Measures Of Food Insecurity Research Articles

The relationship among social support, food insecurity and mental health for adults with severe mental illness and type 2 diabetes: A survey study.

People living with severe mental illness are at increased risk of medical comorbidity as well as poverty, food insecurity, and inadequate social support in managing their mental and physical health conditions. Lack of access to sufficient food negatively affects a person's ability to manage health conditions, in particular diabetes, which is twice as common among people with severe mental illness as the general population. This study aimed to explore associations among food insecurity, social support, and psychiatric symptoms among adults with severe mental illness and diabetes. A cross-sectional survey was conducted between January and May 2021 among adults (N = 156) with severe mental illness and type 2 diabetes who received primary care through a large academic health-care system (26% response rate). Valid and reliable questionnaires were implemented to measure food insecurity, social support, and mental health. Regression analysis was applied to examine the associations between food security status, social support, and mental health. Food insecurity and social support are both correlated with psychiatric symptom severity. Specifically, support from family members has the largest protective role against food insecurity. This study found food insecurity is likely a critical issue to address whenever it is present in adults with severe mental illness (SMI) and type 2 diabetes. The presence of family support mitigates the need for addressing food insecurity. Practices and policies aimed at both addressing health inequities such as food insecurity and strengthening family support among people living with SMI and comorbid medical conditions are important adjuncts to self-management interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Measuring Food Insecurity in Older Adults Using Both Physical and Economic Food Access, NHANES 2013–18

BackgroundEconomic food insecurity tools are used to detect need for assistance in the general population. However, in older adults, food insecurity can also be due to factors other than economic, such as physical inability to shop or cook. ObjectivesWe determined: 1) the proportion of older adults in the United States who experience physical and/or economic food insecurity; 2) differences in characteristics, diet quality, chronic conditions, and depression by economic and/or physical food insecurity; and 3) the relation of physical and economic food insecurity with diet quality and with depression. MethodsData from adults aged ≥60 y of the NHANES (2013–2018) were used. Groups were created based on economic food security [measured using the USDA's Household Food Security Survey Module (HFSSM)] and physical food security (measured using questions evaluating ability to shop and cook). Depression, Healthy Eating Index (HEI-2015) score, and socioeconomic characteristics were compared by food security group. Rao–Scott χ2 tests were used to test for significant differences between categorical variables, and t tests for continuous variables. Associations between food security status, HEI-2015, and depression score were examined using linear regression analysis. ResultsOne-quarter (25.0%) of older adults had physical difficulty accessing food but were not living in economically food insecure households. Those who lived in economically food insecure households and also had physical difficulties accessing food had the lowest mean HEI-2015 score (51.7) and highest mean depression score (6.9); both were significantly lower than the mean scores of those who lived in food secure households (HEI-2015 = 57.3; depression = 2.1; P < 0.01). ConclusionsConsidering physical ability to shop for and prepare food when measuring food insecurity in older adults can help identify those who might need dietary and mental health support the most, and those who need food assistance but would otherwise be missed if only measuring economic access.

Food Insecurity and Functional Disability Among Older Adults in Ghana: The Role of Sex and Physical Activity.

We examined the associations between food insecurity and functional disability among older adults in Ghana and, the roles of sex and physical activity on the relationship. A cross-sectional study design was employed. A total of 4446 older adults (50+ years of age) from the Study on Global Aging and Adult Health Ghana Wave 2, a countrywide study, was completed in2015. Logistic regression models were used to examine the associations between measures of food insecurity and functional disability using data from Study on Global Aging and Adult Health Ghana Wave 2. Functional disability was assessed using World Health Organization Disability Assessment Schedule 2.0 composed of 12 items in 6 domains of cognition, mobility, self-care, getting along, life activities, and participation in society. Food insecurity was assessed from 12-month food sufficiency and experience of hunger over the last 12months. Approximately 11% were identified as having functional disability. The prevalence of food insecurity was 23.8% for insufficient food intake and 18.3% for hunger. Adjusting for all variables, older adults who reported consuming insufficient food (OR 2.27; 95% CI 1.57, 3.28), and those who experienced hunger (OR 2.35; 95% CI 1.59, 3.46) had higher odds of functional disability, compared with those not reporting these issues. Sex differences modified the association between hunger and functional disability. Physical activity served as a protective factor (OR 0.60; 95% CI 0.38, 0.95) on the association implying that older adults who engaged in physical activity were 40% less likely to experience food insecurity-induced functional disability. Food insecurity is associated with functional disability among older adults. Results highlight the usefulness of tackling the social determinants of health and promoting financial/social security in older age in a changing Ghanaian society.

