High Prevalence Of Food Insecurity Research Articles

Socioeconomic, demographic, and obstetric inequalities in food insecurity in pregnant women

Abstract Objectives: to estimate the prevalence of Food Insecurity (FI) in pregnant women and to identify its association with demographic, socioeconomic, obstetric, and anthropometric variables in female users of Family Health Units (FHUs) in the city of Colombo, state of Paraná, South Region of Brazil. Methods: a cross-sectional study of a representative sample of pregnant women from 17 FHUs in Colombo. We used the short version of the Brazilian Household Food Insecurity Measurement Scale (EBIA). In addition, we used Poisson Regression Models with robust, crude, and adjusted variance to investigate the association between FI and exposure variables. Results: 316 pregnant women participated in the study. The prevalence of FI was 45.1% (CI95% = 39.6-50.6). Adjusted analysis showed higher prevalence of FI in pregnant women with 30 years of age or older (PR = 1.66; IC95% = 1.02-2.69), with black skin or indigenous background (PR= 1.39; CI95%= 1.08-1.79), with 7 years of education or less (PR = 1.58; CI95% = 1.14-2.19), and with lower income (PR = 2.07; CI95% = 1.36-3.14). Conclusions: There was a high prevalence of FI among pregnant women, particularly among those of older age and with worse socioeconomic conditions, a group that should be considered a priority for actions aimed at promoting food security.

Complexities of Addressing Food Insecurity in an Urban Population.

There is an association between food insecurity, poor health outcomes, and increased health care spending. The Temple Food Insecurity Program was initiated to screen patients for food insecurity as part of the post Temple University Hospital discharge process. The community is economically challenged and food insecurity is a significant problem. Food insecure patients were identified and referred to community-based resources, with a 30-day follow-up call. Screening was successful in 3655 patients, 27% (n = 987) of whom reported food insecurity. Of these patients, 66% (n = 647) were already receiving benefits through the Supplemental Nutrition Assistance Program (SNAP), but were still food insecure. All patients with food insecurity were referred to one of 2 resources for help. Despite significant need, less than a quarter of patients connected with these resources. Qualitative data revealed that some patients did not remember the information provided to them, were overwhelmed with poor health or other social determinants of health, had competing priorities, did not perceive the need for food assistance; and experienced system barriers. Health literacy also was an issue. Health care systems addressing food insecurity should consider the high prevalence of food insecurity in impoverished regions, the reality that SNAP benefits may not alleviate food insecurity for many patients, and the need for individualized, custom care plans that address barriers and reflect patient priorities and capabilities. Engaging patients differently may be aided by additional communication from community food resources directly to patients who provide permission for this added service.

Food insecurity and depressive symptoms of older adults living alone in South Korea

ABSTRACTIn South Korea, the number of older adults living alone is rapidly increasing with the growth of the ageing population. Although there is some evidence of a link between financial strain and depression in this population, there is limited empirical evidence on the relationship between food insecurity and depression in older adults living alone despite the fact that they have a high prevalence of food insecurity and tend to seek food assistance. This study aims to investigate whether food insecurity explains depressive symptoms in Korean older adults living alone. We employed data from the Korea Welfare Panel Study collected from a large-scale national sample in South Korea. Our sample consisted of 815 older adults aged 65 or older who lived alone. Conducting ordinary least square regression analyses, we tested the main effect of food insecurity on depression and the interaction effect of food insecurity and low income. We found that the relationship between food insecurity and depressive symptoms differed by low-income status (b = 6.27, p = 0.047). The association was significant only in the low-income group (b = 1.37, p = 0.04). These findings suggest that protecting access to food may be a promising strategy to lessen depressive symptoms associated with financial strain among older adults living alone.

Factors associated with food insecurity among older homeless adults: results from the HOPE HOME study.

