Food Insecurity Score Research Articles

Investigating the mediating role of physical activity within the association between food insecurity and BMI

Food insecurity is linked with obesity and while the mechanisms behind this association are complex, lower levels of leisure-time physical activity in those with food insecurity may contribute to this. Individual-level factors (such as concerns of performing physical activity) may partly determine levels of physical activity within individuals with food insecurity, as such individuals may seek to minimise their levels of physical activity in order to preserve energy. Using the Food Insecurity Physical Activity Concerns Scale (FIPACS) (used to measure concerns of performing leisure-time physical activity, focusing on factors specific to food insecurity), the current study investigated whether the association between household food insecurity and body mass index (BMI) is explained by a mediation pathway of FIPACS scores and leisure-time physical activity. We also investigated whether the association between food insecurity and FIPACS scores is moderated by nutrition knowledge. Participants (N = 329, food insecure = 55) completed an online survey consisting of the FIPACS, the International Physical Activity Questionnaire long-form (IPAQ), the Diet, Disease, and Weight management sub-section of the General Nutrition Knowledge Questionnaire, a measure of diet quality, and self-reported BMI. Findings revealed that FIPACS scores and leisure-time physical activity did not mediate the association between food insecurity and BMI (b < 0.01, SE = 0.01). Additionally, nutrition knowledge did not moderate the association between food insecurity and FIPACS scores (b = −0.09, SE = 0.08). Findings suggest that concerns of performing physical activity in the context of food insecurity are unrelated to leisure-time physical activity, and that these two factors do not explain the association between food insecurity and BMI. Future research should investigate other factors in the link between food insecurity, physical activity, and BMI.

Seasonal variations in household food security and consumption affect women's nutritional status in rural South Ethiopia.

Food availability varies seasonally in most rural areas of developing nations, especially in areas affected by drought and climate change, with women being one of the most vulnerable groups. This study aimed to assess the effect of seasonal variation in household food security, adequate dietary diversity, food consumption, and wealth on the nutritional status of women of reproductive age in a rural community in South Ethiopia. Further, the study aimed at identifying associated factors with women's nutrition status. An open cohort study was conducted from June 2021 to June 2022, with follow-up visits every three months. Anthropometric measurements were carried out along with interviews. Data were analyzed using STATA version 15. Multilevel, multiple linear regressions were employed. Findings revealed that women's average body mass index (BMI) was 20.4 kg/m2 (95% CI: 20.4-20.5). The highest (20.6 kg/m2, 95% CI: 20.5-20.8) was observed in December, while the lowest (20.2 kg/m2, 95% CI: 20-20.3) occurred in September. During the main postharvest period in December, the household food insecurity score was the lowest (median: 4, Inter quartile range (IQR): 0-9), while the household dietary diversity score (median: 6, IQR: 5-7), and the household food consumption score were the highest (median: 50.5, IQR: 44-70). Factors such as household food security, food consumption, previous season BMI, age, marital status, and membership in safety net programs were identified as determinants of women's BMI. The study showed the vulnerability of women in drought-prone areas to seasonal undernutrition. We recommend collaborative work among stakeholders to ensure sustainable food access and minimize seasonal food shortages' effect on women's nutrition and overall well-being.

Impact of a school-based food assistance program on household food insecurity in Greece, 2012–2019: a multi-year evaluation of the DIATROFI program

