Marginal Food Research Articles

Reassessing the burden of food insecurity in youth and young adults with youth-onset diabetes: The importance of marginal food security

IntroductionWhereas marginal food insecurity has been recognized as important in Canadian food security policy, the category of marginal food security (MFS) is often ignored in US food security research. MethodsPrevalence of FI was estimated according to the conventional and an alternate classification of MFS with food insecurity among 938 youth and young adults (YYA) with youth-onset type 1 diabetes (T1D) and 156 with youth-onset of type 2 diabetes (T2D) from the SEARCH Food Security Cohort Study (2018-2021). Multivariable regression was used to estimate the association of MFS and conventionally defined food insecurity (FI) ascertained with diabetes-related outcomes, including acute diabetes complications, health care utilization, and diabetes self-management among YYA with T1D. ResultsMFS affected 10% of participants with T1D diabetes and 20% of participants with T2D. Classifying MFS with FI increased FI prevalence from 18.0% to 27.8% in participants with T1D and 34.6% to 55.1% in participants with T2D. Compared to T1D with high food security, YYA with T1D who were FI had higher odds hypoglycemia (2.1, 95%CI 1.2-3.6) and ketoacidosis (1.6, 95%CI 1.0-2.6), but no association was seen in MFS. The FI group also had higher odds of emergency department use and hospitalization (2.3, 95%CI 1.5-3.4; 2.4, 95%CI 1.5-3.9) and lower odds of technology use and checking glucose (0.6, 95%CI 0.4-0.9; 0.3, 95%CI 0.1-0.6). The MFS group exhibited associations of similar directions. Discussion and ConclusionsHealth care providers should consider care of patients with T1D and MFS the same way they care for patients with FI.

Nutritional status, food security and other correlates among adult tuberculosis patients in a block of Murshidabad district, West Bengal.

Tuberculosis (TB) and malnutrition are epidemiologically interrelated two major public health problems in India. Food security also influences nutritional status. This aspect needs evaluation in diverse geographical areas. This study aimed to assess the level of food security, nutritional status and correlates among adult TB patients in a block of Murshidabad, West Bengal. This cross-sectional study was undertaken in the Nabagram block of Murshidabad district during April-July 2023. All adult (≥18 years) patients registered under the Tuberculosis Unit of the block during a reference period of 6 months (October 2022-March 2023) were considered study subjects. Eighty such eligible participants recruited randomly were interviewed with a pre-designed schedule for socio-demographic and programmatic characteristics. Household food security was measured using a validated U.S. Household Food Security Survey Module. Anthropometric measurements were taken, and nutritional status was determined based on body mass index. Statistical Package for the Social Sciences (SPSS) version 26 was used for analysis. Among 80 TB patients, 51% were underweight and 20% were severely underweight. The majority (90%) of them had high or marginal food security, and 10% had low or very low food security. On multivariable logistic regression, Hindu religion (adjusted odds ratio (AOR): 6.74, 95% confidence interval (CI): 2.12-29.39), presence of any chronic morbidity (AOR: 11.61, 95%CI: 2.71-49.78) and receipt of dietary counselling by a health worker (AOR: 7.25, 95%CI: 1.22-43.13) appeared as predictors of underweight. Underweight among TB patients is quite prevalent in the area, and few programmatic interventions are influencing factors. This underscores the importance of nutritional counselling services and the universal provision of Poshan benefits.

Cross-sectional analysis of the association between household food insecurity and mental health conditions in children aged 5–11 years in Canada

BackgroundChildren living in food insecure households have poorer mental health outcomes compared with their food-secure peers; however, the relationship between the severity of food insecurity and diagnosed mental health conditions...

Association of food insecurity with reduced cancer screening rates.

