1
|
Slotnick MJ, Ansari S, Parnarouskis L, Gearhardt AN, Wolfson JA, Leung CW. Persistent and Changing Food Insecurity Among Students at a Midwestern University is Associated With Behavioral and Mental Health Outcomes. Am J Health Promot 2024; 38:483-491. [PMID: 38130004 DOI: 10.1177/08901171231224102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE To assess associations between persistent and changing food insecurity and behavioral and mental health outcomes in college students. DESIGN Online surveys conducted November 2018 and March 2019 (freshman year), and March 2020 (sophomore year) were used to assess food insecurity, which was then used to create 4 food security transitions: persistent food insecurity, emergent food insecurity, emergent food security, and persistent food security. SETTING Large Midwestern university. SAMPLE 593 students completing all 3 surveys. MEASURES Dietary intake and behavioral and mental health outcomes (eating disorders, anxiety, depression, sleep quality) were assessed using validated instruments. ANALYSIS Associations between food security transitions and dietary intake, behavioral, and mental health outcomes were examined using generalized linear models. RESULTS Compared to persistent food security, emergent and persistent food insecurity was associated with lower (7% and 13% respectively) intake of fruits and vegetables combined; persistent food insecurity was associated with 17% lower intake of fruits, 6% lower intake of fiber and 10% higher intake of added sugar from beverages. Compared to persistent food secure students, eating disorder symptom risk was higher for emergent food insecure (OR = 7.61, 95% CI: 3.32, 17.48), and persistent food insecure (OR = 6.60, 95% CI: 2.60, 16.72) students; emergent (OR = 2.05, 95% CI: 1.14, 3.71) and persistent (OR = 2.55, 95% CI: 1.34, 4.87) food insecure students had higher odds of poor sleep quality, and persistent food insecure, emergent food insecure, and emergent food secure students had higher odds of anxiety and depression (OR range 2.35-2.85). CONCLUSION Food security transitions were associated with aspects of low diet quality and poorer behavioral and mental health outcomes among college students.
Collapse
Affiliation(s)
- Melissa J Slotnick
- Department of Nutritional Sciences, School of Public Health, The University of Michigan, Ann Arbor, MI, USA
| | - Saba Ansari
- Department of Health Management and Policy, School of Public Health, The University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
2
|
Suh CK, Huliganga A, Collymore J, Desai N, Mora M, Hatchett L. Participants' Experiences With a Community Based Participatory Research Produce Prescription Program: Findings From a Qualitative Study. Am J Health Promot 2024; 38:522-527. [PMID: 38345636 DOI: 10.1177/08901171241233094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
PURPOSE The purpose of this study was to explore a food-insecure, low income, predominantly African American community's experiences with a produce prescription program (PPP). DESIGN Researchers conducted 3 focus groups and 4 individual interviews with Maywood Veggie Rx (VRxM) participants asking questions about the logistics of the program while also exploring ideas around health, food, and community. SETTING This produce prescription program took place in Maywood, Illinois which is an urban underserved community with 23.5 K people, most of whom are Black/African American (61%) and Hispanic (32%). PARTICIPANTS The 24 participants interviewed through focus groups and individual interviews were enrolled in the 2021-2022 VRxM program. Participants were mainly female, with only three participants being males. Ages ranged between 34 and 74 years of age with a mean age of 56.3. METHOD Qualitative data from transcripts were then coded via a grounded theory approach to identify common themes. RESULTS A research team of seven including the two Co-PIs, three medical students and two dietetic interns identified 278 codes which were then condensed into 117 codes and then placed into 9 categories. Researchers identified three recurrent themes among the experiences of VRxM participants: (1) trust building, (2) culturally relevant and adaptive nutrition education, and (3) bidirectional feedback. These three themes mirror many of the principles of Community Based Participatory Research (CBPR). CONCLUSION The study findings identify common themes among the experiences of VRxM which are in line with the collaborative approach of CBPR principles. Produce Prescription Programs should utilize CBPR principles in the creation and implementation of programming to improve the participant experience. Future research should include additional focus groups on new iterations of VRxM and should also include those people who chose not to participate in VRxM to explore barriers to participation.
Collapse
Affiliation(s)
| | | | | | - Naomi Desai
- Loyola Stritch School of Medicine, Maywood, IL, USA
| | - Mary Mora
- Loyola Stritch School of Medicine, Maywood, IL, USA
| | | |
Collapse
|
3
|
Gray VB, Grijalva-Martinez E, Zuniga C, Buran M, Stamper N, Bianco S. SNAP-Ed Programming for College Students Experiencing Food Insecurity: A Qualitative Process-Focused Evaluation. J Acad Nutr Diet 2024; 124:607-627. [PMID: 38052305 DOI: 10.1016/j.jand.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Growing recognition of food insecurity experienced by college students has led to efforts on college campuses to provide students with food assistance benefits and related nutrition education. A Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program was developed for college students as one of these efforts. OBJECTIVE To explore program content, recruitment, and implementation through experiences of program implementers in a novel SNAP-Ed intervention among college students. DESIGN This qualitative study used focus groups and a case study approach to elicit program implementers' experiences delivering SNAP-Ed to college students. PARTICIPANTS/SETTING Students, staff, and faculty (n = 26) implementing SNAP-Ed with college students experiencing food insecurity across eight campuses in the California State University system participated in 8 focus groups in 2021-2022. MAIN OUTCOME MEASURES A process evaluation framework was used to evaluate content fit and orientation; recruitment, retention, and reach; and structure and capacity for implementation. ANALYSES PERFORMED Focus groups were recorded, transcribed, and coded via thematic analysis using NVivo (QSR International, Burlington, MA). RESULTS Five themes were identified: (1) need for this work to extend college-based basic needs services; (2) importance of aligning programming with college student context/needs; (3) common factors important for attracting/engaging the audience; (4) program barriers; and (5) training/team sharing for extending ideas. CONCLUSIONS Study findings suggest tailoring SNAP-Ed programming to the needs of college students experiencing food insecurity, such as integrating student-relevant cooking skills, recipes, and topics of interest. Additional intervention and research efforts may lead to a new model for serving college students with SNAP-Ed.
Collapse
|
4
|
Wu AJ, Huggins M, Lin HTG, Caballero-Gonzalez A, Dalvie N, Battista ED, Taveras EM, Fiechtner L. Satisfaction with a meal kit delivery program and feasibility of a phase I trial in the intervening in food insecurity to reduce and mitigate (InFoRM) childhood obesity study. Pediatr Obes 2024; 19:e13111. [PMID: 38439559 PMCID: PMC11006563 DOI: 10.1111/ijpo.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/25/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Food and nutrition security interventions have been demonstrated to optimize health, prevent and treat chronic diseases among adult populations. Despite the increasing prevalence and intersection of food insecurity and childhood obesity in the United States, there are few food and nutrition security interventions targeted to children and families. OBJECTIVES The primary purpose of this phase I randomized, crossover trial was to assess the safety, acceptability and satisfaction of a meal kit delivery program among children with obesity living in households with food insecurity. Secondarily, we assessed the feasibility of our study design, recruitment and retention to inform future larger scale trials. METHODS We delivered 6 weeks of healthy meal kits, which included fresh pre-portioned ingredients and simple picture-based recipes (two recipes/week) in English or Spanish to prepare one-pot, under 30-min meals (after preparation ~ 10 servings/week). RESULTS Caregivers received and prepared the meal kits and reported overall satisfaction with the meal kit delivery program. CONCLUSION A meal kit delivery intervention for children with obesity and food insecurity is acceptable and a phase I randomized, crossover trial is feasible.
Collapse
Affiliation(s)
- Allison J Wu
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
- Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Marissa Huggins
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Arlette Caballero-Gonzalez
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Nisha Dalvie
- Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Division of Newborn Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Elsie M Taveras
- Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts, USA
| | - Lauren Fiechtner
- Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts, USA
- Health and Research, The Greater Boston Food Bank, Boston, Massachusetts, USA
- Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, Massachusetts, USA
| |
Collapse
|
5
|
Ylitalo KR, Cox W, Janda-Thomte KM, Walter K, Gill J, Hess B. A dynamic, multilevel process evaluation of a produce prescription program at a federally qualified health center: 2017-2021 description, implementation, and infrastructure. Transl Behav Med 2024:ibae015. [PMID: 38642402 DOI: 10.1093/tbm/ibae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024] Open
Abstract
The "Food as Medicine" (FAM) movement encourages public health and medical professionals to recognize the importance of dietary patterns and food access. The purpose of this work was to describe patient and physician engagement with a produce prescription (PRx) program to improve access to fresh vegetables in a healthcare setting. A Federally Qualified Health Center, regenerative farm, and academic institution partnered for the PRx program (2017-21). During harvest seasons, patients redeemed "prescriptions" for initial and "refill" produce boxes. Baseline food insecurity surveys were embedded in electronic medical records. Refill surveys assessed satisfaction and confidence. Electronic surveys to prescribing physicians assessed program knowledge, expectations, and motivations. Across 8 biannual harvests generating 9986 produce boxes, 8046 patients received prescriptions, 6227 redeemed prescriptions for ≥1 box, and 720 redeemed for ≥2 boxes. Seasonally, initial redemption rates ranged from 64.5% to 82.7%; refill rates ranged from 6.8% to 16.7%. Among participants, 70.8% sometimes/often worried food would run out and 66.7% sometimes/often ran out of food. Among those with refills, there was high satisfaction with food quality (95.8%) and variety (97.2%), and 94.2% were confident preparing meals from produce. Among physicians (n = 22), 100% self-reported adequate knowledge about PRx for patient recommendations, and 100% believed PRx had benefit for patients. Chronic conditions (77%), low socioeconomic status (64%), and food insecurity (59%) were common motivating factors for prescriptions. We demonstrated the feasibility of implementing a cross-sector, seasonal PRx program within a multisite healthcare system. More research is needed to refine implementation toward greater patient refill rates.
Collapse
Affiliation(s)
- Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
| | | | | | - Katie Walter
- World Hunger Relief Institute, Elm Mott, TX, USA
| | | | | |
Collapse
|
6
|
Hammad NM, Wolfson JA, de Ferranti SD, Willett WC, Leung CW. Food Insecurity and Ideal Cardiovascular Health Risk Factors Among US Adolescents. J Am Heart Assoc 2024; 13:e033323. [PMID: 38591328 DOI: 10.1161/jaha.123.033323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/08/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Food insecurity, a social and economic condition of limited availability of healthy food, is a risk factor for adverse cardiovascular health outcomes among adults; few studies have been conducted in adolescents. This study explores the association between food insecurity and cardiovascular health risk factors among a nationally representative sample of US adolescents, adopting the American Heart Association's Life's Essential 8 metric. METHODS AND RESULTS We analyzed data from 2534 adolescents aged 12 to 19 years from the 2013 to 2018 National Health and Nutrition Examination Surveys. In the sample, 24.8% of adolescents lived in food-insecure households. After multivariable adjustment, food insecurity was associated with a 3.23-unit lower total Life's Essential 8 score (95% CI, -6.32, -0.15) and lower scores on diet quality (β=-5.39 [95% CI, -8.91, -1.87]) and nicotine exposure (β=-4.85 [95% CI, -9.24, -0.45]). Regarding diet, food insecurity was associated with 5% lower Healthy Eating Index-2015 scores [95% CI, -7%, -2%], particularly lower intakes of whole grains and seafood/plant proteins and marginally higher intake of added sugar. Regarding nicotine exposure, food insecurity was associated with ever use of a tobacco product among m (odds ratio, 1.74 [95% CI, 1.20-2.53]). Compared with their food-secure counterparts, food-insecure male (odds ratio, 1.98 [95% CI, 1.07-3.65]) and female (odds ratio, 3.22 [95% CI, 1.60-6.45]) adolescents had higher odds of living with a current indoor smoker. CONCLUSIONS In this nationally representative sample of adolescents, food insecurity was associated with multiple indicators of cardiovascular health risk. These findings underscore the need for public health interventions and policies to reduce food insecurity and improve cardioprotective behaviors during adolescence, with particular efforts targeting diet quality and nicotine exposure.
