Food Secure Women Research Articles

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

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

Food insecurity and women's mental health in the Chitwan Valley of Nepal

Food insecurity is a major threat to global public health and sustainable development. As of 2022, 2.4 billion people worldwide experienced moderate to severe food insecurity. The occurrence and severity of food insecurity can depend greatly on power and social hierarchies, with women and girls often being less food secure than men and boys even within the same household. Moreover, social roles, such as the socialization of a mother to feed her children, impact food insecurity and its consequences. This study aims to uncover the relationships between food insecurity and mental health for women in the Chitwan Valley of Nepal. Utilizing longitudinal data from the Chitwan Valley Family Study, we connect food security data from 2015 with mental health data collected from 2016 to 2018. We find that women have a higher prevalence of major depressive disorder, generalized anxiety disorder, and panic attacks than men, especially if they are experiencing food insecurity. Among women, we find that those who have recently experienced severe food insecurity have a significantly higher likelihood of meeting diagnostic criteria for generalized anxiety disorder and panic attacks than food-secure women. However, women's food insecurity is not significantly correlated with major depressive disorder. Moreover, we find that food insecurity is likely to co-occur with women's agricultural and wage work. These findings suggest a need for gender-attentive policy and programs accounting for both causes and consequences of food insecurity.

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

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

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

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

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

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

Relationship between food insecurity and smoking status among women living with and at risk for HIV in the USA: a cohort study

ObjectivesPeople living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV...

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

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

Delay discounting and obesity in food insecure and food secure women.

The relation between food insecurity (FI) and delay discounting (DD) and probability discounting (PD) for food and money was tested in women. In addition, discounting was tested as a variable that mediates the relation between obesity and FI. Women recruited from a community sample (N = 92) completed questionnaires. They completed the food choice questionnaire, the monetary choice questionnaire, measures for food and money probability discounting (which quantify sensitivity to risk aversion), and demographic measures. Women with FI had higher rates of obesity and higher food DD compared to food-secure women. However, DD for money or probability discounting for food or money did not significantly differ between FI and food secure groups when controlling for significant covariates. Neither DD or PD significantly mediated the relation between FI and obesity. These results suggest that FI is associated with greater impulsive food choice, but its association with other monetary discounting and probability discounting for food and money appears contingent upon other demographic factors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Higher Parity, Pre-Pregnancy BMI and Rate of Gestational Weight Gain Are Associated with Gestational Diabetes Mellitus in Food Insecure Women.

Food insecurity may exacerbate adverse maternal health outcomes during pregnancy, however, this association has not been well established, particularly in the context of developing countries. This study aimed to identify the associations between household food insecurity and gestational diabetes mellitus (GDM) risk among urban pregnant women. Household food insecurity was assessed using the translated 10-item Radimer/Cornell hunger scale. Logistic regression models were used to estimate the associations between food insecurity status and GDM risk. About 35.6% of women experienced food insecurity, with 25.2% reported household food insecurity, 8.0% individual food insecurity, and 2.4% child hunger. Food insecure women were at significantly higher risk of developing GDM compared to food secure women (AOR = 16.65, 95% CI = 6.17–24.98). The significant association between food insecurity and GDM risk was influenced by pre-pregnancy BMI, parity and rate of GWG at second trimester. Food insecure women with parity ≥ 2 (AOR = 4.21, 95% CI = 1.98–8.92), overweight/obese BMI prior to pregnancy (AOR = 12.11, 95% CI = 6.09–24.10) and excessive rate of GWG in the second trimester (AOR = 9.66, 95% CI = 4.27–21.83) were significantly more likely to develop GDM compared to food secure women. Food insecurity showed strong association with GDM risk in that the association was influenced by maternal biological and physical characteristics. Multipronged interventions may be necessary for food insecure pregnant women who are not only at risk of overweight/obesity prior to pregnancy but also may have excessive gestational weight gain, in order to effectively reduce GDM risk.

