Food-insecure Women Research Articles

Food Insecurity and Cardiometabolic Risk among Turkish Adults: A Cross-Sectional Study

This study examined 175 volunteers aged 18‒64 to explore the connection between food insecurity and anthropometric measurements, diet quality scores and cardiometabolic risk factors. The design of the study is cross-sectional, and the data were obtained using a number of questionnaires applied to individuals who visited the diet clinic. Participants' diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015) and food security was evaluated using the Household Food Insecurity Access Scale. Cardiometabolic risk factors were determined based on HEI-2015 scores, Body Mass Index (BMI), waist circumference, waist/height ratio, physician-diagnosed diabetes, hypertension, dyslipidemia, regular physical activity status, and smoking habits. As a result of the study, 41.1% of the participants were found to be food-insecure, and 77.8% had diet quality that needed improvement. The average BMI value of food-insecure women was found to be higher than that of food-secure women (32.37±7.77 kg/m2 and 29.86±5.22 kg/m2, respectively) (p=0.003). Furthermore, food-insecure women had a higher average waist circumference (p=0.001). A significant negative relationship was determined between BMI value, waist circumference and waist/height ratio, which are among the cardiometabolic risk factors, and food insecurity.

Antenatal healthcare providers' knowledge, attitudes and practices regarding food insecurity in pregnancy: A qualitative investigation based at a specialist antenatal hospital in Melbourne, Australia.

Food insecurity exists when accessibility and availability of nutritious food is restricted, increasing the risk of adverse health outcomes. Pregnant women are especially vulnerable to food insecurity, which is concerning as optimal nutrition to support both their own health and the health and growth of their unborn child is critical. Antenatal healthcare providers (AHPs) are central to provision of pregnancy care. We aimed to assess AHPs' knowledge, attitudes and management of food insecurity. Semi-structured interviews were conducted face-to-face, via telephone or online via Webex with 16 AHPs at the Royal Women's Hospital located in Melbourne, Australia. Interviews were thematically analysed according to Charmaz's constructivist grounded theory approach to ascertain AHPs' knowledge, attitudes and practices regarding food insecurity during pregnancy. AHPs had limited knowledge and awareness of food insecurity in pregnancy. Lack of experience in managing food insecurity and time constraints limit their capacity to support and deliver care to food-insecure women. There was a reported lack of structure and clarity surrounding referral pathways for effective management of food insecurity during pregnancy, as well as a lack of clarity regarding practitioner responsibility in managing this issue. Current assessment and management of food insecurity during pregnancy in the antenatal setting is suboptimal. Professional development strategies targeted to AHPs are urgently needed to assist optimal care of women who are food insecure during pregnancy to assist with supporting best maternal and child health.

Associations between cooking self-efficacy, attitude, and behaviors among people living alone: A cross-sectional survey analysis

Cooking-related literacy and attitudes may play important roles in preventing and reducing diet-related chronic diseases and nutrition disparities. People living alone are an under-researched but growing population who face above average food insecurity rates. This study's objectives were to 1) test how cooking self-efficacy and attitude are stratified demographically among a sample of people living alone, focusing on variations across gender, age, and food security, and 2) examine how cooking self-efficacy and attitude are associated with two indicators of cooking behavior – cooking frequency and convenience orientation. We draw from a cross-sectional survey analysis of 493 adults living alone in Illinois, USA with validated measures for cooking self-efficacy, attitude, frequency, convenience orientation, and demographic characteristics. Hierarchical linear regression models were used to examine demographic factors explaining variation in self-efficacy and attitude, with attention to interactions between gender, food insecurity, and age. Poisson and OLS linear regression models were used to examine associations between self-efficacy and attitude and cooking frequency and convenience orientation. We find cooking-related self-efficacy and attitude showed strong but distinct associations with cooking frequency and convenience orientation. Overall, food insecure groups had lower self-efficacy than those who were food secure; however, food insecure women had higher self-efficacy than men in similar positions, apart from older-adult women who held particularly low efficacy. Cooking attitudes varied in small ways, notably with food insecure younger and older women possessing more negative cooking attitudes than middle-aged women. This research highlights the importance of understanding the cooking-related orientations of single-living people, while demonstrating that this group's ability to prevent and manage food insecurity is not uniform. These results can inform targeted interventions around food and nutrition insecurity, cooking attitudes, and self-efficacy among single-living populations.