BackgroundChildhood food insecurity can persist among low socioeconomic areas in high-income countries. Universal Free School Meal (UFSM) programs are designed to respond to this pressing issue. This study aimed to conduct a multi-year evaluation of the DIATROFI Program’s impact on household food insecurity in Greece. MethodsThis study utilized data from 18,716 students (618 kindergarten to high schools), from low socioeconomic areas participating in the school-level UFSM Program DIATROFI between 2012 and 2019. Parents of students completed annual baseline and follow-up paper-based self-completed questionnaires. The primary outcome was household food insecurity, measured using the Food Security Survey Module (FSSM) at both questionnaires, and evaluated through mixed linear and logistic regression models with repeated measurements. FindingsStudents’ median age was 9 years old (Interquartile range (IQR): 6·5, 12·0), 51·6% (n=9,658) were girls, and 82·2% (n=15,382) lived in low/medium socioeconomic affluence households. Households with food insecurity reduced from 51·5% (n=9,630) to 47·6% (n=8,901) after one school year. Food insecurity score declined steadily for four years of consecutive participation, compared to baseline score (one-year b:–0·26; 95% Confidence Interval (CI):–0·30, –0·22, and four-year –1·28; –1·53, –1·03). The likelihood of retaining food insecure status reduced from 17% after one-year participation (Odds Ratio (OR): 0·83; 95% CI: 0·79, 0·87) to 36% after four-year participation (0·64; 0·49, 0·82). The Program’s impact on household food insecurity alleviation was greater among households with low parental education and low socioeconomic affluence. InterpretationThe DIATROFI Program effectively improved household food security during and after the Greek socioeconomic crisis. School-level UFSM programs targeting underprivileged students can improve household food insecurity, with a more pronounced effect with increased years of participation, and among economically disadvantaged households. FundingThe DIATROFI Program was funded through various national and private organizations, including national prefecture authorities, Greek payment authorities, philanthropic/charitable organizations, and private companies.

“Factors Associated with Malnutrition among Adults Living with HIV in the Rutshuru Health Zone (DRC)”

Introduction: The aim of this study was to determine the factors associated with malnutrition among adults living with HIV (PLHIV) in the Rutshuru Health Zone. Methodology: The study was a 4-month cross-sectional analysis of 307 adult PLHIV undergoing antiretroviral treatment (ART). Malnutrition was assessed by calculating the body mass index (BMI) and food insecurity by the food insecurity score (HFIAS - FANTA). Results: The prevalence of malnutrition was 13% and food insecurity 71%. Diarrhoea was a factor associated with malnutrition {p = 0.013; OR = 3.113; 95% CI = [1.236-7.836]}. Conclusion: Malnutrition and food insecurity were significant among adult PLHIV on ART, and diarrhoea was an exposure factor. Shortcomings in the provision of care were noted among providers. Hence the need to implement nutritional education and capacity-building programmes for care providers at the sites surveyed.

Association of Household Food Insecurity with Stunting and Underweight Among Iranian Children Aged 2 - 5 Years old

Background: Although previous literature has assessed the association of household food insecurity with nutritional outcomes among children, the findings are inconsistent across different study populations. Objectives: We aimed to evaluate the association of household food insecurity with nutritional outcomes among children residing in Khalkhal city, Iran. Methods: The present cross-sectional study was conducted on 300 Iranian children aged 2 - 5 years who visited urban and rural health care centers between November 2021 and March 2022. Subjects were included in the survey using multi-stage cluster sampling. Household food security status was assessed using the United States Department of Agriculture (USDA) 18-item food security questionnaire. Odds ratios (95% confidence interval) for stunting according to the food insecurity score were estimated using multivariable logistic regression in three models. Results: In the present study, 39% of participants had food security, while the prevalence of food insecurity without hunger, food insecurity with moderate hunger, and food insecurity with severe hunger were 22.3%, 23%, and 15.7%, respectively. In all models, both categorized and continuous food insecurity scores correlated negatively with weight (P for all &lt; 0.001). Food insecurity did not predict the risk of stunting in all subjects before and after adjustment (Model 1: OR (CI) = 1.008 (0.96-1.05), P = 0.72; Model 2: OR (CI) = 1.01 (0.96 - 1.05), P = 0.65; Model 3: OR (CI) = 0.98 (0.92-1.04), P = 0.53). Conclusions: In the current study, we found that Iranian families with the lowest income had the highest food insecurity scores. Household food insecurity was negatively correlated with weight status among children aged 2 - 5 years.

Relationships between Food Insecurity, Self-Efficacy, and Changes in Body Mass Index among the Youth in Taiwan: Analysis from a Longitudinal Cohort Survey.

