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Mokari-Yamchi A, Faghfouri AH, Gholami S, Nattagh-Eshtivani E, Gheibi S. Association of household food insecurity with sociodemographic factors and obesity in US youth: findings from the National Health and Nutrition Examination Survey 2017-2018. Front Public Health 2024; 12:1387638. [PMID: 39086807 PMCID: PMC11288867 DOI: 10.3389/fpubh.2024.1387638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Background The objective is to determine the prevalence of household food insecurity (HFI) based on sociodemographic factors and their relationship to obesity in youth. Methods The study included a sample of 1,962 youth (aged 6-18) from the National Health and Nutrition Examination Survey (NHANES). The US Household Food Security Survey Module is used to measure food security over the past 12 months. Logistic regression models were used to estimate adjusted odds ratios (ORs) while controlling for covariates. Results In total, 27.4% of the individuals surveyed experienced HFI. Youth from food insecure households were more likely to be obese (adjusted odds ratio [aOR]: 1.59 [95% confidence interval: 1.19-2.13]) and also having abdominal obesity (aOR: 1.56 [95% CI: 1.19-2.03]). however, factors such as non-Hispanic ethnicity, having a Head of household with a college degree, and households with an income exceeding 350% of the poverty line were associated with a reduced risk of facing HFI. Conclusion Hispanic individuals, households with lower parental education levels, and lower family incomes, are disproportionately affected by food insecurity. Furthermore, HFI has been associated with an increased risk of overweight and abdominal obesity among youth. Addressing FI requires targeted policies and interventions that prioritize vulnerable groups.
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Affiliation(s)
- Amin Mokari-Yamchi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Amir Hossein Faghfouri
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Samira Gholami
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Elyas Nattagh-Eshtivani
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Shahsanam Gheibi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Parekh T, Xue H, Al-Kindi S, Nasir K, Cheskin LJ, Cuellar AE. Food Environment Quality and Cardiovascular Disease Mortality in the United States: a County-Level Analysis from 2017 to 2019. J Gen Intern Med 2024; 39:176-185. [PMID: 37507552 PMCID: PMC10853151 DOI: 10.1007/s11606-023-08335-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Upstream socioeconomic circumstances including food insecurity and food desert are important drivers of community-level health disparities in cardiovascular mortality let alone traditional risk factors. The study assessed the association between differences in food environment quality and cardiovascular mortality in US adults. DESIGN Retrospective analysis of the association between cardiovascular mortality among US adults aged 45 and above and food environment quality, measured as the food environment index (FEI), in 2615 US counties. FEI was measured by equal weights of food insecurity (limited access to a reliable food source) and food desert (limited access to healthy food), ranging from 0 (worst) to 10 (best). Age-adjusted cardiovascular mortality rates per 100,000 adults aged 45 and above in the calendar year 2017-2019. County-level association between CVD mortality rate and FEI was modeled using generalized linear regression. Data were weighted using county population. RESULT Median CVD deaths per 100,000 population were 645.4 (IQR 561.5, 747.0) among adults aged 45 years and above across US counties in 2017-2019. About 12.8% (IQR 10.7%, 15.1%) of residents were food insecure and 6.3% (IQR 3.6%, 9.9%) were living in food desert areas. Comparing counties by FEI quartiles, the CVD mortality rate was higher in the least healthy FE counties (704.3 vs 598.6 deaths per 100,000 population) compared to the healthiest FE counties. One unit increase in FEI was associated with - 12.95 CVD deaths/100,000 population. In the subgroup analysis of counties with higher income inequality, the healthiest food environment was associated with 46.4 lower CVD deaths/100,000 population than the least healthy food environment. One unit increase in FEI in counties with higher income inequality was associated with a fivefold decrease in CVD mortality difference in African American counties (- 18.4 deaths/100,000 population) when compared to non-African American counties (- 3.63 deaths/100,000 population). CONCLUSION In this retrospective multi-county study in the USA, a higher food environment index was significantly associated with lower cardiovascular mortality.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA.