1592 Background: Social determinants of health, including access to adequate food and nutrition, influence many aspects of health, including cancer screening. This study explored the associations between food insecurity and cancer screening. Methods: A retrospective analysis was conducted using the National Health Interview Series from 2018-2022 to capture contemporary screening events. Based on scaled questionnaires, food security was stratified into either food secure or insecure, and then subgrouped into high, marginal, or low security. Associations were made with rates of undergoing at least one screening test. Relationships between variables were evaluated using Chi-Square and Cochran-Armitage trend tests. Logistic regression models were applied to find factors associated with cancer screening. Results: Patients included in analyses included: 51,957 for colon, 40,103 for breast, 45,983 for cervical, and 25,781 for prostate cancer screening. Between 2018-2022, those with food insecurity had significantly lower rates of cancer screening than those with food security across all four cancer screens, including colon (68.1% vs. 76.1%, p < 0.0001), cervical (83.3% vs. 87.5%, p < 0.0001), breast (73.3% vs. 79.5%, p < 0.0001) and prostate (41.3% vs. 54.0%, p < 0.0001) (Table). This was similar when comparing low, marginal, and high food security, respectively, for colon (68.1% vs. 68.2% vs. 76.1%, p < 0.0001), cervical (82.8% vs. 84.1% vs. 87.5%; p < 0.0001), breast (72.7% vs. 74.1% vs. 79.5%, p < 0.0001), and PSA screening (40.7% vs. 42.2% vs. 54.0%; p < 0.0001). Other variables were also analyzed, including insurance type, age, race, BMI, and health status. Those with public health insurance had lower screening rates for cervical cancer compared to those with private insurance (p < 0.0001). Individuals with food insecurity reported worse health than those who were food secure (p < 0.0001). Lower food security disproportionately affected Black patients (p < 0.001), and was associated with younger age (p < 0.0001) and higher rates of obesity (p < 0.0001). Conclusions: Individuals with self-reported food insecurity were found to have lower cancer screening rates than those who were food secure. Further analyses revealed associations between low food security status and obesity, public health insurance, younger age, and Black race. These data suggest that addressing food insecurity should be a priority, as these populations appear most vulnerable to lacking appropriate cancer screening. [Table: see text]

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.

Nutrition knowledge, body image and food security risk amongst development rugby league players.

This study aimed to describe the nutrition knowledge, food security risk and eating disorder risk of development male rugby league players. Sixty athletes from one Australian professional rugby league club volunteered. A cross sectional online survey questionnaire consisted of three sections (Eating Disorders Inventory (EDI-3), Nutrition Knowledge and Food Security). All athletes completed the online survey without assistance using a personal electronic device. The mean total knowledge score was 65.7±13.1%. There was a positive relationship between age and knowledge score, P=0.050, r2=0.06. The majority of players had breakfast everyday (N.=45, 73.8%), took pack lunches (N.=33, 55.0%), and had homemade evening meals (N.=55, 91.7%). The majority of players ate more than 1 hour before training (N.=45, 75%) and all players (n=60, 100%) ate within half an hour of training finishing. The majority of participants agreed that nutrition could influence physical and cognitive aspects of nutrition however, skill-based activities were perceived by fewer participants to be influenced by nutrition. The majority (N.=38, 63.3%) had high food security, six (10.0%) had marginal food security, whereas 10 (16.7%) and six (10.0%) had low and very low security respectively. These results show a concerning levels of eating disorder risk, food insecurity and poor nutrition knowledge amongst male development rugby league players. However, it does show that they believe nutrition can impact their health and performance, and they do mostly appear to adhere to the nutrition principals for optimising health and performance.

The Association Between Food Insecurity and Intimate Partner Violence Among U.S. Army Soldiers.

Food insecurity in the military ranges between 25% and 33%, significantly higher than the 10.5% for civilians reported by the U.S. Department of Agriculture. The primary objective of this study is to analyze the association between food insecurity and intimate partner violence (IPV) victimization among U.S. Army Soldiers. The secondary objective is to determine if there are any moderating effects in the relationship between food insecurity and IPV victimization by demographic, financial, and mental health covariates. A cross-sectional, online survey was administered by the U.S. Army Public Health Center at an Army installation in 2019; 56% of respondents reported that they were married or in a relationship (n = 2,740). The main predictor was the two-item food insecurity screener (Hunger Vital Signs), which measures marginal food insecurity (encompassing marginal, low, and very low food security). The main outcome was IPV victimization as measured by the Hurt, Insult, Threaten, Scream scale. Multiple logistic regression was used to assess the association between marginal food insecurity and IPV victimization, controlling for demographic, financial, and mental health covariates. In a multivariable model, marginally food insecure respondents had 2.05-fold greater adjusted odds of reporting any IPV victimization when compared to highly food secure respondents (95% confidence interval [1.40, 3.00]). The only interaction that was statistically significant was between anxiety and food insecurity on IPV victimization (p = .0034). Interactions by soldier's military rank, birth sex, and race and ethnicity were not statistically significant. IPV has implications for the emotional and physical health of survivors. In addition, service members who are food insecure may experience similar decrements in emotional and physical health due to suboptimal nutrient intake. By addressing both food insecurity and IPV, the military has the potential to increase the overall well-being of its service members and their dependents.