Food insecurity is a heightened concern among economically disadvantaged youth, and it may contribute to the atypical body mass index (BMI) patterns frequently observed in this group. Self-efficacy seems to intervene in the negative impacts of contextual restraints. This study investigated the relationship between food insecurity, self-efficacy, and BMI trajectory among economically disadvantaged Taiwanese youth. We utilized three-wave longitudinal data from the Taiwan Database of Children and Youth in Poverty. The Food Insecurity Score (FIS) assessed food insecurity with a 4-item scale measuring reduced meal frequency, hunger, skipping meals, and economic constraints. Moreover, the General Self-Efficacy Scale (GSES) assessed self-efficacy, showcasing the ability to handle stress effectively and envision success scenarios, contributing to positive outcomes. By employing latent growth modeling, we were able to delineate the impacts of baseline food insecurity and self-efficacy on initial BMI and its subsequent growth trajectory. Elevated baseline FIS significantly predicted higher initial BMI (coefficient = 0.420, p = 0.042). Baseline GSES was negatively associated with initial BMI (coefficient = -0.093, p < 0.001) but positively predicted the BMI growth rate (coefficient = 0.023, p = 0.011). Enhancing self-efficacy may be an effective multidisciplinary intervention to address psychosocial and socioeconomic factors when tackling weight problems in vulnerable youth groups.

Food insecurity and quality of life in patients with sickle cell disease.

Little is known about the relationship between quality of life (QOL) and food insecurity (FI) among patients with sickle cell disease (SCD). We hypothesized FI is associated with lower QOL in children and young adults with SCD. Overall (N=99), 22% screened positive for FI. Supplemental Nutrition Assistance Program (SNAP) enrollment was 50 and 71% among people from food secure and FI households, respectively. A higher FI score was correlated with lower overall QOL (r=-0.22, p=.03), specifically lower QOL in worry and communication domains. Interventions for FI beyond SNAP may be important for QOL among people living with SCD.

Food Security and Diet Quality Improvements among At-Risk, Low-Income, Older Adults following a Free Meal Pilot Program.

Older adults are at a greater risk for food insecurity compared to the general population. This study aimed to describe changes in diet quality and food insecurity following a free meal program at low-income, older adult housing complexes. Study participants were recruited from two low-income older adult public housing complexes in Kentucky. Fifty participants were enrolled and received 1-4 free weekly meals across 3 months as part of the Meals on Wings pilot program. Surveys and a 24 h dietary recall were completed at baseline and 3 months. Participants were predominately female, 69 years of age, and Black or African American race. Food security status (FSS) and dietary quality through the Healthy Eating Index (HEI) were assessed as primary measures. Participants were placed in "at-risk" categories of the (1a) lower quartile of the HEI and (1b) lower than 51% HEI, or (2) "low" or "very low" food security status based on the USDA Household Food Security Screener (FSS). Multiple linear regression (MLR) models were conducted for HEI and FSS scores to include time, group, time*group interaction, and control of meal utilization percentage (i.e., dose). The MLR for the HEI quartile had a significant time by quartile interaction that was present for an increase in the HEI in Q1 (n = 12; 32.42 ± 5.95% to n = 6; 46.10 ± 10.62%; p < 0.0001) and a decrease in the HEI for Q4 (n = 12; 70.68 ± 7.13% to n = 9; 52.36 ± 11.57%; p < 0.0001). For those low food security participants (n = 24; 48.0%), the average food insecurity score from the 6-item USDA screener improved from 4.09 ± 1.62 at baseline to 2.63 ± 2.41 at 3 months (p = 0.0064). The MLR for the FSS had a significant group*time interaction (p = 0.0071). In our population, particularly those vulnerable with lowest dietary quality and food insecurity status, we did see improvements across the free meal pilot program. However, a small sample, limited generalizability, and limited data collection measures urge caution when using these results to extrapolate for the general population. However, the current results are promising and should encourage further investigation of the effects of meal assistance programs on the health and well-being of older adults.