Cash Transfer versus Staple Food Subsidies: An Effective Factor on Food Security and Expenditure of Urban Households in Iran

Background: In 2010, food subsidy program implemented since 1979 was replaced by unconditional cash transfer (CT) in Iran. The present pre-and-post evaluation study aims to compare food security and expenditures of urban households during the implementation of food subsidy and CT programs.
 Methods: Using a stratified cluster sampling method, 266 households were selected from Tehran city. Data were collected in two phases: before (2009) and after (2012) implementing CT program using questionnaires including demographics; household expenditure; locally validated Household Food Insecurity Access Scale (HFIAS); and three consecutive 24-hours diet recalls. Seven focus group discussions (FGDs) with women were also held.
 Results: After implementing CT program, the households' food and total expenditures increased and their family size decreased. Mild, moderate, and severe food insecurity increased from 19.3%, 13.3%, and 11% to 28.4%, 15.5%, and 12.5%, respectively (P<0.001). There was a significant decrease in consumption of fat and oils and sugary food groups (time effect P<0.05). The consumption of fruits, meat, and dairy products was lower in the food insecure women than in the food secure ones (group effect P<0.05). However, the food secure and insecure households behaved differently in terms of only sugar consumption (time group effect P<0.05). Based on the FGDs, relative deprivation and social gaps increased.
 Conclusion: Considering the reduction in welfare index, targeting poor/vulnerable groups, as well as conditional CT could be considered in Iran.

Intimate partner violence, food insecurity and COVID-19 among newly married women in Nawalparasi district of Nepal: a longitudinal study

This paper examines factors associated with intimate partner violence (IPV) among newly married women in Nepal, and how IPV was affected by food insecurity and COVID-19. Given evidence that food insecurity is associated with IPV and COVID-19, we explored whether increased food insecurity during COVID-19 is associated with changes in IPV. We used data from a cohort study of 200 newly married women aged 18–25 years, interviewed five times over two years at 6-month intervals (02/2018-07/2020), including after COVID-19-associated lockdowns. Bivariate analysis and mixed-effects logistic regression models were used to examine the association between selected risk factors and recent IPV. IPV increased from 24.5% at baseline to 49.2% before COVID-19 and to 80.4% after COVID-19. After adjusting for covariates, we find that both COVID-19 (OR = 2.93, 95% CI 1.07–8.02) and food insecurity (OR = 7.12, 95% CI 4.04–12.56) are associated with increased odds of IPV, and IPV increased more for food-insecure women post COVID-19 (compared to non-food insecure), but this was not statistically significant (confidence interval 0.76–8.69, p-value = 0.131). Young, newly married women experience high rates of IPV that increase with time in marriage, and COVID-19 has exacerbated this, especially for food-insecure women in the present sample. Along with enforcement of laws against IPV, our results suggest that special attention needs to be paid to women during a crisis time like the current COVID-19 pandemic, especially those who experience other household stressors.

Exploring differences in disordered eating and related appetitive traits among women based on childhood and current food security status

Despite emerging evidence that food insecurity (FI) is associated with elevated rates of eating pathology, little is known about the lasting impact of FI on eating behaviors. Studies that have explored the association between FI during childhood and eating behavior in adulthood have not accounted for current FI. The present study explored differences in disordered eating (DE) and related appetitive traits among four groups of cisgender female mothers: individuals who (1) endorsed childhood FI only (n = 96), (2) endorsed current FI only (n = 134), (3) endorsed both childhood and current FI (n = 257), and (4) denied both childhood and current FI (n = 146). Participants responded to online questionnaires including items from the USDA Household Food Security Survey Module, the 7-item Eating Disorder Examination-Questionnaire, the Eating Disorder Diagnostic Scale, and the Adult Eating Behavior Questionnaire. Adjusting for age and race/ethnicity, ANCOVAs explored mean differences between groups in DE and appetitive traits, and a modified Poisson regression model examined differences in binge-eating prevalence across the four FI groups. The “current FI only” group consistently endorsed the highest levels of DE and related appetitive traits followed by the “current and childhood FI” group, suggesting newly food-insecure women may be at highest risk for DE. Interestingly, across almost all constructs, the “childhood FI only” group did not differ significantly from the “no FI” group. These findings suggest that improved access to food may help offset risk for adult DE related to experiences of FI in childhood.