The US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity. We conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. We assessed food security and receipt of food assistance. We used multivariable logistic regression to examine factors associated with very low food security. The majority of the cohort was male and African American. Over half (55.4%) met criteria for food insecurity, 24.3% reported very low food security. Half (51.7%) reported receiving monetary food assistance. In the multivariable model, those who were primarily sheltered in the prior 6 months, (multi-institution users [AOR = 0.44, 95% CI: 0.22-0.86]) had less than half the odds of very low food security compared with those who were unsheltered. Depressive symptoms (AOR = 3.01, 1.69-5.38), oral pain (AOR = 2.15, 1.24-3.74) and cognitive impairment (AOR = 2.21, 1.12-4.35) were associated with increased odds of very low food security. Older homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups.

Impact of climate variability on household food availability in Tigray, Ethiopia

BackgroundCurrently, climate variability is a hot issue across the globe, especially in countries where rain-fed agriculture is a means of livelihood. Climate variability increases the risks of hunger in the region as it affects all four components of food security: food availability, food accessibility, food utilization and food stability. Rainfall shortage or excess hampers food production in the region, causing food insecurity and escalating famine. Extreme weather is affecting people indirectly through the sequential rather direct depletion of their assets. Therefore, looking on the impact of climate on food security is crucial to build a sustainable production system.ResultsRandomized data from 150 households were collected and analyzed using SPSS software. Household Food Balance Model analysis indicates that 15.7% of the households met the recommended daily calorie intake of 2100 kcal per adult equivalent/day, while 84.3% of the households fell below the daily recommended calorie intake. The average calorie intake of the households covers only 56.2%. Female-headed households are found to be more food insecure than their male counterpart. Those food insecure households use different coping mechanism to avert the shortage like daily laborer, reducing meal, borrowing, selling productive asset and switching meals. Moreover, the annual rainfall of a 20-year record averaged 725 ml (with a standard deviation of 6.7), with the minimum and maximum records at 354.5 and 1037 ml, respectively. Similarly, the average precipitation concentration index (PCI) stood at about 24.4 ml, recording a minimum and maximum PCI of 15.6 ml and 41.7, respectively. Finally, the coefficient of variability of rainfall variability is 0.16, which indicates the variation in inter-annual rainfall distribution is medium.ConclusionsThe result shows a high prevalence of food insecurity in the rural community with high prevalence in female-headed household. Therefore, strong intervention is required by the government and should exhaustively work on promoting irrigation, providing credit to farmers and subsidizing farm inputs to improve food security in rural Tigray.

Socioeconomic correlates of dietary diversity and its association with adherence and psychosocial functioning of people living with HIV in rural Zambia.

The intersection of nutrition and HIV underscores the importance of adequate food and a diverse diet. In communities with high prevalence of food insecurity and HIV, there is a substantial co-occurrence of low dietary diversity, undernutrition, and adverse health outcomes. The aim of this study was to identify correlates of individual dietary diversity (IDD) and its association with health outcomes for people living with HIV (PLHIV) in rural Zambia. The study used a cross-sectional design using data from 101 PLHIV. We calculated IDD using a composite score based on dietary diversity, food frequency, and the relative nutritional importance of different food groups. Adherence was measured using the visual analog scale. Psychosocial functioning was measured using the Structural Barriers to Medication-taking Scale and the Perceived Stress Scale. Data were analyzed using linear and logistic regressions. Multiple imputation was conducted to address missing data. Staples were the most commonly consumed food group. Income and household size were negatively associated with IDD scores. Assets were positively associated with IDD scores. Residing in Lundazi and having a poor or fair self-rated health were associated with lower IDD scores. IDD was also associated, albeit not significant, with desirable health outcomes, including adherence and lower levels of perceived barriers to pill taking and stress. Findings suggest a heterogeneous effect of socioeconomic variables on IDD. Understanding this heterogeneity is important for the design of interventions. Interventions that combine opportunities to generate economic resources with food and nutrition coaching may be appropriate and effective.

