Food Security Scale Research Articles

The association between hunger-coping economic tradeoffs and food insecurity among female recipients of charitable food assistance

Food insecurity is an indicator of well-being in the United States. A high proportion of recipients of charitable food assistance (CFA) are women and are often in charge of specific household managerial responsibilities (e.g., childcare, transportation). Consequently, they frequently face choices between paying for food and paying for other basic need(s). This study aims to examine which hunger-coping economic tradeoffs place females with at least one dependent child in the house and females without a dependent child in the house at risk for experiencing food insecurity. Data was collected at 10 Houston-area and 10-Atlanta-area food pantries in 2022 (N=883). Using USDA cutoff criteria, households were considered food insecure based on ≥3 affirmative responses to the 18-item Food Security Scale Module. Hunger-coping economic tradeoff experiences were based on affirmative responses to whether anyone in the household ever had to choose between food and six basic needs (i.e. childcare, medicine/medical care, utilities, rent/mortgage, transportation, education). Covariate-adjusted logistic regression models were conducted to understand the relationship between six hunger-coping economic tradeoffs and food insecurity for the entire analytic sample and stratified by whether the female participant had a child in house. Standard errors in all regression models were corrected to account for multiple observations within a pantry. Adults, on average, were 55 years old (58% food insecure; 47% Hispanic; 42% black). Four hunger-coping economic tradeoffs were related to experiencing food insecurity. Economic tradeoffs between food and a) medicine/medical care and b) transportation elevated the likelihood of food insecurity, regardless of child status. Tradeoffs between food and childcare increased the risk for experiencing food insecurity among females with a dependent child. Deciding to pay between food and utilities was related to food insecurity experiences among females without a dependent child. Increases in Supplemental Nutrition Assistance Program (SNAP) benefits and eligibility along with programs to enhance resources related to medical care, transportation, childcare and utilities could help reduce food insecurity, especially among CFA recipients.

The Association between Food Insecurity and Insomnia Symptoms among Young Adults in Puerto Rico and the Mediating Role of Psychological Distress Symptoms

Residents of Puerto Rico face a high burden of food insecurity (FI), which has been associated with insomnia symptoms (IS). However, this association remains understudied in Puerto Rican young adults, a vulnerable group experiencing an elevated prevalence of FI and poor sleep. We evaluated the association between FI and IS and the mediating role of psychological distress symptoms among young adults in Puerto Rico. Data are derived from the PR-OUTLOOK cohort (2020–2023) of adults aged 18–29 y. We assessed FI with the six-item USDA Household Food Security Scale and IS with the 5-item Women’s Health Initiative Insomnia Rating Scale. Psychological distress symptoms included depressive symptoms (CES-D-10), anxiety (STAI-10), and perceived stress (PSS-4). Poisson’s regression models estimated prevalence ratios (PRs) with 95% confidence intervals (CIs). The Karlson–Holm–Breen method estimated the mediation percentage of each psychological distress symptom on the association between FI and IS. Notably, 24.8% of participants experienced FI, and 30.4% reported elevated IS. FI was associated with IS (PR = 1.41, 95% CI = 1.24, 1.60), an association partially mediated by depressive (31.6%), perceived stress (17.6%), and anxiety symptoms (17.2%), accounting for 35.8% of the mediation percentage. Future research should confirm these findings using objective assessments of sleep and psychosocial stress.

Measuring Food Insecurity in Children under 5 Years of Age with Acute Undernutrition in Valle Del Cauca-Colombia.

Our objective was to assess food insecurity among children under 5 years old with moderate, and severe malnutrition from Valle del Cauca, a state located in the southwestern region of Colombia. A descriptive observational study was conducted, including children whose weight-for-height (W/H) indicator was below 2 SD, as recorded on the World Health Organization (WHO) growth charts, or who exhibited severe malnutrition phenotypes such as marasmus or Kwashiorkor. Family and child food security were evaluated using the Latin American and Caribbean Food Security Scale (ELCSA). 58.6% of households with acutely malnourished children experienced food insecurity. A statistically significant relationship was found between food insecurity and children of Afro-Colombian and Indigenous descent. According to caregivers' perceptions, 30.2% of child malnutrition cases were related to poor feeding and caregiving practices. Not all children with acute malnutrition suffer from food insecurity. Therefore, the findings of this research suggest that governmental efforts should focus not only on ensuring food availability, but also on educating caregivers about the importance of a balanced and nutritious diet tailored to the specific characteristics of each region and promoting appropriate caregiving practices.