Pooled analysis of the association between food insecurity and violence against women: Evidence from low- and middle-income settings.

Intimate partner violence impacts relationships across the socioeconomic spectrum, nonetheless its prevalence is reported to be highest in areas that are most socio-economically deprived. Poverty has direct and indirect impacts on intimate partner violence (IPV) risk, however, one of the postulated pathways is through food insecurity. The aim of this paper is to describe the association between food insecurity (household hunger) and women's experiences, and men's perpetration, of intimate partner violence and non-partner sexual violence in data from Africa and Asia. We conducted a pooled analysis of data from baseline interviews with men and women participating in six Violence Against Women prevention intervention evaluations and present a meta-analysis using mixed-effects Poisson regression models. Data were from South Africa (two studies), Ghana, Rwanda (two data sets), and Afghanistan and comprised interviews with 6545 adult women and 8104 adult men. We assessed food insecurity with the Household Hunger Scale. Overall, 27.9% of women experienced moderate food insecurity (range from 11.1% to 44.4%), while 28.8% of women reported severe food insecurity (range from 7.1 to 54.7%). Overall food insecurity was associated with an increased likelihood of women experiencing physical intimate partner violence, adjusted incidence rate ratio (aIRR) = 1.40 (95% CI = 1.23 to 1.60) for moderate food insecurity and aIRR = 1.73 (95% CI = 1.41 to 2.12) for severe food insecurity. It was also associated with an increased likelihood of men reporting perpetration of physical IPV, with aIRR = 1.24 (95% CI = 1.11 to 1.39) for moderate food insecurity and aIRR = 1.18 (95% CI = 1.02 to 1.37) for severe food insecurity. Food insecurity was not significantly associated with women's experience of non-partner sexual violence, aIRR = 1.27 (95% CI = 0.93 to 1.74) for moderate or severe food insecurity vs none, nor men's perpetration of non-partner sexual violence aIRR = 1.02 (95% CI = 0.90 to 1.15). Food insecurity is associated with increased physical intimate partner violence perpetration and experience reported by men and women. It was not associated with non-partner sexual violence perpetration, although there was some evidence to suggest an elevated risk of non-partner sexual violence among food-insecure women. Prevention programming needs to embrace food insecurity as a driver of intimate partner violence perpetration, however, non-partner sexual violence prevention needs to be shaped around a separate understanding of its drivers.

Food security status and breast cancer screening among women in the United States: Evidence from the Health and Retirement Study and Health Care and Nutrition Study

To assess the impact of food insecurity on biennial breast cancer screenings (i.e., mammography or breast X-ray) among older women in the United States (US). Data from the 2014 and 2016 waves of the Health and Retirement Study and the 2013 Health Care and Nutrition Study were used. The analyses were limited to a nationally representative sample of 2,861 women between 50 and 74years of age, residing in the US. We employed a propensity score weighting method to balance observed confounders between food-secure and food-insecure women and fit a binary logistic regression to investigate population-level estimates for the association between food security and breast cancer screening. Food insecurity was significantly associated with failure to obtain a mammogram or breast X-ray within the past two years. Food-insecure women had 54% lower odds of reporting breast cancer screening in the past 2years (adjusted OR = 0.46; 95% CI 0.30-0.70, p-value < 0.001) as compared to food-secure women. Additional factors associated with a higher likelihood of receiving breast cancer screenings included greater educational attainment, higher household income, regular access to health care/advice, not smoking, and not being physically disabled or experiencing depressive symptoms. Results demonstrate a socioeconomic gradient existing in regard to the utilization of regular breast cancer screenings among women. Those who tend to have lower education, lower income, and lack of reliable healthcare access are more likely to be food insecure. Thus, more likely to face the financial, logistical, or environmental barriers in obtaining screening services that accompany food insecurity.