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Sadeer Al-Kindi
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Khurram Nasir
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, 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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Hernández-Vásquez A, Olazo-Cardenas KM, Visconti-Lopez FJ, Barrenechea-Pulache A. What Drives Abdominal Obesity in Peru? A Multilevel Analysis Approach Using a Nationally Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610333. [PMID: 36011966 PMCID: PMC9407803 DOI: 10.3390/ijerph191610333] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 06/01/2023]
Abstract
Abdominal obesity (AO) is a serious public health threat due to its increasing prevalence and effect on the development of various non-communicable diseases. A multilevel analysis of the 2019 Demographic and Family Health Survey (ENDES in Spanish) using the Latin American Diabetes Association (ALAD in Spanish) cut-off points was carried out to evaluate the individual and contextual factors associated with AO in Peru. A total of 30,585 individuals 18 years and older were included in the analysis. The prevalence of AO among Peruvians in 2019 was 56.5%. Individuals of older age (aOR 4.64; 95% CI: 3.95-5.45), women (aOR 2.74; 95% CI: 2.33-3.23), individuals with a higher wealth index (aOR 2.81; 95% CI: 2.40-3.30) and having only secondary education (aOR 1.45; 95% CI: 1.21-1.75) showed increased odds of presenting AO compared to their peers. At a contextual level, only the Human Development Index (aOR 1.59; 95% CI: 1.17-2.16) was associated with the development of AO. A high Human Development Index is the contextual factor most associated with AO. It is necessary to formulate and implement new public health policies focused on these associated factors in order to reduce the prevalence of OA and prevent the excessive burden of associated noncommunicable diseases.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15024, Peru
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Aguiar A, Maia I, Pinto M, Duarte R. Food Insecurity in Portugal during the COVID-19 Pandemic: Prevalence and Associated Sociodemographic Characteristics. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2022. [PMCID: PMC9059064 DOI: 10.1159/000522319] [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] [Indexed: 11/19/2022] Open
Abstract
Introduction The current worldwide COVID-19 pandemic has been having a considerable impact not only on health but also on the economy of societies, emphasizing food insecurity as a significant public health concern. Aim The objective of this study was to characterize the scenario of food insecurity in Portugal during the COVID-19 pandemic and explore its related sociodemographic characteristics. Methodology This is a cross-sectional study, using data from an online survey, performed from November 2020 until February 2021, including 882 residents aged 18 years or older in Portugal. Data on sociodemographics and food security status were collected, the latter was evaluated using the United States Household Food Security Survey Module: Six-Item Short Form. Crude and adjusted logistic regression models were performed (covariates: education, household income perception, and the working status during the COVID-19 pandemic). The odds ratio (OR) and respective 95% confidence intervals (CI) were estimated. Results Most participants were women (71.3%), with a mean age of 36.8 years (SD 11.0). Food insecurity prevalence was 6.8%. Less-educated individuals (≤12 years of schooling; OR 2.966; 95% CI 1.250–7.042), and those who were and remained unemployed since the beginning of the pandemic (OR 2.602; 95% CI 1.004–6.742) had higher odds of belonging to a food-insecure household, regardless of education, working status during the COVID-19 pandemic, and household income perception. Moreover, lower odds of belonging to a food-insecure household were observed among those reporting a comfortable household income (OR 0.007; 95% CI 0.001–0.062) than those who perceived their household income as insufficient, independently of education and the working status during the COVID-19 pandemic. Conclusions These findings highlight the population groups that are at a greater risk of food insecurity during the current COVID-19 pandemic. Effective public health strategies should be developed aiming to address food insecurity during this crisis, especially among the higher risk groups.
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Affiliation(s)
- Ana Aguiar
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- *Ana Aguiar,
| | - Isabel Maia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Marta Pinto
- Unidade de Investigação Clínica da ARS Norte, Porto, Portugal
- Faculdade de Psicologia e Ciências da Educação, Universidade do Porto, Porto, Portugal
| | - Raquel Duarte
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Unidade de Investigação Clínica da ARS Norte, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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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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Bigand TL, Dietz J, Gubitz HN, Wilson M. Chronic pain and depressive symptoms are related to food insecurity among urban food bank users. J Public Health (Oxf) 2021; 43:573-580. [PMID: 32567657 DOI: 10.1093/pubmed/fdaa062] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/03/2020] [Accepted: 04/30/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Food bank users suffer high food insecurity. Food insecurity increases risk for chronic health conditions. However, chronic pain and its relation to food insecurity among food bank users is unknown. Knowledge about populations with chronic pain is important to direct appropriate public health nutritional strategies. METHODS Participants completed a survey including sleep, pain, depressive symptoms and food insecurity measures. Descriptive statistics characterized the burden of chronic pain among the sample, and a series of chi-square and t-tests assessed for demographic differences between food bank users who reported pain compared to those who did not. Logistic regression tested for variables predicting food insecurity. RESULTS Within the sample (N = 207), 53% reported a chronic pain diagnosis. Adults with pain were more likely to receive food stamps and to have a mental health condition than those without pain. Regression analyses revealed that depressive symptoms and chronic pain significantly predicted food insecurity when controlling for age and gender. CONCLUSIONS Exploring the link between depression, pain and nutritional resources may enhance understanding of causal relationships driving food insecurity. Public health officials should address nutritional needs of adults including those with chronic pain who use food bank services.
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Affiliation(s)
- Teresa L Bigand
- Department of Nursing, Washington State University, Spokane, WA 99202, USA.,Professional Nursing Development Office, Professional Nursing Development Office, Providence Health Care, Spokane, WA 99204, USA
| | - Jeremy Dietz
- Department of Public Health and Health Economics, London School of Hygiene and Tropical Medicine London, London WC1E 7HT, UK
| | - Hannah N Gubitz
- Department of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Marian Wilson
- Department of Nursing, Washington State University, Spokane, WA 99202, USA
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Daly A, Sapra A, Albers CE, Dufner AM, Bhandari P. Food Insecurity and Diabetes: The Role of Federally Qualified Health Centers as Pillars of Community Health. Cureus 2021; 13:e13841. [PMID: 33854855 PMCID: PMC8037472 DOI: 10.7759/cureus.13841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Food insecurity is a complex public health problem affecting millions of people globally. It leads to negative health outcomes in the afflicted population and the society at large. There is a self-perpetuating vicious cycle between food insecurity and chronic health conditions like diabetes. It is important for healthcare professionals to be aware of its existence, to be able to recognize it, and to work with their patients to find solutions for it. Simultaneously, the providers should advocate for their patients and make program administrators, policymakers, and legislatures aware of this crisis. During the current coronavirus disease 2019 (COVID-19) pandemic, when economies have been badly affected and many people have lost their jobs, this subject has arguably assumed much greater importance. In this article, we discuss the magnitude of the problem, its relation to diabetes mellitus, and the role that a Federally Qualified Health Center (FQHC) can play in mitigating this problem.