Collapse
Affiliation(s)
- Nour M Hammad
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA
| | - Julia A Wolfson
- Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore MD
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | | | - Walter C Willett
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA
| | - Cindy W Leung
- Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA
| |
Collapse
|
7
|
Chai L. Exploring the Impact of Length of Residence and Food Insecurity on Weight Status Among Canadian Immigrants. Am J Health Promot 2024:8901171241246842. [PMID: 38621955 DOI: 10.1177/08901171241246842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
PURPOSE While the individual impacts of long-term residence and food insecurity on overweight/obesity are well-documented, their combined effect on immigrants' weight status is less understood. This study examines the interaction between length of residence and food insecurity in predicting overweight/obesity among immigrants and investigates whether this relationship is gender-specific. DESIGN A national cross-sectional survey. SETTING The 2017-2018 Canadian Community Health Survey. SUBJECTS Immigrants aged 18 and older (N = 13 680). MEASURES All focal variables were self-reported. ANALYSIS Logistic regression models were employed. RESULTS Long-term immigrants were more likely to report overweight/obesity than their short-term counterparts (OR = 1.39; P < .001). Moreover, immigrants from food-insecure households were at a higher risk of reporting overweight/obesity (OR = 1.27; P < .05) compared to those from food-secure households. The analysis further revealed that food insecurity exacerbated the detrimental association between length of residence and overweight/obesity in men (OR = 2.63; P < .01) but not in women (OR = .66; P > .05). CONCLUSION The findings suggest that long-term immigrant men may be especially susceptible to the compounded chronic stressors of extended residence and food insecurity. Health professionals and policymakers should advocate for psychosocial resources to help mitigate these adverse effects and support the well-being of immigrant populations.
Collapse
Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, ON, USA
| |
Collapse
|
8
|
Suresh A, Jordanova KE, Boardman MB, Canavan CR, D'cruze TT, Dev A, Kennedy MA. "Everyone's struggling right now": Impact of COVID-19 on addressing food insecurity in rural primary care. Fam Pract 2024; 41:161-167. [PMID: 37962422 DOI: 10.1093/fampra/cmad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Primary care practices can address food insecurity (FI) through routine screening, practice-based food programmes, and referrals to community resources. The COVID-19 pandemic had disproportionate impacts on health outcomes for food-insecure households. OBJECTIVE To describe the impact of the COVID-19 pandemic on FI screening and interventions in rural primary care practices in northern New England. METHODS We conducted semi-structured interviews with thirteen providers and staff regarding changes to FI screening and interventions, community resources and partnerships, and patient food needs during the pandemic. Themes and exemplar quotations were identified through iterative discussion. RESULTS Practices reported more frequent informal discussions with patients about FI during the pandemic. Despite limitations in site operations, practices created programmes to distribute food at practice locations or through food deliveries. The adoption of telemedicine had variable impacts on FI screening, creating challenges for some while facilitating screening outside of scheduled visits for others. Practices reported increased food availability due to new or expanded community programmes, but lack of transportation and delivery availability were challenges. New and stronger connections formed between practices and community partners. Increased awareness of FI among both patients and practice staff resulted in decreased stigma. CONCLUSION Screening for and addressing FI was a priority for rural primary care practices during the pandemic. The implementation of practice-based FI interventions was supported by stronger practice-community connections and a decrease in stigma. The experiences of providers and staff during the pandemic provide insight into best practices for engaging primary care practices in reducing FI.
Collapse
Affiliation(s)
- Arvind Suresh
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Kayla E Jordanova
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, United States
| | - Maureen B Boardman
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Chelsey R Canavan
- Population Health Department, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, United States
| | - Tiffany T D'cruze
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Alka Dev
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, United States
| | - Meaghan A Kennedy
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| |
Collapse
|
9
|
Celeste-Villalvir A, Palar K, Then-Paulino A, Wallace DD, Jimenez-Paulino G, Fulcar MA, Acevedo R, Derose KP. Perceived Impacts of Urban Gardens and Peer Nutritional Counseling for People Living With HIV in the Dominican Republic. J Nutr Educ Behav 2024:S1499-4046(24)00051-4. [PMID: 38613552 DOI: 10.1016/j.jneb.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE Explore participants' perceptions of urban gardens and peer nutritional counseling intervention for people with HIV and food insecurity on antiretroviral therapy in the Dominican Republic. METHODS Semistructured endline interviews (n = 21) with intervention participants about their perceptions of diet, health, and quality of life. A codebook was applied to verbatim transcripts, and coded data were analyzed using matrices to identify themes. RESULTS Participants were mostly Dominican (86%; 14% Haitian); 57% were men; the mean age was 45 years. The most salient experiences described by intervention participants were improved dietary quality and diversity, improved food security, and saving money. Participants also emphasized improved social interactions, mental health, and emotional well-being. CONCLUSIONS AND IMPLICATIONS Urban gardens and peer nutritional counseling may improve participants' diet and psychosocial well-being. Nutrition programs with marginalized populations may need to improve access to healthy foods and build camaraderie and linkages to programs addressing structural factors.
Collapse
Affiliation(s)
| | - Kartika Palar
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Amarilis Then-Paulino
- Facultad de Ciencias de la Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic
| | - Deshira D Wallace
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Gipsy Jimenez-Paulino
- Facultad de Ciencias de la Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic
| | - Maria Altagracia Fulcar
- World Food Programme, Country Office for the Dominican Republic, Santo Domingo, Dominican Republic
| | - Ramon Acevedo
- Consejo Nacional para el VIH y Sida, Santo Domingo, Dominican Republic
| | - Kathryn P Derose
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA; Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA.
| |
Collapse
|
10
|
Morselli LL, Amjad R, James R, Kindel TL, Kwitek AE, Williams JS, Grobe JL, Kidambi S. Diet in Food Insecurity: A Mediator of Metabolic Health? J Endocr Soc 2024; 8:bvae062. [PMID: 38623381 PMCID: PMC11017326 DOI: 10.1210/jendso/bvae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Indexed: 04/17/2024] Open
Abstract
Objective Food insecurity (FI) is associated with poor metabolic health. It is assumed that energy intake and diet quality underlie this association. We tested the hypothesis that dietary factors (quantity and quality) mediate the association of FI with excess weight, waist circumference and glycemic control [glycohemoglobin (A1C)]. Methods A mediation analysis was performed on data from the National Health And Nutrition Examination Survey using FI as an independent variable; body mass index (BMI), waist circumference, and A1C as metabolic outcome variables and total energy intake, macronutrients, and diet quality measured by the Healthy Eating Index-2015 (HEI-2015) as potential mediators. Results Despite a greater prevalence of obesity in participants experiencing FI, daily reported energy intake was similar in food-secure and -insecure subjects. In adjusted analyses of the overall cohort, none of the examined dietary factors mediated associations between FI and metabolic outcomes. In race-stratified analyses, total sugar consumption was a partial mediator of BMI in non-Hispanic Whites, while diet quality measures (HEI-2015 total score and added sugar subscore) were partial mediators of waist circumference and BMI, respectively, for those in the "other" ethnic group. Conclusion Dietary factors are not the main factors underlying the association of FI with metabolic health. Future studies should investigate whether other social determinants of health commonly present in the context of FI play a role in this association.
Collapse
Affiliation(s)
- Lisa L Morselli
- Department of Medicine, Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Rabia Amjad
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Roland James
- Department of Medicine, Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Tammy L Kindel
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Anne E Kwitek
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Joni S Williams
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Justin L Grobe
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Comprehensive Rodent Metabolic Phenotyping Core, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Srividya Kidambi
- Department of Medicine, Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| |
Collapse
|
11
|
Mamo DN, Worku KM, Adem YF, Shibabaw AA, Habte A, Haile Y. Household food security status and its associated factors among pensioners in Arba Minch town, South Ethiopia. Front Nutr 2024; 11:1363434. [PMID: 38646102 PMCID: PMC11026661 DOI: 10.3389/fnut.2024.1363434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Food insecurity has remained a serious public health problem in developing countries, such as Ethiopia, over the past two decades. Vulnerable populations, such as pensioners, have been affected by this problem because of emerging socio-demographic changes, a global financial crisis, and climate change, all of which have contributed to the high food prices. Hence, this study aimed to assess household food security status and associated factors among pensioners in Arba Minch town, South Ethiopia. Methods A community-based cross-sectional study design was conducted from September to October 2023. Two hundred forty-four pensioners were chosen using a simple random sampling technique. Data were collected, cleaned, and entered into EPI-Data version 4.6 and exported to SPSS version 25 for analysis. Variables with a p-value of ≤0.25 in the bivariate analyses were candidates for the multivariable regression analysis. In the multivariable logistic regression, variables with a p-value of 0.05 were considered to have a significant association with the dependent variable. Results A total of 238 retired people were interviewed, with a response rate of 97.5%. Among the interviewed pensioners, 223 (91.4%) households were food insecure. Having more than one dependent member [AOR = 2.4, 95% C.I: 1.30, 6.64], being jobless after retirement [AOR = 3, 95% C.I:1.17, 5.61], and being in the lowest tertile of wealth status [AOR = 2, 95% C.I:1.36, 4.99] were identified as predictors of food insecurity. Conclusion The magnitude of household food insecurity was higher compared to the national average, and factors such as the current occupational status of the household head, dependency ratio, and wealth status of the household were significantly associated with household food insecurity. Therefore, policymakers and programmers should provide new strategies focusing on additional income-generating activities and salary increments and consider free services such as school fees and healthcare.
Collapse
Affiliation(s)
- Daniel Niguse Mamo
- Department of Health Informatics, School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Kassahun Misgana Worku
- Department of Medical Laboratory Science, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Yonas Fissha Adem
- Department of Public Health, Dessie College of Health Sciences, Dessie, Ethiopia
| | - Adamu Ambachew Shibabaw
- Department of Health Informatics, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Aklilu Habte
- School of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Yosef Haile
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
12
|
Cope AL, Chestnutt IG. A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries. Community Dent Oral Epidemiol 2024. [PMID: 38571289 DOI: 10.1111/cdoe.12959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/08/2023] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. METHODS A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. RESULTS Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. CONCLUSIONS This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.
Collapse
Affiliation(s)
- A L Cope
- Dental Public Health, School of Dentistry, Cardiff University, Cardiff, UK
| | - I G Chestnutt
- Dental Public Health, School of Dentistry, Cardiff University, Cardiff, UK
| |
Collapse
|
13
|
Wossenseged F, Franklin K, Gordon T, Buscetta A, Wallen GR, Bonham VL, Farmer N. Bidirectional Relationship Between Sickle Cell Disease and Food Insecurity: Scoping Review. Health Equity 2024; 8:238-248. [PMID: 38595934 PMCID: PMC11002324 DOI: 10.1089/heq.2023.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction In the United States, sickle cell disease (SCD)-the homozygous inheritance of a point mutation within the beta-globin chain of hemoglobin-affects between 80,000 and 100,000 people. Adequate nutrition can influence the pathophysiology of SCD, and individuals with SCD who are undernourished are more likely to have impaired immune function and disease exacerbation. Undernourishment is often caused by food insecurity (FI), which is defined as "a household-level economic and social condition of limited or uncertain access to adequate food" by the USDA. FI disproportionately affects African Americans, a population disproportionately affected by SCD in the United States. Objectives We performed a scoping review to better understand the relationship between FI and SCD severity. Methods A comprehensive search for peer-reviewed research articles and meeting abstracts was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Selected studies were reviewed for descriptive analysis by three independent reviewers. Results In total, 72 studies were identified, 62 were excluded for meeting inclusion criteria. The remaining 10 studies, 5 of which were meeting abstracts, were reviewed. Although limited evidence is available, the results of this scoping review suggest a bidirectional relationship between SCD and FI. Seven key themes were identified to help elucidate this relationship: 1) prevalence of FI among individuals with SCD, 2) child versus caregiver experiences of FI, 3) psychosocial factors, 4) food assistance benefits, 5) dietary intake, 6) external spending, 7) healthcare utilization. Conclusion Findings from this scoping review suggest how SCD and FI work in tandem to exacerbate each other. Furthermore, the findings illustrate current gaps in the literature and opportunities for actions to address FI among individuals living with SCD.
