Child Food Insecurity Research Articles

Prevalence and Determinants Stunting Among Children Under Two Years in Indonesian District

The study aims to analyze the prevalence and determinants of stunting in children under two years of age in Tojo Una-Una District, Indonesia as focus location of stunting. The method is Cross-sectional study design, the sample of 300 children aged 0-23 months, stratified random sampling technique. Data collection in June-July 2022. Stunting data was obtained by measuring body length using the length measuring board. The WHO-Antro 2005 software was used to determine the Z-Score height per age. Univariate, bivariate, and multivariate analyzes used SPSS version 22.00. The Results of this research show that 33.7% of children under the age of two are stunted. Stunting in children under the age of two is associated with child age, birth weight, and food insecurity. In addition to a history of low birth weight (AOR=2.7, 95% CI: 1.2-5.7) and experiencing food insecurity (AOR=1.9, 95% CI: 1.1-3.5), children aged 12-23 months (AOR=3.5, 95% CI: 1.7-7.2) have a higher tendency to experience stunting than those who are not. The Conclusion is the prevalence of stunting which is more than 20 percent is a priority health problem that must be resolved by 2024. Interventions to reduce stunting by reducing the incidence of low birth weight, reducing food insecurity, managing birth spacing > 3 years, number of children less than 3, and breastfeeding.

Children’s Educational Outcomes and Persistence and Severity of Household Food Insecurity in India: Longitudinal Evidence from Young Lives

BackgroundFood insecurity is a pressing global challenge with far-reaching consequences for health and well-being. However, little attention has focused specifically on the experiences of children and adolescents over the age of 5 y in food insecure households. ObjectivesWe examine whether the persistence and severity of household food insecurity are negatively associated with children’s educational outcomes. MethodsWe used data for the younger cohort of the longitudinal Young Lives data from rounds 3 (2009), 4 (2013), and 5 (2016), when children were aged 8 y, 12 y, and 15 y, respectively. Drawing on the Household Food Insecurity and Access Scale, we used descriptive statistics, graphical analysis, and multilevel regressions to document how the persistence and severity of household food insecurity are associated with children’s educational outcomes (years of education, maths, and vocabulary [PPVT] test scores). We controlled for potentially confounding sociodemographic characteristics, including children’s own baseline grade attained and test scores in “value-added” models, to provide robust estimates of household food insecurity in predicting children’s educational outcomes. ResultsHousehold food insecurity generally declined between 2009 and 2016. Fewer than 50% of households were food secure across the 3 rounds of data we examined. Our robust, multivariate, value-added models show that the persistence and severity of food insecurity are negatively associated with all 3 children’s educational outcomes we examined. ConclusionsWe add to a small but growing literature exploring how household food insecurity is associated with children’s educational outcomes in the Global South. Our findings on severity of food insecurity highlight the importance of understanding food insecurity along the severity continuum rather than as a dichotomous state, as previously done in existing literature. Addressing household food insecurity in childhood and adolescence may be a key factor to improve children’s educational outcomes.

Food Insecurity and Food Allergy in Children of an Urban Minority Community: A Cross-Sectional Study

Childhood food insecurity was exacerbated during the COVID-19 pandemic, with burdens falling disproportionately on minority children. This study aims to describe the prevalence of food insecurity in food-allergic children of an urban minority community and examine the association between food insecurity and food allergy.

Food Insecurity in the Pediatric Food Allergy Population

Food insecurity affects approximately 15% of children in the United States and has increased due to the COVID-19 pandemic and rising food costs. Previous studies have shown higher rates of food insecurity in food allergic children, though data is limited. We aim to investigate food insecurity trends in an urban, children’s hospital-based, Allergy/Immunology outpatient clinic.

The Association Between Child Food Allergy and Food Insecurity in the Family Unit

The Association Between Child Food Allergy and Food Insecurity in the Family Unit

Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition-Narrative Review.

The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition.

Food insecurity and dental caries prevalence in children and adolescents: A systematic review and meta-analysis.