The relationship between fecal incontinence and food insecurity in United States women: an analysis of 2005–2010 National Health and Nutrition Examination Survey

Fecal incontinence is a prevalent debilitating pelvic floor disorder characterized by the involuntary loss of stool. Fecal incontinence is known to be associated with constipation and loose stool, advancing age, chronic comorbidities, and prior anorectal trauma, among other biologic risk factors. The relationship between social determinants of health, such as food insecurity, and fecal incontinence is not well-elucidated. We aimed to investigate the association between fecal incontinence and food insecurity using a nationally representative sample of US adult women. Our secondary aim was to examine the role of diet by assessing dietary differences between participants with versus without fecal incontinence and between food insecure women with and without fecal incontinence. We analyzed data from the National Health and Nutrition Examination Survey, a nationally representative series of cross-sectional health surveys. Fecal incontinence was defined as accidental leakage of stool within the last 30 days. Food insecurity was assessed using the household food security measure created by the US Department of Agriculture. Dietary data from NHANES dietary interviews titled "Individual Foods, First Day" and "Individual Foods, Second Day," which estimates the foods and drinks consumed in the preceding 24 hours, were pooled. The association between fecal incontinence and food insecurity was analyzed using logistic regression after controlling for patient characteristics. A total of 3,216 women were included, representing nearly 130 million US women. Of these, 10.9% had fecal incontinence. There were no significant differences in diet between women with and without fecal incontinence. Food insecure women in the overall sample reported higher carbohydrate and sugar intake and lower fiber and alcohol intake (all p<0.05). Amongst food insecure women, those with fecal incontinence had higher calorie and total fats intake than those without fecal incontinence; there were no significant differences in other dietary components. There was a significant association between food insecurity and fecal incontinence, such that women with food insecurity had higher odds of fecal incontinence after adjusting for patient characteristics and diet (OR 1.76; 95% CI=1.17-2.66; p=0.008). Food insecurity is associated with fecal incontinence even after accounting for diet. Understanding the role of social determinants of health in fecal incontinence symptomatology and treatment is important to potentially alleviate symptom burden and improve quality of life in at-risk populations.

Food insecure women's experiences of their nutritional health and wellbeing in Europe: a qualitative systematic review and meta-ethnography

BackgroundFood insecurity has increased since the 2008 global financial crisis. Particularly vulnerable are mothers with young children, pregnant women, and lone parents (the majority of whom are women). This systematic review and meta-ethnography of qualitative studies aimed to explore women's experiences of food insecurity and how it affects their nutritional health and wellbeing. MethodsSix electronic databases were searched from Jan 1, 2008, to July 10, 2021, with no language restrictions. Search terms included “food insecurity”, “women”, and “nutrition”. This search was supplemented by grey literature, reference list, and citation searches. Screening was done in duplicate. Following title and abstract screening, full texts were screened against the inclusion criteria (ie, qualitative research, focus on women of childbearing age, pregnancy nutritional health or wellbeing, data from 2008 onwards, and high-income European countries). We adhered to PRISMA and eMERGe guidelines for meta-ethnographic reporting. Methodological quality was assessed using the CASP qualitative checklist. Data were synthesised according to Noblit and Hare's seven phases of meta-ethnography. FindingsWe identified 11 589 unique records; 23 publications reporting data from 22 unique studies were included, comprising 647 women. We identified two key themes: accessing sufficient food and embodying food insecurity, comprising eight subthemes. Our meta-ethnography provides a progressive storyline of women's experiences of food insecurity. This storyline includes how women attempt to access sufficient food, they are unable to meet their nutritional needs, how this is embedded into their everyday lives, and embodied in unhealthful physical, social, and mental nutritional health and wellbeing. InterpretationThis meta-ethnography concludes a need for greater recognition of the psychosocial impact of food insecurity on vulnerable women, in addition to the impact on their nutritional health and wellbeing. The review demonstrates a lack of change over time, qualitatively for women's experiences. A strength and limitation of this review is the range of studies from different European contexts, where contextual factors could affect the experiences of women. FundingThe Economic and Social Research Council.