Caregiver-reported household food insecurity and child-reported food insecurity in relation to eating disorder risk factors and symptoms among preadolescent children.

To examine the relation of caregiver-reported household food insecurity (FI) and child-reported FI with eating disorder (ED) risk factors and symptoms, including effect modification by gender, in preadolescent children. Data were from the Family Food Study, a cross-sectional study of households with incomes ≤200% of the federal poverty line in southeastern Michigan. Children aged 8-10 years (n= 194) and their female primary caregivers reported separately on FI status. Children reported ED risk factors/symptoms via the 24-item Children's Eating Attitudes Test (ChEAT-24), with higher scores indicating more ED risk factors/symptoms. Linear mixed models were used to examine associations between FI measures with the ChEAT-24 total score, plus subscale scores for dieting, food preoccupation, weight preoccupation, vomiting, and social pressure to eat/gain weight. Models were adjusted for child age, child gender, caregiver race/ethnicity, caregiver education, and household income. Among all children, child-reported FI, but not caregiver-reported household FI, was associated with more ED risk factors/symptoms. Child-reported FI (vs. no FI) was associated with higher average ChEAT-24 total score (β=2.41, 95% CI: 0.57, 4.25). Child-reported FI was also associated with more food preoccupation, more weight preoccupation, and more social pressure to eat. Caregiver-reported household FI was marginally associated with less dieting in girls, and child-reported FI was associated with more dieting in boys. Child-reported FI may be more salient than caregiver-reported household FI as a risk factor for ED-related outcomes in preadolescent children. Gender may modify the association between FI and dieting behavior. More child-reported food insecurity, but not parent-reported household food insecurity, was associated with more eating disorder risk factors and symptoms among preadolescent boys and girls. These findings emphasize the need for future studies that investigate the role of food insecurity in the development of eating disorders, especially studies that measure child-reported experience of food insecurity.

Food security, food insecurity, and Canada’s national food policy: Meaning, measures, and assessment

We review the Canadian federal government‘s recently enacted Food Policy for Canada (FPC). Three arguments are developed. First, the development and vision statement of the FPC implies that improving Canadian food security is a specific objective of the policy. Second, if assessed by the measure of food insecurity promulgated by Statistics Canada, the effectiveness of the FPC in reducing Canadian food insecurity will primarily depend on the extent to which it improves household incomes and/or lowers food prices. We evaluate the current programmatic content by these criteria. Third, and related to the second point, we argue that the variation in the severity of food insecurity is an important consideration in assessing the effectiveness of FPC programs in reducing food insecurity as measured by Statistics Canada. Finally, we combine these three arguments into a simple figure/heuristic that can serve as a guide to the assessment and development of FPC programs seeking to enhance food insecurity in Canada.

Implications of COVID-19 labour market shock for child and household hungers in South Africa: Do social protection programs protect?'

BackgroundRecent studies have confirmed that the COVID-19 lockdown has caused massive job losses. However, the impact of this loss on food security is not well-understood. Moreover, a paucity of evidence exists regarding social protection grants’ countervailing effects against such shocks. This study examined the effects of job loss (labour income loss) on child and household hungers (our two measures food insecurity) during COVID-19 pandemic in South Africa. It also ascertained whether these effect were offset by alternative social grant programs to document the protective role of the latter.Data and methodsWe used South Africa’s National Income Dynamics Study (NIDS) and the Coronavirus Rapid Mobile Survey (CRAM) data. These data cover a nationally representative sample of 7073 individuals. We employed a probit model to estimate the effect of job loss and receipts of various social grants on child and households’ hungers. We also estimated the double-selection logit model to account for the model’s uncertainty surrounding the variable selection and treatment-effects estimation using lasso (Telasso) for causal inference of our analysis.ResultsOur analyses showed that households exposed to a labour market shock during the pandemic experienced a significant increase in our measures of food insecurity (child and household hungers). Specifically, we found that compared with households containing employed respondents, households with respondents who lost their jobs due to COVID-19 lockdown were 5.4% more likely to report child hunger and 2.6% more likely to report household hunger in the past seven days A receipt of child support grant reduces the likelihood of reporting child hunger and household hunger by 21.7%and 16.9% respectively among these households. A receipt of old age pension grant reduces the likelihood of reporting household hunger by 24% with no significant effect on child hunger.ConclusionThe COVID-19 lockdown resulted in unprecedent job losses with significant implications for food insecurity. Job loss due to COVID-19 lockdown significantly increased food insecurity in South Africa. Receipts of social grants effectively offset this adverse effect. The protective effect of the social grant is heterogenous across its alternative programs (child support grant and old age pension grant) and food insecurity, suggesting the differences in the size of transfers and motivations for sending these transfers.

