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Bikomeye JC, Awoyinka I, Kwarteng JL, Beyer AM, Rine S, Beyer KMM. Disparities in Cardiovascular Disease-Related Outcomes Among Cancer Survivors in the United States: A Systematic Review of the Literature. Heart Lung Circ 2024; 33:576-604. [PMID: 38184426 PMCID: PMC11144115 DOI: 10.1016/j.hlc.2023.11.003] [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: 08/11/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Cancer and cardiovascular disease (CVD) are major causes of morbidity and mortality in the United States (US). Cancer survivors have increased risks for CVD and CVD-related mortality due to multiple factors including cancer treatment-related cardiotoxicity. Disparities are rooted in differential exposure to risk factors and social determinants of health (SDOH), including systemic racism. This review aimed to assess SDOH's role in disparities, document CVD-related disparities among US cancer survivors, and identify literature gaps for future research. METHODS Following the Peer Review of Electronic Search Strategies (PRESS) guidelines, MEDLINE, PsycINFO, and Scopus were searched on March 15, 2021, with an update conducted on September 26, 2023. Articles screening was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, a pre-defined Population, Exposure, Comparison, Outcomes, and Settings (PECOS) framework, and the Rayyan platform. A modified version of the Newcastle-Ottawa Scale was used to assess the risk of bias, and RAW Graphs for alluvial charts. This review is registered with PROSPERO under ID #CRD42021236460. RESULTS Out of 7,719 retrieved articles, 24 were included, and discussed diverse SDOH that contribute to CVD-related disparities among cancer survivors. The 24 included studies had a large combined total sample size (n=7,704,645; median=19,707). While various disparities have been investigated, including rural-urban, sex, socioeconomic status, and age, a notable observation is that non-Hispanic Black cancer survivors experience disproportionately adverse CVD outcomes when compared to non-Hispanic White survivors. This underscores historical racism and discrimination against non-Hispanic Black individuals as fundamental drivers of CVD-related disparities. CONCLUSIONS Stakeholders should work to eliminate the root causes of disparities. Clinicians should increase screening for risk factors that exacerbate CVD-related disparities among cancer survivors. Researchers should prioritise the investigation of systemic factors driving disparities in cancer and CVD and develop innovative interventions to mitigate risk in cancer survivors.
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Affiliation(s)
- Jean C Bikomeye
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Iwalola Awoyinka
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jamila L Kwarteng
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andreas M Beyer
- Department of Medicine and Physiology, Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sarah Rine
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kirsten M M Beyer
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
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Pengpid S, Peltzer K. Longitudinal Associations Between Food Insecurity and Mental Health in Aging Adults in South Africa. Clin Gerontol 2024:1-9. [PMID: 38600746 DOI: 10.1080/07317115.2024.2341328] [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] [Indexed: 04/12/2024]
Abstract
OBJECTIVES The aim of this study was to assess the longitudinal unidirectional and bidirectional associations between food insecurity and mental health among aging adults in South Africa. METHODS The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa (HAALSI) study. RESULTS The proportion of food insecurity was 20.2% in 2015, 24.1% in 2019 and 18.4% in 2021/2022. Food insecurity was positively associated depressive symptoms, poor life satisfaction, poor sleep quality, PTSD, loneliness, impaired cognition, and current tobacco use. Compared to without food insecurity in all three study waves, having food insecurity in one wave and/or two to three waves was positively associated with incident depressive symptoms, incident poor life satisfaction, incident poor sleep quality, incident PTSD, incident loneliness, incident current tobacco use, and incident current heavy alcohol use. PTSD, impaired cognition, current tobacco use and current heavy alcohol use were positively associated with incident food insecurity. CONCLUSION We found that food insecurity was unidirectionally associated with depressive symptoms, poor life satisfaction, poor sleep quality and loneliness, and bidirectionally associated with PTSD, impaired cognition, current tobacco use and current heavy alcohol use. CLINICAL IMPLICATIONS Enhanced screening and management of food insecurity may reduce mental ill-health in South Africa.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Brostow DP, Donovan M, Penzenik M, Stamper CE, Spark T, Lowry CA, Ishaq SL, Hoisington AJ, Brenner LA. Food desert residence has limited impact on veteran fecal microbiome composition: a U.S. Veteran Microbiome Project study. mSystems 2023; 8:e0071723. [PMID: 37874170 PMCID: PMC10734509 DOI: 10.1128/msystems.00717-23] [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: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 10/25/2023] Open
Abstract
IMPORTANCE Social and economic inequities can have a profound impact on human health. The inequities could result in alterations to the gut microbiome, an important factor that may have profound abilities to alter health outcomes. Moreover, the strong correlations between social and economic inequities have been long understood. However, to date, limited research regarding the microbiome and mental health within the context of socioeconomic inequities exists. One particular inequity that may influence both mental health and the gut microbiome is living in a food desert. Persons living in food deserts may lack access to sufficient and/or nutritious food and often experience other inequities, such as increased exposure to air pollution and poor access to healthcare. Together, these factors may confer a unique risk for microbial perturbation. Indeed, external factors beyond a food desert might compound over time to have a lasting effect on an individual's gut microbiome. Therefore, adoption of a life-course approach is expected to increase the ecological validity of research related to social inequities, the gut microbiome, and physical and mental health.
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Affiliation(s)
- Diana P. Brostow
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colorado, USA
| | - Meghan Donovan
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
| | - Molly Penzenik
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Christopher E. Stamper
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colorado, USA
| | - Talia Spark
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
| | - Christopher A. Lowry
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colorado, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
- Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, Colorado, USA
- Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Suzanne L. Ishaq
- School of Food and Agriculture, University of Maine, Orono, Maine, USA
| | - Andrew J. Hoisington
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colorado, USA
- Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Systems Engineering & Management, Air Force Institute of Technology, Wright-Patterson AFB, Dayton, Ohio, USA
| | - Lisa A. Brenner
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, Colorado, USA
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colorado, USA
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Fong JH. Risk Factors for Food Insecurity among Older Adults in India: Study Based on LASI, 2017-2018. Nutrients 2023; 15:3794. [PMID: 37686826 PMCID: PMC10490409 DOI: 10.3390/nu15173794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Food security is linked to the nutritional status and well-being of older adults. India is a rapidly aging nation that ranks highly on the 2022 Global Hunger Index. This paper examines the prevalence and risk factors of food insecurity in India's older population. METHODS We used data from the 2017-2018 Longitudinal Aging Study in India. The sample size was 31,532 adults aged 60 years and above. Food insecurity was measured using a four-item version of the Food Insecurity Experience scale. Multivariable logistic regressions using individual-level weights were implemented to assess the risk factors of food insecurity. RESULTS The prevalence of food insecurity was 10.5% in the weighted sample. Sociodemographic factors were important in explaining food insecurity. Older adults who were male, younger, lowly educated, socially disadvantaged, in rural areas, and outside the Northern region were most vulnerable to food insecurity, controlling for various confounders. Additionally, low economic status, no occupational pension, currently working, social isolation, physical impairment, functional disabilities, poor self-rated health, and arthritis were associated with an increased risk of food insecurity. CONCLUSIONS More active food assistance programs catering to older adults and a better provision of economic and social security are warranted to establish a food-secure environment for rapidly aging India.
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Affiliation(s)
- Joelle H Fong
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore 259771, Singapore
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Ing CT, Clemens B, Ahn HJ, Kaholokula JK, Hovmand PS, Seto TB, Novotny R. Food Insecurity and Blood Pressure in a Multiethnic Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6242. [PMID: 37444090 PMCID: PMC10341426 DOI: 10.3390/ijerph20136242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
Food insecurity is a social determinant of health and is increasingly recognized as a risk factor for hypertension. Native Hawaiians bear a disproportionate burden of hypertension and known risk factors. Despite this, the relative effects of food insecurity and financial instability on blood pressure have yet to be investigated in this population. This study examines the relative effects of food insecurity and financial instability on blood pressure, controlling for potential confounders in a multiethnic sample. Participants (n = 124) were recruited from a U.S. Department of Agriculture-funded study called the Children's Healthy Living Center of Excellence. Biometrics (i.e., blood pressure, weight, and height) were measured. Demographics, physical activity, diet, psychosocial variables, food insecurity, and financial instability were assessed via self-report questionnaires. Hierarchical linear regression models were conducted. Model 1, which included sociodemographic variables and known biological risk factors, explained a small but significant amount of variance in systolic blood pressure. Model 2 added physical activity and daily intake of fruit, fiber, and whole grains, significantly improving the model. Model 3 added financial instability and food insecurity, further improving the model (R2 = 0.37, F = 2.67, p = 0.031). Food insecurity, female sex, and BMI were significantly and independently associated with increased systolic blood pressure. These results suggest a direct relationship between food insecurity and systolic blood pressure, which persisted after controlling for physical activity, consumption of fruits, fiber, and whole grains, and BMI. Efforts to reduce food insecurity, particularly among Native Hawaiians, may help reduce hypertension in this high-risk population.