Association between food insecurity and edentulism for older adults: A pilot study.

This pilot study examined the association between food insecurity and edentulism among older adults in Washington State. This study focused on adults aged 50 years and older, who were recruited through seven community-based organizations in Washington State. The exposure variable was food security level (high, marginal, and low/very low food security) assessed using the 10-item U.S. Adult Food Security Survey. The outcome was edentulism, defined as having zero natural teeth. Confounder-adjusted odds ratios (OR) and 95% confidence intervals (CIs) were generated using binary logistic regression models (α = 0.05). Of the 216 participants, 28.7% (n = 62) had low/very low food security and 7.9% (n = 17) had zero teeth. Older adults with low or very low food security had greater odds of being edentulous compared to those with marginal or high food security, although the difference was not statistically significant (OR: 1.39; 95% CI: 0.46, 4.20; p = 0.56). Future research should explore food insecurity-focused interventions aimed at preventing edentulism in older adults in a broader effort to address oral health inequities.

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.

Associations Between Food Insecurity and Diet Quality Among Graduate Students and Postdoctoral Trainees in the Health Sciences at a Private University in Boston: A Cross-Sectional Study

BackgroundFood insecurity is a pivotal determinant of health outcomes. Little evidence exists on the association between food insecurity and health behaviors and outcomes, including diet quality, among graduate students or postdoctoral trainees. ObjectivesThis study aimed to examine the association between food insecurity and diet quality among graduate students and postdoctoral trainees at 3 health-focused graduate schools (public health, medical, and dental medicine) within Harvard University. MethodsBetween April and June 2023, 1287 graduate students and 458 postdoctoral trainees at the health-focused schools within Harvard University completed a web-based survey. The primary exposure was food security status, assessed using the United States Household Food Security Survey Module. The primary outcome was diet quality, measured using the 30-day Prime Diet Quality Score screener (ranges from 0 to 126, with higher scores indicating healthier diets). The associations between food insecurity and diet quality were examined using multivariable regression models, adjusting for sociodemographic covariates. ResultsAmong graduate students, compared with those with high food security, diet quality was significantly lower among those experiencing marginal food security [β: −4.7; 95% confidence interval (CI): −6.5, −2.9], low food security (β: −5.4; 95% CI: −7.6, −3.3), and very low food security (β: −4.4; 95% CI: −7.4, −1.4). Poor diet quality included lower intake frequencies of vegetables, fruits, beans/peas/soy products, nuts/seeds, poultry, fish, low-fat dairy, and liquid oils, and higher intake frequencies of refined grains/baked products, sugar-sweetened beverages, and fried foods. Among postdoctoral trainees, compared with those with high food security, diet quality was significantly lower among those experiencing low food security (β: −5.1; 95% CI: −8.8, −1.4), and very low food security (β: −5.2; 95% CI: −10.2, −0.2). Poor diet quality included lower intake frequencies of dark green leafy vegetables, other fruits, and whole grains. ConclusionsGraduate students and postdoctoral trainees who experienced degrees of food insecurity reported lower diet quality. These observations underscore the need for policies and interventions to simultaneously reduce food insecurity and improve diet quality.

Food insecurity is associated with metabolic syndrome among US adults: NHANES 2005–2016

The primary objective of this study was to examine the association between food security status and metabolic syndrome (MetS) using a nationally representative dataset. We hypothesized that food insecurity would be associated with an increased odds of having MetS. This was a cross-sectional analysis of data from the 2005–2006 to 2015–2016 National Health and Nutrition Examination Survey data collection cycles. Food security was measured using the US Food Security Survey Module. Presence of MetS was determined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The association between food insecurity and MetS was examined using logistic regression models stratified by sex and adjusted for poverty to income ratio, age, race, marital status, educational attainment, smoking status, and body mass index. After adjusting for covariates, men with marginal (odds ratio, 1.64; 95% confidence interval [CI], 1.22–2.20) and low (odds ratio, 1.33; 95% CI, 1.02–1.73) food security had a higher odds of having MetS than men with full food security; however, this association was lost among men with very low food security. For women, very low food security was associated with a 1.61 times greater odds of having MetS (95% CI, 1.16–2.25). These results suggest that food insecurity is generally associated with an increased prevalence of MetS for women, but not necessarily for men. These findings highlight the need to address rising food insecurity rates, while also highlighting the need for further research to fully elucidate the role of gender and sex in food insecurity and chronic disease.

