Food Insecure Populations Research Articles

A mixed-method evaluation of the New York State Healthy Pantry Initiative: application of the SNAP-Ed evaluation framework

ABSTRACT Food pantry nutrition environments are important settings for improving access to healthful foods among food-insecure populations. The Healthy Pantry Initiative (HPI) used policy, systems, and environmental (PSE) changes to improve the food pantry nutrition environment from October 2018 through September 2019. Program implementers assessed the need for PSE changes, developed action plans, and collected baseline, implementation, and follow-up data. Guided by the SNAP-Ed Evaluation framework, the collected data were used to capture information about HPI need, planning, adoption, implementation, and reach, from the perspective of frontline nutrition educators.

Impact of floods on food security in rural Afghanistan

Floods, affecting roughly one million Afghans annually and causing substantial economic losses, is one of the most frequent disasters. This study examines the impacts of floods on household food security in rural Afghanistan, where 80 % of the population relies on subsistence farming and consists of 80 % of the food-insecure population. Based on the 2022 Data in Emergency Monitoring Round 5 dataset, a two-stage least squares with an instrumental variable is applied to analyze the relationship, considering district altitude and unconditional aid. Our findings reveal the negative impacts of floods, i.e., flood exposure decreases the Food Consumption Score (FCS) by 7.1 points and the Household Dietary Diversity Score (HDDS) by 0.14 points. Additionally, flood exposure increases the Household Hunger Scale (HHS) by 0.77 points and significantly raises the probability of moderate and severe food insecurity by 11 % and 20 %, respectively. Food aid offers a lifeline, boosting FCS by 1.54 points and reducing HHS by 0.42 points while mitigating food insecurity risks. High-altitude areas experience greater vulnerability, with higher hunger levels and lower dietary diversity compared to lowlands. Our research suggests prioritizing preventative strategies like area-based policies and flood preparedness plans over solely relying on post-disaster relief initiatives. Additionally, accounting for topographical variations, at least at the district level, is crucial for future food security studies in Afghanistan and similar contexts. These findings hold significant implications for achieving UN Sustainable Development Goals 2 (Zero Hunger) and 13 (Climate Action).

Hungry, stressed, or both? An ecological momentary assessment in food secure and insecure populations

Hungry, stressed, or both? An ecological momentary assessment in food secure and insecure populations

Modeling chronic disease risk across equity factors using a population-based prediction model: the Chronic Disease Population Risk Tool (CDPoRT)

BackgroundPredicting chronic disease incidence at a population level can help inform overall future chronic disease burden and opportunities for prevention. This study aimed to estimate the future burden of chronic...

A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries.

To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.

Increasing food insecurity severity is associated with lower diet quality in Australian adults

Food insecurity, the inadequate or insecure access to food due to financial constraints, is a growing concern in high-income countries like Australia(1). Food insecure adults may have reduced diet quality due to constraints on food purchasing and consumption(2) but further research is needed to understand how the severity of food insecurity impacts diet quality in an Australian setting. This study aimed to examine the relationship between diet quality and increasing severity of household food insecurity using validated measurement tools. A cross-sectional, online survey of Australian adults (aged 18 years+) used the USDA Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately, or severely food insecure. The Australian Recommended Food Score (ARFS; score between 0–73) determined diet quality (ARFS total) and sub-scale scores for eight food groups(3), with higher scores indicating higher diet quality. Diet quality score results are further categorised as “needs work” (<33), “getting there” (33-38), “excellent” (39-46) or “outstanding” (47+). Survey-weighted linear regression (adjusted for age, sex, income, education, location, household composition) analyses indicate that 45% of participants were living in households that experienced food insecurity, comprising 7% marginally, 18% moderately and 20% severely food insecure households. The ARFS total survey-weighted mean score for the whole sample (n = 804) was 32.4 (SD = 9.8). As the severity of household food insecurity increased, ARFS scores decreased. Marginally food insecure respondents reported a mean ARFS score three points lower than food-secure adults (B=-2.7; 95%CI [−5.11, −0.34]; p = 0.03), and scores reduced by six points for moderately (B=-5.6; 95%CI [−7.26, −3.90]; p<0.001) and twelve points for severely food insecure respondents (B=-11.5; 95%CI [−13.21, −9.78]; p<0.001). Marginally food insecure respondents had significantly lower vegetable sub-scale scores, moderately food insecure respondents had significantly lower sub-scale scores for all food groups except dairy, severely food insecure respondents had significantly lower scores for all sub-scale scores. Poorer diet quality is evident in adults living with any food insecurity but gets progressively worse as the severity of food insecurity increases. Interventions to reduce food insecurity and increase diet quality are required to prevent adverse nutrition-related health outcomes in food-insecure populations in Australia and beyond.