Association between food insecurity and obesity in an agricultural community of women from El Jadida, Morocco

<abstract><sec> <title>Background</title> Food insecurity (FI) has received much attention in the last decades due to its strong association with obesity. Indeed, it has begun to be a serious concern, especially in developing countries undergoing a nutritional transition. </sec><sec> <title>Objective</title> The aim of this study was to examine the association between FI, food intake and the risk of obesity in an agricultural community of women from El Jadida Province in Morocco. </sec><sec> <title>Materials and methods</title> The survey included a sample of 214 women. Weight and height were measured, and the body mass index was calculated. FI was measured using a household FI access scale. Food intake was evaluated using two 24-hour dietary recalls. Variance tests and Chi-square tests are applied for means ± standard deviations comparisons and proportions with percentages of continuous and categorical variables, respectively. </sec><sec> <title>Results</title> The female population surveyed had an average age of 44 ± 13 years, 42% were obese, 36% were overweight, and 86% were centrally obese (CO). FI was observed in 78% of the sample, and it is found to be associated with both overweight, general obesity (GO) and CO (P ≤ 0.001). The risk of GO was extremely high in women with mild FI (unadjusted OR = 31.33, 95% CI: 7.01, 140.06). This association remained high after adjustment for socio-demographic variables (adjusted OR = 24.98, 95% CI: 5.36, 116.35). Compared with food secure women, the risk of CO was significantly higher in women with moderate FI (unadjusted OR = 16.44, 95% CI: 3.56, 75.91). This association remained significant after adjustment for socio-demographic variables (OR adjusted = 36.51, 95% CI: 4.81, 276.7). FI was associated with high daily energy (P &lt; 0.013) and low iron intakes (P &lt; 0.019). </sec><sec> <title>Conclusion</title> There is a high prevalence of FI associated with overweight, GO and CO and with high energy intake among the rural female population. Hence, intervention programs must consider food security in the fight against obesity and its associated problems, by ensuring women's access to a variety of high quality foods and the achievement of a balanced diet at the local and national levels. </sec></abstract>

Supplemental Material for Delay Discounting and Obesity in Food Insecure and Food Secure Women

Supplemental Material for Delay Discounting and Obesity in Food Insecure and Food Secure Women

Maternal Food Insecurity is Positively Associated with Postpartum Mental Disorders in Ontario, Canada

Household food insecurity has been associated with pregnancy complications and poorer birth outcomes in the United States and with maternal mental disorders in the United Kingdom, but there has been little investigation of the effects of food insecurity during this life stage in Canada. Our objective was to examine the relationship between the food insecurity status of women during pregnancy and maternal and birth outcomes and health in infancy in Canada. We drew on data from 1998 women in Ontario, Canada, whose food insecurity was assessed using the Household Food Security Survey Module on the Canadian Community Health Survey, cycles 2005 to 2011-2012. These records were linked to multiple health administrative databases to identify indications of adverse health outcomes during pregnancy, at birth, and during children's first year of life. We included women who gave birth between 9months prior and 6months after their interview date, and for whom infant outcome data were available. Multivariable Poisson regression models were used to compare outcomes by maternal food security status, expressed as adjusted relative risks (aRR) with 95% CIs. While pregnant, 5.6% of women were marginally food insecure and 10.0% were moderately or severely food insecure. Food insecurity was unrelated to pregnancy complications and adverse birth outcomes, but 26.8% of women with moderate or severe food insecurity had treatment for postpartum mental disorders in the 6-month postpartum period, compared to 13.9% of food-secure women (aRR, 1.86; 95% CI, 1.40-2.46). Children born to food-insecure mothers were at elevated risk of being treated in an emergency department in the first year of life (aRR, 1.18; 95% CI, 1.01-1.38). Maternal food insecurity during pregnancy in Ontario, Canada, is associated with postpartum mental disorders and a greater likelihood of infants being treated in an emergency department.

Persistent Food Insecurity, but not HIV, is Associated with Depressive Symptoms Among Perinatal Women in Kenya: A Longitudinal Perspective.

Food insecurity (FI) is an understudied risk factor for depression among perinatal women in sub-Saharan Africa. We therefore explored the longitudinal relationship between FI and depressive symptoms among a cohort of perinatal women of mixed HIV status (n = 371) in Kenya (NCT02974972, NCT02979418). Using longitudinal linear and logistic regressions with random effects, we assessed bivariate and adjusted associations between maternalFI and depressive symptoms. HIV status was also assessed as a potential effect modifier. At baseline, 58% of pregnant women had probable depression (CES-D score > 16) and 84% were severely food insecure. In adjusted analyses, severely food-insecure women had 5.90 greater odds (95% CI 2.32, 15.02, p < 0.001) of having probable depression and scored 4.58 points higher on the CES-D scale(SE: 1.04, p < 0.001) relative to food-secure women. HIV status did not modify the association between FI and depressive symptoms. Interventions to reduce FI may reduce perinatal depression, benefiting mothers and their infants.

