Food-secure Participants Research Articles

Food Security Status is not Associated with Increased Risk of Metabolic Syndrome in Korean Adults.

Background: It is still uncertain whether food insecurity increases the risk of metabolic syndrome. Recent reports from the United States and developing countries have shown conflicting results on this issue. This study aimed to investigate the association between food security status and metabolic syndrome in Korean adults. Methods: We performed a nationwide population study using data for 18,782 adults obtained from the 2012 to 2015 Korean National Health and Nutrition Examination Surveys. The 18-item Food Security Survey Module was utilized to assess household food security status. We used multiple logistic regression models to determine the association between food security status and metabolic syndrome. Results: The overall prevalence of food insecurity was 8.2% and that of metabolic syndrome was 27.3%. The prevalences of metabolic syndrome were 26.2%, 32.3%, 30.2%, and 28.8% in the high, marginal, low, and very low food security groups, respectively. Food-insecure participants (participants in the low food security and very low food security groups) were significantly more likely to be female, divorced/widowed/separated, and current smokers compared to food-secure participants. Food-insecure participants also had lower incomes, lower education attainments, and lower physical activities (P < 0.05). Compared with the high food security group, the marginal (odds ratio [OR]: 1.34, 95% confidence interval [95% CI]: 1.19-1.50, P < 0.001) and low food security groups (OR: 1.22, 95% CI: 1.04-1.42, P = 0.01) had increased odds of metabolic syndrome in the unadjusted models. However, after controlling for covariates, including age, sex, marital status, education attainment, household income, smoking, alcohol intake, and physical activity, neither marginal food security (adjusted odds ratio [aOR]: 1.02, 95% CI: 0.87-1.19, P = 0.86) nor low food security (aOR: 0.88, 95% CI: 0.71-1.08, P = 0.22) was significantly associated with an increased risk of metabolic syndrome. Conclusions: Contrary to a prior report from the United States, food security status was not significantly associated with the risk of metabolic syndrome in Korean adults.

Foods for Health: An Integrated Social Medical Approach to Food Insecurity Among Patients With Diabetes

Examine a clinic-based approach to improve food security and glycemic control among patients with diabetes. One-group repeated-measures design. Federally Qualified Health Centers in a large Midwest city. Of the 933 patients with diabetes who consented at baseline, 398 (42.66%) returned during the follow-up period for a visit that included Hemoglobin A1c (HbA1c) results. Integrated social medicine approach that includes food insecurity screening, nutrition education, and assistance accessing food resources as a standard-of-care practice designed to minimize disruptions in how patients and providers experience medical care. HbA1c collected as part of a standard blood panel. Repeated-measure, mixed-effect linear regression models. There was a decrease in mean HbA1c (Δ = -0.22, P = 0.01) over the study period. The model examining change over time, glycemic control (GC), and food security status (F1, 352 = 5.80, P = 0.02) indicated that among participants with poor GC (33.12%), food secure (FS) participants exhibited significantly greater levels of improvement than food insecure (FI) participants (Δ = -0.55, P = 0.04). Among participants with good GC, changes in HbA1c were not significantly different between FS and FI participants (Δ = 0.23, P = 0.21). Providing nutrition education and food assistance improved HbA1c profiles among FS and FI participants, but FI participants may face social and structural challenges that require additional support from health care teams.

Does the effect of lifestyle intervention for individuals with diabetes vary by food insecurity status? A preplanned subgroup analysis of the REAL HEALTH randomized clinical trial

IntroductionWe aimed to test the effectiveness of a lifestyle intervention (LI) for individuals with food insecurity and type 2 diabetes.Research design and methodsAdults with type 2 diabetes, body mass index...

Food security moderates relationship between perceived food environment and diet quality among adults in communities with low access to healthy food retail.