Food Insecurity Among Aging SNAP Participants and Eligible Nonparticipants in Two Predominantly Low-Income Black Neighborhoods: Implications for SNAP Enrollment and Outreach for Older Adults

BackgroundThe Supplemental Nutrition Assistance Program (SNAP) plays a critical role in alleviating poverty and food insecurity. Despite these benefits, many older Americans who are eligible for SNAP do not participate in the program. Few studies have explored household factors and food insecurity outcomes associated with nonparticipation among older Black Americans. ObjectivesThe study aim was to explore changes in food insecurity and related financial hardship outcomes between 2020 and 2021 among SNAP participants, eligible nonparticipants, and ineligible nonparticipants; compare reasons for not participating in SNAP; and to compare household factors associated with SNAP nonparticipation. MethodsLongitudinal design examining data from 2020 and 2021 to assess changes in food insecurity over the course of the coronavirus disease 2019 pandemic. Participants/settingParticipants were 528 adults (aged 30 to 97 years) in households randomly selected from a listing of all residential addresses in two predominantly Black neighborhoods with lower incomes in Pittsburgh, PA, and surveyed between March to May 2020 and May to December 2021. Main outcome measuresFood security was measured using the validated 6-item US Department of Agriculture Adult Food Security Survey Module. Statistical analyses performedFindings are based on a descriptive analysis of food security and related indicators. Statistical testing was performed to assess differences between SNAP participation status and individual characteristics, food security, and financial hardship using Wald F test for continuous measures and Pearson χ2 test for categorical measures. A multivariable linear model was used to assess the association of SNAP participation and eligibility status with change in food insecurity. ResultsIn cross-sectional analyses of 2021 data, no differences were observed between SNAP participants and eligible nonparticipants for food insecurity, food bank use, mean weekly food spending per person, and difficulty paying for basics. However, with respect to changes in food insecurity over the course of the pandemic, SNAP participants experienced a greater improvement in mean food security scores between 2020 and 2021 (–0.52 reduction in mean food insecurity score or a 16% improvement in food security; P ≤ 0.05) relative to SNAP-eligible nonparticipants. Perceived ineligibility (71.3%) and perceived lack of need (23%) were the most common reasons for not participating in SNAP. ConclusionsMore than one-third of SNAP participants and eligible nonparticipants experienced food insecurity and financial hardship. However, there were differences in the changes in food insecurity between these groups.

Association between adult food insecurity and mortality among adults aged 20-79 years with diabetes: A population-based retrospective cohort study.

There is limited research on the relationship between food insecurity and mortality among individuals with diabetes. This study aims to investigate the impact of food insecurity on all-cause and cause-specific mortality in adults with diabetes. This study included 5749 adults with diabetes from the National Health and Nutrition Examination Survey cycles 2003-2018 and followed up until 31 December 2019. Food insecurity was measured by the Food Security Survey Module. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals for both all-cause mortality and cause-specific mortality. The weighted prevalence of full food security, marginal food security, low food security, and very low food security was 70.8%, 11.0%, 10.4%, and 7.8%, respectively. Food insecurity demonstrated a significant correlation with diminished diet quality and reduced consumption of healthy foods. Over the course of 42,272.0 person-years of follow-up, we documented 1091 deaths, of which 370 were attributed to cardiovascular disease and 180 to cancer. After adjusting for multiple variables, food insecurity scores were significantly and linearly associated with increased all-cause mortality. Comparing to full food security, participants experiencing very low food security had a multivariate-adjusted HR of 1.48 (1.12, 1.95) for all-cause mortality (ptrend = 0.010). Food insecurity was associated with increased all-cause mortality and compromised diet quality, especially in individuals experiencing very low food security. Future strategies may necessitate the monitoring of and interventions for food insecurity among individuals with diabetes.

“It has changed my life”: unconditional cash transfers and personalized infant feeding support- a feasibility intervention trial among women living with HIV in western Kenya

