Children In Food-insecure Households Research Articles

How food insecurity affects children's behavior problems in early childhood: The nutrition and family stress pathways.

This study examines how household food insecurity shapes young children's behavior problems in Singapore. The analysis is based on two waves of data collected before and during COVID-19 from a nationally representative sample of 2,601 children in the Singapore Longitudinal Early Development Study (SG-LEADS, Mage = 4.5 at wave 1, Mage = 6 at wave 2). Results based on propensity score matching, fixed effects analysis and lagged-variable models show a positive association between household food insecurity and children's behavior problems both concurrently and over a two-year period. Two mediating pathways of this association are identified-children's dietary intake and family stress. Children in food-insecure households tend to consume fewer vegetables and more sugar-sweetened beverages and carbohydrates, which is associated with elevated behavior problems. Parents in food-insecure households exhibit greater emotional distress, diminished parental warmth, and increased punitive parenting practices, also contributing to their children's behavior problems. The family stress pathway has a stronger explanatory power than the nutrition pathway on children's behavior problems. This study reveals that food insecurity is a risk factor for children's behavior problems in early childhood which can lead to later developmental vulnerabilities for children in financially deprived families.

THE RELATIONSHIP BETWEEN FOOD INSECURITY, THE CHILD SUPPORT GRANT AND CHILDCARE ARRANGEMENTS

Food insecurity is endemic in South Africa because of high levels of poverty. Children in foodinsecure households may be exposed to childcare instabilities. However, the role of social protection in mediating the relationship between food insecurity and childcare arrangements is not well understood. This study explored the relationship between food insecurity, childcare arrangements and the child support grant (CSG) in a township in Cape Town. The study designwas mixed-methods; a hunger scale was administered to 120 participants and in-depth interviews conducted with 23 primary caregivers of children under 2 years of age. The findings indicated that despite being food insecure, many households had stable childcare arrangements, presumably because of the CSG and the age of the children at the time of the study. Further research is needed to unpack the relationship between food insecurity, childcare arrangementsand the CSG. Keywords: childcare arrangements, child support grant, food insecurity

Sugar-sweetened beverage intake and convenience store shopping as mediators of the food insecurity-Tooth decay relationship among low-income children in Washington state.

There are oral health disparities in the U.S. and children in food-insecure households have a higher burden of tooth decay. Identifying the mechanisms underlying the food insecurity-tooth decay relationship could inform public health interventions. This study examined how sugar-sweetened beverage (SSB) intake and frequent convenience store shopping mediated the food insecurity-tooth decay relationship for lower-income children. Cross-sectional study data included a household survey, beverage questionnaire, and dental examination. The sample included 452 lower-income, racially-diverse, child-caregiver dyads in 2018 from King County in Washington state. The exposure was household food insecurity, the outcome was untreated decayed tooth surfaces, and the proposed mediators were SSB intake and frequent convenience store shopping (≥2 times/week). Causal mediation analyses via the potential outcomes framework was used to estimate natural indirect and direct effects. Fifty-five percent of participants were in food-insecure households, the mean number of decayed tooth surfaces among children was 0.87 (standard deviation [SD] = 1.99), the mean SSB intake was 17 fluid ounces (fl/oz)/day (SD = 35), and 18% of households frequently shopped at a convenience store. After adjusting for confounders, household food insecurity and log-transformed SSB intake (fluid ounces/day) were positively associated with decayed tooth surfaces, but not at the a α = 0.05 level (mean ratio [MR] 1.60; 95% confidence interval [CI] 0.89, 2.88; p = .12 and MR 1.16; 95% CI 0.93, 1.46; p = .19, respectively). Frequent convenience store shopping was associated with 2.75 times more decayed tooth surfaces (95% CI 1.61, 4.67; p < .001). SSB intake mediated 10% of the food insecurity-tooth decay relationship (p = .35) and frequent convenience store shopping mediated 22% (p = .33). Interventions aimed at addressing oral health disparities in children in food-insecure households could potentially focus on reducing intake of SSBs and improving access to healthful foods in lower-income communities.