The association of food insecurity with non-alcoholic fatty liver disease (NAFLD) in a sample of Iranian adults: a path analysis of a cross-sectional survey

ObjectivesThe present study aims to examine the hypothetical model of the relationship between food insecurity and Non-alcoholic fatty liver disease (NAFLD) in a sample of Iranian adults.MethodsIn this cross-sectional study, 275 subjects (18–70 years old) who met the inclusion criteria were recruited. Fatty liver was diagnosed by abdominal ultrasonography, and eligible patients underwent liver fibro scan assessment to determine fibrosis and steatosis. Food insecurity was assessed using the validated six-item Short Questionnaire of Household Food Security Scale (SQHFSS). Data were analyzed using SPSS 24.0 and IBM SPSS Amos 24.0.ResultsAmong 275 subjects (44.37 ± 11.67 years old, 51.6% male) included in the analysis, 23.6% were food insecure. Food insecurity, general and abdominal obesity were associated with an increased risk of NAFLD, even after multiple adjustments (OR: 2.95, 95% CI: 1.02, 8.57; OR: 3.27, 95% CI: 1.50, 7.11; and OR: 3.81, 95% CI: 1.55, 9.32, respectively). According to the primary hypothesis, food insecurity and NAFLD were fitted into a model (χ2/df = 1.36, GFI = 0.982, AGFI = 0.952, CFI = 0.954, IFI = 0.959, SRMR = 0.040, RMSEA = 0.037); accordingly, food insecurity and obesity (general and abdominal) directly affected NAFLD (β = 0.12, P = 0.03; β = 0.13, P = 0.02; β = 0.31, P < 0.001, respectively).ConclusionFood insecurity was a predictor of, and directly associated with, NAFLD. Social determinants should be considered in the pathogenesis of NAFLD, although the possible underlying biological mechanisms in this association are yet to be determined.

Food insecurity, dietary inadequacy, and malnutrition in the Gaza Strip: a cross-sectional nutritional assessment of refugee children entering the first grade of UNRWA schools and their households before the conflict of 2023–24

Gaza has long been subjected to food insecurity; however, little was known about the influence of food insecurity on the nutritional wellbeing of schoolchildren. To fill this gap, the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), which provides humanitarian relief to Palestine refugees, assessed the nutritional status, diet, and food security of refugee children about to enter first grade (aged 4-10 years, mean age 72·1 months) in mid-2023 during a required health examination. As part of an annual School Entrance Health Examinations that began in May, a cross-sectional food security and nutritional assessment was added from July 8, to Sept 7, 2023, during which children being examined at six study-designated UNRWA clinics across Gaza were systematically sampled (in a 1:4 ratio) and parental or guardian consent sought for their participation. Household food security was assessed by a seven-point Arab Family food Security Scale score, and respondents were asked about family receipt of food assistance. The 1-week meal patterns of the children were probed, and intake frequencies of 49 foods in the past month categorised into ten nutritious food groups to assess diet diversity. The weight, height, and haemoglobin concentrations (assessed with a photometric analyser) of the children were measured. The UNRWA Research Review Board approved all study procedures. Approximately 34 000 children underwent the annual School Entrance Health Examination in Gaza in May, 2023 and approximately 16 000 children were estimated to have completed the additional food security and nutritional assessments from July 8, to early Sept 7, 2023, of whom 3814 were systematically sampled at six UNRWA clinics across Gaza, with 3229 (84·7%) parents or guardians consenting for their children to participate. 3155 were interviewed about household food security with a seven-point Arab Family Food Security Score, and 3212 were asked about food assistance receipt. 2694 (83·9%) of 3212 households were on food assistance, 787 (24·9%) of 3155 were classified as food secure (0-2 points), 1025 (32·5%) were classified as moderately (3-5 points) food insecure, and 1343 (42·6%) as severely food insecure (6-7 points). 219 (28·5%) of 768 children reported missing breakfast and 213 (28·4%) of 750 reported missing dinner in the food-secure group, 438 (47·2%) of 928 reported missing breakfast and 426 (45·6%) of 934 reported missing dinner in the moderately food-insecure group, and 956 (75·5%) of 1267 reported missing breakfast and 951 (74·8%) of 1272 reported missing dinner in the severely food-insecure group. Lunch was missed daily by 30 (3·8%) of 786 children in the food-secure group, 54 (5·3%) of 1023 in the moderately food-insecure group, and 193 (14·5%) of 1334 in the severely food-insecure group. Diets were poor in dairy items, meat, poultry, fish, pulses, eggs, and vitamin A-rich vegetables and fruit, and 2225 (68·9%) of 3229 children did not consume a minimally diverse diet every day (≥5 nutritious food groups). 72 (2·5%) of 2913 children had stunting and 129 (4·4%) of 2913 had wasting (less than -2 Z scores), and 963 (29·8%) of 3229 had anaemia (haemoglobin <11·5 g/dL). Boys and girls were similar in their diets, anthropometric Z scores, and prevalence of anaemia. Gazan families with children about to enter first grade were food insecure and reliant on food assistance, possibly protecting the anthropometric status of the children, whose diets however lacked diversity. Japan Ministry of Foreign Affairs and the Vitamin Angels Alliance, USA. For the Arabic translation of the abstract see Supplementary Materials section.