Associations among food security, BMI, diet diversity and food consumption patterns of women in rural Kenya

Enhancing food security is one of the United Nations Sustainable Development Goals. Improved agricultural production is an approach to addressing food insecurity. However, these efforts can result in significant changes that are associated with increased risk of non-communicable chronic diseases. Previous research with women in Central Kenya found that the number of years a woman-farmer was engaged in dairy development was associated with greater food security and energy (kJ) intake. No studies have examined food security and the nutrition transition among rural farm women involved in dairy development initiatives. A cross-sectional survey was conducted in 2009 and again in 2017. Chain referral sampling was used in 2009 to recruit 111 women in five groups based on how long they had been a dairy group member (non-members and members from one to more than 10 years). In 2017, 20 women were randomly selected from 85 of the dairy-group member households surveyed in 2009 and a comparison group of 20 women was randomly selected from a list that was generated by referral from the participants. In person one-on-one interviews were conducted with a translator. Demographic, household food security, and dietary intake were collected in both years. In 2009 women’s height and weight data were collected for BMI calculation. Associations among food security, BMI, dietary intake, and year of data collection were examined. Demographic characteristics were comparable between 2009 and 2017 and between food secure and food insecure households. In both years, the majority of households were categorized as not food insecure (67% and 75%; 2009 and 2017, respectively). In 2009 almost half the women (49.4%) had BMIs in the overweight and obese category. Food secure women had a significantly higher median BMI (26.5) compared with food insecure women (24.0). Diet diversity was low (<5) for all women and there was little evidence for a classic “western diet” of the nutrition transition. There was evidence of globalization in food availability and greater purchasing capacity that was demonstrated by the high proportion of women that consumed sugar, refined fats and oils, refined maize and wheat flours, and bread. Household food security was associated with the consumption of sugar, cabbage, wheat flour and bread. These findings support a unique rural nutrition transition, with food security, characterized by low dietary diversity, access to refined basic foods and high unhealthy BMI. Governments and non-governmental organizations need to support nutrition- sensitive agriculture and public health programs to curb the crisis of overweight, undernourishment and chronic diseases. Key words: agriculture, nutrition transition, rural, farm, Kenya, women, BMI, diet diversity

Emotional Eating Partially Mediates the Relationship Between Food Insecurity and Obesity in Latina Women Residing in the Northeast U.S.

Abstract Objectives To examine the mediating role of emotional eating (EE) in the association between food insecurity (FI) and obesity in U.S. Latina women. Methods This study had a cross-sectional design. Participants were Latina women (n = 297) recruited from a community health center serving a large portion of the Latino population in Lawrence, Massachusetts. FI was measured with the 6-item USDA Household Food Security Scale. EE was measured with the Three Factor Eating Questionnaire R18-V2. Measured height and weight were used to calculate BMI; obesity was defined as BMI &amp;gt; 30.0 kg/m2. Covariates included: age, education, marital status, physical activity and country of birth. Mediation was tested using the Baron and Kenny method and the mediated proportion was calculated. Analyses included multivariable logistic regression and linear regression. Results Women were on average 46 ± 5 years. The majority were Dominicans (73%), born outside of the U.S. (78%), and with an education level of high school or less (70%). Overall, 36% of women experienced FI. Compared to food secure women, FI women were more likely to be obese (42% vs. 58%; P = 0.01), and had higher emotional eating scores (2.02 vs. 1.78; P = 0.03). In adjusted models, FI was associated with higher odds of obesity (Step 1 = OR: 1.78; 95% CI: 1.08–2.94) and higher EE scores (Step 2 = 0.23; 95% CI: 0.009–0.45). In turn, EE was associated with higher odds of obesity (Step 3 = OR: 1.81; 95% CI: 1.37–2.41). When EE was included in the main effects model, FI was only marginally significantly associated with obesity (Step 4 = OR: 1.62; 95% CI: 0.96–2.72) and EE explained 22% of the association between FI and obesity. Conclusions The association between FI and obesity is partially mediated by EE in Latina women. Longitudinal studies are needed to confirm our findings and to determine whether EE is an important intervention target to decrease obesity in this vulnerable group. Funding Sources Research reported in this abstract was supported by the National Institutes of Health, National Institute of Mental Health, National Institute of Minority Health and Health Disparities and Centers for Disease Control and Prevention.