Food Apartheid and Food Insecurity

A Food desert usually occurs in a low-income or minority community with limited access to low-cost fresh and healthy food options. This is due mainly to a lack of grocery stores, farmers’ markets, and healthy food providers, resulting in food insecurity. Household food insecurity was related to significantly worse general health, some acute and chronic health problems, and worse health care access, including forgone care and heightened emergency department use, for children. Compared to rates had they not been food insecure, children in food-insecure households had higher rates of lifetime asthma diagnosis and depressive symptoms, which were 19.1% and 27.9% higher, rates of forgone medical care that were 179.8% higher, and rates of emergency department use that were 25.9% higher. This paper explores food deserts, food insecurity, and occurrences of food apartheid and recommends potential solutions.

Socio-Economic Determinants of Goat Milk Consumption by Rural Households in the Niger Valley of Benin and Implications for the Development of a Smallholder Dairy Goat Program

Goats, more popular than cattle in rural Benin, are mainly kept for meat production. Their milk is still unpopular but can provide the much-needed nutrients for children in food-insecure households. This study explored the socio-economic factors affecting the attitude of rural households in the Niger Valley of Benin toward goat milk consumption. Data were collected through individual face-to-face interviews of 721 heads of households or their representatives. Binary logistic regression analysis was carried out to test the association between socioeconomic variables and goat milk consumption. Goat milk and its products were consumed in 14.7% of the surveyed households and were not part of the traditional diets of remaining 81.8%. Their sensory qualities were further reasons reported by 18.4% of respondents for their non-consumption. A household's likelihood to consume goat milk or its derivatives was significantly influenced by the sociocultural background of its head and whether it kept goats or not. The odds of consuming goat milk and/or its derivatives were 2.285 and 2.017 times higher, respectively, for households from Dendi and Peulh socio-cultural groups. Despite the recorded cultural barriers, there is room for increasing goat milk consumption by rural households by increasing its availability and raising awareness of its nutritional and health benefits.

Household food insecurity and unimproved toilet facilities associate with child morbidity: evidence from a cross-sectional study in Bangladesh

BackgroundDespite recent progress in rural economic development and food production, the prevalence of household food insecurity (FI) and use of unimproved toilet facilities are widespread in Bangladesh. Evidence regarding the consequencs of household FI and poor sanitation on child morbidity is scarce. This study aimed to understand the association of FI and unimproved toilet facility with morbidity status of under-5 children in Bangladesh.MethodsWe used data from a cross-sectional survey that was conducted as part of an evaluation of the Maternal, Infant and Young Child Nutrition (MIYCN) Program in 9 districts of Bangladesh. The study population included children aged 6–59 months and their caregivers, identified using a two-stage cluster-sampling procedure. Child morbidity status was the outcome variable, and household FI status and type of toilet used were considered the main exposure variables in this study. We performed logistic regression, calculated adjusted odds ratios (AOR) to assess the association of child morbidity with household FI and unimproved toilet facility after adjusting for potential confounders.ResultsA total of 1,728 households were eligible for this analysis. About 23% of the households were food-insecure, and a large number of households had improved toilet facilities (93.4%). In the multivariable logistic regression model, we found that children in food-insecure households with unimproved toilet facility had 5.88 (AOR: 5.88; 95% CI 2.52, 13.70) times more chance, of being morbid compared to the children of food-secure households with improved toilet facility. A similar association of FI and toilet facilities with each of the morbidity components was observed, including diarrhea (AOR:3.6; 95% CI 1.79, 7.89), fever (AOR:3.47; 95% CI 1.72, 6.99), difficult or fast breathing with cough (AOR:3.88; 95% CI 1.99, 7.59), and difficult or fast breathing with blocked or running nose (AOR:1.29; 95% CI 0.56, 2.95).ConclusionsOur study shows that household FI and unimproved toilet facility jointly have more deteriorative effects on child morbidity than either of these conditions alone. Therefore, it is recommended to consider these two critical factors while designing a public health intervention for reducing morbidity among under-five children.

An Assessment of the Relationship of SNAP and Anemia Among School-Aged Children and Adolescents Living in Households With Food Insecurity.