Collapse
Affiliation(s)
- Faeben Wossenseged
- Social and Behavioral Research Branch, National Institutes of Health, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Kristina Franklin
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
| | - Talya Gordon
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
| | - Ashley Buscetta
- Social and Behavioral Research Branch, National Institutes of Health, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Gwenyth R. Wallen
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
| | - Vence L. Bonham
- Social and Behavioral Research Branch, National Institutes of Health, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Nicole Farmer
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
| |
Collapse
|
14
|
Lamont A, Speed D. Food insecurity and body dissatisfaction in a sample of Canadian adults. J Health Psychol 2024:13591053241242342. [PMID: 38566401 DOI: 10.1177/13591053241242342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Food insecurity may predict poorer body image, which is associated with increased risk of mental health problems. However, minimal attention has been given to the food insecurity-body image link and to factors that may influence this link, such as assigned sex; importantly, females are more likely to experience both food insecurity and body dissatisfaction. The present study used data from the 2017 to 2018 Canadian Community Health Survey (N = 32,017) to investigate the effects of food insecurity and sex on body satisfaction via generalized ordered logistic regression. Results indicated: (1) Food insecurity predicted lower odds of body satisfaction, (2) Males were more likely than females to be satisfied with their bodies, and (3) Food insecurity no longer predicted body satisfaction following the inclusion of sex. Findings suggest the association between food insecurity and body satisfaction may largely be driven by the link between food insecurity and sex. Further investigation is warranted.
Collapse
Affiliation(s)
| | - David Speed
- University of New Brunswick - Saint John, Canada
| |
Collapse
|
15
|
Smith J, Stevens H, Lake AA, Teasdale S, Giles EL. Food insecurity in adults with severe mental illness: A systematic review with meta-analysis. J Psychiatr Ment Health Nurs 2024; 31:133-151. [PMID: 37621069 DOI: 10.1111/jpm.12969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/12/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION Food insecurity in adults living with Severe Mental Illness (SMI) is an underresearched area worldwide. AIM This systematic review and meta-analysis aimed to identify and collate evidence on food insecurity in adults with SMI, in high- and upper-middle income countries. METHOD A comprehensive electronic search was completed up to August 2022. Random effects meta-analysis was undertaken to determine the prevalence and the odds ratio for food insecurity in adults with SMI. Narrative synthesis explored the data further. RESULTS Sixteen publications were included (13 in the meta-analysis). The prevalence estimate of food insecurity in adults with SMI was 41% (95% CI: 29% to 53%, I2 = 99.9%, n = 13). Adults with SMI were 3.31 (95% CI: 2.03 to 5.41) times more likely to experience food insecurity than comparators without SMI (z = 6.29, p < .001, I2 = 98.9%, n = 6). Food insecurity appears to be a risk factor for developing SMI. DISCUSSION This review suggests adults with SMI living in high- or upper-middle income countries are more likely to experience food insecurity than the general population and that this relationship may be inverse. IMPLICATIONS FOR PRACTICE Mental health practitioners should be aware of food insecurity and support individuals with SMI to access sufficient food.
Collapse
Affiliation(s)
- Jo Smith
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Research and Development Team, Tees, Esk and Wear Valleys NHS Foundation Trust, Flatts Lane Centre, Middlesbrough, UK
| | - Heidi Stevens
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Amelia A Lake
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Scott Teasdale
- Discipline of Psychiatry & Mental Health, UNSW Sydney, Kensington, New South Wales, Australia
- Mindgardens Neuroscience Network, Randwick, New South Wales, Australia
| | - Emma L Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| |
Collapse
|
16
|
Daundasekara SS, Marshall AN, Schuler BR, Testa A, Hernandez DC. Lower Perceived Neighborhood Collective Efficacy Indirectly Influences the Association Between Perceived Maternal Exposure to Community Violence and Household Food Insecurity. Fam Community Health 2024; 47:117-129. [PMID: 38372329 PMCID: PMC10878717 DOI: 10.1097/fch.0000000000000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Individuals of color and of low socioeconomic status are at greater risk of experiencing community violence and food insecurity, which are both influenced by neighborhood conditions. We evaluated neighborhood collective efficacy as a linkage between community violence exposure and household food insecurity. METHODS Mothers from the Future of Families and Child Wellbeing Study who completed phone surveys when the child was 3 (time 1, T1) and 5 years old (time 2, T2) were included (n = 2068). A covariate-adjusted structural equation model estimated direct and indirect effects of community violence exposure on household food insecurity. A covariate-adjusted multiple mediator model estimated the indirect effects of the 2 neighborhood collective efficacy subscales (informal social control; social cohesion and trust). RESULTS At T1, 40% of mothers reported community violence exposure; 15% experienced food insecurity at T2. Mean neighborhood collective efficacy (range 1-5) at T1 was 2.44 (SD = 0.94). Neighborhood collective efficacy indirectly influenced the association between community violence exposure and food insecurity (indirect effect = 0.022, 95% CI = 0.007 to 0.040). Only social cohesion and trust contributed independent variance to the indirect effect model (indirect effect = 0.028, 95% CI = 0.001 to 0.056). CONCLUSIONS Community-based efforts to reduce household food insecurity should emphasize building social cohesion and trust in communities experiencing violence.
Collapse
Affiliation(s)
- Sajeevika S Daundasekara
- Department of Food Science & Technology, Faculty of Agriculture, University of Peradeniya, Peradeniya, Sri Lanka (Dr Daundasekara); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana (Dr Marshall); School of Social Work, Temple University, Philadelphia, Pennsylvania (Dr Schuler); Department of Management, Policy, & Community Health, School of Public Health San Antonio, The University of Texas Health Science Center at Houston, San Antonio (Dr Testa); and Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston (Dr Hernandez)
| | | | | | | | | |
Collapse
|
17
|
Berkowitz SA, Drake C, Byhoff E. Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries. Int J Soc Determinants Health Health Serv 2024; 54:76-86. [PMID: 38087472 PMCID: PMC10954393 DOI: 10.1177/27551938231219200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/04/2023] [Accepted: 09/22/2023] [Indexed: 01/18/2024]
Abstract
We sought to determine whether a country's social policy configuration-its welfare state regime-is associated with food insecurity risk. We conducted a cross-sectional study of 2017 U.N. Food and Agriculture Organization individual-level food insecurity survey data from 19 countries (the most recent data available prior to COVID-19). Countries were categorized into three welfare state regimes: liberal (e.g., the United States), corporatist (e.g., Germany), or social democratic (e.g., Norway). Food insecurity probability, calibrated to an international reference standard, was calculated using a Rasch model. We used linear regression to compare food insecurity probability across regime types, adjusting for per-capita gross domestic product, age, gender, education, and household composition. There were 19,008 participants. The mean food insecurity probability was 0.067 (SD: 0.217). In adjusted analyses and compared with liberal regimes, food insecurity probability was lower in corporatist (risk difference: -0.039, 95% CI -0.066 to -0.011, p = .006) and social democratic regimes (risk difference: -0.037, 95% CI -0.062 to -0.012, p = .004). Social policy configuration is strongly associated with food insecurity risk. Social policy changes may help lower food insecurity risk in countries with high risk.
Collapse
Affiliation(s)
- Seth A. Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Connor Drake
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, Durham, NC, USA
- Department of Population Health Science, Duke University School of Medicine, Durham, NC, USA
| | - Elena Byhoff
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, USA
| |
Collapse
|
18
|
Long CR, Yaroch AL, Shanks CB, Short E, Mitchell E, Stotz SA, Seligman HK. Perspective: Leveraging Electronic Health Record Data Within Food Is Medicine Program Evaluation: Considerations and Potential Paths Forward. Adv Nutr 2024; 15:100192. [PMID: 38401799 PMCID: PMC10951502 DOI: 10.1016/j.advnut.2024.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/19/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024] Open
Abstract
Government, health care systems and payers, philanthropic entities, advocacy groups, nonprofit organizations, community groups, and for-profit companies are presently making the case for Food is Medicine (FIM) nutrition programs to become reimbursable within health care services. FIM researchers are working urgently to build evidence for FIM programs' cost-effectiveness by showing improvements in health outcomes and health care utilization. However, primary collection of this data is costly, difficult to implement, and burdensome to participants. Electronic health records (EHRs) offer a promising alternative to primary data collection because they provide already-collected information from existing clinical care. A few FIM studies have leveraged EHRs to demonstrate positive impacts on biomarkers or health care utilization, but many FIM studies run into insurmountable difficulties in their attempts to use EHRs. The authors of this commentary serve as evaluators and/or technical assistance providers with the United States Department of Agriculture's Gus Schumacher Nutrition Incentive Program National Training, Technical Assistance, Evaluation, and Information Center. They work closely with over 100 Gus Schumacher Nutrition Incentive Program Produce Prescription FIM projects, which, as of 2023, span 34 US states and territories. In this commentary, we describe recurring challenges related to using EHRs in FIM evaluation, particularly in relation to biomarkers and health care utilization. We also outline potential opportunities and reasonable expectations for what can be learned from EHR data and describe other (non-EHR) data sources to consider for evaluation of long-term health outcomes and health care utilization. Large integrated health systems may be best positioned to use their own data to examine outcomes of interest to the broader field.
Collapse
Affiliation(s)
| | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
| | | | - Eliza Short
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
| | | | - Sarah A Stotz
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA
| | - Hilary K Seligman
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
19
|
Marmolejo C, Banta JE, Siapco G, Baba Djara M. Examining the association of student mental health and food security with college GPA. J Am Coll Health 2024; 72:819-825. [PMID: 35417289 DOI: 10.1080/07448481.2022.2058327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/18/2022] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Low food security and poor mental health are a persistent concern for college students. OBJECTIVE Examine how food security and mental health are associated with college student's grade point average (GPA). METHODS American College Health Association (ACHA)-National College Health Assessment III survey data Spring 2020 of students from 75 US universities (n = 48,103) were utilized to examine relationships among mental health, food security and academic performance (GPA). RESULTS The majority of the population self-reported high food security (58.3%) and moderate psychological distress (50.8%). Very low food security (B = -.523, OR = .59, p < .001) and moderate psychological distress (B = -0.19, OR = .83, p < .001) were inversely associated with high GPA. Reduced food security was associated with worse mental health measures. CONCLUSIONS Food security and mental health are negatively associated with GPA. To improve student success, universities must enhance services that address food insecurity and mental health.
Collapse
Affiliation(s)
- Connie Marmolejo
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Jim E Banta
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Gina Siapco
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Monita Baba Djara
- School of Public Health, Loma Linda University, Loma Linda, California, USA
| |
Collapse
|
20
|
Burnette CB, Burt SA, Klump KL. The ignored role of disadvantage in eating disorders. Trends Mol Med 2024; 30:305-307. [PMID: 38000984 DOI: 10.1016/j.molmed.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
The misconception that eating disorders are conditions of affluence has shaped research and public understanding for decades. Here, we highlight links between socioeconomic disadvantage and eating disorder risk. With prevailing stereotypes discredited, we argue that considering disadvantage as a key eating disorder risk factor will advance science and reduce disparities.
Collapse
Affiliation(s)
- C Blair Burnette
- Department of Psychology, Michigan State University, East Lansing, MI, USA.
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
21
|
Frongillo EA, Bethancourt HJ, Norcini Pala A, Maya S, Wu KC, Kizer JR, Tien PC, Kempf MC, Hanna DB, Appleton AA, Merenstein D, D'Souza G, Ofotokun I, Konkle-Parker D, Michos ED, Krier S, Stosor V, Turan B, Weiser SD. Complementing the United States Household Food Security Survey Module with Items Reflecting Social Unacceptability. J Nutr 2024; 154:1428-1439. [PMID: 38408732 PMCID: PMC11007734 DOI: 10.1016/j.tjnut.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/11/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Social unacceptability of food access is part of the lived experience of food insecurity but is not assessed as part of the United States Household Food Security Survey Module (HFSSM). OBJECTIVES The objectives were as follows: 1) to determine the psychometric properties of 2 additional items on social unacceptability in relation to the HFSSM items and 2) to test whether these 2 items provided added predictive accuracy to that of the HFSSM items for mental health outcomes. METHODS Cross-sectional data used were from the Intersection of Material-Need Insecurities and HIV and Cardiovascular Health substudy of the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study. Data on the 10-item HFSSM and 2 new items reflecting social unacceptability were collected between Fall 2020 and Fall 2021 from 1342 participants from 10 United States cities. The 2 social unacceptability items were examined psychometrically in relation to the HFSSM-10 items using models from item response theory. Linear and logistic regression was used to examine prediction of mental health measured by the 20-item Center for Epidemiologic Studies Depression scale and the 10-item Perceived Stress Scale. RESULTS The social unacceptability items were affirmed throughout the range of severity of food insecurity but with increasing frequency at higher severity of food insecurity. From item response theory models, the subconstructs reflected in the HFSSM-10 and the subconstruct of social unacceptability were distinct, not falling into one dimension. Regression models confirmed that social unacceptability was distinct from the subconstructs reflected in the HFSSM-10. The social unacceptability items as a separate scale explained more (∼1%) variation in mental health than when combined with the HFSSM-10 items in a single scale, and the social unacceptability subconstruct explained more (∼1%) variation in mental health not explained by the HFSSM-10. CONCLUSIONS Two social unacceptability items used as a separate scale along with the HFSSM-10 predicted mental health more accurately than did the HFSSM-10 alone.