To examine the relationship between food security status, diet quality measured using Healthy Eating Index-2010 (HEI-2010) scores, demographics and the following factors: perceptions of healthy food availability, healthy eating identity and perceived control of healthy eating. A cross-sectional study in 2016-2017 using three 24-h dietary recalls and one psychosocial survey. Two urban communities in Cleveland and Columbus, Ohio, USA, with low access to healthy food retailers. Primary food shoppers living in the targeted geographic areas (N 450). Our results indicated that high school graduates had lower HEI-2010 scores compared with participants who had some college education or more (β = -2·77, P = 0·02). Participants receiving Supplemental Nutrition Assistance Program (SNAP) benefits had lower HEI-2010 scores (β = -2·69, P = 0·03). Healthy eating identity was associated with higher HEI-2010 scores (β = 1·85, P = 0·004). Food security status moderated the relationship between perception of healthy food availability and HEI-2010 scores. Among participants with very low food security (VLFS), greater perceptions of healthy food availability were associated with higher HEI-2010 scores (β = 3·25, P = 0·03), compared with food secure participants. Only 14 % of VLFS participants used a personal vehicle as transportation to their primary food shopping store. Findings offer targets for future intervention development and evaluation to promote community nutrition. These targets include strategies to improve the value of SNAP benefits, promote access to quality education, increase transportation options to healthy food retailers and develop nutrition programming to promote healthy eating identity.

Psychological mechanisms associated with food security status and BMI in adults: a mixed methods study.

This study examined psychological constructs (delay discounting, grit, future time perspective and subjective social status) in relation to food security status and body weight. A simultaneous triangulation mixed methods design was used to collect quantitative and qualitative data. Quantitative data were collected in fifty-six adults. Independent variables included food security status (food secure or food insecure) and BMI category (normal weight or overweight/obese). Participants, matched on race (African American and White), were categorised into four food security status by BMI category groups. Psychological constructs were measured via validated questionnaires. Qualitative data were collected in a subsample of twelve participants via in-depth interviews. This study was conducted in Baton Rouge, Louisiana. The sample was 66 % female and 48 % African American with a mean age of 32·3 (sd 9·2) years and BMI of 28·8 (sd 7·7) kg/m2. Quantitative results showed that food-insecure participants with overweight/obesity had greater delay discounting (-3·78 v. -6·16, P = 0·01; -3·78 v. -5·75, P = 0·02) and poorer grit (3·37 v. 3·99, P = 0·02; 3·37 v. 4·02, P = 0·02 ) than their food-secure counterparts and food-insecure participants with normal weight. Food-insecure participants with overweight/obesity also had a shorter time period for financial planning (0·72 v. 4·14, P = 0·02) than food-secure participants with normal weight. Qualitative data largely supported quantitative findings with participants discussing varied perceptions of psychological constructs. This study found differences in delaying gratification, grit and financial planning between food security status and body weight groups.

Examining Shopping Patterns, Use of Food-Related Resources, and Proposed Solutions to Improve Healthy Food Access Among Food Insecure and Food Secure Eastern North Carolina Residents

In the Southern United States (U.S.), food insecurity rates are higher in rural (20.8%) versus urban communities (15%). Food insecurity can exacerbate diet-related disease. Thus, the purpose of this study was to examine differences in the use of food-related community resources and potential solutions proposed among food insecure versus food secure residents. A community survey (n = 370) was conducted in rural eastern North Carolina, with questions pertaining to food security status and food-related resources. The IBM SPSS Statistics software and SAS software were used to examine differences in food-related resources, and qualitative data analysis was used to examine differences in solutions offered between food insecure and food secure participants. Of the 370 respondents, forty-eight-point-six percent were classified as food insecure. Food insecure participants were more likely to report shopping for groceries at a convenience/discount store, less likely to use their own vehicle for transportation, and less likely to purchase food from local producers. Food insecure participants were more likely to suggest solutions related to reducing the cost of healthy food, while food secure participants were more likely to suggest educational or convenience-related interventions.