The role of prenatal food insecurity on breastfeeding behaviors: findings from the United States pregnancy risk assessment monitoring system

BackgroundIn addition to its health and nutritional benefits, breastfeeding can save low-income, food insecure mothers the cost of infant formula so that money can be spent on food and other necessities. Yet breastfeeding may exacerbate food insecurity by negatively affecting maternal employment. The relationship between food insecurity and breastfeeding has been explored previously, with varying results. The purpose of this study was to determine the relationship between prenatal food insecurity and breastfeeding initiation and early cessation (< 10 weeks) among U.S. mothers.MethodsData were pooled from 2012 to 2013 (Phase 7) of the Pregnancy Risk Assessment Monitoring System, a population-based cross-sectional survey of postpartum women administered 2–4 months after delivery. The analytic sample was drawn from Colorado, Maine, New Mexico, Oregon, Pennsylvania, and Vermont, and limited to mothers aged 20 years and older whose infants were alive and living with them at the time of the survey (n = 10,159). We used binomial and multinomial logistic models to assess the predictive association between food insecurity and breastfeeding initiation and early cessation, respectively, while controlling for confounders.ResultsMost women reported prenatal food security (90.5%) and breastfeeding initiation (91.0%). Of those who initiated breastfeeding, 72.7% breastfed for > 10 weeks. A larger proportion of food secure women compared to food insecure women, initiated breastfeeding (91.4% vs. 87.6%, P < 0.01), and patterns of early breastfeeding cessation differed significantly between the two groups (P < 0.01). In the final models, prenatal food insecurity was not associated with breastfeeding initiation or early cessation, with one exception. Compared to food secure mothers, mothers reporting food insecurity had a lower risk of breastfeeding for 4–6 weeks than for > 10 weeks, independent of covariates (relative risk ratio 0.65; 95% CI 0.50, 0.85; P < 0.01). Women who were married, had a college degree, and did not smoke were more likely to initiate breastfeeding and breastfeed for a longer time, regardless of food security status (P < 0.01).ConclusionsSocioeconomic, psychosocial, and physiological factors explain the association between prenatal food insecurity and breastfeeding outcomes among this U.S. sample. More targeted and effective interventions and policies are needed to encourage the initiation and duration of breastfeeding, regardless of food security status.

Food-Insecure Women Eat a Less Diverse Diet in a More Temporally Variable Way: Evidence from the US National Health and Nutrition Examination Survey, 2013-4.

Food insecurity is associated with high body weight amongst women, but not men, in high-income countries. Previous research using food recalls suggests that the total energy intake of food-insecure women is not elevated, though macronutrient composition may differ from that of food-secure women. There is limited evidence on temporal patterns of food consumption. Here, we used food recalls from women in the 2013-4 cycle of the National Health and Nutrition Examination Survey (NHANES, n = 2798) to characterise temporal patterns of food consumption in relation to food insecurity. Compared to the food-secure, food-insecure women had more variable time gaps between eating; ate a smaller and less variable number of distinct foods at a time; were more variable from day to day in their time of first consumption; were more variable from day to day in the number of times they ate; and consumed relatively more carbohydrate, less protein, and less fibre. However, their overall energy intake was no higher. Food-insecure women had higher BMIs (2.25 kg/m2), and around 15% of the BMI difference between food-insecure and food-secure women was accounted for by their more variable time gaps between eating, their lower diversity of foods, and their lower fibre consumption. Food insecurity is associated with measureable differences in the temporal pattern of food consumption, and some of these differences shed light on how food-insecure women come to have higher body weights.

Relationship of food insecurity to women's dietary outcomes: a systematic review.

ContextFood insecurity matters for women’s nutrition and health.ObjectiveThis review sought to comprehensively evaluate how food insecurity relates to a full range of dietary outcomes (food groups, total energy, macronutrients, micronutrients, and overall dietary quality) among adult women living in Canada and the United States.Data sourcesPeer-reviewed databases (PubMed/MEDLINE, CINAHL, Scopus, Web of Science) and gray literature sources from 1995 to 2016 were searched.Data extractionObservational studies were used to calculate a percentage difference in dietary intake for food-insecure and food-secure groups.ResultsOf the 24 included studies, the majority found food-insecure women had lower food group frequencies (dairy, total fruits and vegetables, total grains, and meats/meat alternatives) and intakes of macro- and micronutrients relative to food-secure women. Methodological quality varied. Among high-quality studies, food insecurity was negatively associated with dairy, fruits and vegetables, grains, meats/meats alternatives, protein, total fat, calcium, iron, magnesium, vitamins A and C, and folate.ConclusionsResults hold practical relevance for selecting nutritional targets in programs, particularly for nutrient-rich foods with iron and folate, which are more important for women’s health.