Collapse
Affiliation(s)
- Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Hilary J Bethancourt
- Department of Medicine, University of California San Francisco, San Franciso, CA, United States
| | | | - Sigal Maya
- Department of Medicine, University of California San Francisco, San Franciso, CA, United States
| | - Katherine C Wu
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
| | - Jorge R Kizer
- Department of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States; Cardiology Section, San Francisco Veterans Affairs Health System, San Francisco, CA, United States
| | - Phyllis C Tien
- Department of Medicine, University of California San Francisco, San Franciso, CA, United States; Infectious Diseases Section, San Francisco Veterans Affairs Health System, San Francisco, CA, United States
| | - Mirjam-Colette Kempf
- Schools of Nursing and Medicine, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - David B Hanna
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Allison A Appleton
- Epidemiology & Biostatistics, University at Albany School of Public Health, Albany, NY, United States
| | - Daniel Merenstein
- Department of Family Medicine, Georgetown University, Washington, DC, United States
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Igho Ofotokun
- School of Medicine, Emory University, Atlanta, GA, United States
| | - Deborah Konkle-Parker
- Schools of Nursing, Medicine, and Population Health, University of Mississippi Medical Center, Jackson, MS, United States
| | - Erin D Michos
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Sarah Krier
- Infectious Diseases & Microbiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Valentina Stosor
- School of Medicine, Northwestern University, Evanston, IL, United States
| | - Bulent Turan
- Department of Psychology, Koc University, Istanbul, Turkey; Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sheri D Weiser
- Department of Medicine, University of California San Francisco, San Franciso, CA, United States
| |
Collapse
|
22
|
Liebe RA, Porter KJ, Adams LM, Hedrick VE, Serrano EL, Cook N, Misyak SA. "I'm Doing the Best that I Can": Mothers Lived Experience with Food Insecurity, Coping Strategies, and Mental Health Implications. Curr Dev Nutr 2024; 8:102136. [PMID: 38645883 PMCID: PMC11031732 DOI: 10.1016/j.cdnut.2024.102136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/23/2024] Open
Abstract
Background Food insecurity can have lasting physical and mental health consequences. The experience of food insecurity within a household may disproportionately impact mothers because they tend to manage the household food environment. Objective This study sought to understand the stresses faced by United States mothers experiencing food insecurity, related coping mechanisms, and the impacts of these stressors on their mental health. Methods Semistructured interviews were conducted in May and June 2022 with a purposive sample of Virginia mothers who reported experiences of food insecurity. Participants were recruited from a related survey and university and community LISTSERVs. Interviews were transcribed and analyzed by trained coders. A thematic analysis was conducted to describe themes that emerged from the data. Virtual interviews were 20-60 min in duration. Mothers with children living in their household, having experienced food insecurity, and living in Virginia were eligible. Results The following 3 themes emerged from the interviews with the mothers (n = 15): 1) food insecurity added stress to mothers' lives in multiple ways (e.g. worry about obtaining the "right" foods and internalized or experienced stigma), 2) mothers used positive and negative coping strategies to address the impacts of these stressors (e.g. use of community resources and reduced personal food intake), and 3) the stressors and coping strategies had varying impacts on mothers' mental health (e.g. added to existing mental health challenges or reduced their mental capacity to make changes). Conclusions Study findings suggest that a multilevel and tailored approach to address diverse stressors is warranted. Future research should explore emotional coping strategies that comprehensively empower mothers to manage stressors, leverage resources, and reduce social stigma associated with food insecurity and accessing nutrition and mental health assistance. This may improve their household food security and mitigate the burden of stressors on their mental health because system-level solutions to food insecurity are pursued.
Collapse
Affiliation(s)
- Rachel A Liebe
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States
| | - Kathleen J Porter
- Department of Public Health Sciences, University of Virginia, Christiansburg, VA, United States
| | - Leah M Adams
- Department of Psychology, George Mason University, Fairfax, VA, United States
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Elena L Serrano
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
- The Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Natalie Cook
- Department of Population Health Science, Virginia Tech, Blacksburg, VA, United States
| | - Sarah A Misyak
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
- The Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
| |
Collapse
|
23
|
Baxter KA, Kerr J, Nambiar S, Gallegos D, Penny RA, Laws R, Byrne R. A design thinking-led approach to develop a responsive feeding intervention for Australian families vulnerable to food insecurity: Eat, Learn, Grow. Health Expect 2024; 27:e14051. [PMID: 38642335 PMCID: PMC11032130 DOI: 10.1111/hex.14051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Design thinking is an iterative process that innovates solutions through a person-centric approach and is increasingly used across health contexts. The person-centric approach lends itself to working with groups with complex needs. One such group is families experiencing economic hardship, who are vulnerable to food insecurity and face challenges with child feeding. OBJECTIVE This study describes the application of a design thinking framework, utilizing mixed methods, including co-design, to develop a responsive child-feeding intervention for Australian families-'Eat, Learn, Grow'. METHODS Guided by the five stages of design thinking, which comprises empathizing, defining, ideating, prototyping, and testing. We engaged with parents/caregivers of a child aged 6 months to 3 years through co-design workshops (n = 13), direct observation of mealtimes (n = 10), a cross-sectional survey (n = 213) and semistructured interviews (n = 29). Findings across these methods were synthesized using affinity mapping to clarify the intervention parameters. Parent user testing (n = 12) was conducted online with intervention prototypes to determine acceptability and accessibility. A co-design workshop with child health experts (n = 9) was then undertaken to review and co-design content for the final intervention. RESULTS Through the design thinking process, an innovative digital child-feeding intervention was created. This intervention utilized a mobile-first design and consisted of a series of short and interactive modules that used a learning technology tool. The design is based on the concept of microlearning and responds to participants' preferences for visual, brief and plain language information accessed via a mobile phone. User testing sessions with parents and the expert co-design workshop indicated that the intervention was highly acceptable. CONCLUSIONS Design thinking encourages researchers to approach problems creatively and to design health interventions that align with participant needs. Applying mixed methods-including co-design- within this framework allows for a better understanding of user contexts, preferences and priorities, ensuring solutions are more acceptable and likely to be engaged.
Collapse
Affiliation(s)
- Kimberley A. Baxter
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
| | - Jeremy Kerr
- School of Design, Education and Social Justice, Faculty of Creative IndustriesQueensland University of TechnologyKelvin GroveAustralia
| | - Smita Nambiar
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
| | - Robyn A. Penny
- Child Health Liaison, Children's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition, Faculty of Health SciencesDeakin UniversityBurwoodAustralia
| | - Rebecca Byrne
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
| |
Collapse
|
24
|
Fu P, Wen J, Duan X, Hu X, Chen F, Yuan P. Association between adult food insecurity and mortality among adults aged 20-79 years with diabetes: A population-based retrospective cohort study. Diabet Med 2024; 41:e15268. [PMID: 38140919 DOI: 10.1111/dme.15268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/23/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
AIMS There is limited research on the relationship between food insecurity and mortality among individuals with diabetes. This study aims to investigate the impact of food insecurity on all-cause and cause-specific mortality in adults with diabetes. RESEARCH DESIGN AND METHODS This study included 5749 adults with diabetes from the National Health and Nutrition Examination Survey cycles 2003-2018 and followed up until 31 December 2019. Food insecurity was measured by the Food Security Survey Module. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals for both all-cause mortality and cause-specific mortality. RESULTS The weighted prevalence of full food security, marginal food security, low food security, and very low food security was 70.8%, 11.0%, 10.4%, and 7.8%, respectively. Food insecurity demonstrated a significant correlation with diminished diet quality and reduced consumption of healthy foods. Over the course of 42,272.0 person-years of follow-up, we documented 1091 deaths, of which 370 were attributed to cardiovascular disease and 180 to cancer. After adjusting for multiple variables, food insecurity scores were significantly and linearly associated with increased all-cause mortality. Comparing to full food security, participants experiencing very low food security had a multivariate-adjusted HR of 1.48 (1.12, 1.95) for all-cause mortality (ptrend = 0.010). CONCLUSIONS Food insecurity was associated with increased all-cause mortality and compromised diet quality, especially in individuals experiencing very low food security. Future strategies may necessitate the monitoring of and interventions for food insecurity among individuals with diabetes.
Collapse
Affiliation(s)
- Pengbo Fu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jin Wen
- Institude of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxia Duan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaowen Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fangyan Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ping Yuan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
25
|
Temelkova S, Lofton S, Lo E, Wise J, McDonald EK. Nourishing Conversations: Using Motivational Interviewing in a Community Teaching Kitchen to Promote Healthy Eating via a Food as Medicine Intervention. Nutrients 2024; 16:960. [PMID: 38612994 PMCID: PMC11013884 DOI: 10.3390/nu16070960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/11/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
It is well known that dietary choices impact both individual and global health. However, there are numerous challenges at the personal and systemic level to fostering sustainable healthy eating patterns. There is a need for innovative ways to navigate these barriers. Food as Medicine (FM) and Culinary Medicine (CM) are approaches to helping individuals achieve healthier diets that also recognize the potential to alleviate the burden of chronic diseases through healthy eating. Teaching kitchens, which offer an interactive environment for learning nutrition and cooking skills, are valuable educational tools for FM and CM interventions. Motivational interviewing (MI), a type of person-centered counseling, facilitates behavior change and may enhance FM and CM programs involving teaching kitchens. In this commentary, we share our experience with using MI in a community-based CM program at a teaching kitchen. In demonstrating our application of MI principles, we hope to offer an additional strategy for improving dietary quality and delivering nutrition education.
Collapse
Affiliation(s)
- Sara Temelkova
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Saria Lofton
- College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Elaine Lo
- Department of Public Health Sciences, University of Chicago, Chicago, IL 60637, USA
| | | | - Edwin K. McDonald
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
- Good Food Catalyst, Chicago, IL 60612, USA
| |
Collapse
|
26
|
McGeechan GJ, Moore H, Le Sauvage N, Smith J, Giles EL. Considerations for peer research and implications for mental health professionals: learning from research on food insecurity and severe mental illness. J Psychiatr Ment Health Nurs 2024. [PMID: 38528678 DOI: 10.1111/jpm.13050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/13/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT Peer research methodologies and methods are increasingly used in research, particularly to benefit from lived experiences. The experiences of peer researchers with severe mental illness are less common, including the impact on them of conducting peer-led research. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE This paper shares the experience of peer research and suggests in the context of food insecurity, that it is not well understood by some healthcare professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE Implications include considerations around trauma-informed care and the need for screening for food insecurity in mental healthcare settings. Research implications include providing training for peer research and needing to consider longevity of peer researcher relationships. ABSTRACT Introduction Food insecurity means that a person does not have access to sufficient nutritious food for normal growth and health. This can lead to health problems such as obesity, heart disease, diabetes and other long term chronic health conditions. People living with a severe mental illness are more likely to experience food insecurity than people without a severe mental illness. Aim The aim of this paper is to present a lived experience narrative of two peer researchers. Peer researchers conducted interviews with adults with severe mental illness from Northern England as part of a funded research project. These interviews discussed experiences of food insecurity and strategies to tackle it and were conducted between March and December 2022. Thesis The following paper does not discuss the results of the interviews themselves. Rather the narrative begins with an overview of peer research, before sharing the experiences of the two peer researchers in undertaking this project. Implications for Practice This includes healthcare professionals understanding food insecurity, what it is and what it is not, thinking about trauma-informed care, and screening for food insecurity. Peer research implications centre on adequate support and training, considerations to longevity of peer research relationships and reducing unnecessary research burden for peer researchers.