BackgroundThe syndemic effects of poverty, food insecurity and living with HIV are recognized as global health priorities, including through the United Nations Sustainability Goals 1, 2 and 3. Today, women and girls account for 63% of all new HIV infections in eastern and southern Africa, including Kenya. Pregnant and postpartum women living with HIV in this setting face unique challenges including increased financial insecurity as women leave the work force to care for their newborn infants. This contributes to poverty, food scarcity and stress.MethodsTo address financial insecurity, improve infant feeding and reduce stress among mothers living with HIV in this setting, we developed a multilevel intervention, Supporting Healthy Mothers, consisting of 10 monthly unconditional cash transfers (10,000 KES, ~$75 USD/month) and personalized infant feeding support from pregnancy to 7 months postpartum. We conducted a non-randomized feasibility trial of this intervention among women engaged in HIV care in Kisumu, Kenya. From February 23, 2022 to March 23, 2022, we enrolled a total of 40 women who were 20–35 weeks pregnant—20 women to the intervention group at a public clinic, and 20 women to the control group at a similar clinic. Our aim was to assess feasibility, acceptability, and the potential impact of the intervention on food security, infant feeding and maternal mental health.ResultsAnalyzing data from all 40 participants, we found a significant reduction in food insecurity scores from baseline for the intervention group when compared to the control group at 6 weeks and 6 months postpartum (p = 0.0008 and p < 0.0001, respectively). Qualitative exit interviews with intervention group participants confirmed women felt more financially secure and had newly acquired practical knowledge and skills related to infant feeding. Women found the two intervention components highly acceptable and described an overall positive impact on wellbeing.ConclusionsThe Supporting Healthy Mothers intervention has potential to positively impact women across the perinatal period and beyond by increasing financial security and supporting women to overcome infant feeding challenges and should be assessed in larger trials.Trial registrationSupporting Healthy Mothers was registered with ClinicalTrials.gov Protocol Registration and Results System, initially published on February 1, 2022. ClinicalTrials.gov ID: NCT05219552 Protocol ID: K23MH116807.

The Importance of Screening for Food Insecurity in Children with Sickle Cell Anemia: An Ancillary Study to the Severe Acute Malnutrition Feasibility Trial in Nigeria

Introduction Household food insecurity-lacking access to, or having uncertain access to, food that meets a person's dietary needs-is a longstanding problem in Nigeria that has continued to worsen in recent years. One of its most severe consequences is malnutrition, particularly affecting children due to their high nutrient demand coupled with higher energy expenditure. Even in high-income countries, such as the United States, many children with sickle cell anemia have lower weights and heights than their healthy peers. Due to their elevated nutrient requirements, children with sickle cell anemia may be at an even greater risk of malnutrition when faced with limited access to adequate food. The relationship between childhood food insecurity and malnutrition has been previously studied in younger children in Nigeria, but rarely in older children, and to our knowledge, never in older children with sickle cell anemia. We tested the hypothesis that there is a direct association between increased food insecurity and more severe malnutrition (lower body mass index [BMI] z-score) in older children with sickle cell anemia in Nigeria. Methods This was a planned analysis of the data of children enrolled in a feasibility trial for managing severe acute malnutrition in older children with sickle cell anemia in Nigeria (SAMS trial; #NCT03634488). In this study, children 5-12 years old with sickle cell anemia and uncomplicated severe acute malnutrition (BMI z-score &amp;lt;-3.0) were randomly assigned to receive either supplemental ready-to-use therapeutic food (RUTF) only or RUTF combined with moderate fixed-dose hydroxyurea therapy for 12 weeks. Baseline anthropometric data were obtained for each participant. Upon enrollment in the trial, the participants' caregivers completed the US Household Food Security Survey Module (HFSSM). Using the eight questions in the childhood portion of this standardized survey, we categorized the participants into three food security statuses: food security (0-1), low food security (2-4), and very low food security (5-8). Childhood food security scores were also measured as a continuous variable on a scale of 0-8, with higher scores indicating greater food insecurity. We constructed a linear regression model to estimate the association between childhood food insecurity and baseline BMI z-score. Results Data were collected between August 2021 and May 2022. The median age of the 108 participants in the study was 10.3 years (IQR 8.8-11.5). Most participants had low (55%) or very low (34%) food security. BMI z-score was not associated with categorical food security status (p=0.108). However, higher food insecurity as a continuous variable was associated with a lower BMI z-score (Pearson correlation -0.23, p=0.015; Figure 1). In a multivariable linear regression with sex, age at study entry, total hemoglobin, employment status, and head of household educational status, the childhood food insecurity score was negatively associated with the BMI z-score (Beta coefficient = -.05, p=0.047). Conclusions Our study reveals a high prevalence of food insecurity among older children with sickle cell anemia in Nigeria. Moreover, children experiencing higher food insecurity also exhibited more severe malnutrition, as evidenced by their lower BMI z-scores. Based on these results, we have started implementing food insecurity assessment as routine medical care in children with sickle cell anemia at multiple clinics in northern Nigeria. Children experiencing higher levels of food insecurity are referred to nutritional counseling, where they receive guidance on locally available nutrient-dense foods and preparation strategies. Figure 1.The predicted baseline body mass index z-score with 95% confidence intervals based on childhood food insecurity scores from a linear regression model of the participants in the SAMS trial.

