Food Security Status Research Articles

Differences in Cooking Behavior and Infrastructure by Food Security Status Among Historically Underserved College Students

ABSTRACT Food insecurity is a growing concern among diverse college students. This study examined how cooking confidence, behavior, and kitchen infrastructure differ among low-income, first-generation college students. Multiple linear regression was used to assess differences in access to cooking confidence, behavior, and infrastructure by food security status among students at three college campuses from Northern, Central and Southern California (n = 404). Fifty-eight percent of students were food insecure. Food insecure students reported significantly less access to cooking infrastructure (p < .001) and less cooking behavior (p < .002). Colleges might consider addressing cooking resources and kitchen facilities for historically underserved students.

Household Food Security Status and Diet Diversity Predictors of Mother Child-Dyads from Rural Smallholders in Three Agroecological Zones of Malawi

ABSTRACT Data from mother-child dyads (n = 375) living in rural smallholder farming households in Malawi was utilized. Households with an average income of >$4.2 US dollars per member had 60% lower odds (OR: 0.40, 95%CI: 0.19–0.82) of food insecurity. Household food insecurity was a predictor of Minimum Dietary Diversity for Women (MDD-W) (OR: 0.43, 95%CI: 0.21–0.89). Children whose female caregivers met MDD-W had 37 times higher odds (OR: 37.6, 95%CI: 13.9–117) of meeting the recommended dietary diversity score. To address food and nutrition security in this population, an approach that encompasses women’s empowerment and income diversification is required.

Exploring food safety knowledge and practices in Lebanon

Background: Lebanon’s economic and financial crises have affected the quality-of-life, including food safety and food security. Aim: To assess food safety knowledge and practices among a sample Lebanese population and the association with the sociodemographic and economic characteristics of participants. Methods: This cross-sectional study collected data online from 412 Lebanese adults aged ≥ 18 years [mostly female (77.7%)] between October and December 2021. The data included their sociodemographic characteristics, food safety knowledge and practices, experience of food insecurity, and financial wellbeing. We conducted logistic regression analyses to explore the associations between food safety knowledge and practices, sociodemographic variables, and food security status of participants. Results: A significantly higher proportion of married (vs single) participants said they reheated refrigerated meat or chicken before consumption (74.3% vs 63.1%, P = 0.017). A significantly higher proportion of participants in the higher income category and those with university education (versus lower level of education) knew the characteristics of a contaminated food (34.2% vs 15.0%, P = 0.008). Older participants were significantly more knowledgeable about the management of leftover food (mean 34.54 years vs 31.25 years; P = 0.014). Household food security status did not show any statistically significant association with any of the 5 food safety measures examined. Conclusion: This study confirms the existence of suboptimal food safety knowledge and practices by almost half of the sample. There is therefore a need for evidence-based public health interventions to increase knowledge, and promote better practices, of safe food handling, thereby reducing the risk of foodborne diseases in Lebanon.

Socioeconomic status and sleep duration among a representative, cross-sectional sample of US adults

BackgroundSleep is a crucial determinant of physical and mental health outcomes, and insufficient sleep is highly prevalent among United States adults. Although some risk factors of poor sleep have been extensively studied, including substance use, age, health behaviors, and others, the associations between socioeconomic status (SES) and sleep remain inconclusive. There is limited evidence on SES and sleep duration among the US adult population. This study analyzed the relationships between three SES indicators (poverty, education, and food security), and sleep duration.MethodsWe used responses from the 2017-March 2020 National Health and Nutrition Examination Survey (NHANES). Respondents younger than 25 years old were excluded. Sleep duration was classified using self-reported sleep time and stratified by work vs. non-workdays. SES was operationalized using three indicators: poverty-income ratio, educational attainment, and food security status. We imputed missing data for socioeconomic status and outcome variables using multiple imputation. Weighted Poisson regression models with robust standard errors were used to calculate the crude and adjusted prevalence ratios for insufficient sleep duration (< 7 h of self-reported sleep) on workdays and non-workdays separately by each of the three SES indicators.ResultsWe included a total of 8,457 individuals. In the adjusted model, participants with lower income, educational status, and food security had significantly higher prevalence of insufficient sleep duration on both workdays and non-workdays. For example, low-income individuals (poverty-income ratio < 1) had 1.22 (95% CI 1.04–1.44) and 2.08 (95% CI 1.61–2.67) higher prevalence of insufficient sleep as compared to high income individuals on workday and non-workdays, respectively. In general, we found larger differences by level of SES indicator for the non-workday than for the workday outcome. There were no major differences in gender-stratified analysis. We also found that lower SES was associated with higher prevalence of excessive sleep (≥ 9 h).ConclusionSocioeconomic status indicators are significantly associated with sleep duration in the US adult population. Lower SES correlates with increased prevalence of insufficient sleep duration, which has implications for the overall wellbeing of US adults with lower SES. Targeted interventions and further research are needed to reduce this disparity.