Collapse
Affiliation(s)
- Grant J McGeechan
- Centre for Applied Psychological Science, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
| | | | | | - Jo Smith
- Tees, Esk and Wear Valley NHS Foundation Trust, Flatts Lane Centre, Middlesbrough, UK
- School of Health and Life Sciences, Centuria Building South, Teesside University, Middlesbrough, UK
| | - Emma L Giles
- School of Health and Life Sciences, Centuria Building South, Teesside University, Middlesbrough, UK
| |
Collapse
|
27
|
Nguyen CJ, Huang J, Kownacki C, Streitmatter K, McCaffrey J. NEFPAT Plus: A Valid and Reliable Tool for Assessing the Nutrition Environment in Food Pantries. J Nutr Educ Behav 2024:S1499-4046(24)00028-9. [PMID: 38520424 DOI: 10.1016/j.jneb.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 01/23/2024] [Accepted: 02/21/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE To develop a consumer nutrition environment assessment tool to assess policy, systems, and environmental initiatives that are implemented in food pantries, which incorporates recent national guidance, and evaluate its validity and reliability. SETTING Illinois, US. DESIGN This study had 4 phases: (1) tool revision, (2) pilot testing, (3) content validity assessment, and (4) interrater and test-retest reliability assessment. The original Nutrition Environment Food Pantry Assessment Tool (NEFPAT) was revised to incorporate evidence from updated guidelines and evidence. The NEFPAT+ was pilot-tested by 9 professionals at 5 food pantries. After revisions, 18 experts rated the content validity. Interrater and test-retest reliability was based on 2-4 professionals completing independent evaluations at 21 food pantries twice, 1 month apart. ANALYSIS Content validity indices and intraclass correlation (ICC) coefficients for reliability estimates were compared with established thresholds. RESULTS The NEFPAT+ was rated content valid by 94% of experts. The ICC for NEFPAT+ scores indicated excellent interrater reliability (ICC, 0.96; 99% confidence interval, 0.75-0.97) and good test-retest reliability (ICC: 0.80; 99% confidence interval, 0.60-0.92). CONCLUSIONS Evidence supports the content validity, interrater reliability, and test-retest reliability of the NEFPAT+. Future studies can assess how NEFPAT+ scores relate to intervention outcomes and dietary behaviors.
Collapse
Affiliation(s)
| | - Jiayi Huang
- Office of Extension and Outreach, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Caitlin Kownacki
- Office of Extension and Outreach, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Kaitlyn Streitmatter
- Office of Extension and Outreach, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Jennifer McCaffrey
- Office of Extension and Outreach, University of Illinois at Urbana-Champaign, Champaign, IL
| |
Collapse
|
28
|
Pasha VC, Gerchow L, Lyndon A, Clark-Cutaia M, Wright F. Understanding Food Insecurity as a Determinant of Health in Pregnancy Within the United States: An Integrative Review. Health Equity 2024; 8:206-225. [PMID: 38559844 PMCID: PMC10979674 DOI: 10.1089/heq.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 04/04/2024] Open
Abstract
Background Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.5%) U.S. households experienced food insecurity. However, the association between food security and pregnancy outcomes in the United States is poorly understood. Purpose The purpose of this review was to critically appraise the state of the evidence related to food insecurity as a determinant of health within the context of pregnancy in the United States. We also explored the relationship between food insecurity and pregnancy outcomes. Methods PubMed, CINAHL, Web of Science, and Food and Nutrition Science databases were used. The inclusion criteria were peer-reviewed studies about food (in)security, position articles from professional organizations, and policy articles about pregnancy outcomes and breastfeeding practices. Studies conducted outside of the United States and those without an adequate definition of food (in)security were excluded. Neonatal health outcomes were also excluded. Included articles were critically appraised with the STROBE and Critical Appraisal Skills Program checklists. Results Nineteen studies met the inclusion criteria. Inconsistencies exist in defining and measuring household food (in)security. Pregnant and postpartum people experienced several adverse physiological and psychological outcomes that impact pregnancy compared with those who do not. Intersections between neighborhood conditions and other economic hardships were identified. Findings regarding the impact of food insecurity on breastfeeding behaviors were mixed, but generally food insecurity was not associated with poor breastfeeding outcomes in adjusted models. Conclusion Inconsistencies in definitions and measures of food security limit definitive conclusions. There is a need for standardizing definitions and measures of food insecurity, as well as a heightened awareness and policy change to alleviate experiences of food insecurity.
Collapse
Affiliation(s)
- Veronica C. Pasha
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Lauren Gerchow
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Audrey Lyndon
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Maya Clark-Cutaia
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Fay Wright
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| |
Collapse
|
29
|
Molenaar A, Lukose D, Brennan L, Jenkins EL, McCaffrey TA. Using Natural Language Processing to Explore Social Media Opinions on Food Security: Sentiment Analysis and Topic Modeling Study. J Med Internet Res 2024; 26:e47826. [PMID: 38512326 PMCID: PMC10995791 DOI: 10.2196/47826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Social media has the potential to be of great value in understanding patterns in public health using large-scale analysis approaches (eg, data science and natural language processing [NLP]), 2 of which have been used in public health: sentiment analysis and topic modeling; however, their use in the area of food security and public health nutrition is limited. OBJECTIVE This study aims to explore the potential use of NLP tools to gather insights from real-world social media data on the public health issue of food security. METHODS A search strategy for obtaining tweets was developed using food security terms. Tweets were collected using the Twitter application programming interface from January 1, 2019, to December 31, 2021, filtered for Australia-based users only. Sentiment analysis of the tweets was performed using the Valence Aware Dictionary and Sentiment Reasoner. Topic modeling exploring the content of tweets was conducted using latent Dirichlet allocation with BigML (BigML, Inc). Sentiment, topic, and engagement (the sum of likes, retweets, quotations, and replies) were compared across years. RESULTS In total, 38,070 tweets were collected from 14,880 Twitter users. Overall, the sentiment when discussing food security was positive, although this varied across the 3 years. Positive sentiment remained higher during the COVID-19 lockdown periods in Australia. The topic model contained 10 topics (in order from highest to lowest probability in the data set): "Global production," "Food insecurity and health," "Use of food banks," "Giving to food banks," "Family poverty," "Food relief provision," "Global food insecurity," "Climate change," "Australian food insecurity," and "Human rights." The topic "Giving to food banks," which focused on support and donation, had the highest proportion of positive sentiment, and "Global food insecurity," which covered food insecurity prevalence worldwide, had the highest proportion of negative sentiment. When compared with news, there were some events, such as COVID-19 support payment introduction and bushfires across Australia, that were associated with high periods of positive or negative sentiment. Topics related to food insecurity prevalence, poverty, and food relief in Australia were not consistently more prominent during the COVID-19 pandemic than before the pandemic. Negative tweets received substantially higher engagement across 2019 and 2020. There was no clear relationship between topics that were more likely to be positive or negative and have higher or lower engagement, indicating that the identified topics are discrete issues. CONCLUSIONS In this study, we demonstrated the potential use of sentiment analysis and topic modeling to explore evolution in conversations on food security using social media data. Future use of NLP in food security requires the context of and interpretation by public health experts and the use of broader data sets, with the potential to track dimensions or events related to food security to inform evidence-based decision-making in this area.
Collapse
Affiliation(s)
- Annika Molenaar
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | | | - Linda Brennan
- School of Media and Communication, RMIT University, Melbourne, Australia
| | - Eva L Jenkins
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| |
Collapse
|
30
|
Johnson R, Beam M. A Call to Action: How Social Work Programs Can Respond to Student Food Insecurity. Soc Work 2024; 69:133-141. [PMID: 38390669 DOI: 10.1093/sw/swae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 08/11/2023] [Accepted: 09/27/2023] [Indexed: 02/24/2024]
Abstract
The COVID-19 pandemic exacerbated student food insecurity on college campuses and exposed the vulnerability of institutions with no food emergency response. During the COVID-19 pandemic and for years to come, the need for social work to lead efforts on college campuses to address student food insecurity is even greater. The need will continue to be significant for social workers in higher education to support students with basic needs, including resources for food, housing, childcare, and transportation. As has been true after other pandemics and economic downturns, professionally trained social workers are critical to brokering resources for individuals in crisis. This article critically examines the role of social work education in addressing the issue of student food insecurity. Through a conceptual lens, it explores the many dimensions of this problem and highlights vital contributions that social work can make within a higher education setting to alleviate food insecurity, enhance student well-being, and promote equitable opportunities for academic success.
Collapse
Affiliation(s)
- Raenece Johnson
- MSW, LLMSW-Macro, is coordinator of field education, Sociology, Anthropology, Social Work & Criminal Justice, Oakland University, Rochester, MI, USA
| | - Maria Beam
- PhD, is director of social work and MSW program director, Sociology, Anthropology, Social Work & Criminal Justice, Oakland University, Rochester, MI, USA
| |
Collapse
|
31
|
Ahmed T, Shane J, Chu C, Edwards A, Verdino J, Caicedo D, Ilieva RT, Jiang K, Brusche D, Wong HY, Yan A, Shay L, Aleong C. "If the college adjusted the prices…": comparing food secure and insecure college students during the COVID-19 pandemic. J Am Coll Health 2024:1-12. [PMID: 38498602 DOI: 10.1080/07448481.2024.2325928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/22/2024] [Indexed: 03/20/2024]
Abstract
Objective: We examined how students' food insecurity related to their demographic information, academic experiences, use of food programs, and reflections on food during the COVID-19 pandemic. Participants: 246 NYC undergraduates during the first 9 months of the pandemic. Methods: Students reported on food insecurity (eg, USDA's 10-item AFSSM), household income, impact of food insecurity on academics, GPA, and use of food programs. They wrote two food narratives. Results: 135 (54.88%) participants reported high food security; 51 (20.73%) reported low or very low food security. Compared to high food security students, low and very low-security students were more likely to identify as Black and first-generation immigrants, reported lower household income, more frequently used food programs, had a lower GPA, reported more academic difficulties, and wrote more often about financial and programmatic difficulties related to food. Conclusions: Food-insecure students need greater financial, academic, and programmatic support during public health crises.
Collapse
Affiliation(s)
- Tanzina Ahmed
- CUNY Kingsborough Community College, Brooklyn, New York, USA
| | - Jacob Shane
- CUNY Brooklyn College, Brooklyn, New York, USA
| | - Caitlin Chu
- Carleton College, North Field, Minnesota, USA
| | | | - Joseph Verdino
- CUNY Kingsborough Community College, Brooklyn, New York, USA
| | - David Caicedo
- CUNY Borough of Manhattan Community College, New York, New York, USA
| | - Rositsa T Ilieva
- CUNY Urban Food Policy Institute, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Karen Jiang
- CUNY Brooklyn College, Brooklyn, New York, USA
| | | | - Ho Yan Wong
- Columbia University, New York, New York, USA
| | - Anita Yan
- CUNY Brooklyn College, Brooklyn, New York, USA
| | - Liam Shay
- Villanova University, Villanova, Pennsylvania, USA
| | | |
Collapse
|
32
|
Cypel YS, Maguen S, Bernhard PA, Culpepper WJ, Schneiderman AI. Prevalence and Correlates of Food and/or Housing Instability among Men and Women Post-9/11 US Veterans. Int J Environ Res Public Health 2024; 21:356. [PMID: 38541355 PMCID: PMC10970277 DOI: 10.3390/ijerph21030356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
Food and/or housing instability (FHI) has been minimally examined in post-9/11 US veterans. A randomly selected nationally representative sample of men and women veterans (n = 38,633) from the post-9/11 US veteran population were mailed invitation letters to complete a survey on health and well-being. Principal component analysis and multivariable logistic regression were used to identify FHI's key constructs and correlates for 15,166 men and women respondents (9524 men, 5642 women). One-third of veterans reported FHI; it was significantly more likely among women than men (crude odds ratio = 1.31, 95% CI:1.21-1.41) and most prevalent post-service (64.2%). "Mental Health/Stress/Trauma", "Physical Health", and "Substance Use" were FHI's major constructs. In both sexes, significant adjusted associations (p < 0.01) were found between FHI and homelessness, depression, adverse childhood experiences, low social support, being enlisted, being non-deployed, living with seriously ill/disabled person(s), and living in dangerous neighborhoods. In men only, posttraumatic stress disorder (adjusted odds ratio (AOR) = 1.37, 95% CI:1.14-1.64), cholesterol level (elevated versus normal, AOR = 0.79, 95% CI:0.67-0.92), hypertension (AOR = 1.25, 95% CI:1.07-1.47), and illegal/street drug use (AOR = 1.28, 95% CI:1.10-1.49) were significant (p < 0.01). In women only, morbid obesity (AOR = 1.90, 95%CI:1.05-3.42) and diabetes (AOR = 1.53, 95% CI:1.06-2.20) were significant (p < 0.05). Interventions are needed that jointly target adverse food and housing, especially for post-9/11 veteran women and enlisted personnel.
