Purdue Extension, Purdue University, West Lafayette, IN, USA
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Abene JA, Tong J, Minuk J, Lindenfeldar G, Chen Y, Chao AM. Food insecurity and binge eating: A systematic review and meta-analysis. Int J Eat Disord 2023; 56:1301-1322. [PMID: 37040535 PMCID: PMC10524553 DOI: 10.1002/eat.23956] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 04/13/2023]
Abstract
OBJECTIVE This review synthesized literature on the relationship between food insecurity and binge eating. METHODS Relevant studies were identified by searching PubMed, CINAHL, PsycINFO, and gray literature from inception to October 2022. Eligible studies included primary research that assessed the relationship between food insecurity and binge eating. Data extraction was performed independently by two reviewers. Pooled odds ratios and 95% confidence intervals (CI) were obtained from random effect models with the R package meta. Analyses were stratified by binge eating versus binge-eating disorder (BED), study type (cross-sectional vs. longitudinal), and age (adults vs. adolescents). RESULTS We included 24 articles that reported on 20 studies, and 13 articles were included in the meta-analysis. Based on the random effects meta-analysis, the odds of adults in the food insecure group having binge eating were 1.66 (95% CI = 1.42, 1.93) times the odds of adults in the food secure group having binge eating. The odds of adults in the food insecure group having BED were 2.70 (95% CI = 1.47, 4.96) times the odds of adults in the food secure group having BED. Insufficient data were available for a meta-analysis on adolescents or longitudinal relationships. CONCLUSIONS These findings support that food insecurity is associated with binge eating in adults. There is a need for research to investigate the mechanisms underlying this relationship. Results highlight the importance of screening participants with food insecurity for disordered eating behaviors and vice versa. Future research is needed to examine whether interventions targeting food insecurity may help to mitigate disordered eating behaviors. PUBLIC SIGNIFICANCE Food insecurity is a common but under-recognized contributor to binge eating. In this article, we systematically reviewed research that has been published on the relationship between food insecurity and binge eating. We found support that food insecurity should be considered in the prevention and treatment of binge eating.
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Affiliation(s)
- Jessica A. Abene
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
| | - Jiayi Tong
- University of Pennsylvania, Department of Biostatistics, Epidemiology, and Informatics, Philadelphia, PA, USA
| | - Jeffrey Minuk
- Temple University Hospital, Department of Internal Medicine, Philadelphia, PA, USA
| | | | - Yong Chen
- University of Pennsylvania, Department of Biostatistics, Epidemiology, and Informatics, Philadelphia, PA, USA
| | - Ariana M. Chao
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
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Larson N, Tavernier RE, Berge JM, Barr-Anderson DJ, Neumark-Sztainer D. Implications of the COVID-19 Pandemic for the Well-Being of Emerging Adult Populations: A Synthesis of Findings From the COVID-19 Eating and Activity Over Time (C-EAT) Study. EMERGING ADULTHOOD (PRINT) 2023; 11:779-796. [PMID: 37832141 PMCID: PMC10064195 DOI: 10.1177/21676968231166034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Research addressing the impact of the COVID-19 pandemic on psychosocial well-being and health behavior is accumulating; however, implications for emerging adult populations are underexplored. This manuscript synthesizes findings from a mixed-methods study of well-being, eating and activity behaviors, and food insecurity among a diverse, longitudinal cohort of emerging adults. The review includes findings from 11 original studies that involved collecting online surveys from 720 emerging adults and in-depth, virtual interviews with 33 respondents who were food insecure. Findings indicated the pandemic had widespread impacts on well-being. Population groups at greatest risk for poor outcomes included women; those who identified as Black, Indigenous, or a Person of Color; persons in households of low socioeconomic status; parents of young children; and persons who previously experienced mental health challenges or weight stigma. Further research will be needed to evaluate efforts to improve the well-being of emerging adults in the aftermath of the pandemic.