Children in food-insecure households have an increased risk of anemia. Participation in Supplemental Nutrition Assistance Programs (SNAP) has several benefits. However, it is unknown if it ameliorates anemia among school-aged children and adolescents living in food-insecure households. This study aims to assess the association of SNAP participation and anemia among children and adolescents living in households experiencing food insecurity. The sample population (n = 1635), aged 6 to 18 years, were pooled from the 2003–2014 National Health and Nutrition Examination Survey (NHANES). The exposure of interest was self-reported household SNAP participation. The outcome variable was the presence or absence of anemia, classified using the blood hematocrit concentration values. Survey weighted logistic regression was performed to calculate the odds ratio (OR) and 95% Confidence Interval (CI) of the association between participation in SNAP and anemia in food-insecure children. We found that over 80% of anemic children and adolescents, living in food-insecure households, participated in SNAP, while 63% of non-anemic children and adolescents, living in food-insecure households participated in SNAP (p = .007). Among children living in food-insecure households, SNAP participants had 3-fold increased odds of anemia compared to those who do not participate in SNAP, after adjusting for confounders (OR = 3.33, 95% CI: 1.25–8.88). In this study, SNAP participation was associated with increased odds of anemia in children and adolescents living in food-insecure households. Additional research is needed to assess if these unexpected findings are related to the adequacy of SNAP, affordability, and accessibility to healthy foods, or the household and individual food preferences in food-insecure households.

Food insecurity, food parenting practices, and child eating behaviors among low-income Hispanic families of young children

Food insecurity is associated with negative food parenting practices that may promote child obesity, including pressure to eat and food restriction. Less is known about the relationship between food insecurity and positive food parenting practices, including exposing the child to new foods and involving the child in food preparation. Further, few studies have investigated the associations between food insecurity and child eating behaviors that have been linked to poor dietary outcomes. Using baseline data collected as part of a larger pilot intervention, we examined the relationships between food security status, food parenting practices, and child eating behaviors in a predominately Hispanic, low-income sample of parents and their preschool aged children (n = 66). Between July of 2019 and 2020, caregivers recruited from 4 urban communities in Rhode Island completed assessments of household food security, food parenting practices, and four child eating behaviors: food responsiveness, emotional overeating, enjoyment of food, and satiety responsiveness. Although 46% of caregivers reported food insecurity, food insecurity was not directly associated with any food parenting practice. Children in food insecure households were rated as higher in levels of food responsiveness and enjoyment of food as compared to children in food secure households. Children in food insecure households were rated as lower in satiety responsiveness as compared to children in food secure households. Child emotional overeating did not vary by food security status. Future interventions to reduce child obesity among low-income Hispanic families should assess food security status and consider any level of food insecurity as a potential signal of unhealthy child eating behaviors.

Associations among Food Security, School Meal Participation, and Students' Diet Quality in the First School Nutrition and Meal Cost Study.

The Healthy, Hunger-Free Kids Act of 2010 updated the nutrition standards in the National School Lunch and School Breakfast Programs (NSLP and SBP) and expanded universal free meals’ availability in low-income schools. Past studies have shown that school meals are an important resource for children in food-insecure households. This analysis used data from the School Nutrition and Meal Cost Study to classify students as food insecure (FI), marginally secure (MS), or food secure (FS). Diet quality from school and nonschool foods that students consumed was assessed using Healthy Eating Index (HEI)-2010 scores. Chi-squared and two-tailed t-tests were conducted to compare school meal participation, students’ energy intakes, and diet quality across food security groups. FI and MS students were significantly more likely to participate in NSLP than FS students (79%, 71%, and 49%, respectively). SBP participation followed a similar pattern but was lower (38% FI, 33% MS, and 16% FS). Compared to FS students, FI and MS students more likely attended schools offering SBP, universal free meals, or afterschool snacks and suppers. School meals contributed significantly more energy to FI and MS students’ diets than to FS students (22%, 20%, and 13%, respectively). All groups’ dietary intakes from school foods were of higher quality than non-school foods. These findings highlight the role of school meals in meeting the energy and diet quality needs of FI and MS students.

Household food insecurity and children's oral health: Findings from the 2016-2018 National Survey of Children's Health.