Collapse
Affiliation(s)
- Yasmin S. Cypel
- Health Outcomes Military Exposures, Epidemiology Program, Office of Patient Care Services, US Department of Veterans Affairs, Washington, DC 20420, USA; (P.A.B.); (W.J.C.); (A.I.S.)
| | - Shira Maguen
- San Francisco VA Health Care System, San Francisco, CA 94121, USA;
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California—San Francisco, San Francisco, CA 94143, USA
| | - Paul A. Bernhard
- Health Outcomes Military Exposures, Epidemiology Program, Office of Patient Care Services, US Department of Veterans Affairs, Washington, DC 20420, USA; (P.A.B.); (W.J.C.); (A.I.S.)
| | - William J. Culpepper
- Health Outcomes Military Exposures, Epidemiology Program, Office of Patient Care Services, US Department of Veterans Affairs, Washington, DC 20420, USA; (P.A.B.); (W.J.C.); (A.I.S.)
| | - Aaron I. Schneiderman
- Health Outcomes Military Exposures, Epidemiology Program, Office of Patient Care Services, US Department of Veterans Affairs, Washington, DC 20420, USA; (P.A.B.); (W.J.C.); (A.I.S.)
| |
Collapse
|
33
|
Willows ND, Loewen OK, Blanchet R, Godrich SL, Veugelers PJ, Alexander Research Committee. Indigenous Identity and Household Food Insecurity are Associated with Poor Health Outcomes in Canada. CAN J DIET PRACT RES 2024:1-7. [PMID: 38477299 DOI: 10.3148/cjdpr-2023-024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Purpose: To examine whether Indigenous identity and food insecurity combined were associated with self-reported poor health.Methods: Data from the 2015-2016 Canadian Community Health Survey and multiple logistic regression were employed to evaluate the association between Indigenous identity, household food insecurity, and health outcomes, adjusted for individual and household covariates. The Alexander Research Committee in Alexander First Nation (Treaty 6) reviewed the manuscript and commented on the interpretation of study findings.Results: Data were from 59082 adults (3756 Indigenous). The prevalence of household food insecurity was 26.3% for Indigenous adults and 9.8% for non-Indigenous adults (weighted to the Canadian population). Food-secure Indigenous adults, food-insecure non-Indigenous adults, and food-insecure Indigenous adults had significantly (p < 0.001) greater odds of poor health outcomes than food-secure non-Indigenous adults (referent group). Food-insecure Indigenous adults had 1.96 [95% CI:1.53,2.52], 3.73 [95% CI: 2.95,4.72], 3.00 [95% CI:2.37,3.79], and 3.94 [95% CI:3.02,5.14] greater odds of a chronic health condition, a chronic mental health disorder, poor general health, and poor mental health, respectively, compared to food-secure non-Indigenous adults.Conclusions: Health policy decisions and programs should focus on food security initiatives for all Canadians, including addressing the unique challenges of Indigenous communities, irrespective of their food security status.
Collapse
Affiliation(s)
- Noreen D Willows
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB
| | - Olivia K Loewen
- School of Public Health, University of Alberta, Edmonton, AB
| | - Rosanne Blanchet
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal, Montreal, QC
| | - Stephanie L Godrich
- School of Medical and Health Sciences, Centre for People, Place and Planet, Edith Cowan University, Bunbury, Western Australia
| | | | | |
Collapse
|
34
|
Smith J, Eskandari F, McGeechan GJ, Teasdale SB, Lake AA, Ker S, Williamson K, Augustine A, Sauvage NL, Lynch C, Moore H, Scott S, Ekers D, Whittaker V, Robinson J, Giles EL. Food insecurity in adults with severe mental illness living in Northern England: A co-produced cross-sectional study. Nutr Diet 2024. [PMID: 38472093 DOI: 10.1111/1747-0080.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/10/2024] [Accepted: 02/05/2024] [Indexed: 03/14/2024]
Abstract
AIM This study aimed to explore food insecurity prevalence and experiences of adults with severe mental illness living in Northern England. METHODS This mixed-methods cross-sectional study took place between March and October 2022. Participants were adults with self-reported severe mental illness living in Northern England. The survey included demographic, health, and financial questions. Food insecurity was measured using the US Department of Agriculture Adult Food Security measure. Quantitative data were analysed using descriptive statistics and binary logistic regression; and qualitative data using content analysis. RESULTS In total, 135 participants completed the survey, with a mean age of 44.7 years (SD: 14.1, range: 18-75 years). Participants were predominantly male (53.3%), white (88%) and from Yorkshire (50.4%). The food insecurity prevalence was 50.4% (n = 68). There was statistical significance in food insecurity status by region (p = 0.001); impacts of severe mental illness on activities of daily living (p = 0.02); and the Covid pandemic on food access (p < 0.001). The North West had the highest prevalence of food insecurity (73.3%); followed by the Humber and North East regions (66.7%); and Yorkshire (33.8%). In multivariable binary logistic regression, severe mental illness' impact on daily living was the only predictive variable for food insecurity (odds ratio = 4.618, 95% confidence interval: 1.071-19.924, p = 0.04). CONCLUSION The prevalence of food insecurity in this study is higher than is reported in similar studies (41%). Mental health practitioners should routinely assess and monitor food insecurity in people living with severe mental illness. Further research should focus on food insecurity interventions in this population.
Collapse
Affiliation(s)
- Jo Smith
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
| | - Fatemeh Eskandari
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
| | - Grant J McGeechan
- Fuse, The Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Centre for Applied Psychological Science, Teesside University, School of Social Sciences, Humanities and Law, Middlesbrough, UK
| | - Scott B Teasdale
- Department of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Mindgardens Neuroscience Network, University of New South Wales, Sydney, New South Wales, Australia
| | - Amelia A Lake
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
| | - Suzy Ker
- Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
| | - Kevin Williamson
- Rotherham, Doncaster and South Humber NHS Foundation Trust, Doncaster, UK
| | | | | | - Chris Lynch
- Equally Well UK, Centre for Mental Health, London, UK
| | - Hannah Moore
- Equally Well UK, Centre for Mental Health, London, UK
| | - Steph Scott
- Fuse, The Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Ridley Building, 5th Floor, Newcastle University, Newcastle upon Tyne, UK
| | - David Ekers
- Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
| | - Vicki Whittaker
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Jonathan Robinson
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Emma L Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
35
|
Jia J, Gombi-Vaca MF, Bliss Barsness C, Peterson H, Pratt R, Wolfson J, Caspi CE. Effect of a Multicomponent Food Pantry Intervention in Client Subgroups. Nutrients 2024; 16:805. [PMID: 38542716 PMCID: PMC10974327 DOI: 10.3390/nu16060805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 04/01/2024] Open
Abstract
Nutrition promotion programs may have varying effects and influence health disparities. SuperShelf promotes healthy choices in food pantries through inventory changes and nudge implementation (e.g., choice architecture). This secondary analysis of the SuperShelf cluster-randomized trial assessed whether the effect of SuperShelf on client diet quality differed by equity characteristics. English-, Spanish-, or Somali-speaking adult clients from 11 food pantries in Minnesota were included (N = 193). We measured change in diet quality by the Healthy Eating Index 2015 (HEI-2015; maximum score 100) using up to two 24 h dietary recalls from pre-intervention and post-intervention periods. We used linear mixed-effects models to determine whether the effect of SuperShelf on diet quality varied by self-reported gender, race/ethnicity, education, and employment status. In separate adjusted models, the interactions of SuperShelf and gender, education, or employment status were not significant. The interaction of SuperShelf and race/ethnicity was significant (p-interaction = 0.008), but pairwise comparisons in diet quality were non-significant in all racial/ethnic subgroups. SuperShelf did not have differential effects on diet quality by gender, race/ethnicity, education, or employment status, suggesting it does not worsen dietary disparities among food pantry clients, though more subgroup analyses are needed to explore potential racial/ethnic disparities in this context.
Collapse
Affiliation(s)
- Jenny Jia
- Division of General Internal Medicine, Department of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Maria F. Gombi-Vaca
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT 06103, USA; (M.F.G.-V.); (C.E.C.)
| | - Christina Bliss Barsness
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN 55455, USA (R.P.)
| | - Hikaru Peterson
- Department of Applied Economics, University of Minnesota, St. Paul, MN 55108, USA;
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN 55455, USA (R.P.)
| | - Julian Wolfson
- Division of Biostatistics, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Caitlin E. Caspi
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT 06103, USA; (M.F.G.-V.); (C.E.C.)
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| |
Collapse
|
36
|
Maxwell SL, Price JC, Perito ER, Rosenthal P, Wojcicki JM. Food insecurity is a risk factor for metabolic dysfunction-associated steatotic liver disease in Latinx children. Pediatr Obes 2024:e13109. [PMID: 38453472 DOI: 10.1111/ijpo.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 11/29/2023] [Accepted: 01/24/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease among US children. Studies have associated food insecurity with MASLD in adults, but there are few studies of pediatric MASLD, particularly in high-risk populations. We assessed the impact of household food insecurity at 4 years of age on MASLD in Latinx children. METHODS Using a prospective cohort design, Latina mothers were recruited during pregnancy and followed with their children until early to mid-childhood. Our primary exposure was household food insecurity at 4 years of age measured using the validated US Household Food Security Food Module. Our primary outcome, MASLD, was defined as alanine transaminase (ALT) ≥95th% for age/gender plus body mass index (BMI) ≥85% at time of ALT measurement (assessed between ages 5-12). We used multivariable logistic regression models to test for independent associations between household food insecurity and pediatric MASLD. RESULTS Among 136 children, 28.7% reported household food insecurity at 4 years of age and 27.2% had MASLD in early to middle childhood. Approximately 49% of children with MASLD and 21% of children without MASLD were food insecure (p < 0.01). Exposure to household food insecurity at age 4 was independently associated with a 3.7-fold higher odds of MASLD later in childhood (95% CI: 1.5-9.0, p < 0.01). CONCLUSIONS Exposure to household food insecurity at 4 years of age was associated with increased risk for MASLD later in childhood. Further studies are needed to explore mechanism(s) and impact of reducing food insecurity on risk for MASLD.
Collapse
Affiliation(s)
- Sarah L Maxwell
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer C Price
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Emily R Perito
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Philip Rosenthal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Janet M Wojcicki
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
37
|
de Aquino Guerreiro N, Manfrinato CV, Lourenço BH, Franco MDCP, Stedefeldt E, Tomita LY. Insufficient Answer During the Public Health Emergency: A Lesson from the Persistence of Food Insecurity in Low-Income Communities. Ecol Food Nutr 2024:1-14. [PMID: 38454757 DOI: 10.1080/03670244.2024.2326925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Cohort study in deprived communities to investigate the persistence of food insecurity (FI) during the COVID-19 was conducted. Sample were derived from a list of mobile phone numbers provided by community leaders and local nonprofit organizations. Temporal trends and prevalence ratios of FI persistence, categorized as "never," "occasional FI," "consistent FI," were calculated. A total of 302 households completed three assessments, the majority nonwhite women. During the follow-up, families covered by social assistance increased; however, their income decreased (p < 0.05). 33% were "consistent," and 46% "occasional" FI. Permanent difficulties accessing gas canisters, hygiene products, and hand sanitizers were observed.