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Affiliation(s)
- Claire Townsend Ing
- Department of Native Hawaiian Health, University of Hawaii at Mānoa, 677 Ala Moana Boulevard, Honolulu, HI 96813, USA
| | - Brettany Clemens
- Nancy Atmospera-Walch School of Nursing, University of Hawaii at Mānoa, 2528 McCarthy Mall, Honolulu, HI 96822, USA
| | - Hyeong Jun Ahn
- Department of Complementary & Integrative Medicine, University of Hawaii at Mānoa, 651 Ilalo Street, Honolulu, HI 96813, USA
| | | | - Peter S. Hovmand
- Center for Community Health Integration, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Todd B. Seto
- Cardiovascular Diseases, Queen’s Medical Center, 550 S Beretania Street, Honolulu, HI 96813, USA
| | - Rachel Novotny
- Human Nutrition, Food and Animal Sciences, University of Hawaii at Mānoa, 1955 East-West Road, Honolulu, HI 96822, USA
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Joulaei H, Keshani P, Foroozanfar Z, Afrashteh S, Hosseinkhani Z, Mohsenpour MA, Moghimi G, Homayouni Meymandi A. Food insecurity status and its contributing factors in slums' dwellers of southwest Iran, 2021: a cross-sectional study. Arch Public Health 2023; 81:38. [PMID: 36899422 PMCID: PMC9999310 DOI: 10.1186/s13690-023-01049-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 02/24/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND One major factor causing food insecurity is believed to be poverty. Approximately 20 million Iranians live in slums with a vulnerable socioeconomic context. The outbreak of COVID-19, on top of the economic sanctions against Iran, has increased this vulnerability and made its inhabitants prone to food insecurity. The current study investigates food insecurity and its associated socioeconomic factors among slum residents of Shiraz, southwest Iran. METHODS Random cluster sampling was used to select the participants in this cross-sectional study. The heads of the households completed the validated Household Food Insecurity Access Scale questionnaire to assess food insecurity. Univariate analysis was utilized to calculate the unadjusted associations between the study variables. Moreover, a multiple logistic regression model was employed to determine the adjusted association of each independent variable with the food insecurity risk. RESULTS Among the 1227 households, the prevalence of food insecurity was 87.20%, with 53.87% experiencing moderate and 33.33% experiencing severe food insecurity. A significant relationship was observed between socioeconomic status and food insecurity, indicating that people with low socioeconomic status are more prone to food insecurity (P < 0.001). CONCLUSIONS The current study revealed that food insecurity is highly prevalent in slum areas of southwest Iran. The socioeconomic status of households was the most important determinant of food insecurity among them. Noticeably, the coincidence of the COVID-19 pandemic with the economic crisis in Iran has amplified the poverty and food insecurity cycle. Hence, the government should consider equity-based interventions to reduce poverty and its related outcomes on food security. Furthermore, NGOs, charities, and governmental organizations should focus on local community-oriented programs to make basic food baskets available for the most vulnerable households.
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Affiliation(s)
- Hassan Joulaei
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Keshani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Ali Mohsenpour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ghasem Moghimi
- Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Homayouni Meymandi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Sun Y, Rong S, Liu B, Du Y, Wu Y, Chen L, Xiao Q, Snetselaar L, Wallace R, Bao W. Meal Skipping and Shorter Meal Intervals Are Associated with Increased Risk of All-Cause and Cardiovascular Disease Mortality among US Adults. J Acad Nutr Diet 2023; 123:417-426.e3. [PMID: 35964910 DOI: 10.1016/j.jand.2022.08.119] [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: 02/13/2021] [Revised: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous dietary studies and current dietary guidelines have mainly focused on dietary intake and food patterns. Little is known about the association between eating behaviors such as meal frequency, skipping and intervals, and mortality. OBJECTIVE The objective was to examine the associations of meal frequency, skipping, and intervals with all-cause and cardiovascular disease (CVD) mortality. DESIGN This was a prospective study. PARTICIPANTS/SETTING A total of 24,011 adults (aged ≥40 years) who participated in the National Health and Nutrition Examination Survey 1999-2014 were included in this study. Eating behaviors were assessed using 24-hour recall. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2015. MAIN OUTCOME MEASURES The outcomes were all-cause and CVD mortality. STATISTICAL ANALYSES PERFORMED Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) of all-cause and CVD mortality. RESULTS During 185,398 person-years of follow-up period, 4,175 deaths occurred, including 878 cardiovascular deaths. Most participants ate three meals per day. Compared with participants eating three meals per day, the multivariable-adjusted HRs for participants eating one meal per day were 1.30 (95% CI 1.03 to 1.64) for all-cause mortality, and 1.83 (95% CI 1.26 to 2.65) for CVD mortality. Participants who skipped breakfast have multivariable-adjusted HRs 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariable-adjusted HRs for all-cause mortality were 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1.32) for skipping dinner compared with those who did not. Among participants eating three meals per day, the multivariable-adjusted HR for participants with an average interval of ≤4.5 hours in two adjacent meals was 1.17 (95% CI 1.04 to 1.32) for all-cause mortality, comparing with those having a meal interval of 4.6 to 5.5 hours. CONCLUSIONS In this large, prospective study of US adults aged 40 years or older, eating one meal per day was associated with an increased risk of all-cause and CVD mortality. Skipping breakfast was associated with increased risk of CVD mortality, whereas skipping lunch or dinner was associated with increased risk of all-cause mortality. Among participant with three meals per day, a meal interval of ≤4.5 hours in two adjacent meals was associated with higher all-cause mortality.
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Affiliation(s)
- Yangbo Sun
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Yang Du
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Yuxiao Wu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Xiao
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa
| | - Linda Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Robert Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Obesity Research and Education Initiative and Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa.
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Pengpid S, Peltzer K. Food insecurity and health outcomes among community-dwelling middle-aged and older adults in India. Sci Rep 2023; 13:1136. [PMID: 36670204 PMCID: PMC9859825 DOI: 10.1038/s41598-023-28397-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
The study assessed associations between food insecurity and mental, physical, and behavioural health outcomes in India. The study analysed national cross-sectional population-based data (N = 72,262; ≥ 45 years) from in India in 2017-2018. The overall prevalence of food insecurity was 9.7%. Food insecurity was significantly positively associated with poor mental health [low life satisfaction (AOR: 2.75, 95% CI 2.35-3.23), low self-reported health (AOR: 1.61, 95% CI 1.11-1.42), insomnia symptoms (AOR: 1.64, 95% CI 1.45-1.85), depressive symptoms (AOR: 2.21, 95% CI 1.97-2.48), major depressive disorder (AOR: 2.37, 95% CI 2.03-2.77), Alzheimer's/dementia (AOR: 1.75, 95% CI 1.13-2.69), and poorer cognitive functioning (AOR: 0.68, 95% CI 0.49-0.93)], poor physical health [bone or joint disease (AOR: 1.18, 95% CI 1.04-1.34), angina (AOR: 1.80, 95% CI 1.58-2.06), underweight (AOR: 1.28, 95% CI 1.16-1.40), chronic lung disease (AOR: 1.22, 95% CI 1.03-1.45), and functional disability (AOR: 1.68, 95% CI 1.47-1.92)], and health risk behaviour [tobacco use (AOR: 1.13, 95% CI 1.01-1.25), heavy episodic drinking (AOR: 1.45, 95% CI 1.10-1.91) and physical inactivity (AOR: 1.42, 95% CI 1.21-1.67)]. Furthermore, food insecurity was negatively associated with overweight/obesity (AOR: 0.80, 95% CI 0.73-0.88). Food insecurity was associated with seven poor mental health indicators, five poor physical health conditions, and three health risk behaviours. Programmes and policies that improve food availability may help improve mental and physical health among middle-aged and older adults in India.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand. .,Department of Psychology, University of the Free State, Bloemfontein, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Wufeng, Taichung, 41354, Taiwan.