Associations Between Mobility, Food Insecurity, and Transactional Sex Among Women in Cohabitating Partnerships: An Analysis From 6 African Countries 2016-2017.

Mobile women are at risk of HIV infection in sub-Saharan Africa, although we lack evidence for HIV risk among women in mobile partnerships, especially in the context of household food insecurity, a growing concern in the region. Women aged 15-59 years with a cohabitating male partner who participated in population-based HIV impact assessment surveys in Eswatini, Lesotho, Namibia, Tanzania, Uganda, and Zambia. We evaluated the association between women's and their partner's mobility (being away from home for more than 1 month or staying elsewhere) and transactional sex (selling sex or receiving money or goods in exchange for sex). We examined associations for effect measure modification by food insecurity level in the household in the past month. We used survey-weighted logistic regression, pooled and by country, adjusting for individual, partner, and household-level variables. Among women with a cohabitating male partner, 8.0% reported transactional sex, ranging from 2.7% in Lesotho to 13.4% in Uganda. Women's mobility [aOR 1.35 (95% CI: 1.08 to 1.68)], but not their partner's mobility [aOR 0.91 (0.74-1.12)], was associated with transactional sex. Food insecurity was associated with transactional sex independent of mobility [aOR 1.29 (1.10-1.52)]. Among those who were food insecure, mobility was not associated with increased odds of transactional sex. Food insecurity and women's mobility each increased the odds of transactional sex. Because transactional sex is associated with HIV risk, prevention programs can address the needs of mobile and food-insecure women, including those in cohabitating relationships.

Gender Differences in the Relationship Between Food Insecurity and Body Mass Index Among Adults in the USA.

In the USA, nearly 40% of adults ≥ 20 years have a body mass index (BMI) ≥ 30, and 11% of households are reported as food insecure. In adults, evidence shows women are more likely than men to be food insecure. Among adults with food insecurity, differences in BMI exist between men and women with women reporting higher BMI. Factors associated with this difference in BMI between genders are less understood. The aim of this study was to assess gender differences in the relationship between food insecurity and BMI. Hierarchical models were analyzed using a general linear model by entering covariates sequentially in blocks (demographics, lifestyle behaviors, comorbidities, and dietary variables) and stratified by gender. The sample included 25,567 adults in the USA from the National Health and Nutrition Examination Survey (NHANES), 2005-2014. The dependent variable was BMI, and food insecurity was the primary predictor. Approximately 51% of the sample was women. Food insecure women were significantly more likely to have higher BMI compared to food secure women in the fully adjusted model after controlling for demographics (β = 1.79; 95% CI 1.17, 2.41); demographic and lifestyle factors (β = 1.79; 95% CI 1.19, 2.38); demographic, lifestyle, and comorbidities (β = 1.21; 95% CI 0.65, 1.77); and demographic, lifestyle, comorbidities, and dietary variables (β = 1.23; 95% CI 0.67, 1.79). There were no significant associations between food insecure and food secure men in the fully adjusted model variables (β = 0.36; 95% CI - 0.26, 0.98). In this sample of adults, food insecurity was significantly associated with higher BMI among women after adjusting for demographics, lifestyle factors, comorbidities, and dietary variables. This difference was not observed among men. More research is necessary to understand this relationship among women.

Gestational Diabetes, Subsequent Type 2 Diabetes, and Food Security Status: National Health and Nutrition Examination Survey, 2007-2018.