Food insecurity (FI) is associated with dietary practices, which can act as a risk factor for dental caries. This study aimed to investigate the relationship between FI and dental caries prevalence in children and adolescents. MEDLINE (via PubMed), EMBASE, SCOPUS, ISI web of knowledge, Cochrane, and ProQuest Dissertations & Theses Global database (up to April 19, 2022) as well as reference lists were searched. Eligible studies compared dental caries prevalence in food-secure and food-insecure individuals younger than 19 years. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using a modified Newcastle-Ottawa Scale. Meta-analysis was performed, and the pooled odds ratio (OR) was calculated at 95% confidence interval (95% CI). Among the 1350 retrieved records, 10 cross-sectional reports were selected for systematic review. Six studies involving 8631 participants were included in the meta-analysis. More than half of the reports were published within the period 2019-2021. All studies except one were judged as low risk of bias. Overall, the prevalence of dental caries was greater among the food-insecure children and adolescents (OR: 2.01, 95% CI: 1.52-2.65, p < .001, I2 : 73.5%). Similarly, all three categories of FI were significantly associated with caries experience (marginal FI: OR: 1.88, 95% CI: 1.56-2.27, p < .001, I2 : 0.0%; low FI: OR: 2.42, 95% CI: 1.42-4.14, p=.001, I2 : 74.4%; very low FI: OR: 2.37, 95% CI: 1.88-3.00, p < .001, I2 : 0.0%). The results showed a significant association between FI status and dental caries in both childhood and adolescence; however, there was a lack of longitudinal studies for a better understanding of this association. Health policies leading to reduction in FI may also aim to reduce dental caries.

Prevalence and Severity of Food Insecurity Before and During the Coronavirus Disease 2019 Pandemic Among Adults and Youth in Australia, Canada, Chile, Mexico, the United Kingdom, and the United States

BackgroundDisruptions from the coronavirus disease 2019 (COVID-19) pandemic potentially exacerbated food insecurity among adults and youth. ObjectivesThe objective was to examine changes in the prevalence and severity of food insecurity among adults and youth from before (2019) to during (2020) the pandemic in multiple countries. MethodsRepeated cross-sectional data were collected among adults aged 18–100 y (n = 63,278) in 5 countries in November to December in 2018–2020 and among youth aged 10–17 y (n = 23,107) in 6 countries in November to December in 2019 and 2020. Food insecurity in the past year was captured using the Household Food Security Survey Module and the Child Food Insecurity Experiences Scale. Changes in the prevalence and severity of food insecurity were examined using logistic and generalized logit regression models, respectively. Models included age, gender, racial-ethnic identity, and other sociodemographic characteristics associated with food insecurity to adjust for possible sample differences across waves. Models were weighted to reflect each country’s population. ResultsAdults [adjusted OR (AOR): 1.15; 95% CI: 1.02, 1.31] and youth (AOR: 1.43; 95% CI: 1.19, 1.71) in Mexico were more likely to live in food-insecure households in 2020 compared to 2019. Adults in Australia (AOR: 0.81; 95% CI: 0.72, 0.92) and Canada (AOR: 0.87; 95% CI: 0.77, 0.99) were less likely to live in food-insecure households in 2020. Trends in severity aligned with changes in prevalence, with some exceptions. Youth in Australia (AOR: 2.24; 95% CI: 1.65, 3.02) and the United States (AOR: 1.39; 95% CI: 1.04, 1.86) were more likely to have many compared with no experiences of food insecurity in 2020 compared to 2019. There was no evidence of change among adults and youth in the remaining countries. ConclusionsExcept for Mexico, few changes in food insecurity among adults and youth were observed from before to during the COVID-19 pandemic. Action is needed to support households at risk of food insecurity.

School Feeding Programme Implementation and its Challenges in Basic Education Schools in Rwanda

The condition of food insecurity and malnutrition for school-aged children and adolescents remains one of the most influential determinants of learning outcomes. Healthy and well-nourished students learn better, have a prodigious opportunity to thrive and fulfil their potential as adults, and increase their earning potential. The purpose of this study was twofold: a) to examine the implementation level of the school feeding programme and b) to identify the existing challenges that limit the school feeding programme from realizing its full potential in basic education schools. The study was directed by a descriptive research design, and 227 were selected using stratified and simple random sampling approaches, with 73.7% males and 26.3% females. The bulk of participants (39.2%) were between the ages of 30 and 40. Questionnaires and interview guides were used to obtain quantitative and qualitative data. The numeric data were descriptively examined using SPSS, and the qualitative data was studied using theme analysis. The study established a moderate level of school feeding implementation in terms of programmes coverage, school meal and cost, school meal preparation, and service. The study revealed different challenges hindering the effectiveness of the school feeding programme in basic education schools, including insufficient food served to the students in quantity and quality, inadequate materials and infrastructure, and unaffordable prices of required groceries from the market. To improve the efficiency and effectiveness of school feeding programmes, the Rwandan government and its partners in these programmes should raise the school feeding fund allotted to basic education institutions throughout the country. To the same extent, the Rwandan government is advised to a) transfer the school feeding fund to the schools for timely use, b) provide the schools with the necessary equipment and materials for cooking and serving meals to students, as well as the provision of required dining rooms, c) find an adequate way to fix the country's progressive price increase, and d) promote the school gardening concept (such as growing vegetables and other relevant crops). Keywords: School feeding programmes, Basic education schools, Implementation, Challenges, physiological and psychological needs, Sustainable Development Goals (SDGs).