Exploring the determinants of malnutrition in 2–5 year Iranian children using structural equation modeling: national food and nutrition surveillance

BackgroundChildhood malnutrition remains a critical public health challenge in low- and middle-income countries, contributing significantly to morbidity and mortality among children aged 2–5 years. This study was undertaken to assess the nutritional status of 2–5 y children and to explore the main determinants of child malnutrition in eight food insecure provinces of Iran.MethodsIn each province, participants were invited to attend the health house/center to complete the questionnaire on the pre-appointed day. In this study, an android application comprising electronic questionnaires was employed for data collection. Anthropometric, dietary, food security and socioeconomic status (SES) assessments were performed. Structural equation modeling (SEM) was done to assess the structural relationship of malnutrition indicators (z-score of height to age (HAZ), z-score of weight to age (WAZ) and z-score of weight to height (WHZ)) with other variables.ResultsOverall, 2247 children aged 42.2 ± 0.3 months were enrolled in the study, of whom 1048 (46.6%) were female and 1438 (64%) were urban residents. Based on Z score criteria, 216 (10.1%) of the studied children had less than − 2SD HAZ, 193 (8.4%) had lower than − 2SD WHZ and 188 (8.1%) had lower than − 2SD WAZ. The prevalence rates of stunting, wasting and underweight were not significantly different between boys and girls. Nevertheless, the occurrence of stunting was significantly higher in children residing in rural than in urban areas (p = 0.025). SEM analysis revealed that higher SES had a positive relationship with HAZ (0.089), WAZ (0.163) and WHZ (0.109). The effect of SES was greatest on WAZ, indicated by the highest absolute value of a path coefficient. There were specific indirect effects of father’s education on HAZ (0.032, p = 0.001), WHZ (0.045, < 0.001) and WAZ (0.061, < 0.001) through effect on SES and DDS. SES had a direct effect on DDS (0.202).ConclusionsOur findings using SEM approach provided more concrete evidence for the effect of the household’s SES on child’s nutritional status. Nevertheless, we still need to monitor the studied population in the context of our surveillance program to document more conclusive causal associations.

Associations Between Food Security, Housing and Health in South Australia.

Food security is becoming increasingly difficult to achieve for many households. Research has shown that food insecurity is associated with socioeconomic disadvantage, including housing pressures, and may contribute to poor health outcomes. There is lack of data on these associations in the South Australian setting, where food security is not consistently monitored. A population health survey was administered to South Australian participants in April 2023. Descriptive analysis was conducted on data regarding food insecurity, housing circumstances, chronic and mental health conditions. Multivariate logistic regression analysis was performed to assess associations between food security and health outcomes. From a sample of 3002 participants, 16.4% reported low and very low food security. These participants tended to be renting, facing housing cost pressures, and lacking infrastructure to store and prepare food. When controlling for confounders, food insecurity was found to be associated with increased likelihood of having at least one chronic condition, mental health condition, and decreased overall wellbeing. Food security is itself a determinant of health. Regular monitoring of theprevalence of household food insecurity and addressing the structural factors influencing food affordability and availability are required. Further research on its links to health outcomes is warranted. SO WHAT?: Evidence-based action to address food insecurity will become more pressing as the crises of cost-of-living, housing, health system pressures and environmental disasters converge.