Dietary patterns among U.S. food insecure cancer survivors and the risk of mortality: NHANES 1999–2018

PurposeFood insecurity—the lack of unabated access to nutritious foods—is a consequence many cancer survivors face. Food insecurity is associated with adverse health outcomes and lower diet quality in the general public. The goal of this analysis was to extract major and prevailing dietary patterns among food insecure cancer survivors from observed 24-h recall data and evaluate their relationship to survival after a cancer diagnosis.MethodsWe implemented two dietary patterns analysis approaches: penalized logistic regression and principal components analysis. Using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) study, we extracted three dietary patterns. Additionally, we evaluated the HEI-2015 for comparison. Cox proportional hazards models assessed the relationship between the diet quality indices and survival after a cancer diagnosis.ResultsThere were 981 deaths from all causes and 343 cancer-related deaths. After multivariable adjustment, we found higher risks of all-cause mortality associated with higher adherence to Pattern #1 (HR 1.25; 95% CI 1.09–1.43) and Pattern #2 (HR 1.15; 95% CI 1.01–1.31) among cancer survivors.ConclusionAmong all cancer survivors, higher adherence to major and prevailing dietary patterns from the U.S. food insecure cancer survivor population may lead to worse survival outcomes.

Fighting Classroom Hunger : Analysis of Mid-day Meal Scheme of Odisha

India State Hunger Index (ISHI) reported that, “India is home to the world’s largest food insecure population, with more than 200 million people who are hungry.” Adding to this, the report urged that, the country’s poor performance is driven by its high levels of child under-nutrition and poor calorie count. Education plays a vital role in the development of human potential. State Governments are spending considerable portion of their resources to provide educational facilities all over the country. In spite of these efforts, the goal of cent percent universalization of elementary education appears to be far and elusive due to inherent socio-economic factors present in the society. Free and compulsory education up to the age of 14 years is the constitutional commitment and it is estimated that primary school children (6-14 years) form about 20% of the total population. Poor school enrolment and high school dropout rate are attributed to the poor nutritional status of the children compounded by poor socio-economic condition, child labour and lack of motivation. The researchers have used empirical research to find the real gap in the system.

Associations between a cash voucher intervention, food consumption, and coping strategies in Somali food-insecure populations

BackgroundThis cross-sectional study aimed to explore the association between cash voucher assistance on building community resiliency and improving food security among 1371 households (HH) living in northern and southern regions of Somalia. The secondary data analysis used endline data from participants in World Vision’s Emergency Food Security Program from May 2018 to May 2019. The participants received unconditional cash vouchers, conditional cash for work vouchers, and nutrition and livelihood trainings. Logistic regression analysis was conducted to explore the association between program interventions and food consumption score (FCS, borderline/poor: 0–35, acceptable: > 35) and reduced coping strategy index (rCSI, acceptable: 0–3, emergency/crisis: 4–56).ResultsA total of 41.5% of all HH that received cash vouchers reported borderline/poor FCS and 71.1% had emergency/crisis rCSI. Utilization of vouchers for food purchase (0.34; 0.23, 0.51) and purchase of more types of food for greater dietary diversity (0.70; 0.55, 0.89) were negatively associated with acceptable FCS. Participants who redeemed cash vouchers were less likely to have an emergency/crisis rCSI (0.68; 0.61, 0.76). Utilization of cash vouchers had a positive association with increased conflict within the HH (2.90; 1.29, 6.48). Participants reporting benefits from improved community rehabilitation through increased check dams were more likely to have acceptable rCSI (2.37; 1.45, 3.89).ConclusionsOur findings suggest that interventions utilizing cash vouchers have to consider contextual factors in calculations of voucher entitlements, increase investment in water management and livelihood skills training, and expand nutrition and livelihood trainings to men and boys to foster women empowerment and improve food security outcomes.

Accounting for the evolution of sedentarism on minimum dietary energy requirements

Estimates of food-insecure populations are biased upwards, lacking adjustment for global increases in sedentary behavior in recent decades. We construct a household model to account for sedentary choices during leisure and work time decisions. The model rationalizes increasing sedentary behavior from the household by accounting for increasing returns to cognitive human capital vs physical capital, alongside increased productivity of more sedentary activities both at work and at home. The household model informs an empirical model applied to our unique international pseudo-panel data on sitting time, proxy-ing for sedentarism. We econometrically estimate a transfer function linking sedentarism to widely available covariates and make out-of-sample predictions. It is applicable to most countries. The estimated sedentary time can be used to adjust the physical activity level reflected in the minimum dietary energy requirement used to determine a cutoff for food insecurity.