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Hill CM, Tseng AS, Holzhauer K, Littman AJ, Jones-Smith JC. Association between health care access and food insecurity among lower-income older adults with multiple chronic conditions in Washington State, USA. Public Health Nutr 2023; 26:199-207. [PMID: 35603699 PMCID: PMC11077446 DOI: 10.1017/s1368980022001240] [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: 08/31/2021] [Revised: 02/03/2022] [Accepted: 05/04/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Lower-income older adults with multiple chronic conditions (MCC) are highly vulnerable to food insecurity. However, few studies have considered how health care access is related to food insecurity among older adults with MCC. The aims of this study were to examine associations between MCC and food insecurity, and, among older adults with MCC, between health care access and food insecurity. DESIGN Cross-sectional study data from the 2019 Behavioral Risk Factor Surveillance System survey. SETTING Washington State, USA. PARTICIPANTS Lower-income adults, aged 50 years or older (n 2118). MCC was defined as having ≥ 2 of 11 possible conditions. Health care access comprised three variables (unable to afford seeing the doctor, no health care coverage and not having a primary care provider (PCP)). Food insecurity was defined as buying food that did not last and not having money to get more. RESULTS The overall prevalence of food insecurity was 26·0 % and was 1·50 times greater (95 % CI 1·16, 1·95) among participants with MCC compared to those without MCC. Among those with MCC (n 1580), inability to afford seeing a doctor was associated with food insecurity (prevalence ratio (PR) 1·83; 95 % CI 1·46, 2·28), but not having health insurance (PR 1·49; 95 % CI 0·98, 2·24) and not having a PCP (PR 1·10; 95 % CI 0·77, 1·57) were not. CONCLUSIONS Inability to afford healthcare is related to food insecurity among older adults with MCC. Future work should focus on collecting longitudinal data that can clarify the temporal relationship between MCC and food insecurity.
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Affiliation(s)
- Courtney M Hill
- Department of Epidemiology, University of
Washington, Seattle, WA98195, USA
| | - Ashley S Tseng
- Department of Epidemiology, University of
Washington, Seattle, WA98195, USA
| | | | - Alyson J Littman
- Department of Epidemiology, University of
Washington, Seattle, WA98195, USA
- Seattle Epidemiologic Research and Information
Center, Department of Veterans Affairs Puget Sound Health Care System,
Seattle, WA, USA
- Seattle-Denver Center of Innovation for Veteran-Centered and
Value-Driven Care, Health Services Research and Development,
Department of Veterans Affairs Puget Sound Health Care System, Seattle,
WA, USA
| | - Jessica C Jones-Smith
- Department of Epidemiology, University of
Washington, Seattle, WA98195, USA
- Department of Health Systems and Population Health,
University of Washington, Seattle,
WA, USA
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Salinas-Roca B, Rubió-Piqué L, Carrillo-Álvarez E, Franco-Alcaine G. Impact of Health and Social Factors on the Cardiometabolic Risk in People with Food Insecurity: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14447. [PMID: 36361326 PMCID: PMC9655931 DOI: 10.3390/ijerph192114447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Food plays a key role in people's health and quality of life. Inadequate eating habits or a deficient diet can lead to the development of non-communicable diseases (NCDs). The present review aims to describe the health and social factors related to food insecurity (FI) in adults in high-income countries and evaluate their impact on cardiometabolic risk (CMR). Following the PRISMA procedures, a systematic review was conducted by searching in biomedical databases. Full articles were screened (nf = 228) and critically appraised, and 12 studies met the inclusion criteria. Based on the selected studies, the results grouped information based on (i) the characteristics of the population in FI, (ii) the impact of FI on NCDs, and (iii) the cardiovascular and all-cause mortality risk of the FI population. Considering the minimum and maximum percentage data, people of the categories female sex (46.2-57.6%), education level lower than high school (11-67.46%), non-Hispanic white ethnicity (37.4-58%), single or separated or widowed (45-64.8%), and current smoker (35.5-61.1%) make up the population with FI in high-income countries. All of these factors presented a significant association (p < 0.001) with cardiovascular risk factors. The highest odds ratios (OR) for the FI population are described for obesity (OR = 2.49, 95% CI; 1.16-5.33) and myocardial infarction (OR = 2.19, 95% CI). Interventions that integrate FI screening and the measurement of CMR factors into routine clinical care may be an important step to identify vulnerable populations and subsequently improve and prevent NCDs. Thus, food-diet policies and public-health-based interventions are needed to be included in the measurement of CMR in the assessment of FI.
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Affiliation(s)
- Blanca Salinas-Roca
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig 2, 25198 Lleida, Spain
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain
| | - Laura Rubió-Piqué
- Antioxidants Research Group, Food Technology Department, AGROTECNIO-CERCA Center, University of Lleida, Av/Alcalde Rovira Roure 191, 25198 Lleida, Spain
| | - Elena Carrillo-Álvarez
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326-332, 08025 Barcelona, Spain
| | - Gemma Franco-Alcaine
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig 2, 25198 Lleida, Spain
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11
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Muhammad T, Saravanakumar P, Sharma A, Srivastava S, Irshad CV. Association of food insecurity with physical frailty among older adults: study based on LASI, 2017-18. Arch Gerontol Geriatr 2022; 103:104762. [PMID: 35841798 DOI: 10.1016/j.archger.2022.104762] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Food security can be directly linked to nutritional status and either directly or indirectly, it has an impact on health status and well-being of the population. Physical frailty is one of the most important phenotypes used to understand the vulnerable nature of older adults. This paper examined the association between food security and physical frailty in older adults. METHODS We used data from the Longitudinal Ageing Study in India (LASI, 2017-18), wave-1. The sample size was 31,464 older adults aged 60 years and above. Physical frailty was assessed using the modified version of frailty phenotype proposed by Fried and colleagues. Multivariable logistic regression was used to establish the association between food insecurity with physical frailty. RESULTS A proportion of 30.65% of older adults were frail in this study. Older adults with food insecurity had higher prevalence of exhaustion (12.1% vs 6.5%), unintentional weight loss (65.5% vs 5.1%), and weak grip strength (8.6% vs 7.9%) in comparison to their food secure counterparts. After adjusting for a large number of confounders, older adults who reported food insecurity had significantly higher odds of being frail [AOR: 2.68; CI: 2.26-3.19] in comparison to older adults with no food insecurity. CONCLUSION The study showed that food insecurity is associated with physical frailty among older adults in India. It is suggested that food security programs in the country may be considered as an effective strategy to prevent physical frailty among older adults.
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Affiliation(s)
- T Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
| | - Priya Saravanakumar
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Building 10, Level 7, 235 Jones St, Ultimo, Sydney, NSW 2007, Australia
| | - Abhishek Sharma
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India
| | - C V Irshad
- Department of Humanities and Social Sciences, Indian Institute of Technology, Madras, 600036 India.
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12
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Isaura ER, Chen YC, Yang SH. Childhood socioeconomic status and adulthood dietary diversity among Indonesian adults. Front Nutr 2022; 9:948208. [PMID: 36211520 PMCID: PMC9537565 DOI: 10.3389/fnut.2022.948208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022] Open
Abstract
Food insecurity problems still exist among people in low-to-middle income countries. The long-term disadvantages of socioeconomic status may contribute to chronic food insecurity. However, whether childhood socioeconomic status factors are related to food insecurity in adulthood remains unclear. Thus, the aim of this study was to test the association between childhood socioeconomic status factors and one of the proxies for adulthood food security, dietary diversity. This study used the 2014 RAND Indonesia Family Life Survey dataset with 22,559 adult participants as study samples. The childhood socioeconomic status factors consisted of 16 questions about the participants’ conditions when they were 12 years old. Adult dietary diversity was assessed using the United Nations World Food Programme’s food consumption score. A linear regression model was used to analyze the association between variables. This study found that the number of owned books (β coef.: 3.713–7.846, p < 0.001), the use of safe drinking-water sources (β coef.: 0.707–5.447, p < 0.001–0.009) and standard toilets (β coef.: 1.263–4.955, p < 0.001–0.002), parents with the habit of alcohol consumption (β coef.: 2.983, p = 0.044) or the combination with smoking habits (β coef.: 1.878, p < 0.001), self-employed with the permanent worker (β coef.: 2.904, p = 0.001), still married biological parents (β coef.: 1.379, p < 0.001), the number of rooms (β coef.: 0.968, p < 0.001), people (β coef.: 0.231, p < 0.001), and younger siblings (β coef.: 0.209–0.368, p < 0.001–0.039) in the same house were positively and significantly associated with the outcome variable. Furthermore, in the order of childhood socioeconomic status factors, self-employment without permanent workers and casual work types (β coef.: –9.661 to –2.094, p < 0.001–0.001), houses with electricity facilities (β coef.: –4.007, p < 0.001), and parents with smoking habits (β coef.: –0.578, p = 0.006) were negatively and significantly associated with the food security proxy. In conclusion, childhood and early socioeconomic disadvantage is related to adult food security status and may lead to poor health.