Household food insecurity is associated with depressive symptoms: results from a Mexican population-based survey

The objective of this cross-sectional study was to assess the relationship between food insecurity and depression in the Mexican population. We used data from the 2012 health and nutrition survey (ENSANUT), which is representative of the Mexican population. Food insecurity was determined by the Latin American and Caribbean Food Security Scale (ELCSA). Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale Short-Form (CES-D-SF). Adjusted logistic regression analyses and ANCOVA were used. Out of 33,011 participants, 5788 (18%) had high depressive symptoms and 24,098 (73%) experienced food insecurity. The adjusted logistic regression analysis showed that, participants with mild food insecurity, (OR = 1.47,95% CI = 1.27 to 1.71), moderate food insecurity (OR = 2.14,95% CI = 1.85 to 2.47) and severe food insecurity (OR = 3.01,95% CI = 2.51 to 3.60,) were more likely to have high depressive symptoms than food secure participants. Participants with moderate food insecurity (OR =1.45, 95% CI = 1.28 to 1.64) and severe food insecurity (OR =2.04, 95% CI = 1.76 to 2.37) were more likely to suffer from depression as compared to participants with mild food insecurity. Participants with severe food insecurity were more likely (OR=1.41, 95% CI = 1.21 to 1.65) to suffer from depression compared to participants with moderate food insecurity. This paper provides an overview of the complex problem of food insecurity and mental health. Despite the unknown causality, the analysis suggests a strong association between depression and food insecurity. This problem calls for much more attention from the scientific community. Given the high prevalence of depression and the high prevalence of household food insecurity in Mexico, the implementation of successful public health programs to improve food security is necessary.

Housing and Food Insecurity and Chronic Disease Among Three Racial Groups in Hawai'i.

IntroductionFood and housing insecurity are social determinants of health related to chronic disease, including diabetes, cardiovascular disease (CVD), and asthma. How these insecurities affect chronic disease among the 3 largest racial groups in Hawaiʻi is unknown. The purpose of this study was to examine chronic disease by housing and food insecurity among whites, Asians, and Native Hawaiian/other Pacific Islanders (NHOPIs) in Hawaiʻi.MethodsWe pooled data on 9,907 respondents from the 2009 and 2012 Behavioral Risk Factor Surveillance System. Dependent variables were diabetes, CVD, and asthma. Independent variables were housing and food insecurity. Logistic regression models were stratified by race to examine within-group differences by severity of insecurity.ResultsCompared with housing secure respondents, housing insecure NHOPIs had higher adjusted odds of diabetes (odds ratio [OR] = 1.85; 95% confidence interval [CI], 1.13–3.01) and CVD (OR = 1.85; 95% CI, 1.04–3.28), and housing insecure whites (OR = 1.52; 95% CI, 1.12–2.04) and Asians (OR = 1.93; 95% CI, 1.29–2.88) had higher adjusted odds of asthma. Compared with food secure participants, food insecure NHOPIs had higher adjusted odds of diabetes (OR = 2.17; 95% CI, 1.28–3.68); food insecure whites (OR = 1.88; 95% CI, 1.16–3.05) and NHOPIs (OR = 2.04; 95% CI, 1.10–3.78) had higher adjusted odds of CVD, and food insecure whites (OR = 1.53; 95% CI, 1.06–2.22) and Asians (OR = 1.79; 95% CI, 1.05–3.06) had higher adjusted odds of asthma.ConclusionHousing and food insecurity are associated with higher rates of chronic diseases among some races in Hawaiʻi. Policy makers should work to increase affordable housing and improve policies to increase food affordability.

Food Insecurity and Odds of High Allostatic Load in Puerto Rican Adults: The Role of Participation in the Supplemental Nutrition Assistance Program During 5 Years of Follow-Up.