The purpose of the present study is to examine the association between household food insecurity and oral health problems among US children, and the role that socioeconomic, insurance, and oral health care utilization variables play in this association. A large, nationally representative sample of children from the 2016-2018 National Survey of Children's Health (NSCH) was employed in the present study (N=99,962). Logistic regression and negative binomial regression were used to assess the influence of household food insecurity on diverse oral health problems and unmet oral health care needs. The Karlson-Holm-Breen (KHB) method was used to examine the attenuating roles of socioeconomic, insurance, and oral health care utilization variables. Children in food-insecure households exhibited significantly greater odds of all examined oral health problems as well as unmet oral health care needs. These associations were a) most pronounced in the case of moderate-to-severe food insecurity and b) partly explained by a subset of socioeconomic and insurance-related variables. Household food insecurity is a potent risk factor for oral health problems and unmet oral health care needs among US children. Programmatic efforts to address household food insecurity may yield collateral benefits for the oral health of children. Furthermore, because socioeconomic status and insurance-related variables explain part of the association, targeted interventions to improve these factors may improve oral health among at-risk children.

Child Feeding Practice and Primary Health Care as Major Correlates of Stunting and Underweight among 6- to 23-Month-Old Infants and Young Children in Food-Insecure Households in Ethiopia.

ABSTRACTBackgroundChild undernutrition is a major public health problem in Ethiopia. Stunting is highest in food-insecure areas and insufficient evidence may impair the design of suitable interventions.ObjectivesThis study aimed to identify key factors contributing to undernutrition among 6- to 23-mo-old children.MethodsA community-based cross-sectional study in food-insecure areas of Amhara and Oromia regions in April-June, 2018, enrolled 464 mother–child dyads. Bivariate and multivariate logistic regression analyses were conducted.ResultsThe prevalence of stunting (43.1%), wasting (12.3%), and underweight (27.3%) were high. Factors significantly associated with both stunting and underweight were child age of 12–23 mo (vs 6–11 mo), female, more siblings, lack of zinc supplement for diarrhea, inadequate diet diversity, and lack of iodized salt in complementary food. Conclusions: Our findings support the need to emphasize appropriate child feeding practices and iodized salt utilization. Improvement of primary health care services related to micronutrient supplementation and family spacing also are important to address child undernutrition in the study area.

Obesity and Hunger Threaten the Foundations of Child Health

Obesity and Hunger Threaten the Foundations of Child Health

Nutritional Status of Children (Aged 2-5 Years) in Food Secure and Insecure Households in Kuyu Woreda, Oromia, Ethiopia

Malnutrition, poor child feeding practices and low dietary diversity are common in low income households, where food insecurity is prevalent. Therefore, this study was designed to assess and compare nutritional status of children (aged 2-5 years) in food secure and insecure households of Kuyu woreda. A community based comparative, cross sectional study was conducted in March, 2016. Multi stages sampling methods were employed to select 612 children, out of which 304 children were from food secure and 308 from insecure households. Dietary diversity score was assessed using a 24 hrs recall method. Anthropometric measurements of children were taken and nutritional status was generated using WHO Anthro v.3.2.2. Statistical Package for Social Sciences version 20.0 was used to perform descriptive statistics, independent samples T test and chi-square test analyses. P value <0.05 was considered as statistically significant. The prevalence of stunting, underweight and wasting was 48.7%, 36.7% and 20.5% respectively for children in food insecure households. While the prevalence of stunting was 43%, underweight 30.9% and wasting 16.8% for children in food secure households. Daily meal frequency; having breakfast, midmorning, afternoon and bedtime snack among children in food secure households were significantly higher than food insecure households (p<0.05). In addition, children restriction and pressure during meal were significantly (p<0.05) higher in food insecure households compared to their counterparts. Moreover, this study found that food secure and insecure households were significantly different in children's dietary diversity scores (x2=13.1, p<0.001), child feeding practices (x2=11.2, p= 0.001), consumption of dairy products (x2=15.44, p<0.001) and vitamin A rich fruits and vegetables (x2=8.37, p=0.004). Most importantly, the study revealed that nutritional statuses of children from food secure households were significantly better compared to those from their counterparts. Therefore, Productivity Safety Net Program with all responsible bodies should be intensified to improve the nutritional status, child feeding practices and dietary diversity scores of children in the study area. Keywords : under nutrition, children aged 2-5 years, feeding practices, food insecurity DOI : 10.7176/ALST/81-02 Publication date: August 31st 2020

Household Food Insecurity Predicts Childhood Undernutrition: A Cross-Sectional Study in West Oromia (Ethiopia).