Fatores associados à insegurança alimentar em pessoas que vivem com HIV/AIDS

Objective: To analyze factors associated with food insecurity in people living with HIV/AIDS. Methods: Cross-sectional study carried out with 205 patients treated, from December 2016 to April 2017, at a referral hospital in infectious diseases in the state of Ceara. The study collected socioeconomic (income, occupation, housing conditions, schooling), demographic (sex, age, marital status), and anthropometric (weight and height) data, along with data on habits (use of alcohol, drugs and practice of physical activity) and food safety. Food insecurity was evaluated through the Brazilian Food Insecurity Scale, and its associations, with use of Pearson’s chi-square test and prevalence ratio. Results: Out of 205 patients, 68.3% (n=140) were men; 56.1% (n=115) were 39 to 58 years old; 61% (n=125) were single; 60% (n=124) were unemployed; 49.8% (n=102) had income lower than 1½ minimum wage; 38.5% (n=79) had studied only up to middle school; 47.3% (n=97) were overweight; 70.7% (n=145) lived with 4 or fewer people; 79.5% (n=163) did not use alcohol; 87.3% (n=179) did not use drugs, and 64.4% (n=132) did not practice any physical activity. Food insecurity was 47.3% (n=97). Of these, 10.7% (n=22) were at a serious level. Statistical associations were found between food insecurity and age group (p = 0.009), schooling (p = 0.013), number of people per household (p < 0.001), and monthly household income (p < 0.001). Conclusion: A high prevalence of food insecurity was observed in the sample, and it was associated with demographic (age) and socioeconomic characteristics (income, schooling and housing conditions).

Access to Care and Health Outcomes Among Women Veterans Using Veterans Administration Health Care: Association With Food Insufficiency

BackgroundFood insecurity has been associated with worse health outcomes in the civilian population. Male veterans of the Gulf Wars have been shown to have a higher prevalence of food insecurity than similarly situated civilians. Women veterans have more risk factors for food insecurity, relative to male veterans, yet little is known about the prevalence of food insecurity in this cohort. MethodsWe used the Women Veterans' Health Utilization and Experience Survey for this analysis. Our study population consisted of women veterans who had at least three primary care or women's health visits to 1 of 12 Veteran's Health Administration health care facilities from December 2013 to November 2014. Multiple logistic regression was used to examine the relationship between food insufficiency (an inadequate amount of food intake owing to a lack of money or resources), delayed/missed care, anxiety, depression, and self-reported fair to poor health, controlling for race/ethnicity, marital status, and employment status. ResultsThe prevalence of food insufficiency among women veterans was 27.6%. Being food insufficient was associated with 16.4, 15.4, 14.9, and 12.1 percentage point increases in the probability of delayed/missed care, screening positive for anxiety, screening positive for depression, and reporting fair to poor health, respectively (p < .05). ConclusionsThe prevalence of food insufficiency in this cohort was associated with delayed access to health care and worse health outcomes. Interventions addressing Veterans Administration access and health outcomes will need to examine the potential role of food insufficiency.

Chronic disease burden predicts food insecurity among older adults.

Increased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity. Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS. USA. Respondents of the 2013 HRS HCNS with household incomes <300 % of the federal poverty line (n 3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0-1, 2-4, ≥5 conditions), with multiple chronic conditions (MCC) defined as ≥2 conditions. The prevalence of food insecurity was 27·8 %. Compared with those having 0-1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2-4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37). A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

A High Prevalence of Food Insecurity Among University Students in Appalachia Reflects a Need for Educational Interventions and Policy Advocacy

ObjectivesTo measure prevalence and correlates of food insecurity among college students in Appalachia, compare food-insecure and food-secure students on correlates, and identify predictor variables. DesignCross-sectional, online questionnaire. SettingUniversity in Appalachia. ParticipantsNonprobability, random sample of 1,093 students (317 male [30.1%]; 723 females [68.4%]). Main Outcome MeasuresFood insecurity, coping strategies, money expenditure, academic progress, and demographics. AnalysisCorrelational, chi-square, and regression. ResultsA total of 239 students experienced low food security (21.9%) whereas 266 had experienced very low food security (24.3%) in the past 12 months. Predictor variables were higher money expenditure and coping strategy scale scores, lower grade point averages, male gender, receiving financial aid, fair or poor self-rated health status, and never cooking for self or others. These variables accounted for 48.1% of variance in food security scores. Most frequently used coping strategies included purchasing cheap, processed food (n = 282; 57.4%), stretching food (n = 199; 40.5%), and eating less healthy meals to eat more (n = 174; 35.4%). Conclusions and ImplicationsFood-insecure students need interventions that teach budgeting skills and how to purchase and prepare healthy foods, as well as policies that increase access to food resource assistance.