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Affiliation(s)
- Emyr Reisha Isaura
- Department of Nutrition, Faculty of Public Health, Airlangga University, Surabaya, Indonesia
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Research Group of Food Safety and Food Security, Faculty of Public Health, Airlangga University, Surabaya, Indonesia
| | - Yang-Ching Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Shwu-Huey Yang,
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Parekh T, Xue H, Cheskin LJ, Cuellar AE. Food insecurity and housing instability as determinants of cardiovascular health outcomes: A systematic review. Nutr Metab Cardiovasc Dis 2022; 32:1590-1608. [PMID: 35487828 DOI: 10.1016/j.numecd.2022.03.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/26/2022] [Accepted: 03/28/2022] [Indexed: 11/22/2022]
Abstract
AIMS The primary objective of this study is to conduct a systematic review of existing literature on the association between food insecurity and housing instability with CVD and its subtypes-related outcomes. Summarizing the comprehensive evidence for independent/interchangeable relationship of food and housing instability with CVD outcomes may inform specific interventions strategies to reduce CVD-risk. DATA SYNTHESIS The search focused on English-language articles in PubMed/Medline, from January 1, 2010, to June 1, 2021, with restriction to the US adult population. We included studies estimating the association between food insecurity or/and housing instability(exposure) and CVD-subtypes-related health outcomes (outcome). The study methodological quality was assessed using the Study Quality Assessment Tools (SQAT). Nineteen studies met eligibility criteria, consisted of 15 cross-sectional and 4 cohort studies. Of total studies, 7 examined housing instability, 11 studies focused on food insecurity, and one examined both. Food insecurity/housing instability was associated with increased overall CVD-mortality rate and greater healthcare cost utilization, while evidence were mixed for hospital readmission rate. By subtype, stroke mortality was greater with food insecurity but not with housing instability. The likelihood of myocardial infarction, coronary heart disease, and congestive heart failure was greater with food insecurity. Although mortality with MI was higher with housing instability, readmission and surgical procedure rates were significantly lower than housing stable adults. CONCLUSION Findings from this review suggest an urgent need to test the impact of screening for food and housing insecurities, referral services, and community engagement for CV health, within clinical and public health settings. PROTOCOL REGISTRATION Prospero CRD4202123352.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Lawrence J Cheskin
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
| | - Alison E Cuellar
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA.
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Sharedalal P, Shah N, Sreenivasan J, Michaud L, Sharedalal A, Kaul R, Panza JA, Aronow WS, Cooper HA. Trends in 10-Year Predicted Risk of Cardiovascular Disease Associated With Food Insecurity, 2007-2016. Front Cardiovasc Med 2022; 9:851984. [PMID: 35686041 PMCID: PMC9170893 DOI: 10.3389/fcvm.2022.851984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/29/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Consumption of a healthy diet improves cardiovascular (CV) risk factors and reduces the development of cardiovascular disease (CVD). Food insecure (FIS) adults often consume an unhealthy diet, which can promote obesity, type 2 diabetes mellitus (T2DM), hypertension (HTN), and hyperlipidemia (HLD). The Supplemental Nutrition Assistance Program (SNAP) is designed to combat food insecurity by increasing access to healthy foods. However, there is a paucity of data on the association of SNAP participation among FIS adults and these CVD risk factors. Methods The National Health and Nutrition Examination Survey (NHANES) is a publicly available, ongoing survey administered by the Centers for Disease Control and Prevention and the National Center for Health Statistics. We analyzed five survey cycles (2007-2016) of adult participants who responded to the CVD risk profile questionnaire data. We estimated the burden of select CVD risk factors among the FIS population and the association with participation in SNAP. Results Among 10,449 adult participants of the survey, 3,485 (33.3%) identified themselves as FIS. Food insecurity was more common among those who were younger, female, Hispanic, and Black. Among the FIS, SNAP recipients, when compared to non-SNAP recipients, had a lower prevalence of HLD (36.3 vs. 40.1% p = 0.02), whereas rates of T2DM, HTN, and obesity were similar. Over the 10-year survey period, FIS SNAP recipients demonstrated a reduction in the prevalence of HTN (p < 0.001) and HLD (p < 0.001) which was not evident among those not receiving SNAP. However, obesity decreased only among those not receiving SNAP. The prevalence of T2DM did not change over the study period in either group. Conclusion Over a 10-year period, FIS adults who received SNAP demonstrated a reduction in the prevalence of HTN and HLD, which was not seen among those not receiving SNAP. However, the prevalence of obesity and T2DM did not decline among SNAP recipients, suggesting that additional approaches are required to impact these important CVD risk factors.
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Affiliation(s)
- Parija Sharedalal
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Neal Shah
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Jayakumar Sreenivasan
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Liana Michaud
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Anmol Sharedalal
- School of Medicine, St. George’s University, St. George’s, Grenada
| | - Risheek Kaul
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Julio A. Panza
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Wilbert S. Aronow
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
| | - Howard A. Cooper
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States
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15
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Srivastava S, Muhammad T. Rural-urban differences in food insecurity and associated cognitive impairment among older adults: findings from a nationally representative survey. BMC Geriatr 2022; 22:287. [PMID: 35387591 PMCID: PMC8985064 DOI: 10.1186/s12877-022-02984-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 03/25/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Due to rapid urbanization, Covid-19 pandemic and increasing food prices, a higher rate of food insecurity has been observed in recent years in India. Thus, we aim to study the prevalence of food insecurity among older Indian adults and the association of food insecurity as a modifiable risk factor with late-life cognitive impairment. METHOD Data for this study were obtained from the recent release of the Longitudinal Ageing Study in India (2017-18). The total sample size for the study was 31,464 older adults aged 60 years and above. Cognitive functioning was measured through five broad domains (memory, orientation, arithmetic function, executive function, and object naming) adapted from the cognitive module of the US Health and Retirement Study (HRS). Descriptive statistics along with cross-tabulation were presented in the study. Additionally, multivariable logistic regression analysis was used to fulfil the objectives of the study. RESULTS It was found that 7.7% of older adults in rural areas reduced their size of meals due to unavailability (urban, 3.2%), 41.2% of them did not eat enough food of their choice (urban, 38.3%), 6.9% were hungry but did not eat food (urban, 2.6%), 5.0% did not eat for whole day (urban, 2.2%), and 6.9% lost weight due to lack of food in their household (urban, 2.9%). It was found that older adults who did not have enough food of their choice had significantly higher odds [AOR: 1.24; CI: 1.14, 1.35] of suffering from cognitive impairment in reference to their counterparts. Similarly, the older adults who were hungry but did not eat were 30% [AOR: 1.30; CI: 1.02, 1.73] more likely to suffer from cognitive impairment in reference to their counterparts. Interaction model revealed that older adults who had food insecurity in rural areas had higher odds of cognitive impairment than older adults who had food insecurity in urban areas. CONCLUSION The findings of the study highlight that the food security status in older adults may bring about greater challenges due to their limited economic resources. Interventions focusing on food security may have unintended positive impacts on late-life mental wellbeing as the older age is associated with higher cognitive deficits.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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16
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Household and child food insecurity and CVD risk factors in lower-income adolescents aged 12-17 years from the National Health and Nutrition Examination Survey (NHANES) 2007-2016. Public Health Nutr 2022; 25:922-929. [PMID: 34155968 PMCID: PMC9991548 DOI: 10.1017/s1368980021002652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Household food insecurity is associated with CVD risk factors in low-income adults, but research on these associations among adolescents is inconsistent. This study investigates whether household and child food insecurity is associated with CVD risk factors in lower-income adolescents. DESIGN Cross-sectional. Multivariable linear regression assessed the association between household and child food security and CVD risk factors. Household and child food security was measured using the US Food Security Survey Module. The analyses were adjusted for adolescent's age, sex, race/ethnicity, smoking status, physical activity and sedentary time, as well as household income and the head-of-household's education and marital status. SETTING The USA. PARTICIPANTS The sample was comprised of 2876 adolescents, aged 12-17 years, with household incomes at or below 300 % federal poverty line from the National Health and Nutrition Examination Survey cycles 2007-2016. RESULTS The weighted prevalence of household food insecurity in the analytic sample was 33·4 %, and the weighted prevalence of child food insecurity was 17·4 %. After multivariable adjustment, there were no significant associations between household and child food insecurity and BMI-for-age Z-score, systolic and diastolic blood pressure, HDL-cholesterol, total cholesterol, fasting TAG, fasting LDL-cholesterol and fasting plasma glucose. CONCLUSIONS Despite observed associations in adults, household food insecurity was not associated with CVD risk factors in a national sample of lower-income adolescents. Child food insecurity was also not associated with CVD risk factors. More research should be conducted to confirm these associations.
