Food Insecurity Research Articles

Economic growth and food insecurity: evidence via panel estimation

ABSTRACT This study investigates the effect of income changes on the prevalence of undernourishment as a proxy for food insecurity using a balanced panel of 145 economies. Additionally, it examines whether there are heterogeneous effects on undernourishment based on country income strata. Utilizing a panel local projections (LP) model, this study demonstrates that higher-income growth alleviates food insecurity, particularly in lower-income countries. These results underscore the significance of food insecurity within the framework of economic development and offer policymakers vital information on the degree to which economic progress can alleviate it.

Drought Dynamics in Sub-Saharan Africa: Impacts and Adaptation Strategies

The escalation in both frequency and severity of drought events has significantly amplified the vulnerability of numerous countries, particularly in developing ones, imposing substantial economic, environmental, and social pressures. This article presents a systematic review of drought occurrences in Sub-Saharan Africa (SSA), examining historical trends, current impacts, and projected future implications. Through this comprehensive assessment, a clear trend of intensifying drought phenomena emerges across SSA, leading to crop failures, drying of water sources, loss of pasture, food shortages, and an increase in food prices. This review also highlights the concerning potential for worsening conditions in certain regions, resulting in consequences such as migration, food insecurity, malnutrition, family disintegration, crop losses, and increased disease prevalence, notably HIV/AIDS. This study further reveals that current adaptation measures by governments and NGOs should be improved to effectively adapt to the diverse impacts of drought, and it contributes to a deeper understanding of drought dynamics in Sub-Saharan Africa and assesses its critical impacts on food security and social well-being. It also evaluates adaptation measures across different countries, highlighting their strengths and weaknesses and enabling quick identification of areas for improvement. Additionally, it informs resilience-building efforts in vulnerable communities.

North Carolina Academic Health Centers and Social Determinants of Health

Background Academic health centers (AHCs) have traditionally focused on 3 core missions: patient care, research, and education. The current changing health care environment requires AHCs to broaden their focus to improve the health of their communities. This study reports the opportunities and challenges for the 5 North Carolina AHCs addressing social determinants of health (SDOH). Methods We used a mixed methods design. We analyzed financial data from systemwide community benefits reports and the Form 990 Schedule H of the primary medical centers (when available) from the 5 AHCs, and we conducted 4 key informant (KI) interviews at each of the 5 AHCs for a total of 20 interviews. Results Overall, AHCs spend a very small percentage of their total spending on community improvement services and community benefit operations. By far, the largest amount spent on community benefit is for treating patients eligible for charity care. Food insecurity and access to health care were the most addressed SDOH. Housing was viewed as a crisis that needed to be addressed at statewide and national levels. Limitations Community benefits reports from North Carolina AHCs lack important details. Key informant interviews provide far more recent information on the quantity and breadth of initiatives than the latest community benefits reports that were all completed pre-pandemic. We only interviewed 4 stakeholders from each AHC in North Carolina. Conclusion A new strategic vision must incorporate social accountability into the AHCs’ core missions to remove barriers and institute and sustain change, but the AHCs face a steep challenge to incorporate social accountability at a core mission level.

Abstract 4137191: Association of Cost-Related Medication Non-Adherence with Food Insecurity in U.S. Adults with Atherosclerotic Cardiovascular Disease

