Food insecure households faced greater challenges putting healthy food on the table during the COVID-19 pandemic in Australia

Comparing Food Security Before and During the COVID-19 Pandemic: Considerations When Choosing Measures

The Need for Investment in Rigorous Interventions to Improve Child Food Security

Understanding Triggers of Food Insecurity

The Development, Implementation, and Evaluation of Innovative Strategies to Reduce Food Insecurity among Children in the United States

Association Between Household Food Security and Disordered Eating Behaviors Among Young Adults with Diabetes: The SEARCH for Diabetes in Youth Study

BACKGROUND AND OBJECTIVES:Food insecurity and pediatric obesity affect young children. We examine how food insecurity relates to obesity, underweight, stunting, health, and development among children <4 years of age.METHODS:Caregivers of young children participated in a cross-sectional survey at medical centers in 5 US cities. Inclusion criteria were age of <48 months. Exclusion criteria were severely ill or injured and private health insurance. The Household Food Security Survey Module defined 3 exposure groups: food secure, household food insecure and child food secure, and household food insecure and child food insecure. Dependent measures were obesity (weight-age >90th percentile), underweight (weight-age <5th percentile), stunting (height/length-age <5th percentile), and caregiver-reported child health and developmental risk. Multivariable logistic regression analyses, adjusted for demographic confounders, maternal BMI, and food assistance program participation examined relations between exposure groups and dependent variables, with age-stratification: 0 to 12, 13 to 24, 25 to 36, and 37 to 48 months of age.RESULTS:Within this multiethnic sample (N = 28 184 children, 50% non-Hispanic African American, 34% Hispanic, 14% non-Hispanic white), 27% were household food insecure. With 1 exception at 25 to 36 months, neither household nor child food insecurity were associated with obesity, underweight, or stunting, but both were associated with increased odds of fair or poor health and developmental risk at multiple ages.CONCLUSIONS:Among children <4 years of age, food insecurity is associated with fair or poor health and developmental risk, not with anthropometry. Findings support American Academy of Pediatrics recommendations for food insecurity screening and referrals to help families cope with economic hardships and associated stressors.

This study examines the issue of consumer agency within the food system as manifested by food secure and food insecure households in an urban neighborhood in the United States. Using a self-administered mail survey this study examines food retailer perception and shopping behaviour of food secure and insecure households in Lansing, Michigan. Food security represents a useful lens through which to examine the issue of agency since food, while a necessary part of life, is nonetheless something that is difficult to access for a large sector of the population. By examining both food secure and food insecure households, light is shed on some of the factors that lead to the relative ability of each group to successfully and reliably obtain food. In particular, this study focuses on the perception and behaviour of consumers in relation to the decision to shop, or not to shop, at various food retailers. Some theories of consumer behaviour tend to focus either on class related cultural elements which determine taste preferences while other theories focus on structural elements of the food system which force a limited selection onto various social groups. While certainly class culture influences taste preference to some extent, results from this study suggest that structural elements of the food system and economic differences between food secure and food insecure households have a larger influence on store choice than cultural preferences. In fact, both food secure and insecure households indicated similar sets of criteria used in determining store choices. However, in examination of actual shopping behaviours, this study found that food insecure households are more likely to shop at deep discounters and more likely to travel farther to obtain food. These results suggest that structural elements such as food retailer locations limit the range of shopping options of food insecure households when compared to food secure households. Keywords: food desert, food access, food security, consumer, food retailer

Primary Subject areaSocial PaediatricsBackgroundThere are concerns of increased food insecurity rates during the COVID-19 pandemic, but there is no evidence to date about families with children with an acute or chronic illness. Parents with a child admitted to the hospital may also experience hospital-based food insecurity, defined as the inability of caregivers to afford adequate food during their child’s hospitalization.ObjectivesWe aimed to measure the prevalence of household and hospital-based food insecurity in an academic pediatric hospital setting during the COVD-19 pandemic. We also explored the effects of food insecurity on parental distress and overall caregivers’ experiences obtaining food during their hospital stay.Design/MethodsThis was a cross-sectional study from April to October 2020. Household food insecurity was measured using the 18-item U.S. Household Food Security Survey Module. Three adapted questions about hospital-based food insecurity were added. Parental distress was measured with the validated Distress Thermometer for Parents: “0” indicates “no distress” and “10” indicates “extreme distress”. Descriptive statistics were used to assess the proportions of food insecurity. Linear regression models were used to explore the relationship between food insecurity and parental distress adjusted for potential confounders. To explore caregivers’ experiences we included one open-ended question in our survey, asking: “Do you have any other feedback regarding your food situation during your child’s hospital admission?”. Recurrent themes were identified using qualitative analysis.Results851 families were reached by telephone and 775 (91.0%) provided consent to participate. 435 (56.1%) completed at least one questionnaire [Figure 1 Study Flow Diagram]. Caregivers described a high prevalence of household (34.2%) and hospital-based (38.0%) food insecurity. Both adult (B= 0.21 [95% CI 0.07-0.36]), child (B= 0.38 [95% CI 0.10-0.66]) and hospital-based (B= 0.56 [95% CI 0.30-0.83]) food insecurity were significantly associated with parental distress independent of covariates [Table]. In the qualitative analysis, the financial burden and emotional and practical barriers obtaining food in the hospital were identified as important themes. Parents also commented that they “need to eat to be able to take part in the care of their child during hospitalization”.ConclusionBoth household and hospital-based food insecurity were highly prevalent in caregivers and significantly associated with parental distress, independent of covariates. High parental distress is known to be associated with a child’s maladjustment to illness and adherence with medical treatment. Hospitals need to strongly consider reducing barriers for parents to obtain food for themselves during their child’s admission in order to reduce parental distress.