IntroductionDespite many studies linking various risk factors to the association between gestational diabetes and subsequent type 2 diabetes, little is known about how food insecurity affects their association. We aimed to assess how the association between gestational diabetes and subsequent type 2 diabetes varies by food security status among women in the US.MethodsThis study is a secondary data analysis of 9,505 US women aged 20 years or older who had at least 1 live birth; we used cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2007 through 2018. The main outcome was a diagnosis of type 2 diabetes in the subsequent years after the first live birth. We used multivariable survey-weighted negative binomial regressions to examine whether the association between gestational diabetes and subsequent type 2 diabetes differed by food security status, with and without adjusting for health behavior factors.ResultsGestational diabetes was significantly associated with subsequent type 2 diabetes (incidence rate ratio [IRR], 2.57; 95% CI, 2.45–2.69). The association between gestational diabetes and subsequent type 2 diabetes was significantly different by food security status (IRR, 2.34; 95% CI, 2.23–2.45 among food-secure women; IRR, 2.99; 95% CI, 2.70–3.28 among food-insecure women).ConclusionThe association between gestational diabetes and subsequent type 2 diabetes differs significantly by food security status. Public health and health care practitioners should consider food security status when designing and implementing diabetes prevention interventions for women with a history of gestational diabetes.

Experiences of Food-Insecure Pregnant Women and Factors Influencing Their Food Choices

IntroductionFood insecurity (FI), an inadequate access to healthy, affordable food, is a public health concern primarily driven by material hardship. Optimal antenatal nutrition promotes best health outcomes for the mother and baby. Pregnant women experiencing FI are less able to access healthy foods, increasing the risk of complications such as gestational diabetes and preterm labour. Little is known about the experiences of food-insecure pregnant women in obtaining sufficient, nutritious food, their perceptions regarding antenatal nutrition and how this contributes to their food choices.MethodsThis qualitative study conducted from August to November 2020, during the COVID-19 pandemic, examined the experiences and coping strategies of food-insecure pregnant women, and the factors influencing their food choices. Seven English-speaking food-insecure pregnant women participated in semi-structured interviews. Interview transcripts were thematically analysed, informed by grounded theory methodology.ResultsThree themes were identified through analysis of the interviews related to strategies that managed household food supply, factors that influenced food choices, and experiences of pregnancy during the COVID-19 pandemic. As a result of a limited food budget, pregnancy symptoms, the cognitive overload that attends the FI experience, and the acute yet significant impact of the pandemic, food-insecure pregnant women in this study defaulted to cheap and convenient food choices despite acknowledging the importance of eating well for pregnancy.ConclusionFI during pregnancy is burdensome, relentless and undermines women’s wellbeing. Supportive strategies within antenatal healthcare settings are urgently required to deliver an equitable health response for vulnerable women.

The prevalence of overweight/obesity and its association with household food insecurity among women living with HIV in rural Eswatini

BackgroundEswatini is currently afflicted by an extremely high prevalence of HIV (27%) and malnutrition (both under-and over-nutrition). While rates of overweight/obesity in the general adult population have been documented, data on overweight/obesity and associated risk factors among women living with HIV (WLHIV) in Eswatini is limited. This study examines the prevalence of overweight/obesity and associated risk factors, with an emphasis on clarifying the association between household food insecurity and overweight/obesity for WLHIV in rural Eswatini.MethodsThis cross-sectional study was conducted among WLHIV (n = 166) in rural communities of Eswatini. Data were collected using an interviewer-administered survey questionnaire between October and November, 2017. Body Mass Index (BMI) was calculated to determine overweight and obesity among study participants. Women with BMI values of 25 kg/m2 or greater were classified as being overweight/obese. Multivariable log-binomial regression models were used to examine associations between household food insecurity and overweight/obesity in our study.ResultsNearly a third (32.5%) of the women in our study were overweight and almost a quarter were obese (22.9%). We found significant associations between household food insecurity and overweight/obesity, with women who experienced household food insecurity the most being 0.38 times less likely to be overweight/obese compared to those who experienced household food insecurity the least (ARR: 0.38, 95% CI: 0.2–0.71). In our study sample, women who perceived themselves as being in poor health were less likely to be overweight/obese compared to those who perceived themselves as being in good health (ARR: 0.58, 95% CI: 0.39–0.86). We found significant associations between overweight/obesity and alcohol use, with the risk of overweight/obesity nearly 1.5 times higher among women who consumed alcohol compared to those who did not (ARR: 1.49, 95% CI: 1.07–2.05).ConclusionsThe high prevalence of overweight/obesity among food insecure women in poverty stricken communities may pose significant challenges for nutritional health and HIV management. With an increasing prevalence of overweight/obesity in food insecure households, there is a need to re-evaluate current strategies and develop multi-level targeted interventions that include prevention of excessive weight gain among women, particularly those living with HIV in rural Eswatini. HIV programs could include screening to identify individuals at risk for overweight/obesity in this population, and provide nutrition education for weight management for those individuals.