Background: The association of cost-related medication non-adherence (CRN) with food insecurity (FI) is not well described in those with atherosclerotic cardiovascular disease (ASCVD). Research Questions: Is FI associated with CRN in those with ASCVD, and does enrollment in the Supplemental Nutrition Assistance Program (SNAP) modify this effect? Methods: Data from the National Health Interview Survey (NHIS) 2011-2018 cycles were analyzed. A total of 22,304 adults (weighted: 17.7 million) with ASCVD and available food security, medication adherence and linked mortality data from the National Death Index were included. FI was defined as 3 or more affirmative responses to the USDA food security survey. CRN was identified by an affirmative response to delayed prescription filling, took less medication, or skipped medication doses to save money in the past 12 months. Analyses accounted for the complex survey design to obtain nationally representative estimates. Survey-weighted logistic regression was used to determine predictors of CRN, and Cox regression was used for mortality analyses. Results: Among adults with ASCVD, 13.3% (95% CI 12.7-13.9%; 2.34 million) reported CRN, 15.0% (95% CI 14.3-15.7%; 2.65 million) reported FI, and 5.7% (95% CI 5.3-6.2%; 1.01 million) reported both concomitantly. Those reporting CRN were more likely to be younger, female, non-white, without health insurance, below the federal poverty limit, have lower educational attainment, more comorbidities, and report FI. FI and SNAP enrollment were significantly associated with CRN after multivariable adjustment (adjusted odds ratio [aOR] 4.35 [95% CI 3.74-5.05] and 1.28 [95% CI 1.06-1.55], respectively). A significant interaction was observed between FI and SNAP enrollment (Pint = 0.001), and FI was associated with lower odds of CRN among the SNAP-enrolled versus unenrolled (aOR 2.50 [95% CI 1.98-3.14] vs 5.74 [95% CI 4.82-6.85]) (Figure 1). CRN and food security were not significant predictors of all-cause or cardiovascular mortality in the fully adjusted models. Conclusion: Among adults with ASCVD, FI and SNAP enrollment independently predict CRN. Among adults with ASCVD and FI, more than one third reported CRN and those without SNAP had more than twice the odds of CRN. Greater SNAP enrollment may improve medication adherence in those with ASCVD and FI.

Abstract 4136977: Childhood Food Security and Cardiometabolic Health in Young Adulthood

Background: Food insecurity is associated with adverse cardiometabolic health in adults. To understand the early, long-term impact of food insecurity, we examined the associations of food insecurity in childhood with young adult cardiovascular-kidney-metabolic (CKM) syndrome stage and suboptimal cardiovascular health (CVH), and the modifying effects of participation during childhood in the Supplemental Nutrition Assistance Program (SNAP). Methods: In the Future of Families and Child Wellbeing Study of individuals enrolled at birth (1998-2000) and followed through age 22 years (2020-24) across 20 US cities, the associations of household food insecurity during childhood (age 3-5 years; score ≥1 on the US Household Food Security Survey) with CKM stage (0 [reference], 1, 2, or 3/4) and Life’s Essential 8 CVH score (high 80-100 [reference], intermediate 50-79, low 0-49) at age 22 years were evaluated with adjusted multinomial logistic regression. The interactions of food insecurity and SNAP participation, and food insecurity and race, were evaluated. Results: Among 1,071 participants, 53% were female; 53% non-Hispanic Black, 25% non-Hispanic White, 18% Hispanic; 39% lived in households with food insecurity, and 44% participated in SNAP. Food insecurity was associated with higher odds of being in CKM Stage 1 (aOR 1.41 [95% CI: 1.02-1.93]) and Stage 3/4 (aOR 1.78 [95% CI 1.11-2.83]) compared with Stage 0 at year 22 (Table). Food insecurity was also associated with having intermediate vs. high CVH in young adulthood (aOR 1.46 [95% CI 1.04-2.06]). SNAP participation modified the association of food insecurity and CVH; ffood insecurity was more strongly associated with intermediate vs. high CVH among those who did not participate in SNAP (aOR 2.37 [95% CI 1.39-4.04]) compared to those who were SNAP participants (aOR 0.79 [95% CI 0.46-1.35]) in childhood. There was no significant interaction of food insecurity and race for either outcome. Conclusions: Childhood food insecurity is associated with worse cardiometabolic health in young adulthood, especially among children whose families did not participate in SNAP. Policies to promote food security in children may promote cardiometabolic health across the life course.