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Affiliation(s)
- Anne Daly
- Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, USA
| | - Amit Sapra
- Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, USA
| | - Christine E Albers
- Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, USA
| | - Anastasia M Dufner
- Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, USA
| | - Priyanka Bhandari
- Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, USA
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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: 26] [Impact Index Per Article: 6.5] [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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Wilcox S, Sharpe PA, Liese AD, Dunn C, Hutto B. Socioeconomic factors associated with diet quality and meeting dietary guidelines in disadvantaged neighborhoods in the Southeast United States. ETHNICITY & HEALTH 2020; 25:1115-1131. [PMID: 29966432 PMCID: PMC6314910 DOI: 10.1080/13557858.2018.1493434] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
Objective: To examine diet quality and dietary intake among residents of disadvantaged neighborhoods in the Southeast United States (U.S.) and to examine associations between dietary and socioeconomic factors. Design: We examined baseline data from an evaluation study of a healthy food access initiative. Participants were recruited from two urban settings comprising seven neighborhoods of high household poverty (17% to 62%). Participants completed in-person interviews with measures of education, household income, and food security and one unannounced 24-hour dietary recall by telephone with trained registered dietitians. Food desert residence was coded based on U.S. Census data. Proportions meeting 2010 Dietary Guidelines for Americans and Healthy Eating Index 2010 (HEI-2010) scores were computed. Associations between dietary variables and participant's education, household income, food security, and food desert residence were tested. Results: Participants (n = 465) were predominantly African American (92%), women (80%), and overweight or obese (79%), and 52 ± 14 years of age. Sixty-three percent had low or very low food security, and 82% lived in census tracts of low income and low access to supermarkets (urban food desert). HEI-2010 scores averaged 48.8 ± 13.1. A minority of participants met dietary guidelines. Diet quality was lower among participants with lower education and among those from food insecure households (p < .05). Household income and food security were positively associated with meeting several dietary guidelines (p < .05). Food desert residence was unrelated to diet variables. Conclusions: In this disadvantaged population, significant nutritional concerns were observed, and socioeconomic factors were associated with diet quality and meeting dietary guidelines. Interventions must address broader economic, social, and policy issues such as access to affordable healthy foods.
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Affiliation(s)
- Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208.
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Patricia A. Sharpe
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Angela D. Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Caroline Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208
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10
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Pourmotabbed A, Moosavian SP, Hadi A, Mohammadi H, Dadfarma A, Rezaei S, Babaei A, Moradi S, Mirzaei K. The Relationship between Food Insecurity and Risk of Overweight or Obesity in under 18 Years Individuals: A Systematic Review and Meta-Analysis. Int J Prev Med 2020; 11:158. [PMID: 33312467 PMCID: PMC7716614 DOI: 10.4103/ijpvm.ijpvm_463_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/23/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Food insecurit (FI) has been considered as reason for childhood and adolescent overweight/obesity (OW/OB). Hence, this study was undertaken to assess these relationships. DESIGN Related articles were found by searching the Web of Science, Scopus, PubMed and Embase databases until October 2019. Odds ratio (OR) was analized by a random-effects model. Standard methods were used for assessment of heterogeneity and publication bias. Data were available from 32 studies. The risk ratios of 139,762 participants were pooled from these articles for the meta-analysis. RESULTS This study domenstrated that children and adolescents in food-insecure condition are not at risk of OW/OB (OR = 1.02 95% CI: 0.99, 1.05). However, subgroup analysis indicated that FI related with inhanced risk of OW/OB in adolescents living in developed countries (OR = 1.14; 95% CI: 1.02, 1.27). Other subgroup analysis indicated that severe FI increased the risk of OW/OB among adolescents (OR = 1.24 95% CI: 1.03-1.49). In addition, we found that lower economic development significantly decreased risk of OW/OB among under 6 year children (OR = 0.88; 95% CI: 0.84, 0.93). CONCLUSIONS Our results showed that higher FI degrees were related with more risks of OW/OB among adolescents (12-18 years). Moreover, the country economic levels had effect on the association between FI and risk of OW/OB.
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Affiliation(s)
- Ali Pourmotabbed
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyedeh Parisa Moosavian
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Dadfarma
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahabeddin Rezaei
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Babaei
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajjad Moradi
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khadijah Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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11
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Ignasiak KR, Peterson KD. Implementation and Evaluation of a Small-Scale Farm to School Program in Rural Wisconsin Area Elementary Schools. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1721392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kara R. Ignasiak
- Department of Food and Nutrition, University of Wisconsin-Stout, Menomonie, WI, USA
| | - Kerry D. Peterson
- Department of Food and Nutrition, University of Wisconsin-Stout, Menomonie, WI, USA
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Flórez KR, Katic BJ, López-Cevallos DF, Murillo R, Cancel-Tirado D, Aponte-Soto L, Echeverria SE. The double burden of food insecurity and obesity among Latino youth: Understanding the role of generational status. Pediatr Obes 2019; 14:e12525. [PMID: 31022773 DOI: 10.1111/ijpo.12525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 02/11/2019] [Accepted: 02/25/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Obesity is linked to food insecurity and generational status; however, little is known about how both impact obesity risk among Latino youth. OBJECTIVE To investigate the joint effect of generational status and food insecurity on obesity prevalence among Latino youth. METHODS We pooled data from the 2011 to 2017 waves of the National Health Interview Survey to derive a sample Latino youth aged 12 to 17 (N = 7532). Four generational categories were constructed: first generation (foreign-born children); second generation (US-born child; foreign-born parent[s]); 2.5 generation (US-born child; one foreign-born parent and one US-born parent); third generation (US-born child; U.S.-born parent[s]). Food insecurity was defined by monthly instances of food scarcity over the past year. Obesity was measured using age- and sex-specific body mass index percentile cut-offs. Log-binomial multivariable regression models estimated the association between generational status and food insecurity categories on obesity. RESULTS Obesity percentages among food-insecure households ranged from 12.8% in the first generation, 15.8% in the second, 24.3% in the 2.5, and 19.2% in the third. In fully adjusted models, 2.5 generation food secure youth had the highest prevalence of obesity (aPR: 1.53; 95% CI, 1.09-2.16) when compared with first generation food secure youth, followed by third generation food insecure youth (aPR: 1.49; 95% CI, 1.01-2.20). CONCLUSIONS Food security status is associated with increased obesity prevalence among Latino youth across the generations. Given that obesity is a risk factor for top causes of mortality and morbidity, growing rates among this population is of public health and clinical importance.