Background Despite mixed reports, food insecurity emerges as a predictor of nutritional status, assumably limiting the quantity and quality of dietary intake. In Ethiopia, the prevalence of childhood undernutrition and food insecurity is highly pronounced. However, whether household food insecurity predicts undernutrition in children was not yet well established. Thus, the aim of the present study was to identify the link between household food access and undernutrition in children aged 6–23 months in West Oromia zones, Ethiopia. Methods A cross-sectional study was conducted on a sample of 525 households during June–October 2016. Food access was measured as Household Food Insecurity Access Scale. Semistructured interviewer-administered questionnaires were employed to collect data on sociodemographics, child health, child dietary practices, household food security, and anthropometrics. The height and weight of children aged 6–23 months in each household were measured. Multivariate logistic regression models were constructed to assess the association between household food insecurity and child nutritional status measured from undernutrition indicators. Results Overall, more than two-thirds (69%) of households were classified as food insecure (had insufficient access to adequate food), with a mean (SD) household food access score of 7.9 (7.7). The respective prevalence of mild and moderate food-insecure households was 56.6% and 12.4%. Higher proportions of children in food-insecure households were stunted (41.8% vs. 15.5%), underweight (22.0% vs. 6.1%), and wasted (14.9% vs. 6.1%). Overall, the prevalence of child undernutrition was 21.3% in the target population, with 16.2% stunted, 6.9% underweight, and 6.3% wasted. The present finding shows food-secure households were 54% protective (OR: 0.46, 95% CI: 0.25–0.84) for child undernutrition. Compared to children in food-secure households, children who were reportedly living in moderately food-insecure households were over twice more likely stunted (OR: 2.09, 95% CI: 1.02–4.28) and over 4 times more likely underweight (OR: 4.73, 95% CI: 1.81–12.35). However, household food insecurity was not a correlate for acute malnutrition (wasting) in children. Conclusions The prevalence of household's food insecurity situation is very common and more pronounced among households with undernourished children aged 6–23 months in Ethiopia. The analysis of this work shows that moderately food-insecure households are a salient predictor for composite undernutrition, stunting, and underweight, but not for wasting. Thus, this finding informs the need for multisectoral strategies and policies to combat household's food insecurity and multiple forms of child undernutrition, beyond the socioeconomic wellbeing.

Feeding Practices and Nutritional Status of Children (Aged 2-5 Years) in Food Secure and Insecure Households in Kuyu Woreda, Oromia, Ethiopia

Malnutrition, poor child feeding practices and low dietary diversity are common in low income households, where food insecurity is prevalent. Therefore, this study was designed to assess and compare nutritional status, feeding practices and dietary diversity scores of children (aged 2-5 years) in food secure and insecure households of Kuyu woreda. A community based comparative, cross sectional study was conducted in March, 2016. Multi stages sampling methods were employed to select 612 children, out of which 304 children were from food secure and 308 from insecure households. Dietary diversity score was assessed using a 24 hrs recall method. Anthropometric measurements of children were taken and nutritional status was generated using WHO Anthro v.3.2.2. Statistical Package for Social Sciences (SPSS) version 20.0 was used to perform descriptive statistics, independent samples T test and chi-square test analyses. P value <0.05 was considered as statistically significant. The prevalence of stunting, underweight and wasting was 48.7%, 36.7% and 20.5% respectively for children in food insecure households. While the prevalence of stunting was 43%, underweight 30.9% and wasting 16.8% for children in food secure households. Daily meal frequency; having breakfast, midmorning, afternoon and bedtime snack among children in food secure households were significantly higher than food insecure households (p<0.05). In addition, children restriction and pressure during meal were significantly (p<0.05) higher in food insecure households compared to their counterparts. Moreover, this study found that food secure and insecure households were significantly different in children's dietary diversity scores (x2=13.1, p<0.001), child feeding practices (x2=11.2, p= 0.001), consumption of dairy products (x2=15.44, p<0.001) and vitamin A rich fruits and vegetables (x2=8.37, p=0.004). Most importantly, the study revealed that nutritional statuses of children from food secure households were significantly better compared to those from their counterparts. Therefore, all responsible bodies should support poor communities through providing foods or cash money to improve the nutritional status, child feeding practices and dietary diversity scores of children in the study area.