Adolescent Health Risk Behaviors, Adverse Experiences, and Self-reported Hunger: Analysis of 10 States from the 2019 Youth Risk Behavior Surveys

ABSTRACT We examined associations between adolescent self-reported hunger, health risk behaviors, and adverse experiences during the 2018–2019 school year. Youth Risk Behavior Survey data were pooled from 10 states. Prevalence ratios were calculated, and we assessed effect measure modification by sex. The prevalence of self-reported hunger was 13%. Self-reported hunger was associated with a higher prevalence of every health risk behavior/adverse experience analyzed, even after adjusting for sex, grade, and race/ethnicity. Sex did not modify associations. Findings underscore needs for longitudinal research with more robust measures of adolescent food insecurity to clarify the temporality of relationships.

FOOD SECURITY CONDITIONS IN EAST PRIANGAN WEST JAVA: FOOD SAFETY OR FOOD INSECURITY?

Compared with the average poverty rate in the West Java Area, the poverty rate in the East Priangan Zone is very high. One measure of food insecurity is the high hunger rate in the country. The problem of food security has always been the biggest worry, as food is a fundamental human need, so economic growth is quite influential. The author is interested in researching the extent of food protection in the East Priangan Area on the basis of the significance and validity of the issues, as well as attempts to achieve food security. The study discusses different facets of food protection linked to farmers' households in the East Priangan Area. The report was undertaken in the East Priangan Area through a library study of numerous research findings and secondary evidence supporting food protection concerns. The issues explored are (1) the principle of food protection, (2) the efficiency of food security, and (3) the plan for realizing food security. The findings of the study showed that (1) the definition of food protection includes three foundations of food security, consisting of aspects of supply, access to food and utilization of food, (2) the degree of food security of districts and cities in eastern Priangan belongs to the very food safety group of food security, and (3) the techniques that can be applied to address the problems of food security.

Food and nutrition security impacts of resilience capacity: Evidence from rural Ethiopia

Resilience analysis framed on a twin-track approach of harmonizing humanitarian and development interventions is a nascent paradigm to food and nutrition security. This study contributes to the limited empirical literature that assesses the effect of resilience on food and nutrition insecurity modeled as separate variables for policy uptake in Ethiopia. The panel data comes from the Ethiopian Socioeconomic Survey. We estimated the resilience capacity index by combining factor analysis and structural equation modeling. The study employed kilocalories, food poverty, dietary diversity, food consumption, and multidimensional food security perspectives. Assets ownership, access to social services, and adaptive capacity are the core elements of resilience. We evidenced that resilience capacity enhanced food and nutrition security outcomes. Alternative food and nutrition insecurity measures complement but could not serve as a proxy to each other. The regression results revealed that resilience reduces household food and nutrition insecurity. Nevertheless, the food insecure possesses fewer resources, attributes, and farm assets face extreme poverty and thus benefit less from resilience. Complimentary food and nutrition insecurity measures give a more nuanced description and improve the targeting efficiency of interventions. Farming is no longer the merely or even the principal source of subsistence for many rural households. Issues that require more attention in policies to reinforce resilience capacities in ensuring food and nutrition security include fostering the rural non-farm economy, human capital formation, access to productive assets, and commercialization. Besides, the role of broader agri-food systems change is of utmost importance. Policy measures that enhance growth from below would also go a long way in building resilience for food and nutrition security and break the deeply entrenched cycle of subsistence and vulnerability of smallholder farming. • Integrating alternative food security measures heightens the targeting efficiency. • Resilience protect food and nutrition insecurity in the presence of shocks. • Growth from below would go a long way in enhancing resilience for food security. • Sustainable food and nutrition security need agri-food systems transformation.