Livelihood diversification strategies and food security in the Weaving-based livelihood system of Gamo Zone, Southern Ethiopia

Background Livelihood diversification involves households earning through various economic activities, such as non-farm businesses, entrepreneurship, and off-farm jobs, improving sustainability, resilience, risk sharing, employment opportunities, and reducing poverty and food insecurity. However, little research has been done on the status, factors and relation of livelihood diversification and food security. This study explores the relationship between food security and livelihood diversification in the Chencha district of southern Ethiopia, focusing on determinants and their connection with household food security. Methods Quantitative and qualitative data were collected from 303 randomly selected households using surveys, key informant interviews, focus group discussions, and observations. Data were analyzed by using descriptive statistics, Herfindahl-Hirschman Index, Ordered probit regression and Pearson’s correlation coefficient. Results The result revealed that subsistence farming (52.1%) and weaving (38.6%) activities were reported as the primary and secondary main income sources of households. A majority of households (90.7%) diversified their livelihood. Based on income share, non-farm, on-farm, and off-farm income sources contributed, 72.96%, 25.3%, and 1.74% of total household income, respectively. Formal employment, weaving, barber/hairdresser, cattle production and sale, cereal production, and vegetable production (Potato) were highly paying livelihood activities in order. Households who combined on-farm, off-farm, and non-farm have gained far larger mean income followed by on-farm and non-farm strategies. Ordered Probit model results showed that landholding size, livestock holding size, and access to farmer training center (FTC) have positively affected the extent of livelihood diversification. Positive association was found between livelihood diversification and the food security status of households. Conclusion thus, the majority of weaving-based livelihood groups diversify their livelihood activities to on-farm, off-farm, and non-farm activities. Hence, supporting the weaving activity and motivating females’ participation, increasing other livelihood options, and modernizing the system with appropriate training, education, and market linkage seems inevitable.

Off-Farm Activities and Food Security Status: A Study of Smallholder Farmers in Kilifi South Sub-County, Kenya

Off-Farm Activities and Food Security Status: A Study of Smallholder Farmers in Kilifi South Sub-County, Kenya

Analysis of Effects of Financial Risk on the Welfare Status of Cocoa Farmers in Southwest Nigeria

Cocoa farming supports rural livelihoods, yet farmers face financial risks that threaten their welfare. Thus, this study examines the impact of financial risk on the welfare of cocoa farmers in Southwest Nigeria. A multi-stage sampling method was employed to select 396 respondents from two states known for high cocoa production and certification program involvement. Data were analyzed using descriptive statistics and a Seemingly Unrelated Regression Equation (SURE) model to determine the effects of financial risk on welfare indicators such as household income, food security, and poverty status. The findings reveal that 74.5% of respondents were classified as non-poor, with certification program adopters and non-adopters showing similar poverty levels. Key variables influencing welfare included farm size, cooperative membership, education, and financial risk. While larger farms and cooperative memberships positively impacted household income and food security, financial risk was associated with both increased income and heightened food insecurity and poverty risk. The study recommends the need for targeted interventions to mitigate financial risks, including expanded access to credit, financial literacy training, and cooperative support.

Assessing the impact of the COVID-19 pandemic on goat farming systems in rural mediterranean regions

Numerous studies have highlighted the detrimental effects of COVID-19 disruptions on various aspects of rural farming communities worldwide, including economic status, food security and nutritional status. However, despite this extensive literature, there is a striking gap in understanding the nuanced impacts of these disruptions on different segments of smallholder goat keepers, particularly in the Eastern Mediterranean region of Turkiye. The aim of this study is to shed light on the multifaceted impact of the COVID-19 pandemic on goat farming and the local community in rural areas. Data was collected to examine the impact of COVID-19 on various dimensions such as input use, agricultural production (livestock and crops, etc.), market accessibility and food safety among goat farmers in Tufanbeyli, Feke and Karatas districts of Turkiye. The results showed that goat farming in rural areas under the pressure of COVID-19 had a negative impact on input management and marketing. In addition, it was found that breeders suffered economic setbacks, particularly due to the disruption to production and family nutrition caused by COVID-19.