Moderate and severe household food insecurity in families of people living with HIV/Aids: scale validation and associated factors.

Vulnerable population groups, including people living with HIV/Aids (PLHA), may have a high prevalence of food insecurity (FI). A cross-sectional study evaluated the internal validity of the Brazilian Food Insecurity Scale (Escala Brasileira de Insegurança Alimentar - EBIA) and measured the prevalence of FI in a sample of 796 PLHA in João Pessoa, Paraíba State (PB). The validation was performed using a Rasch analysis. The association of FI with sociodemographic and clinical characteristics was assessed using the chi-square test. Associated variables were included in a Poisson multiple regression model. The EBIA was valid for PLHA with fit values within the expected limits and item severity conforming to the theoretical model. The EBIA identified 66.5% of PLHA with FI in the sample (30.8% mild FI, 18.1% moderate FI and 17.6% severe FI). Moderate FI and severe FI were associated with an age younger than 43 years (prevalence ratio (PR) = 1.49; 95% confidence interval (CI): 1.14-1.86), primary education (PR=1.64; 95% CI: 1.24-2.17), income per capita lower than ½ minimum wage (MW) (PR=1.83; 95% CI: 1.37-2.44), lack of occupation (PR=1.59; 95% CI: 1.16-2.19) and adult-only households with a female reference person (PR=2.19; 95% CI: 1.45-3.31). The PLHA in this study had a high prevalence of FI, worsening their living conditions and potentially exacerbating their health problems.

Household food insecurity and dietary patterns in rural and urban American Indian families with young children

BackgroundHigh food insecurity has been demonstrated in rural American Indian households, but little is known about American Indian families in urban settings or the association of food insecurity with diet for these families. The purpose of this study was to examine the prevalence of food insecurity in American Indian households by urban-rural status, correlates of food insecurity in these households, and the relationship between food insecurity and diet in these households.MethodsDyads consisting of an adult caregiver and a child (2–5 years old) from the same household in five urban and rural American Indian communities were included. Demographic information was collected, and food insecurity was assessed using two validated items from the USDA Household Food Security Survey. Factors associated with food insecurity were examined using logistic regression. Child and adult diets were assessed using food screeners. Coping strategies were assessed through focus group discussions. These cross-sectional baseline data were collected from 2/2013 through 4/2015 for the Healthy Children, Strong Families 2 randomized controlled trial of a healthy lifestyles intervention for American Indian families.ResultsA high prevalence of food insecurity was determined (61%) and was associated with American Indian ethnicity, lower educational level, single adult households, WIC participation, and urban settings (p = 0.05). Food insecure adults had significantly lower intake of vegetables (p < 0.05) and higher intakes of fruit juice (<0.001), other sugar-sweetened beverages (p < 0.05), and fried potatoes (p < 0.001) than food secure adults. Food insecure children had significantly higher intakes of fried potatoes (p < 0.05), soda (p = 0.01), and sports drinks (p < 0.05). Focus group participants indicated different strategies were used by urban and rural households to address food insecurity.ConclusionsThe prevalence of food insecurity in American Indian households in our sample is extremely high, and geographic designation may be an important contributing factor. Moreover, food insecurity had a significant negative influence on dietary intake for families. Understanding strategies employed by households may help inform future interventions to address food insecurity.Trial registration (NCT01776255). Registered: January 16, 2013. Date of enrollment: February 6, 2013.