Beyond the Classroom: The Influence of Food Insecurity, Mental Health, and Sleep Quality on University Students' Academic Performance.

We aimed to analyze the association between food insecurity (FI) and academic performance in university students, including mental health and sleep quality (SQ), in an association model. A cross-sectional design included university students (n = 466, 72.5% women) from Mexico. We applied the Latin American and Caribbean Food Security Scale, the Depression Anxiety and Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index. Students self-reported their academic grading (AG) and perceptions about their academic performance. Spearman's rho and multiple logistic regression models were used. Almost half (47%) experienced some level of FI. The median AG was 95. AG was not significantly (p > 0.05) correlated with FI, nor with depression, anxiety, stress, and SQ. Considering mental health and SQ, moderate/severe FI remained significantly associated with perceived overall progress in college (OR: 2.96; 95%CI: 1.49, 5.88) and attendance to classes (OR:3.14; 95%CI: 1.19, 8.28) as poor or regular, and it was positively related to perceiving difficulties in completing their studies (OR:2.75; 95%CI: 1.43, 5.29). Stress, anxiety, depression symptoms, and poor SQ were also significantly associated with poor/regular perception of academic performance. These findings highlight the need to address psychological and nutritional factors in university students to promote their well-being and academic success.

Clusters of Sociodemographic Characteristics and Their Association with Food Insecurity in Mexican University Students.

Food insecurity (FI) expresses irregular access to sufficient, safe, and nutritious food. We analyze the association between clusters of sociodemographic characteristics and FI in university students from Mexico. The Latin American and Caribbean Food Security Scale was applied, and household type, socioeconomic status (SES), and the characteristics of the head of the household, among others, were asked in a cross-sectional study. We performed Two-Step cluster analysis and logistic regression models. We included 466 university students (72.5% women, 47% with FI). We identified three clusters; Cluster-1 (n = 163) included a single-parent (37.4%) or co-resident/roommate (27%) household type, middle SES (63.2%); the head of the household is usually a woman (76.1%), single (71.8%), and with bachelor's degree (41.7%) or less educational level (46.6%). Cluster-2 (n = 144) included the nuclear (89.6%) household type, high SES (76.4%); the head of the household is usually a man (79.2%), in a relationship (99.3%), and with a bachelor's degree (63.2%) or graduate level (33.3%). Cluster-3 (n = 147) is very similar to Cluster-2. The difference is that Cluster-3 includes middle SES (70.1%), and the head of the household's educational level is high school or less (100%). Only belonging to Cluster-1 was positively associated with FI (OR = 1.96, 95%CI: 1.24, 3.09). These results show the interrelationships between multiple sociodemographic characteristics and should contribute to developing interventions that simultaneously address numerous sociodemographic factors to diminish FI in university students.