The Determinants of Food Insecurity Among Hispanic/Latinx Households With Young Children: A Narrative Review.

Food insecurity has disproportionately impacted Hispanic/Latinx households in the United States, specifically those with young children. Although the literature provides evidence of an association between food insecurity and adverse health outcomes in young children, minimal research has addressed the social determinants and related risk factors associated with food insecurity among Hispanic/Latinx households with children under three, a highly vulnerable population. Using the Socio-Ecological Model (SEM) as a framework, this narrative review identified factors associated with food insecurity among Hispanic/Latinx households with children under three. A literature search was conducted using PubMed and four additional search engines. Inclusion criteria consisted of articles published in English from November 1996 to May 2022 that examined food insecurity among Hispanic/Latinx households with children under three. Articles were excluded if conducted in settings other than the US and/or focused on refugees and temporary migrant workers. Data were extracted (i.e., objective, setting, population, study design, measures of food insecurity, results) from the final articles (n = 27). The strength of each article's evidence was also evaluated. Results identified individual factors (i.e., intergenerational poverty, education, acculturation, language, etc.), interpersonal factors (i.e., household composition, social support, cultural customs), organizational factors (i.e., interagency collaboration, organizational rules), community factors (i.e., food environment, stigma, etc.), and public policy/societal factors (i.e., nutrition assistance programs, benefit cliffs, etc.) associated with a food security status of this population. Overall, most articles were classified as "medium" or higher quality for the strength of evidence, and more frequently focused on individual or policy factors. Findings indicate the need for more research to include a focus on public policy/society factors, as well as on multiple levels of the SEM with considerations of how individual and policy levels intersect and to create or adapt nutrition-related and culturally appropriate interventions to improve food security of Hispanic/Latinx households with young children.

Childhood obesity, food insecurity and climate change: a tale of two island groups

Childhood obesity, food insecurity and climate change: a tale of two island groups

Childhood food insecurity, mental distress in young adulthood and the supplemental nutrition assistance program

Food insecurity affects 14% of US homes with children and has been associated with increased mental health problems. Few studies have examined long-term consequences for mental health and the role of social policies. This study examined the association between childhood household food insecurity (HHFI) and young adult psychological distress, and the moderating role of caregiver psychological distress and the Supplemental Nutrition Assistance Program (SNAP) using data from the Panel Study of Income Dynamics (1995–2015). The sample comprised 2782 children ages 0–12 years in 1997. Past-year HHFI was measured using the USDA 18-item questionnaire in 1997, 1999, 2001 and 2003. Young adults' non-specific psychological distress was measured with the Kessler (K6) scale in 2005, 2007, 2009, 2011, 2013 and 2015. Three trajectories of food insecurity were identified: 1) Persistent food security (70.5%); 2) Intermediate/fluctuating food insecurity (24.6%), and; 3) Persistent food insecurity (4.9%). Compared to persistent food security, fluctuating and persistent food insecurity were associated with significantly higher levels of psychological distress. This association was robust to adjusting for socio-demographic factors, caregiver psychological distress, and family access to governmental supports: [Adj. ORs (95% CI's = 1.72 (1.59–1.85) and 2.06 (1.81–2.33)]. Having a caregiver who suffered from psychological distress (1997 and/or 2002) and growing up with persistent food insecurity placed children at greater risk for mental health problems. Access to SNAP attenuated this risk. Early HHFI is associated with psychological distress in young adulthood. Interventions to increase access to SNAP and address caregivers mental health may prevent mental health problems associated with childhood HHFI.

Child and adolescent food insecurity in South Africa: A household-level analysis of hunger.