Abstract 4147638: Food Security, Depression, and the Association of Depression with Adherence to Cardiovascular Disease Risk Reduction Measures among Rural Caregivers of Patients with Chronic Diseases

Introduction: Caregivers are at high risk of cardiovascular disease (CVD) and depression compared to non-caregivers. Food security has been suggested to be a risk factor for depression. Depression may be connected to poor self-care. Studies exploring food security, depression and its relationship to adherence to CVD risk reduction measures among rural caregivers are lacking. Aims: To determine: 1) the association between food security and depression in rural caregivers, and 2) the relationship between depression and caregiver burden, and reported adherence to recommended CVD risk reduction measures in rural caregivers of patients with chronic diseases. Method: In this cross-sectional study, 277 rural caregivers (mean age 54 ± 14 years; 76% were female; and 70% were married) provided self-reported data on their sociodemographic factors, food insecurity (US Household Food Security Survey Module), caregiver burden (Zarit Burden Interview), depression (Patient Health Questionnaire-9), and adherence to recommended CVD risk reduction measures (Medical Outcomes Study Specific Adherence Scale). Hierarchical regression analysis was performed. Results: In this study, food insecurity and high depressive symptoms were prevalent in 23% and 25% of rural caregivers, respectively. Food insecurity was associated with higher depressive symptoms ( β = 0.21; p <.01), controlling for covariates. Caregivers who reported higher depressive symptoms had higher caregiver burden ( β = 0.49; p <.01) and poor adherence to recommended CVD risk reduction measures ( β = 0.18; p <.01) compared to those with low or no depressive symptoms, controlling for covariates. Conclusion: In rural caregivers, food insecurity was associated with higher depressive symptoms. Depressive symptoms were negatively associated with adherence to recommended CVD risk reduction behaviors. Greater attention should be given to food security and psychosocial factors to reduce CVD risk in this population.

Minimizing postharvest food losses: a vital strategy to alleviate food insecurity and malnutrition in developing nations: a review

Abstract As global food production encounters escalating challenges, postharvest losses (PHLs) emerge as a critical yet often overlooked issue. Despite considerable progress in food production, PHLs remain a significant concern, accounting for an average of 14% of food production in 2021. Against the backdrop of 811 million people facing food insecurity and the triple burden of malnutrition, it becomes increasingly evident that reducing food losses offers a sustainable solution to enhancing global food and nutritional security, particularly in developing countries. This review aims to underscore the significance of PHLs, their impact on global food security, and the current PHL scenario in developing nations. Despite the abundance of innovative technologies developed by researchers, accessibility to these technologies remains limited for farmers in many countries. The ongoing struggle and dire circumstances surrounding proper food handling in developing nations necessitate immediate action. Research efforts must focus on assessing the regional applicability, costs, and economic returns of existing technologies for mitigating PHLs. In addition to capital investments, the long-term sustainability of reducing PHLs hinges on ensuring the effective use of these technologies through education and training. Graphical Abstract

Abstract 4138718: Teen Pregnancy and Risk of Premature Major Adverse Cardiovascular Events

Introduction: Teen pregnancy (TP), defined as pregnancy between 10 and 19 years, is associated with adverse pregnancy outcomes and perpetuates socioeconomic disadvantage, but the impact in later life is not well studied. We investigated the association of TP with premature major adverse cardiovascular events (PMACE) Methods: We used data from the National Health and Nutrition Examination Survey 1999–2018. Surveys were linked with the National Death Index to ascertain mortality records. Only adult females aged 20 years and older were included in the analysis. Participants were divided into 3 groups based on age at their first life birth: 19 or younger (TP), 20 and above (non-TP), and nulliparous women (NP). TP was ascertained by age at first life birth ≤ 19 years, and PMACE was defined as any self-reported diagnosis of coronary artery disease, stroke, heart failure, or all-cause mortality occurring before age 65. We assessed the association between these groups and PMACE using univariate and multivariate logistic regression models. Result: Among 19,737 (weighted frequency of 83,450,668) adult females, 24.2% had a history of TP, 54.3% had a history of non-TP and 21.5% were NP. Compared with NP females, females with TP had a higher odd of PMACE with an unadjusted odd ratio of 3.75 (95%CI, 2.80 - 5.01) versus 2.07 (1.55 – 2.75) among non-TP. Adjusting for age, race, alcohol use, smoking, and social determinants of health factors such as income, educational status, insurance status, and food insecurity, TP remained independently associated with higher odds of PMACE with an adjusted odd ratio of 1.66 (95%CI, 1.19 – 2.30); p=0.003, but this association was not statistically significant among non-TP females with aOR 1.32 (0.95 – 1.84); p=0.10. Conclusion: Teen pregnancy was associated with higher likelihood of PMACE. This association may be indicative of the enduring impact of social determinants of health factors associated with teen pregnancy into adulthood.