Validity of the Food Insecurity Experience Scale (FIES) for use in Sub‐Saharan Africa (SSA)

BackgroundThe Food Insecurity Experience Scale (FIES), an 8‐item questionnaire is the latest experience‐based metric of severity of food insecurity recently developed by the United Nations Food and Agricultural Organization Voices of the Hungry project (FAO‐VOH), thus its latent dimensional structure and psychometric properties haven't been fully explored for SSA. The objectives of this study were to assess the psychometric properties of FIES for measuring food security in SSA using the Rasch measurement model and to examine the prevalence of food insecurity (FI) among adults ages 19 and older.MethodsTo assess the intended validity of the FIES, the Rasch modeling procedure was applied to the SSA survey data collected in 2014 and 2015 by the Gallup World Poll (GWP) and FAO‐VOH. Data were provided by 58, 324 respondents aged 19 years and above. All respondents with missing food security information on any of the FIES questions were omitted from this analysis. SAS (version 9.3) and R (version 3.1.3) were used to perform the analysis.ResultsUsing the derived FI thresholds for SSA, the prevalence of FI (including moderate and severe FI) was 57%. There was higher prevalence of FI among older adults ≥ 50 years than younger adults 19–49 years (59.1% and 56.5% respectively, p&lt;0.0001), and among women than men (58.4% and 55.6% respectively, p&lt;0.0001). The severity of the items at country level estimated under the Rasch‐model assumptions ranged from 1.7 logistic units in Mauritania to 4.63 logistic units in Namibia. There was good reliability of the scale for all countries (≥ 0.7). Most of the item‐infit statistics were &lt;1.4, except for the item “worrying about not having enough food to eat at any time in the past 12 months due to lack of money or other resources” in Namibia and Sudan. Additionally, several countries in the Western region and Islands showed high item‐outfit (≥ 1.8) for the item “going without eating for a whole day”. This was also true in the responses by older adults. Four countries showed significant correlations between residuals for the questions “being hungry but not eating” and “running out of food”. Finally, there were differences in the order of severity for most of the items of SSA countries compared to the order seen in the combined SSA metric. However, there were no differences in the order of item severity between older and younger adults.ConclusionsFIES demonstrated acceptable levels of internal validity, although the question “not eating for whole day” may need to be cognitively tested in a few countries. The similarity in response patterns by younger and older adults suggests that food security is experienced similarly in the two age groups, thus the overall prevalence of FI in these two age groups can be directly compared. Because the response patterns were different by country level, it is recommended that a SSA standard excluding the correlated items be used and a strict significance level be employed in cross‐country FI prevalence comparisons.Support or Funding InformationNone

Food Group Intake Differs among Adult Food Secure, Low Food Secure and Very Low Food Secure Rural, Midwestern Emergency Food Pantry Users

ObjectivePrevious research has documented the high prevalence of food insecurity, or uncertain access to healthy foods, and poor dietary intake in emergency food pantry (EFP) users. However, no studies have determined whether there are differences in dietary intake when stratified by food security status within the EFP population. This study evaluated associations between food security status and the intake of key nutrients and food groups among EFP clients.Study Design, Setting and ParticipantsAdult EFP clients (n=445) from a multistate sample of 24 rural, Midwestern EFPs participated at a single time point from September–November 2014.Outcome Measures and AnalysisParticipants completed a characteristics survey, the 18‐item U.S. Household Food Security Survey Module, and up to three National Cancer Institute Automated Self‐Administered 24‐hour dietary recalls (ASA24s). Adult food security status, classified as food secure, low or very low food secure, was the independent variable while mean intake of energy, vitamins, minerals, and food groups were dependent variables. Multiple linear regression models adjusted for energy and other confounders were used to determine associations between food security status and nutrient/food group outcomes.ResultsLow adult food security was significantly positively associated with total energy (kcal) intake (β=245.81 p=0.02) compared with very low food security. Adult food security was significantly positively associated with whole fruit (cup equivalents) intake (β=0.17 p=0.04) compared with low food security.Conclusions and ImplicationsResults suggest that food security, low food security, and very low food security status may be specifically associated with the consumption of key food groups and therefore differences in dietary intake by food security range should be considered in the development of future initiatives that target this population.Support or Funding InformationThis project is supported by the Agriculture and Food Research Initiative competitive grant no. 2013‐69004‐20401 of the USDA National Institute of Food and Agriculture.