Piloting Home Produce Delivery to Improve Food Security, Budget, and Diet in Families with Children: A Mixed-Methods Study

BackgroundFew children in food insecure (FI) households meet dietary recommendations for fruit and vegetables (“produce”). Barriers include affordability, accessibility, and desirability. Home produce delivery may reduce FI, increase produce consumption, and decrease budget tradeoffs. ObjectiveEvaluate the acceptability and potential impact of delivering produce through home visiting programs on FI, diet, and budget tradeoffs. MethodsIn this prospective pre/post mixed methods study, 51 parents engaged in home visiting programs were enrolled. Participants completed pre- and post-program surveys on FI (18-item Food Security Scale), produce consumption, and budget tradeoffs. Pre- and post-surveys were compared using McNemar’s test and weighted kappas. Interview guides were based on Social Cognitive Theory and a previously published framework. Interviews were conducted in English or Spanish; thematic analysis was completed. ResultsTwenty-nine (56.9%) participants completed both surveys. Most were female (96.3%) and Hispanic (79.3%) (Table 1). Food security improved in the post-period, with more participants reporting high food security (pre: 6.9%, post: 31.0%) and fewer reporting very low food security (pre: 20.7%, post: 6.9%, P<0.01) (Table 2). Budgetary tradeoffs decreased in the post-program period (pre: 71.4%, post: 48.1%, P = 0.03). Fifteen participants were interviewed. Themes included 1) saved money, 2) increased fruit and vegetable consumption, and 3) interest in future participation. ConclusionThis pilot study found that an intervention for delivery of produce through home visiting programs was acceptable to participants and resulted in potential improvements in FI and household budgets. This supports future studies to further explore the impact of this novel intervention.

The Association Between Food Security and Mammography Screening: Cross-Sectional Survey Results From the National Health Interview Survey

ObjectiveThere are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants. MethodsFemale respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features. ResultsIn all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (P < .001) and very low food security (P < .001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (P = .009) were less likely to report screening. DiscussionIn a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening.

A surge in food insecurity during the COVID-19 pandemic in a cohort in Mexico City.

The COVID-19 pandemic has not only caused tremendous loss of life and health but has also greatly disrupted the world economy. The impact of this disruption has been especially harsh in urban settings of developing countries. We estimated the impact of the pandemic on the occurrence of food insecurity in a cohort of women living in Mexico City, and the socioeconomic characteristics associated with food insecurity severity. We analyzed data longitudinally from 685 women in the Mexico City-based ELEMENT cohort. Food insecurity at the household level was gathered using the Latin American and Caribbean Food Security Scale and measured in-person during 2015 to 2019 before the pandemic and by telephone during 2020-2021, in the midst of the pandemic. Fluctuations in the average of food insecurity as a function of calendar time were modeled using kernel-weighted local polynomial regression. Fixed and random-effects ordinal logistic regression models of food insecurity were fitted, with timing of data collection (pre-pandemic vs. during pandemic) as the main predictor. Food insecurity (at any level) increased from 41.6% during the pre-pandemic period to 53.8% in the pandemic stage. This increase was higher in the combined severe-moderate food insecurity levels: from 1.6% pre-pandemic to 16.8% during the pandemic. The odds of severe food insecurity were 3.4 times higher during the pandemic relative to pre-pandemic levels (p<0.01). Socioeconomic status quintile (Q) was significantly related to food insecurity (Q2 OR = 0.35 p<0.1, Q3 OR = 0.48 p = 0.014, Q4 OR = 0.24 p<0.01, and Q5 OR = 0.17 p<0.01), as well as lack of access to social security (OR = 1.69, p = 0.01), and schooling (OR = 0.37, p<0.01). Food insecurity increased in Mexico City households in the ELEMENT cohort as a result of the COVID-19 pandemic. These results contribute to the body of evidence suggesting that governments should implement well-designed, focalized programs in the context of economic crisis such as the one caused by COVID-19 to prevent families from the expected adverse health and well-being consequences associated to food insecurity, especially for the most vulnerable.

The Prevalence of Food Insecurity among Postgraduate Students and Its Impact on Their Academic Performance: Evidence from Jordan

Background: Food insecurity (FI) is a public health issue which is receiving increasing attention in many countries. In responding to sustainable development goals, achieving food security is of essential importance. This study aims to demonstrate the level of food insecurity among postgraduate students at Jerash University/Jordan, discuss the most important factors associated with it, and show its relation to the student's academic performance. Methods: A random sample of 126 postgraduate students has been interviewed in this cross-sectional study. The level of FI for the study sample was determined using the 10-item US Adult Household Food Security Scale Module (HFSSM). The association between students’ characteristics and their food security (FS) level was analyzed through chi-square test and a multivariate regression method. Results: The results of the study revealed that 67% had marginal or fragile food security level, 25% were highly food secure, and 8% of the sample suffered from food insecurity. The results showed that the association between food security and students' gender and age was insignificant (P &gt; 0.05). As for the rest of the associated characteristics, there was a significant relationship between the students' food security and their marital status, family size, stable-income work, and their monthly income. Conclusion: A percentage of postgraduate students suffer from food insecurity, which is an important obstacle to their academic progress. Moreover, the level of food security is related to the student's marital status, family size, job with stable income, and the amount of monthly income.