A Novel Measure of Housing Insecurity, Poverty and Use of Unclean Cooking Fuel Are Associated With Greater Food Insecurity in Slums and Informal Settlements

ObjectivesGlobally, an estimated 1.6 billion people live in inadequate housing, with 1 billion living in slums and informal settlements. However, there has not been a way of measuring inadequate housing or housing insecurity in the global South, neither is there an understanding of the relationship between housing insecurity and food insecurity in slums and informal settlements. Using a newly validated scale, we assessed the effect of housing insecurity on food insecurity among the urban poor. MethodsData for this study were collected from three slums in Ghana (N = 1,033). First, we assessed measures of housing insecurity (Multilevel Multidimensional Housing Insecurity Scale-MMHIS) and food insecurity (Household Food Insecurity Access Scale - HFIAS); we then assessed slum severity (Slum Severity Index- SSI), poverty, and subjective socio-economic status (SES) as confounding variables. Finally, we assessed choice of food over water or energy, neighborhood health, type of cooking fuel, and socio-demography. Following descriptive and bivariate analyses, we built an additive multivariable model by including all covariates significant at p < 0.05. We assessed the effect of housing insecurity on food insecurity using Poisson regression, adjusting for both confounding and socio-demographic variables. ResultsIn the bivariate models, MMHIS (IRR = 1.07, p < .001), SSI (IRR = 1.11, p < .001), and Poverty (IRR = 1.19, p < .001), were associated with an increase in the estimated rate ratios of food insecurity while subjective SES was associated with a decrease in food insecurity (IRR = 0.90, p < .001). In the multivariable model, MMHIS (IRR = 1.04, p < .001) and poverty (IRR = 1.17, p < .05) were significantly associated with an increase in the food insecurity rate ratios. Other measures that increased the rate ratio of food insecurity included the choice of food over energy or water (IRR = 1.27, p < .01), use of charcoal (IRR = 1.15, p < .05), and female headed households (IRR = 1.17, p < .001). Higher SES and neighborhood health scores were associated with decreased food insecurity rate ratios. ConclusionsThese data show that housing insecurity is a significant predictor of greater food insecurity in slums. Funding SourcesThis work was supported by a Pilot Project Grant at the University of Texas at Arlington and the Keough School of Global Affairs at the University of Notre Dame.

Infant Sex-Specific Associations between Prenatal Food Insecurity and Low Birthweight: A Multistate Analysis

BackgroundLow birthweight is associated with increased risk of neonatal mortality and adverse outcomes among survivors. As maternal sociodemographic factors do not explain all of the risk in low birthweight, exploring exposures occurring during critical periods, such as maternal food insecurity, should be considered from a life course perspective. ObjectivesTo explore the association between prenatal food insecurity and low birthweight, as well as whether or not there may be a sex-specific response using a multistate survey. MethodsPregnancy Risk Assessment Monitoring System (PRAMS) data of live births from 11 states during 2009–2017 were used, restricting to women with a singleton birth. Food insecurity was determined by a single question in PRAMS, and low birthweight was defined as a birth <2500 g. Multivariable logistic regression was used, stratified by infant sex and adjusted for maternal sociodemographic and prepregnancy health characteristics. ResultsThere were n = 50,915 women from 2009 to 2017, with 9.1% experiencing food insecurity. Unadjusted results revealed that food-insecure mothers had an increased odds ratio of delivering a low-birthweight baby (OR: 1.38; 95% CI: 1.25, 1.53). Adjustment for covariates appeared to explain the association among male infants, whereas magnitudes remained greater among female infants (adjusted OR: 1.13; 95% CI: 0.94, 1.35). ConclusionsFindings suggest a sex-specific response to prenatal food insecurity, particularly among female offspring. Future studies are warranted with more precise measures of food insecurity and to understand the difference by infant sex.