Factors Associated with Sugar-Sweetened Beverage Intake Among Young Children - United States, 2021.

Because limited data exist about factors related to sugar-sweetened beverage (SSB) intake among younger children, we investigated factors associated with SSB intake among US children aged 1 to 5 years. We examined SSB intake (0, 1-3, or ≥4 times/week) by using data from the 2021 National Survey of Children's Health. We performed a multinomial logistic regression to calculate adjusted odds ratios (aORs) for select sociodemographic and household factors associated with moderate (1-3 times/week) and high (≥4 times/week) SSB intake. Overall, 36% of children consumed SSBs 1 to 3 times/week and 21% consumed 4 or more times/week. Both moderate and high SSB intake were associated with child's age, child's race and ethnicity, highest caregiver education level, household income, primary household language, and frequency of family meals. For example, children who lived in households with caregiver education level of high school graduate or less were significantly more likely to have moderate (aOR, 2.06) and high (aOR, 2.81) SSB intake than those who lived in households with caregiver education level of college degree or higher. High SSB intake was also associated with marginal household food sufficiency, nonmetropolitan statistical area status, and receipt of government food benefits. Several sociodemographic and household factors were significantly associated with SSB intake among children aged 1 to 5 years. Public health initiatives designed to address SSB intake among young children in various settings including pediatric health care, early care and education, and the child's home could consider key associated factors.

Investigating level of food security among patients with hypertension and diabetes at a student-run free clinic

Background Nutritional recommendations for patients with type 2 diabetes mellitus (T2DM) and hypertension assume high food security. However, food insecurity is estimated to affect 10% of the US population and more so patients at our student-run free clinic (SRFC). The aims of the study were to (1) assess food security in patients with a diagnosis of T2DM, hypertension, or both and (2) examine the relationship between food security and glycated hemoglobin (HbA1C) or blood pressure at an SRFC. Methods Eligible participants completed a 10-item food security questionnaire and an item addressing perceived barriers. Most recent HbA1C and blood pressure measurements were gathered. Comparisons were made using univariate or multivariate linear regression analysis. Results Results from 79 participants showed that 25.3% experienced high food security, 29.1% had marginal food security, 13.9% had low food security, and 30.4% had very low food security. No statistically significant association was found between food security category and HbA1C or blood pressure. However, we did find that approximately 73% of patients experienced some degree of food insecurity. Conclusions Patients at our SRFC are ethnically and racially diverse, most have a high school education or less, and most have food insecurity. No association between food security category and HbA1C or blood pressure control was found. Providers should consider the degree of food insecurity and incorporate a culturally sensitive approach when making nutritional recommendations.

The impact of crop diversification on food security of farmers in Northern Bangladesh

BackgroundCrop diversification is the potential for greater dietary diversity, and reduced micronutrient deficiencies and malnutrition. Despite the increasing global concern of improving food security, the nature and extent of food security at the household level in rural areas are not well-documented. This paper determines the factors that influence crop diversification and its association with food security which helps policy maker to take proper steps in norther part of Bangladesh.MethodsThe effect of crop diversification on household food security in northern Bangladesh was measured by adopting the Herfindahl index (HI). Food Consumption Score (FCS) and Household Food Insecurity Access Score (HFIAS) were used to determine the food security status. The binary logistic regression model and multinominal logit model were performed to identify the factors influencing crop diversification and food security, respectively. All these analyses were performed based on 609 household samples collected from six northern districts of Bangladesh.ResultsDescriptive statistics show that the majority of farmers in the study districts reported 12–13 different crops, while only farmers in Bogura mentioned 19 different crops grown in their field. After calculating crop diversification using HI index, it is apparent that about 64% respondents irrespective of region produced different types of crops and around one third of them possessed in the middle categories neither they were fully crop diversified nor non crop-diversified. About 40% households had better Food Consumption Score lead to only 3.28% belonged to below poverty line and rest of the household fall in borderline. The analysis confirm that the crop diversified households were found to be more food secured or marginal food secured then that of less crop diversified households.Conclusion and policy recommendationWe may infer from the factor analysis that, in line with the government policy to raise significantly the standard of living of the farmers, government should facilitate and encourage farmers to grow several crops rather than just one and provide training opportunities. In addition, food insecure people as well as the low food secure group might overcome their circumstances if the government places greater emphasis on education, training, and off-farm activities by providing financial support.