Limited evidence demonstrates pathways linking food insecurity (FI) to chronic disease. Allostatic load (AL) may elucidate potential pathways, capturing both primary (neuroendocrine, inflammation) and secondary (metabolic, cardiovascular) physiological disturbances. We examined the longitudinal association of FI with 5-year AL and primary and secondary subsystem dysregulation and tested moderation by Supplemental Nutrition Assistance Program (SNAP) participation. We analyzed data from the longitudinal Boston Puerto Rican Health Study among 733 adults aged 45 to 75 years. Participants categorized as food insecure (assessed by US survey module) experienced FI at baseline and/or year 5. AL score comprised 11 biological components (5 primary, 6 secondary). We classified participants as having high scores for AL (≥6 dysregulated components), primary system (≥3), and secondary system (≥4). Multivariate models estimated odds ratios (OR), adjusting for baseline AL, sociodemographic, cultural, and behavioral characteristics. By study end, 33.8% had experienced FI, 65.5% had participated in SNAP, and 37.5% had high AL. In adjusted models, FI was not associated with AL (OR [95% confidence intervals] = 1.07 [0.70-1.64]) or secondary system (0.82 [0.48-1.40]) scores, but was associated with high primary system scores (1.71 [1.25-2.36]). SNAP participation seemed to moderate the FI-primary system relationship (p = .06); food-insecure participants never receiving SNAP (mean (SE) = 2.06 (0.14)) had higher scores than food-secure participants receiving (1.72 (0.06], p = .02) or never receiving SNAP (1.64 (0.10), p = .01) and food-insecure participants receiving SNAP (1.80 (0.07), p = .08). FI is associated with dysregulated components of the primary AL system, and this relationship may be stronger for those not receiving SNAP. Research is needed in additional populations to test AL as a plausible pathway connecting FI to chronic disease and SNAP as a moderator.

Women in food insecure, rural Appalachian households participate in risky sexual behaviors: a pilot study

ABSTRACTHuman papillomavirus (HPV) is the main causative agent of cervical cancer. This cross-sectional survey examined differences in HPV status and risky sexual behaviors between food-secure and food-insecure adult females living in rural Appalachia (n = 153). Most had HPV-negative test results [n = 139 (91.4%)]. Overall, 49 participants (35.5%) had low Risky Sexual Behavior scores, while 28 (20.3%) and 61 (44.2%), respectively, had medium- and high-risk levels. Non-fully food-secure participants had significantly higher scores, compared to their fully food-secure counterparts (p < 0.001). Women living in food-insecure households may be at risk for riskier sexual behaviors, which may contribute to the higher cervical cancer rates in Appalachia.

Food acquisition methods and correlates of food insecurity in adults on probation in Rhode Island.

BackgroundIndividuals under community corrections supervision may be at increased risk for food insecurity because they face challenges similar to other marginalized populations, such as people experiencing housing instability or substance users. The prevalence of food insecurity and its correlates have not been studied in the community corrections population.MethodsWe conducted a cross-sectional study in 2016, surveying 304 probationers in Rhode Island to estimate the prevalence of food insecurity, identify food acquisition methods, and determine characteristics of groups most at-risk for food insecurity. We used chi-square and Fisher’s exact tests to assess differences in sociodemographics and eating and food acquisition patterns, GIS to examine geospatial differences, and ordinal logistic regression to identify independent correlates across the four levels of food security.ResultsNearly three-quarters (70.4%) of the participants experienced food insecurity, with almost half (48.0%) having very low food security. This is substantially higher than the general population within the state of Rhode Island, which reported a prevalence of 12.8% food insecurity with 6.1% very low food security in 2016. Participants with very low food security most often acquired lunch foods from convenience stores (and less likely from grocery stores) compared to the other three levels of food security. Participants did not differ significantly with regards to places for food acquisition related to breakfast or dinner meals based upon food security status. In adjusted models, being homeless (AOR 2.34, 95% CI: 1.31, 4.18) and depressed (AOR 3.12, 95% CI: 1.98, 4.91) were independently associated with a greater odds of being in a food insecure group. Compared to having help with meals none of the time, participants who reported having meal help all of the time (AOR 0.28, 95% CI: 0.12, 0.64), most of the time (AOR 0.31, 95% CI: 0.15, 0.61), and some of the time (AOR 0.54, 95% CI: 0.29, 0.98) had a lower odds of being in a food insecure group. Food insecure participants resided in different neighborhoods than food secure participants. The highest density of food insecure participants resided in census tracts with the lowest median incomes for the general population. The areas of highest density for each level of food security for our participants were in the census tracts with the lowest levels of full-time employment for the general population.ConclusionsThe prevalence of food insecurity and very low food security were markedly higher in our probation population compared to the general RI population. These findings suggest that access to food on a regular basis is a challenge for adults on probation. Depression and being homeless were independently associated with a greater odds of being in a food insecure group. In addition to intervening directly on food insecurity, developing interventions and policies that address the contributing factors of food insecurity, such as safe housing and treatment for depression, are critical.