595-P: Creation of a Food Insecurity Risk Score for Adults with Diabetes

Current measurement of food insecurity in the US has largely focused the USDA scales. However, these scales do not capture multidimensional risk associated with food insecurity, account for stigma associated with being considered food insecure, or adequately capture the idea of nutrition security which is particularly important for individuals with diabetes. We aimed to create a more comprehensive set of questions allowing identification of an individual as being food insecure without reliance on questions only focused on food quantity and cost. We used data collected from 614 adults with type 2 diabetes recruited for a cross-sectional study on social determinants of health in Milwaukee, Wisconsin. The mean age of the sample was 55 years with mean duration of diabetes diagnosis of 9 years. The 6-item USDA food insecurity scale was used as the outcome with a variety of questions capturing social risk used to create a risk score for food insecurity. A series of questions were tested with the final risk score ranging from 0-7 based on questions including: 1) income less than $25,000, 2) going without food, clothing, or housing due to needing funds for medical care, 3) being worried or stressed about paying rent or mortgage, 4) being worried or stressed about money to buy nutritious meals, 5) not seeing a doctor due to cost, 6) not filling prescriptions due to cost, and 7) neighborhood being unsafe due to crime. In the full sample of adults with diabetes, those indicating 2 risks were 3.5 times more likely to be food insecure, those indicating 3 risks were 10.8 times more likely to be food insecure, and those indicating 4+ items were 54.2 times more likely to be food insecure. Use of this tool can identify food insecure adults in a way that captures food and nutrition security while being inclusive of individuals who may feel stigma associated with food insecurity. In addition, it can identify levels of risk capturing multiple facets of the underlying issue of poverty to screen more comprehensively. Disclosure L.E.Egede: None. R.J.Walker: None. Funding American Diabetes Association (1-19-JDF-075) ; National Institute of Diabetes and Digestive Kidney Disease (K24DK093699, R01DK118038, R01DK120861, PI: Egede) , the National Institute for Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker)

Considering gender differences in measuring household food insecurity in northern Ghana

ABSTRACT This study compares estimates of household food insecurity between men and women living within the same household (n = 866) to assess whether there is a gender bias in reporting. The main research question is, do household food insecurity scores and prevalence categories differ between male and female spouses within households in the sample? Findings indicate that men's household food insecurity estimates were lower on average at 3.49, than women's estimates at 5.06. There is also a statistically significant decrease in men's estimates when compared to women's. Overall, these findings question the reliability of household-level food insecurity measures that rely on heads of households' estimations by pointing to discrepancies found in this reporting between husbands and wives within the same household. Since this study sampled married women and men within the same household, gender differences found are also more directly attributable to gender than in most other studies that compare male and female-headed households' food insecurity reporting. Though further assessments across other cases are needed, more reliable measures of household food insecurity could include averaging estimates of multiple individuals within households. Qualitative research into the gendered dynamics could also improve sampling and the interpretation of findings from surveys on household-level measures.

Factors influencing low-income households' food insecurity in Bangladesh during the COVID-19 lockdown.

BackgroundThe COVID-19 pandemic and countrywide lockdown could negatively impact household food insecurity among low-income households. This study aimed to investigate the prevalence of household food insecurity and its influencing factors among low-income people in Bangladesh during the lockdown of COVID-19.MethodsThis cross-sectional study was conducted through face-to-face interviews from 500 low-income households during the countrywide COVID-19 lockdown. A pretested, structured and validated questionnaire was used to collect socioeconomic characteristics, household income conditions, and food accessibility. Household Food Insecurity Access Scale (HFIAS) and Dietary Diversity Score (DDS) were used to measure food insecurity. Multinomial logistic regression models were estimated to evaluate and predict risk factors that influence food insecurity.ResultsThe study found that above 67% of households was mild-to-moderate food insecure while 23% experienced severe food insecurity. Significantly, 88%, 97.4%, and 93.4% of the households had anxiety and uncertainty, inadequate quality, and inadequate quantity of food, respectively. The regression analysis revealed the age 36–50 years (RRR: 4.86; 95% CI: 2.31–7.44, RRR: 4.16; 95% CI: 2.25–6.10) and monthly income <58.3 USD (RRR: 3.04; 95% CI: 1.12–5.14, RRR: 3.26; 95% CI: 1.79–4.71) were significantly associated with food insecurity (p <0.001). Likewise, less-income (RRR: 3.87; 95% CI: 1.37–6.46, RRR: 2.99; 95% CI: 1.16–4.83), increase in food prices (RRR: 1.29; 95% CI: 0.32–2.33, RRR: 1.08; 95% CI: 0.05–1.12), and those who did not have same type of earning as before during the COVID-19 lockdown (RRR: 3.41; 95% CI: 1.33–5.62, RRR: 2.60; 95% CI: 0.99–4.24) were potential risk factor for MMFI and FI.ConclusionThis study found that households become more susceptible to food insecurity during the COVID-19 pandemic and lockdown period. Based on the findings, we suggest some essential food policies and adequate food assistance to mitigate these negative consequences.