Food insecurity impacts childhood nutritional status, physical and cognitive development, and increases lifetime risk for chronic disease. Previous South African studies have examined hunger at the sub-national level without a specific focus on children and adolescents. This study determines the national prevalence of childhood food insecurity, from birth to adolescence, and identifies factors associated with hunger within the household. Individual and household-level data were extracted from the South African National Health and Nutrition Examination Survey (SANHANES-1). Prevalence of food insecurity was assessed using the Community Childhood Hunger Identification Project (CCHIP) index. Multinomial logistic regression analyses were conducted on all households (with and without children) to determine the predictors of food insecurity, with additional analyses adjusting for child dependency and sociodemographic characteristics of household heads in households with children. Of 5 098 households surveyed, 68.6% had children and adolescents present (0-19 years). Of these households, 32.5% (95% Confidence Interval [CI]: 29.5-35.7) were experiencing hunger and 26.3% (95% CI: 23.9-28.8) were at risk of hunger. Among all the households, significant associations for experiencing hunger were the presence of children and adolescents: Adjusted Odds Ratio (AOR) = 1.68 (95% CI: 1.12-2.53); being female-headed: AOR = 1.53 (95% CI: 1.21-1.94) and informally-located; AOR = 1.6 (95% CI: 1.07-2.43). Of the racial groups, having a non-African household head, Coloured: AOR = 0.29 (95% CI: 0.19-0.44) and White/Indian/Asian: AOR = 0.12 (95% CI: 0.04-0.33) conferred lower odds of experiencing hunger; and, the household head having secondary/tertiary education conferred lower odds of experiencing hunger; AOR = 0.40 (95% CI: 0.28-0.56) as well as being at risk of hunger; AOR = 0.69 (95% CI: 0.52-0.92). Receiving social grants, pensions, or remittances more than doubled the odds of experiencing hunger; AOR = 2.15 (95% CI: 1.49-3.09). After adjusting for child dependency in households with children, having at least one older child (age 15-19 years old) did not change the odds of food insecurity. In summary, only 41% of South African households with children and adolescents were food secure. The associations between household head sociodemographics, household location and size on household food insecurity indicate a need for multi-sectoral interventions to bolster sustainable food systems for households with children and adolescents and to improve public protections for female-headed, African-headed and informally-located households dependent on social grants.

Trends in Overall and Micronutrient-Containing Dietary Supplement Use in US Adults and Children, NHANES 2007–2018

Dietary supplement (DS) use is widespread in the United States and contributes large amounts of micronutrients to users. Most studies have relied on data from 1 assessment method to characterize the prevalence of DS use. Combining multiple methods enhances the ability to capture nutrient exposures from DSs and examine trends over time. The objective of this study was to characterize DS use and examine trends in any DS as well as micronutrient-containing (MN) DS use in a nationally representative sample of the US population (≥1 y) from the 2007-2018 NHANES using a combined approach. NHANES obtains an in-home inventory with a frequency-based dietary supplement and prescription medicine questionnaire (DSMQ), and two 24-h dietary recalls (24HRs). Trends in the prevalence of use and selected types of products used were estimated for the population and by sex, age, race/Hispanic origin, family income [poverty-to-income ratio (PIR)], and household food security (food-secure vs. food-insecure) using the DSMQ or ≥ 1 24HR. Linear trends were tested using orthogonal polynomials (significance set at P<0.05). DS use increased from 50% in 2007 to 56% in 2018 (P=0.001); use of MN products increased from 46% to 49% (P=0.03), and single-nutrient DS (e.g., magnesium, vitamins B-12 and D) use also increased (all P<0.001). In contrast, multivitamin-mineral use decreased (70% to 56%; P<0.001). In adults (≥19 y), any (54% to 61%) and MN (49% to 54%) DS use increased, especially in men, non-Hispanic blacks and Hispanics, and low-income adults (PIR≤130%). In children (1-18 y), any DS use remained stable (∼38%), as did MN use, except for food-insecure children, whose use increased from 24% to 31% over the decade (P=0.03). The prevalence of any and MN DS use increased over time in the United States. This may be partially attributed to increased use of single-nutrient products. Population subgroups differed in their DS use.

Unmet Medical Needs and Food Insecurity in Children with Neurodevelopmental Disorders: Findings from the 2019 National Health Interview Survey (NHIS).

In the United States, 17% of children ages 3-17 have a developmental disorder. The complexity of care for such children require families to provide a significant amount of health care at home, representing a substantial economic cost. Our study identifies sociodemographic characteristics of children with neurodevelopmental disorders (NDD) that are predictive of unmet medical needs and food insecurity. We modeled the outcomes using a multivariable generalized linear model and a robust Cox proportional hazard model. Among children with NDD, 7.4% reported a delay in obtaining care, 3.6% avoided getting care and 17.3% live in a household that experienced food insecurity. Lack of health insurance and lack of usual source of care increased the risk for cost-related delay in medical care and cost-related avoidance of medical care. Children with NDD whose parents have less than a college degree and those from households with income &lt;$75,000 had increased risk for food insecurity in the past 30 days. Our results underscore the need to implement additional screening to identify children with NDD who are at greater risk for unmet medical and social needs by health care providers and care coordination organizations.