Interrelationship between food security status, home availability of variety of fruits and vegetables and their dietary intake among low-income pregnant women.

To (i) determine differences in the availability of variety of fruits and vegetables (F&V) at home by food security status; and (ii) examine the inter-associations between food security status, availability of variety of F&V at home and frequency of F&V intake, among low-income pregnant women. Design/Setting Participants were interviewed to collect food security status, home availability of variety of F&V and frequency of F&V intake. Bivariate analyses, multivariate regression and exploratory mediation analyses were conducted using IBM SPSS Statistics version 23.0 and the PROCESS macro. Low-income pregnant women (n 198) were interviewed if they were ≥18 years of age, in the second trimester of pregnancy, and spoke English or Spanish. Low/very low food security was found among 43 % of participants. Compared with fully food-secure participants, very low food-secure participants reported a lower variety of fruits (P=0·028) and vegetables (P=0·058) available at home. Mediation analyses indicated that through home availability of variety of fresh F&V, food security status was associated with the daily intake of F&V (indirect effect (95 % CI): fresh fruits, -0·039 (-0·074, -0·013); fresh vegetables, -0·048 (-0·083, -0·023)). As food security worsened, the available variety of fresh F&V decreased, which was associated with lower intake. The study highlights the interlink between food security, home food environment and diet quality, and the importance of nutrition education intervention to promote a healthy home food environment and improved pregnancy outcomes among low-income women.

Food Security Status is Associated with Diet Quality in Indiana Supplemental Nutrition Assistance Program‐Education (SNAP‐Ed) Eligible Adults

BackgroundFood security and socioeconomic status have been associated with diet quality. Supplemental Nutrition Assistance Program‐Education (SNAP‐Ed) aims to improve the diet quality of low resource populations; however, little is known about the association of food security status with diet quality in the SNAP‐Ed eligible population.ObjectiveThe objective of this study was to determine whether food security status is associated with diet quality in a sample of Indiana SNAP‐Ed eligible adult participants.MethodsSNAP‐Ed eligible adults age ≥18 y (n = 261) from 31 Indiana counties were recruited to participate from August 2015 to May 2016. Baseline food security score was assigned for household adults using the 10‐item United States Household Food Security Survey Module and used to classify participants as food secure (0–2) or food insecure (3–10). Baseline Healthy Eating Index‐2010 (HEI‐2010) score was assigned using dietary data collected from the National Cancer Institute Automated Self‐Administered 24‐Hour Recall Tool (2014 version with 1–2 days of recalls per participant). A generalized linear regression model was used to estimate the association between food security status and HEI‐2010 score for this cross‐sectional study.ResultsFood security status is significantly associated with total HEI‐2010 score (β = 4.7; p = 0.01) at baseline. The mean total HEI‐2010 score was 45.1 ± 14.0 (Mean ± SD) for food secure participants (n = 68) and 40.4 ± 12.1 (Mean ± SD) for food insecure participants (n = 139).ConclusionDiet quality is lower in food insecure SNAP‐Ed eligible Indiana adults compared with their food secure counterparts. There is a strong need for nutrition interventions to improve diet quality, particularly targeting food insecure audiences within in low‐resource populations.Support or Funding InformationThis activity was funded, by Purdue, as part of AgSEED Crossroads funding to support Indiana's Agriculture and Rural Development and the Purdue Health and Human Sciences Cooperative Extension Nutrition Education Program.