Abstract 4132288: Associations Between Health-Related Social Needs and Cardiovascular Health Among US Adults

Background Unfavorable: health-related social needs (HRSNs) have the potential to worsen health and wellbeing and drive health disparities. Its associations with cardiovascular health (CVH), assessed by Life’s Essential 8 (LE8), have not been comprehensively examined among US adults. Research Questions/Hypothesis: Whether unfavorable HRSNs are associated with worse CVH. Goals/Aims: To determine associations between unfavorable HRSNs and CVH in a large, diverse, nationally representative sample of US adults. Methods: We used the National Health and Nutrition Examination Survey 2011–March 2020 data for adults aged ≥20 years. We grouped LE8 scores as low (0–49), moderate (50–79), and high (80–100) CVH. We identified 8 unfavorable HRSNs: unemployed, low family poverty-to-income ratio, food insecurity, less than high school education, no healthcare access, no health insurance, no homeownership, and living alone. We assigned a value of 1 for the unfavorable status of each. The number of unfavorable HRSNs was summed and ranged from 0 to 8, with higher numbers indicating more unfavorable HRSNs. We categorized unfavorable HRSNs as none, 1–2, 3–4, and ≥5. We used multivariable linear and multinomial logistic regression to examine the association between HRSNs and CVH. Results: We included 14 947 participants (n=7340 male [49.3%]; mean [SE] age, 46.4 [0.35] years). Of those, 29.1% were categorized as having HRSNs 0, 40.4%; HRSNs 1–2, 21.5% HRSNs 3–4, and 9.0% HRSNs ≥5. The prevalence of low, moderate, and high CVH was 14.7%, 63.5%, and 21.8%, respectively. Every one-unit increase in unfavorable HRSNs was associated with 1.59 points lower LE8 scores ( P <.001). Comparing participants with HRSNs values of 1–2, 3–4, and ≥5 to those with none, the fully adjusted prevalence ratios for low CVH were 1.42 (1.17–1.73), 2.11 (1.69–2.63), and 2.42 (1.90–3.08), respectively. The corresponding prevalence ratios for high CVH were 0.77 (0.68–0.87), 0.58 (0.49–0.67), and 0.46 (0.38–0.55). The associations were consistent across subgroups and in sensitivity analyses. Conclusions: A graded association exists between unfavorable HRSNs and higher prevalence of low CVH or lower prevalence of high CVH. Public health interventions targeting unfavorable HRSNs might reduce health disparities and promote CVH.

Physio-Metabolic Mechanisms Behind Postharvest Quality Deterioration in Broccoli (Brassica oleracea var. Italica) and Swiss Chard (Beta vulgaris L. var. Cicla): A Review