Development and validation of measure of household food insecurity in Northern Rao PDR

AbstractIntroductionLao PDR is one of the poorest countries in the world, ranked the 138th of 188 developing countries. Although household food insecurity has been prevalent in Northern Rao PDR, no valid measurement of household food insecurity exists. Therefore, the study was to develop a household food insecurity questionnaire and verify the validity of the questionnaire in the rural areas of Lao PDR.Materials and MethodsUsing a multistage-sampling cross-sectional study, the sample included 373 households with children under 5 years of age living in Xieng Khouang, Lao PDR. The questionnaire was composed of 18 items based on the US household Food Security Survey Module and partially modified to local circumstances. Internal consistency of questions measured with Cronbach's α was adequate, result of 0.746. External validity was evaluated through comparison analyses between food insecurity levels and household socioeconomic indicators.Results and discussionAmong 373 households, 42.7% were food-insecure and 4.3% were food-insecure with hunger. There were more food-insecure households in those with lower maternal education levels (P &lt; 0.001), greater number of household members (P &lt; 0.001), longer travel time to farmland (P = 0.003), and lower household asset scores (P &lt; 0.001). Households with the residence made of natural material for walls (P &lt; 0.001), roofs (P &lt; 0.001) and floors (P &lt; 0.001) as well as without electricity (P &lt; 0.001), pipe to supply drinking water (P &lt; 0.001), and income other than agriculture (P &lt; 0.001) had higher food insecurity than their counterparts. In addition, inadequate maternal prenatal care and education, child health care, and vaccinations increased household food insecurity. Mothers and children in food-insecure households had lower intakes of various food groups including protein-source foods. This study would provide a valid instrument to assess food insecurity and be used in the future as an evaluation tool for the improvement of nutritional deficiencies as well as a tool for selection of target subjects in Northern Rao PDR.

The Hunger Vital Sign Identifies Household Food Insecurity among Children in Emergency Departments and Primary Care.

This study aimed: (1) to examine the sensitivity and specificity of the 2-item Hunger Vital Sign against the 18-item Household Food Security Survey Module (HFSSM) in identifying young children in food insecure households in emergency department and primary care sites and (2) to examine associations between food insecurity and adverse health conditions. We conducted cross-sectional surveys from 2009–2017 among 5039 caregivers of children age <48 months. We measured adverse child health by caregiver-reported perceived health, prior hospitalizations, and developmental risk (Parents’ Evaluation of Developmental Status). Analyses were conducted using covariate-adjusted logistic regression. Sensitivity and specificity of the Hunger Vital Sign against the HFSSM were 96.7% and 86.2%. Using the HFSSM, children in the emergency department had a 28% increase in the odds of experiencing food insecurity, compared to children in primary care, aOR = 1.28, 95% Confidence Interval (CI) = 1.08–1.52, p = 0.005. Using the Hunger Vital Sign, the increase was 26%, aOR = 1.26, 95% CI = 1.08–1.46, and p = 0.003. The odds of children’s adverse health conditions were significantly greater in food insecure households, compared to food secure households, using either HFSSM or the Hunger Vital Sign. Screening for food insecurity with the Hunger Vital Sign identifies children at risk for adverse health conditions in both primary care and emergency department sites, and can be used to connect families with resources to alleviate food insecurity.

Disrupted Relationships, Chaos, and Altered Family Meals in Food-Insecure Households: Experiences of Caregivers and Children

BackgroundRegular family meals foster healthy physical and social development of children but often occur less frequently in households experiencing food insecurity. How food insecurity influences the quality of these interactions is not understood well. ObjectiveTo better understand family meal experiences of caregivers and children living in food-insecure households. DesignA qualitative method with cross-sectional sample was used, collecting data using semistructured interview guides. ParticipantsTwenty ethnically diverse caregiver–child (aged 9 to 15 years) dyads in South Carolina were interviewed. Statistical analysisData were analyzed using grounded theory in Nvivo 10. ResultsFood-insecure households described family meals that varied in frequency, location, and quality of foods served, especially during times of food shortages. Interpersonal relationships drove the quality of mealtime interactions for these households. Household chaos not only influenced the frequency and location of meals, but also strained mealtime interactions in households with poor interpersonal relationships. In these homes, household chaos included conflicts with work and afterschool schedules, food shortages, coping with poverty and food insecurity (eg, working extra hours or seeking food assistance), and children visiting multiple homes, particularly when food was limited. All households experienced chaos, but strong interpersonal relationships were described as the primary reason for enjoyable mealtime experiences with few disruptions. ConclusionsExploring family meal experiences of children in food-insecure households highlights the importance of interpersonal relationships and regular, positive mealtime interactions that may strengthen emotional connections in families to improve child health outcomes.