Food insecurity and diabetes self-management among food pantry clients.

To examine the association between level of food security and diabetes self-management among food pantry clients, which is largely not possible using clinic-based sampling methods. Cross-sectional descriptive study. Community-based food pantries in California, Ohio and Texas, USA, from March 2012 through March 2014. Convenience sample of adults with diabetes queuing at pantries (n 1237; 83 % response). Sampled adults were stratified as food secure, low food secure or very low food secure. We used point-of-care glycated Hb (HbA1c) testing to determine glycaemic control and captured diabetes self-management using validated survey items. The sample was 70 % female, 55 % Latino/Hispanic, 25 % white and 10 % black/African American, with a mean age of 56 years. Eighty-four per cent were food insecure, one-half of whom had very low food security. Mean HbA1c was 8·1 % and did not vary significantly by food security status. In adjusted models, very-low-food-secure participants, compared with both low-food-secure and food-secure participants, had poorer diabetes self-efficacy, greater diabetes distress, greater medication non-adherence, higher prevalence of severe hypoglycaemic episodes, higher prevalence of depressive symptoms, more medication affordability challenges, and more food and medicine or health supply trade-offs. Few studies of the health impact of food security have been able to examine very low food security. In a food pantry sample with high rates of food insecurity, we found that diabetes self-management becomes increasingly difficult as food security worsens. The efficacy of interventions to improve diabetes self-management may increase if food security is simultaneously addressed.

The Relationship Between Dietary Quality and Food Insecurity for a Sample of Low-Income Mothers

To determine if there were differences in dietary quality between food insecure and food secure mothers enrolled in a prospective study. Low-income mothers completed surveys and >2 dietary recalls, as well as semi-structured interviews, at baseline (n=101). Dietary quality was evaluated using the HEI-2010 component and total scores. There were no significant differences in HEI-2010 component or total scores between food insecure and food secure participants. Our results suggest the salience of other factors, including race/ethnicity, household income, and access to federal food assistance, which complicate the relationship between food insecurity and dietary quality.

Food Insecurity and Medication Adherence in Low-Income Older Medicare Beneficiaries With Type 2 Diabetes

Little is known about diabetes management among low-income older Americans. This study used statewide self-administered survey and Medicare claims data to examine the relationships of food insecurity and medication (re)fill adherence in a sample of Medicare Part D beneficiaries with type 2 diabetes in need of food assistance in Georgia in 2008 (n = 243, mean age 74.2 ± 7.8 years, 27.2% African American, 77.4% female). (Re)fill adherence to oral hypoglycemics was measured as Proportion of Days Covered. Food insecurity was assessed using a six-item validated standard measure. About 54% of the sample were food insecure. About 28% of the diabetic sample did not (re)fill any diabetes medication and over 80% had at least one diabetes complication. Food insecure participants showed comparable (re)fill adherence to food secure participants. However, 57% of food insecure participants were nonadherent to oral hypoglycemics. Underlying basic needs must be addressed to improve diabetes management in this population.

Food-insecure dietary patterns are associated with poor longitudinal glycemic control in diabetes: results from the Boston Puerto Rican Health study.