Collapse
Affiliation(s)
| | | | | | | | - Elke Stedefeldt
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Luciana Yuki Tomita
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
| |
Collapse
|
38
|
Halama N, Ciftci O, Lambert L, Ford O, Rainville AJ. Impact of food security on coping strategies: a comparison of high school and college perceptions. J Am Coll Health 2024:1-9. [PMID: 38442346 DOI: 10.1080/07448481.2024.2317179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/30/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To examine coping strategies in relation to student experience of food insecurity during the transitionary period from high school to college. PARTICIPANTS Freshmen undergraduates (n = 231) enrolled in one of two public universities during December of 2021, living in traditional student housing. METHODS Participants were emailed a link to a USDA 6-item food insecurity and coping strategies survey to investigate if students' degree of food insecurity correlates to coping strategies used. Questions were answered about experiences as a high school senior and college freshman. Data was analyzed with group comparison tests. RESULTS Food insecurity rates approximately doubled from students' high school experience to college. Students with lower food security during both their high school and college experience were significantly more likely to practice coping strategies. CONCLUSION Improving education on utilization of available resources may help students obtain adequate nutrition, decreasing their need to rely on coping strategies.
Collapse
Affiliation(s)
- Nora Halama
- Department of Nutrition and Hospitality Management, University of Mississippi, Oxford, Mississippi, USA
| | - Olena Ciftci
- Department of Nutrition and Hospitality Management, University of Mississippi, Oxford, Mississippi, USA
| | - Laurel Lambert
- Department of Nutrition and Hospitality Management, University of Mississippi, Oxford, Mississippi, USA
| | - Olivia Ford
- Dietetics Program, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Alice Jo Rainville
- Dietetics Program, Eastern Michigan University, Ypsilanti, Michigan, USA
| |
Collapse
|
39
|
Al Khatib A. COVID-19, economic crisis, and food insecurity worsen the double burden of malnutrition in Lebanon. Front Public Health 2024; 12:1333565. [PMID: 38504679 PMCID: PMC10948441 DOI: 10.3389/fpubh.2024.1333565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/12/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Alissar Al Khatib
- Department of Nursing, Almoosa College of Health Sciences, Al Ahsaa, Saudi Arabia
| |
Collapse
|
40
|
Kansanga MM, Batung E, Mohammed K, Sano Y, Taabazuing MM, Luginaah I. Beyond Purchasing Power: The Association Between Sense of Community Belongingness and Food Insecurity Among Older Adults in Canada. J Aging Soc Policy 2024; 36:189-208. [PMID: 36892989 DOI: 10.1080/08959420.2023.2182082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/12/2022] [Indexed: 03/10/2023]
Abstract
Food is a basic human need, yet a significant proportion of older Canadian adults are vulnerable to food insecurity. The health risks associated with aging make food insecurity among this subgroup a critical policy issue. In Canada, policy solutions to food insecurity are however skewed toward the provision of income support to vulnerable groups. While these income support programs are timely, little emphasis is placed on social factors such as sense of community belongingness. This is despite evidence that food insecurity is a socially mediated experience that goes beyond the ability to purchase food. Drawing data from the Canadian Community Health Survey (n = 24,546) and using negative log-log regression, we examined the association between sense of community belongingness and food insecurity among older adults. Findings show that older adults with a "very weak" (odds ratio [OR] = 1.40, p < .001) and "somewhat weak" (OR = 1.23, p < .01) sense of community belongingness were significantly more likely to be food insecure compared to those with a "very strong" sense of belongingness. This study contributes to a growing body of the literature that demonstrates the need for an integrated approach to addressing food insecurity - one that goes beyond income support to include consideration of social factors like sense of community belonging.
Collapse
Affiliation(s)
| | - Evans Batung
- Department of Geography and Environment, University of Western Ontario, London, Canada
| | - Kamaldeen Mohammed
- Department of Geography and Environment, University of Western Ontario, London, Canada
| | - Yujiro Sano
- Department of Sociology, University of Western Ontario, London, Canada
| | - Mary-Margaret Taabazuing
- Department of Medicine, Division of Geriatric Medicine, University of Western Ontario, London, Canada
| | - Isaac Luginaah
- Department of Geography and Environment, University of Western Ontario, London, Canada
| |
Collapse
|
41
|
Aldubaybi AA, Coneyworth LJ, Jethwa PH. Assessing the prevalence and potential drivers of food insecurity and the relationship with mental wellbeing in UK university students: A cross-sectional study. NUTR BULL 2024; 49:96-107. [PMID: 38311588 DOI: 10.1111/nbu.12662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
Food insecurity (FI) among university students in the United States has been associated with poor mental wellbeing, but very little is known about the relationship between FI and mental wellbeing in the UK university population. Here we examined the prevalence of FI, determined potential drivers for it and its relationship with mental wellbeing and coping ability. Students studying at UK universities (n = 289) completed an online self-reported questionnaire to obtain socio-economic characteristics including financial status, FI status (Household Food Insecurity Access scale), mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale) and coping ability (coping flexibility scale). FI was observed in 28% of the participants and was associated with financial independence, running out of money, borrowing money and lacking confidence to purchase healthy foods (p < 0.05). Although we cannot determine directionality, logistic regression analysis revealed those who were judged as FI were more likely to shop often (OR = 3.139 95% CI 1.533-6.429), never snacked between meals (OR = 4.261 95% CI 1.309-13.875) and the amount of food purchased was affected by perceptions of the price of food in general (OR = 2.954 95% CI 1.675-5.210). Financial instability and the inability to access nutritious food may contribute to the decrease in mental wellbeing (p < 0.01) and lower ability to cope with stressful situations (p < 0.01) in food-insecure students although the direction of these relationships cannot be determined from this cross-sectional study. This study has identified that there is a need to develop appropriate strategies to combat FI in university students and to improve mental health.
Collapse
Affiliation(s)
- Afnan A Aldubaybi
- Divisions of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, UK
| | - Lisa J Coneyworth
- Divisions of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, UK
| | - Preeti H Jethwa
- Divisions of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, UK
| |
Collapse
|
42
|
Nguyen J, Kurz Goodwin C, Elie-York S, Brown BC, Sambandham A, Umble K, Ammerman AS. An Exploratory Study of the Perceived Need for and Acceptability of a Healthy Frozen Meal Product Among Rural Corner Store Customers in North Carolina. Ecol Food Nutr 2024; 63:98-111. [PMID: 38318712 DOI: 10.1080/03670244.2024.2308668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
This pilot study assesses barriers to obtaining healthy affordable food and the early-stage acceptability of a novel subsidized healthy frozen meal product designed to address food insecurity and nutritional status among corner store customers in rural North Carolina. A convenience sample of 50 customers were surveyed to examine the perceived availability of healthy food options, barriers to maintaining healthy diets, food shopping and consumption habits, and reception of the product. Findings confirmed barriers to obtaining healthy foods that the product seeks to address, the validity of corner stores as the intervention site, and approval of the product's taste and concept.
Collapse
Affiliation(s)
- Julie Nguyen
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Celeste Kurz Goodwin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Sebastian Elie-York
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Blanche Covington Brown
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Akshay Sambandham
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Karl Umble
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
| |
Collapse
|
43
|
O'Sullivan EJ, Daly C, Kennedy A. Prevalence of food insecurity among caregivers of young children during the COVID-19 pandemic in Ireland. NUTR BULL 2024; 49:73-81. [PMID: 38234252 DOI: 10.1111/nbu.12658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
Our objectives were to explore the prevalence of food insecurity in primary caregivers of young children in Ireland and to compare two tools for measuring food insecurity during the COVID-19 crisis. A cross-sectional online survey was conducted among caregivers of children aged <2 years in Ireland in May/June 2020. Relevant survey questions were closed-ended using two established tools for measuring food poverty/insecurity; the Irish Food Poverty Indicator and the Food Insecurity Experience Scale, developed by the Food and Agriculture Organization. Descriptive statistics were used to calculate the prevalence of food poverty/insecurity. To explore agreement in the classification of food insecurity by the Food Poverty Indicator and the Food Insecurity Experience Scale, Cohen's κ was used. Analyses are based on 716 participants; most had a 3rd-level education and were married or in a partnership. Per the food poverty index, Ireland's national measure of food poverty, 3.9% (n = 28) of our sample were experiencing food poverty. This rose to 10.5% (n = 75) experiencing food insecurity when using the Food Insecurity Experience Scale, which also measures worry/anxiety around access to food. There was low agreement between the tools, with 11.3% of the sample classified as food secure by one tool and food insecure by the other. Our current measure of food poverty in Ireland may not be sufficient to describe the food-access struggles or worry/anxiety about food access, experienced by the population, particularly during an emergency like COVID-19.
Collapse
Affiliation(s)
- Elizabeth J O'Sullivan
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
| | - Caoimhe Daly
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
| | - Aileen Kennedy
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
| |
Collapse
|
44
|
Martinez SM, Singh S, Esaryk E, Ritchie L. SNAP Student Rules Are Not So Snappy: Lessons Learned From a Qualitative Study of California County Agency Workers. J Nutr Educ Behav 2024; 56:133-144. [PMID: 38206242 DOI: 10.1016/j.jneb.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To examine the college student Supplemental Nutrition Assistance Program (SNAP) application process from the perspective of county agency workers. DESIGN A qualitative study that included semistructured individual and group interviews (n = 14) between February and December, 2021. SETTING Nine California counties with a University of California campus. PARTICIPANTS A total of 24 county agency workers who regularly process or advise on college student SNAP applications. PHENOMENON OF INTEREST Facilitators and barriers to processing student SNAP applications. ANALYSIS Interviews were recorded, transcribed, and coded using thematic analysis. RESULTS Five themes were identified regarding student applications: (1) a need for more consistency in policy dissemination and program administration, (2) student exemptions and the application process are perceived as challenging for students, (3) facilitators of successfully processing student applications, (4) tracking policy changes is burdensome, and (5) eliminate the student rules. CONCLUSION AND IMPLICATIONS County agency workers perceived that students experience unnecessary barriers to accessing SNAP benefits and that implementing the student rules was taxing. Expanding SNAP access to low-income college students could be an equitable solution to mitigate the risk of student hunger while they pursue their degrees.
Collapse
Affiliation(s)
- Suzanna M Martinez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
| | - Sonali Singh
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Erin Esaryk
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Lorrene Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA
| |
Collapse
|
45
|
Palimaru AI, Caldwell JI, Cohen DA, Shah D, Kuo T. Food recovery and produce distribution as a system strategy for increasing access to healthy food among populations experiencing food insecurity: lessons for post-pandemic planning. Glob Health Promot 2024; 31:25-35. [PMID: 37661757 DOI: 10.1177/17579759231193354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Using data from an intercept survey of 428 adults who received free surplus produce at five distribution sites and qualitative data from 15 interviews with site personnel, we examined facilitators (e.g. community partnerships, coalition support) and challenges (e.g. limited refrigerated storage, lack of transportation infrastructure) to operating a food recovery and distribution program in Los Angeles County. Overall, this food system intervention appeared to fill an unmet need for recipients, nearly 80% of whom were food insecure and 60% visited a site several months/year or monthly. For many living in this county's underserved communities, this effort was instrumental in increasing access to healthy food before and during the COVID-19 pandemic. To sustain/expand this program's reach, local governments and food assistance programs should provide greater coordination and oversight, and invest more resources into this food recovery and distribution infrastructure.