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Affiliation(s)
- Karen R Flórez
- Department of Environmental, Occupational, and Geospatial Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Bozena J Katic
- Department of Environmental, Occupational, and Geospatial Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA.,Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Daniel F López-Cevallos
- School of Language, Culture, and Society, College of Liberal Arts, Oregon State University, Corvallis, OR, USA
| | - Rosenda Murillo
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - Doris Cancel-Tirado
- Division of Health and Exercise Sciences, Western Oregon University, Monmouth, OR, USA
| | - Lisa Aponte-Soto
- Office of Community Based Practice, University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Sandra E Echeverria
- Department of Public Health Education, University of North Carolina, Greenboro, NC, USA
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Maia I, Monjardino T, Frias B, Canhão H, Cunha Branco J, Lucas R, Santos AC. Food Insecurity in Portugal Among Middle- and Older-Aged Adults at a Time of Economic Crisis Recovery: Prevalence and Determinants. Food Nutr Bull 2019; 40:504-513. [PMID: 31272218 DOI: 10.1177/0379572119858170] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND To characterize the scenario of food insecurity in Portugal at a time of economic crisis recovery is of the utmost relevance. OBJECTIVE This study aimed to estimate the prevalence and to identify the determinants of food insecurity during economic crisis recovery in a population-based urban sample of middle- and older-aged Portuguese adults. METHODS A cross-sectional study including 604 participants of the EPIPorto cohort was conducted. Data on sociodemographic characteristics and on food security status were collected. Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Logistic regression models, crude and adjusted for sex, age, education, and household income perception, were performed. RESULTS The prevalence of food insecurity was 16.6%. Women (odds ratio [OR] = 1.96; 95% confidence interval [CI]: 1.09-3.54), those less educated (OR = 5.46; 95% CI: 2.84-10.46), and those who had the perception of an insufficient household income (OR = 10.39; 95% CI: 5.00-21.56) were more likely to belong to a food insecure household. Unmarried individuals (OR = 1.79; 95% CI: 1.05-3.06) and lower white-collar workers (OR = 2.22; 95% CI: 1.03-4.77) were also more prone to live within a food insecure household, regardless of sex, age, education, and household income perception. CONCLUSIONS The obtained information is valuable for the development of intervention strategies to reduce food insecurity in middle- and older-aged adults, suggesting that women, unmarried, less educated individuals, less skilled workers, and lower income families should be targeted.
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Affiliation(s)
- Isabel Maia
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
| | - Teresa Monjardino
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Brenda Frias
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
| | - Helena Canhão
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,Sociedade Portuguesa de Reumatologia, Lisboa, Portugal
| | - Jaime Cunha Branco
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,Sociedade Portuguesa de Reumatologia, Lisboa, Portugal.,Serviço de Reumatologia do Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - Raquel Lucas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
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14
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Vercammen KA, Moran AJ, McClain AC, Thorndike AN, Fulay AP, Rimm EB. Food Security and 10-Year Cardiovascular Disease Risk Among U.S. Adults. Am J Prev Med 2019; 56:689-697. [PMID: 30885515 PMCID: PMC8011593 DOI: 10.1016/j.amepre.2018.11.016] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Cardiovascular disease is a leading cause of mortality in the U.S. Although the risk of cardiovascular disease can be mitigated substantially by following a healthy lifestyle, adhering to a healthy diet and other healthy behaviors are limited by reduced food security. This study aims to determine the association between food security and cardiovascular disease risk. METHODS Three samples from the 2007-2014 National Health and Nutrition Examination Survey were examined: (1) 7,340 non-fasting adults (aged 40-79 years); (2) 13,518 non-fasting adults (aged 20-64 years); and (3) 6,494 fasting adults (aged 20-64 years). Food security was assessed using the U.S. Household Food Security Survey Module, with households categorized as having full, marginal, low, or very low food security. Regressions were conducted in 2018 to test the associations between food security status and odds of ≥20% 10-year cardiovascular disease risk among middle-aged to older adults (OR, 95% CI) and cardiovascular disease risk factors among all adults (β, 95% CI). RESULTS Compared with adults with full food security, those with very low food security had higher odds of ≥20% 10-year cardiovascular disease risk (OR=2.36, 95% CI=1.25, 4.46), whereas those with marginal food security had higher systolic blood pressure (β=0.94 mmHg, 95% CI=0.09, 1.80). Compared with adults with full food security, adults with different levels of food security had higher BMIs (marginal: 0.76, 95% CI=0.26, 1.26; low: 0.97, 95% CI=0.34, 1.60; and very low: 1.03, 95% CI=0.44, 1.63) and higher odds of current smoking (marginal: OR=1.43, 95% CI=1.17, 1.75; low: OR=1.47, 95% CI=1.22, 1.77; and very low: OR=1.95, 95% CI=1.60, 2.37). CONCLUSIONS Adults with food insecurity have elevated cardiovascular disease risk factors and excess predicted 10-year cardiovascular disease risk. Substantially improving food security may be an important public health intervention to reduce future cardiovascular disease in the U.S.