Food insecurity and health-related quality of life among a nationally representative sample of older adults: cross-sectional analysis

BackgroundFood insecurity is a significant health issue among older adults and contributes to poorer quality of life and mental health. However, limited evidence is available among older adults. Thus, the study evaluated the associations between food security and multiple outcomes related to health-related quality of life. We examined whether participants’ sex and participation in the federal Supplemental Nutrition Assistance Program (SNAP)/or receiving the Food Stamp program might modify these associations.MethodsCross-sectional analysis of the 2007–2012 National Health and Nutrition Examination Surveys (NHANES). A sample of 3,375 adults aged ≥ 60 years with household incomes ≤ 300% of the federal poverty level (FPBL). Food security was assessed using the 18-item US Household Food Security Survey Module and categorized as food security, marginal food security, and food insecurity. Outcomes were the CDC Health-Related Quality of Life measures (HRQOL-4).ResultsApproximately 8% experienced marginal food security and 12% experienced food insecurity. Over the past month, food insecurity was significantly associated with ≥ 16 days of poor physical health (OR 1.88, 95% CI 1.23, 2.85, P-trend = 0.005), ≥ 16 days of poor mental health (OR 2.22, 95% CI 1.50, 3.28, P-trend < 0.0001), and ≥ 16 days of feeling anxious (OR 3.33, 95% CI 2.30, 4.81, P-trend < 0.0001) after multivariate adjustment. The association between food insecurity and poor physical health was stronger in females (P-interaction = 0.02). There was no evidence for effect modification in any of these associations among those receiving benefits from the federal SNAP/Food Stamp program.ConclusionsFood insecurity was positively associated with multiple adverse health outcomes. Public health programs and policies targeted for older adults are needed to mitigate the extent of food insecurity to promote overall health and well-being.

Associations between food insecurity and diabetes risk factors in US adolescents in the National Health and Nutrition Examination Survey (NHANES) 2007-2016.

To evaluate the associations between household food insecurity and diabetes risk factors among lower-income US adolescents. Cross-sectional analysis. Household food security status was measured using the 18-item Food Security Survey Module. Simple and multivariable linear and logistic regressions were used to assess the association between food security status and fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), HbA1C and homoeostatic model assessment - insulin resistance (HOMA-IR). The analyses were adjusted for household and adolescent demographic and health characteristics. USA. 3412 US adolescents aged 12-19 years with household incomes ≤300 % of the federal poverty line from the National Health and Nutrition Examination Survey cycles 2007-2016. The weighted prevalence of marginal food security was 15·4 % and of food insecurity was 32·9 %. After multivariate adjustment, adolescents with food insecurity had a 0·04 % higher HbA1C (95 % CI 0·00, 0·09, P-value = 0·04) than adolescents with food security. There was also a significant overall trend between severity of food insecurity and higher HbA1C (Ptrend = 0·045). There were no significant mean differences in adolescents' FPG, OGTT or HOMA-IR by household food security. Food insecurity was associated with slightly higher HbA1c in a 10-year sample of lower-income US adolescents aged 12-19 years; however, other associations with diabetes risk factors were not significant. Overall, this suggests slight evidence for an association between food insecurity and diabetes risk in US adolescents. Further investigation is warranted to examine this association over time.

Association between adult food insecurity and mortality among adults aged 20-79 years with diabetes: A population-based retrospective cohort study.

There is limited research on the relationship between food insecurity and mortality among individuals with diabetes. This study aims to investigate the impact of food insecurity on all-cause and cause-specific mortality in adults with diabetes. This study included 5749 adults with diabetes from the National Health and Nutrition Examination Survey cycles 2003-2018 and followed up until 31 December 2019. Food insecurity was measured by the Food Security Survey Module. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals for both all-cause mortality and cause-specific mortality. The weighted prevalence of full food security, marginal food security, low food security, and very low food security was 70.8%, 11.0%, 10.4%, and 7.8%, respectively. Food insecurity demonstrated a significant correlation with diminished diet quality and reduced consumption of healthy foods. Over the course of 42,272.0 person-years of follow-up, we documented 1091 deaths, of which 370 were attributed to cardiovascular disease and 180 to cancer. After adjusting for multiple variables, food insecurity scores were significantly and linearly associated with increased all-cause mortality. Comparing to full food security, participants experiencing very low food security had a multivariate-adjusted HR of 1.48 (1.12, 1.95) for all-cause mortality (ptrend = 0.010). Food insecurity was associated with increased all-cause mortality and compromised diet quality, especially in individuals experiencing very low food security. Future strategies may necessitate the monitoring of and interventions for food insecurity among individuals with diabetes.