Food Insecurity and Health Outcomes Other than Malnutrition in Southern Africa: A Descriptive Systematic Review.

Food insecurity (FI) is one of the major causes of malnutrition and is associated with a range of negative health outcomes in low and middle-income countries. The burden of FI in southern Africa is unknown, although FI continues to be a major public health problem across sub-Saharan Africa as a whole. Therefore, this review sought to identify empirical studies that related FI to health outcomes among adults in southern Africa. Altogether, 14 publications using diverse measures of FI were reviewed. The majority of the studies measured FI using modified versions of the United States Department of Agriculture Household Food Security Survey Module. A wide range in prevalence and severity of FI was reported (18–91%), depending on the measurement tool and population under investigation. Furthermore, FI was mostly associated with hypertension, diabetes, anxiety, depression and increased risk of human immunodeficiency virus (HIV) acquisition. Based on the findings, future research is needed, especially in countries with as yet no empirical studies on the subject, to identify and standardize measures of FI suitable for the southern African context and to inform public health policies and appropriate interventions aiming to alleviate FI and potentially improve health outcomes in the region.

COVID-19 in rural Africa: Food access disruptions, food insecurity and coping strategies in Kenya, Namibia, and Tanzania.

This study assesses the extent of COVID‐19‐related food insecurity in Kenya, Tanzania, and Namibia. Using the Household Food Insecurity Access Scale, we measure food insecurity in various dimensions and document several food access disruptions associated with the COVID‐19 pandemic between April and July 2020. Furthermore, we assess the association of COVID‐19 countermeasures with the adoption of various strategies in line with the coping strategies index. We rely on a unique phone survey that followed households who participated in an earlier field‐based survey. First, through Ordinary Least‐Squares and Probit regressions, we show a strong and statistically significant association between COVID‐19 countermeasures and food access disruptions and food insecurity in each of the three countries. We then use a multivariate probit regression model to understand the use of the various coping strategies, including reducing food intake, increasing food search, and relying more on less nutritious foods. We provide evidence on the complementarities and trade‐offs in using these coping strategies. COVID‐19 and related lockdown measures coincided with a deleterious increase in food insecurity in rural Africa.

Classification Differences in Food Insecurity Measures between the United States and Canada: Practical Implications for Trend Monitoring and Health Research

BackgroundFood insecurity, inadequate access to food due to financial constraints, is a major public health issue in the United States and Canada, where the same 18-item questionnaire is used to monitor food insecurity. Researchers often assume that findings on food insecurity from the 2 countries are comparable with each other, but there are between-country differences in how food insecurity status is determined. ObjectivesWe aimed to compare the distribution of household food insecurity in the Canadian population applying the US and Canadian classification schemes. We also examined the extent to which associations between food insecurity and adults’ health differ under the 2 schemes. MethodsWe used the population-representative Canadian Community Health Survey 2005–2017 linked to administrative health records. Food insecurity was measured by the Household Food Security Survey Module. Adults 18 y and older with valid food insecurity status were included from all jurisdictions except Quebec (n = 403,200). We cross-tabulated food insecurity status classified by the US and Canadian schemes. We also fitted logistic regressions on self-reported and objective health measures adjusting for confounders. ResultsApplying the Canadian classification scheme, 7.7% of households were food insecure; the number fell to 6.0% with the US scheme. Associations between food insecurity status and health measures were mostly similar across classification schemes, although the associations between food insecurity and self-reported health were slightly larger if the US scheme was applied. Marginal food security/insecurity was associated with worse health measures irrespective of the classification scheme. United States–Canada discordance in classification of marginal food security/insecurity had a limited effect on health prediction. ConclusionsUnited States–Canada differences in classification affected the apparent distribution of household food insecurity but not the associations between food insecurity and measures of adult health. Marginal food security/insecurity should be set apart from the food-secure group for trend monitoring and health research.