Household Food Insecurity and Cognition in Youth and Young Adults with Youth-Onset Diabetes.

We evaluated the association of household food insecurity (FI) with cognition in youth and young adults with type 1 diabetes (T1D) or type 2 diabetes (T2D). In this cross-sectional study, age-adjusted scores for composite Fluid Cognition, and sub-domain scores for Receptive Language and Inhibitory Control and Attention, were modeled stratified by diabetes-type using linear regression, with FI in the past year as the predictor, controlling for covariates. Tests for processing speed, inhibitory control/attention, working memory, episodic memory, and cognitive flexibility were administered to measure composite Fluid Cognition score. The NIHT-CB Picture Vocabulary Test was used to assess Crystallized Cognition score and rapid identification of congruent versus noncongruent items were used to assess Inhibitory Control and Attention score. The SEARCH for Diabetes in Youth study, representative of 5 U.S. states. Included 1574 youth and young adults with T1D or T2D, mean age of 21 years, mean diabetes duration of 11 years, 51% non-Hispanic white, and 47% had higher HbA1c levels (>9% HbA1c). Approximately 18% of the 1,240 participants with T1D and 31% of the 334 with T2D experienced FI. The food-insecure group with T1D had a lower composite Fluid Cognition score (β= -2.5, 95% confidence interval (CI)= -4.8, -0.1) and a lower Crystallized Cognition score (β= -3.4, CI= -5.6, -1.3) than food-secure peers. Findings were attenuated to non-significance after adjustment for demographics. Among T2D participants, no associations were observed. In participants with T1D effect modification by glycemic levels were found in the association between FI and composite Fluid Cognition score but adjustment for socioeconomic characteristics attenuated the interaction (p=0.0531). Food-insecure youth and young adults with T1D or T2D did not have different cognition compared to those who were food-secure after adjustment for confounders. Longitudinal research is needed to further understand relations amongst these factors.

Evaluation of food insecurity and its association with food consumption and some variables among college students

BackgroundStudents are an important group threatened by food insecurity. Food insecurity among college students is one of the research topics that is attracting attention worldwide, and interest in this topic is growing by the day. Food insecurity has a negative impact on students' biological, mental and social health. This study aimed to determine the prevalence of food insecurity and correlate it with frequency of food consumption and some variables among undergraduate students.MethodsThis descriptive-analytical study was conducted with 1149 university students at Akdeniz University, Antalya, Turkey. The demographic characteristics of the individuals (gender, age, living situation, income status, and health information), anthropometric measurements (body weight and height), nutritional habits, frequency of food consumption, and Household Food Insecurity Access Scale (HFIAS) were questioned. Statistical Package for the Social Sciences (SPSS) software was used for statistical analyses.ResultsIt was found that 13.1% of the students have mild, 13.0% moderate, and 9.4% severe food insecurity. The rate of individuals with and without food security differs according to gender, living situation, and income status (p < 0.05). There was a statistically significant correlations between the food insecurity score and age (p = 0.047), the number of main meals (p < 0.001) and snacks (0.007), and consumption frequency of certain foods (p < 0.05).ConclusionsThe prevalance of students facing food insecurity was high. Individuals with food insecurity have a lower frequency of healthy food consumption than individuals with food security. Steps should be taken to ensure nutritional security among undergraduate students, who are the young adult population.