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community
Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca Emery Tavernier
- Department of Family Medicine and
Biobehavioral Health, University of Minnesota Medical
School, Duluth, MN, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community
Health, University of Minnesota Medical School,
University of Minnesota, Minneapolis, MN, USA
| | | | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community
Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Ludwig-Borycz E, Neumark-Sztainer D, Larson N, Baylin A, Jones AD, Webster A, Bauer KW. Personal, behavioural and socio-environmental correlates of emerging adults' sustainable food consumption in a cross-sectional analysis. Public Health Nutr 2023; 26:1306-1316. [PMID: 37013850 PMCID: PMC10346036 DOI: 10.1017/s1368980023000654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 01/30/2023] [Accepted: 03/22/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Describe how dietary intake patterns of US young adults align with the EAT-Lancet Planetary Health Diet (PHD) sustainable diet goals and identify personal, behavioural, and socio-environmental correlates of sustainable intake. DESIGN Data on past-year dietary intake were captured using a FFQ. The PHD was applied to specific food groups, and a total PHD score was calculated. Linear regression models were used to identify associations between personal, behavioural and socio-environmental factors and PHD scores. SETTING This cross-sectional analysis uses data from the second wave of EAT 2010-2018 (Eating and Activity over Time), a population-based longitudinal study recruited in Minnesota. PARTICIPANTS Ethnically/racially diverse group of participants (n 1308) with a mean age of 22·1 (sd 2·0) years. RESULTS The mean PHD score was 4·1 (sd 1·4) on a scale of 0-14, with 14 representing the most sustainable. On average, participants consumed fewer whole grains, fish, legumes, soya, and nuts than ideal for a sustainable diet, and an excess of eggs, added sugar, and meat. The PHD score was higher for participants with higher socio-economic status (SES) and greater educational attainment. Higher home availability of healthy food (β = 0·24, P < 0·001) and less frequent fast-food consumption (β = -0·26, P < 0·001) were the strongest correlates of PHD scores. CONCLUSIONS Results suggest that a high percentage of participants may not be achieving the sustainable diet goals defined by the PHD. Reductions in meat consumption and increases in plant-based foods are necessary to increase the sustainability of US young adults' diets.
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Affiliation(s)
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI48109, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Andrew D Jones
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI48109, USA
| | - Allison Webster
- International Food Information Council Foundation, Washington, DC, USA
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI48109, USA
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Nagata JM, Chu J, Cervantez L, Ganson KT, Testa A, Jackson DB, Murray SB, Weiser SD. Food insecurity and binge-eating disorder in early adolescence. Int J Eat Disord 2023; 56:1233-1239. [PMID: 37013949 PMCID: PMC10247527 DOI: 10.1002/eat.23944] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Food insecurity is defined as lack of consistent access to adequate food for healthy living. The objective of this study was to determine the associations between food insecurity and binge-eating disorder in a national cohort of 9- to 14-year-old children. METHOD We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,035, 2016-2020). Logistic regression analyses estimated the associations between food insecurity at baseline, year 1, or year 2 (exposure) and binge eating, subclinical binge-eating disorder (Other Specified Feeding and Eating Disorder-Binge-Eating Disorder [OSFED-BED]), and binge-eating disorder (BED) (outcome) based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at 2-year follow-up. RESULTS The prevalence of food insecurity in the study was 15.8%. At 2-year follow-up, 1.71% of the sample received a diagnosis of BED or OSFED-BED, while 6.62% reported binge eating. Food insecurity was associated with 1.67 higher odds of BED or OSFED-BED (95% CI 1.04-2.69) and 1.31 higher odds of binge-eating symptoms (95% CI 1.01-1.71). DISCUSSION Food insecurity in early adolescence is associated with higher odds of developing future binge-eating and BED or OSFED-BED. Clinicians may consider assessing for binge eating in adolescents with food insecurity and provide support in accessing appropriate food resources. PUBLIC SIGNIFICANCE Prior research has shown that food insecurity is associated with disordered eating behaviors, including binge eating in adulthood. This study explored whether food insecurity in early adolescence increases risk for developing binge-eating disorder (BED). Targeted screening for BED in adolescents experiencing FI, and vice versa, may be warranted.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, California, 94143, USA
| | - Jonathan Chu
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, California, 94143, USA
| | - Levi Cervantez
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, California, 94143, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, Ontario, M5S 1V4, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, 7000 Fannin St, Houston, TX, 77030, USA
| | - Dylan B. Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Stuart B. Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA
| | - Sheri D. Weiser
- Department of Medicine, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA, 94110, USA
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44
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Tari Selcuk K, Atan RM, Arslan S, Sahin N. Is food insecurity related to sustainable and healthy eating behaviors? ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27694-8. [PMID: 37204579 DOI: 10.1007/s11356-023-27694-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/12/2023] [Indexed: 05/20/2023]
Abstract
