Food security moderates relationship between perceived food environment and diet quality among adults in communities with low access to healthy food retail.

The built environment impacts obesogenic behaviors and in turn body weight outcomes. This review summarizes recent research demonstrating environmental impacts on dietary intake and obesity with a specific focus on the neighborhood food environment. In the previous five years, an abundance of reviews and research studies have been undertaken to elucidate how the neighborhood food environment impacts diet and obesity. This includes studies using primary data collection and secondary data analyses in various populations across the globe. Taken together, current research presents mixed evidence on the impact of the neighborhood food environment on both dietary intake and obesity. While there is some evidence that certain features of the neighborhood food environment influence health behaviors and outcomes in particular populations, it is imperative to acknowledge the complexity of how neighborhood features interact and constantly evolve when considering place-based influences on health behaviors and outcomes.

Despite challenges due to the COVID-19 pandemic, reports from regional and national meetings of the Expanded Food and Nutrition Education program (EFNEP) have provided anecdotal evidence that the program has persevered, pivoted, and continued to positively impact the lives of some of the nation's most vulnerable populations. However, there have been necessary changes to program delivery, inevitable changes in the lives of participants, and changes in the food environment that may have impacted program outcomes. This study compares national EFNEP data (demographics, behavior change data, and 24 h dietary recall data) of participants from two federal fiscal years, before the COVID-19 pandemic and during the pandemic. Linear mixed model analysis of variance and covariance were used to assess the effects of year on program outcomes. Results of this study provide quantitative evidence of the resiliency of EFNEP to facilitate positive behavior changes related to diet quality, physical activity, food safety, food resource management, and food security. Amidst changes in the food environment during the COVID-19 pandemic, these results emphasize the importance and value of federal nutrition education programs in any food environment.

BackgroundLinks between diet and food security are well established, but less is known about how food and nutrition security affect a household’s ability to decide what to consume. ObjectivesThis study’s purpose was to quantify and compare causal pathways from 1) food and nutrition security to perceived dietary choice and 2) food and nutrition security to perceived healthfulness of food choice while testing for mediation by perceived limited availability of foods and utilization barriers to healthful meals. MethodsCausal mediation analysis was conducted using an observational data set. Exposures included food insecurity and nutrition insecurity; mediators included perceived limited availability and utilization barriers; outcomes included perceived dietary choice and healthfulness choice; covariates included income and education. ResultsDietary choice (range 0–4) was 0.9 to 1.1 points lower for participants with food/nutrition insecurity compared with participants with food/nutrition security (direct effects). Neither mediation nor moderation by perceived limited availability were present. Seventeen percent and 11 %, respectively, of the effects of food and nutrition security on dietary choice could be contributed to utilization barriers (mediation). Moderation by utilization barriers was present only for nutrition security (differences in dietary choice only present when barriers were low). Healthfulness choice (range 0–4) was 0.6 to 0.7 points lower for participants with food/nutrition insecurity compared with participants with food/nutrition security (direct effects). Mediation by perceived limited availability and utilization barriers was not present. Moderation was present only for nutrition security (differences in healthfulness choice only present when perceived limited availability was low; differences in healthfulness choice only present when barriers were low). ConclusionsFood and nutrition security affect food choices, with utilization barriers acting as an intermediary step. When environmental and household utilization barriers to healthful food purchasing and preparation are high, the ability to decide what to consume does not differ between households with nutrition security and those with nutrition insecurity.

Food security is one of the most challenging topics globally; however, the concept of food security has taken on additional dimensions that are general and are less detailed. This study aims to identify the intellectual structure of food security research and the changes in this structure. This paper analyzed 3169 documents from the Web of Science database through a bibliometric review. A review of the published documents shows an increasing trend over the past 46 years. In accordance with co-occurrence analysis, 125 keywords were grouped into five clusters: food security and sustainable development; food security and socioeconomic factors; food security policy and governance; coping strategies for poverty, inequality, and hunger; and modern food security management. This study identifies four streams within food security research: sustainability and environmental, socioeconomic, cultural, and political factors. The paper concludes that even though food security might investigate many significant areas, other new dimensions should still be considered. Further gaps in the literature emerge that present avenues for future research directions. Reviewing indicators and techniques of food security assessment and identifying high-risk groups should be a priority.

During the COVID-19 pandemic, U.S. food assistance programs allowed the use of program benefits to order groceries online. We examined relationships between the food environment, food assistance, online grocery ordering, and diet quality among adults from one low-income, low food access community in Northeastern Connecticut during the pandemic. Via online survey, adults (n = 276) reported their perceived home and store food environments, food assistance participation, whether they ordered groceries online, and consumption frequency and liking of foods/beverages to calculate diet quality indices. Those who ordered groceries online (44.6%) were more likely to participate in food assistance programs and report greater diet quality. Perceived healthiness of store and home food environments was variable, with the ease of obtaining and selecting unhealthy foods in the neighborhood significantly greater than healthy foods. Healthier perceived home food environments were associated with significantly higher diet qualities, especially among individuals who participated in multiple food assistance programs. Ordering groceries online interacted with multiple measures of the food environment to influence diet quality. Generally, the poorest diet quality was observed among individuals who perceived their store and home food environments as least healthy and who did not order groceries online. Thus, ordering groceries online may support higher diet quality among adults who can use their food assistance for purchasing groceries online and who live in low-income, low-access food environments.