The objective were to: (1) evaluate associations between food security and women diagnosed with gestational diabetes mellitus (GDM) and (2) evaluate if women in food insecure (FI) households had adverse maternal and neonatal outcomes. This was an observational study from October 2018 until September 2019. Postpartum resident clinic patients who delivered term, singleton infant at 37 weeks' or longer gestation were screened. Participants completed a survey using the U.S. Household Food Security Survey Module (US HFSSM). Survey responses were classified as: food secure (FS) and FI (marginal, low, very low FS). The primary outcome was GDM. Our secondary outcome was neonatal intensive care unit (NICU) admissions for hypoglycemia. We evaluated the rate of GDM in FS and FI groups. Demographic data included: prepregnancy body mass index, total weight gain during pregnancy, birth weight, and mode of delivery. A logistic regression model was used to analyze the association between food insecurity and GDM. Ap-value of less than 0.05 was considered statistically significant. There were 150 patients screened to participate; of these, 70 patients were enrolled (36 GDM and 34 without GDM [NGDM]). More patients in FI households, 71% (n = 17), were diagnosed with GDM, compared with 33% (n = 15) in the FS (FS) households (adjusted odds ratio 7.05;p < 0.01). Of patients who reported FI, 50% (n = 12) were black, 46% (n = 11) Hispanic, and 4% (n = 1) Caucasian, compared with 13% (n = 6) black, 30% (n = 14) Hispanic, and 57% (n = 26) Caucasian in patients who reported FS (p < 0.001). Although not significant, 25% (n = 6) of neonates from an FI household had an NICU admission for hypoglycemia compared with 7% (n = 3) from an FS household (p = 0.054). Pregnant women with GDM are more likely to experience FI than those with NGDM. Infants of mothers in FI households also had increased rates of NICU admission for hypoglycemia.

Who Eats, Where, What, and How? COVID-19, Food Security, and Canadian Foodscapes

Rapid urbanization in urban areas causes dissimilarity of food access in each household. It is become one of urban food security problem. Urban farming is a strategy to improve food access in urban areas. The purpose of this study was to analyze the difference in food security and coping strategy of agriculture and fisheries urban farming households. This observational study used a cross-sectional design. A sample of 62 households were divided into 2 groups: agriculture and fisheries urban farming households. Food security was assessed by United States Household Food Security Survey Module (US-HFSSM) questionnaire while coping strategy was assessed by Reduced Coping Strategy Index (RCSI) questionnaire. The difference of household food security and coping strategy in both groups was analyzed by Chi square test. A total of 64,7% household in agriculture group were in food secured, while 75% households in fishery group were in food insecure with severe hunger degrees. There was no difference of household food security between agriculture and fisheries urban farming group (p = 0,255), although two groups had different in food security status. Most of agriculture urban farming household has RCSI score &lt;14 (65,6%), while the majority of fishery urban farming household has RCSI score ≥ 14 (66,7%). There was a difference of coping strategy between agriculture and fishery urban farming household (p = 0,021). Agriculture urban farming households were secured and rarely do coping strategy compared to fishery urban farming households. Government programs to improve food security should be more focused on groups of fishery urban farming households.Keywords: coping strategy, food security, household, urban farming

This study analyzed the food and nutrition security of selected urban and rural households in Pili, Camarines Sur, Philippines during the COVID-19 pandemic. It determined the prevalence of food insecurity among the selected urban and rural households, analyzed the determinants of food insecurity in these households, determined the prevalence of malnutrition, and assessed the relationship between the households’ food security and nutrition security. Primary data from a survey of 185 urban and rural households and secondary data from the Electronic Operation Timbang Plus (e-OPT) Tool were used to determine the prevalence of food insecurity using the Food Insecurity Experience Scale (FIES) of the Food and Agriculture Organization (FAO) and nutrition insecurity between urban and rural households, respectively. Results revealed that, during the pandemic, there were more (89.1%) food-insecure households most of which were from urban areas (88.3%). The ordered logistic regression analysis also showed that food insecurity in urban households was determined by the age of the household head, household monthly income, household size, and access to credit, while food insecurity in rural households was determined by education, monthly income, household daily food expenditure, and land ownership. Stunting and wasting among children under the age of five were more evident in urban households; however, rural households had a higher prevalence of stunted and wasted children aged 6 – 12 yr. The Fisher’s Exact Test results showed that the food security status and nutrition security level of children aged 0 – 5 yr and school-aged children were unrelated. Targeted courses of action are recommended to address area-specific nutrition problems.