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17
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Chang R, Javed Z, Taha M, Yahya T, Valero-Elizondo J, Brandt EJ, Cainzos-Achirica M, Mahajan S, Ali HJ, Nasir K. Food insecurity and cardiovascular disease: Current trends and future directions. Am J Prev Cardiol 2022; 9:100303. [PMID: 34988538 PMCID: PMC8702994 DOI: 10.1016/j.ajpc.2021.100303] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/20/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
Food insecurity (FI) - a state of limited access to nutritionally adequate food - is notably more prominent among patients with cardiovascular disease (CVD) than the general population. Current research suggests that FI increases the risk of cardiovascular morbidity and mortality through various behavioral and biological pathways. Importantly, FI is more prevalent among low-income households and disproportionately affects households with children, particularly those led by single mothers. These disparities necessitate solutions specifically geared towards helping these high-risk subgroups, who also experience increased risk of CVD associated with FI. Further, individuals with CVD may experience increased risk of FI due to the financial burden imposed by CVD care. While participation in federal aid programs like the Supplemental Nutrition Assistance Program and the Special Supplemental Nutrition Program for Women, Infants, and Children has been associated with cardiovascular health benefits, residual FI and lower dietary quality among many families suggest a need for better outreach and expanded public assistance programs. Healthcare systems and community organizations can play a vital role in screening individuals for FI and connecting them with food and educational resources. While further research is needed to evaluate sociodemographic differences in the FI-CVD relationship, interventions at the policy, health system, and community levels can help address both the burden of FI and its impacts on cardiovascular health.
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Affiliation(s)
- Ryan Chang
- Washington University in St. Louis, St. Louis, MO, USA
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
| | - Zulqarnain Javed
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
| | - Mohamad Taha
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Tamer Yahya
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Javier Valero-Elizondo
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), USA
| | - Eric J. Brandt
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Miguel Cainzos-Achirica
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), USA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Shiwani Mahajan
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Hyeon-Ju Ali
- Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Khurram Nasir
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), USA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins Medicine, Baltimore, MD, USA
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Beltrán S, Arenas DJ, Pharel M, Montgomery C, Lopez‐Hinojosa I, DeLisser HM. Food insecurity, type 2 diabetes, and hyperglycaemia: A systematic review and meta-analysis. Endocrinol Diabetes Metab 2022; 5:e00315. [PMID: 34726354 PMCID: PMC8754242 DOI: 10.1002/edm2.315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/18/2021] [Accepted: 10/24/2021] [Indexed: 12/16/2022] Open
Abstract
AIMS Food insecurity (FIS) is a major public health issue with possible implications for type 2 diabetes mellitus (T2DM) risk. We conducted a systematic review and meta-analysis to explore the association between FIS and T2DM. METHODS We performed a systematic search in PubMed, Embase, Scopus, and Web of Science. All cross-sectional, peer-reviewed studies investigating the link between FIS and T2DM were included. Population characteristics, study sizes, covariates, T2DM diagnoses, and diabetes-related clinical measures such as fasting blood glucose (FBG) and HbA1c were extracted from each study. Outcomes were compared between food insecure and food secure individuals. Effect sizes were combined across studies using the random effect model. RESULTS Forty-nine peer-reviewed studies investigating the link between FIS and T2DM were identified (n = 258,250). Results of meta-analyses showed no association between FIS and clinically determined T2DM either through FBG or HbA1c: OR = 1.22 [95%CI: 0.96, 1.55], Q(df = 5) = 12.5, I2 = 60% and OR = 1.21 [95%CI: 0.95, 1.54], Q(df = 5) = 14; I2 = 71% respectively. Standardized mean difference (SMD) meta-analyses yielded no association between FIS and FBG or HbA1c: g = 0.06 [95%CI: -0.06, 0.17], Q(df = 5) = 15.8, I2 = 68%; g = 0.11 [95% CI: -0.02, 0.25], Q(df = 7) = 26.8, I2 = 74% respectively. For children, no association was found between FIS and HbA1c: g = 0.06 [95%CI: 0.00, 0.17], Q(df = 2) = 5.7, I2 = 65%. CONCLUSIONS Despite multiple proposed mechanisms linking FIS to T2DM, integration of the available literature suggests FIS is not associated with clinically determined T2DM or increases in FBG or HbA1c among adult patients.
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Affiliation(s)
- Sourik Beltrán
- Department of MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Daniel J. Arenas
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Canada Montgomery
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Horace M. DeLisser
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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19
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Kumar S, Bansal A, Shri N, Nath NJ, Dosaya D. Effect of food insecurity on the cognitive problems among elderly in India. BMC Geriatr 2021; 21:725. [PMID: 34922495 PMCID: PMC8684220 DOI: 10.1186/s12877-021-02689-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/29/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Food Insecurity (FI) is a crucial social determinant of health, independent of other socioeconomic factors, as inadequate food resources create a threat to physical and mental health especially among older person. The present study explores the associations between FI and cognitive ability among the aged population in India. METHODS To measure the cognitive functioning we have used two proxies, word recall and computational problem. Descriptive analysis and multivariable logistic regression was used to understand the prevalence of word recall and computational problem by food security and some selected sociodemographic parameters. All the results were reported at 95% confidence interval. RESULTS We have used the data from the first wave of longitudinal ageing study of India (LASI), with a sample of 31,464 older persons 60 years and above. The study identified that 17 and 5% of the older population in India experiencing computational and word recall problem, respectively. It was found that respondents from food secure households were 14% less likely to have word recall problems [AOR:0.86, 95% CI:0.31-0.98], and 55% likely to have computational problems [AOR:0.45, 95% CI:0.29-0.70]. We also found poor cognitive functioning among those experiencing disability, severe ADL, and IADL. Further, factors such as age, education, marital status, working status, health related factors were the major contributors to the cognitive functioning in older adults. CONCLUSION This study suggest that food insecurity is associated with a lower level of cognition among the elderly in India, which highlight the need of food policy and interventional strategies to address food insecurity, especially among the individuals belonging to lower wealth quintiles. Furthermore, increasing the coverage of food distribution may also help to decrease the burden of disease for the at most risk population. Also, there is a need for specific programs and policies that improve the availability of nutritious food among elderly.
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Affiliation(s)
- Shubham Kumar
- International Institute for Population Sciences, Govandi East, Mumbai, 400088 India
| | - Anjali Bansal
- International Institute for Population Sciences, Govandi East, Mumbai, 400088 India
| | - Neha Shri
- International Institute for Population Sciences, Govandi East, Mumbai, 400088 India
| | - Nayan Jyoti Nath
- CHRIST (Deemed-to-be-University), Central Campus, Bengaluru, India
| | - Divya Dosaya
- Birla Institute of Technology and Science, Pilani, India
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20
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Lauren BN, Silver ER, Faye AS, Rogers AM, Woo-Baidal JA, Ozanne EM, Hur C. Predictors of households at risk for food insecurity in the United States during the COVID-19 pandemic. Public Health Nutr 2021; 24:3929-3936. [PMID: 33500018 PMCID: PMC8207551 DOI: 10.1017/s1368980021000355] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 01/04/2021] [Accepted: 01/20/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine associations between sociodemographic and mental health characteristics with household risk for food insecurity during the COVID-19 outbreak. DESIGN Cross-sectional online survey analysed using univariable tests and a multivariable logistic regression model. SETTING The United States during the week of 30 March 2020. PARTICIPANTS A convenience sample of 1965 American adults using Amazon's Mechanical Turk platform. Participants reporting household food insecurity prior to the pandemic were excluded from analyses. RESULTS One thousand two hundred and fifty participants reported household food security before the COVID-19 outbreak. Among this subset, 41 % were identified as at risk for food insecurity after COVID-19, 55 % were women and 73 % were white. On a multivariable analysis, race, income, relationship status, living situation, anxiety and depression were significantly associated with an incident risk for food insecurity. Black, Asian and Hispanic/Latino respondents, respondents with an annual income <$100 000 and those living with children or others were significantly more likely to be newly at risk for food insecurity. Individuals at risk for food insecurity were 2·60 (95 % CI 1·91, 3·55) times more likely to screen positively for anxiety and 1·71 (95 % CI 1·21, 2·42) times more likely to screen positively for depression. CONCLUSIONS An increased risk for food insecurity during the COVID-19 pandemic is common, and certain populations are particularly vulnerable. There are strong associations between being at risk for food insecurity and anxiety/depression. Interventions to increase access to healthful foods, especially among minority and low-income individuals, and ease the socioemotional effects of the outbreak are crucial to relieving the economic stress of this pandemic.