Abstract MP04: Food Insecurity And Blood Pressure Control: The Coronary Artery Risk In Young Adults (cardia) Study

Background: Food insecurity (FI), the limited access to healthy and affordable food, is a social determinant of health that hinders blood pressure (BP) control in individuals with hypertension. Cross-sectional studies that examine this relationship do not allow for observations over time. We used longitudinal data on CARDIA Study participants with hypertension to examine the association between FI and BP control over 15 years. Methods: Generalized estimating equations were used to examine the association between FI and BP control across repeated observations on 605 participants with physician diagnosed and self-reported hypertension. Participants had some FI if they endorsed any of the following statements: “We have enough food to eat, but not always the kinds of food we want to eat”; “Sometimes we don’t have enough food to eat”; “Often we don’t have enough food to eat.” We estimated odds ratios (OR) and 95% confidence interval (CI) for control of systolic blood pressure (SBP) &lt;140 mmHg, diastolic blood pressure (DBP) &lt; 90 mmHg and combined measures of SBP and DBP. We calculated sequentially adjusted models and interaction terms based on previous research. Model 1 was adjusted for age, gender, race and field center. Model 2 was additionally adjusted for antihypertensive medication use, maximum education, marital status and household income. Model 3 was additionally adjusted for BMI, physical activity, smoking status and alcohol intake. Results: FI was reported by 21.7% of study participants (N=131). FI was reported in Black participants (N=106), and women (N=89) most. Gender modified the association of FI with BP control, whereby food insecure women were less likely to control BP Table 1. Other interactions were not significant. Conclusions: Food insecure women had more difficulty with BP control than food insecure men. Explanations for the differential influence of FI on men and women should be studied so that targeted interventions can be developed.

Acute and Enduring Effects of Mindful Eating on Delay and Probability Discounting for Food and Money in Food-Insecure Women

Acute and Enduring Effects of Mindful Eating on Delay and Probability Discounting for Food and Money in Food-Insecure Women

Evaluating the Full Plate Living lifestyle intervention in low-income monolingual Latinas with and without food insecurity.

Introduction:Food insecurity has long been associated with poor physical and mental health, especially among women from underrepresented minorities. Despite efforts to reduce food insecurity, rates continue to rise and remain disproportionately high among Latinx living in the United States, a group reporting worse mental health symptoms than any other ethnic group during the COVID-19 pandemic. The need to reduce the health burden associated with food insecurity among Latinas is urgent and requires a more targeted and innovative approach. Interventions using a popular education approach have proven effective among underserved populations, especially when these are delivered by community health workers. However, food insecurity status of the participants is often unreported and it is not clear whether or not results vary between those with and without food insecurity.Objectives:The aim of this quasi-experimental study was to examine physical and mental health changes among Latinas with, and without, food insecurity following a multicomponent health intervention led by community health workers using a popular education approach.Methods:Enrolled obese Latinas (N = 98) with and without food insecurity responded to demographic, health behaviors and mental health surveys and completed biometric measurements at baseline, immediately following the intervention and at 3 months.Results:At baseline, participants with food insecurity reported more anxiety and depression than those without, but average body mass index was comparable. Depression, anxiety and body mass index were lower at 3 months post and no statistically significant differences were seen between the groups. Participants with food insecurity benefited as much from the intervention as those without.We found that, although community health workers are not licensed healthcare professionals, with proper training and support, they were able to successfully reduce the risk of chronic diseases and improve mental health symptoms among food-insecure Latinas.Conclusion:Given the promising results, similar interventions should be implemented on a larger scale in Latino communities among food insecure women. Long-term sustainability should also be explored.