Increasing food insecurity severity is associated with lower diet quality.

Food insecurity may reduce diet quality, but the relationship between food insecurity severity and diet quality is under-researched. This study aimed to examine the relationship between diet quality and severity of household food insecurity. A cross-sectional, online survey used the United States Department of Agriculture Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately or severely food insecure. The Australian Recommended Food Score (ARFS; scored 0–73) determined diet quality (ARFS total and sub-scale scores). Survey-weighted linear regression (adjusted for age, sex, income, education, location and household composition) was conducted. Tasmania, Australia. Community-dwelling adults (aged 18 years and over). The mean ARFS total for the sample (n 804, 53 % female, 29 % aged > 65 years) was 32·4 (sd = 9·8). As the severity of household food insecurity increased, ARFS total decreased. Marginally food-insecure respondents reported a mean ARFS score three points lower than food-secure adults (B = –2·7; 95 % CI (–5·11, –0·34); P = 0·03) and reduced by six points for moderately (B = –5·6; 95 % CI (–7·26, –3·90); P < 0·001) and twelve points for severely food-insecure respondents (B = –11·5; 95 % CI (–13·21, –9·78); P < 0·001). Marginally food-insecure respondents had significantly lower vegetable sub-scale scores, moderately food-insecure respondents had significantly lower sub-scale scores for all food groups except dairy and severely food-insecure respondents had significantly lower scores for all sub-scale scores. Poorer diet quality is evident in marginally, moderately and severely food-insecure adults. Interventions to reduce food insecurity and increase diet quality are required to prevent poorer nutrition-related health outcomes in food-insecure populations in Australia.

Enhancing Rice Yield in Paddy Fields Through Beneficial Organisms

In recent years, the global food-insecure population has increase. To improve food production while safeguarding the environment, ecological intensification techniques have become crucial. Considering rice's significance in feeding half the world, here we focused on the role of weeds, birds, and dragonflies, organisms that naturally occur in crop fields, in a paddy field in Brazil. We observed no significant differences in rice production between areas with or without a second weeding. However, access restriction experiments revealed that the presence of birds and dragonflies led to a remarkable 37% increase in rice yield, equivalent to approximately 71.6 additional bags per hectare. Results reinforce that promoting biodiversity-friendly practices in agriculture is essential for sustainable farming and aligns with global biodiversity initiatives, including COP 15, the 43rd Conference of FAO, and the Sustainable Rice Platform's Standard for Sustainable Rice Cultivation. Emphasizing these practices will not only enhance food production but also contribute to a healthier environment for generations to come.

Sustainable Development Goals and The Role of Food Banks in Fighting Hunger and Food Waste in the State of Paraná-Brazil

Objective: This article aims to analyze how food banks in the state of Paraná, Brazil, contribute to meeting the Sustainable Development Goals (SDGs). Theoretical framework: Reducing food waste is essential for reducing environmental, social and economic impacts and contributes directly to achieving SDGs 2 and 12. Food banks make a significant contribution to directing food that has no commercial value, but is suitable for human consumption, to the food and nutrition insecure population. Method: The methods used were descriptive, bibliographical and a multiple case study, with semi-structured interviews with food bank managers. Results and conclusion: The results show that SDGs 2 and 12 have been directly met. Specifically, in relation to targets 2.1 and 2.2, the practices seek to allocate food to people who are food and nutrition insecure (children, the elderly, hospitals and care homes). As for meeting target 12.3, there is a very intense movement by food banks to combat food waste, in order to increase food collection from donors, raise awareness among the population about the problems of food waste, support family farming with food purchases and, internally, develop minimum processing practices for food at an advanced stage of ripeness. Research implications: This study contributes by demonstrating the practices developed by food banks that come closer to the SDGs and favor the development of a fairer and more sustainable society. Originality/value: This study proposed bringing SDGs 2 and 12 closer to the role played by food banks, adding value to scientific knowledge.