Effect of a comprehensive nutrition education program on nutritional behavior and food security of female-headed households who receive welfare support in Zanjan Province, Iran

BackgroundIn recent years, the food security and dietary quality of many Iranian families have deteriorated due to unprecedented inflation. Nutrition education programs can be an effective and inexpensive method to improve food quality and security. The present study aimed to investigate the effect of a comprehensive nutrition education program for low-income women who are heads of households and are covered by the Zanjan province’s welfare.MethodsThe food security of 2600 female-headed households covered by the Welfare of Zanjan province was evaluated using a standard 6-item questionnaire. A total of 600 women with the highest food insecurity scores were selected for the comprehensive nutrition education program. The participants received six sessions of 1.5 h of courses about how to improve the quality of their diets and manage their budgets and be physically active. At the beginning of the study and one month after the completion of the intervention, the participants were asked to complete a questionnaire designed and validated by the investigators. The scores of each section before and after the intervention were compared using paired t-test method and p values ​​of < 0.05 were considered statistically significant.ResultsThe prevalence of severe food insecurity among female-headed households who receive welfare support in Abhar, Khodabandeh, and Zanjan cities was 59.5%, 75%, and 62%, respectively. A total of 505 participants successfully completed the courses. After completion of the educational intervention, diet quality, physical activity, budgeting, and food safety scores of the participants increased by 6%, 4%, 4%, and 5%, respectively, which were statistically significant (p < 0.001). However, no significant difference was observed in the food insecurity scores.ConclusionThe comprehensive nutrition education program without financial or nutritional support can have a small but significant impact on the improvement of the nutritional behaviors and dietary quality of low-income people.

Association between food insecurity and quality of life among older adults (60+) in six low and middle-income countries

Food insecurity is a key social determinant of health and nutrition. However, very few studies have examined the association of food insecurity and quality of life outcomes among older adults in low and middle-income settings. In this study, we examine the association of food insecurity with self-rated poor quality of life, low life satisfaction, and WHO quality of life (WHOQol). Nationally representative data from WHO's Study on global AGEing and adult health (SAGE) consisting of 20,026 older adults were analyzed. The association of food insecurity with self-rated poor quality of life and low life satisfaction was assessed using bivariate and multivariate logistic regression analysis. Multivariate linear regression models examine the association between food insecurity and WHOQol score. Pooled data analysis of six countries showed older adults with severe food insecurity were two times more likely to report poor quality of life (OR = 2.49, CI 2.10, 2.96; p < 0.001) and low life satisfaction (OR = 2.36, CI 1.94, 2.87; p < 0.001), respectively. Similarly, older adults with severe food insecurity had 3.60 (CI-4.25, −2.95; p < 0.001) points lower WHO-QoL score than those who are food secure. These results show that the association of food insecurity is statistically significant with all three outcomes of quality of life in all six countries adjusting for sociodemographic and health measures. Public health and social security interventions are important to prevent food insecurity to promote overall wellbeing of the growing older population in low and middle-income countries.

Association Between Household Food Insecurity (Access) Scores, Poverty Indicators and Child Malnutrition in Botswana

ABSTRACT In Botswana the Household Food Insecurity Access Scale (HFIAS) has been used in studying the urban-poor, but less in rural settings high in poverty, child malnutrition (CM), and social protection beneficiaries. This cross-sectional study compared HFIAS scores, household poverty (HP) and CM in two rural districts: Bobirwa with moderate and Mabutsane with high poverty. Households (n = 872) with children under-five years participated. Most children (87.6%) experienced food insecurity. Mean HFIAS for all households was 11.0 ± 8. HFIAS scores were higher in Mabutsane (p < .001). HFIAS scores were consistently associated with HP and CM in both districts. HFIAS can assist in targeting the rural-poor.

Food insecurity, dietary diversity and the right to adequate food among households in landslide-prone communities in Eastern Uganda: A cohort study.