Leafy vegetables are among the potential foods that can combat food insecurity in developing countries. Their major drawback is a short shelf life, which limits their supply chain and is commonly associated with their high metabolic activities. Leafy vegetables have a high water content, which determines their freshness. Moisture loss through respiration and transpiration at postharvest storage is one quality attribute that leads to rapid quality deterioration. Little has been carried out in studying the mechanisms associated with the quality deterioration of leafy vegetables; however, understanding these mechanisms may aid in developing effective preservation measures. Furthermore, recent literature reviews that focus on discussing the mechanisms that lead to quality loss in leafy vegetables are scarce. The current paper aims to review the physiological and biochemical processes associated with quality deterioration in leafy vegetables. The respiration, ethylene production, moisture loss, colour, and texture are highly associated with the quality deterioration of fresh produce and, thus will be discussed critically in selected leafy vegetables, namely: broccoli and Swiss chard. The findings from this review indicate that the quality deterioration in leafy vegetables is primarily enzymatic. Understanding the mechanisms of quality deterioration involves identifying the specific enzymes responsible for each metabolic process and examining the internal and external factors that influence enzyme activities.

Nutrition, immunity, and infectious diseases in the context of climate change and health syndemic: a scoping review for North America

Abstract Climate change exacerbates global food insecurity, leading to undernutrition and immunodeficiency, which in turn increases susceptibility to infectious diseases. In this way, climate change creates a syndemic, with undernutrition, immunity, and infectious disease risk adversely interacting. This scoping review aims to map: (1) trends in research about climate change impacts on food security; and (2) the extent to which food security is connected to the immune system and infectious diseases in published climate change research in North America. Using a scoping review process, we identified studies that described food security in the context of climate change in North America. A search string was developed and used to search five electronic databases for articles without language restriction. Data on food security pillars and their relationship with infectious diseases and the immune system were extracted from relevant articles and descriptively synthesized. We identified 204 published articles that met the inclusion criteria. The number of articles linking climate change to food security in North America increased yearly, with regional differences in the number of publications, climate variables analyzed, and study methods used. At least one connection between food security and the immune system or infectious diseases was discussed in 72 articles (35.3%). Of these, eleven articles mentioned both the immune system and infectious diseases and separately described their relationship with food security. However, only eight articles linked or described the relationship between food, immune systems, and infection—for example, by describing extreme weather events that reduced food security, resulting in malnutrition causing immunosuppression, thereby increasing the likelihood of infections. This highlights a gap in research on the adverse interaction between undernutrition, the immune system, and infectious disease risk in the context of climate change. This review underscores the need to study the interconnected and cascading health outcomes of climate change.

Understanding the Food and Nutrition Insecurity Drivers in Some Emergency-Affected Countries in the Eastern Mediterranean Region from 2020 to 2024

This research seeks to enhance the understanding of the multifaceted drivers of food and nutrition insecurity in emergency-affected countries within the Eastern Mediterranean region and investigate the dynamics of food and nutrition security in countries facing emerging emergencies. This is a descriptive aim to determine the key factors and challenges affecting food security and nutrition status in ten countries in the Eastern Mediterranean region (Afghanistan, Djibouti, Iraq, Lebanon, Pakistan, Palestine (Gaza Strip), Somalia, Sudan, Syria, and Yemen). The research reveals that all selected countries experienced severe levels of food insecurity, with many reaching Phase 3 or above according to the IPC classification. In 2020, Afghanistan and Yemen were particularly hard-hit, with food insecurity affecting 42% and 45% of their populations; in 2024 in Gaza and Sudan, the same figures were 93% and 54% of the population, respectively, representing worse food insecurity crises in the region. Somalia, Sudan, and Djibouti also faced significant food insecurity rates. Many key drivers of food security are standard in most countries, and the linkage between food insecurity and malnutrition levels has a similar trend in almost all countries. However, none of the countries achieved all the 2025 global nutrition targets, while some reached one or two targets. Reaching sustainable development goals is still challenging in these countries since nutrition and food security levels, included in many goals, have not yet been reached. Food security and malnutrition in emergency-affected countries are driven by conflict, political instability, natural disasters, and socioeconomic conditions, which disrupt agricultural activities and infrastructure, exacerbating these challenges. To address these issues, we recommend a multisectoral approach, conflict resolution, climate-smart agriculture, integration of emergency responses with long-term strategies, and strengthening health and nutrition information systems.