Balancing on the redline: a qualitative study of the experiences purchasing sugar-sweetened beverages among Indigenous adults in a Canadian urban neighbourhood

ObjectiveGrowing evidence suggests that inner-city residents actively navigate their food landscape to meet a wide range of socio-economic needs. Given the increasing focus of health policies on sugar-sweetened beverages (SSB) through price-based strategies, it is critical to understand purchasing habits of populations with higher SSB intake. This study examined urban Indigenous adults’ SSB shopping behaviour and experiences.MethodsWe conducted a community-based participatory research study using semi-structured interviews with a purposive sample of Indigenous adults (≥ 18 years old) from the North End neighbourhood of Winnipeg. Interviews were audio recorded, transcribed verbatim, and thematically analyzed.ResultsAll 20 participants (women = 10; men = 8; two-spirit = 2) consumed SSB on a regular, daily basis either at the time of the interview or at a prior period in their lives. Themes defining residents’ SSB shopping behaviour and experiences of shopping for SSB included balancing on the redline, specifically (1) balancing SSB purchasing constraints and facilitators with savvy shopping approaches and (2) balancing (stereo)typical reactions with resilient coping approaches. Residents procured SSB in various stores within and beyond the boundaries of the North End neighbourhood. SSB is a considerable, reoccurring expense, requiring savvy price-shopping strategies in order to access. Indigenous adults experience judgement and stereotyping when purchasing SSB, including intersecting racial, class, and weight stigma.ConclusionPurchasing SSB is perceived as a source of judgement when outside of inner-city neighbourhoods. Policymakers should consider how policies directed at SSB, which are consumed by Indigenous and food-insecure populations in greater quantities, may magnify existing racial, class, and weight-based discrimination.

A global long-term daily reanalysis of reference evapotranspiration for drought and food-security monitoring

NOAA has developed a global reference evapotranspiration (ET0) reanalysis using the UN Food and Agriculture Organization formulation (FAO-56) of the Penman-Monteith equation forced by MERRA phase 2 (MERRA2) meteorological and radiative drivers. The NOAA ET0 reanalysis is provided daily from January 1, 1980 to the near-present at a resolution of 0.5° latitude × 0.625° longitude. The reanalysis is verified against station data across southern Africa, a region presenting both significant challenges regarding hydroclimatic variability and observational quantity and quality and significant potential benefits to food-insecure populations. These data are generated from observations from the Southern African Science Service Centre for Climate Change and Adaptive Land Management (SASSCAL) network. We further verified globally against spatially distributed ET0 derived from two reanalyses–the Global Data Assimilation System (GDAS) and Princeton Global Forcing (PGF)–and these verifications produced similar results, yet demonstrated wide regional and seasonal differences. We also present cases that verify the operational applicability of the reanalysis in long-established drought, famine, crop- and pastoral-stress metrics, and in predictability assessments of drought forecasts.

The politics of agricultural policy and nutrition: A case study of Malawi's Farm Input Subsidy Programme (FISP).

The concept of food and nutrition policy has broadened from simply being an aspect of health policy, to policy interventions from across a wide range of sectors, but still with potentially important impact on nutritional outcomes. This wider and more complex conceptualisation involves policy with multiple objectives and stakeholder influences. Thus, it becomes particularly important to understand the dynamics of these policy processes, including policy design and implementation. To add to this literature, we apply the Kaleidoscope Model for understanding policy change in developing country contexts to the case-study of an agricultural input subsidy (AIS) programme in Malawi, the Farm Input Subsidy Programme (FISP), exploring the dynamics of the FISP policy process including nutritional impact. Over a three-month period between 2017 and 2019 we conducted in-depth interviews with key stakeholders at national and district levels, and focus groups with people from rural districts in Malawi. We also undertook a review of literature relating to the political economy of the FISP. We analysed the data thematically, as per the domains of the Kaleidoscope Model. The analysis across the FISP policy process including policy design and implementation highlights how stakeholders' ideas, interests and influence have shaped the evolution of FISP policy including constraints to policy improvement-and the nutritional impacts of this. This approach extends the literature on the tensions, contradictions and challenges in food and nutrition policy by examining the reasons that these occur in Malawi with the FISP. We also add to the political science and policy analysis literature on policy implementation, extending the concept of veto players to include those targeted by the policy. The findings are important for consideration by policymakers and other stakeholders seeking to address malnutrition in rural, food-insecure populations in Malawi and other low-income settings.

Food Insecurity, telomere length and the potential modifying effects of social support in National Health and Nutrition Examination Survey.