Household food insecurity (HFI) is the limited or uncertain availability of nutritionally adequate and safe foods and has been associated with decreased cognitive function in persons without diabetes. In persons with diabetes, little is known about the impact of HFI, but cognitive function is known to decline with diabetes duration and poorer glycemic control. We evaluated the cross-sectional association of HFI with cognitive function in youth and young adults (YYA) with type 1 diabetes (T1D), focusing on executive function as measured with the NIH Toolbox Cognition Battery (score range 39-146) and a potential interaction of HFI with glycemic control (high risk &amp;gt;9% vs. optimal/suboptimal ≤9% HbA1c). Age-adjusted composite fluid cognition score was modeled using multivariable linear regression, with HFI (≥3 affirmations on US Household Food Security Survey Module) as the predictor, controlling for covariates. Among 1,272 YYA with T1D (mean age 21, diabetes duration 11 years, 57% non-Hispanic white), 55% had high-risk glycemic control and 18% were food insecure. Food insecure T1D YYA had a 2.7 (SD=1.2) lower fluid cognition score than their food secure peers (93.7 vs. 96.4, p=0.03). Adjustment for sex, race/ethnicity, diabetes duration, site, and glycemic control attenuated this association (β=1.2, p=0.30). However, glycemic control turned out to modify the association of HFI with cognition (multiplicative interaction in adjusted model p&amp;lt;0.01). Among YYA with HbA1c ≤9%, food insecure individuals had a lower mean fluid cognition score than the food secure (99 vs. 104, p&amp;lt;0.02); for YYA with high-risk glycemic control, no association was observed. In this cross-sectional study, food insecurity has a detrimental relationship with cognition among T1D YYA, particularly among those with optimal/suboptimal glycemic control levels. Longitudinal research is needed to further delineate the temporal relationships between household food insecurity, glycemic control, and cognition. Disclosure A. D. Liese: None. B. A. Reboussin: None. A. S. Shah: None. S. M. Marcovina: None. L. M. Dolan: None. D. Dabelea: None. C. Pihoker: None. J. A. Mendoza: None. A. D. Brown: None. A. Shapiro: None. E. A. Frongillo: None. G. Wilkening: None. J. Fridriksson: None. A. Merchant: None. L. Henkin: None. E. T. Jensen: None. Funding National Institutes of Health (1R01DK117461, 1UC4DK108173)

Food insecurity has been linked to adverse mental health outcomes. This study assessed the association between household food insecurity and self-perceived mental health status and anxiety symptoms among Canadians in the early months of the COVID-19 pandemic. The Canadian Perspectives Survey Series 2 collected cross-sectional data from May 4 to 10, 2020, on Canadians aged 15 years or older residing in the ten provinces. The brief six-item Household Food Security Survey Module was used to measure participants' households as food secure or marginally, moderately or severely food insecure within the previous 30 days. Logistic regression was used to assess associations between food security status and self-perceived fair or poor mental health and moderate or severe anxiety symptoms, adjusting for sociodemographic covariates. Approximately one in seven Canadians (14.6%) lived in a household that experienced some level of food insecurity. Of these individuals, 9.3% reported recently accessing free food from a community organization. About one in five Canadians self-perceived their mental health as fair or poor (22.0%), or self-reported moderate or severe anxiety symptoms (18.2%). With covariate adjustment, individuals in households with moderate food insecurity had nearly three times higher odds of reporting fair or poor mental health, and moderate or severe anxiety symptoms, compared with individuals in food-secure households. Among those with severe food insecurity, adjusted odds ratios were 4.0 (95% confidence interval [CI]: 2.0 to 7.9) for fair or poor mental health, and 7.6 (95% CI: 3.9 to 14.7) for moderate or severe anxiety symptoms. In the early period of the COVID-19 epidemic in Canada, household food insecurity was independently associated with poorer mental health outcomes. Monitoring both food insecurity and mental health will be important as the COVID-19 pandemic continues.

Association Between Self-Reported Impact of the COVID-19 Pandemic on Food Security and Overall Level of Stress Among Rutgers Biomedical and Health Sciences-Newark Students