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Affiliation(s)
- Kelsey A Vercammen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Alyssa J Moran
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Amanda C McClain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Anne N Thorndike
- Department of Medicine, Harvard Medical School, Boston, Massachusetts; General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts
| | - Aarohee P Fulay
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Moradi S, Mirzababaei A, Mohammadi H, Moosavian SP, Arab A, Jannat B, Mirzaei K. Food insecurity and the risk of undernutrition complications among children and adolescents: A systematic review and meta-analysis. Nutrition 2018; 62:52-60. [PMID: 30852458 DOI: 10.1016/j.nut.2018.11.029] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/19/2018] [Accepted: 11/27/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis was performed to examine the association between household food insecurity and the risk of being underweight, stunting, and wasting in children and adolescents. METHODS Pertinent studies were identified by searching PubMed, Web of Science, and Scopus databases up to June 2018. A total of 21 studies met the inclusion criteria to be included in the pooled analysis. The risk ratio of 55 173 individuals from 12 different countries were pooled in these studies for our meta-analysis. RESULTS It was found that food insecurity increased the risk of stunting (odds ratio [OR] = 1.17; 95% confidence interval [CI]: 1.09-1.25) and underweight (OR = 1.17; 95% CI: 1.01-1.36) but not of wasting (OR = 1.04; 95% CI: 0.96-1.12). Subgroup analysis by age indicated that food insecurity increased the risk of stunting (OR = 1.20; 95% CI: 1.02-1.39) and underweight (OR = 1.34; 95% CI: 1.02-1.77) in children older than 5 y. This association was significant just for stunting risk (OR = 1.14; 95% CI: 1.05-1.23) in children younger than 5 y. Furthermore, among children and adolescents, risk of stunting or being underweight increased by the intensification of the level of food insecurity in food-insecure households. Furthermore, subgroup analysis by country development levels showed that children and adolescents living in developing countries had higher risk of stunting (OR = 1.16; 95% CI: 1.05-1.27). CONCLUSIONS Household food insecurity appears to be associated with higher risk of stunting and being underweight among children and adolescents. In addition, the intensification of the level of food insecurity and the increased age of children may increase the risk of stunting or being underweight in food-insecure households. Also, the level of economic development is an important factor in the effects of food insecurity on risk of stunting.
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Affiliation(s)
- Sajjad Moradi
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyedeh Parisa Moosavian
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Aceves-Martins M, Cruickshank M, Fraser C, Brazzelli M. Child food insecurity in the UK: a rapid review. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundFood insecurity (FI) is a multifaceted, socioeconomic problem involving difficulties accessing sufficient, safe and nutritious food to meet people’s dietary requirements and preferences for a healthy life. For children experiencing FI, there are some potentially negative developmental consequences and it is, therefore, important to understand the links between FI and children’s health and well-being as well as any strategies undertaken to address FI. The overall objective of this assessment was to determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.ObjectiveTo determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.Data sourcesThe databases searched on 4 December 2017 included MEDLINE (including In-Process & Other Non-Indexed Citations and E-pub ahead of print files), EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Commonwealth Agricultural Bureaux (CAB) abstracts, The Cochrane Library, Education Resources Information Centre (ERIC), PsycINFO, the Social Science Citation Index and the Applied Social Sciences Index and Abstracts (ASSIA).MethodsA rapid review of the current published and unpublished literature was conducted, including all study designs from specified high-income countries in children aged ≤ 18 years. Searches were conducted of major health-care, nutrition, education and social science databases from 1995 onwards, and websites of relevant UK and international organisations. Final searches were undertaken in December 2017.ResultsIn total, 109 studies were selected. Only five studies were conducted in the UK, four of which provided qualitative data. Possible factors associated with child FI were identified, for example socioeconomic status, material deprivation, living in public housing and having unemployed or poorly educated parents. Children’s health, well-being and academic outcomes were all negatively affected by FI. The mediating effects of family stressors and parenting practices in the relationship between FI and children’s health and well-being outcomes were not clear. Food assistance programmes were generally effective in mitigating FI and improving nutritional outcomes (including hunger) in the short term, but did not eradicate FI, eliminate its effects on children’s health or have an impact on academic outcomes. No reports assessing the prevalence of child FI in the UK or the cost-effectiveness and sustainability of interventions to tackle FI were identified.LimitationsThere was a lack of consistency in how FI was defined and measured across studies. Most of the studies used indirect measurements of child FI through parental reports. The majority of studies were conducted in North America. Only five studies were conducted in the UK. Thirty potentially relevant studies were not included in the review as a result of time and resource constraints. Most studies were observational and caution is advised in interpreting their results.ConclusionsA number of factors that were related to child FI were identified, as were negative associations between child FI and physical, mental and social outcomes. However, these findings should be interpreted with caution because of the correlational nature of the analyses and the fact that it is difficult to determine if some factors are predictors or consequences of FI.Future researchThere is an urgent requirement for the development of a reliable instrument to measure and monitor child FI in the UK and for well-designed interventions or programmes to tackle child FI.Study registrationThis study is registered as PROSPERO CRD42017084818.FundingThe National Institute for Health Research Public Health Research programme. The Health Services Research Unit is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.