Financial toxicity in early-onset colorectal cancer: A National Health Interview Survey study

BackgroundFinancial toxicity is increasingly recognized as a devastating outcome of cancer treatment but is poorly characterized in patients with early-onset colorectal cancer. Young patients are particularly vulnerable to financial toxicity as they are frequently underinsured and may suffer significant disruptions to professional and financial growth. We hypothesized that financial toxicity associated with colorectal cancer treatment confers long-lasting effects on patients’ well-being and disproportionately impacts patients diagnosed at <50 years of age. MethodsA retrospective cross-sectional analysis of the National Health Interview Survey from years 2019 to 2021 was performed. Patients with a history of colorectal cancer were included and stratified by age at diagnosis. Randomly selected age-matched controls with no cancer history were used for comparison. The primary endpoint was financial toxicity, as assessed by a composite score formulated from 12 National Health Interview Survey items. The secondary endpoint was food security assessed by the United States Department of Agriculture’s food security scale, embedded in the National Health Interview Survey. ResultsWhen compared to age-matched controls, patients with colorectal cancer experienced significant financial toxicity, as reflected by a composite financial toxicity score (P = .027). Within patients with colorectal cancer, female sex (adjusted odds ratio = 1.46, P = .046) and early-onset disease (adjusted odds ratio = 2.11, P = .002) were found to significantly increase the risk of financial toxicity. Patients with early-onset colorectal cancer more frequently experienced food insecurity (P = .011), delayed necessary medical care (P = .053), mental health counseling (P = .043), and filling prescriptions (P = .007) due to cost when compared to patients with average-onset colorectal cancer. ConclusionColorectal cancer is associated with significant long-term financial toxicity, which disproportionately impacts patients diagnosed at <50 years of age. Targeted interventions are warranted to reduce financial toxicity for patients with high-risk colorectal cancer.

Factorial effects contributing to food security in Mexico during COVID-19 context

The COVID-19 pandemic has altered the social, economic and environmental order of the world, and it wreaked havoc in many aspects of the life of societies, including the food insecurity (FI) rates in the regions. Due to the multifaceted nature of this phenomenon, it is required a better understanding of the associated variables that contribute to food security (FS), such as the socioeconomic and demographic variables for designing effective and efficient policy interventions. In this sense, this study describes an innovative way of interpreting the causal influence of the interaction effects between the socioeconomic and demographic variables on the level of FS experienced by Mexican households during the pandemic crisis. The period from March to May of 2021, a digital survey was applied to 630 households to analyze the harmonized version of the Latin American and Caribbean Food Security Scale (ELCSA). For this, a factorial regression model was used to estimate the factorial effects contribution of the mentioned variables under study, obtaining important results on the level of FS in two Mexican states: Nayarit and the State of Mexico. The obtained model shows the contribution factors, involved on the level of FS, are the following: mother's job, household incomes, the portion of income destined for food, the interaction between the family members with the place of residence, the interaction of the gender of the household head with the place of residence, the interaction of the mother's job with the father's schooling, and the interaction of the father's schooling with the portion of income spent on food. These findings offer essential insights for identifying vulnerable groups susceptible to experiencing food insecurity, in order to facilitate effective intervention in the multiple areas that require improvement, thus enhancing food security in the regions and contributing to the achievement of the SDG.

Head of household disability can increase household food insecurity: an analysis of a Colombian population survey

This study investigated the association between head of household disability and the severity of food insecurity in Colombian households during 2017. A secondary data analysis was conducted based on 2017 Colombian National Quality of Life Survey (ECV 2017). As the independent variable, disability was assessed using questions from the Washington group, whereas the dependent variable - food insecurity - was measured by the Latin American and Caribbean Food Security Scale (ELCSA). Sociodemographic confounding variables and variables related to food insecurity were included. Association was analyzed by ordinal logistic regression, and the odds ratio (OR) was estimated with its 95% confidence intervals (95%CI). All calculations considered the complex sampling of ECV 2017. Data from 8,488 heads of household were included. A total of 9.2% of the participants had some type of disability and 41.8% reported some level of household food insecurity. Households with a head of household with some disability were 30% more likely to develop severe food insecurity compared with households with a head of household without disabilities (OR = 1.30; 95%CI: 1.07-1.59), adjusted for multiple confounding variables. In 2017, Colombian households with heads of household with disabilities were more likely to develop severe food insecurity. It is essential to implement nutritional assistance programs aimed at vulnerable populations, such as people with disabilities.