OBJECTIVETo determine whether dietary patterns associated with food insecurity are associated with poor longitudinal glycemic control.RESEARCH DESIGN AND METHODSIn a prospective, population-based, longitudinal cohort study, we ascertained food security (Food Security Survey Module), dietary pattern (Healthy Eating Index–2005 [HEI 2005]), and hemoglobin A1c (HbA1c) in Puerto Rican adults aged 45–75 years with diabetes at baseline (2004–2009) and HbA1c at ∼2 years follow-up (2006–2012). We determined associations between food insecurity and dietary pattern and assessed whether those dietary patterns were associated with poorer HbA1c concentration over time, using multivariable-adjusted repeated subjects mixed-effects models.RESULTSThere were 584 participants with diabetes at baseline and 516 at follow-up. Food-insecure participants reported lower overall dietary quality and lower intake of fruit and vegetables. A food insecurity*HEI 2005 interaction (P < 0.001) suggested that better diet quality was more strongly associated with lower HbA1c in food-insecure than food-secure participants. In adjusted models, lower follow-up HbA1c was associated with greater HEI 2005 score (β = −0.01 HbA1c % per HEI 2005 point, per year, P = 0.003) and with subscores of total vegetables (β = −0.09, P = 0.04) and dark green and orange vegetables and legumes (β = −0.06, P = 0.048). Compared with the minimum total vegetable score, a participant with the maximum score showed relative improvements of HbA1c of 0.5% per year.CONCLUSIONSFood insecurity was associated with lower overall dietary quality and lower consumption of plant-based foods, which was associated with poor longitudinal glycemic control.

Food insecurity among Dutch food bank recipients: a cross-sectional study

ObjectiveTo determine the prevalence of (very) low food security among Dutch food bank recipients, and to identify potential demographic, lifestyle and nutrition-related factors associated with (very) low food security.Setting11 of...

Food Security and Cardiovascular Disease Risk Among Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2003–2008

IntroductionLittle is known about the relationship between food security status and predicted 10-year cardiovascular disease risk. The objective of this study was to examine the associations between food security status and cardiovascular disease risk factors and predicted 10-year risk in a national sample of US adults.MethodsA cross-sectional analysis using data from 10,455 adults aged 20 years or older from the National Health and Nutrition Examination Survey 2003–2008 was conducted. Four levels of food security status were defined by using 10 questions.ResultsAmong all participants, 83.9% had full food security, 6.7% had marginal food security, 5.8% had low food security, and 3.6% had very low food security. After adjustment, mean hemoglobin A1c was 0.15% greater and mean concentration of C-reactive protein was 0.8 mg/L greater among participants with very low food security than among those with full food security. The adjusted mean concentration of cotinine among participants with very low food security was almost double that of participants with full food security (112.8 vs 62.0 ng/mL, P < .001). No significant associations between food security status and systolic blood pressure or concentrations of total cholesterol, high-density lipoprotein cholesterol, or non-high-density lipoprotein cholesterol were observed. Participants aged 30 to 59 years with very low food security were more likely to have a predicted 10-year cardiovascular disease risk greater than 20% than fully food secure participants (adjusted prevalence ratio, 2.38; 95% CI, 1.31–4.31).ConclusionAdults aged 30 to 59 years with very low food security showed evidence of increased predicted 10-year cardiovascular disease risk.

Food Insecurity Is Linked to a Food Environment Promoting Obesity in Households With Children

To determine the extent to which the presence and accessibility of healthful and less healthful foods in children's homes vary with level of food security. A total of 41 parents or primary caregivers who had at least 1 child ages 2-13 and resided in a low-income area with limited food access completed a home food inventory and a validated measure assessing household food security. Compared with food-secure participants, marginal or low/very low food-secure caregivers reported significantly more obesity-promoting foods in the home, more microwavable or quick-cook frozen foods, and greater access to less healthful foods in the kitchen (all Ps < .05). Given the greater presence and accessibility of less healthful foods, targeting home food environment may improve diet quality and health status in children of low-income, food insecure households.