Food insecurity in a diverse community pediatric gastroenterology clinic: Screening strategies and insights

AbstractObjectivesWe aimed to evaluate the prevalence of food insecurity (FI) in the community pediatric gastroenterology (GI) subspecialty clinic at Texas Children's Hospital (TCH) West Campus and to assess the utilization of services through our partnership with a local food bank.MethodsFrom July 1, 2023, to February 29, 2024, all patients seen in the pediatric GI clinic at TCH West Campus were screened for FI using the validated Hunger Vital Sign tool and given the opportunity to consult with a local food bank representative. A retrospective chart review was then performed on patients who completed the implemented FI screening process.Results13.4% of the total patients screened positive for FI. Hispanic patients (p < 0.0001), patients with the preferred language of Spanish (p < 0.0001), those enrolled in Medicaid or Children's Health Insurance Program (p < 0.0001), and patients with obesity (body mass index ≥ 30.0, p = 0.0003) were more likely to screen positive for FI. Poor weight gain/failure to thrive and steatotic liver disease were significantly more common in those with FI (p < 0.0001 and p = 0.0003, respectively), while celiac disease, abdominal pain, and blood in stool were more common in those without FI (p = 0.0003, 0.0475, and 0.0404, respectively). As a result of our implemented FI screening process, 68.4% of those screening positive opted for resource referral, with 50.7% successfully receiving assistance in combating FI.ConclusionsIdentifying the potential impact of FI in common pediatric GI conditions calls for proactive screening and more holistic, patient‐centered approaches in clinical practice

Mixed-methods to explore barriers to the use of food security initiatives in a historically black college and university (HBCU)

Abstract Background To assess students’ use and perception of the initiatives to tackle food insecurity (FI) in a Texas historically black college and university (HBCU). Methods HBCU students > 18 years (288 students). A mixed-methods approach involving an online survey, focus group discussions and key informant interviews were conducted among the students and major stakeholders to evaluate the prevalence of FI, and gain insights into the challenges to accessing, utilizing and effectively implementing food security (FS) initiatives. Results FI affected 63.5% of the participants. The awareness and utilization of the food pantry were 27.9% and 8.1% respectively while for the meal share programs, awareness and utilization were 30.1% and 15.0%, respectively. A significant association was found between FI and the place of residence (p = 0.027). Binary logistic regression model showed that students’ school year was a predictor of food pantry awareness (p < 0.05), residence and FI status were predictors of the meal share program utilization (p < 0.05). Five themes, including poor awareness and visibility of campus resources, bureaucratic process and logistics, insufficient funds, personnel and other resources to run the initiatives, ineffective communication, and stigma due to location emerged as the main barriers to the use of the resources. Conclusions This study emphasizes the necessity for HBCUs to address these hurdles in order to successfully help students in need with FI resources.

The effect of different light spectra on selenium bioaccumulation by Spirulina platensis cyanobacteria in flat plate photobioreactors

Selenium (Se) plays a crucial role in human health, influencing conditions such as cancer, diabetes, and neurological disorders. With global population growth and unequal nutrient distribution threatening food security, new approaches are needed to meet the nutritional needs of the world. Se is essential for immune function, metabolism, and antioxidant defense, and in regions suffering from food insecurity and malnutrition, selenium-enriched food could offer an affordable solution. Spirulina platensis, microalgae, can bioaccumulate Se from its environment, enhancing its nutritional value. This study explores how different light spectra (red, white, yellow, and blue LEDs) affect Se bioaccumulation in Spirulina when Na2SeO3 is added to the culture medium in photobioreactors. The results show that red light made the highest Se bioaccumulation (0.118 mg.L−1), followed by white, yellow, and blue light. Se addition also increased cell dry weight by 46%, 33%, 22%, and 60%, respectively, compared to photobioreactors without Se, with biomass productivity highest under red light. Furthermore, Se boosted maximum Chl α concentration, improving photosynthetic efficiency. These findings suggest that optimizing light conditions can significantly enhance the nutritional value of Spirulina, offering a potential solution to global hunger by providing a sustainable, selenium-enriched food source.