Monthly Variations in Dietary Intake of Women Participating in the Supplemental Nutrition Assistance Program

BackgroundHouseholds participating in the Supplemental Nutrition Assistance Program (SNAP) have been shown to spend the majority of their program benefits within the first 3 days of receipt. Hence, it is important to investigate dietary intakes of SNAP participants based on time since receipt of benefits. ObjectiveThe objectives of this study were to investigate the dietary intake of women participating in SNAP over 1 month and to compare diet quality between food secure and food insecure women using two indices. DesignA longitudinal design was used to examine monthly dietary intake of women in SNAP. Participants were measured for height and weight. A demographics questionnaire and a food frequency questionnaire (FFQ) based on a reference period of 1 week were administered. The FFQ was completed four times, with an interval of 1 week, so that it reflected the diets of participants during weeks 1, 2, 3, and 4 of benefit receipt. Participants also completed the US adult food security module. The Healthy Eating Index-2010 and the Dietary Guidelines Adherence Index 2015 were used to assess diet quality. Participants/settingA total of 217 women were recruited from low-income housing and neighborhood centers in Central Texas from January to December 2015. Women enrolled in SNAP, aged 18 to 50 years, and of Hispanic, African-American, and white race or ethnicity participated in the study. Fifty-eight women were lost during follow-up. Data from eight participants was excluded due to reporting of implausible caloric intakes, thereby resulting in a final sample of 151. Main outcome measuresFood group, nutrient intake, and diet quality were the main outcome measures of the study. Statistical analysisA mixed linear model was conducted using week since receipt of benefits as the independent variable and food group, nutrient intake, and diet quality as the dependent variables. An analysis of variance was conducted to determine differences in diet quality based on food security status for each week of the monthly SNAP cycle. ResultsA significant decrease in daily intakes of fruits, vegetables, dairy, and diet quality was observed over the month (P<0.05, with Bonferroni adjustment). Food secure women had higher diet quality than those with very low food security (P<0.05, with Bonferroni adjustment). However, a decline in diet quality was observed in all groups of women, classified according to food security status. ConclusionsThese results show that dietary intake of SNAP participants varies based on time since receipt of benefits.

Abstract P317: An Activity Space Approach to Assessing the Food Environments of Food Secure and Insecure Women

Introduction: Community food environments (FE) are an important correlate of diet- and weight-related CV health. Conventional approaches to measuring the FE focus on residential neighborhoods, and do not assess the full extent of food sources regularly encountered and used. Further, little attention has been given to how individual diet-related experiences, like food insecurity, may interact with features of the FE to affect health. To address these limitations, we use an activity space approach, defined by the locations women routinely visit, to measure FE exposure and use, and assess differences by food security status. Hypothesis: Food-related spatial behavior and features of the FE differ between a) conventional and activity space definitions, and b) food secure and insecure women. Methods: We present initial results (n=51) from an ongoing clinic-based study of low-income African American women in Atlanta, GA. Data are collected in-person using a Google Map-powered activity space questionnaire. USDA’s 10-item adult scale is used to measure food insecurity. Retail FE data are from Dun &amp; Bradstreet. ArcGIS 10.5 was used to define three environments: residential census tract (CT), and convex hull polygons of overall and food-specific activity spaces. We tested differences, by food security status, in mean behaviors and FE features with one-way ANOVAs. Results: Eighty-eight percent of women were food insecure. Food insecure women were lower income, less often employed, and less often had access to a car. CTs contained fewer supermarkets (μ=1.2 SD =1.4) and fast food restaurants (μ=3.9 SD =3.2) than activity spaces (μ=7.9 SD =7.0; μ=55.5 SD =44.1, respectively). On average, 6.7% ( SD =13.5) of utilized food sources fell within CT bounds, while 53.4% ( SD =35.5) fell within activity spaces. Compared to food secure women, food insecure women had smaller overall (μ=329.8km 2 SD =340.4 vs. μ=548.3km 2 SD =422.4; p =0.16) and food-specific (μ=48.1km 2 SD =74.3 vs. μ=85.6km 2 SD =106.4; p =0.28) activity spaces, and a smaller proportion of their utilized supermarkets fell within their activity spaces (μ=60.9% SD =42.4 vs. μ=81.9% SD =21.4; p =0.24). FE features did not differ by food security status. Conclusions: Conventional FE definitions likely underestimate the number of food sources women encounter, and do not capture the majority of sources used. Smaller activity spaces among food insecure women suggest that routine spatial mobility may be constrained by factors like transportation access. Still, food insecure women more often traveled outside of their activity spaces to utilize supermarkets, suggesting a dual burden of constrained spatial mobility and access. Interestingly, FE features did not differ by food security status. In planned future analyses, any observed differences in diet and weight may indicate variation in how women interact with the FE, rather than differences in exposure.