In this cross-sectional study, it was aimed to investigate the relationship between sustainable and healthy eating behaviors such as nutritional insecurity and a healthy and balanced diet, interest in regional and organic food products, consumption of seasonal food and avoidance of food waste, preference for locally produced foods, reduction of meat consumption, preference for eggs from free-range chickens, and sustainable fishery products, and consumption of low-fat food products in adults. The study included 410 adults who were reached through social media applications. Data were collected through an online questionnaire including the Descriptive Information Form, the Household Food Insecurity Access Scale (HFIAS), and the Sustainable Healthy Eating Behaviors Scale (SHEBS). The proportion of participants determined as mildly food insecure, moderately food insecure, and severely food insecure was 10.2%, 6.6%, and 7.6%, respectively. Linear regression analysis revealed that in Models 1, 2, and 3, there was a statistically significant negative association between food insecurity and the components of sustainable and healthy eating behaviors such as healthy and balanced diet (β - 0.226, p < 0.001), quality labels (β - 0.230, p < 0.001), seasonal foods, which are of avoidance of food waste (β - 0.261, p < 0.001), animal welfare (β - 0.174, p < 0.001), and fat intake (β - 0.181, p < 0.001). In conclusion, food insecurity negatively affects healthy and balanced diet behaviors, interest in regional and organic food products, seasonal food products consumption and avoidance of food waste, consumption of low-fat food products, and the choice of products such as free-range chicken eggs, and sustainable fisheries.
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Affiliation(s)
- Kevser Tari Selcuk
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey.
| | - Ramazan Mert Atan
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey
- Department of Nutrition and Dietetics, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Sedat Arslan
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - Nursel Sahin
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey
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45
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Subramaniam M, Koh YS, Vaingankar JA, Abdin E, Shafie S, Chang S, Kwok KW, Chow WL, Chong SA. Food insufficiency, adverse childhood experiences and mental health: results of the Singapore Mental Health Study 2016. Public Health Nutr 2023; 26:1044-1051. [PMID: 36451283 PMCID: PMC10346029 DOI: 10.1017/s1368980022002567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 10/17/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE This study aimed to investigate the prevalence and correlates of food insufficiency and its association with mental disorders and adverse childhood experiences (ACE) in Singapore. DESIGN This analysis utilised data from the Singapore Mental Health Study (SMHS 2016). SETTING SMHS 2016 was a population-based, psychiatric epidemiological study conducted among Singapore residents. PARTICIPANTS Interviews were conducted with 6126 respondents. Respondents were included if they were aged 18 years and above, Singapore citizens or permanent residents and able to speak in English, Chinese or Malay. RESULTS The prevalence of food insufficiency was 2·0 % (95 % CI (1·6, 2·5)) among adult Singapore residents. Relative to respondents who did not endorse any ACE, those with ACE (OR: 2·9, 95 % CI (1·2, 6·6)) had higher odds of food insufficiency. In addition, there were significant associations between lifetime mental disorders and food insufficiency. Bipolar disorder (OR: 2·7, 95 % CI (1·2, 6·0)), generalised anxiety disorder (OR: 4·5, 95 % CI (1·5, 13·5)) and suicidal behaviour (OR: 2·37, 95 % CI (1·04, 5·41)) were shown to be significantly associated with higher odds of food insufficiency. CONCLUSIONS The prevalence of food insufficiency is low in Singapore. However, this study identifies a vulnerable group of food-insufficient adults that is significantly associated with mental disorders, including suicidality. Government-funded food assistance programmes and multi-agency efforts to deal with the social determinants of food insufficiency, such as income sufficiency and early detection and intervention of mental distress, are key to ensuring a sustainable and equitable food system.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yen Sin Koh
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Kian Woon Kwok
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Wai Leng Chow
- Epidemiology and Communicable Diseases Division, Ministry of Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
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46
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Maia I, Oliveira A, Santos AC. Food insecurity is associated with an unhealthy lifestyle score in middle- and older-aged adults: findings from the EPIPorto cohort. Food Secur 2023; 15:661-671. [PMID: 37223752 PMCID: PMC10088709 DOI: 10.1007/s12571-023-01366-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/15/2023] [Indexed: 05/25/2023]
Abstract
The association of food insecurity with the combined effect of lifestyles is still limited. This study evaluated the association between food insecurity and a lifestyle score in middle- and older-aged adults. A cross-sectional study (2013-2016) was performed among 595 individuals (≥ 50 years) from the EPIPorto cohort (Porto, Portugal). Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Information on fruit and vegetable consumption (F&V), physical activity (PA) practice, tobacco smoking, and alcohol consumption were included in a lifestyle score. Those with F&V < five portions/day, < 150 min/week of moderate-intensity PA or < 75 min/week of vigorous-intensity PA, current smokers, consumers of > one drink of alcoholic beverages in women, and > two in men were assigned with one point; all the others had nil points. The score could range from 0 to 4, and was further categorised into three categories. Food insecurity was positively associated with an unhealthy lifestyle profile (OR = 2.272; 95%CI:1.079-4.782), independently of the adjustment variables. Analysing each lifestyle component, food insecurity was associated with low PA practice (OR = 2.365; 95%CI:1.020-5.485). Individuals from food insecure households were more likely to have an unhealthy lifestyle profile. Public health strategies should be developed among food insecure individuals to promote healthy lifestyles.