Impact of improved cassava cultivars on income generation and food security of women farmers in Mkuranga district, Tanzania

PurposeThe study was conducted to investigate the impact of improved cassava cultivars on income generation and food security status of women farmers in Tanzania.Design/methodology/approachData were collected from 300 respondents (150 with improved cassava cultivars and 150 without) who were selected using purposive and random sampling techniques. Double Difference, Descriptive Statistics were the analytical tools. The Cost-of-Calorie Index was used to measure food security status of the respondents.FindingsResults show that Double Difference estimates indicated that the annual income of the women farmers with improved cassava cultivars increased by TZS 143,495.20 which was higher than that of the women farmers without improved cassava cultivars which increased by only TZS 58,500. There was a positive impact on income as a result of using the improved cassava cultivars. The Cost-of-Calorie Index showed that the food security line per adult equivalent per month was TZS 2,743.81 and TZS 2,076.69 for farmers with and without improved cassava cultivars respectively. About 66% of the women farmers with improved cassava cultivars and 33% of the women farmers without improved cassava cultivars were food secure. Policies should be formulated to encourage women farmers to adopt and sustain the use of improved cultivars of cassava.Research limitations/implicationsThe research may be limited by its scope and generalizability, as it focuses on a specific geographic area (Mkuranga District) and demographic group (women farmers).Social implicationsThe study shed light on the role of agricultural interventions in empowering women economically and enhancing their food security, potentially leading to improved social status and decision-making power within their households and communities.Originality/valueThe study contributes to the existing body of knowledge by emphasizing the benefits for women farmers when using improved cassava cultivars for income generation and food sufficiency.

Comparing Food Security Status Using Dietary Intake and Expenditure Methods based on Socioeconomic Factors in Newly Merged Districts of Khyber Pakhtunkhwa

This study analysed food security among rural households in the merged districts of Bajaur and Mohmand, Khyber Pakhtunkhwa, Pakistan, using the Dietary Intake and Expenditure Methods. Food security, linked to the Sustainable Development Goals of ending hunger, is deeply influenced by socioeconomic factors such as age, education, employment, family structure, and asset ownership. Data from 384 households revealed distinct levels of food security across demographics. The Dietary Intake Method defines a household as food secure if per capita intake is at least 2,350 kcal daily, while the Expenditure Method classifies households as food secure if monthly food spending meets two-thirds of the sample’s average. Results showed that food insecurity peaks among older household heads (61-90 years), with 76.47% food insecure by expenditure and 22.06% by dietary intake methods, whereas younger heads (20-30 years) reported lower food insecurity rates underscoring 15.91% by expenditure method and 18.18% by dietary intake method. Illiterate household heads faced high food insecurity rates of 49.01% by expenditure method and 31.13% by dietary intake method, while education significantly lowered these rates. Family size also influenced outcomes undermining larger families having 16-21 members showed elevated food insecurity of 84.91% in both methods, compared to smaller families having 2-5 members. Employment substantially decreased food insecurity, illustrating that the rates dropped to 23.13% by expenditure method and 47.62% by dietary intake method for employed households. Asset ownership, especially livestock and land, helped to mitigate food insecurity. Households without livestock or land had 64.5% and 58.74% food insecurity through expenditure method respectively, compared to 33.02% and 12.24% among those with these assets. Extended families and lack of foreign remittances also correlated with higher food insecurity rates. Policy recommendations include enhancing economic opportunities, especially in rural areas, to improve employment and incomes. Investments in education, especially for household heads, could bolster food security resilience. Programs supporting asset ownership, such as livestock and land, could serve as economic buffers for vulnerable households.