Health Care as a Partner in Federal Nutrition Programs: Call for Advocacy.

Health Care as a Partner in Federal Nutrition Programs: Call for Advocacy.

Systems Mapping of the New Zealand Free and Healthy School Lunch Programme: Perspectives from Lunch Providers.

As part of the COVID-19 economic recovery package, the Aotearoa New Zealand Government rolled out a universal free and healthy lunch programme to the 25% least advantaged schools nationwide. This study explored experiences of school lunch providers in the Hawke’s Bay region. The aim was to create a systems map identifying points of intervention through which the lunch programme could be improved to meet the goal of reducing child food insecurity. Twelve lunch providers were interviewed to generate casual loop diagrams which were examined and integrated to form a single systems map. Seven themes arose during analysis: teacher support, principal support, nutrition guidelines and government support, supply chain, ingredient suppliers, student feedback and food waste. Teacher support was important for getting students to try new foods and eat the nutritious lunches. Principal support was a strong theme impacting opportunities for broader student engagement. This study employed systems science to highlight the importance of support from different stakeholders within the lunch programme to achieve the goal of reduced child food insecurity. Further work is needed to ensure the programme meets the wider goals of the government and community, and to determine the potential broader benefits of the programme.

Food Insecurity in Broome County and its Effect on Adolescent Academic Performance

Food insecurity is a growing concern among children within the U.S., as the number of households who are food insecure has grown in the wake of the COVID-19 pandemic. Food insecurity in children can lead to a multitude of cognitive complications. My research investigates the relationship between food insecurity and academic performance in elementary schools in Broome County. To uncover how food insecurity and academic performance are linked, interviews were conducted with school staff (teachers, administrators, a food service manager), the area's socioeconomic status was analyzed, standardized testing scores were compiled, and the food offerings in the area were explored. The results indicate that a place with higher food insecurity and higher poverty could result in lower academic performance, as observed through test scores and observations of the school staff. The results could also highlight that an area with lower food insecurity results in higher academic performance. This demonstrates the need to provide supplementary food and expanded free meals for children in schools to maximize their ability to succeed academically. Free meals for students through the National School Lunch Program should be provided into the future and supplementary programs should be accessible to all, not just those in areas with high food insecurity, to ensure schools give their students the resources they need to succeed.

Development, Validity, and Cross-Context Equivalence of the Child Food Insecurity Experiences Scale for Assessing Food Insecurity of School-Age Children and Adolescents

BackgroundChildren ages 6 to 17 years can accurately assess their own food insecurity, whereas parents are inaccurate reporters of their children’s experiences of food insecurity. No globally applicable scale to assess the food insecurity of children has been developed and validated. ObjectivesWe aimed to develop a globally applicable, experience-based measure of child and adolescent food insecurity and establish the validity and cross-contextual equivalence of the measure. MethodsThe 10-item Child Food Insecurity Experiences Scale (CFIES) was based on items previously validated from questionnaires from the United States, Venezuela, and Lebanon. Cognitive interviews were conducted to check understanding of the items. The questionnaire then was administered in 15 surveys in 13 countries. Other items in each survey that assessed the household socioeconomic status, household food security, or child psychological functioning were selected as criterion variables to compare to the scores from the CFIES. To investigate accuracy (i.e., criterion validity), linear regression estimated the associations of the CFIES scores with the criterion variables. To investigate the cross-contextual equivalence (i.e., measurement invariance), the alignment method was used based on classical measurement theory. ResultsAcross the 15 surveys, the mean scale scores for the CFIES ranged from 1.65 to 5.86 (possible range of 0 to 20) and the Cronbach alpha ranged from 0.88 to 0.94. The variance explained by a 1-factor model ranged from 0.92 to 0.99. Accuracy was demonstrated by expected associations with criterion variables. The percentages of equivalent thresholds and loadings across the 15 surveys were 28.0 and 5.33, respectively, for a total percentage of nonequivalent thresholds and loadings of 16.7, well below the guideline of <25%. That is, 83.3% of thresholds and loadings were equivalent across these surveys. ConclusionsThe CFIES provides a globally applicable, valid, and cross-contextually equivalent measure of the experiences of food insecurity of school-aged children and adolescents, as reported by them.

Association of Food Insecurity with Mental Health Outcomes in Parents and Children.

Food insecurity affects 13.7 million US households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. To identify the associations of food insecurity and mental health outcomes in parents and children DATA SOURCES: PubMed, Embase, Web of Science, and PsycInfo STUDY ELIGIBILITY CRITERIA: We included original research published in English from January 1990 to June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the United States. Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.