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Affiliation(s)
- Brianna N Lauren
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, 622 W 168th St, PH9E-105, New York, NY10032, USA
| | - Elisabeth R Silver
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, 622 W 168th St, PH9E-105, New York, NY10032, USA
| | - Adam S Faye
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Alexandra M Rogers
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, 622 W 168th St, PH9E-105, New York, NY10032, USA
| | - Jennifer A Woo-Baidal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Elissa M Ozanne
- Department of Population Health Sciences, University of Utah, School of Medicine, Salt Lake, UT, USA
| | - Chin Hur
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, 622 W 168th St, PH9E-105, New York, NY10032, USA
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
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21
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Janda KM, Ranjit N, Salvo D, Nielsen A, Lemoine P, Casnovsky J, van den Berg A. Correlates of Transitions in Food Insecurity Status during the Early Stages of the COVID-19 Pandemic among Ethnically Diverse Households in Central Texas. Nutrients 2021; 13:2597. [PMID: 34444757 PMCID: PMC8401244 DOI: 10.3390/nu13082597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/25/2022] Open
Abstract
Food insecurity increased substantially in the USA during the early stages of the 2020 COVID-19 pandemic. The purpose of this study was to identify potential sociodemographic and food access-related factors that were associated with continuing or transitioning into food insecurity in a diverse population. An electronic survey was completed by 367 households living in low-income communities in Central Texas during June-July 2020. Multinomial logistic regression models were developed to examine the associations among food insecurity transitions during COVID-19 and various sociodemographic and food access-related factors, including race/ethnicity, children in the household, loss of employment/wages, language, and issues with food availability, accessibility, affordability, and stability during the pandemic. Sociodemographic and food access-related factors associated with staying or becoming newly food insecure were similar but not identical. Having children in the household, changes in employment/wages, changing shopping location due to food availability, accessibility and/or affordability issues, issues with food availability, and stability of food supply were associated with becoming newly food insecure and staying food insecure during the pandemic. Identifying as Latino and/or Black was associated with staying food insecure during COVID-19. These findings suggest that the COVID-19 pandemic did not create new food insecurity disparities. Rather, the pandemic exacerbated pre-existing disparities.
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Affiliation(s)
- Kathryn M. Janda
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Nalini Ranjit
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Aida Nielsen
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - Pablo Lemoine
- Centro Nacional de Consultoría, Bogotá 110221, Colombia;
| | | | - Alexandra van den Berg
- UTHealth School of Public Health, Austin, TX 78701, USA; (N.R.); (A.N.); (A.v.d.B.)
- Michael and Susan Dell Center for Healthy Living, Austin, TX 78701, USA
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22
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Joseph C, Feiner C, Leung CW. Food insecurity is associated with serious psychological distress among low-income California adults. J Health Psychol 2021; 27:2249-2260. [PMID: 34213360 DOI: 10.1177/13591053211028913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined differences in the associations between food insecurity and serious psychological distress (SPD) by key sociodemographic factors in a population-based sample of low-income adults from the 2017 California Health Interview Survey (n = 6266). After adjusting for sociodemographic characteristics, low food security, and very low food security were both positively associated with SPD among all low-income adults. Upon stratification, these associations were most pronounced among adults under age 50, males, and in adults with children. Understanding disparities in the associations between food insecurity and psychological distress is critical in developing effective programs or policies to target the most vulnerable sub-groups.
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23
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Walker S, Baum JI. Eggs as an affordable source of nutrients for adults and children living in food-insecure environments. Nutr Rev 2021; 80:178-186. [PMID: 34027973 DOI: 10.1093/nutrit/nuab019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/10/2021] [Accepted: 03/02/2021] [Indexed: 01/03/2023] Open
Abstract
Food insecurity affects an estimated 12% of households in the United States. Adults and children who experience food insecurity are increased risk for development of metabolic diseases such as type 2 diabetes, obesity, and cardiovascular disease. The negative health outcomes associated with food insecurity are multifactorial; however, many of them may be caused by limited nutritional intake and poor diet quality. Dietary intake of eggs may be an applicable solution for food-insecure families who are challenged by limited nutritional intake. Eggs contain a variety of nutrients that support metabolic health. For instance, eggs are a complete source of high-quality protein and contain 16 vitamins and minerals. Furthermore, eggs are cost efficient. When comparing the relationship between foods on the basis of calories and unit cost, the energy cost of eggs is significantly less when compared with that of other animal-protein foods such as meat, poultry, and fish. However, dietary intake of eggs is controversial in regard to cardiovascular health. Thus, the aim of this review is to summarize the role of eggs in the diet and the impact eggs have on health for adults and children living in a food-insecure environment.
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Affiliation(s)
- Sam Walker
- S. Walker and J.I. Baum are with the Department of Food Science, University of Arkansas. S. Walker and J.I. Baum are with the Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, Arkansas, USA
| | - J I Baum
- S. Walker and J.I. Baum are with the Department of Food Science, University of Arkansas. S. Walker and J.I. Baum are with the Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, Arkansas, USA
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24
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Mei J, Fulay AP, Wolfson JA, Leung CW. Food Insecurity and Dietary Intake among College Students with Unlimited Meal Plans at a Large, Midwestern University. J Acad Nutr Diet 2021; 121:2267-2274. [PMID: 33972204 DOI: 10.1016/j.jand.2021.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/23/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Food insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown. OBJECTIVES This study examined the association between food insecurity and dietary intake in a sample of undergraduate students with unlimited meal plans and dining hall access at a large, public Midwestern university. DESIGN The study design is cross-sectional. The data used are baseline data from a broader sugar-sweetened beverage intervention study that were collected using a Qualtrics survey prior to the intervention. PARTICIPANTS/SETTING The sample consisted of 1033 undergraduate students recruited from 3 dining halls. The data were collected in November 2018. MAIN OUTCOME MEASURES Food security was assessed using the 6-item Short Form Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15. STATISTICAL ANALYSES PERFORMED Generalized linear regression models were used to examine differences in dietary intake by students' food security status, adjusting for students' sociodemographic characteristics. RESULTS In the sample, 14% of students were food-insecure. After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits (P = 0.02), 9% lower intake of vegetables (P < 0.001), 10% higher intake of dairy (P = 0.002), 6% higher intake of total added sugars (P = 0.01), 10% higher intake of added sugars from sugar-sweetened beverages (P = 0.01), 4% higher intake of calcium (P = 0.01), and 4% lower intake of fiber (P = 0.01) compared with food-secure students. With respect to beverage intake, food-insecure students had 56% higher intake of total sugar-sweetened beverages (P = 0.002), which was driven by 185% higher intake of energy and sports drinks (P = 0.001), and 121% higher intake of sweetened teas (P = 0.001). CONCLUSIONS Despite having identical food resources within campus dining halls, there were significant differences in the diets of college students by food security status.
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25
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Jafri A, Mathe N, Aglago EK, Konyole SO, Ouedraogo M, Audain K, Zongo U, Laar AK, Johnson J, Sanou D. Food availability, accessibility and dietary practices during the COVID-19 pandemic: a multi-country survey. Public Health Nutr 2021; 24:1798-1805. [PMID: 33663623 PMCID: PMC8007937 DOI: 10.1017/s1368980021000987] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the perceived effects of the coronavirus disease (COVID-19) pandemic lockdown measures on food availability, accessibility, dietary practices and strategies used by participants to cope with these measures. DESIGN We conducted a cross-sectional multi-country online survey between May and July 2020. We used a study-specific questionnaire mainly based on the adaptation of questions to assess food security and coping strategies from the World Food Programme's 'Emergency Food Security Assessment' and 'The Coping Strategy Index'. SETTING The questionnaire was hosted online using Google Forms and shared using social media platforms. PARTICIPANTS A total of 1075 adult participants from eighty-two countries completed the questionnaire. RESULTS As a prelude to COVID-19 lockdowns, 62·7 % of the participants reported to have stockpiled food, mainly cereals (59·5 % of the respondents) and legumes (48·8 %). An increase in the prices of staples, such as cereals and legumes, was widely reported. Price increases have been identified as an obstacle to food acquisition by 32·7 % of participants. Participants reported having lesser variety (50·4 %), quality (30·2 %) and quantity (39·2 %) of foods, with disparities across regions. Vulnerable groups were reported to be facing some struggle to acquire adequate food, especially people with chronic diseases (20·2 %), the elderly (17·3 %) and children (14·5 %). To cope with the situation, participants mostly relied on less preferred foods (49 %), reduced portion sizes (30 %) and/or reduced the number of meals (25·7 %). CONCLUSIONS The COVID-19 pandemic negatively impacted food accessibility and availability, altered dietary practices and worsened the food insecurity situation, particularly in the most fragile regions.