Telomere length (TL) is a posited pathway through which chronic stress results in biological dysregulation and subsequent adverse health outcomes. Food insecurity is associated with shorter TL. Social support, which is defined by the size and function of an individual's social network, is associated with better health outcomes. The present study assesses whether social support modifies the relationship between food security and TL. Cross-sectional study design. Linear regression was used to assess the association between food insecurity and TL, stratified by social support level. A multiplicative interacted model was used to formally test modification. Data come from the National Health and Nutrition Examination Survey 1999-2000 and 2001-2002 waves. Adults aged 60 years and older who have measurements for TL. Our sample comprised 2674 participants, and 63·5 % of the total sample had low social support, with 13·3 % being food insecure. In fully adjusted models, food insecurity was negatively though modestly associated (P = 0·13) with TL. Associations between food insecurity and TL were significantly modified by social support (interaction P = 0·026), whereby food insecurity had a stronger effect among individuals with high social support (coefficient = -0·099 (95 % CI: -0·161, -0·038)) compared to low social support (coefficient = -0·001, (95 % CI: -0·033, 0·032)). Food insecurity is modestly associated with shorter TL. Contrary to our hypothesis, food insecurity had more deleterious effects on TL among participants with high social support than low social support. Results may indicate that the food insecure population is a higher needs population, and increased social support reflects these needs rather than providing protective effects.

Food Insecurity in the Elective Enhanced Recovery After Surgery Colorectal Surgical Population: Prevalence and Implications for Surgical Outcomes.

Food insecurity is defined as having limited or uncertain availability of nutritionally adequate food. Approximately 10.5% of U.S. households are food-insecure. Our study aimed to determine the prevalence and postoperative implications of food insecurity in a diverse group of colorectal surgery patients admitted to a hospital in an area with a higher-than-average median income. The 6-question Household Food Security Survey was added to the colorectal surgery ERAS program preoperative paperwork. Patient demographics, comorbidities, operative parameters, length of stay, and postoperative outcomes were collected by review of electronic medical records. A total of 294 ERAS patients (88.8%) completed the survey over an 11-month period. Thirty-three patients (11.2%) were identified as food-insecure. Food-insecure patients were more likely to be non-white (P = .003), younger (P = .009), smokers (P = .004), chronic narcotic users (P < .001), unmarried (P = .007), and have more comorbidities (P = .004). The food-insecure population had more frequent postoperative ileus (P = .044). Hospital length of stay was significantly longer in food-insecure patients (8.6days vs 5.4days, P < .001). Food-insecure patients also had higher rates of >30-day mortality (P = .049). Food insecurity was found to occur in patients that lived in communities deemed both affluent and distressed. These patients had longer hospital stays and higher mortality. A food insecurity questionnaire can easily identify patients at risk. Further investigations to mitigate these complications are warranted.

The Association between Food Security Status and the Home Food Environment among a Sample of Rural South Carolina Residents.

Prior research suggests that food security status may have an effect on the home food environment. Further, the literature suggests that food access factors may function to influence said relationship. The purpose of this research is to fill a gap in the literature on this relationship, as well as to identify potential food access effect modifiers. This research employs linear mixed effects modeling with a random intercept variable (zip codes). Eleven food access variables are included in regression analyses and are tested as potential effect modifiers in the association between food security status and the home food environment. Food security status is significantly associated with the home food environment (95% CI = 0.1-1.38) in the unadjusted model. In the adjusted model, food pantry usage is found to be a significant effect modifier on the association between food security status and the home food environment. This research concludes that food security status has a significant but disparate effect on the home food environment depending on participant food pantry usage. Practical implications from this research would be for relevant stakeholders to potentially improve rural food pantry access in order to increase the home food environment among rural and food insecure populations.

Dietary Strategies for Complementary Feeding between 6 and 24 Months of Age: The Evidence.

Suboptimal complementary feeding practices remain highly prevent. This review aims to comprehensively synthesize new emerging evidence on a set of topics related to the selection and consumption of complementary foods. We synthesized evidence related to five key topics focused on nutritional interventions that target the complementary feeding period, based on four systematic reviews that include updated evidence to February 2022. While there have been many studies examining interventions during the complementary feeding period, there is an overall lack of relevant information through which to draw conclusions on the ideal feeding schedule by food type. Similarly, few studies have examined the effects of animal milk versus infant formula for non-breastfed infants (6-11 months), though those that did found a greater risk of anemia among infants who were provided cow's milk. This review highlights a number of interventions that are successful at improving micronutrient status and anthropometry during the complementary feeding period, including fortified blended foods, locally and commercially produced supplementary foods, and small-quantity lipid-based nutrient supplements. Complementary feeding education for caregivers can also be used to improve nutrition outcomes among infants in both food secure and insecure populations.