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Affiliation(s)
- Isabel Maia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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47
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Hallward L, Nagata JM, Testa A, Jackson DB, Ganson KT. Associations between gender identity, eating disorder psychopathology, and food insecurity among Canadian adolescents and young adults during the COVID-19 pandemic. Eat Behav 2023; 49:101723. [PMID: 37030063 DOI: 10.1016/j.eatbeh.2023.101723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/10/2023]
Abstract
There is a clear association between food insecurity and eating disorder (ED) psychopathology, mainly among samples in the United States and prior to the COVID-19 pandemic. However, Canadians experience food insecurity as well, which may have been heightened by the pandemic and its associated restrictions. The associations between food insecurity and ED psychopathology among Canadians remains underexamined. Therefore, the purpose of this study was to explore associations between food insecurity and ED psychopathology by gender identity among a national sample Canadian adolescents and young adults. Data were collected from 2714 participants aged 16 to 30 years old from across Canada. Participants reported sociodemographic characteristics, ED psychopathology, and food insecurity experienced during the COVID-19 pandemic through an online survey. Descriptive statistics, chi-square tests, ANOVAs, and regression analyses were conducted. Overall, 8.9% of the sample experienced food insecurity, with the highest prevalence among transgender and gender nonconforming individuals. Generally, those with no food insecurity reported the lowest ED psychopathology compared to higher ED psychopathology among those with food insecurity. Several unique differences were observed between cisgender men and cisgender women, while there were no significant associations between food insecurity and ED psychopathology found among transgender and gender nonconforming individuals. Further research is needed to investigate how the relationship between food insecurity and ED psychopathology differs based on gender, and to continue to explore food insecurity experienced beyond the COVID-19 pandemic as food insecurity possesses a considerable health threat to all.
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Affiliation(s)
- Laura Hallward
- School of Kinesiology, Western University, London, ON, Canada.
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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48
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Lu I, Welle E, Sadeghzadeh CJ, Harnack LJ, Perez-Velazco X, De Marco M, Pratt R, Caspi C. Experiences of Parents Earning Low Wages in Raleigh, North Carolina: Compounding Effects of Caretaker Responsibility, Piecemeal Resources, and Lack of Economic Opportunities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2023; 19:600-618. [PMID: 39081553 PMCID: PMC11286216 DOI: 10.1080/19320248.2023.2195578] [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: 04/05/2023]
Abstract
We conducted interviews with parents earning low wages to understand their experiences related to financial responsibilities and use of government and informal resources in Raleigh, North Carolina. Inadequate economic opportunities and assistance programs, and high costs of living, compounded into cycles of playing catch up on expenses. Assistance programs aimed at alleviating hardships related to poverty were described as piecemeal. We found that social and economic systems failed to support parents earning low wages. Our findings suggest that ordinances that assure a livable minimum wage paired with expansions of safety net programs could better meet the needs these parents.