Seguridad alimentaria en familias de Yurimaguas, Perú: Características y factores asociados

Food security is sufficient access to safe and nutritious foods to satisfy nutritional needs and personal preferences, and to lead a healthy and active life. Objectives. To determine food security in 160 households of human settlement of Yurimaguas district, Loreto department, Perú and factors associated with it. Methods. The selected households had among their members at least one child under 18 years of age and an unmet basic need, which for all of them, did not have the sewage service. In these households, the Latin American and Caribbean Food Security Scale (ELCSA) was applied, consisting of 15 items and a sociodemographic and socioeconomic survey. The households were classified as food secure, or mildly, moderately or severely food insecure. Results. Among households, 3.1% were classified as food secure and 96.9% as food insecure (78.8% as mildly insecure, 16.9% as moderately insecure and 1.2% as severely insecure). Food- insecure households had a greater number of minors, mothers with a lower educational level and the daily expenditure in food was lower in comparison with food-secure households. Conclusions. A very high percentage of the households surveyed in the study area were food insecure, although mostly mild. Associated with the number of minors in the home, the mother's education and daily spending on food purchases.

Risk factors for household food insecurity in the Eastern Caribbean Health Outcomes Research Network cohort study.

Globally, 1.3 billion people were considered food insecure as of 2022. In the Caribbean region, the prevalence of moderate or severe food insecurity was 71.3% as of 2020, the highest of all subregions in Latin America. Experienced based measurement scales, like the Latin American and Caribbean Food Security Scale, are efficient measurement tools of food insecurity used globally. The Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study is a population-based longitudinal cohort study in the two Caribbean U.S. territories of Puerto Rico and the U.S. Virgin Islands, as well as in Barbados and Trinidad & Tobago. The purpose of this research was to examine the demographic, psychosocial, behavioral, and environmental risk factors associated with household food insecurity (HFI) among adults ≥40 years of age in the ECHORN cohort. A cross-sectional analysis of baseline ECHORN cohort study data was conducted. The primary outcome was household food insecurity (none, mild, moderate/severe). A total of 16 known and potential risk factors were examined for their association with HFI. The ANOVA and chi-square statistics were used in bivariate analysis. Ordinal logistic regression was used for the multivariable and sex stratified analyses. More than one-quarter of the sample (27.3%) experienced HFI. In bivariate analyses, all risk factors examined except for sex, were significantly associated with HFI status. In the multivariable analysis, all variables except sex, education, marital status, smoking status, and residing in Puerto Rico were significant predictors of HFI in the adjusted model. In sex stratified analysis, depression, food availability, self-rated physical health, and island site were significantly associated with increased odds of worsening HFI for women, but not for men. Source of potable water was an important risk factor for both men and women. The prevalence of HFI in the ECHORN cohort study is comparable to other studies conducted in the region. While women did not have an increased risk of HFI compared to men, a different set of risk factors affected their vulnerability to HFI. More research is needed to understand how water and food security are interrelated in the ECHORN cohort.

Food Insecurity During the Covid-19 Confinement in Ecuador, Estimated by the Latin American and Caribbean Food Security Scale - A Cross-sectional Study

Food Insecurity During the Covid-19 Confinement in Ecuador, Estimated by the Latin American and Caribbean Food Security Scale - A Cross-sectional Study

Abstract 13184: Relationships Between Food Insecurity and Dietary Quality in Persons With Cardiovascular Disease in NHANES (National Health and Nutrition Examination Survey), 2009-2020