The Relationship Between Socioeconomic Factors and Food Security in Pregnant Women

Background: Food security is among the phenomena that have influenced the worldwide policy-making in the recent years. Furthermore, recent studies have reported extensive food insecurity in Iran. Objectives: The present study aimed at defining the levels of food security and investigating its correlation with socioeconomic factors among pregnant women in city of Rasht (Iran) in 2014. Methods: The present cross sectional study included 420 pregnant women in their 14 to 42 weeks of pregnancy. The sampling method was convenience, and the data were collected using demographic-obstetrics, socioeconomic factors, and food security status questionnaires through face-to-face interviews. The data were analyzed using SPSS 19. Results: The results revealed that 30.9 of the pregnant women had food insecurity (19.6 had food insecurity without hunger, 8.9 had moderate hunger, and 2.4 had severe hunger), while 69.1 had complete food security. Food security was significantly correlated with socioeconomic status of the family, residence area, husband�s occupation, number of employed family members, monthly income, and monthly food cost (P value < 0.001). The results of the logistic regression analysis revealed that husband�s occupation (OR = 1.28), economic status (OR = 1.53), and residence area (OR = 1.43) had increasing effects on food insecurity. Conclusions: Considering the high prevalence of food insecurity among pregnant women and its adverse impact on the mother and the fetus, it seems necessary to investigate the level of food security in women during prenatal care and to support pregnant women with food insecurity in particular. © 2017, Shiraz University of Medical Sciences.

Screening for Food Insecurity in Six Veterans Administration Clinics for the Homeless, June-December 2015.

ObjectiveWe assessed findings from a food-insecurity screening of a national sample of Veterans Administration clinics for homeless and formerly homeless veterans.MethodsWe reviewed results from initial screenings administered at 6 Veterans Administration primary care clinics for the homeless and responses from clinic staff members interviewed about the screening program.ResultsA total of 270 patients were screened. The average age was 53 years, and most were male (93.1%). Screening showed a high prevalence of food insecurity. Of the 270, 48.5% reported they experienced food insecurity in the previous 3 months, 55.0% reported averaging 2 meals a day, and 27.3% averaged 1 meal a day. Eighty-seven percent prepared their own meals, relying on food they bought (54.2%), help from friends and family (19.1%), and soup kitchens and food pantries (22%); 47.3% received Supplemental Nutrition Assistance Program benefits (food stamps). Additionally, of those who screened positive for food insecurity 19.8% had diabetes or prediabetes, and 43.5% reported hypoglycemia symptoms when without food. Clinic staff members responded positively to the screening program and described it as a good rapport builder with patients.ConclusionsIntegrating screening for food insecurity among patients in clinical settings was well received by both patients and health care providers. Addressing these positive findings of food insecurity requires a multidisciplinary health care approach.

Gender and education as predictors of food insecurity among coffee farming households of the Jimma zone, Southwest of Ethiopia

Adequate quantity and quality of food are required for optimal health, growth and development of human life. Thus, availability of food has been a major concern in every community at all time and context. Access to food can be worse in a cash crop setting where products are meant for parties other than the farming household itself. Meanwhile, the Ethiopian coffee sub-sector represents the livelihood of eight million farming households, generating a quarter of the foreign exchange earnings of the country. However, the net impact of such an agricultural system on the availability and access of food remains unknown to date. Thus, we used empirical data to assess a household’s food insecurity and identify context specific determinants in the setting. The study was conducted in three randomly selected coffee producing sub-districts of the Jimma Zone, an area which is believed to be the birth place of coffee. A total of 749 coffee farming households were included in the study. Food insecurity was measured using a household food insecurity access scale, while determinants were assessed using a structured questionnaire. Data were entered into EpiData and the analysis was performed using SPSS version 21. The study findings showed a high prevalence of food insecurity (n = 517; 68.8%). In multivariable logistic regression, households with a formally educated head were found to be 39% less likely to face food insecurity as compared to those who had no formal education [OR = 0.61 (0.38, 0.99)]. Similarly, households with an educated spouse were 36% less likely to have food insecurity [OR = 0.64 (0.42, 0.97)]. Those households in which the husband was responsible for purchasing food were more than twice as likely to be food insecure than those in which the wife was responsible food purchasing [OR = 2.4 (1.58, 3.33)]. Similarly, households which utilized saving and credit service were 59% less likely to have food insecurity than those did not utilise such a service [OR = 0.41 (0.31-0.58)]. There exists a high prevalence of food insecurity among the studied households. Food security interventions in the setting should focus on gender, education and financial services rather than the classic income dominated approach as it fails to predict the existing prevalent food insecurity.