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Affiliation(s)
- Isabel Lu
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill
| | - Emily Welle
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, United States
| | - Claire Jon Sadeghzadeh
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill
| | - Lisa J Harnack
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, United States
| | - Ximena Perez-Velazco
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill
| | - Molly De Marco
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, United States
| | - Caitlin Caspi
- Rudd Center for Food Policy and Obesity, University of Connecticut, United States; Department of Allied Health Sciences, University of Connecticut, United States
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49
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O'Connor SM, Zickgraf HF, Hazzard VM, Haller LL, Wildes JE. Exploring differences in disordered eating and related appetitive traits among women based on childhood and current food security status. Eat Behav 2023; 49:101729. [PMID: 37087983 PMCID: PMC10247474 DOI: 10.1016/j.eatbeh.2023.101729] [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: 11/15/2022] [Revised: 03/17/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
Despite emerging evidence that food insecurity (FI) is associated with elevated rates of eating pathology, little is known about the lasting impact of FI on eating behaviors. Studies that have explored the association between FI during childhood and eating behavior in adulthood have not accounted for current FI. The present study explored differences in disordered eating (DE) and related appetitive traits among four groups of cisgender female mothers: individuals who (1) endorsed childhood FI only (n = 96), (2) endorsed current FI only (n = 134), (3) endorsed both childhood and current FI (n = 257), and (4) denied both childhood and current FI (n = 146). Participants responded to online questionnaires including items from the USDA Household Food Security Survey Module, the 7-item Eating Disorder Examination-Questionnaire, the Eating Disorder Diagnostic Scale, and the Adult Eating Behavior Questionnaire. Adjusting for age and race/ethnicity, ANCOVAs explored mean differences between groups in DE and appetitive traits, and a modified Poisson regression model examined differences in binge-eating prevalence across the four FI groups. The "current FI only" group consistently endorsed the highest levels of DE and related appetitive traits followed by the "current and childhood FI" group, suggesting newly food-insecure women may be at highest risk for DE. Interestingly, across almost all constructs, the "childhood FI only" group did not differ significantly from the "no FI" group. These findings suggest that improved access to food may help offset risk for adult DE related to experiences of FI in childhood.
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Affiliation(s)
- Shannon M O'Connor
- Department of Psychology, Montclair State University, Montclair, NJ, United States of America.
| | - Hana F Zickgraf
- Division of Autism and Related Disorders & Division of Pediatric Gastroenterology, Hepatology, and Nutrition Department of Pediatrics, Emory University School of Medicine Emory University, Atlanta, GA, United States of America
| | - Vivienne M Hazzard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Leora L Haller
- Department of Psychology, Montclair State University, Montclair, NJ, United States of America
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
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50
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Kosmas JA, Wildes JE, Graham AK, O'Connor SM. The role of stress in the association among food insecurity, eating disorder pathology, and binge eating-related appetitive traits. Eat Behav 2023; 49:101709. [PMID: 36822033 PMCID: PMC10238633 DOI: 10.1016/j.eatbeh.2023.101709] [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: 06/08/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE Growing literature demonstrates a positive association between food insecurity (FI) and eating disorder pathology. Additionally, FI has been associated with two appetitive traits strongly linked to binge eating, food responsiveness and emotional overeating. However, little research has investigated factors that might help to explain these associations. One hypothesis is that experiencing FI may increase stress, and that eating disorder pathology, particularly binge eating-related phenotypes, may serve as a coping strategy. This study explores stress as a potential mechanism in the association between FI and general eating disorder pathology, as well as two appetitive traits strongly associated with binge eating (food responsiveness and emotional overeating). METHODS Cis-gender women (N = 634) completed online questionnaires assessing FI, stress, eating disorder pathology (measured via the total score on the Short Eating Disorder Examination Questionnaire), and binge eating-related appetitive traits (measured via the Adult Eating Behavior Questionnaire). Cross-sectional indirect effects analyses with a 1000-sample bootstrap were used to test pathways among FI, stress, and eating-related constructs. RESULTS FI was significantly associated with eating disorder pathology and associated appetitive traits (ps < 0.001). Stress explained a significant proportion of the correlation between FI and each eating-related construct. CONCLUSIONS Our findings extend prior research on the relationships between FI, eating disorder pathology, and binge eating-related appetitive traits to provide preliminary evidence that stress may act as an underlying mechanism. Future studies should use longitudinal designs to assess the prospective relationships among these constructs.
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Affiliation(s)
- Jacqueline A Kosmas
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, USA
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
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