High Prevalence of Food Insecurity and Related Disparities Among US College and University Students From 2015–2019

ObjectiveWe examined food insecurity prevalence among college students included as part of a large, ongoing, nationally representative survey and examined trends and associations with sociodemographic measures. MethodsData come from the Panel Study of Income Dynamics, a nationally representative longitudinal household panel survey, and include 2,538 college students from 2015–2019. Food security status was assessed using the US Department of Agriculture's 18-item Household Food Security Survey Module. ResultsFrom 2015 to 2019, 11% of college students experienced marginal food security, and 15% experienced food insecurity. Food insecurity was 12% in 2015 and 14% in 2017 and 2019. More Black and Hispanic students experienced food insecurity than White students (21% and 26%, vs 9%, respectively; P <0.001), as did first-generation than non-first-generation students (18% vs 10%; P = 0.01). Conclusions and ImplicationsCollege food insecurity is an urgent public health issue demanding greater response from colleges and universities and state and federal governments.

Human consumption of seaweed and freshwater aquatic plants in ancient Europe

During the Mesolithic in Europe, there is widespread evidence for an increase in exploitation of aquatic resources. In contrast, the subsequent Neolithic is characterised by the spread of farming, land ownership, and full sedentism, which lead to the perception of marine resources subsequently representing marginal or famine food or being abandoned altogether even at the furthermost coastal limits of Europe. Here, we examine biomarkers extracted from human dental calculus, using sequential thermal desorption- and pyrolysis-GCMS, to report direct evidence for widespread consumption of seaweed and submerged aquatic and freshwater plants across Europe. Notably, evidence of consumption of these resources extends through the Neolithic transition to farming and into the Early Middle Ages, suggesting that these resources, now rarely eaten in Europe, only became marginal much more recently. Understanding ancient foodstuffs is crucial to reconstructing the past, while a better knowledge of local, forgotten resources is likewise important today.

The British Columbia Farmers’ Market Nutrition Coupon Program Reduces Short-Term Household Food Insecurity Among Adults With Low Incomes: A Pragmatic Randomized Controlled Trial

BackgroundThe British Columbia Farmers’ Market Nutrition Coupon Program (BC FMNCP) provides households with low incomes with coupons to purchase healthy foods from farmers’ markets. ObjectiveTo examine the impact of the BC FMNCP on the short-term household food insecurity, malnutrition risk, mental well-being, sense of community (secondary outcomes), and subjective social status (exploratory outcome) of adults with low incomes post-intervention and 16 weeks post-intervention. DesignSecondary analyses from a pragmatic randomized controlled trial conducted in 2019 that collected data at baseline, post-intervention, and 16 weeks post-intervention. Participants/settingAdults ≥18 years with low incomes were randomized to an FMNCP group (n = 143) or a no-intervention control group (n = 142). InterventionParticipants in the FMNCP group received 16 coupon sheets valued at $21 Canadian dollars (CAD)/sheet over 10 to 15 weeks to purchase healthy foods from farmers’ markets and were eligible to participate in nutrition skill-building activities. Main outcome measuresOutcomes included short-term household food insecurity (modified version of Health Canada’s 18-item Household Food Security Survey Module), malnutrition risk (Malnutrition Universal Screening Tool), mental well-being (Warwick-Edinburgh Mental Well-Being Scale), sense of community (Brief Sense of Community Scale), and subjective social status (MacArthur Scale of Subjective Social Status community scale). Statistical analysisMixed-effects linear regression and multinomial logistic regression examined between-group differences in outcomes post-intervention and 16 weeks post-intervention. ResultsThe risk of marginal and severe short-term household food insecurity was lower among those in the FMNCP group compared with those in the control group (relative risk ratio [RRR] 0.15, P = 0.01 and RRR 0.16, P = 0.02) post-intervention, with sustained reductions in severe household food insecurity 16 weeks post-intervention (RRR 0.11, P = 0.01). No statistically significant differences were observed in malnutrition risk, mental well-being, sense of community, or subjective social status post-intervention or 16 weeks post-intervention. ConclusionsThe BC FMNCP reduced short-term household food insecurity but was not found to improve malnutrition risk or psychosocial well-being among adults with low incomes compared with a no-intervention control group.