Downy mildew of millets - An overview

Amidst global food insecurity, malnutrition, agricultural challenges, and climate change, millet farming is emerging as a viable alternativedue to its high nutritional value, resilience to extreme weather conditions, and adaptability to marginal soils. Often referred to as “super-crops”, millets gained international recognition in March 2021 during the 75th session of the United Nations General Assembly. Millets rank among the most important crops globally, following rice, wheat, maize, and sorghum. However, they are susceptible to more than fifty diseases, with the most destructive being ‘Downy Mildew’. This disease is caused by oomycete pathogens such as Sclerospora graminicola, Peronosclerospora sorghi and Sclerophthora macrospora, posing a significant threat to millet production, with yield losses ranging from 50% to 100%. This review emphasizes the importance of millet and the devastating effects of downy mildew on its yields. It explores the physiological and histological changes induced by the disease, the characterization of effector protein, and the genetic variability in millet populations. Additionally, various management techniques for combating downy mildew are examined, including chemical treatments, induced resistance, organic-based approaches, cultural practices, resistant genotypes, and advancements in nanotechnology. By compiling current knowledge on millet disease and effective management strategies, this review aims to serve as a comprehensive resource for researchers and farmers, supporting sustainable millet farming and improving global food security.

The association between food production, food security, household consumer behaviour and waist‐hip ratio amongst women in smallholder farming households in Kilifi County, Kenya

AbstractFood insecurity disproportionately affects smallholder farming households and within them women, who bear primary caregiving responsibilities and contend with time and resource constraints that heighten their vulnerability to adverse nutrition‐related health outcomes. This study cross‐sectionally investigates the association between food production practices, household consumer behaviour, and the experience of food insecurity with women's waist‐hip ratio (WHR), a key indicator of abdominal obesity, in a coastal community in Kenya. In total, 394 households were randomly selected from a list of farming households in Kaloleni and Rabai sub‐counties of Kilifi. Trained enumerators administered questionnaires to adult female family members who play a pivotal role in household management. Household dietary diversity scores (HDDS) were computed from 16 food groups consumed in the 7 days preceding the survey. Waist‐hip measurements focused on these females, representing vulnerable populations. Pathway‐based regression models were constructed using STATA version 13 (p < 0.05). Most households practised mixed farming (59.9%) and monocropping (73.2%) and most female respondents were widowed (75.1%) with limited education (73.1% had no formal education) and over 20 years of farming experience. Food insecurity was prevalent, affecting 80.7% of households. Limited dietary diversity was noted with an average HDDS of 9. The most commonly consumed foods were cereals, spices, condiments and beverages, while meat, eggs and fruits were infrequently eaten. An inverse association was observed between HDDS and WHR (standardised regression coefficient = −0.1328; p = 0.026) but while food insecurity was inversely associated with both HDD and WHR, these associations did not reach statistical significance (HDDS‐standardised regression coefficient −0.0294; p = 0.592: WHR‐standardised regression coefficient −0.0155; p = 0.791). Existing research has primarily addressed the undernutrition and hunger‐related impacts of food insecurity. The findings underscore the need to better understand the complex interplay between food insecurity and nutritional health, including markers of adiposity, to effectively promote health.

The protein transition—environmental footprints of farmed fish, microalgae and chicken for food, a case study in Kenya