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Affiliation(s)
- Ali Jafri
- Mohammed VI University of Health Sciences, Université Mohammed VI des Sciences de la Santé, avenue Taieb Naciri, Casablanca, Morocco
| | - Nonsikelelo Mathe
- Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Alberta, Canada
| | - Elom K Aglago
- Nutrition and Metabolism Section, International Agency for Research on Cancer (IARC), Lyon, France
| | - Silvenus O Konyole
- Department of Nutritional Sciences, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | | | - Keiron Audain
- Department of Food Science and Nutrition, University of Zambia, Lusaka, Zambia
| | - Urbain Zongo
- Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
| | | | - Jeffrey Johnson
- Alliance for Canadian Health Outcomes Research in Diabetes, University of Alberta, Alberta, Canada
| | - Dia Sanou
- Food and Agriculture Organization of the United Nations, Addis Ababa, Ethiopia
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Effect of Neighborhood and Individual-Level Socioeconomic Factors on Colorectal Cancer Screening Adherence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094398. [PMID: 33919106 PMCID: PMC8122519 DOI: 10.3390/ijerph18094398] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023]
Abstract
Despite the effectiveness of screenings in reducing colorectal cancer (CRC) mortality, ~25% of US adults do not adhere to screening guidelines. Prior studies associate socioeconomic status (SES) with low screening adherence and suggest that neighborhood deprivation can influence CRC outcomes. We comprehensively investigated the effect of neighborhood SES circumstances (nSES), individual SES, and race/ethnicity on adherence to CRC screening in a multiethnic cross-sectional study. Participant surveys assessing 32 individual-level socioeconomic and healthcare access measures were administered from 2017 to 2018. Participant data were joined with nine nSES measures from the US Census at the census tract level. Univariate, LASSO, and multivariable mixed-effect logistic regression models were used for variable reduction and evaluation of associations. The total study population included 526 participants aged 50–85; 29% of participants were non-adherent. In the final multivariable model, age (p = 0.02) and Non-Hispanic Black race (p = 0.02) were associated with higher odds of adherence. Factors associated with lower adherence were home rental (vs. ownership) (p = 0.003), perception of low healthcare quality (p = 0.006), no routine checkup within two years (p = 0.002), perceived discrimination (p = 0.02), and nSES deprivation (p = 0.02). After comprehensive variable methods were applied, socioeconomic indicators at the neighborhood and individual level were found to contribute to low CRC screening adherence.
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27
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Beltrán S, Pharel M, Montgomery CT, López-Hinojosa IJ, Arenas DJ, DeLisser HM. Food insecurity and hypertension: A systematic review and meta-analysis. PLoS One 2020; 15:e0241628. [PMID: 33201873 PMCID: PMC7671545 DOI: 10.1371/journal.pone.0241628] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/17/2020] [Indexed: 12/26/2022] Open
Abstract
Background Food insecurity (FIS) is an important public health issue associated with cardiovascular risk. Given the association of FIS with diets of poorer nutritional quality and higher salt intake as well as chronic stress, numerous studies have explored the link between FIS and hypertension. However, no systematic review or meta-analysis has yet to integrate or analyze the existing literature. Methods We performed a wide and inclusive search of peer-reviewed quantitative data exploring FIS and hypertension. A broad-terms, systematic search of the literature was conducted in PubMed, Embase, Scopus, and Web of Science for all English-language, human studies containing primary data on the relationship between FIS and hypertension. Patient population characteristics, study size, and method to explore hypertension were extracted from each study. Effect sizes including odds ratios and standardized mean differences were extracted or calculated based on studies’ primary data. Comparable studies were combined by the random effects model for meta-analyses along with assessment of heterogeneity and publication bias. Results A total of 36 studies were included in the final analyses. The studies were combined into different subgroups for meta-analyses as there were important differences in patient population characteristics, methodology to assess hypertension, and choice of effect size reporting (or calculability from primary data). For adults, there were no significantly increased odds of elevated blood pressures for food insecure individuals in studies where researchers measured the blood pressures: OR = 0.91 [95%CI: 0.79, 1.04; n = 29,781; Q(df = 6) = 7.6; I2 = 21%]. This remained true upon analysis of studies which adjusted for subject BMI. Similarly, in studies for which the standardized mean difference was calculable, there was no significant difference in measured blood pressures between food secure and FIS individuals: g = 0.00 [95%CI: -0.04, 0.05; n = 12,122; Q(df = 4) = 3.6; I2 = 0%]. As for retrospective studies that inspected medical records for diagnosis of hypertension, there were no significantly increased odds of hypertension in food insecure adults: OR = 1.11 [95%CI: 0.86, 1.42; n = 2,887; Q(df = 2) = 0.7; I2 = 0%]. In contrast, there was a significant association between food insecurity and self-reports of previous diagnoses of hypertension: 1.46 [95%CI: 1.13, 1.88; n = 127,467; Q(df = 7) = 235; I2 = 97%]. Only five pediatric studies were identified which together showed a significant association between FIS and hypertension: OR = 1.44 [95%CI: 1.16, 1.79; n = 19,038; Q(df = 4) = 5.7; I2 = 30%]. However, the small number of pediatric studies were not sufficient for subgroup meta-analyses based on individual study methodologies. Discussion In this systematic review and meta-analysis, an association was found between adult FIS and self-reported hypertension, but not with hypertension determined by blood pressure measurement or chart review. Further, while there is evidence of an association between FIS and hypertension among pediatric subjects, the limited number of studies precluded a deeper analysis of this association. These data highlight the need for more rigorous and longitudinal investigations of the relationship between FIS and hypertension in adult and pediatric populations.
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Affiliation(s)
- Sourik Beltrán
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Marissa Pharel
- Rush Medical College, Rush University, Chicago, Illinois, United States of America
| | - Canada T. Montgomery
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Itzel J. López-Hinojosa
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Daniel J. Arenas
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Horace M. DeLisser
- Academic Programs Office, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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28
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Food Insecurity, Depression, and Race: Correlations Observed Among College Students at a University in the Southeastern United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218268. [PMID: 33182386 PMCID: PMC7664923 DOI: 10.3390/ijerph17218268] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 11/17/2022]
Abstract
Food insecurity is common among college students in the United States and is associated with poorer health-related outcomes and academic performance. The aims of this study were to assess the prevalence of food insecurity at a large, public university in Mississippi, a state with the second highest rate of food insecurity in the nation, and to examine the associations between food insecurity, depression, and race in this group of students. Food security was measured using the United States Department of Agriculture Household Food Security Survey Module: Six-Item Short Form, and depression was measured using the Patient Health Questionnaire-9. In total, 131 students ages 18-24 participated in the study. Food insecurity was present in 38.2% of students surveyed. The odds of food insecurity were higher among African American students compared to Caucasian students (OR = 3.50, 95% CI: 1.38, 8.90). Students with very low food security had 4.52-times greater odds of having depression than food-secure students (p = 0.011, 95% CI: 1.42, 14.36). Neither body mass index nor body fat percentage were associated with food security status. Further research is needed on strategies to address the risk of depression among food-insecure college students and the racial disparity in food insecurity rates present among college students.
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Willis SK, Simonsen SE, Hemmert RB, Baayd J, Digre KB, Zick CD. Food Insecurity and the Risk of Obesity, Depression, and Self-Rated Health in Women. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2020; 1:308-317. [PMID: 33786494 PMCID: PMC7784806 DOI: 10.1089/whr.2020.0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/21/2020] [Indexed: 06/12/2023]
Abstract
Background/Introduction/Objective: Recent studies have shown that food insecurity is associated with obesity, depression, and other adverse health outcomes although little research has been focused on these relationships in underrepresented cultural and social groups. In this study we elucidate the relationship between food insecurity, community factors, dietary patterns, race/ethnicity and health among underrepresented women. Materials and Methods: The data for this investigation come from a cross-sectional survey of women drawn from five urban Utah communities of color, including African immigrants/refugees, African Americans, Hispanics, American Indians/Alaska Natives, and Pacific Islanders, and women from four rural Utah counties. Multivariate logistic regression was used to assess the relationship between food insecurity and obesity risk, self-reported depression, and self-assessed health. Results: Urban women of color were more likely to report food insecurity than rural non-Hispanic white women. Obesity and depression scores were positively associated with food insecurity. Conclusions: Utah women of color had higher levels of food insecurity than reported in state or national data, highlight an important disparity. Nutritional education initiatives, evaluating food assistance programs, and screenings in clinical settings targeting specific racial/ethnic groups may help address the disparities observed in this study.
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Affiliation(s)
- Sydney K. Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sara E. Simonsen
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | - Jami Baayd
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Kathleen B. Digre
- Department of Neurology and Ophthalmology and University of Utah, Salt Lake City, Utah, USA
| | - Cathleen D. Zick
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah, USA
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Himmelgreen D, Romero-Daza N, Heuer J, Lucas W, Salinas-Miranda AA, Stoddard T. Using syndemic theory to understand food insecurity and diet-related chronic diseases. Soc Sci Med 2020; 295:113124. [PMID: 32586635 DOI: 10.1016/j.socscimed.2020.113124] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/28/2022]
Abstract
Syndemic Theory (ST) provides a framework to examine mutually enhancing diseases/health issues under conditions of social inequality and inequity. ST has been used in multiple disciplines to address interacting infectious diseases, noncommunicable diseases, and mental health conditions. The theory has been critiqued for its inability to measure disease interactions and their individual and combined health outcomes. This article reviews literature that strongly suggests a syndemic between food insecurity (FI) and diet-related chronic diseases (DRCDs), and proposes a model to measure the extent of such interaction. The article seeks to: (1) examine the potential syndemic between FI and DRCDs; (2) illustrate how the incorporation of Life History Theory (LHT), into a syndemic framework can help to highlight critical lifeperiods when FI-DRCD interactions result in adverse health outcomes; (3) discuss the use of mixed methods to identify and measure syndemics to enhance the precision and predictive power of ST; and (4) propose an analytical model for the examination of the FI-DRCD syndemic through the life course. The proposed model is more relevant now given the significant increase in FI globally as a result of the ongoing COVID-19 pandemic. The differential impact that the pandemic appears to have among various age groups and by other demographic factors (e.g., race, gender, income) offers an opportunity to examine the potential FI-DRCD syndemic under the lens of LHT.