Background: Most guidelines recommend a nutrient-rich, heart-healthy diet for management of cardiovascular disease (CVD). Following dietary guidelines may be challenging for individuals experiencing food insecurity, but there is limited knowledge on how food insecurity relates to diet quality in persons with CVD. Hypothesis: We hypothesized that for persons with CVD (hypertension, heart disease, angina, MI, heart failure, or stroke), higher levels of food insecurity would be associated with lower levels of dietary quality. Methods: This was a cross-sectional analysis of 5 cycles of data (2009-2020) from the nationally representative National Health and Nutrition Examination Survey (NHANES). Participants aged &gt; 19 with self-reported CVD were included. Food insecurity was measured using the 10-item Food Security Scale. Dietary intake was measured using 24-hour dietary recall from which individual nutrients were derived. Key nutrients examined as indicators of diet quality included sodium, potassium, polyunsaturated and monounsaturated fats, fiber, and total sugars. Relationships between food insecurity and diet quality were quantified using multivariable linear regression models, incorporating NHANES sample weights and controlling for common sociodemographic confounders. Results: The sample consisted of 17,102 persons (weighted study N = 311,708,767). Half were female (55.48%); most were non-Hispanic White (68.74%) and in middle (45-64 years, 44.82%) or late adulthood (≥65 years, 32.29%). Nearly a quarter (23.9%) were food insecure. With the exception of sodium intake (sodium, mg, β=-156, p=0.02), higher levels of food insecurity were significantly associated with poorer diet quality (potassium, mg: β=-157, p&lt;0.004; polyunsaturated fats, gm: β=-1.81, p&lt;0.003; monounsaturated fats, gm: β= -2.19, p=0.003, fiber, mg: β= -1.08, p=0.003, total sugars, gm: β=13.15; p&lt;0.010). Conclusions: In persons with CVD, higher levels of food insecurity were significantly associated with lower diet quality in key nutrients essential for a heart-healthy diet. This study underscores the importance of considering social determinants of health to support patient and family success in following heart-healthy guidelines.

Food Insecurity is Associated with Low Dietary Diversity in Rural Women in Mexico: Results from the Mexican National Health and Nutrition Survey, ENSANUT 2018

ABSTRACT Rural women suffer greater vulnerability to food insecurity (FI) compared to their urban or male counterparts. We analyzed the association between food security (FS) status and dietary diversity (DD) in rural women through data from the Mexican National Health and Nutrition Survey (ENSANUT) 2018 from 2,099 rural women. DD was measured using a semi-quantitative food frequency questionnaire. FS was measured using the Latin America and Caribbean Food Security Scale (ELCSA). The prevalence of any level of FI was 70.1%. Mean DD score was 3.8. Mild FI was associated with low DD (OR 1.49, 95% CI 1.06, 2.10). Results highlight the need for government strategies targeted to this population sector to improve their diet quality.

Development and Validation of an Abbreviated Child and Adult Food Security Scale for Use in Clinical and Research Settings in the United States

BackgroundFood insecurity (FI) prevalence was consistently >10% over the past 20 years, indicating chronic economic hardship. Recession periods exacerbate already high prevalence of FI, reflecting acute economic hardship. To monitor FI and respond quickly to changes in prevalence, an abbreviated food security scale measuring presence and severity of household FI in adults and children is needed. ObjectiveOur aim was to develop an abbreviated, sensitive, specific, and valid food security scale to identify severity levels of FI in households with children. DesignCross-sectional and longitudinal survey data were analyzed for years 1998 to 2022. Participants/settingParticipants were racially diverse primary caregivers of 69,040 index children younger than 4 years accessing health care in 5 US cities. Statistical analyses performedSensitivity, specificity, positive and negative predictive values, accuracy, and area under the receiver operator curve were used to test combinations of questions for the most effective abbreviated scale to assess levels of severity of adult and child FI compared with the Household Food Security Survey Module. Adjusted logistic regression models assessed convergent validity between the Abbreviated Child and Adult Food Security Scale (ACAFSS) and health measures. McNemar tests examined the ACAFSS performance in times of acute economic hardship. ResultsThe ACAFSS exhibited 91.2% sensitivity; 99.6% specificity; 98.3% and 97.6% positive and negative predictive values, respectively; 97.7% accuracy; and a 99.6% area under the receiver operator curve, while showing high convergent validity. ConclusionsThe ACAFSS is highly sensitive, specific, and valid for detecting severity levels of FI among racially diverse households with children. The ACAFSS is recommended as a stand-alone scale or a follow-up scale after households with children screen positive for FI risk. The ACAFSS is also recommended for planning interventions and evaluating their effects not only on the binary categories of food security and FI, but also on changes in levels of severity, especially when rapid decision making is crucial.