AbstractChallenges of land scarcity, climate change and water shortage are contributing to escalating the shortage of protein rich food in sub-Saharan Africa. In Kenya a total of 27.8% of the population was undernourished, and a total of 72.3% were categorised as moderately or severe food insecure in 2021–2022. The need to investigate alternative protein sources with less impacts on land, water and climate change, which potentially could replace, at least some of the current production of livestock as the main protein source, is getting increasingly urgent. The main aim of this study is therefore to conduct an environmental footprint analysis of favourable protein production systems in Kenya to evaluate environmental impacts on land, water, and climate. The methodological approach used in this study is referred to as environmental footprint analysis, which is applied to assess; (1) farmed fish in ponds, (2) farmed fish in solar based affordable recirculation aquaculture systems (A-RAS), (3) dried spirulina (Arthrospira Platensis), and (4) chicken from semi-intensive farms. The results show that the most promising alternatives to cattle production are dried spirulina produced in ponds, followed by fish produced in affordable recirculation systems (A-RAS) run on solar energy. Spirulina fully replacing beef production would reduce water usage with 34.7 billion m3/year, land/water surface area with 34.8 thousand km2/year, and GHG emission with 28.2 megaton CO2eq/year. For fish farmed in A-RAS, such replacement would reduce water, land and emissions with 30.7 billion m3/year, 32.0 thousand km2/ year and 23.0 megaton CO2eq/year, respectively. This study illustrates that it is possible to tackle urgent challenges of food and nutrition security for millions of people in sub-Saharan Africa and worldwide with a sustainable protein transition towards a more sustainable, inclusive production system of small-scale farmers, if making use of alternative protein sources, such as from solar based A-RAS and microalgae.

Investigating health professionals' perspectives and experiences of food security‐related conversations in diabetes care

AbstractAimsHousehold food insecurity (FI) is a serious public health concern and disproportionately affects people living with chronic health conditions, undermining diabetes self‐management. Little is known about healthcare professionals' (HCPs) experiences of supporting people affected by diabetes and FI, and no national guidelines incorporate consideration of FI within UK diabetes care. A qualitative study of NHS HCPs' consideration of FI within diabetes care, and the extent to which it informs their clinical practice, was undertaken.MethodsFifteen HCPs providing self‐management support to people with Type 1 or Type 2 diabetes in a Scottish Health Board took part in semi‐structured interviews. Data were analysed using a thematic framework approach informed by the Capability, Opportunity, Motivation and Behaviour (COM‐B) model of behaviour change.ResultsAlthough the potential impact of FI on diabetes self‐management was recognised, this important consideration was not currently core to their clinical practice. Enablers and barriers identified included: personal feelings about raising the issue, lack of knowledge of available resources, the patient‐practitioner relationship, and the wider socioeconomic environment. Practical suggestions to support HCPs included: specific training on communication, access to patient support information, use of a screening tool to assess FI, and building NHS‐third sector links.ConclusionsOur findings provide insight into cognitive factors, emotional processes and environmental systems impacting on HCPs' practice supporting individuals with diabetes and FI. Research with affected patients is needed to gain a better understanding of how to provide support within NHS settings.

EFFECTS OF HEALTH EXPENDITURE ON FOOD SECURITY STATUS OF RURAL HOUSEHOLDS IN OGUN STATE, NIGERIA

The study assessed the effect of health expenditure on the food security status of rural households in Ogun State, Nigeria. Multistage sampling procedure was used to select 120 rural households in the study area. Data was collected from the respondents with the aid of a semi-structured questionnaire complemented with an interview guide. Descriptive statistics, food security index, cost of illness procedure and binary logit regression model were the analytical techniques used for data analysis. Findings from the study revealed that majority (79.2%) of the respondent were male, married (90.8%), with a mean household size of 5 persons. Also, the mean age of the respondents was found to be 54 years with most of them involved in farming as their major occupation. Findings also revealed that majority of the rural households suffered from various illnesses such as malaria, waist/back pain, fever, high blood pressure, rheumatism and other illnesses with an average estimated cost of illness (₦45, 973.68 per month). The results of the food security status of the rural households revealed that a higher percentage (53.3%) of the rural households were food insecure. Factors found to significantly affect the food security status of the rural households were cost of illness (p<0.1) and other socio-economic variables such as education (p<0.1), income (p<0.05) and sex of the household head (p<0.01). Therefore, this study recommends that government should subsidize the cost of drugs and other medical expenses for poor households particularly those in the rural areas in order to reduce their financial burden on health care and increase their economic access to food.