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Affiliation(s)
- David Himmelgreen
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA.
| | - Nancy Romero-Daza
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
| | - Jacquelyn Heuer
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
| | - William Lucas
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
| | - Abraham A Salinas-Miranda
- USF Center of Excellence in MCH Education, Science & Practice, University of South Florida, 13201 Bruce B. Downs Blvd, UPC 523, Tampa, FL, 33612, USA
| | - Theresa Stoddard
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
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31
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Barone A, Krummel DA, Lee SY. Availability of Food Options and Nutrition Education in Local Food Pantries. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:492-502. [PMID: 32094023 DOI: 10.1016/j.jneb.2019.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 12/04/2019] [Accepted: 12/13/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Explore the availability of food options and nutrition education at food pantries and identify the barriers to offering them to pantry clients. DESIGN Cross-sectional, mixed-methods study. SETTING Food pantry, Cincinnati, OH. PARTICIPANTS A total of 41 food pantry coordinators (aged 63.4 ± 9.1 years), recruited by e-mail/phone in an urban area. PHENOMENON OF INTEREST Availability of food options and nutrition education and barriers to improving food options and providing nutrition education at food pantries. ANALYSIS Survey data were collected using Qualtrics and analyzed using SPSS software. In-depth interviews were transcribed verbatim, transcripts were independently coded, and codes and themes were discussed until a consensus was reached. RESULTS The availability of fresh produce, dairy, low-sodium canned vegetables, and whole grains were limited, and 10 food pantries (24%) offered nutrition education to their clients. Challenges to improving food options were lack of space and equipment for storage and transportation. Identified barriers to providing nutrition education included the lack of space, funding, personnel with nutrition expertise, and clients' low interest in nutrition education. CONCLUSIONS AND IMPLICATIONS The availability of healthy food choices and nutrition education were limited at local food pantries. Collaborative efforts with community partners and nutrition experts may be necessary to overcome those barriers.
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Affiliation(s)
- Adam Barone
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH
| | - Debra A Krummel
- Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH
| | - Seung-Yeon Lee
- Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH.
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Harrington RA, Califf RM, Balamurugan A, Brown N, Benjamin RM, Braund WE, Hipp J, Konig M, Sanchez E, Joynt Maddox KE. Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association. Circulation 2020; 141:e615-e644. [PMID: 32078375 DOI: 10.1161/cir.0000000000000753] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Understanding and addressing the unique health needs of people residing in rural America is critical to the American Heart Association's pursuit of a world with longer, healthier lives. Improving the health of rural populations is consistent with the American Heart Association's commitment to health equity and its focus on social determinants of health to reduce and ideally to eliminate health disparities. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders to make rural populations a priority in programming, research, and policy. This advisory first summarizes existing data on rural populations, communities, and health outcomes; explores 3 major groups of factors underlying urban-rural disparities in health outcomes, including individual factors, social determinants of health, and health delivery system factors; and then proposes a set of solutions spanning health system innovation, policy, and research aimed at improving rural health.
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Abstract
South Africa represents one of the most rapidly aging countries in sub-Saharan Africa with a rising burden of age-related psychological morbidities. Despite having one of the highest human development scores in the region, the country faces serious poverty and food insecurity related challenges. Previous studies have shown a positive association between food insecurity and poor mental health among the adult population, however there is no systematic evidence on this association among the elderly population in an African setting. In the present study, we aimed to address this research gap by analyzing cross-sectional data (n = 931) on the over-50 population (>50 years) from the SAGE (Study on global AGEing and adult health) Well-Being of Older People Study (WOPS) of the World Health Organization, conducted between 2010 and 2013. The outcome variable was perceived depression and the explanatory variables included several sociodemographic factors including self-reported food insecurity. The independent associations between the outcome and explanatory variables were measured using multivariable regression analysis. Results showed that close to a quarter of the population (22.6%, 95% CI = 21.4, 24.7) reported having depression in the last 12 months, with the percentage being markedly higher among women (71.4%). In the multivariable regression analysis, self-reported food insecurity was found to be the strongest predictor of depression among both sexes. For instance, severe food insecurity increased the odds of depression by 4.805 [3.325, 7.911] times among men and by 4.115 [2.030, 8.341] times among women. Based on the present findings, it is suggested that national food security programs focus on promoting food security among the elderly population in an effort to improve their mental health status. Nonetheless, the data were cross-sectional and the associations can’t imply causality.
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Portela-Parra ET, Leung CW. Food Insecurity Is Associated with Lower Cognitive Functioning in a National Sample of Older Adults. J Nutr 2019; 149:1812-1817. [PMID: 31240308 PMCID: PMC6768814 DOI: 10.1093/jn/nxz120] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/11/2019] [Accepted: 05/10/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Food insecurity, a social and economic condition of inadequate food resources, is known to affect cognitive development in children. However, research is sparse among adult populations, particularly older adults who may be more susceptible to accelerated cognitive decline. OBJECTIVE The aim of this study was to examine the associations between food insecurity and cognitive functioning among older adults. METHODS Data came from 1823 older adults (≥60 y) with incomes ≤300% of the federal poverty level (FPL) from the 2011-2014 NHANES. Food security was measured using the 10-item Adult Food Security Survey Module. Cognitive function was measured using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word learning subtest and delayed word recall, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). The cognitive assessments were then standardized and an overall cognitive function z score was created by averaging across all cognitive assessments. Associations with food insecurity were examined using multivariate linear regression models, adjusting for sociodemographic and health characteristics. RESULTS In the analytic population, the prevalence of food insecurity was 23.7%. Across all cognitive assessments, the mean scores among food-insecure adults was significantly lower than the mean scores among food-secure adults. After adjusting for sociodemographic and health characteristics, food insecurity was associated with lower scores on the CERAD word learning subtest (β = -0.14, 95% CI: -0.26, -0.01), the AFT (β = -0.13, 95% CI: -0.25, -0.002), and the DSST (β = -0.24, 95% CI: -0.33, -0.15). Food insecurity was also associated with a lower score on the overall cognitive function z score (β = -0.15, 95% CI: -0.26, -0.05). CONCLUSIONS In this national sample of 1823 adults aged ≥60 y, food insecurity was inversely associated with cognitive function, which may translate into higher risk of cognitive impairment over time.
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Affiliation(s)
| | - Cindy W Leung
- Center for Health and Community, University of California, San Francisco, CA, USA
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Mirzaeipour F, Seyedmazhari M, Pishgooie AH, Hazaryan M. Assessment of risk factors for coronary artery disease in military personnel: A study from Iran. J Family Med Prim Care 2019; 8:1347-1351. [PMID: 31143719 PMCID: PMC6510073 DOI: 10.4103/jfmpc.jfmpc_109_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction: Cardiovascular diseases are the most significant cause of mortality. Although the risk factors of this disease are well known, the strength of these factors varies in different populations and needs to be investigated. Aim: The aim of this study is to estimate the amount of the effect of each classic risk factor on CAD (coronary artery disease) among Aja personnel. Materials and Methods: This matched case-control study was conducted on 1000 male Aja personnel admitted selecting Aja hospitals in Tehran in 2017. The samples were selected using purposive-graded sampling method. The 250 military patients hospitalized for CAD were considered as a case group. Each case was individually matched for age and service force with tree military patients without CAD. Data were gathered using standard demographic information and history of risk factors questionnaire and analyzed using SPSS 23 and statistical tests. Odds ratio measured trough Cochran–Mantel–Haenszel test and used to estimate the amount of the effect of each classic risk factors on CAD. Results: Data analysis indicated that the risk factors including diabetes, hyperlipidemia, smoking, hypertension, and positive family history of CAD enhance the probability of CAD as much as 79.2%, 77.3%, 67.7%, 64.1%, and 56.6%, respectively. Conclusion: Diabetes and other modifiable risk factors have the greatest impact on CAD among the concerned Aja personnel. Hence, the authorities can consider the independent amount of the effect of each risk factor and modify them in order to prevent the disease more effectively and purposefully among the personnel.
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Affiliation(s)
- Farshid Mirzaeipour
- Department of Critical Care Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Marjan Seyedmazhari
- Department of Medical-Surgical Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Amir Hosein Pishgooie
- Department of Critical Care Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Mahsa Hazaryan
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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