Effects of vegetable commercialization on household food security: a generalized propensity score matching approach

ABSTRACT The commercialization of smallholder farmers is seen as the most significant driver of improved food security and household welfare in most countries with low-agricultural economies. This study used a Generalized Propensity Score Matching (GPSM) approach to evaluate the average causal effects of vegetable commercialization levels on the food security status of households in Sabbata Hawas Woreda, Oromia Region, Ethiopia. Data were collected through surveys of 385 farm households, key informant interviews, focus group discussions, and observations. The results revealed that vegetable commercialization had both positive and negative effects on households’ food security. The MAHFP increased steadily as the levels of commercialization increased. However, the lower levels of commercialization are associated with negative outcomes for calorie intake, food consumption scores, and household dietary diversity scores. The caloric intake, HDDS, and FCS were improved after commercialization levels reached 50%, 40%, and 25% respectively. The findings indicate that an increase in commercialization may not always lead to consistent increases across all indicators of food security and it has heterogeneous effects on households with different levels of commercialization. The subsequent policy recommendations of the study results are that, even though smallholder commercialization strategies are crucial for ensuring increased food production, productivity, and incomes for food security, it still requires taking into account the heterogeneous food security effects of vegetable commercialization levels.

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

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

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

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

Factors Associated with Metabolically Unhealthy Obesity and Its Relation to Food Insecurity in Korean Adults with Obesity.

The association between food insecurity and metabolically unhealthy obesity (MUO) in the population with obesity is unclear. We evaluated factors associated with MUO and the relationship between food insecurity and MUO in individuals with obesity. We analyzed data from 5191 adults with obesity (body mass index ≥ 25 kg/m2) from the 8th Korea National Health and Nutrition Examination Survey 2019-2021. MUO was defined when participants with obesity had any of the following: (1) triglycerides ≥ 150 mg/dL, (2) High-density lipoprotein-cholesterol < 40 mg/dL (men), <50 mg/dL (women), (3) systolic blood pressure ≥ 135 mmHg, diastolic blood pressure ≥85 mmHg or on treatment for hypertension, (4) fasting glucose ≥ 100 mg/dL, or on treatment for diabetes. The odds ratios (ORs) and 95% confidence intervals (CIs) for MUO according to food security status, sociodemographic characteristics, and lifestyle factors were calculated using multivariate logistic regression analysis. The prevalence of MUO and metabolically healthy obesity (MHO) among the participants was 85.4% and 14.6%, respectively. In the multivariate model, the OR (95% CIs) for MUO in the food insecurity group was 1.87 (1.03-3.43). The odds for MUO were higher among participants with older age, higher BMI, <12 years of education, lower fat intake, non-manual work, and moderated and low physical activity than among their counterparts. Food insecurity, older age, higher BMI, lower educational level, lower fat intake, non-manual workers, and lower physical activity were associated with MUO. Therefore, targeted interventions and policies are needed for vulnerable groups.

Effect of COVID-19 pandemic on household food insecurity: evidence from the United Arab Emirates

PurposeThe objective of this study was to measure the prevalence and severity of food insecurity in the United Arab Emirates (UAE) during May 2021 to June 2022, and to assess the impact of the COVID-19 pandemic on household food insecurity.Design/methodology/approachThis study measured the prevalence of household food insecurity in UAE during May 2021 to June 2022 by employing FAO’s Food Insecurity Experience Scale (FIES). The impact of the COVID-19 pandemic on household food security was evaluated by employing a truncated regression model, using survey data from 504 respondents.FindingsAbout 34% of the households were found to be food secure. About 22% of them experienced moderate or severe food insecurity (i.e. have eaten less than they thought should have) whereas almost none have experienced severe food insecurity during the sample period. The truncated model results show that households’ region of residence, livelihood source, education level, income and number of elderlies have a significant association with the probability of experiencing food insecurity. The pandemic-induced unemployment and disruptions in physical access to food positively associated with the probability of experiencing food insecurity.Social implicationsIt is critical to regularly monitor households’ food security status, and design strategies that explicitly consider the food security status of UAE’s significant expat population; most of whom are migrant manual labourers earning low wages, are less job-secured and have poorer access to health care.Originality/valueAlthough several studies assessed the impact of the pandemic on food security in different countries, there is a lack of studies assessing the impact of the pandemic on food security in the import-dependent Gulf Cooperation Council (GCC) countries, whose food security might be severely impacted due to the COVID-19-induced global food supply chain disruptions. Our application of the truncated regression model also contributes to the food security literature.