We assessed food insecurity, dietary diversity and the right to adequate food among households in communities in Eastern Uganda that were affected by major landslides in 2010 and 2018. A prospective cohort study was applied to select 422 households during May-August (the food-plenty season) of 2019. In January-March (the food-poor season) of 2020, 388 households were re-assessed. Socio-demographic, food security, dietary diversity and right to adequate food data were collected using structured questionnaires. Four focus groups discussions and key informant interviews with 10 purposively sampled duty-bearers explored issues of food insecurity, dietary and the right to adequate food. The affected households had significantly higher mean (SE) food insecurity scores than controls, both during the food plenty season: 15.3 (0.5) vs. 10.8 (0.5), and during food-poor season: 15.9 (0.4) vs. 12.5 (0.0). The affected households had significantly lower mean (SE) dietary diversity scores than controls during the food plenty season: 5.4 (0.2) vs. 7.5 (0.2) and during the food poor season: 5.2 (0.2) vs. 7.3 (0.1). Multivariate analyses showed that the disaster event, education and main source of livelihood, were significantly associated with household food security and dietary diversity during the food-plenty season whereas during the food-poor season, the disaster event and education were associated with household food security and dietary diversity. During both food seasons, the majority of affected and control households reported to have consumed unsafe food. Cash-handout was the most preferred for ensuring the right to adequate food. Comprehension and awareness of human rights principles and state obligations were low. The severity of food-insecurity and dietary diversity differed significantly between the affected and control households during both food seasons. Moreover, the right to adequate food of landslide victims faced challenges to its realization. There is need for policy and planning frameworks that cater for seasonal variations, disaster effects and right to adequate food in order to reduce landslide victims' vulnerability to food insecurity and poor dietary diversity. In the long-term, education and income diversification program interventions need to be integrated into disaster recovery programs since they are central in enhancing the resilience of rural livelihoods to shocks and stressors on the food system.

English

This study assessed the impacts of Farmer Field Schools (FFS) on household food security and environmental conservation in the Western Province of Kenya. The outcome variables were: Maize yield per acre, income per acre, household food insecurity score and environmental conservation score. Principal component analysis and propensity score matching techniques were used for analyses and regression method to test the robustness of matching results. We found that FFS households harvest higher crop yield of up to 9.45 bags which is significantly different (p&lt;0.05) from their counterparts. Consequently, FFS households earn significantly (p&lt;0.05) higher income estimated over KSh 2,800 per acre than Non-FFS households. Although the EC score were not significantly different, FS scores were low in FFS households. The study showed that FFS program significantly (-0.42**) reduce severity of food insecurity this implies that FFS plays a critical role in enhancing household food security. Key words: Farmer field schools, food security, environmental conservation.

Food Insecurity and Coping Strategies amongst Undergraduate Students during the COVID-19 pandemic in Malaysia

Introduction: Undergraduate students are at a high risk for food insecurity and knowledge on relevant coping strategies is the key issue in dealing with food insecurity. Therefore, this study is aimed at determining the food insecurity status, coping strategies, and the factors associated with food insecurity and coping strategies during the COVID-19 pandemic. Methods: This cross-sectional study involved 383 undergraduate students from health-related courses at the International Islamic University Malaysia Kuantan campus. The participants were selected by convenience sampling. The instrument used for data collection was a self-administered questionnaire consisting of three parts: socio-demographic background, food insecurity, and coping strategies. The data were analysed as descriptive and inferential analyses, such as Chi-Square, Mann-Whitney, and Kruskal-Wallis. Results: It was found that 21.41% of the participants reported experiencing food insecurity. There were significant associations between parents’ income (p&lt;0.001), financial status (p&lt;0.001), academic performance (p = 0.04) and working part-time (p = 0.01) with food insecurity. It was also discovered that there were significant associations between working part-time (p&lt;0.001), faculty of study (p&lt;0.001), academic year (p&lt;0.001), financial status (p&lt;0.001), academic cumulative grade point average (CGPA) (p&lt;0.001) and monthly expenses (p = 0.01) with Malaysian Coping Strategies Instruments (MCSI) score. A significant association between food insecurity and MCSI score (p&lt;0.001) was also found in this study. Conclusion: The prevalence of food insecurity was consistent with previous studies, which is considered high in Malaysia. The findings could assist university authorities to identify the characteristics of the students that are related to food insecurity.