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Affiliation(s)
| | | | - Cynthia Fraser
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Francis L, DePriest K, Wilson M, Gross D. Child Poverty, Toxic Stress, and Social Determinants of Health: Screening and Care Coordination. ONLINE JOURNAL OF ISSUES IN NURSING 2018; 23. [PMID: 31427855 DOI: 10.3912/ojin.vol23no03man02] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Social determinants of health (SDOH) refer to the social, economic, and physical conditions in which people live that may affect their health. Poverty, which affects nearly 15 million children in the United States, has far-reaching effects on children's physical and mental health. Although it is difficult to change a family's economic circumstances, nurses can play a critical role to address SDOH through screening and effective coordination of care. As nurses, our role is to minimize the effects of SDOH, including poverty, on child health and well-being through our practice, research, and professional education. We present three exemplars of child poverty to demonstrate the impact on child health and well-being and propose a model of care for nurses to assess and address SDOH in the pediatric clinical setting.
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Moradi S, Mirzababaei A, Dadfarma A, Rezaei S, Mohammadi H, Jannat B, Mirzaei K. Food insecurity and adult weight abnormality risk: a systematic review and meta-analysis. Eur J Nutr 2018; 58:45-61. [PMID: 30219965 DOI: 10.1007/s00394-018-1819-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/11/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Research into the relationship between food insecurity and weight abnormality has yielded varied and contradictory results. Therefore, a systematic review and meta-analysis were carried out to examine the association between food insecurity and weight abnormality in adults. METHODS Pertinent studies were identified by searching PubMed and Scopus databases, up to February 2018. Data were available from 31 studies. These studies were conducted in 14 different countries. The odds ratio of 115,993 individuals in these studies was pooled for the meta-analysis. RESULTS The present meta-analysis showed that adults in food-insecure households are more at risk of obesity (OR 1.15, 95% CI 1.06-1.23). Subgroup analysis by gender also revealed that women had a higher risk of obesity compared to men in food-insecure households (OR 1.26, 95% CI 1.05-1.46). Furthermore, subgroup analysis by food insecurity level implied that a severe level of household food insecurity may be associated with a higher risk of underweight (49%) than overweight (37%) or obesity (29%) among adults. In addition, subgroup analysis revealed that with lower levels of national economic development, the risk of weight abnormality shifted from obesity to underweight. CONCLUSION It seems that adults in food-insecure households, especially women, are at higher risk of obesity. The weight abnormality risk may increase with the intensification of the level of food insecurity. Also, the level of economic development is an important factor in the effects of food insecurity on weight status. However, due to the high heterogeneity among studies, the results should be interpreted with caution.
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Affiliation(s)
- Sajjad Moradi
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Halal Research Center of IRI, FDA, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Alireza Dadfarma
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Shahabeddin Rezaei
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Students Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.
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Abstract
OBJECTIVE Increasing evidence has suggested an association between food insecurity and the risk of anaemia. Therefore, a systematic review and meta-analysis were performed to examine the associations between food insecurity and anaemia risk. SETTING Pertinent studies were identified by searching PubMed and EMBASE databases up to August 2017. Data were available from nineteen studies; seventeen studies were cross-sectional and two studies were longitudinal. Risk ratios of 95993 individual participants from twelve different countries in these studies were pooled for the meta-analysis. RESULTS The results showed that there was an overall positive relationship between food insecurity and anaemia risk (OR=1·27; 95 % CI 1·13, 1·40). Similar results were observed for Fe-deficiency anaemia (OR=1·45; 95 % CI 1·04, 1·86). These results revealed that food insecurity at two levels, including mild food insecurity (OR=1·15; 95 % CI 1·00, 1·31) and moderate food insecurity (OR=1·36; 95 % CI 1·23, 1·48), increased the risk of anaemia. In addition, it was found that age had an impact on the associations between food insecurity and anaemia risk (OR=1·22; 95 % CI 1·09, 1·36). Age subgroup analysis indicated that food insecurity significantly increased the risk of anaemia among infants/toddlers (OR=1·17; 95 % CI 1·05, 1·29) and adult women (OR=1·35; 95 % CI 1·16, 1·54). CONCLUSIONS It seems that infants, toddlers and adult women in food-insecure households are at a higher risk of anaemia. To prevent anaemia in food-insecure households, these age groups may require more nutritional support.
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Spanish adaptation and validation of the Child Food Security Survey Module (CFSSM-S). Public Health Nutr 2018; 21:2753-2761. [PMID: 29996952 DOI: 10.1017/s1368980018001672] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study aimed to assess the: (i) internal structure of the Spanish Child Food Security Survey Module (CFSSM-S) with exploratory and confirmatory factor analysis (EFA and CFA); (ii) measurement invariance by gender, grade, weight status, socio-economic status (SES) and family affluence; and (iii) relationships with these external variables. DESIGN A cross-sectional study was conducted. The CFSSM-S and other tools were employed to assess food insecurity, weight status, SES and family affluence, respectively. SETTING A secondary school (grades 7-10) in the city of Terrassa in Catalonia, Spain. SUBJECTS Participants included adolescent boys and girls (n 426) aged 12-17 years. RESULTS The cross-validation design with EFA and CFA captured a single factor, 'food insecurity'. The goodness-of-fit for the one-factor model with CFA (root-mean-square error of approximation=0·038, comparative fit index=0·984, Tucker-Lewis index=0·979) and internal consistency (ω=0·95) were excellent. The measurement invariance indicated that CFSSM-S could be used across genders, grades, weight status, SES and family affluence. Only mean differences for SES and family affluence were found which showed a linear trend, indicating higher CFSSM-S scores for participants with lower SES and family affluence. Of participants, 1·9 % experienced very low food security, 16·4 % low food security and 81·7 % were food secure. CONCLUSIONS The CFSSM-S is the first validated instrument to assess food insecurity with psychometric guarantees in Spanish adolescents. Researchers and health practitioners in Spain could use this self-reported questionnaire to gain more information about adolescent health in relation to food insecurity.