Determinants of Food Security Under Different Land Use Systems: Example of Pastoralists and Agro-Pastoralists in Northeastern Ethiopia

The issue of ensuring food and nutrition security has become a prominent item on the global agenda, particularly for low-income countries with high population growth rates. Despite the implementation of numerous policies and programs with the objective of enhancing household calorie intake, food insecurity is worsening in Ethiopia. It is crucial to comprehend the principal factors influencing food security, as this knowledge is essential for implementing effective interventions to enhance food security. Therefore, this study aimed to estimate the food security status of households, measure the extent and severity of food insecurity, and identify the determinants of food security in Northeastern Ethiopia. The data for this study were collected through key informant interviews, focus group discussions, and a multi-stage sampling method, which involved the selection of 300 households. Descriptive and inferential statistics, the Foster–Greer–Thorbecke (FGT) index, and a probit model were employed to analyze the collected data. The results indicate that 41.67% of the sample households were food secure. By decomposing the results to the two land use systems, 34.62% and 50.69% of the pastoral and agro-pastoral households were food secure, respectively, indicating that agro-pastoral households were relatively more food secure than pastoral counterparts. Furthermore, the gap and severity of food insecurity among the sample households were calculated using FGT indices, resulting in a value of 15.02% and 5.31%, respectively. The probit model revealed that educational attainment, the number of milking cows, cultivated farm size, annual farm income, and participation in off-farm activities were significant predictors of improved household food security status. The findings of this study suggest that policies aimed at addressing food insecurity should consider livelihood diversification, the promotion of education and training, and the strengthening of institutional and technological environments.

Food Insecurity and Its Relationship with Food Intake and Demographic Factors in Pregnant Women in Tehran

Background: Food security is described as physical and economic access for all people at all times to sufficient food for an active and healthy life. The purpose of this study was to investigate the prevalence of food insecurity and its relationship with the health status of pregnant women referred to North Tehran Health Center. Methods: The current study is a cross-sectional study conducted on 160 pregnant women in the third trimester covered by North Tehran Health Center in 2017-2018. Food security status, and dietary intake were assessed using general demographic and socioeconomic questionnaires, USDA 18-item household food security, and semi-quantitative food frequency recall, respectively. Statistical analysis was performed using SPSS and nutritionist IV software. Significance level was set at 0.05. Results: The study showed that 21.8% of mothers suffered insecure nutritional status and 78.2% of them were in safe nutritional status. There was a significant difference (P=0.013) between the two category of food groups (P=0.013). The mean consumption of legumes in people with insecure nutrition status (65.72±42.40 g) was more than nutrition secure group (50.08±29.77 g). Other food items showed no significant difference between the two groups of safe and unsafe nutrition status. In terms of economic status, there was a significant difference between safe and unsafe groups (P=0.001). Conclusion: In this study, food insecurity rate and prevalence of pregnant women was much less than that other studies. Given the role of the economic situation in the ability to purchase and supply food, probably one of the main reasons of more consumption of legumes in insecure groups would be low-income level and lower purchasing power of other food groups, such as meat.

The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation

IntroductionFood as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine. MethodsRecipe4Health, a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a ‘Food Farmacy’ (16 weekly produce home deliveries) alone or in combination with a ‘Behavioral Pharmacy’ (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record (EHR) outcomes over 12 months was conducted. Participants were 2,643 Recipe4Health patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023-2024. ResultsThere was a significant increase in produce consumption from baseline to four months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dl[-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dl [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy. ConclusionsRecipe4Health resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.