Prevalence of Food Insecurity in Low-Income Neighborhoods in West Texas

ObjectiveTo determine the prevalence of food insecurity and the coping strategies and to investigate the role of safety nets among low-income households in urban and rural west Texas. DesignThe Core Food Security Module, an 18-item scale, was used in a cross-sectional purposeful convenience sample comparing rural and urban households, whereas the demographic survey assessed participation in food assistance/safety net programs. SettingRural and urban neighborhoods in west Texas. ParticipantsSample size of 191 participants from low-income households, predominantly African American and Hispanic people. Main Outcomes MeasuresLevels of food insecurity and use of safety nets. AnalysesComparisons between rural and urban households and between food-secure and food-insecure households were analyzed using the chi-square test of independence for categorical variables. Fisher's exact test was used whenever the number in each cell was < 5 in 2 × 2 contingency tables. ResultsPrevalence of household and child food insecurity in west Texas was 63% and 43%, respectively. Forgoing balanced meals was a common coping strategy. There was high intake of affordable energy-intense foods. Conclusions and ImplicationsThe high prevalence of food insecurity in low-income households in west Texas led to high intake of energy-intense food with low nutrients, resulting in higher prevalence of anemia, obesity, and other chronic diseases. There was low participation in safety net programs. Educational interventions on food choices are recommended.

Household food security and breast-feeding duration among Canadian Inuit.

There have been few studies investigating the association between food security and breast-feeding duration and none have been conducted among Canadian Inuit, a population disproportionately burdened with food insecurity. We evaluated the association between household food security and breast-feeding duration in Canadian Inuit children. Data were obtained from the Nunavut Inuit Child Health Survey, a population-based cross-sectional survey. The Canadian Territory of Nunavut in 2007 and 2008. Caregivers of Inuit children aged 3-5 years. Participating children were randomly sampled from community medical centre lists. Out of 215 children, 147 lived in food-insecure households (68·4 %). Using restricted mean survival time models, we estimated that children in food-secure households were breast-fed for 16·8 (95 % CI 12·5, 21·2) months and children in food-insecure households were breast-fed for 21·4 (95 % CI 17·9, 24·8) months. In models adjusting for social class, traditional knowledge and child health, household food security was not associated with breast-feeding duration (hazard ratio=0·82, 95 % CI 0·58, 1·14). Our research does not support the hypothesis that children living in food-insecure households were breast-fed for a longer duration than children living in food-secure households. However, we found that more than 50 % of mothers in food-insecure households continued breast-feeding well beyond 1 year. Many mothers in food-secure households also continued to breast-feed beyond 1 year. Given the high prevalence of food insecurity in Inuit communities, we need to ensure infants and their caregivers are being adequately nourished to support growth and breast-feeding, respectively.

Low fruit consumption and omission of daily meals as risk factors for increased blood pressure in adults

A population-based cross-sectional survey with cluster sampling design and with inverse sampling was conducted in 2010, in a sample of 1590 adults (19-60 years old) exposed to a high prevalence of food insecurity, in the municipality of Duque de Caxias, metropolitan region of Rio de Janeiro, Brazil. The objective of the study was to evaluate the association of socio-demographic factors, the consumption of fruits and vegetables and the number of meals with increased blood pressure (BP). A hierarchical model that considered variables related to the basic, intermediate and immediate determinants of increased BP was adopted. By using Poisson's regression, univariate models were tested to obtain the prevalence ratio (PR) and its respective 95 % CI. After fitting the model, age (age group 50-59 years) (PR 1·62; 95 % CI 1·09, 2·41), low consumption of fruits in a week (PR 1·37; 95 % CI 1·07, 1·74), fewer meals per day (PR 1·72; 95 % CI 1·21, 2·43) and overweight (PR 1·78; 95 % CI 1·31, 2·20) remained significantly associated with increased BP. Therefore, the results found here reinforce the importance of encouraging and developing strategies that ensure access to healthy foods to minimise increased BP in similar populations.