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Young CF, Yun K, Kang E, Shubrook JH, Dugan JA. Correlations Between A1C and Diabetes Knowledge, Diabetes Numeracy, and Food Security in a Vulnerable Type 2 Diabetes Population. Diabetes Spectr 2018; 31:177-183. [PMID: 29773938 PMCID: PMC5951226 DOI: 10.2337/ds17-0036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Type 2 diabetes is over-represented in vulnerable populations. Vulnerable patients managing diabetes are challenged with less-than-optimal processes and outcomes of care; thus, Healthy People 2020 and the American Diabetes Association have renewed the focus on social determinants of health with regard to the management of chronic diseases such as diabetes. This study explored the correlations between A1C and social and personal factors, including diabetes knowledge, diabetes numeracy, and food security. The Diabetes Numeracy Test-15, the Spoken Knowledge in Low Literacy Diabetes Scale, and the U.S. Department of Agriculture Food Security Questionnaire were administered to a Caucasian study population (n = 96) receiving diabetes care at a federally qualified health center. Although the correlation coefficients generated by the results obtained from the three questionnaires and A1C levels were generally small, a correlation coefficient of 0.46 was found between food security and A1C. An improved understanding of factors that contribute to the successful self-management of diabetes is necessary to improve diabetes outcomes in vulnerable populations.
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Affiliation(s)
- Clipper F. Young
- College of Osteopathic Medicine, Touro University California, Vallejo, CA
- College of Pharmacy, Touro University California, Vallejo, CA
| | - Kenneth Yun
- College of Osteopathic Medicine, Touro University California, Vallejo, CA
| | - Edward Kang
- College of Education and Health Sciences, Touro University California, Vallejo, CA
| | - Jay H. Shubrook
- College of Osteopathic Medicine, Touro University California, Vallejo, CA
| | - Joy A. Dugan
- College of Osteopathic Medicine, Touro University California, Vallejo, CA
- College of Education and Health Sciences, Touro University California, Vallejo, CA
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Bilodeau M, Ma C, Al-Sayegh H, Wolfe J, Bona K. Household material hardship in families of children post-chemotherapy. Pediatr Blood Cancer 2018; 65:10.1002/pbc.26743. [PMID: 28941160 PMCID: PMC6042835 DOI: 10.1002/pbc.26743] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 12/19/2022]
Abstract
Poverty is an important patient-reported outcome of therapy and a potential predictor of outcome disparities in pediatric cancer. We previously identified that nearly 30% of pediatric cancer families experience household material hardship (HMH), a concrete measure of poverty including food, energy, or housing insecurity, during the first 6 months of chemotherapy. We conducted a follow-up survey in a subcohort of these families at least 1 year off-therapy and found that 32% reported HMH in early survivorship. Persistently high concrete resource needs off-therapy may have significance for child health and quality of life, and thus represent targets for future investigation.
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Affiliation(s)
- Madeline Bilodeau
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Clement Ma
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Hasan Al-Sayegh
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Joanne Wolfe
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Kira Bona
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States. J Acad Nutr Diet 2017; 117:1991-2002. [PMID: 29173349 DOI: 10.1016/j.jand.2017.09.027] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Indexed: 02/03/2023]
Abstract
It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.
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Nakitto M, Asano K, Choi I, Yoon J. Dietary intakes of adolescents from food insecure households: analysis of data from the 6 th (2013-2015) Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2017; 11:507-516. [PMID: 29209462 PMCID: PMC5712502 DOI: 10.4162/nrp.2017.11.6.507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/21/2017] [Accepted: 09/05/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed at evaluating the dietary intakes of Korean adolescents affected by food insecurity, in comparison with those who were food secure. SUBJECTS/METHODS The study used one day 24-hour dietary recall data from the 6th Korea National Health and Nutrition Examination Survey. The study subjects consisted of 1,453 adolescents of whom 695 were middle school-aged and 758 were high school-aged. Food security status was assessed using the 18-item questionnaire. Nutrient intake was evaluated in terms of nutrient density, insufficient intake, and excessive intake for selected nutrients, in addition to meeting the appropriate range for total energy intake and energy intakes from carbohydrate, sugar, protein, fat, and saturated fatty acids. Food intake was evaluated in terms of food group servings and dietary diversity score (DDS). RESULTS The percentages of food insecurity were 11.1% for middle school-aged adolescents and 16.8% for high school-aged adolescents. Food insecure middle school-aged adolescents had higher intake of carbohydrate (P = 0.006) but lower intake of fat (P = 0.010) and saturated fatty acids (P = 0.005) than their food secure counterparts although the intake of both groups was in the recommended ranges. Nutrient intake among high school-aged adolescents was generally similar regardless of food security status. Both food secure and insecure adolescents showed insufficient intake of vitamin A, vitamin C, and calcium, and excessive sodium intake. They additionally had low prevalence of meeting appropriate intake ranges for energy, carbohydrate, and sugar. Food intake in terms of food group servings and DDS was also similar regardless of food security status among both age groups, with low intakes of foods from fruit and dairy groups. CONCLUSIONS Except for a few nutrients among the middle school-aged adolescents, dietary intakes among Korean adolescents did not differ by food security status in this study.