Hunger mediates the relationship between food insecurity and binge eating among bariatric surgery candidates.

The food insecurity-obesity paradox suggests that people lacking access to adequately nutritious foods are more susceptible to disordered eating. However, the mechanisms underlying the relationship between food insecurity and binge eating are not well understood. This study sought to assess the role of eating behaviors (i.e., cognitive restraint, disinhibition, and hunger) as mediators between food insecurity and binge eating among a sample of preoperative bariatric candidates. University hospital in the Appalachian region of the United States. A total of 369 adults seeking bariatric surgery were included in this cross-sectional study. Patients completed validated measures of food insecurity and eating behaviors as part of a routine psychological evaluation prior to bariatric surgery. Food insecurity was significantly related to binge eating symptoms (r[369] = .14, P < .01) and hunger (r[369] = .11, P < .05). Hunger mediated the relationship between food insecurity and binge eating (b = 1.23, standard error = .62, 95% confidence interval .08-2.54). Food insecurity was not associated with restraint (r[369] = .06, P = .27) or disinhibition (r[369] = .02, P = .69). Food insecurity presents a unique pathway to binge eating that has several implications for intervention prior to bariatric surgery. Identification of food insecurity and the subsequent effects on eating behaviors is crucial to understanding the factors relevant to disordered eating prior to bariatric surgery.

National Trends and Disparities in Severe Food Insecurity in Brazil between 2004 and 2018

ABSTRACTBackgroundThe Brazilian Household Food Insecurity Measurement Scale (EBIA) is the main tool for assessing household food insecurity (FI) in Brazil and facilitates the monitoring and improvement of national public policies to promote food security. Since 2004, the Brazilian government has conducted National Household Sample Surveys, and in 2018, the government carried out the last national evaluation of FI.ObjectivesTo describe trends in severe FI in Brazil from 2004 to 2018.MethodsData from 3 cross-sectional Brazilian National Household Sample Surveys (sample sizes: 2004 = 112,530; 2009 = 120,910; 2013 = 116,196) and from the last Household Budget Survey (sample size = 57,920) that assessed the status of FI using the EBIA were analyzed. Changes in severe FI during 2 periods (2004–2013; 2013–2018) were estimated while considering sociodemographic factors.ResultsThe period between 2004 and 2013 was marked by a significant decrease in severe FI (–53.6%), but this trend reversed in 2013–2018 (+43.8%). The greatest decrease in severe FI occurred in the Northeast (–57.6%) among households where the reference person was a man (–57.6%) and self-identified as white (–58.1%) (2004–2013). In 2013–2018, households with children aged ≤4 y (+6.3%) and members aged ≥65 y (+12.5%) experienced the lowest increases in severe FI.ConclusionsAfter a significant reduction from 2004 to 2013, severe FI increased sharply from 2013 to 2018, likely due to disruptions in public policies aimed at reducing hunger and unemployment rates.

Socioeconomic risks of food insecurity during the Covid-19 pandemic in the UK: findings from the Understanding Society Covid Survey

BackgroundWe estimated socioeconomic factors associated with food insecurity during the first year of the Covid pandemic in the UK and explored potential mechanisms explaining these associations.MethodsData were from the April, July, and September 2020 waves of the UK Understanding Society Covid Survey. Food insecurity was measured as ‘not having access to healthy and nutritious food’ and ‘reporting being hungry but not eating’. Logistic regression estimated the relationship between socioeconomic factors and food insecurity. A decomposition approach explored if financial vulnerability and having Covid-19 explained associations between socioeconomics factors and food insecurity.ResultsSingle parents and young people aged 16–30 years had a higher odds of reporting both measures of food insecurity. Financial insecurity explained 5% to 25% of the likelihood of reporting being food insecure for young people and single parents depending on the food insecurity measure used. Experiencing Covid-19 symptoms explained less than 5% of the likelihood of being food insecure for single parents but approximately 30% of not having access to healthy and nutritious food for young people.ConclusionPolicies providing additional financial support may help to reduce the impact of Covid-19 on food insecurity in the UK.