Abstract 12347: Investigating Correlates of Hypertension Among Primarily Hispanic Women

Introduction: Under-recognized risk factors (social, economic, cultural, psychological) may contribute to the development of HTN among Hispanic women that warrant investigation. The purpose of this study was to explore the unique contribution of education, food insecurity, household size, Hispanic ethnicity, marital status, neighborhood crime, BMI, waist circumference (WC), and subjective physical activity on HTN, SBP, and DBP on a sample of primarily Hispanic women. Methods: Female guardians ( N = 227, 69.6% Hispanic, 32.7±8.3 years) of preschoolers completed sociodemographic and health history and behavior questionnaires. BMI, WC, SBP, and DBP were objectively measured per protocol. Participants with SBP ≥130 and/or DBP ≥80, on medication for HTN, or diagnosed with HTN were categorized with HTN. Unadjusted bivariate associations, and multivariate linear regression and logistic regression, adjusted for age, were conducted. Results: A total of 33.2% of women had HTN and 38.9% were food insecure. Mean BMI was 31.2±7.3 kg/m 2 , WC 99.2±17.2 in., SBP 112.1±12.7 mmHg, and DBP 75.0±10.6 mmHg. HTN was significantly associated with food insecurity (χ 2 (1, n = 180) = 4.50, p = .046). Women with HTN had significantly higher BMI (32.8±6.9 vs 30.4±7.5, t (226) = -2.30, p = .023) and WC (103.0±15.3 vs 97.2±17.8, t (228) = -2.41, p = .017) than those without. In adjusted linear regression models, food insecure women had significantly lower SBP ( B =-4.44, p =.028). Single women had higher SBP ( B =4.20, p =.087), but it did not reach significance, and significantly higher DBP ( B =4.90, p =.022) than married women. As WC increased, SBP increased ( B =.228, p =.077), which trended towards significance, and DBP significantly increased ( B =.229, p =.04). In adjusted logistic regression model, women with food insecurity were less likely to have HTN (OR = .35, p =.021) and single women were more likely [OR = 4.19, p =.008] to have HTN than married women. There were no other significant associations ( p s&gt;.05). Conclusion: This sample of primarily Hispanic women with food insecurity had lower risks for HTN, an unexpected finding. Single women had a higher risk for HTN than married women suggesting the need for further exploration surrounding psychosocial impacts of marital status on HTN.

Food Security Status, Coping Strategies, and Health of Women’s Welfare Society Beneficiaries in Jeddah, Saudi Arabia: A Facility-Based Study

ABSTRACT This study assessed the food security status of low-income women in Jeddah, Saudi Arabia in addition to their coping strategies, health, and well-being. A cross-sectional study was conducted on 113 women receiving food assistance from a women’s welfare society. Data were collected using in-person structured interviews. Overall, 50% of the women were food-insecure. Compared with food-secure women, food-insecure women were more likely to utilize many coping strategies. The mean score of coping strategies was significantly greater among food-insecure women, than that of food-secure women (21.0 ± 5.35 and 10.2 ± 5.78, respectively; p < .001). Food-insecure women were also more likely to report poor mental and overall health compared to food-secure women (p = .008 and p < .001, respectively). However, there was no significant difference in life satisfaction between both food security groups (p = .260). Low-income women may use several strategies to cope with food insecurity, which may affect mental and overall health. Further research is needed on the effect of food insecurity on health and well-being of low-income groups in Saudi Arabia. Qualitative data are also needed to better understand the reasons of food insecurity and preventing poor health outcomes among disadvantaged populations in Saudi Arabia.