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Affiliation(s)
- Mariam Nakitto
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
| | - Kana Asano
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
| | - Injoo Choi
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
| | - Jihyun Yoon
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea.,Research Institute of Human Ecology, Seoul National University, Seoul 08826, Korea
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Food Security and Leukocyte Telomere Length in Adult Americans. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:5427657. [PMID: 28951768 PMCID: PMC5603122 DOI: 10.1155/2017/5427657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 12/22/2022]
Abstract
Background and Purpose Leukocyte telomere length (LTL) is a biomarker of biologic age. Whether food security status modulates LTL is still unknown. We investigated the association between food security and LTL in participants of the 1999–2002 US National Health and Nutrition Examination Survey (NHANES). Methods Analysis of covariance (ANCOVA) was used to evaluate the association between food security categories and LTL controlling for sex, race, and education and accounting for the survey design and sample weights. Results We included 10,888 participants with 5228 (48.0%) being men. They were aged on average 44.1 years. In all, 2362 (21.7%) had less than high school, 2787 (25.6%) had achieved high school, while 5705 (52.5%) had done more than high school. In sex-, race-, and education-adjusted ANCOVA, average LTL (T/S ratio) for participants with high food security versus those with marginal, low, or very low food security was 1.32 versus 1.20 for the age group 25–35 years and 1.26 versus 1.11 for the 35–45 years, (p < 0.001). Conclusion The association between food insecurity and LTL shortening in young adults suggest that some of the future effects of food insecurity on chronic disease risk in this population could be mediated by telomere shortening.
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Swindle TM, Fitzgerald S, McKelvey L, Whiteside-Mansell L. Application of Noninferiority Tests to Examine the Food Insecurity-Obesity Relationship in Children. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2017; 13:228-239. [PMID: 30906494 PMCID: PMC6428201 DOI: 10.1080/19320248.2017.1337537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This study applies non-inferiority testing to assess the relationship between child weight and food security status in a sample of 808 children between 3 and 5 years old who were attending an urban, state-funded preschool program. Most families were African American (72.3%). Analyses were conducted using non-inferiority testing to evaluate the overweight-food security association. Odds of being overweight in the Food Insecure (FI) group were .643 (95% CI .525 to .788) while odds from the Food Secure (FS) group were .570 (95% CI .464 to .697), OR=1.127 (P=.004). These findings held across sub-groups of gender, race, and family conflict. Children whose parent indicated education beyond high school showed a reversal with FI odds of overweight less than FS odds (OR=.663). As illustrated in this study, non-inferiority testing provides an alternative analytic approach to examining the association between FI and weight in children.
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Affiliation(s)
- Taren M. Swindle
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
| | - Shalese Fitzgerald
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
| | - Lorraine McKelvey
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of
Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199;
United States of America
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Jafari F, Ehsani S, Nadjarzadeh A, Esmaillzadeh A, Noori-Shadkam M, Salehi-Abargouei A. Household food insecurity is associated with abdominal but not general obesity among Iranian children. BMC Public Health 2017; 17:350. [PMID: 28431549 PMCID: PMC5399801 DOI: 10.1186/s12889-017-4262-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 04/12/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Childhood obesity is increasing all over the world. Food insecurity is mentioned as a possible risk factor; however, previous studies have led to inconsistent results in different societies while data are lacking for the Middle East. We aimed to investigate the relationship between food insecurity and general or abdominal obesity in Iranian children in a cross-sectional study. METHODS Anthropometric data including height, weight, and waist circumference were measured by trained nutritionists. General and abdominal obesity were defined based on world health organization (WHO) and Iranian reference curves for age and gender, respectively. Radimer/Cornell food security questionnaire was filled by parents. Data about the physical activity of participants, family socio-economic status, parental obesity and data about perinatal period were also gathered using self-administered questionnaires. Logistic regression was incorporated to investigate the association between food insecurity and obesity in crude and multi-variable adjusted models. RESULTS A total of 587 children aged 9.30 ± 1.49 years had complete data for analysis. Food insecurity at household level was significantly associated with abdominal obesity (odds ratio (OR) = 1.54; confidence interval (CI):1.01-2.34, p <0.05) and the relationship remained significant after adjusting for all potential confounding variables (OR = 2.02; CI:1.01-4.03, p <0.05). Food insecurity was associated with general obesity neither in crude analysis and multi-variable adjusted models. CONCLUSIONS The slight levels of food insecurity might increase the likelihood of abdominal obesity in Iranian children and macroeconomic policies to improve the food security are necessary. Large-scale prospective studies, particularly in the Middle East, are highly recommended to confirm our results.
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Affiliation(s)
- Fateme Jafari
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Simin Ehsani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmood Noori-Shadkam
- Department of Pediatrics, Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160, Yazd, Iran.
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Abstract
Food insecurity is an important issue in public health even in developed societies, particularly for vulnerable populations. Food insecurity refers to the uncertain or limited access to adequate and safe foods. Emerging evidence shows an association between food insecurity, type 2 diabetes risk factors, and management of type 1 and type 2 diabetes. A review of the current literature describing the association between food insecurity and diabetes reveals possible mechanisms and pathophysiologic pathways. There is less evidence for effective interventions, and much of the current literature is limited to cross-sectional studies. Future work should evaluate longitudinal associations and ways to help vulnerable patients with diabetes access adequate food for effective diabetes management.
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Affiliation(s)
- Utibe R Essien
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, 50 Staniford St, 9th Floor, Boston, MA, 02114, USA
| | - Naysha N Shahid
- Division of General Internal Medicine and Diabetes Population Health Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Seth A Berkowitz
- Harvard Medical School, 50 Staniford St, 9th Floor, Boston, MA, 02114, USA.
- Division of General Internal Medicine and Diabetes Population Health Research Center, Massachusetts General Hospital, Boston, MA, USA.
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