Development and Validation of a Physical Food Security Tool for Older Adults

Anaemia remains among the most prevalent nutritional problems among children in developing countries. In Ethiopia, more than half of children <5 years of age are anaemic. In the early stages of life, it leads to poor cognitive performance, delay psychomotor development and decreases working capacity in later life. The present study aimed to assess the prevalence and associated factors of anaemia among children aged 6-23 months in the Bale zone. A community-based cross-sectional study was conducted from 1 to 30 June 2021. Multistage stratified sampling and simple random sampling techniques were employed to select 770 samples. An interviewer-administered questionnaire was used to collect data on socio-demographic, child health and feeding practices. Haemoglobin levels were estimated using a portable Hemosmart machine. Children with haemoglobin values below 11 g/dl were considered anaemic. Binary logistic regression analysis was performed to identify factors associated with anaemia. Statistical significance was set at P < 0⋅05. The prevalence of anaemia was 47⋅9% (95% CI (44⋅4, 51⋅5)). The multivariate analysis showed that child age (6-11 months) (AOR 1⋅47; 95% CI (1⋅06, 2⋅03)), household food insecurity (AOR 1⋅44; 95% CI (1⋅01, 2⋅04)), having diarrhoea and cough in the past 2 weeks (AOR 1⋅70; 95% CI (1⋅18, 2⋅44)) and (AOR 1⋅97; 95% CI (1⋅28, 3⋅04), respectively), not consuming the recommended dietary diversity (AOR 2⋅72; 95% CI (1⋅96, 3⋅77)) and stunting (AOR 1⋅88; 95% CI (1⋅31, 2⋅70)) were significantly associated with anaemia. Anaemia in children aged 6-23 months was a severe public health problem in the study area. Integrated nutritional interventions combined with iron fortification and supplementation is recommended.

Objective:To inform dietary interventions, it is important to understand antecedents of recommended (henceforth: healthy) dietary behaviors, beyond dietary beliefs and self-efficacy. We used the validated “Eating Identity Type Inventory” to assess the extent to which participants identified as healthy eaters, meat eaters, emotional eaters or picky eaters. We examined correlations between participants' race/ethnicity and other socio-demographic characteristics and affinity with these eating identities, how affinity with these eating identities correlated with self-reports of dietary beliefs, self-efficacy, dietary behaviors and Body Mass Index (BMI), and how well affinity with these eating identities predicted self-reported dietary behaviors and BMI, as compared to self-reported dietary beliefs and self-efficacy.MethodsIn an online survey, a diverse sample of 340 Los Angeles County adults reported eating identities, dietary beliefs, and self-efficacy, dietary behaviors and BMI.ResultsPearson correlations revealed that identifying more as a healthy eater was positively associated with self-reports of being non-Hispanic White, non-Hispanic mixed race, older, and college-educated, while identifying more as a meat eater was positively associated with self-reports of being non-Hispanic Black, younger, and male (α = 0.05). Pearson correlations also showed that healthy eaters had more accurate dietary beliefs and self-efficacy, and emotional eaters had lower self-efficacy (α = 0.05). In linear regressions, identifying more as a healthy eater was associated with self-reporting healthier dietary behaviors and lower BMI, and identifying more as a meat eater and emotional eater was associated with reporting less healthy dietary behaviors and higher BMI, even after accounting for correlations with socio-demographics, dietary beliefs, and self-efficacy (α = 0.05).ConclusionsOur findings highlight the importance of eating identities in understanding dietary behaviors and outcomes, with implications for dietary interventions.

Crime is a public health issue that disproportionately affects racially-marginalized populations. Studies have reported that food stores (e.g., grocery stores, convenience stores) often attract crime due to their volume of cash transactions and limited security. Little is known about how exposure to crime at food stores affects nutrition or health. This study aimed to fill this research gap by exploring the lived experiences of Black Americans. In 2023, 502 Black-identifying adults completed a survey online. They reported their socio-demographics, fruit and vegetable (FV) consumption, food security status, height, weight, and experiences with crime at food stores in their community. Multivariable-adjusted regression models were examined to identify associations between exposure to crime at food stores and the following measures: low food security status, obesity status, and daily servings of FVs. Approximately 150 (29%) participants avoided one or more food stores in their community due to crime; 102 (20%) had witnessed a crime at a food store. Those who avoided food stores had greater odds of low food security (OR: 1.94; 95% CI: 1.25–3.02) and obesity (OR: 2.15; 95% CI: 1.33–3.48) compared to others. Those who witnessed a crime had greater odds of low food security (OR: 3.14; 95% CI: 1.82–5.41). Exposure to crime at food stores was not associated with FV consumption after adjusting for socio-demographics. Exposure to crime in food stores may have negative health and nutritional implications. Future studies should explore these implications for populations that are disproportionately affected by crime.

Food Insecurity and Less Frequent Cooking Dinner at Home Are Associated with Lower Diet Quality in a National Sample of Low-Income Adults in the United States during the Initial Months of the Coronavirus Disease 2019 Pandemic