Collapse
Affiliation(s)
| | - Julia I Caldwell
- Nutrition and Physical Activity Program, Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Deborah A Cohen
- Kaiser Permanente Research and Evaluation, Pasadena, CA, USA
| | - Dipa Shah
- Nutrition and Physical Activity Program, Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Tony Kuo
- Department of Family Medicine, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Population Health Program, UCLA Clinical and Translational Science Institute, Los Angeles, CA, USA
| |
Collapse
|
46
|
Aris IM, Lin PID, Wu AJ, Dabelea D, Lester BM, Wright RJ, Karagas MR, Kerver JM, Dunlop AL, Joseph CL, Camargo CA, Ganiban JM, Schmidt RJ, Strakovsky RS, McEvoy CT, Hipwell AE, O'Shea TM, McCormack LA, Maldonado LE, Niu Z, Ferrara A, Zhu Y, Chehab RF, Kinsey EW, Bush NR, Nguyen RHN, Carroll KN, Barrett ES, Lyall K, Sims-Taylor LM, Trasande L, Biagini JM, Breton CV, Patti MA, Coull B, Amutah-Onukagha N, Hacker MR, James-Todd T, Oken E. Birth outcomes in relation to neighborhood food access and individual food insecurity during pregnancy in the Environmental Influences on Child Health Outcomes (ECHO)-wide cohort study. Am J Clin Nutr 2024:S0002-9165(24)00168-0. [PMID: 38431121 DOI: 10.1016/j.ajcnut.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Limited access to healthy foods, resulting from residence in neighborhoods with low-food access or from household food insecurity, is a public health concern. Contributions of these measures during pregnancy to birth outcomes remain understudied. OBJECTIVES We examined associations between neighborhood food access and individual food insecurity during pregnancy with birth outcomes. METHODS We used data from 53 cohorts participating in the nationwide Environmental Influences on Child Health Outcomes-Wide Cohort Study. Participant inclusion required a geocoded residential address or response to a food insecurity question during pregnancy and information on birth outcomes. Exposures include low-income-low-food-access (LILA, where the nearest supermarket is >0.5 miles for urban or >10 miles for rural areas) or low-income-low-vehicle-access (LILV, where few households have a vehicle and >0.5 miles from the nearest supermarket) neighborhoods and individual food insecurity. Mixed-effects models estimated associations with birth outcomes, adjusting for socioeconomic and pregnancy characteristics. RESULTS Among 22,206 pregnant participants (mean age 30.4 y) with neighborhood food access data, 24.1% resided in LILA neighborhoods and 13.6% in LILV neighborhoods. Of 1630 pregnant participants with individual-level food insecurity data (mean age 29.7 y), 8.0% experienced food insecurity. Residence in LILA (compared with non-LILA) neighborhoods was associated with lower birth weight [β -44.3 g; 95% confidence interval (CI): -62.9, -25.6], lower birth weight-for-gestational-age z-score (-0.09 SD units; -0.12, -0.05), higher odds of small-for-gestational-age [odds ratio (OR) 1.15; 95% CI: 1.00, 1.33], and lower odds of large-for-gestational-age (0.85; 95% CI: 0.77, 0.94). Similar findings were observed for residence in LILV neighborhoods. No associations of individual food insecurity with birth outcomes were observed. CONCLUSIONS Residence in LILA or LILV neighborhoods during pregnancy is associated with adverse birth outcomes. These findings highlight the need for future studies examining whether investing in neighborhood resources to improve food access during pregnancy would promote equitable birth outcomes.
Collapse
Affiliation(s)
- Izzuddin M Aris
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States.
| | - Pi-I D Lin
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Allison J Wu
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Barry M Lester
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Margaret R Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, NH, United States
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Christine Lm Joseph
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, United States
| | - Carlos A Camargo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jody M Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, United States
| | - Rita S Strakovsky
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Cindy T McEvoy
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Thomas Michael O'Shea
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, United States
| | - Lacey A McCormack
- Avera Research Institute, Sioux Falls, SD, United States; Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Rana F Chehab
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Eliza W Kinsey
- Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, PA, United States
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States; Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, United States
| | - Kecia N Carroll
- Division of General Pediatrics, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Lauren M Sims-Taylor
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
| | - Jocelyn M Biagini
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Marisa A Patti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Brent Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Ndidiamaka Amutah-Onukagha
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - Michele R Hacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Tamarra James-Todd
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| |
Collapse
|
47
|
Odoms-Young A, Brown AGM, Agurs-Collins T, Glanz K. Food Insecurity, Neighborhood Food Environment, and Health Disparities: State of the Science, Research Gaps and Opportunities. Am J Clin Nutr 2024; 119:850-861. [PMID: 38160801 DOI: 10.1016/j.ajcnut.2023.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024] Open
Abstract
Food insecurity and the lack of access to affordable, nutritious food are associated with poor dietary quality and an increased risk of diet-related diseases, including cardiovascular disease, diabetes, and certain types of cancer. Those of lower socioeconomic status and racial and ethnic minority groups experience higher rates of food insecurity, are more likely to live in under-resourced food environments, and continue to bear the greatest burden of diet-related chronic diseases in the United States. Despite the growing body of literature in this area, there are still significant gaps in our understanding of the various pathways that link food insecurity and neighborhood food environments to racial/ethnic and socioeconomic disparities in health and the most effective intervention strategies to address these disparities. To better understand the science in this area, the National Institutes of Health, in collaboration with the Centers for Disease Control (CDC) and Prevention and the United States Department of Agriculture (USDA), convened a virtual 3-d workshop 21-23 September 2021: Food Insecurity, Neighborhood Food Environment, and Nutrition Health Disparities: State of the Science. The workshop brought together a diverse group of researchers, practitioners, policymakers, and federal partners with expertise in nutrition, the food environment, health and social policy, and behavioral and social sciences. The workshop had the following 3 research objectives: 1) summarize the state of the science and knowledge gaps related to food insecurity, neighborhood food environments, and nutrition health disparities, 2) identify research opportunities and strategies to address research gaps, and 3) examine evidence-based interventions and implementation approaches to address food insecurity and neighborhood food environments to promote health equity. This article summarizes workshop proceedings and describes research gaps and future opportunities that emerged from discussions.
Collapse
Affiliation(s)
- Angela Odoms-Young
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Alison G M Brown
- National Heart Lung and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States.
| | - Tanya Agurs-Collins
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
48
|
Devia C, Flórez K, Costa SA, Huang TTK. South-to-South parental migration patterns and excess weight among children: Insights from a national cross-sectional study in Colombia. Pediatr Obes 2024; 19:e13099. [PMID: 38286620 DOI: 10.1111/ijpo.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Evidence from Latin America suggests that children embedded in South-to-North migrant networks (i.e. relatives who live abroad, typically in the United States) are at increased risk of excess weight. It is unclear if the same findings apply to children embedded in Latin American intraregional migration or South-to-South migration networks. OBJECTIVE To compare excess weight among Colombian children embedded in South-to-South migration networks (n = 334) to children with non-migrant parents (n = 4272) using Colombia's 2015 National Survey of the Nutritional Situation. METHODS Prevalence ratios (PRs) for excess weight (BMI z-score ≥1) by parent migration history were estimated using weighted multivariable logistic regression adjusting for demographics, child behaviours, community and household indicators, including household food insecurity. RESULTS Most migrant parents returned to Colombia from Venezuela (84%) and reported higher household food insecurity rates than non-migrant parents (59% versus 32%). Models excluding household food insecurity showed that excess weight among children with migrant parents was 51% lower (PR = 0.49; 95% CI 0.25, 0.98) than among children with non-migrant parents. After adjustment for household food insecurity, no statistically significant differences were found. CONCLUSION Colombian children with return migrant parents from Venezuela experienced less excess weight than children with non-migrant parents, but higher rates of food insecurity in migrant households might partially explain this difference. This study calls attention to two serious public health concerns for Colombian children-those who have excess weight and those who lack sufficient food, particularly among migrant returnees (a situation that may have worsened since the COVID-19 pandemic).
Collapse
Affiliation(s)
- Carlos Devia
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Karen Flórez
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Sergio A Costa
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Terry T-K Huang
- Center for Systems & Community Design, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| |
Collapse
|
49
|
Tolkacz M, Reilly D, Studzinski DM, Callahan RE, DeMare A, Kawak S, Ziegler M. Food Insecurity in the Elective Enhanced Recovery After Surgery Colorectal Surgical Population: Prevalence and Implications for Surgical Outcomes. Am Surg 2024; 90:419-426. [PMID: 37703552 DOI: 10.1177/00031348231198122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND Food insecurity is defined as having limited or uncertain availability of nutritionally adequate food. Approximately 10.5% of U.S. households are food-insecure. Our study aimed to determine the prevalence and postoperative implications of food insecurity in a diverse group of colorectal surgery patients admitted to a hospital in an area with a higher-than-average median income. METHODS The 6-question Household Food Security Survey was added to the colorectal surgery ERAS program preoperative paperwork. Patient demographics, comorbidities, operative parameters, length of stay, and postoperative outcomes were collected by review of electronic medical records. RESULTS A total of 294 ERAS patients (88.8%) completed the survey over an 11-month period. Thirty-three patients (11.2%) were identified as food-insecure. Food-insecure patients were more likely to be non-white (P = .003), younger (P = .009), smokers (P = .004), chronic narcotic users (P < .001), unmarried (P = .007), and have more comorbidities (P = .004). The food-insecure population had more frequent postoperative ileus (P = .044). Hospital length of stay was significantly longer in food-insecure patients (8.6 days vs 5.4 days, P < .001). Food-insecure patients also had higher rates of >30-day mortality (P = .049). DISCUSSION Food insecurity was found to occur in patients that lived in communities deemed both affluent and distressed. These patients had longer hospital stays and higher mortality. A food insecurity questionnaire can easily identify patients at risk. Further investigations to mitigate these complications are warranted.
Collapse
Affiliation(s)
- Michael Tolkacz
- Department of General Surgery, Corewell Health - William Beaumont University Hospital, Royal Oak, MI, USA
| | - Danielle Reilly
- Department of Surgery, Geisinger Health System, Danville, PA, USA
| | - Diane M Studzinski
- Department of General Surgery, Corewell Health - William Beaumont University Hospital, Royal Oak, MI, USA
| | - Rose E Callahan
- Department of General Surgery, Corewell Health - William Beaumont University Hospital, Royal Oak, MI, USA
| | - Alexander DeMare
- Department of General Surgery, Corewell Health - William Beaumont University Hospital, Royal Oak, MI, USA
| | - Samer Kawak
- Department of General Surgery, Corewell Health - William Beaumont University Hospital, Royal Oak, MI, USA
| | - Matthew Ziegler
- Department of Colorectal Surgery, Corewell Health - william Beaumont Hospital, Royal Oak, MI, USA
| |
Collapse
|
50
|
Zubizarreta D, Wirtz AL, Humes E, Cooney EE, Stevenson M, Althoff KN, Radix AE, Poteat T, Beyrer C, Wawrzyniak AJ, Mayer KH, Reisner SL. Food Insecurity Is High in a Multi-Site Cohort of Transgender Women Vulnerable to or Living with HIV in the Eastern and Southern United States: Baseline Findings from the LITE Cohort. Nutrients 2024; 16:707. [PMID: 38474837 DOI: 10.3390/nu16050707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/14/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
The prevalence and correlates of food insecurity-the unavailability of food and limited access to it-have not been adequately considered among transgender women (TW), particularly alongside other health-related conditions burdening this population, such as HIV infection. This study examined the prevalence and correlates of food insecurity among TW. Between 2018 and 2020, 1590 TW in the Eastern and Southern U.S. completed a multi-site baseline assessment (socio-behavioral survey and HIV testing). Descriptive statistics were calculated and multivariable Poisson models with robust error variance were used to estimate prevalence ratios and 95% confidence intervals for correlates of food insecurity (dichotomized as sometimes-to-always vs. seldom-to-never running out of food). Eighteen percent of TW were living with HIV and nearly half of participants (44%) reported food insecurity. Correlates of food insecurity included being Black, multiracial, or another race/ethnicity; having < college education, low income, unstable housing, and high anticipated discrimination; and a history of sex work and sexual violence (all p < 0.05). Food insecurity was highly prevalent among TW. Current programs to provide food support do not adequately meet the needs of TW. HIV pr evention and care programs may benefit from addressing food insecurity.
Collapse
Affiliation(s)
- Dougie Zubizarreta
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Andrea L Wirtz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Elizabeth Humes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Erin E Cooney
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Meg Stevenson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Asa E Radix
- Callen-Lorde Community Health Center, New York, NY 10011, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Tonia Poteat
- Division of Healthcare in Adult Populations, School of Nursing, Duke University, Durham, NC 27710, USA
| | - Chris Beyrer
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA
| | - Andrew J Wawrzyniak
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | | | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| |
Collapse
|