Heightened Nutritional Vulnerability Among Food-insecure Canadians in 2015 Than 2004 (P04-053-19)

ObjectivesHousehold food insecurity is a persistent public health issue in Canada. Analyses of dietary intake data from the 2004 Canadian Community Health Survey (CCHS) showed heightened nutritional vulnerability among adults and, to a lesser degree, children in food-insecure households. Given the rise in food prices since 2004, people in food-insecure households may now be at heightened nutritional risk. The objective of this study is to determine how nutritional vulnerability associated with household food insecurity has changed between 2004 and 2015. MethodsDietary intake was assessed on the 2004 CCHS Nutrition (n = 35,107) and 2015 CCHS Nutrition (n = 20,487) using 24-hour recalls, with household food insecurity assessed using the Household Food Security Survey Module. The National Cancer Institute method was used to estimate usual intakes of nutrients of public health concern (calcium, magnesium, vitamin A, vitamin C, folate, zinc, potassium) for food-insecure participants, by survey year, considering children 1–8 years (yr) and 9–18 yr and male and female adults, 19–64 yr. Prevalence of nutrient inadequacy was assessed using the EAR cut-point approach. Differences in usual intake and prevalence of inadequacy between surveys were assessed using t-tests. Weighted bootstrap technique was utilised to generate variance estimates. ResultsIn 2004 and 2015, 8.4% of individuals lived in moderately or severely food-insecure households. Mean usual intakes were lower and prevalence of nutrient inadequacy were higher across groups in 2015 than 2004, but not all differences were statistically significant. Differences in mean potassium and vitamin C intakes were significant in all groups; differences for folate and magnesium were significant in all groups except older children. Calcium was significantly lower in all groups except adult males, and vitamin A was significantly lower in all groups except young children. Young children had significantly lower intakes of zinc. Older children and male adults had significantly higher prevalence of inadequacy for vitamin C. ConclusionsNutritional vulnerability associated with household food insecurity has worsened over time in Canada and remains an area in need of intervention. Funding SourcesOntario Graduate Scholarship, Canada Graduate Scholarship-Masters, Canadian Institutes of Health Research.

Child health and the possibilities for childcare in a context of poverty and food insecurity: The narratives of parents attending a self-managed foodbank in Spain.

Food insecurity would influence children's health and development through its effects on nutrition and household stress in the context of broader poverty-related problems. This study contributes to research regarding the characterisation of food-insecure households with children under the age of 18. In particular, it highlights the social and institutional aspects which influence and interact with parents' attempts to protect their children from hunger and destitution. In this study, we document some aspects of the harsh realities faced by mothers and fathers with children under the age of 18 living in poverty who attended a self-organised foodbank in the city of Madrid in 2015. We used a qualitative methodology consisting of 7 months of participant observation and the conduction of 15 in-depth interviews. This study shows how the possibilities for the meaningful protection of children in food-insecure households can be influenced by parental coping strategies, community resources and availability and accessibility to public help. Foodbanks can help reduce both household hunger (although not meeting all nutritional requirements) and parental psychosocial distress, which might support parents to better protect their children. In particular, self-managed foodbanks appear to help parents cope with emotional distress by reducing feelings of powerlessness and self-blame through their active involvement, and thanks to the collective caring that occurs between members. Public services are of special relevance, since their absence or an active institutional discrimination has been shown to further damage impoverished households with children. We suggest that public policies in Spain are revised and reinforced to enable a more genuine protection of children and their families living under severe deprivation, and to prevent life-long damage. Public institutions could assume that people attending a foodbank are living in severe poverty and need access to adequate and supportive public resources to address it.